Possible interaction between pectin and gluten alters the starch digestibility and texture of wheat bread.

This study incorporated citrus pectin in wheat bread, aiming to develop breads with both desirable texture and slow starch digestibility. Results showed that starch digestibility in wheat bread decreased over the addition of pectin, and the maximum starch digested amount decreased by 6.6 % after the addition of 12 % pectin (wheat flour weight basis). The addition of pectin transferred part of the rapidly digestible starch into slowly digestible starch, and reduced the binding rate constant between slowly digestible starch and digestive enzymes, resulting in overall reduced starch digestibility. Furthermore, the addition of 4 % pectin contributed to the development of wheat bread with softer texture and increased specific volume. Mechanistically, the lowered starch digestibility of wheat bread after the pectin addition was due to (1) residual outermost swollen layer of starch granules, (2) protein and pectin interactions, and (3) increased short-range ordering of starch. This study, therefore, suggests that the addition of an appropriate amount of citrus pectin has the potential to develop bread with both a low glycemic index and desirable texture.

The effects on rehospitalization rate of transitional care using information communication technology in patients with heart failure: A scoping review.

Background: The number of people with heart failure is increasing. These patients have a high readmission rate and need ongoing health care and follow-up after hospital discharge. However, face-to-face nursing care is expensive; therefore, remote care options are required. Objective: To determine whether there are differences in the effects (rehospitalization rate and drug adherence) between face-to-face transitional care and remote technology, such as information and communication technologies, for transitional care in patients with heart failure within 30 days post-discharge. Design: A scoping review. Setting: Patients with heart failure who received an intervention using information and communication technologies within 30 days of discharge after being hospitalized for heart failure, based on published studies. Methods: Eight English, Japanese, and Chinese databases were searched for research papers published between January 2000 and November 2021 that examined outcomes such as readmission rates in patients with heart failure who received transitional care using remote technologies. This study followed the screening criteria outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Results: Seventeen studies were included in this review. Among them, 14 studies reported lower readmission rates in the transitional care group using information and communication technologies compared to the control group, and the difference was statistically significant in nine studies. In addition, one paper showed that the transitional care group experienced more significant improvements in patient satisfaction and quality of life. Conclusions: Transitional care using information and communication technologies can provide necessary guidance according to the patient's schedule, regardless of the patient's location and time. Patients can share their self-monitored information with medical practitioners and receive timely feedback and guidance. With continuous follow-up support from medical practitioners, patients can adjust their care plans to ensure optimal execution, and the patient's doubts and anxieties can be quickly resolved, increasing the patient's self-confidence. As a result, patients' self-care ability was improved, and controlling symptoms and preventing deterioration became easier. We inferred that the transitional care group achieved a higher self-care ability compared with the control group. Transitional care using remote technologies, such as information and communication technologies following discharge for heart failure patients, can help to reduce readmission rates within 30 days of discharge compared to face-to-face care. In addition, the study demonstrated that remote technologies may improve quality of life and patient satisfaction.

Effects of endogenous macronutrients and processing conditions on starch digestibility in wheat bread.

Development of wheat bread with slow starch digestibility is of great importance in terms of generally improving human health. Many factors can be used to determine starch digestibility in wheat bread, including the composition and structure of different bread micro- and macronutrients such as starch, protein, lipid, fiber and polyphenol. Processing conditions including dough hydration, kneading, fermentation, baking and storage parameters are also important factors in determining starch digestibility in wheat bread. This review aimed to summarize these factors from the literature and corresponding mechanisms how they determine starch digestibility. It provides opportunities to reduce starch digestibility in wheat bread by selecting a desirable combination of raw bread ingredients and processing conditions. Considering the global epidemic of chronic diseases such as type 2 diabetes, this review contains important information that can turn wheat bread into a much healthier food product with a lower glycemic index.