Search

Polyphenols are widely known for their putative antioxidant and anti‐inflammatory effects and their potential protective role in several diseases such as type 2 diabetes, cardiovascular disease and cancer. They have also attracted significant interest as 'anti‐obesity' agents, although with mechanisms of action that have been exclusively demonstrated in animal and in vitro studies. This umbrella review aims to evaluate current evidence surrounding the role of polyphenols in obesity and weight management and to establish the usefulness of these agents in combatting obesity. A search of systematic reviews and meta‐analyses of randomised controlled trials was carried out. Nine systematic reviews (of which eight included a meta‐analysis) were included. Evidence of polyphenols' effects on reducing bodyweight is mixed, and where the effects are significant, they are numerically small and unlikely to be of help in reducing bodyweight or preventing weight gain. Future research should focus on establishing the anti‐inflammatory and antioxidant effects of polyphenols through well‐designed randomised controlled trials. Such research could be more valuable and cost‐effective since it has shown potential to improve human health. [ABSTRACT FROM AUTHOR]

Background: People from South Asian heritage are at high risk of type 2 diabetes, but there are limited specific strategies to prevent and manage this condition. The aim was to assess the effectiveness of culturally bespoke lifestyle programmes in South Asians that target weight loss for the prevention or remission of type 2 diabetes mellitus (T2DM). Methods: We performed a systematic review and meta‐analysis of intervention trials. PubMed, Scopus, MEDLINE (EBSCOhost), CINAHL, PsycINFO and CENTRAL were searched. Human intervention trials (randomised controlled trials and quasi‐experimental) investigating the effect of lifestyle interventions on the prevention and remission of T2DM in South Asians were included. Studies including participants at risk of T2DM (prevention trials) and having the disease (remission trials) with duration ≥12 weeks were eligible. For prevention trials, the primary outcome was change in weight (kg) from baseline; for remission trials, it was decrease in HbA1c to non‐diabetic levels (HbA1c ≤ 6.5%) without diabetes medications. Prevention trials were separated into (i) lifestyle modification advice and (ii) lifestyle modification advice including a supervised physical activity programme. Results: Twenty‐four trials were eligible (21 prevention trials and 3 remission trials). In T2DM prevention trials involving only lifestyle modification advice, the mean postintervention difference in weight between intervention and control groups was −0.65 kg (95% confidence interval [CI]: −1.04, −0.26; p = 0.01). Lifestyle modification advice including a physical activity programme was associated with greater decreases in weight: −1.13 kg (95% CI: −2.04, −0.21; p = 0.02). Fasting blood glucose levels were slightly lower in intervention groups for both intervention subtypes, although there was no significant change in HbA1c levels or 2‐h plasma glucose levels. Diabetes remission trials showed potential acceptability but were limited in number and involved a small sample size, and some did not include a control group. Conclusions: In South Asians, lifestyle interventions for prevention of T2DM offer only modest impacts on weight and glucose control and will unlikely reduce diabetes incidence. Alternative lifestyle interventions co‐designed with members of the communities and aimed at both prevention and remission of T2DM must be urgently considered. Systematic review registration number: PROSPERO CRD42022385174 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=385174 Key points: People from South Asian heritage are at high risk of type 2 diabetes.Weight loss is the cornerstone of type 2 diabetes prevention and remission.There are limited specific strategies to prevent and manage type 2 diabetes in South Asians.Lifestyle interventions that aimed to prevent type 2 diabetes in South Asians produced modest effects on weight and glycaemic control and will unlikely reduce diabetes incidence in this population.Diabetes remission trials could potentially be effective and acceptable although they are to date limited in number.Our results can help clinicians and researchers consider alternative lifestyle interventions to reduce diabetes risk and develop further trials of diabetes remission in South Asians. [ABSTRACT FROM AUTHOR]

Glycaemic control is the basis of type 2 diabetes mellitus (T2DM) management and is crucial for preventing diabetes microvascular and macrovascular complications. The South Asian population is at higher risk of T2DM and resultant cardiovascular disease, peripheral vascular disease and death compared to Caucasians. Effective diabetes care has been deemed challenging in this population, but little is known about the usefulness of lifestyle interventions in improving glycaemic control and reducing complications. This narrative review aims to explore the efficacy of lifestyle interventions targeted to South Asians with T2DM in inducing clinically relevant improvements in HbA1c levels at such levels that reduce the risk of diabetes complications. A search of the literature using six databases (MEDLINE (EBSCOhost), PubMed, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Scopus) identified dietary-based, physical-activity-based and education-based interventions that aimed to manage T2DM in South Asians. Results showed that dietary and physical activity interventions (duration 3-12 months) have been effective in generating a clinically relevant decrease in HbA1c levels (≥0.5%) in South Asians with T2DM and could potentially assist in reducing diabetes complications. Education-based interventions produced small effects on glycaemic control. These outcomes support the development of comparable longer-term randomised clinical trials combining dietary and physical activity interventions with the aim to provide further evidence on specific interventions that can lower complications and ensure effective diabetes care in a high-risk population. [ABSTRACT FROM AUTHOR]

There is increasing evidence that the global rise in temperature is contributing to the onset of diabetes, which could be mediated by a concomitant reduction in brown fat activity. Brown (and beige) fat are characterised as possessing a unique mitochondrial protein uncoupling protein (UCP)1 that when activated can rapidly generate large amounts of heat. Primary environmental stimuli of UCP1 include cold-exposure and diet, leading to increased activity of the sympathetic nervous system and large amounts of lipid and glucose being oxidised by brown fat. The exact contribution remains controversial, although recent studies indicate that the amount of brown and beige fat in adult humans has been greatly underestimated. We therefore review the potential mechanisms by which glucose could be utilised within brown and beige fat in adult humans and the extent to which these are sensitive to temperature and diet. This includes the potential contribution from the peridroplet and cytoplasmic mitochondrial sub-fractions recently identified in brown fat, and whether a proportion of glucose oxidation could be UCP1-independent. It is thus predicted that as new methods are developed to assess glucose metabolism by brown fat, a more accurate determination of the thermogenic and non-thermogenic functions could be feasible in humans. [ABSTRACT FROM AUTHOR]

Polyphenols have been suggested to reduce body weight and modify body composition through different mechanisms. These effects have been extensively studied in animals and in vitro and to a lesser extent in humans. The aim of this review is to consider the association between polyphenols and body weight status by focusing on human intervention studies. We conducted a systematic literature search in MEDLINE (via EBSCOhost), ProQuest CENTRAL, and Cochrane CENTRAL without time restrictions. Randomized controlled trials assessing the effect of polyphenols on weight and/or body composition in the overweight and/or obese population were included. Nineteen studies met our inclusion criteria. Results suggest that further research is required before supporting a potential role of polyphenols in reducing weight in overweight and obese individuals (nine studies showed a significant decrease in weight by a mean of 1.47 ± 0.58 kg). Nevertheless, several studies indicated that polyphenols might be effective in preventing small increases in weight during periods of overfeeding rather than reducing weight as such. The outcomes noted do not yet support polyphenol supplementation as a complementary approach in weight loss diets. Further larger trials with a duration of 12 months or more are needed to elucidate the effect of polyphenols on body weight status. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Previous research indicates that university students are not bridging the gap between school and university quickly or effectively enough. Therefore, there is a need to build a level of independence and foster a sense of empowerment prior to entering university, and create a supportive climate for successful learner development. Clear information and support on transition from school to employment could also be improved. Furthermore, there is a challenge for widening access and allowing people from different backgrounds to go into further/higher education. This paper will present the South East Scotland Academies Partnership (SESAP) as a successful model of a collaborative and pedagogical approach to the university pre-entry support stage and to employment. Academies students are S5 and S6 school pupils who attend classes at college and university while still at school. The Academies aim to widen access of young people residing in South East Scotland into Further and Higher education. They focus on preparing students for Higher Education while easing the transition between school and university, developing independent learning skills and building confidence. The project aspires to integrate students successfully into the academic and social aspects of university life; helps them gain a sense of belonging to a group and allows them to make a more informed choice about their selected course and institution. Academies also endeavour to provide students with the opportunity to experience work at their industry of choice and to present them with options and clear information to smooth the transition to employment. Results from a survey distributed to students showed that the Academies have been beneficial in developing their communication and independent learning skills, as well as their confidence. The latter aspects are considered important in enhancing transition. [ABSTRACT FROM AUTHOR]

Non-nutritive sweeteners (NNS) are popular sugar substitutes that can help in weight and diabetes management, but concerns regarding their use have been raised by the public. This study aimed to investigate knowledge, benefits and safety perceptions of NNS in a sample of UK adults. The impact of knowledge dissemination on the change in perceptions was also examined. An online survey was distributed through social media platforms and UK Universities and was completed by 1589 participants aged 18 years and above. Results showed a high-risk perception of NNS and a lack of knowledge in regulations in nearly half the population sample. The artificial attributes of NNS further limited their acceptance. Risk perception has been significantly linked to a lower consumption of sweeteners (p < 0.001) and was affected by gender, occupation, education levels, age and body weight status. Information dissemination significantly reduced risk perception and increased awareness of the benefits of NNS. Results suggest that developing effective communication strategies to educate consumers, potentially through trusted health government agencies and professional bodies, can help them to make informed choices. Education of health professionals could also be valuable in reassuring the public of the benefits of NNS. [ABSTRACT FROM AUTHOR]

Non-nutritive sweeteners (NNS) are suggested to lower energy intake in the diet, but they have been paradoxically involved in the epidemic of obesity and Type 2 diabetes. Stevia is the least studied sweetener. This study aims to investigate the effect of stevia on postprandial glucose levels, appetite and food intake. Methods: 30 participants (20 females/10 males; 26.1 (10.56) years; body mass index (BMI) 23.44 (3.42) Kg/m2) took part in a three-arm crossover trial where they received preloads of water, sugar (60 g) and stevia (1 g) on three different days, followed by an ad libitum pizza lunch. Breakfast was standardised. A one-day diet diary was collected on each test day. Visual analogue scales (VAS) were used to assess subjective feelings of appetite. Blood glucose samples were collected at 30-min intervals until 120 min post lunch. Results: Energy intake did not significantly differ between preloads for ad libitum meals (p = 0.78) and overall day (p = 0.33). VAS scores for hunger and desire to eat (DTE) were lower following stevia preload compared to water (p < 0.05). After adjusting for the sugar preload and calorie content, postprandial glucose levels did not significantly differ between interventions. Conclusion: Stevia lowers appetite sensation and does not further increase food intake and postprandial glucose levels. It could be a useful strategy in obesity and diabetes prevention and management. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate whether ingestion of polyphenol-rich dark chocolate improved salivary cortisol levels and subjective mood states in adults recruited from a health and social care setting. Twenty-six participants ingested 25 g/day of a high polyphenol dark chocolate (containing 500 mg of total flavonoids) or a similar amount of a control dark chocolate containing negligible flavonoids for four weeks. Twenty-four-hour salivary glucocorticoid levels (cortisol and cortisone) were measured by an enzyme-linked immunosorbent assay, and subjective mood was assessed using a validated Positive Affect and Negative Affect Schedule. Total daily cortisol, morning cortisol, and the cortisol/cortisone ratio were significantly reduced (p < 0.001) after ingestion of only the high polyphenol dark chocolate. There were no significant differences between groups for overall scores for positive affect and negative affect. No changes were observed after the control dark chocolate, or any other parameter measured. In conclusion, the findings from this small-scale study indicate lowering of salivary cortisol levels following polyphenol-rich dark chocolate in adults recruited from a health and social care setting. Such changes may be attributable to their ability to inhibit 11β-hydroxysteroid dehydrogenase type 1 activity and warrant further investigation. [ABSTRACT FROM AUTHOR]