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Cognitive acuity is important for academic success. The preliminary efficacy of early time-restricted eating (eTRE) on cognitive acuity was examined in a sample of university students attending a large southwestern university. It was hypothesized that adherence to eTRE would result in improved cognitive acuity as assessed by the Trail Making Tests (i.e., TMT-A and TMT-B) and the Stroop Color and Word Test. Participants were randomized to an intervention group (eTRE) with a daily 6-hour eating window or a control group (CON) with a daily 16-hour eating window; 24 participants initiated the study (13 eTRE and 11 CON). Blood ketones (i.e., β-hydroxybutyrate [BHB]) and brain-derived neurotrophic factor were also assessed. The 8-week intervention was forestalled by COVID-19 laboratory closures beginning in March 2020, and only data obtained at week 0 (baseline) and week 4 were viable for statistical analyses. Study attrition was high (50% for eTRE and 23% for CON). At week 4, there was a 27% and 6% decrease in TMT-B response time for the eTRE and CON groups, respectively (P = .02). TMT-B response time was inversely correlated to plasma BHB among participants (r = -0.633; P = .008). Considering the inverse relationship between TMT-B response time and plasma BHB, these preliminary data suggest that eTRE may improve some aspects of cognitive acuity in this population. Future investigations are needed to confirm these findings and should accommodate individual preferences regarding the initiation time of the eating window while also considering the impact on social influences and exercise engagement.

Inflammation is at the core of many chronic conditions and exacerbates infectious conditions, including the severity of coronavirus disease 2019 (COVID-19) infections.This study aimed to examine the effects of a novel food supplement, palmitoylethanolamide (PEA), specifically Levagen+, as compared with a placebo on proinflammatory biomarkers in adults recently diagnosed with COVID-19 who were unvaccinated and nonhospitalized.This study was a double-blind randomized placebo-controlled trial conducted October 2020-March 2021 (clinicaltrials.gov: NCT04912921). Participants aged 19-53 y were unvaccinated and recently infected with COVID-19 as indicated by a positive test result per RT-PCR or antigen test, and they reported to the test site following diagnosis as allowed by the CDC's return-to-work policy. Participants were stratified by age, sex, and BMI and randomly assigned by coin toss to receive 600 mg Levagen+ twice daily (LEV) or placebo tablets twice daily (CON) for 4 wk. At baseline and week 4, participants completed health histories, 24-h dietary recalls, anthropometrics, and nonfasting blood sampling. The primary outcomes were the 4-wk change between groups for IL-6, C-reactive protein, ferritin, intercellular adhesion molecule 1, soluble P-selectin (sP-selectin), and neutrophil/lymphocyte ratio. Multiple linear regression models were utilized to assess treatment effects on outcomes, adjusting for covariates.A total of 60 participants completed the study (LEV: n = 30; CON: n = 30). After 4 wk of supplementation, sP-selectin (β = -11.5; 95% CI: -19.8, -3.15; P = 0.0078), IL-1β (β = -22.9; 95% CI: -42.4, -3.40; P = 0.0222), and IL-2 (β = -1.73; 95% CI: -3.45, -0.065; P = 0.0492) concentrations were significantly reduced in the LEV group compared with the CON group.Inflammatory mechanisms are crucial to optimal resolution of infectious conditions, yet unchecked secretion of inflammatory mediators can promote the dysregulated immune response implicated in COVID-19 complications. Overall, PEA supplementation produced anti-inflammatory effects in individuals recently diagnosed with COVID-19 who were nonhospitalized.

The purpose of this study was to evaluate nutrition knowledge and diet quality in collegiate athletes to determine if referral to a sports registered dietitian (RD) is warranted. This cross-sectional study analyzed four sections of the Nutrition for Sport Knowledge Questionnaire and the Rapid Eating Assessment for Patients Questionnaire, both validated in athletic populations. The relationship between nutrition knowledge and diet quality was evaluated. Significance was set at P ≤ 0.05. One hundred and twenty athletes reported a median nutrition score of 52 (45–61), and a dietary quality score of 53 (46–58), with a weak, positive association between both (r = 0.28 (95% CI: 0.11–0.44), P

Early in the COVID-19 pandemic, there were limited options for eating away from home, obligating many US adults to prepare foods at home, a situation that provided an opportunity to examine relationships between food skills, resilience, and coping in the initial months of the pandemic. This research surveyed a convenience sample of adults (

Context Urine specific gravity (USG) should be measured at room temperature (20°C), but the temperature of the sample is not always considered. Objective To evaluate the effect of sample temperature on the measurement accuracy of a digital refractometer (DIG), manual optical refractometer (MAN), and hydrometer (HYD). Design Descriptive laboratory study. Main Outcome Measure(s) Urine specific gravity. Results Experiment 1 (24 Brix (°Bx) samples) showed that measurements via the DIG and MAN did not differ from the reference, but HYD provided lower or inconsistent values compared with °Bx and was highly correlated with °Bx solutions (r, > = 0.89). The overall diagnostic ability of elevated USG cut-off values (≥1.020, ≥1.025, ≥1.030) was high for all tools (area under the curve >0.92). Misclassification of samples increased from 0 to 2 at 1.020 to 1 to 3 samples at cutoffs of 1.025 and 1.030 USG. Bland-Altman analysis showed that the DIG 5°C underreported slightly without reporting bias (r = −0.344, P = .13); all other plots for the DIG, MAN, and HYD showed considerably larger underreporting at higher concentrations (r = −0.21 to −0.97 with P >.02) at all temperatures. The outcomes of experiment 2 (33 fresh urine samples) using DIG 20°C as the standard demonstrated only negligible differences between the DIG and MAN at all temperatures but larger differences using the HYD. Conclusions All tools showed reporting bias compared with the °Bx solutions, which can affect the classification of low and high urine concentration at higher USG cutoff values, especially with a sample temperature of 37°C.

Wardenaar, FC, Ortega-Santos, CP, Vento, K, Beaumont, JS, Griffin, SC, Johnston, C, and Kavouras, SA. A 5-day heat acclimation program improves heat stress indicators while maintaining exercise capacity. J Strength Cond Res 35(5): 1279-1286, 2021-This study aimed to evaluate whether a daily 60 minutes isothermic biking protocol during a 5-day period could improve physiological heat acclimation and exercise performance capacity in partially acclimated subjects. A quasi-experimental study consisted of an intervention (INT, n = 7) and control (CON, n = 7) group completing 2 12 minutes Cooper tests (pre-CT on day 1 and post-CT on day 7) and a heat stress test (HST, on day 9). INT performed additional intensive exercise 1 hour per day on days 1-5, whereas CON did not. During CTs and HST, core temperature (Tc, telemetric capsule), skin temperature (Tsk, sensors at neck, right shoulder, left hand, and right shin), and heart rate (HR, chest strap) were continuously monitored and baseline, average, peak, and increment were calculated. During the HST, the INT group showed a smaller baseline-peak Tc increment (INT 0.88 ± 0.27 vs. CON 1.64 ± 0.90° C, p = 0.02), a lower HR peak (150.2 ± 12.6 vs. 173.0 ± 16.8 b·min-1, p = 0.02), and lower Tsk peak (36.47 ± 0.62 vs. 36.54 ± 0.46° C, p = 0.04). There was a nonsignificant, but practical difference based on a moderate effect size for change in pre-CT to post-CT performance of nearly +2.7 ± 12.3% in INT and -3.0 ± 8.5% in CON (p = 0.32 and d = 0.51), and HST distance covered resulting in a nonsignificant difference of 464 ± 849 m between INT and CON (p = 0.38 and d = 0.44). In conclusion a short-term 5-day heat acclimation program including 300 minutes of extra exercise resulted in positive physiological adaptions to heat stress, as indicated by lower core temperature and HR in comparison with a control group.

Oral contraceptive (OC) users have a heightened risk of low plasma concentrations of vitamin B6, a cofactor in the tryptophan-serotonin pathway critical to mood regulation. The purpose of this crossover study was to determine whether vitamin B6 supplementation reduced symptoms of depression and improved mood states in college women using OC. Participants were healthy (aged 18-25 yrs), did not take dietary supplements, and used OC (estrogen with progestin) consistently for at least 1 year. During the 12-week, randomized, double-blind crossover trial (4-week treatment periods [100 mg vitamin B6 daily or placebo] separated by a 4-week washout) participants (

Meal timing is an important consideration when assessing health. The primary outcome of this pilot study was to examine the feasibility and preliminary efficacy of early time-restricted eating (eTRE) on diet quality in a sample of college students attending a large southwestern university. Cardiometabolic indices and anthropometric measures were also obtained. The study was planned as an eight-week intervention; however, COVID-19 necessitated laboratory closures that disrupted data collection at week eight. Hence, only data obtained at week zero (baseline) and week four were viable for analysis and are presented herein. Twenty-five healthy participants were randomized to the intervention group (eTRE) which consisted of a daily 6-hour eating window or the control group (CON) which consisted of a daily 16-hour eating window. Each week, participants were permitted one day off from their respective study protocol. Seventeen participants completed all aspects of the study, and diet quality data were obtained from one additional participant (n = 18). Preliminary findings indicate that the 6-hour eTRE protocol may be beneficial for weight reduction and for reducing energy-dense foods typically consumed during the evening hours or later at night. Future research should accommodate individual preferences with regard to the initiation time of the eating window while also providing evidence-based nutrition recommendations to improve diet quality.

COVID-19 infection and vaccination offer disparate levels of defense against reinfection and breakthrough infection. This study was designed to examine the effects of curcumin supplementation, specifically HydroCurc (CURC), versus placebo (CON) on circulating inflammatory biomarkers in adults who had previously been diagnosed with COVID-19 and subsequently received a primary series of monovalent vaccine doses. This study was conducted between June 2021 and May 2022. Participants were randomized to receive CURC (500 mg) or CON capsules twice daily for four weeks. Blood sampling was completed at baseline and week-4 and analyzed for biomarkers. Linear regression was utilized to examine the between-group differences in post-trial inflammatory biomarker levels, adjusting for baseline and covariates including age, sex, race/ethnicity, and interval between COVID-19 diagnosis and trial enrollment. The sample (n = 31) was 71% female (Age 27.6 ± 10.4 y). The CURC group exhibited significantly lower post-trial concentrations of proinflammatory IL-6 (β = −0.52, 95%CI: −1.03, −0.014, p = 0.046) and MCP-1 (β = −0.12, 95%CI: −0.23, −0.015, p = 0.027) compared to CON, adjusting for baseline and covariates. Curcumin intake confers anti-inflammatory activity and may be a promising prophylactic nutraceutical strategy for COVID-19. These results suggest that 4 weeks of curcumin supplementation resulted in significantly lower concentrations of proinflammatory cytokines in adults who recovered from COVID-19 infection and were subsequently vaccinated.

Objective Arterial stiffness is a strong predictor of cardiovascular mortality, and often precedes elevations in blood pressure. This cross-sectional pilot study examined differences in arterial stiffness, blood pressure, cardiometabolic markers, anthropometric outcomes, and inflammation in vegetarians and matched omnivores. Participants were healthy, non-smoking adults (18–65 years old) adhering to either a vegetarian/vegan or omnivore diet. Omnivores were matched to vegetarians using broad body mass index (BMI) categories. Results Arterial stiffness trended higher in omnivores versus vegetarians (7.0 ± 1.5 and 6.8 ± 1.1 m/s, respectively; p = 0.073). This trend was mainly driven by the male omnivores (p = 0.006 for gender effect and p = 0.294 for eating pattern effect). Omnivores displayed higher HDL concentrations compared to vegetarians, 63.8 ± 18.5 and 55.2 ± 16.9 mg/dL; however, total cholesterol/HDL ratio did not vary significantly between groups; p = 0.310. In men, a vegetarian eating pattern may reduce arterial stiffness; however, this benefit may be limited in women, particularly those who are premenopausal. Future research should examine arterial stiffness and cardiometabolic health outcomes in younger versus older female vegetarians, as these data can provide valuable insights on the role of plant-based eating patterns on arterial stiffness and cardiometabolic health.

Background: Twenty-four–hour urinary sucrose and fructose (24uSF) has been studied as a biomarker of total sugars intake in two feeding studies conducted in the United Kingdom (UK) and Arizona (AZ). We compare the biomarker performance in these populations, testing whether it meets the criteria for a predictive biomarker. Methods: The UK and AZ feeding studies included 13 and 98 participants, respectively, aged 18 to 70 years, consuming their usual diet under controlled conditions. Linear mixed models relating 24uSF to total sugars and personal characteristics were developed in each study and compared. The AZ calibrated biomarker equation was applied to generate biomarker-estimated total sugars intake in UK participants. Stability of the model across AZ study subpopulations was also examined. Results: Model coefficients were similar between the two studies [e.g., log(total sugars): UK 0.99, AZ 1.03, P = 0.67], as was the ratio of calibrated biomarker person-specific bias to between-person variance (UK 0.32, AZ 0.25, P = 0.68). The AZ equation estimated UK log(total sugar intakes) with mean squared prediction error of 0.27, similar to the AZ study estimate (0.28). Within the AZ study, the regression coefficients of log(total sugars) were similar across age, gender, and body mass index subpopulations. Conclusions: Similar model coefficients in the two studies and good prediction of UK sugar intakes by the AZ equation suggest that 24uSF meets the criteria for a predictive biomarker. Testing the biomarker performance in other populations is advisable. Impact: Applications of the 24uSF biomarker will enable improved assessment of the role of sugars intake in risk of chronic disease, including cancer. See related commentary by Prentice, p. 1151

Daily vinegar ingestion has been linked to improved glycemic control, but recent data suggest a separate unexplored role for vinegar in mental health. Utilizing a placebo-controlled, parallel arm study design, this 4-week trial examined the impact of daily vinegar ingestion on mood states and urinary metabolites in healthy college students. Participants were randomized to the vinegar group (VIN: n = 14, 1.5 g acetic acid/day as liquid vinegar) or the control group (CON: n = 11, 0.015 g acetic acid/day as a pill) with no change to customary diet or physical activity. At baseline and at study week four, participants completed the Profile of Mood States (POMS) and the Center for Epidemiological Studies-Depression (CES-D) questionnaires and provided a first-morning urine sample for targeted metabolomics analyses. The change in both POMS depression scores and CES-D scores differed significantly between groups favoring improved affect in the VIN versus CON participants after four weeks. Metabolomics analyses pre and post-intervention suggested metabolite alterations associated with vinegar ingestion that are consistent for improved mood, including enzymatic dysfunction in the hexosamine pathway as well as significant increases in glycine, serine, and threonine metabolism. These data warrant continued investigation of vinegar as a possible agent to improve mood state.

BACKGROUND: The serum natural abundance carbon isotope ratio (CIR) was recently identified as a candidate biomarker of animal protein intake in postmenopausal women. Such a biomarker would help clarify the relation between dietary protein source (plant or animal) and chronic disease risk. OBJECTIVES: We aimed to evaluate the performance of the serum CIR as a biomarker of dietary protein source in a controlled feeding study of men and women of diverse age and BMI. METHODS: We conducted a 15-d feeding study of 100 adults (age: 18–70 y, 55% women) in Phoenix, AZ. Participants were provided individualized diets that approximated habitual food intakes. Serum was collected at the end of the feeding period for biomarker measurements. RESULTS: Median [IQR] animal protein intake was 67 g/d [55–88 g/d], which was 64% of total protein. The serum CIR was positively correlated with animal protein and inversely correlated with plant protein intake, leading to a strong correlation (r(2) = 0.76) with the dietary animal protein ratio (APR; animal/total protein). Regressing serum CIR on the APR, serum nitrogen isotope ratio (NIR), gender, age, and body weight generated an R(2) of 0.78. Following the measurement error model for predictive biomarkers, the resulting regression equation was then inverted to develop a calibrated biomarker equation for APR. Added sugars ratio (added/total sugars intake) and corn intakes also influenced the serum CIR but to a much lesser degree than the APR; variations in these intakes had only small effects on biomarker-estimated APR. CONCLUSIONS: Based on our findings in this US cohort of mixed sex and age, we propose the serum CIR alongside NIR as a predictive dietary biomarker of the APR. We anticipate using this biomarker to generate calibrated estimates based on self-reported intake and ultimately to obtain more precise disease risk estimates according to dietary protein source.

BACKGROUND: Developing approaches for the objective assessment of sugars intake in population research is crucial for generating reliable disease risk estimates, and evidence-based dietary guidelines. Twenty-four-hour urinary sucrose and fructose (24uSF) was developed as a predictive biomarker of total sugars intake based on 3 UK feeding studies, yet its performance as a biomarker of total sugars among US participants is unknown. OBJECTIVES: To investigate the performance of 24uSF as a biomarker of sugars intake among US participants, and to characterize its use. METHODS: Ninety-eight participants, aged 18–70 y, consumed their usual diet under controlled conditions of a feeding study for 15 d, and collected 8 nonconsecutive 24-h urines measured for sucrose and fructose. RESULTS: A linear mixed model regressing log 24uSF biomarker on log total sugars intake along with other covariates explained 56% of the biomarker variance. Total sugars intake was the strongest predictor in the model (Marginal R(2) = 0.52; P

Background Non-Hispanic black (NHB) pregnant women disproportionately experience adverse birth outcomes compared to Non-Hispanic white (NHW) pregnant women. The positive effects of prenatal exercise on maternal and neonatal health may mitigate these disparities. This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age (GA), birthweight (BW), and risks of preterm birth (PTB), cesarean section (CS), and low-birthweight (LBW) neonates. Methods This study performed a secondary data analysis using data from a 24-week, two-arm exercise intervention trial (ENHANCED by Mom). Women with singleton pregnancies (2, and no preexisting health conditions were eligible. The aerobic exercisers (EX) participated in 150 min of moderate-intensity weekly exercise while non-exercising controls (CON) attended low-intensity stretching/breathing sessions. Data on GA, PTB ( Results Participants with complete data (n = 125) were eligible for analyses (EX: n = 58, CON: n = 67). NHB pregnant women delivered lighter neonates (β = − 0.43 kg, 95% CI: − 0.68, − 0.18, p = 0.001). After adjusting for prenatal exercise, racial/ethnic disparities in BW were reduced (β = − 0.39 kg, 95% CI: − 0.65, − 0.13, p = 0.004). Prenatal exercise reduced borderline significant racial/ethnic disparities in PTB (p = 0.053) and GA (p = 0.07) with no effects found for CS and LBW. Conclusions The findings of this study demonstrate that prenatal exercise may attenuate the racial/ethnic disparities observed in neonatal BW, and possibly GA and PTB. Larger, diverse samples and inclusion of maternal biomarkers (e.g., cytokines) are encouraged to further evaluate these relationships.

Vinegar ingestion at mealtime is gaining popularity for its antiglycemic effects; however, it is among the most acidic consumable substances. This study examined tooth wear in healthy adults participating in an 8-week randomized trial examining the effect of daily vinegar ingestion on insulin sensitivity and visceral fat reduction. Twice daily participants consumed a vinegar drink (two tablespoons vinegar in a cup of water; 3.6 g acetic acid) or a commercial vinegar pill (control, 0.045 g acetic acid) at mealtime. Participants were screened for dental erosion using the basic erosive wear examination (BEWE) by a blinded registered dental hygienist at trial baseline and week 8. Mean BEWE scores did not change in the control group but increased 18% in the vinegar group over the 8-week study (

BACKGROUND A diet high in fermentable, oligo-, di-, monosaccharides and polyols (FODMAPs) has been shown to exacerbate symptoms of irritable bowel syndrome (IBS). Previous literature reports significant improvement in IBS symptoms with initiation of a low FODMAP diet (LFD) and monitored reintroduction. However, dietary adherence to the LFD is difficult, with patients stating that the information given by health care providers is often generalized and nonspecific, requiring them to search for supplementary information to fit their needs. OBJECTIVE The aim of our study was to determine whether Heali, a novel artificial intelligence dietary mobile app can improve adherence to the LFD, IBS symptom severity, and quality of life outcomes in adults with IBS or IBS-like symptoms over a 4-week period. METHODS Participants were randomized into 2 groups: the control group (CON), in which participants received educational materials, and the experimental group (APP), in which participants received access to the mobile app and educational materials. Over the course of this unblinded online trial, all participants completed a battery of 5 questionnaires at baseline and at the end of the trial to document IBS symptoms, quality of life, LFD knowledge, and LFD adherence. RESULTS We enrolled 58 participants in the study (29 in each group), and 25 participants completed the study in its entirety (11 and 14 for the CON and APP groups, respectively). Final, per-protocol analyses showed greater improvement in quality of life score for the APP group compared to the CON group (31.1 and 11.8, respectively; P=.04). Reduction in total IBS symptom severity score was 24% greater for the APP group versus the CON group. Although this did not achieve significance (–170 vs –138 respectively; P=.37), the reduction in the subscore for bowel habit dissatisfaction was 2-fold greater for the APP group than for the CON group (P=.05). CONCLUSIONS This initial study provides preliminary evidence that Heali may provide therapeutic benefit to its users, specifically improvements in quality of life and bowel habits. Although this study was underpowered, findings from this study warrant further research in a larger sample of participants to test the efficacy of Heali app use to improve outcomes for patients with IBS. CLINICALTRIAL ClinicalTrials.gov NCT04256551; https://clinicaltrials.gov/ct2/show/NCT04256551

OBJECTIVES: Oral contraception (OC) use has been linked to an increased risk of depression in college women and to poor micronutrient status. Of note, when compared to non-OC users, OC users have a heightened risk of low plasma concentrations of vitamin B6, a cofactor in the tryptophan-serotonin pathway critical to mood regulation. The purpose of this crossover study was to determine whether vitamin B6 supplementation impacted mood states and depression in college women using OC. METHODS: Participants were healthy and between 18–25 y, did not smoke or use dietary supplements, and used OC (estrogen with progestin) consistently for at least one year prior to the start of the study. The 12-week, randomized, double-blind crossover trial (4-week treatment periods [B6: 100 mg/d or control: placebo pill/d] separated by a 4-week washout [no pills taken]) was approved by the university Institutional Review Board, and participants provided written consent. Anthropometric measures, blood sampling, and diet and mood assessments were completed at the start of the trial and at weeks 4, 8, and 12. Participants (n = 8) maintained normal exercise and eating patterns the duration of the study and recorded pill consumption daily. The Profile of Mood States (POMS) and Beck Depression Inventory were used to assess affect. Plasma pyridoxal 5′ phosphate (PLP) concentrations were quantified by enzymatic assay. Repeated measures ANOVA was used to assess treatment effects. RESULTS: Plasma PLP concentrations averaged 66 ± 32 nmol/L at the start of the trial; one participant presented with marginal vitamin B6 status (20–30 nmol/L). Average vitamin B6 intakes did not vary during the trial (1.2–1.4 mg/d); whereas, vitamin B6 status rose significantly following the B6 supplementation period compared to the other three timepoints. POMS scores were not impacted by treatment; however, Beck Depression Inventory scores were reduced 30% by B6 supplementation in comparison to the control treatment (P = 0.047). CONCLUSIONS: These preliminary data support a growing literature suggesting the benefits of B6 supplementation for reducing depression in young women using OC. FUNDING SOURCES: This study was supported in part by the Graduate and Professional Students Association and the Office of the Vice Provost for Research.

There are conflicting reports regarding the efficacy of plant versus animal-derived protein to support muscle and strength development with resistance training. The purpose of this study was to determine whether soy and whey protein supplements matched for leucine would comparably support strength increases and muscle growth following 12 weeks of resistance training. Sixty-one untrained young men (n = 19) and women (n = 42) (18&ndash, 35 year) enrolled in this study, and 48 completed the trial (17 men, 31 women). All participants engaged in supervised resistance training 3&times, /week and consumed 19 grams of whey protein isolate or 26 grams of soy protein isolate, both containing 2 g (grams) of leucine. Multi-level modeling indicated that total body mass (0.68 kg, 95% CI: 0.08, 1.29 kg, p &lt, 0.001), lean body mass (1.54 kg, 95% CI: 0.94, 2.15 kg, 0.001), and peak torque of leg extensors (40.27 Nm, 95% CI: 28.98, 51.57 Nm, p &lt, 0.001) and flexors (20.44 Nm, 95% CI: 12.10, 28.79 Nm, 0.001) increased in both groups. Vastus lateralis muscle thickness tended to increase, but this did not reach statistical significance (0.12 cm, 95% CI: &minus, 0.01, 0.26 cm, p = 0.08). No differences between groups were observed (p &gt, 0.05). These data indicate that increases in lean mass and strength in untrained participants are comparable when strength training and supplementing with soy or whey matched for leucine.

Some studies have reported that vinegar ingestion at mealtime attenuates postprandial glycemia in healthy adults and individuals with type 2 diabetes. Emerging data suggest that chronic vinegar ingestion impacts fat metabolism and reduces adiposity, although no study has yet corroborated the events of vinegar supplementation metabolically through a metabolomics approach. To examine the impact of daily vinegar ingestion on glucose homeostasis, adiposity, and the metabolome, an 8-week, randomized controlled trial design was implemented utilizing two parallel treatment arms: daily red wine vinegar ingestion and a control treatment. Participants were 45 healthy adults at increased risk for metabolic complications as determined by high waist circumferences. Measurements and blood samples were collected pre- and post-intervention. Central adiposity and visceral fat were assessed by waist circumference and dual-energy X-ray absorptiometry, respectively. Plasma metabolites were analyzed using gas chromatography-mass spectrometry (MS) and liquid chromatography-MS/MS. Analysis showed significant reductions in fasting glucose (p = 0.003) and insulin (p0.001). Insulin resistance was reduced 8.3% in the red wine vinegar group and increased 9.7% in the control group (p0.001). No significant between-group differences in body mass index, body weight, waist circumference, or visceral fat were observed. Significant differences were observed in amino valerate and indole-3-acetic acid (p0.05), with high magnitudes of fold change (2) between groups. Metabolic pathway analysis revealed significant alterations in tryptophan metabolism. Although daily red wine vinegar ingestion for 8 weeks induced significant improvements in glucose homeostasis, our results indicate that daily red wine vinegar ingestion for 8 weeks is not associated with reductions in adiposity. This is the first study to investigate the effects of daily red wine vinegar supplementation using a metabolomics approach. Our results provide strong rationales for larger prospective studies to further clarify associations among obesity, chronic diseases, and functional foods such as vinegar using metabolomics.

We appreciate the critique of our paper (Ciuris et al [...]

Despite reported benefits of flaxseeds and psyllium, to our knowledge no studies have compared their effectiveness in adults with type 2 diabetes (T2D). While both psyllium and flaxseeds are plant-derived fibers, flaxseeds contain additional compounds associated with cardiovascular health including alpha linolenic acid, phytoestrogen lignans, vitamin E and carotenoids. The objectives were to determine primarily whether flaxseeds were more effective than psyllium at improving weight and cardiovascular health (glucose, lipids and blood pressure) and secondarily inflammation and oxidative stress in subjects with T2D. We hypothesized, when matched for fiber mass content, daily supplementation with ground flaxseeds (28 g/d) would be more effective than ground psyllium fiber (9 g/d) for improving adiposity and glycemic regulation, serum lipids, blood pressure and markers of inflammation and oxidative stress in participants with T2D. In this comparative effectiveness parallel-design study, adults (18-75y) with T2D were randomized to consume either supplement for 8 weeks with anthropometrics and blood samples collected at baseline and week 8. Flaxseed and psyllium reduced waist circumference (−2.8 ± 2.0 and −1.2 ± 2.4 cm, respectively; p = 0.002 within groups) and oxidized lipoproteins (−2.8 ± 4.2 and −0.1 ± 1.5 nM/L, respectively; p = 0.037 within groups) without affecting body mass, lipids, or blood pressure. Flaxseeds alone increased nitric oxide (+2.4 ± 3.3 vs −0.9 ± 2.7 nM/L; p = 0.044 between groups) suggesting flaxseeds may offer additional vasoprotection. Thus, fiber supplementation is an effective means to reduce waist circumference and oxidative stress in individuals with T2D. In addition, this study was the first to show that flaxseeds increase nitric oxide bioavailability in the vasculature of subjects with T2D.

Objective. Research evidence suggests that vinegar may effectively reduce postprandial glucose in both healthy adults and those with type 2 diabetes. There is heightened consumer interest in commercially available vinegar tablets; however, it is not known whether these products lower postprandial glycemia to the same extent as liquid vinegar. This crossover trial examined the impact of liquid vinegar versus commercial vinegar tablet ingestion at the start of a meal on the 60-minute glucose excursion postmeal in healthy adults. Methods. Twelve young men and women (22.6 ± 0.6 y; 21.2 ± 1.2 kg/m2) completed this 4-arm Latin square crossover trial. Testing was separated by one week and consisted of a test meal (64 g carbohydrate) consumed immediately following one of the four oral treatments: CON, 60 g water (control treatment); VIN, 25 g liquid vinegar (5% acidity; 1.25 g acetic acid) diluted with 35 g water; PILL, four vinegar tablets (1.50 g acetic acid) swallowed whole with 60 g water; and PILL-c, four crushed vinegar tablets dissolved in 60 g water. Capillary blood glucose was tested in the fasted state and at 30 and 60 minutes postmeal. Results. The 60-minute glucose excursion varied significantly by treatment (iAUC: 4.9 ± 0.6, 3.4 ± 0.4, 4.9 ± 0.6, and 4.1 ± 0.5 mmol˖h/l for CON, VIN, PILL, and PILL-c, respectively; F (3, 33) = 3.037, p = 0.043; repeated measures ANOVA). Post hoc analysis revealed a 31% reduction in the glucose postmeal excursion for VIN in comparison to CON and PILL ( p = 0.040 and p = 0.049, respectively). Conclusions. These data suggest that commercial vinegar tablets taken whole at mealtime are not as effective as liquid vinegar for reducing the postmeal glucose excursion in young, healthy adults.

OBJECTIVES: Postprandial glycemia is an important contributor to hemoglobin A1c (HbA1c) concentrations in healthy individuals and those diagnosed with pre-diabetes. It is also an independent risk factor for cardiovascular disease and is linked to obesity and certain cancers. Hence, dietary strategies to minimize postprandial glycemia should be identified. Grain products are common dietary glucose sources, and white bread consumption has been linked to risk for type 2 diabetes. The popularity of gluten-free products has risen dramatically in recent years; yet some research suggests that gluten-free products have a higher glycemic response compared to traditional products, which can have adverse consequences for consumers with hyperglycemia. In these trials, the gluten-free product ingredients were grain-based flours. Products made from non-traditional, non-grain ingredients may produce more favorable glycemic responses. METHODS: Utilizing a Latin squares, crossover study design, we conducted two separate trials to examine the 2-h postprandial glycemic responses to (a) gluten-free nutrition bars and (b) gluten-free breads in comparison to the traditional products in healthy adults (19–35 y; 19–36 kg/m(2)). The novel, substitute ingredients for the gluten-free products were dates for the nutrition bar and a mix of potato, fava bean, garbanzo bean, teff, corn, chia seed, flax seeds or a mix of brown rice flour, tapioca flour, whole grain sorghum flour for the breads. RESULTS: Gluten-free nutrition bar consumption was associated with a 52% reduction in the 2-h glycemic response in comparison to the traditional bar (iAUC: 39.0 ± 6.0 and 82.0 ± 18.0 mg min/dL; P = 0.013). Gluten-free bread (bean and seed based ingredients) was associated with a 23% reduction in the 2-h glycemic response in comparison to wheat bread (iAUC: 112.4 ± 15.7 and 145.3 ± 20.0 mg min/dL; P = 0.004). However, the 2-h glycemic response to the grain-based gluten-free bread product did not differ from wheat bread. CONCLUSIONS: The data suggest that the substitute ingredients used in gluten-free products influence the glycemic response to ingestion. FUNDING SOURCES: Graduate Education Research and Support Program of the Graduate and Professional Student Association of Arizona State University.

Although plant-based diets are promoted for healthy outcomes, these diets are not synonymous with high-quality diets. Plant-based diets can include highly processed, less healthful foods, including savory snacks, pastries, and sugary fruit drinks. This cross-sectional study examined the diet quality of vegetarian and omnivorous adults, matched for gender, age, and adiposity, and related diet quality to standard health biomarkers. Diet quality was assessed using the Rapid Eating and Activity Assessment for Participants Short Version questionnaire. Participants (17 vegetarians and 16 omnivores, 28.2 &plusmn, 8.9 years, 22.5 &plusmn, 2.7 kg/m2) were non-smokers and healthy by self-report. The median duration of adherence to the vegetarian diet was 27 months. Physical activity level and diet quality did not differ significantly between diet groups. Moreover, health biomarkers did not differ by diet groups. When participants were regrouped by low versus high diet quality, health biomarkers differed significantly between groups for fasting insulin, HOMA-IR, triglyceride (TG)/HDL ratio, and blood folate, with more favorable levels in the group with high diet quality. These data suggest that health biomarkers more closely align with diet quality attributes than with plant-based diet categorization. Thus, messaging focused on healthy diet attributes may lead to better health outcomes than the simple promotion of plant-based diets.

OBJECTIVES: Urinary sucrose and fructose has been suggested as a predictive biomarker of total sugars intake based on research involving UK adults. The purpose of this study was to determine the association between sugars consumption and 24-hour urinary sucrose and fructose (24uSF) in US adult population and to investigate the effect of physical activity on this association. METHODS: Fifty seven free-living healthy subjects 20 to 68 years old, participated in a 15-day highly controlled feeding study, consuming their habitual diet, provided by the research metabolic kitchen. Dietary sugars were estimated using Nutrition Data System for Research (NDSR). Subjects collected eight 24-hour urine samples measured for urinary sucrose and fructose. Physical activity was assessed daily using a validated 15-day log that inquired about 38 physical activities across six domains; home activities, transportation, occupation, conditioning, sports and leisure. RESULTS: The 15-d mean total sugars and added sugars intake (SD) of the study population was 112.2 (33.1) g/day and 65.8 (29.0) g/day (9.7%EI), respectively. Significant moderate positive correlation was found between 15-d mean total sugars intake and 8-day mean 24uSF (r = 0.56, P

Life cycle assessment (LCA) evaluates environmental impacts of a product from material extraction through disposal. Applications of LCA in evaluating diets and foods indicate that plant-based foods have lower environmental impacts than animal-based foods, whether on the basis of total weight or weight of the protein content. However, LCA comparisons do not differentiate the true biological value of protein bioavailability. This paper presents a methodology to incorporate protein quality and quantity using the digestible indispensable amino acid score (DIAAS) when making comparisons using LCA data. The methodology also incorporates the Food and Drug Administration&rsquo, s (FDA) reference amounts customarily consumed (RACCs) to best represent actual consumption patterns. Integration of these measures into LCA provides a mechanism to identify foods that offer balance between the true value of their protein and environmental impacts. To demonstrate, this approach is applied to LCA data regarding common protein foods&rsquo, global warming potential (GWP). The end result is a ratio-based score representing the biological value of protein on a GWP basis. Principal findings show that protein powders provide the best efficiency while cheeses, grains, and beef are the least efficient. This study demonstrates a new way to evaluate foods in terms of nutrition and sustainability.

OBJECTIVES: College students’ dietary patterns may predispose them to weight gain and risk for cardiometabolic conditions later in life. Time-restricted feeding (TRF), a type of intermittent fasting, may confer health benefits, including reductions in body weight. Currently, it is unknown if TRF might impact diet quality. The objective of this randomized controlled study was to assess the feasibility of a TRF protocol versus a control (CON) protocol for eight weeks on dietary patterns, anthropometric measures, and cardiometabolic indices in college students. We hypothesized that dietary patterns, anthropometric measures, and cardiometabolic indices would improve for participants in the TRF group. METHODS: Healthy college students were randomly assigned to a TRF intervention group (six-hour daily eating window) or a CON (16-hour daily eating window) for eight weeks. One ‘cheat’ day was permitted each week, and outcomes were measured at weeks zero, four, and eight. Due to COVID-19 restrictions, data collection at week eight was incomplete and these data were not viable; hence, only change data at week four are reported. The Rapid Eating Assessment for Participants [shortened version] questionnaire was used to assess shifts in dietary patterns. RESULTS: Of the 25 initial participants, 17 completed the study (TRF group; n = 7; CON group; n = 10; age, 23 ± 4 years; BMI, 23.2 ± 2.3 kg/m(2)). Six TRF participants withdrew from the trial (43%) due to study-related side effects, including excess hunger and poor energy; additionally, in each group, a single participant was lost to follow-up. Change in body weight at week four was significantly different between the TRF group (−1.1 ± 1.6 kg) and the CON group (0.7 ± 1.3 kg); (P = 0.016). There were no between-group differences for change in dietary patterns and cardiometabolic indices (P > 0.05). CONCLUSIONS: Although dietary patterns and cardiometabolic indices were not altered between groups over the course of the trial, body weight was reduced in the TRF participants compared to the CON participants. These preliminary data suggest that an 18-hour TRF protocol may be useful for weight reduction; however, this protocol is difficult to follow. Future studies should identify modifications to make TRF more acceptable to users and focus on diet quality. FUNDING SOURCES: Arizona State University.

OBJECTIVES: Recent studies have identified the serum natural abundance carbon isotope ratio (CIR) as a candidate biomarker of animal protein intake in postmenopausal women. Such a biomarker would help clarify the contribution of dietary protein source (animal vs. vegetable) to chronic disease risk. Here we evaluate biomarker performance and develop a biomarker calibration equation in a mixed-age and – gender cohort. METHODS: We conducted a 15-d feeding study of 100 adults (age 18–70, 55% women) in Phoenix, AZ. Participants were provided individualized diets that approximated habitual food intakes. Total CIR and nitrogen isotope ratio (NIR) were measured in sera collected at the end of the feeding period. We expressed animal protein as a ratio of total protein intake (AP(ratio)). We evaluated a model of serum CIR based on AP(ratio), the serum NIR, gender, age and body weight, and the resulting regression equation was inverted to develop an equation for the AP(ratio) that we call the calibrated biomarker. We evaluated the association of the calibrated biomarker with actual AP(ratio) using Pearson correlation and 5-fold cross validation. RESULTS: Animal protein intake in this study was 73 ± 30 g/d (mean ± SD) and the AP(ratio) was 0.63 ± 0.13. Our model explained a large proportion of the variation in serum CIR (R(2) = 0.77) and AP(ratio) was the only significant model effect (coefficient = 6.22, SE = 0.44, P

Background A diet high in fermentable, oligo-, di-, monosaccharides and polyols (FODMAPs) has been shown to exacerbate symptoms of irritable bowel syndrome (IBS). Previous literature reports significant improvement in IBS symptoms with initiation of a low FODMAP diet (LFD) and monitored reintroduction. However, dietary adherence to the LFD is difficult, with patients stating that the information given by health care providers is often generalized and nonspecific, requiring them to search for supplementary information to fit their needs. Objective The aim of our study was to determine whether Heali, a novel artificial intelligence dietary mobile app can improve adherence to the LFD, IBS symptom severity, and quality of life outcomes in adults with IBS or IBS-like symptoms over a 4-week period. Methods Participants were randomized into 2 groups: the control group (CON), in which participants received educational materials, and the experimental group (APP), in which participants received access to the mobile app and educational materials. Over the course of this unblinded online trial, all participants completed a battery of 5 questionnaires at baseline and at the end of the trial to document IBS symptoms, quality of life, LFD knowledge, and LFD adherence. Results We enrolled 58 participants in the study (29 in each group), and 25 participants completed the study in its entirety (11 and 14 for the CON and APP groups, respectively). Final, per-protocol analyses showed greater improvement in quality of life score for the APP group compared to the CON group (31.1 and 11.8, respectively; P=.04). Reduction in total IBS symptom severity score was 24% greater for the APP group versus the CON group. Although this did not achieve significance (–170 vs –138 respectively; P=.37), the reduction in the subscore for bowel habit dissatisfaction was 2-fold greater for the APP group than for the CON group (P=.05). Conclusions This initial study provides preliminary evidence that Heali may provide therapeutic benefit to its users, specifically improvements in quality of life and bowel habits. Although this study was underpowered, findings from this study warrant further research in a larger sample of participants to test the efficacy of Heali app use to improve outcomes for patients with IBS. Trial Registration ClinicalTrials.gov NCT04256551; https://clinicaltrials.gov/ct2/show/NCT04256551

Given the popularity of gluten-free diets, research regarding the health implications of gluten-free (GF) products is necessary. This study compared the postprandial glycemic responses to three GF pastas commonly available in the U.S. market to that of wheat pasta in healthy adults. Thirteen healthy non-smoking men and women from a university campus population were enrolled in this randomized 4 × 4 block crossover study and completed all four treatments. Participants followed a standardized diet and activity protocol the day prior to testing, and one week separated testing periods. The test meal (a macaroni and cheese dish prepared with conventional wheat pasta or with GF pasta composed of either brown rice, rice and corn, or corn and quinoa flours) was consumed under observation, and blood was sampled in the fasted state and at one-half hour intervals for the first 2 hours following meal ingestion. A significant pasta × time interaction was observed for the incremental postprandial glycemia curves (p = 0.036, repeated measures ANOVA; effect size [partial eta squared], 0.943). Post-hoc analysis revealed a significant difference for the 30-minute postprandial blood glucose concentrations: the plasma glucose concentration was 57% higher for the GF rice and corn pasta compared to traditional wheat pasta (p = 0.011). Since postprandial glycemia was higher for GF pasta composed of rice and corn flours compared to wheat pasta, more research is needed to understand how the substitute ingredients for GF pastas impact health parameters and disease risk.

Cardiovascular disease risk is elevated in postmenopausal women relative to men of the same age or to younger, premenopausal women. This elevated risk is closely linked to the loss of estrogen, which is a potent stimulator of the vasodilator nitric oxide. While studies have largely supported dietary nitrate supplementation (typically concentrated beetroot juice) to augment plasma nitric oxide, these studies focused mainly on improving vascular fitness of athletes or patient populations. The purpose of this controlled crossover trial was to assess the feasibility of consuming a high-nitrate, leafy green salad twice daily for 10 consecutive days versus a low-nitrate, canned vegetable control (beans, corn, or peas) on plasma nitrate/nitrite concentration and measures of cardiovascular health in postmenopausal women. We hypothesized that plasma nitrate/nitrite concentration and flow-mediated dilation would improve following the leafy green salad treatment. Ten women (52.6 ± 4.9 y; 26.4 ± 6.4 kg/m2) completed the two 10-day treatment periods separated by 2–3 weeks washout. The mean fasting plasma nitrate/nitrite concentration was significantly increased following the high-nitrate salad treatment compared to the control (+156% and+ 16% respectively; P = .002, effect size = 0.661). Flow-mediated dilation responded favorably to the high nitrate salad in comparison to the canned vegetable condition (+17% versus −8% respectively; P = .047, effect size = 0.407); however, there were no treatment effects on peripheral or derived central-aortic blood pressure. These data suggest that daily ingestion of nitrate-rich, leafy green salads may prove a useful strategy for improving cardiovascular health in postmenopausal women.

The Healthy Eating Index-2010 is a measure of diet quality as portrayed by the Dietary Guidelines for Americans; however, computing the Healthy Eating Index score is time consuming and requires trained personnel. The Rapid Eating Assessment for Participants [shortened version] is a simple measure that quickly, in less than 10 min, assesses diet quality in a clinical or research setting. This research evaluated the degree of correlation between these two methods of scoring diet quality, as well as between these methods and other indicators of diet quality, including the nutrient density of the diet, the dietary potential renal acid load, urine pH, and plasma vitamin C concentrations. The research design was a secondary data analysis, and participants were healthy adults (n = 81) self-classified as omnivorous, vegetarian, or vegan. Confounding variables were identified and controlled using partial correlations. The two methods of scoring diet quality were significantly correlated (r = 0.227, p = 0.047). Both the Healthy Eating Index and the Rapid Eating Assessment for Participants scoring methods were correlated to nutrient density of the diets (r = 0.474 and r = 0.472 respectively, p

A recent meta-analysis concluded that vinegar consumption could be considered effective adjunct therapy for improving glycemic control. However, liquid vinegar consumption is often poorly tolerated...