Search

Background Fiber is an important part of a healthy diet and is known to attenuate postprandial glycemia. Orange pomace (OP) is a by-product of orange juice (OJ) production and is a rich source of fiber. Objective Two separate studies determined the impact of added OP to 100% OJ on postprandial glycemic response compared with sugar-matched OJ or whole orange fruit (WOF). Methods Study 1 included 17 adults [65% female, age 39.3 ± 3.1 y, and BMI (in kg/m2) 24.6 ± 0.7], and study 2 included 45 different adults (47% female, age 25.1 ± 4.3 y, and BMI 22.5 ± 1.6). Studies were conducted at separate locations using a randomized, 3-arm, crossover design to test the glycemic response to sugar-matched OJ, OJ with 5 g fiber from OP (OPF), or WOF. The primary outcomes were 2-h glucose incremental area under the curve (iAUC) in study 1, analyzed by repeated measures ANOVA, and maximum glucose concentration (Cmax) in study 2, analyzed using PROC MIXED (ANCOVA). Glucose and insulin concentrations were measured at fasting and multiple time points over 2 h after test product consumption (study 1, serum; study 2, plasma). Results In study 1, glucose iAUC was not significantly lower in OPF compared to the OJ or WOF (825 ± 132 compared with 920 ± 132 and 760 ± 132 mg · min · dL-1, respectively, P = 0.57 for both). In study 2, glucose iAUC was significantly lower in WOF compared with OPF and OJ (689 ± 70.7 compared with 892 ± 70.7 and 974 ± 70.7 mg · min · dL-1, P = 0.02 and 0.001, respectively). Data from both studies indicated OPF reduced Cmax compared with OJ and that the reductions were comparable to WOF (study 1: OPF, 115 ± 4.06 compared with OJ, 124 ± 4.06 and WOF, 114 ± 4.06 mg · dL-¹, P = 0.002 and 0.75, respectively; study 2: OPF, 128 ± 1.92 compared with OJ, 136 ± 1.92 and WOF, 125 ± 1.92 mg · dL-¹, P = 0.001 and 0.28, respectively). Conclusion Data from both studies demonstrated no significant effect of OPF on postprandial iAUC compared with OJ. However, adding OP into OJ attenuates the postprandial glucose Cmax, and the responses were comparable to WOF in healthy adults.

Training to ensure good documentation practices and adherence to regulatory requirements in human nutrition randomized controlled trials has not been given sufficient attention. Furthermore, it is difficult to find this information conveniently organized or in a form relevant to nutrition protocols. Current gaps in training and research surveillance exist in clinical nutrition research because training modules emphasize drugs and devices, promote reliance on monitoring boards, and lack nutrition expertise on human nutrition research teams. Additionally, because eating is essential, ongoing, and highly individualized, it is difficult to distinguish risks associated with interventions from eating under free-living conditions. Controlled-feeding trials provide an option to gain more experimental control over food consumed, but at a price of less external validity, and may pose human behavior issues that are unrelated to the intervention. This paper covers many of the expected practices for documentation and regulation that may be encountered in planning and conducting nutrition intervention trials with examples and references that should be useful to clinical nutrition researchers, funders of research, and research institutions. Included are definitions and guidance on clinical nutrition research oversight (institutional review boards, data safety and monitoring boards, US FDA); participant safety; standard operating procedures; training of investigators, staff, and students; and local culture and reporting requirements relevant to diet-related clinical research conduct and documentation.

Determining the available energy (caloric value) of dietary non-digestible fibers that are fermented to varying degrees by intestinal microbes and metabolized to short chain fatty acids is important for provision of accurate information to food and beverage manufacturers for reformulation and labeling purposes. The objective of this human study was to determine the available energy of soluble fiber products by measuring post consumption breath hydrogen, with inulin as a control.PROMITORResults demonstrated that breath hydrogen production was significantly lower following consumption of SCF70 and SCF85B compared to inulin at all consumption amounts. There were no significant differences in breath hydrogen production following consumption of SCF70 compared to SCF85B.The available energy per gram of fiber was not significantly different between the SCF70 and SCF85B PROMITOR

In a previous study, consumption of a dairy beverage incorporating insoluble β-glucan decreased upper respiratory tract infection (URTI) symptomatic days and severity in marathon runners. In this r...

Background: Cranberry (Vaccinium spp.) has been advocated for treatment of urinary tract infection (UTI); however, its efficacy is controversial. Women have a 50% risk of UTI over their lifetime, and ∼20-30% experience a subsequent UTI recurrence.Objective: We conducted this meta-analysis to assess the effect of cranberry on the risk of UTI recurrence in otherwise healthy women.Methods: Literature published before January 2011 was obtained from 2 published systematic reviews, and we conducted updated searches in EMBASE and MEDLINE (through July 2017). We included randomized controlled trials that were conducted in generally healthy nonpregnant women aged ≥18 y with a history of UTI, compared cranberry intervention to a placebo or control, and reported the outcome as the number of participants experiencing a UTI. Two researchers conducted abstract and full-text screenings, data extractions, and risk of bias assessments independently, and discrepancies were resolved by group consensus. Meta-analyses were performed by using Stata SE software (version 13). We employed a fixed-effect model using the Mantel-Haenszel method to estimate the summary risk if the heterogeneity was low to moderate (I2 300 participants.Conclusion: These results suggest that cranberry may be effective in preventing UTI recurrence in generally healthy women; however, larger high-quality studies are needed to confirm these findings. This trial was registered at crd.york.ac.uk/prospero as CRD42015024439.

Background: Cashews are the third most-consumed tree nut in the United States and are abundant with monounsaturated fatty acids and polyunsaturated fatty acids, which are associated with reduced cardiovascular disease risk. Although a qualified Food and Drug Administration health claim exists for nuts and heart health, cashews have been exempt from its use because cashews exceed the disqualifying amount of saturated fatty acids. Approximately one-third of the saturated fat in cashews is stearic acid, which is relatively neutral on blood lipids, thereby suggesting that cashews could have effects that are similar to those of other nuts. However, clinical data on cashews and blood lipids have been limited.Objective: We investigated the effect of reasonable intakes of cashews on serum lipids in adults with or at risk of high LDL cholesterol.Design: In a randomized, crossover, isocaloric, controlled-feeding study, 51 men and women (aged 21-73 y) with a median LDL-cholesterol concentration of 159 mg/dL (95% CI: 146, 165 mg/dL) at screening consumed typical American diets with cashews (28-64 g/d; 50% of kilocalories from carbohydrate, 18% of kilocalories from protein, and 32% of kilocalories from total fat) or potato chips (control; 54% of kilocalories from carbohydrate, 18% of kilocalories from protein, and 29% of kilocalories from total fat) for 28 d with a ≥2-wk washout period.Results: Consumption of the cashew diet resulted in a significantly greater median change from baseline (compared with the control, all P < 0.05) in total cholesterol [-3.9% (95% CI: -9.3%, 1.7%) compared with 0.8% (95% CI: -1.5%, 4.5%), respectively], LDL cholesterol [-4.8% (95% CI: -12.6%, 3.1%) compared with 1.2% (95% CI: -2.3%, 7.8%), respectively], non-HDL cholesterol [-5.3% (95% CI: -8.6%, 2.1%) compared with 1.7% (95% CI: -0.9%, 5.6%), respectively], and the total-cholesterol:HDL-cholesterol ratio [-0.0% (95% CI: -4.3%, 4.8%) compared with 3.4% (95% CI: 0.6%, 5.2%), respectively]. There were no significant differences between diets for HDL cholesterol and triglyceride.Conclusions: In comparison with a control diet, the incorporation of cashews into typical American diets decreases total cholesterol and LDL cholesterol. Results from this study provide support that the daily consumption of cashews, when substituted for a high-carbohydrate snack, may be a simple dietary strategy to help manage total cholesterol and LDL cholesterol. This study was registered at clinicaltrials.gov as NCT02769741.

Background: The objective of this systematic review was to assess the scope and breadth of publicly available prospective cohort and randomized controlled trial (RCT) literature on 100% fruit juice and dental caries or tooth erosion in humans. Methods: We performed a systematic search in MEDLINE/PubMed, EMBASE, and Web of Science for studies published from inception through May 2018, and the Cochrane Library databases for reports published through January 2018. Prospective cohort studies or RCTs conducted on dental health and 100% fruit juice, and published in English were selected. No restrictions were set for age, sex, geographic location, or socioeconomic status. Results: Eight publications representing five independent prospective cohort studies and nine publications on nine RCTs were included. All prospective cohort studies were in children or adolescents, and all RCTs were in adults. Prospective cohort studies on tooth erosion found no association between juice intake and tooth erosion, while those on dental caries incidence reported either no association or an inverse association between 100% fruit juice intakes and dental caries incidence. RCTs on tooth erosion showed decreased microhardness, increased surface enamel loss, increased erosion depth, greater enamel softening, and/or increased pellicle layer with 100% fruit juice, and those on dental caries showed increased demineralization of enamel slabs with 100% fruit juice. Conclusions: The existing evidence on 100% fruit juice intake and caries and tooth erosion are not conclusive. Overall, prospective cohort studies in children and adolescents found no association between 100% fruit juice intake and tooth erosion or dental caries, but, RCT data in adults suggests that 100% fruit juice could contribute to tooth erosion and dental caries. The RCT data, however, were from small, short-term studies that utilized intra-oral devices generally devoid of normal plaque or saliva action, and generally employed conditions that are not reflective of normal juice consumption.

OBJECTIVES: Cranberry (Vaccinium spp.) has been advocated for maintaining healthy urinary tract function in women; however, the effect in other populations is controversial. The aim of this meta-analysis was to evaluate cranberry intake and the risk of uncomplicated urinary tract infection (UTI) and some categories of complicated UTI in otherwise healthy populations. METHODS: MEDLINE, EMBASE, Cochrane, and Web of Science were systematically searched, and studies screened and extracted using a predefined strategy by two independent investigators. Discrepancies were resolved by discussion with a third investigator. Meta-analysis was performed using RevMan (version 5.3.5, Cochrane, UK). Heterogeneity was assessed with both I(2) and the chi-square tests. A low to moderate (I(2)

Cranberry has been used traditionally to prevent urinary tract infections (UTIs), primarily among generally healthy women prone to recurrent UTIs. Results from a number of published clinical studies have supported this benefit; however, meta-analyses on cranberry and UTI prevention have reported conflicting conclusions. This article explores the methodological differences that contributed to these disparate findings. Despite similar research questions, the meta-analyses varied in the studies that were included, as well as the data that were extracted. In the 2 most comprehensive systematic reviews, heterogeneity was handled differently, leading to an I(2) of 65% in one and 43% in the other. Most notably, the populations influencing the conclusions varied. In one analysis, populations with pathological/physiological conditions contributed 75.6% of the total weight to the summary risk estimate (RR: 0.86; 95% CI: 0.71, 1.04); another weighted the evidence relatively equally across UTI populations (RR: 0.62; 95% CI: 0.49, 0.80); and a third included only women with recurrent UTIs (RR: 0.53; 95% CI: 0.33, 0.83). Because women with recurrent UTIs are the group to whom most recommendations regarding cranberry consumption is directed, inclusion of other groups in the efficacy assessment could influence clinical practice quality. Therefore, conclusions on cranberry and UTIs should consider differences in results across various populations studied when interpreting results from meta-analyses.

In this double-blind, randomized, placebo-controlled parallel study, we examined the effect of dairy-based beverages (250 mL/day) containing 250 mg of dispersible baker's yeast β-glucan (Wellmune) compared to a macronutrient- and calorie-matched control on upper respiratory tract infection (URTI) in marathon runners. Healthy adults running in the 2017 Austin Marathon consumed either β-glucan (

Background Resistant starches type 4 (RS4) are chemically modified starches that are resistant to digestion by human enzymes. Objective We aimed to test our hypothesis that replacement of standard starch with RS4 in a baked breakfast bar would decrease postprandial glycemic and insulinemic responses in healthy adults. Methods In this double-blind, randomized crossover study, 21 healthy adults [10 men; 20–45 y old; BMI (kg/m2): 19.3–27.0] consumed a baked breakfast bar containing tapioca-based RS4 (Actistar 75330; Cargill, Inc.) or a macronutrient-matched control bar, delivering 32 g and 4 g of dietary fiber, respectively. Primary outcome was the incremental area under the curve (iAUC0–120 min) for postprandial capillary glucose. Other outcomes included postprandial serum insulin iAUC0–120 min, glucose and insulin maximum concentration (Cmax), and time to Cmax (Tmax). Results Median glucose iAUC0–120 min was 22% lower (P 0.05) between foods. Conclusion The results suggest that replacement of standard starch with tapioca-based RS4 is a practical approach for reducing available carbohydrate in products and achieving postprandial blood glucose management. This trial was registered at clinicaltrials.gov as NCT03239288.

OBJECTIVES: The relationship of egg consumption and cardiometabolic disease risk is controversial. This report provides an overview on the consistencies and gaps in the evidence base on eggs and cardiometabolic health. METHODS: PubMed database was screened for evidence-based reviews published in English that assessed human studies on egg consumption and cardiometabolic outcomes, augmented by searches in Web of Science and Google. RESULTS: Seven qualitative and 15 quantitative reviews were identified, with >70% having published since 2015. Overall, the systematic reviews were of low quality, while meta-analyses were of moderate to high quality. No association of increased egg intake and risks of heart disease or stroke in the general population were found in the meta-analyses. Increased risk of heart failure was noted in two meta-analyses that analyzed the same three cohort studies. Five recent meta-analyses reported no increased risk of type 2 diabetes mellitus (T2DM) in the general population, although increased risk in US-based populations only was reported. Older (2013) meta-analyses reported increased risk of cardiovascular disease (CVD) or heart disease in T2DM populations and no recent evidence-based reviews were identified. Finally, only one meta-analysis reported intervention studies specifically on eggs and biomarkers (i.e., lipids), and the results contradicted those from observation studies. CONCLUSIONS: Recent evidence-based reviews conclude that increased egg consumption is not associated with CVD in the general population. More research is needed on the positive associations between heart failure and T2DM risk with egg consumption, as well as CVD risk in diabetics, before firm Conclusions can be made. FUNDING SOURCES: Partial support from Egg Nutrition Council.

Purpose. Ready-to-eat cereal (RTEC) consumption has been associated with better nutrient intakes and anthropometric end points compared with breakfast skipping and other breakfasts. Our objective was to evaluate RTEC breakfast type (presweetened and nonpresweetened) on physiological end points. Methods. National Health and Nutrition Examination Survey 2003-2006 data were analyzed using SUDAAN. Participants (n = 6729; 2-17 years) were separated into groups based on breakfast habits as follows: presweetened RTEC (PS-RTEC); nonpresweetened RTEC (NPS-RTEC); breakfast skippers (SKs); other breakfasts (OBs). Presweetened was defined as ≥9 g of added sugars per serving. Results. No differences were found for weight, BMI, waist circumference, blood pressure, or lipids in children consuming PS-RTECs or NPS-RTECs. In children 12 to 17 years old, BMI and percentage of children overweight or obese were lower for consumers of PS-RTECs at breakfast compared with SK or OB groups. Skinfolds were significantly lower in PS-RTEC versus SK or OB groups. SK and OB children (12-17 years old) were nearly twice as likely to be overweight or obese as compared with children consuming PS-RTECs (odds ratio of 1.87 and 2.12, respectively). Conclusion. Consumption of breakfast cereal with higher or lower added sugar was not associated with unhealthy physiological end points in children. The study confirms the association between RTEC consumption and healthier body weights compared with children and adolescents skipping or consuming a non-RTEC breakfast.

Objective: The goal of this study was to simulate the application of the dietary recommendations to increase dietary fiber (DF)-containing foods. Methods: This study used 24-hour dietary recalls from NHANES 2003-2006 to model the impact of different approaches of increasing DF with current dietary patterns of US adults 19 + years: 1) increased all DF-containing foods by 10, 25, 50, or 100%; 2) increased DF content of low DF grain products to a good (2.5 g/serving) or an excellent source level (5.0 g/serving); and 3) increased intake of whole grain foods to meet the recommendation of one-half of total grain. Results: Increasing DF-containing foods by 10, 25, 50, or 100% increased DF intake to 16.9, 18.9, 22.1, and 29.5 g/d, respectively with a concomitant increase in energy of 104, 260, 521, 1042 kcal/d, respectively. Adding 2.5 or 5.0 g/serving DF to low DF grain foods to result in DF intakes of 24.7 and 39.1 g/day, respectively without increased energy. Increasing consumption of whole grain foods increased DF intake to 25.3 g/day but with an additional 1266 kcal/d. Conclusions: Adding additional DF to existing grain-based foods may be a reasonable approach to getting more DF, without increased energy, in the American diet.

Urinary tract infection (UTI), a common bacterial infection, occurs across myriad subject populations from individuals with bladder dysfunction to normal, healthy women. Cranberry has been used tra...

During heating, hundreds Maillard reaction products (MRPs) can form in foods that contain reducing sugars and amino nitrogen groups, which provide browning and positive sensory aspects to a food. R...

Nutrition labels in the U.S. currently use the term ‘dietary fiber’ to indicate the total amount of fiber in a product. FDA has asked for input on the consumer impact of changing the Nutrition Fact...

The FDA is proposing to update the Nutrition Facts Panel (NFP) to help consumers choose more nutrient-dense, lower calorie foods. One consideration in this proposal is including “added sugar” on th...

Over 90% of adults do not obtain the Adequate Intake (AI) for dietary fiber (DF). Using only reliable recalls in NHANES 2003–2006, we modeled the following changes to assess impact on usual DF inta...