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1.
Blueberry anthocyanin intake attenuates the postprandial cardiometabolic effect of an energy-dense food challenge: Results from a double blind, randomized controlled trial in metabolic syndrome participants.
Curtis, PJ, Berends, L, van der Velpen, V, Jennings, A, Haag, L, Chandra, P, Kay, CD, Rimm, EB, Cassidy, A
Clinical nutrition (Edinburgh, Scotland). 2022;(1):165-176
Abstract
BACKGROUND & AIMS Whilst the cardioprotective effects of blueberry intake have been shown in prospective studies and short-term randomized controlled trials (RCTs), it is unknown whether anthocyanin-rich blueberries can attenuate the postprandial, cardiometabolic dysfunction which follows energy-dense food intakes; especially in at-risk populations. We therefore examined whether adding blueberries to a high-fat/high-sugar meal affected the postprandial cardiometabolic response over 24 h. METHODS A parallel, double-blind RCT (n = 45; age 63.4 ± 7.4 years; 64% male; BMI 31.4 ± 3.1 kg/m2) was conducted in participants with metabolic syndrome. After baseline assessments, an energy-dense drink (969 Kcals, 64.5 g fat, 84.5 g carbohydrate, 17.9 g protein) was consumed with either 26 g (freeze-dried) blueberries (equivalent to 1 cup/150 g fresh blueberries) or 26 g isocaloric matched placebo. Repeat blood samples (30, 60, 90, 120, 180, 360 min and 24 h), a 24 h urine collection and vascular measures (at 3, 6, and 24 h) were performed. Insulin and glucose, lipoprotein levels, endothelial function (flow mediated dilatation (FMD)), aortic and systemic arterial stiffness (pulse wave velocity (PWV), Augmentation Index (AIx) respectively), blood pressure (BP), and anthocyanin metabolism (serum and 24 h urine) were assessed. RESULTS Blueberries favorably affected postprandial (0-24 h) concentrations of glucose (p < 0.001), insulin (p < 0.01), total cholesterol (p = 0.04), HDL-C, large HDL particles (L-HDL-P) (both p < 0.01), extra-large HDL particles (XL-HDL-P; p = 0.04) and Apo-A1 (p = 0.01), but not LDL-C, TG, or Apo-B. After a transient higher peak glucose concentration at 1 h after blueberry intake ([8.2 mmol/L, 95%CI: 7.7, 8.8] vs placebo [6.9 mmol/L, 95%CI: 6.4, 7.4]; p = 0.001), blueberries significantly attenuated 3 h glucose ([4.3 mmol/L, 95%CI: 3.8, 4.8] vs placebo [5.1 mmol/L, 95%CI: 4.6, 5.6]; p = 0.03) and insulin concentrations (blueberry: [23.4 pmol/L, 95%CI: 15.4, 31.3] vs placebo [52.9 pmol/L, 95%CI: 41.0, 64.8]; p = 0.0001). Blueberries also improved HDL-C ([1.12 mmol/L, 95%CI: 1.06, 1.19] vs placebo [1.08 mmol/L, 95%CI: 1.02, 1.14]; p = 0.04) at 90 min and XL-HDLP levels ([0.38 × 10-6, 95%CI: 0.35, 0.42] vs placebo [0.35 × 10-6, 95%CI: 0.32, 0.39]; p = 0.02) at 3 h. Likewise, significant improvements were observed 6 h after blueberries for HDL-C ([1.17 mmol/L, 95%CI: 1.11, 1.24] vs placebo [1.10 mmol/L, 95%CI: 1.03, 1.16]; p < 0.001), Apo-A1 ([1.37 mmol/L, 95%CI: 1.32, 1.41] vs placebo [1.31 mmol/L, 95%CI: 1.27, 1.35]; p = 0.003), L-HDLP ([0.70 × 10-6, 95%CI: 0.60, 0.81] vs placebo [0.59 × 10-6, 95%CI: 0.50, 0.68]; p = 0.003) and XL-HDLP ([0.44 × 10-6, 95%CI: 0.40, 0.48] vs placebo [0.40 × 10-6, 95%CI: 0.36, 0.44]; p < 0.001). Similarly, total cholesterol levels were significantly lower 24 h after blueberries ([4.9 mmol/L, 95%CI: 4.6, 5.1] vs placebo [5.0 mmol/L, 95%CI: 4.8, 5.3]; p = 0.04). Conversely, no effects were observed for FMD, PWV, AIx and BP. As anticipated, total anthocyanin-derived phenolic acid metabolite concentrations significantly increased in the 24 h after blueberry intake; especially hippuric acid (6-7-fold serum increase, 10-fold urinary increase). In exploratory analysis, a range of serum/urine metabolites were associated with favorable changes in total cholesterol, HDL-C, XL-HDLP and Apo-A1 (R = 0.43 to 0.50). CONCLUSIONS For the first time, in an at-risk population, we show that single-exposure to the equivalent of 1 cup blueberries (provided as freeze-dried powder) attenuates the deleterious postprandial effects of consuming an energy-dense high-fat/high-sugar meal over 24 h; reducing insulinaemia and glucose levels, lowering cholesterol, and improving HDL-C, fractions of HDL-P and Apo-A1. Consequently, intake of anthocyanin-rich blueberries may reduce the acute cardiometabolic burden of energy-dense meals. CLINICAL TRIAL REGISTRY NCT02035592 at www.clinicaltrials.gov.
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2.
Fat-rich versus carbohydrate-rich nutrition in ALS: a randomised controlled study.
Dorst, J, Doenz, J, Kandler, K, Dreyhaupt, J, Tumani, H, Witzel, S, Schuster, J, Ludolph, AC
Journal of neurology, neurosurgery, and psychiatry. 2022;(3):298-302
Abstract
OBJECTIVE There is growing evidence that the course of amyotrophic lateral sclerosis (ALS) may be influenced beneficially by applying high-caloric food supplements (HCSs). However, it is unknown which composition of nutrients offers optimal tolerability and weight gain. METHODS We conducted a randomised controlled study (Safety and Tolerability of Ultra-high-caloric Food Supplements in Amyotrophic Lateral Sclerosis (ALS); TOLCAL-ALS study) in 64 patients with possible, probable or definite ALS according to El Escorial criteria. Patients were randomised into four groups: a high-caloric fatty supplement (HCFS; 405 kcal/day, 100% fat), an ultra-high-caloric fatty supplement (UHCFS; 810 kcal/day, 100% fat), an ultra-high-caloric, carbohydrate-rich supplement (UHCCS; 900 kcal/day, 49% carbohydrates) and an open control (OC) group without any supplement. The primary endpoint was tolerability. Patients were followed up over 4 weeks. RESULTS Gastrointestinal side effects were most frequent in the UHCFS group (75.0%), while loss of appetite was most frequent in the UHCCS group (35.3%). During intervention, patients gained +0.9 kg/month of body weight (IQR -0.9 to 1.5; p=0.03) in the HCFS group and +0.9 kg/month (IQR -0.8 to 2.0; p=0.05) in the UHCFS group. A non-significant trend for weight gain (+0.6 kg/month (IQR -0.3 to 1.9; p=0.08)) was observed in the UHCCS group. Patients in OC group continued to lose body weight (-0.5 kg/month, IQR -1.4 to 1.3; p=0.42). INTERPRETATION The findings suggest that HCSs frequently cause mild to moderate tolerability issues in patients with ALS, most notably gastrointestinal symptoms in high-fat supplements, and loss of appetite in high-carbohydrate supplements. All three HCSs tested are suited to increase body weight.
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3.
The Impact of Low Energy Availability on Nonexercise Activity Thermogenesis and Physical Activity Behavior in Recreationally Trained Adults.
Martin, A, Hofmann, H, Drenowatz, C, Wallmann-Sperlich, B, Sperlich, B, Koehler, K
International journal of sport nutrition and exercise metabolism. 2021;(4):329-336
Abstract
Energy availability describes the amount of dietary energy remaining for physiological functionality after the energy cost of exercise is deducted. The physiological and hormonal consequences of low energy availability (LEA) are well established, but the impact of LEA on physical activity behavior outside of exercise and, specifically, nonexercise activity thermogenesis (NEAT) has not been systematically examined. The authors conducted a secondary analysis of a repeated-measures crossover study in which recreationally trained young men (n = 6, 25 ± 1.0 years) underwent two 4-day conditions of LEA (15 kcal·kg fat-free mass-1 ·day-1) with and without endurance exercise (LEA + EX and LEA EX) and two energy-balanced control conditions (CON + EX and CON EX). The duration and intensity of physical activity outside of prescribed exercise were assessed using the SenseWear Pro3 armband. LEA did not alter NEAT (p = .41), nor time spent in moderate to vigorous (p = .20) and low-intensity physical activity (p = .17). However, time spent in low-intensity physical activity was lower in LEA + EX than LEA - EX (13.7 ± 0.3 vs. 15.2 ± 0.3 hr/day; p = .002). Short-term LEA does not seem to impact NEAT per se, but the way it is attained may impact physical activity behavior outside of exercise. As the participants expended similar amounts of energy during NEAT (900-1,300 kcal/day = 12.5-18.0 kcal·kg fat-free mass-1·day-1) and prescribed exercise bouts (15.0 kcal·kg fat-free mass-1·day-1), excluding it as a component of energy expenditure may skew the true energy available for physiological functionality in active populations.
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4.
Protein intake, weight loss, dietary intervention, and worsening of quality of life in older patients during chemotherapy for cancer.
Regueme, SC, Echeverria, I, Monéger, N, Durrieu, J, Becerro-Hallard, M, Duc, S, Lafargue, A, Mertens, C, Laksir, H, Ceccaldi, J, et al
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2021;(2):687-696
Abstract
Decreased health-related quality of life (HRQoL) is common in patients with cancer. We investigated the effects of dietary intervention and baseline nutritional status on worsening of HRQoL in older patients during chemotherapy. In this randomized control trial assessing the effect on mortality of dietary advice to increase dietary intake during chemotherapy, this post hoc analysis included 155 patients with cancer at risk of malnutrition. The effects of dietary intervention, baseline Mini Nutritional Assessment item scores, weight loss, and protein and energy intake before treatment on the worsening of HRQoL (physical functioning, fatigue) and secondary outcomes (Timed Up and Go test, one-leg stance time, depressive symptoms, basic (ADL), or instrumental (IADL) activities of daily living) were analyzed by multinomial regressions. Dietary intervention increased total energy and protein intake but had no effect on any examined outcomes. Worsening of fatigue and ADL was predicted by very low protein intake (< 0.8 g kg-1 day-1) before chemotherapy (OR 3.02, 95% CI 1.22-7.46, p = 0.018 and OR 5.21, 95% CI 1.18-22.73, p = 0.029 respectively). Increase in depressive symptomatology was predicted by 5.0-9.9% weight loss before chemotherapy (OR 2.68, 95% CI 1.10-6.80, p = 0.038). Nutritional intervention to prevent HRQoL decline during chemotherapy should focus on patients with very low protein intake along with those with weight loss.
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5.
The Effect of the Low FODMAP Diet on Gastrointestinal Symptoms, Behavioral Problems and Nutrient Intake in Children with Autism Spectrum Disorder: A Randomized Controlled Pilot Trial.
Nogay, NH, Walton, J, Roberts, KM, Nahikian-Nelms, M, Witwer, AN
Journal of autism and developmental disorders. 2021;(8):2800-2811
Abstract
Some research suggests that GI symptoms seen in children with ASD may relate to behavior problems. The objective of this pilot study was to assess the effect of the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet on GI and behavioral problems in children with ASD. At follow-up, the low FODMAP diet group had significant relief in some GI problems compared with both baseline in the group and control group. At baseline and at follow-up, there were no significant differences in behavioral problems between the low FODMAP diet group and the control group. Randomized controlled studies including larger sample sizes are needed to confirm the effects of low FODMAP diets in children with autism who have gastrointestinal problems.
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6.
Effects of 8 wk of 16:8 Time-restricted Eating in Male Middle- and Long-Distance Runners.
Brady, AJ, Langton, HM, Mulligan, M, Egan, B
Medicine and science in sports and exercise. 2021;(3):633-642
Abstract
PURPOSE Eight weeks of time-restricted eating (TRE) in concert with habitual exercise training was investigated for effects on body composition, energy and macronutrient intakes, indices of endurance running performance, and markers of metabolic health in endurance athletes. METHODS Male middle- and long-distance runners (n = 23) were randomly assigned to TRE (n = 12) or habitual dietary intake (CON; n = 11). TRE required participants to consume all of their dietary intake within an 8-h eating window (so-called 16:8 TRE), but dietary patterns, food choices, and energy intake were ad libitum during this window. Participants continued their habitual training during the intervention period. Participants completed an incremental exercise test before (PRE) and after (POST) the 8-wk intervention for the assessment of blood lactate concentrations, running economy, and maximal oxygen uptake. Fasted blood samples were analyzed for glucose, insulin, and triglyceride concentrations. Dietary intake was assessed at PRE, MID (week 4), and POST using a 4-d semiweighed food diary. RESULTS Seventeen participants (TRE, n = 10; CON, n = 7) completed the intervention. Training load did not differ between groups for the duration of the intervention period. TRE resulted in a reduction in body mass (mean difference of -1.92 kg, 95% confidence interval = -3.52 to -0.32, P = 0.022). Self-reported daily energy intake was lower in TRE at MID and POST (group-time interaction, P = 0.049). No effect of TRE was observed for oxygen consumption, respiratory exchange ratio, running economy, blood lactate concentrations, or heart rate during exercise, nor were there any effects on glucose, insulin, or triglyceride concentrations observed. CONCLUSION Eight weeks of 16:8 TRE in middle- and long-distance runners resulted in a decrease in body mass commensurate with a reduction in daily energy intake, but it did not alter indices of endurance running performance or metabolic health.
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7.
The effect of dairy products and non-dairy snacks on food intake, subjective appetite and cortisol levels in children: a randomized control study.
Gheller, BJF, Li, AC, Gheller, ME, Armstrong, T, Vandenboer, E, Bellissimo, N, Anini, Y, Hamilton, J, Nunes, F, Mollard, RC, et al
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2021;(9):1097-1104
Abstract
Dairy snacks are available in various physical forms and their consumption is linked to improved metabolic health. The objective of this study was to determine the effect of dairy snacks of different physical forms on short-term food intake (FI), subjective appetite, and the stress hormone, cortisol, in children. Following a repeated-measures crossover design, 40 children aged 9-14 years randomly consumed 1 of 5 isoenergetic (180 kcal) snacks per study session. These snacks included solid (potato chips, cookies, and cheese), semi-solid (Greek yogurt), and fluid (2% fat milk) snacks. FI was measured 120 min after snack consumption. Subjective appetite was measured at 0 (immediately before the snack), 15, 30, 45, 60, 90, and 120 min. Salivary cortisol (n = 18) was measured after the Greek yogurt and cookie snacks at 0, 30, 60, 90, and 120 min. FI did not differ between snacks (P = 0.15). The Greek yogurt (P < 0.0001) and cheese (P = 0.0009) snacks reduced average appetite compared with the 2% fat milk snack. Salivary cortisol levels were not affected by snack (P = 0.84). This study demonstrates that dairy snacks are as effective as other popular snacks at influencing subsequent FI. However, solid and semi-solid dairy snacks are more effective at repressing subjective appetite than a fluid dairy snack. Registered at ClinicalTrials.gov (NCT02484625). Novelty: Milk, Greek yogurt and cheese have a similar effect on short-term food intake in children as popular potato chips and cookie snacks. Solid, semi-solid and liquid snacks have a similar effect on short-term food intake in children.
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8.
Breakfast Consumption Suppresses Appetite but Does Not Increase Daily Energy Intake or Physical Activity Energy Expenditure When Compared with Breakfast Omission in Adolescent Girls Who Habitually Skip Breakfast: A 7-Day Randomised Crossover Trial.
Zakrzewski-Fruer, JK, Seall, C, Tolfrey, K
Nutrients. 2021;(12)
Abstract
With concerns that adolescent girls often skip breakfast, this study compared the effects of breakfast consumption versus breakfast omission on free-living physical activity (PA) energy expenditure (PAEE) and dietary intakes among adolescent girls classified as habitual breakfast skippers. The participants went through two 7-day conditions in a trial with a crossover design: daily standardised breakfast consumption (energy content: 25% of resting metabolic rate) before 09:00 (BC) and daily breakfast omission (no energy-providing nutrients consumed) until 10:30 (BO). Free-living PAEE, dietary intakes, and perceived appetite, tiredness, and energy levels were assessed. Analyses were linear mixed models. Breakfast manipulation did not affect PAEE or PA duration. Daily fibre intake was higher (p = 0.005; d = 1.31), daily protein intake tended to be higher (p = 0.092; d = 0.54), post-10:30 carbohydrate intake tended to be lower (p = 0.096; d = 0.41), and pre-10:30 hunger and fullness were lower and higher, respectively (p ≤ 0.065; d = 0.33-1.01), in BC versus BO. No other between-condition differences were found. Breakfast-skipping adolescent girls do not compensate for an imbalance in energy intake caused by breakfast consumption versus omission through subsequent changes in PAEE but may increase their carbohydrate intakes later in the day to partially compensate for breakfast omission. Furthermore, breakfast can make substantial contributions to daily fibre intake among adolescent girls.
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9.
Low Energy Availability with and without a High-Protein Diet Suppresses Bone Formation and Increases Bone Resorption in Men: A Randomized Controlled Pilot Study.
Murphy, C, Bilek, LDD, Koehler, K
Nutrients. 2021;(3)
Abstract
Suppression of insulin-like growth factor 1 (IGF-1) and leptin secondary to low energy availability (LEA) may contribute to adverse effects on bone health. Whether a high-protein diet attenuates these effects has not been tested. Seven men completed three five-day conditions operationally defined as LEA (15 kcal kg fat-free mass (FFM)-1 day-1) with low protein (LEA-LP; 0.8 g protein·kg body weight (BW)-1), LEA with high protein (LEA-HP; 1.7 g protein·kg BW-1) and control (CON; 40 kcal·kg FFM-1·day-1, 1.7 g protein·kg BW-1). In all conditions, participants expended 15 kcal·kg FFM-1·day-1 during supervised cycling sessions. Serum samples were analyzed for markers of bone turnover, IGF-1 and leptin. The decrease in leptin during LEA-LP (-65.6 ± 4.3%) and LEA-HP (-54.3 ± 16.7%) was greater than during CON (-25.4 ± 11.4%; p = 0.02). Decreases in P1NP (p = 0.04) and increases in CTX-I (p = 0.04) were greater in LEA than in CON, suggesting that LEA shifted bone turnover in favour of bone resorption. No differences were found between LEA-LP and LEA-HP. Thus, five days of LEA disrupted bone turnover, but these changes were not attenuated by a high-protein diet.
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10.
Short-Term Protein Supplementation Does Not Alter Energy Intake, Macronutrient Intake and Appetite in 50-75 Year Old Adults.
Tuttiett, ER, Green, DJ, Stevenson, EJ, Hill, TR, Corfe, BM, Williams, EA
Nutrients. 2021;(5)
Abstract
Ageing is associated with a reduction in muscle mass and strength, termed sarcopenia. Dietary protein is important for the maintenance of muscle mass through the promotion of muscle protein synthesis. However, protein is also reported to be a highly satiating nutrient. This raises concerns that protein intake for musculoskeletal health reasons in older adults may exacerbate age-related decreased appetite and may result in reduced energy and nutrient intake. This study aimed to investigate the effect of short-term protein supplementation and its timing (morning vs. evening), on energy and nutrient intake and appetite measures in middle-older age adults. Twenty-four 50-75 year olds were recruited to a randomised cross-over trial. In phase 1 (pre-supplementation) participants completed a food diary and reported hunger and appetite on three alternate days. During the second and third phases, participants consumed a 20 g whey protein gel (78 mL/368 kJ), for four days, either in the morning (after breakfast) or the evening (before bed), whilst completing the same assessments as phase 1. No differences in dietary intakes of energy, macronutrients and micronutrients were recorded when comparing the pre-supplementation phase to the protein supplementation phases, irrespective of timing (excluding the contribution of the protein supplement itself). Similarly, no differences were observed in self-reported feelings of hunger and appetite. In conclusion, a 20 g/day whey protein supplement given outside of meal-times did not alter habitual dietary intakes, hunger or appetite in this middle-older age adult population in the short-term. This approach may be a useful strategy to increasing habitual protein intake in the middle-older age population.