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Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: a randomised cross-over trial.
Roager, HM, Vogt, JK, Kristensen, M, Hansen, LBS, Ibrügger, S, Mærkedahl, RB, Bahl, MI, Lind, MV, Nielsen, RL, Frøkiær, H, et al
Gut. 2019;68(1):83-93
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Plain language summary
Whole grain consumption has been linked with decreased risk of lifestyle-related diseases. While animal studies have shown the gut microbiome to be a mediator of metabolic health, human studies examining the effect of whole grain intake of the gut remain inconclusive. The aim of this study was to investigate the effects of a whole grain diet on the gut microbiome, gut functionality and biomarkers of metabolic health. In this randomised, controlled, crossover study, 50 participants completed two 8-week dietary intervention periods comprising of a whole grain diet and a refined grain diet with a 6-week washout period. Examinations were done at the beginning and end of each intervention period to assess anthropometry and various plasma and gut markers. This study found that a whole grain diet as compared with a refined grain diet reduced energy intake and body weight as well as circulating markers of inflammation. Contrary to the hypothesis, these benefits were all observed independent of changes in the gut microbiome. Based on these results, the authors conclude higher intake of whole grains should be recommended to those at risk of inflammation-related disease.
Abstract
OBJECTIVE To investigate whether a whole grain diet alters the gut microbiome and insulin sensitivity, as well as biomarkers of metabolic health and gut functionality. DESIGN 60 Danish adults at risk of developing metabolic syndrome were included in a randomised cross-over trial with two 8-week dietary intervention periods comprising whole grain diet and refined grain diet, separated by a washout period of ≥6 weeks. The response to the interventions on the gut microbiome composition and insulin sensitivity as well on measures of glucose and lipid metabolism, gut functionality, inflammatory markers, anthropometry and urine metabolomics were assessed. RESULTS 50 participants completed both periods with a whole grain intake of 179±50 g/day and 13±10 g/day in the whole grain and refined grain period, respectively. Compliance was confirmed by a difference in plasma alkylresorcinols (p<0.0001). Compared with refined grain, whole grain did not significantly alter glucose homeostasis and did not induce major changes in the faecal microbiome. Also, breath hydrogen levels, plasma short-chain fatty acids, intestinal integrity and intestinal transit time were not affected. The whole grain diet did, however, compared with the refined grain diet, decrease body weight (p<0.0001), serum inflammatory markers, interleukin (IL)-6 (p=0.009) and C-reactive protein (p=0.003). The reduction in body weight was consistent with a reduction in energy intake, and IL-6 reduction was associated with the amount of whole grain consumed, in particular with intake of rye. CONCLUSION Compared with refined grain diet, whole grain diet did not alter insulin sensitivity and gut microbiome but reduced body weight and systemic low-grade inflammation. TRIAL REGISTRATION NUMBER NCT01731366; Results.
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A low-gluten diet induces changes in the intestinal microbiome of healthy Danish adults.
Hansen, LBS, Roager, HM, Søndertoft, NB, Gøbel, RJ, Kristensen, M, Vallès-Colomer, M, Vieira-Silva, S, Ibrügger, S, Lind, MV, Mærkedahl, RB, et al
Nature communications. 2018;(1):4630
Abstract
Adherence to a low-gluten diet has become increasingly common in parts of the general population. However, the effects of reducing gluten-rich food items including wheat, barley and rye cereals in healthy adults are unclear. Here, we undertook a randomised, controlled, cross-over trial involving 60 middle-aged Danish adults without known disorders with two 8-week interventions comparing a low-gluten diet (2 g gluten per day) and a high-gluten diet (18 g gluten per day), separated by a washout period of at least six weeks with habitual diet (12 g gluten per day). We find that, in comparison with a high-gluten diet, a low-gluten diet induces moderate changes in the intestinal microbiome, reduces fasting and postprandial hydrogen exhalation, and leads to improvements in self-reported bloating. These observations suggest that most of the effects of a low-gluten diet in non-coeliac adults may be driven by qualitative changes in dietary fibres.
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Second meal effect on appetite and fermentation of wholegrain rye foods.
Ibrügger, S, Vigsnæs, LK, Blennow, A, Skuflić, D, Raben, A, Lauritzen, L, Kristensen, M
Appetite. 2014;:248-56
Abstract
BACKGROUND Wholegrain rye has been associated with decreased hunger sensations. This may be partly mediated by colonic fermentation. Sustained consumption of fermentable components is known to change the gut microflora and may increase numbers of saccharolytic bacteria. OBJECTIVE To investigate the effect of wholegrain rye consumption on appetite and colonic fermentation after a subsequent meal. METHODS In a randomized, controlled, three-arm cross-over study, twelve healthy male subjects consumed three iso-caloric evening test meals. The test meals were based on white wheat bread (WBB), wholegrain rye kernel bread (RKB), or boiled rye kernels (RK). Breath hydrogen excretion and subjective appetite sensation were measured before and at 30 min intervals for 3 h after a standardized breakfast in the subsequent morning. After the 3 h, an ad libitum lunch meal was served to assess energy intake. In an in vitro study, RKB and RK were subjected to digestion and 24 h-fermentation in order to study SCFA production and growth of selected saccharolytic bacteria. RESULTS The test meals did not differ in their effect on parameters of subjective appetite sensation the following day. Ad libitum energy intake at lunch was, however, reduced by 11% (P < 0.01) after RKB and 7% (P < 0.05) after RK compared with after WWB evening meal. Breath hydrogen excretion was significantly increased following RKB and RK evening meals compared with WWB (P < 0.01 and P < 0.05, respectively). Overall, RKB and RK were readily fermented in vitro and exhibited similar fermentation profiles, although total SCFA production was higher for RK compared with RKB (P < 0.001). In vitro fermentation of RKB and RK both increased the relative quantities of Bifidobacterium and decreased Bacteroides compared with inoculum (P < 0.001). The C. coccoides group was reduced after RKB (P < 0.001). CONCLUSION Consumption of wholegrain rye products reduced subsequent ad libitum energy intake in young healthy men, possibly mediated by mechanisms related to colonic fermentation.
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Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study.
De Craemer, M, De Decker, E, De Bourdeaudhuij, I, Verloigne, M, Duvinage, K, Koletzko, B, Ibrügger, S, Kreichauf, S, Grammatikaki, E, Moreno, L, et al
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2014;:14-26
Abstract
Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers.
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Developing the intervention material to increase physical activity levels of European preschool children: the ToyBox-study.
Duvinage, K, Ibrügger, S, Kreichauf, S, Wildgruber, A, De Craemer, M, De Decker, E, Androutsos, O, Lateva, M, Iotova, V, Socha, P, et al
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2014;:27-39
Abstract
Early childhood is an important period for adopting positive health-related behaviours. More than 95% of European preschool children attend kindergartens, making these settings ideal for the implementation of health promotion interventions. The ToyBox-intervention addressed preschool children, their parents/caregivers and teachers. The aim of the intervention was to improve four energy balance-related behaviours (i.e. healthy snacking, water consumption, physical activity and sedentary behaviour) by implementing a kindergarten-based, family-involved intervention in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). The intervention material was developed following the intervention mapping protocol, taking into account local and cultural differences among the intervention countries. The present paper focuses on the development of the physical activity component of the intervention. Parental involvement was addressed by providing parents/caregivers with two newsletters, two tip cards and a poster. Teachers received a handbook with guidance on environmental changes in the classroom, 26 physical education sessions and suggestions for fun, interactive classroom activities aiming at total class participation to increase preschoolers' physical activity levels. The ToyBox-intervention material was distributed according to a standard time frame. Teachers received their material prior to the start of the intervention and parents/caregivers received their material during the intervention when each energy balance-related behaviour was implemented.
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Extracted oat and barley β-glucans do not affect cholesterol metabolism in young healthy adults.
Ibrügger, S, Kristensen, M, Poulsen, MW, Mikkelsen, MS, Ejsing, J, Jespersen, BM, Dragsted, LO, Engelsen, SB, Bügel, S
The Journal of nutrition. 2013;(10):1579-85
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Abstract
β-Glucans are known to exhibit hypocholesterolemic effects. Increased intestinal viscosity is thought to be crucial for cholesterol lowering. It is suggested that concentration, molecular mass, and structure, including the ratio of (1→3) to (1→4) glucan bonds in the molecule, are of importance for β-glucan functionality. This study investigated the effects of 3 different β-glucan sources, incorporated into a beverage and yogurt, on blood lipids and fecal endpoints. Fourteen participants completed this randomized, crossover, single-blinded study with four 3-wk periods: control and 3.3 g/d oat, barley, and barley mutant β-glucans of similar molecular mass. Before and after each period, fasting and postprandial blood samples were drawn and 3-d fecal samples were collected. Treatment did not affect changes in total, LDL, and HDL cholesterol compared with control; however, consumption of 3.3 g/d of oat β-glucans for 3 wk resulted in greater decreases in total (-0.29 ± 0.09 mmol/L, P < 0.01), LDL (-0.23 ± 0.07 mmol/L, P < 0.01), and HDL (-0.05 ± 0.03 mmol/L, P < 0.05) cholesterol compared with baseline. Changes in LDL in the β-glucan treatments were not related to β-glucan structure (cellotriosyl:cellotetraosyl). Decreases in fasting triacylglycerol were substantially greater after oat β-glucan treatment compared with control (P = 0.03). Fecal dry and wet weight, stool frequency, fecal pH, and energy excretion were unaffected. The results do not fully support the hypocholesterolemic effects by differently structured oat and barley β-glucans. However, substantial differences compared with baseline suggest a potential for oat β-glucan, presumably due to its higher solubility and viscosity. This underlines the importance of elusive structural β-glucan features for beneficial physiologic effects.
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Flaxseed dietary fiber supplements for suppression of appetite and food intake.
Ibrügger, S, Kristensen, M, Mikkelsen, MS, Astrup, A
Appetite. 2012;(2):490-5
Abstract
UNLABELLED We conducted two single-blinded randomized crossover acute studies with 24 and 20 subjects, respectively, to compare (I) CONTROL vs. Flax drink; and (II) Flax drink vs. Flax tablets. The subjects were exposed to one of the treatments after an overnight fast, and rated appetite sensation for 120 min using visual analog scales (VAS). Hereafter they consumed an ad libitum early lunch to assess energy intake. The treatments were iso-caloric and iso-volumeric: CONTROL 300 mL drink; Flax drink: CONTROL drink with addition flax fiber extract (2.5 g of soluble fibers); and Flax tablet: CONTROL drink with flax fiber tablets (2.5 g of soluble fibers). Flax drink increased sensation of satiety and fullness compared to CONTROL and a significant decrease in subsequent energy intake was observed after the Flax drink compared to CONTROL (2937 vs. 3214 kJ). Appetite ratings were similar for Flax tablets and Flax drink as they did not differ by more than 1-4%. Subsequent energy intake was similar after the two treatments (3370 vs. 3379 kJ). A small dose of flaxseed fiber significantly suppresses appetite and energy intake. Furthermore, flaxseed fibers administered as drinks or tablets produce similar responses.