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Nutrients Nov 2020Liver lipid accumulation is a hallmark of non-alcoholic fatty liver disease (NAFLD), broadly associated with insulin resistance. Inositols (INS) are ubiquitous polyols...
Liver lipid accumulation is a hallmark of non-alcoholic fatty liver disease (NAFLD), broadly associated with insulin resistance. Inositols (INS) are ubiquitous polyols implied in many physiological functions. They are produced endogenously, are present in many foods and in dietary supplements. Alterations in INS metabolism seems to play a role in diseases involving insulin resistance such as diabetes and polycystic ovary syndrome. Given its role in other metabolic syndromes, the hypothesis of an INS role as a supplement in NAFLD is intriguing. We performed a systematic review of the literature to find preclinical and clinical evidence of INS supplementation efficacy in NAFLD patients. We retrieved 10 studies on animal models assessing Myoinosiol or Pinitol deficiency or supplementation and one human randomized controlled trial (RCT). Overall, INS deficiency was associated with increased fatty liver in animals. Conversely, INS supplementation in animal models of fatty liver reduced hepatic triglycerides and cholesterol accumulation and maintained a normal ultrastructural liver histopathology. In the one included RCT, Pinitol supplementation obtained similar results. Pinitol significantly reduced liver fat, post-prandial triglycerides, AST levels, lipid peroxidation increasing glutathione peroxidase activity. These results, despite being limited, indicate the need for further evaluation of INS in NAFLD in larger clinical trials.
Topics: Animals; Cholesterol; Dietary Supplements; Female; Glutathione Peroxidase; Humans; Inositol; Insulin Resistance; Lipid Peroxidation; Liver; Male; Non-alcoholic Fatty Liver Disease; Postprandial Period; Randomized Controlled Trials as Topic; Treatment Outcome; Triglycerides
PubMed: 33153126
DOI: 10.3390/nu12113379 -
The Journal of Nutrition Nov 2019It is often assumed that lower postprandial glucose (PPG) and insulin (PPI) responses are induced by slower glucose influx from the gut (e.g., by delayed carbohydrate... (Meta-Analysis)
Meta-Analysis
BACKGROUND
It is often assumed that lower postprandial glucose (PPG) and insulin (PPI) responses are induced by slower glucose influx from the gut (e.g., by delayed carbohydrate digestion). However, changes in the rate of appearance of glucose in the peripheral circulation [rate of appearance of exogenous glucose (RaE)] may be accompanied by changes in endogenous glucose production (EGP) and the rate of disappearance of total glucose into tissues (RdT). The quantitative relationships between reductions in RaE and PPG/PPI levels are unclear.
OBJECTIVES
The objective was to perform a meta-analysis to quantify the effect of changes in RaE on changes in PPG and PPI levels (primary) and EGP and RdT (secondary).
METHODS
We systematically searched the Scopus, Medline, and Cochrane library databases through 10 January 2019 for randomized, controlled, carbohydrate-rich interventions that aimed to reduce RaE in humans, measured using dual or triple stable isotope methods. The 2-h net incremental AUCs for all variables were extracted or calculated. Relationships between RaE and outcomes were quantified by weighted regression analyses.
RESULTS
There were 12 articles, including 17 comparisons, that satisfied the inclusion criteria. The subjects were mainly men (60%), with age and BMI ranges of 18-40 y and 20.0-27.5 kg/m2, respectively. A 10% reduction in RaE was associated with reductions in PPG levels, PPI levels, and the RdT of 7% (95% CI: 2%, 12%; P = 0.010), 8% (95% CI: 2%, 13%; P = 0.012), and 11% (95% CI: 4%, 17%; P = 0.005), respectively, but was not significantly associated with a change in EGP (13%; 95% CI: -7%, 33%; P = 0.176). All fluxes together explained 70% and 26% of the variances in PPG and PPI levels, respectively.
CONCLUSIONS
In adults, reducing glucose RaE by diet is associated with significant reductions in PPG levels, PPI levels, and the rate of glucose disposal. This trial was registered in the PROSPERO database with identifier CRD42018084824.
Topics: Adult; Dietary Carbohydrates; Glucose; Humans; Insulin; Isotopes; Kinetics; Postprandial Period
PubMed: 31291451
DOI: 10.1093/jn/nxz150 -
Obesity Surgery Aug 2019The effect of bariatric surgery on the glycemic control of patients with obesity and type 2 diabetes mellitus is obvious. However, the effect in patients with body mass... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The effect of bariatric surgery on the glycemic control of patients with obesity and type 2 diabetes mellitus is obvious. However, the effect in patients with body mass index (BMI) < 30 kg/m especially Asian population has not been widely reported and acknowledged.
METHODS
We performed a literature search in Medline, Embase, and the Cochrane Library from January 2000 to March 2018. All the studies involving the effect of bariatric surgery on patients with type 2 diabetes and BMI < 30 kg/m from Asian countries or regions were included in this meta-analysis.
RESULTS
Twelve studies including 697 patients were examined in this meta-analysis. Clinical indexes in 6, 12, and 24 months follow-up were analyzed, respectively. BMI and waist circumference reduced by 2.88 kg/m and 12.92 cm, respectively, at 12 months postoperatively. There were reductions in fasting plasma glucose, 2-h postprandial plasma glucose, and glycated hemoglobin A1c at all the three time points after surgery, 3.13 mmol/L, 5.46 mmol/L, and 2.13% at 6 months; 3.22 mmol/L, 6.46 mmol/L, and 2.38% at 12 months; 1.99 mmol/L, 5.84 mmol/L, and 1.58% at 2 years. Insulin only reduced by 1.70 μU/ml at 12 months. C-peptide reduced by 0.70 ng/ml and 0.40 ng/ml at 6 months and 2 years. Bariatric surgery led to reduction in total cholesterol, triglyceride, and low-density lipoprotein cholesterol, while augment in high-density lipoprotein cholesterol at 6 and 12 months. Glucagon-like peptide 1 increased by 2.48 pmol/L and 4.00 pmol/L at half a year 1 year.
CONCLUSIONS
Asian patients with type 2 diabetes and BMI < 30 kg/m could achieve significant improvement in weight, glycemic control, lipid profiles, and β-cell function in short and medium terms after bariatric surgery, but long-term follow-up is necessary to evaluate the effectiveness.
Topics: Asian People; Bariatric Surgery; Blood Glucose; Body Mass Index; C-Peptide; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Humans; Insulin; Lipids; Postoperative Period; Waist Circumference
PubMed: 30972637
DOI: 10.1007/s11695-019-03861-0 -
Frontiers in Nutrition 2021Most milk consumed by humans undergoes heat treatment to ensure microbiological safety and extend shelf life. Although heat treatment impacts the structure and...
Most milk consumed by humans undergoes heat treatment to ensure microbiological safety and extend shelf life. Although heat treatment impacts the structure and physiochemical properties of milk, effects on nutrient absorption in humans are unclear. Therefore, a rapid review was performed to identify studies conducted on healthy human adult subjects that have assessed the impacts of heat treatment of milk on protein and fat digestion and metabolism in the postprandial period (up to 24 h). Relevant databases (Medline, EMBASE, Cochrane, Scopus) were systematically screened for intervention studies on healthy adult men and women that assessed the impact of consuming heat-treated milk on the postprandial kinetics or appearance in peripheral circulation or urine of ingested proteins and/or lipids. The risk-of-bias assessment tool 2 was used for quality assessment. Of 511 unique database records, 4 studies were included encompassing 6 study treatments ( = 57 participants, 20-68 years). Three studies evaluated pasteurization, two evaluated ultra-high temperature (UHT) treatment, and one evaluated oven-heated milk. Protein and lipid appearances in peripheral blood were reported in two sets of two studies. None of the studies used the same heat treatments and outcome measures, limiting generalization of effects. Protein appearance (ng/mL or area under the curve) (as plasma amino acids - lysine) was reduced when milk was oven-heated for 5 h in one study ( = 7 participants), while the other study reported a reduced retention of dietary N with UHT milk ( = 25 participants). Overall plasma triacylglycerol responses were unaffected by milk heat treatments reported, but plasma fatty acid composition differed. The studies observed higher plasma myristic and palmitic acid abundance with successive heat treatment at 2 h ( = 11 participants; pasteurized) and 4 h ( = 14 participants; UHT) after ingestion; other differences were inconsistent. All studies had moderate-high risk of bias, which should be taken into consideration when interpreting findings. This review identified few studies reporting the effects of milk heat treatment on postprandial nutrient responses in adults. Although the findings suggest that milk heat treatment likely affects postprandial protein and lipid dynamics, generalization of the findings is limited as treatments, outcomes, and methods differed across studies. Because of the study variability, and the acute post-prandial nature of the studies, it is also difficult to draw conclusions regarding potential long-term health outcomes. However, the possibility that altered digestive kinetics may influence postprandial protein retention and anabolic use of dietary N suggests heat treatment of milk may impact outcomes such as long-term maintenance of muscle mass.
PubMed: 33996872
DOI: 10.3389/fnut.2021.643350 -
Nutrition (Burbank, Los Angeles County,... Mar 2020Low glycemic index (GI) diets are recommended to reduce the risk for chronic diseases by managing postprandial elevations in blood glucose and insulin. However, to our... (Meta-Analysis)
Meta-Analysis
Low glycemic index (GI) diets are recommended to reduce the risk for chronic diseases by managing postprandial elevations in blood glucose and insulin. However, to our knowledge, a systematic review of randomized controlled trials (RCTs) to investigate this relationship and interpret its clinical relevance has yet to be performed. This review aims to assess the effect of low versus high GI breakfast meals on postprandial glycemic and insulinemic responses in adults. Two researchers independently screened 1100 articles from PubMed, CINAHL, Medline, and Cochrane databases and extracted data from 11 qualified RCTs. Meta-analyses were performed to calculate overall effect sizes of postintervention blood glucose concentration change values at different time points (60, 90, and 120 min) using a random-effects model, reporting their weighted mean differences (WMDs) and 95% confidence intervals (CIs). Low GI breakfasts significantly reduced postprandial blood glucose concentrations at all time points: 60 min (WMD: -1.32 mmol/L; 95% CIs, -1.64 to -0.99), 90 min (WMD: -0.74 mmol/L; 95% CI, -0.92 to -0.56), and 120 min (WMD: -0.44 mmol/L; 95% CI, -0.63 to -0.26). Further analyses not only indicated similar trends following the stratification of studies according to the glycemic load, but also showed a more pronounced decline in glycemic response among individuals with metabolic impairments. These results highlight the benefits of lowering breakfast meal GI to provide clinically relevant reductions in acute glucose response.
Topics: Adult; Blood Glucose; Breakfast; Female; Glycemic Index; Glycemic Load; Humans; Insulin; Male; Postprandial Period; Randomized Controlled Trials as Topic
PubMed: 31838460
DOI: 10.1016/j.nut.2019.110634 -
Nutrients Jul 2020(MO) is a multipurpose plant consumed as food and known for its medicinal uses, among others. Leaves, seeds and pods are the main parts used as food or food...
(MO) is a multipurpose plant consumed as food and known for its medicinal uses, among others. Leaves, seeds and pods are the main parts used as food or food supplements. Nutritionally rich and with a high polyphenol content in the form of phenolic acids, flavonoids and glucosinolates, MO has been shown to exert numerous in vitro activities and in vivo effects, including hypoglycemic activity. A systematic search was carried out in the PubMed database and reference lists on the effects of MO on glucose metabolism. Thirty-three animal studies and eight human studies were included. Water and organic solvent extracts of leaves and, secondly, seeds, have been extensively assayed in animal models, showing the hypoglycemic effect, both under acute conditions and in long-term administrations and also prevention of other metabolic changes and complications associated to the hyperglycemic status. In humans, clinical trials are scarce, with variable designs and testing mainly dry leaf powder alone or mixed with other foods or MO aqueous preparations. Although the reported results are encouraging, especially those from postprandial studies, more human studies are certainly needed with more stringent inclusion criteria and a sufficient number of diabetic or prediabetic subjects. Moreover, trying to quantify the bioactive substances administered with the experimental material tested would facilitate comparison between studies.
Topics: Adult; Animals; Blood Glucose; Diabetes Mellitus; Diabetes Mellitus, Experimental; Dietary Supplements; Female; Humans; Hypoglycemic Agents; Lipid Metabolism; Male; Middle Aged; Moringa oleifera; Plant Extracts; Plant Leaves; Postprandial Period; Prediabetic State; Rats; Seeds; Young Adult
PubMed: 32664295
DOI: 10.3390/nu12072050 -
Clinical Nutrition (Edinburgh, Scotland) Nov 2020The aim of this study was to compare the metabolic benefits of diabetes-specific formulas (DSF) high in monounsaturated fatty acids (MUFA) with standard formulas (STDF)... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of this study was to compare the metabolic benefits of diabetes-specific formulas (DSF) high in monounsaturated fatty acids (MUFA) with standard formulas (STDF) in adult patients with type 1, type 2 diabetes or stress-induced hyperglycaemia.
RESEARCH DESIGN AND METHODS
A systematic review and meta-analysis were conducted through a literature search using different electronic databases from the index date to December 2018. We included randomised controlled trials that assessed the health benefits of high MUFA DSF vs STDF. Included outcomes were glycaemic control, lipid metabolism and tolerance. Effect sizes were calculated as standardised mean differences (SMDs) (<0.4 were considered small, 0.4-0.7 moderate and >0.7 large). This systematic review was registered as CRD42018108931 on Prospero.
RESULTS
Of 385 references reviewed, 18 studies involving 845 adults met our inclusion criteria and contributed to the meta-analysis. Use of a high MUFA DSF compared with a STDF was associated with a statistically significant decrease in peak of postprandial glucose [SMD -1.53, 95% confidence interval (CI) -2.44 to -0.61], incremental glucose response (SMD -1.19, 95% CI -1.71 to -0.68), area under the curve of plasma insulin (SMD -0.65, 95% CI -1.03 to -0.26), mean blood glucose level (SMD -0.41, 95% CI -0.63 to -0.19), glycosylated haemoglobin (HbA1c) change (SMD -0.63, 95% CI -1.21 to -0.05), glucose variability (SMD -0.93, -1.55 to -0.31), mean administered insulin dose (SMD -0.49, 95% CI -0.85 to -0.14), mean blood triglycerides (SMD -0.34, 95% CI -0.65 to -0.03) and increase of mean blood high-density lipoproteins (SMD +0.42, 95% CI 0.08 to 0.76). Non-significant differences were found for tolerance [odds ratio (OR) 0.95, 95% CI 0.87 to 1.05].
CONCLUSIONS
This meta-analysis shows that a DSF (oral supplements and tube feeds) high in MUFAs can improve glucose control and metabolic risk factors among patients with diabetes or stress-induced hyperglycaemia compared with a STDF.
Topics: Blood Glucose; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diet, Diabetic; Dietary Supplements; Enteral Nutrition; Fatty Acids, Monounsaturated; Food, Formulated; Glycated Hemoglobin; Glycemic Control; Humans; Hyperglycemia; Insulin; Lipid Metabolism; Postprandial Period; Randomized Controlled Trials as Topic
PubMed: 32222291
DOI: 10.1016/j.clnu.2020.02.036 -
International Journal of Food Sciences... Nov 2020Replacement of food rich in saturated fatty acids (SFAs) with unsaturated fatty acids (UFAs) is a well-known dietary strategy to reduce the risk of cardiovascular... (Meta-Analysis)
Meta-Analysis
Replacement of food rich in saturated fatty acids (SFAs) with unsaturated fatty acids (UFAs) is a well-known dietary strategy to reduce the risk of cardiovascular disease while its impact on postprandial blood lipids is less examined. This study assessed the effects of fatty acids composition on the postprandial triglycerides and cholesterol responses. Seventeen randomised controlled trials were identified and pooled analysis results revealed that consumption of a UFAs-rich or an SFAs-rich breakfast meal did not acutely affect postprandial triglycerides and cholesterol responses. However, subgroup analysis observed that triglycerides incremental area under the curve was lower with an SFAs-rich meal (SMD: -0.36; 95% CI: -0.57, -0.15) over a less than 8 h duration, while was higher (SMD: 0.59; 95% CI: 0.05, 1.23) over a longer postprandial duration. It suggests that the postprandial duration is of importance when evaluating the effects of fatty acids composition on blood lipid responses.
Topics: Breakfast; Fatty Acids; Humans; Lipids; Postprandial Period; Randomized Controlled Trials as Topic
PubMed: 32223451
DOI: 10.1080/09637486.2020.1744534 -
Current Nutrition Reports Dec 2020Recurrent post-prandial metabolic imbalances are important contributing factors to the development of cardiovascular disease (CVD). This study evaluated whether...
PURPOSE OF REVIEW
Recurrent post-prandial metabolic imbalances are important contributing factors to the development of cardiovascular disease (CVD). This study evaluated whether anthocyanin consumption attenuates the deleterious postprandial response of high-fat meals on CVD risk factors including blood pressure, vascular endothelial function, lipid profile and biomarkers related to oxidative stress, antioxidant status and immune response.
RECENT FINDINGS
Five electronic databases were searched up to the period of 1 February 2020, yielding 13 eligible studies, including randomised or cross-over clinical trials (18-59 years of age), using PRISMA guidelines (PROSPERO registration: CRD42019126265). Potential bias was assessed using the revised Cochrane risk-of-bias tool for randomised trials. Beneficial effects of anthocyanins were reported in biomarkers of oxidative stress and antioxidant status in 6 out of 9 studies, and in 3 out of 6 studies for inflammatory response. Two positive results were found concerning attenuation of post-prandial endothelial dysfunction, increased triacylglycerol and total cholesterol exerted by the high fat meal. Blood pressure and lipoproteins were the parameters with least beneficial results. Our systematic literature review revealed beneficial effects of dietary anthocyanin interventions on CVD risk factors following a HFM challenge; however, heterogeneity in results exists. The most promising results were for the attenuation of deleterious postprandial effects on oxidative stress and antioxidant status, triacylglycerol and total cholesterol concentrations, vascular endothelial function and inflammatory biomarkers. Post-prandial changes in blood pressure and lipoproteins were least affected by anthocyanins. Further studies are required in order to better elucidate the post-prandial effects of anthocyanins and CVD risk factors.
Topics: Adolescent; Adult; Anthocyanins; Antioxidants; Biomarkers; Blood Pressure; Cardiovascular Diseases; Cross-Over Studies; Data Management; Databases, Factual; Diet, High-Fat; Female; Humans; Lipids; Male; Meals; Middle Aged; Oxidative Stress; Postprandial Period; Risk Factors; Triglycerides; Young Adult
PubMed: 32613517
DOI: 10.1007/s13668-020-00328-y -
Nutrients Jul 2019Postprandial hypotension (PPH) is under-recognised, but common, particularly in the elderly, and is of clear clinical importance due to both the independent association...
Postprandial hypotension (PPH) is under-recognised, but common, particularly in the elderly, and is of clear clinical importance due to both the independent association between PPH and an increase in mortality and lack of effective management for this condition. Following health concerns surrounding excessive consumption of sugar, there has been a trend in the use of low- or non-nutritive sweeteners as an alternative. Due to the lack of literature in this area, we conducted a systematic search to identify studies relevant to the effects of different types of sweeteners on postprandial blood pressure (BP). The BP response to ingestion of sweeteners is generally unaffected in healthy young subjects, however in elderly subjects, glucose induces the greatest decrease in postprandial BP, while the response to sucrose is less pronounced. The limited studies investigating other nutritive and non-nutritive sweeteners have demonstrated minimal or no effect on postprandial BP. Dietary modification by replacing high nutritive sweeteners (glucose, fructose, and sucrose) with low nutritive (d-xylose, xylitol, erythritol, maltose, maltodextrin, and tagatose) and non-nutritive sweeteners may be a simple and effective management strategy for PPH.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Blood Pressure; Female; Humans; Hypotension; Male; Middle Aged; Non-Nutritive Sweeteners; Nutritive Sweeteners; Postprandial Period; Risk Factors; Young Adult
PubMed: 31349678
DOI: 10.3390/nu11081717