-
Nutrients Jan 2016Subjective feelings of appetite are measured using visual analogue scales (VAS) in controlled trials. However, the methods used to analyze VAS during the Satiation (pre-... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Subjective feelings of appetite are measured using visual analogue scales (VAS) in controlled trials. However, the methods used to analyze VAS during the Satiation (pre- to post-meal) and Satiety (post-meal to subsequent meal) periods vary broadly, making it difficult to compare results amongst independent studies testing the same product. This review proposes a methodology to analyze VAS during both the Satiation and Satiety periods, allowing us to compare results in a meta-analysis.
METHODS
A methodology to express VAS results as incremental areas under the curve (iAUC) for both the Satiation and Satiety periods is proposed using polydextrose as a case study. Further, a systematic review and meta-analysis on subjective feelings of appetite was conducted following the PRISMA methodology. Meta-analyses were expressed as Standardized Mean Difference (SMD).
RESULTS
Seven studies were included in the meta-analysis. There were important differences in the methods used to analyze appetite ratings amongst these studies. The separate subjective feelings of appetite reported were Hunger, Satisfaction, Fullness, Prospective Food Consumption, and the Desire to Eat. The method proposed here allowed the results of the different studies to be homogenized. The meta-analysis showed that Desire to Eat during the Satiation period favors polydextrose for the reduction of this subjective feeling of appetite (SMD = 0.24, I² < 0.01, p = 0.018); this effect was also significant in the sub-analysis by sex for the male population (SMD = 0.35, I² < 0.01, p = 0.015). There were no other significant results.
CONCLUSION
It is possible to compare VAS results from separate studies. The assessment of iAUC for both the Satiation and Satiety periods generates results of homogeneous magnitudes. This case study demonstrates, for the first time, that polydextrose reduces the Desire to Eat during the Satiation period. This may explain, at least in part, the observed effects of polydextrose on the reduction of levels of energy intake at subsequent meals.
Topics: Adult; Appetite; Area Under Curve; Emotions; Female; Food Additives; Glucans; Humans; Hunger; Male; Middle Aged; Postprandial Period; Randomized Controlled Trials as Topic; Research Design; Satiation; Visual Analog Scale
PubMed: 26784221
DOI: 10.3390/nu8010045 -
Diabetologia Apr 2013The aim of this work was to compare the glucose-lowering efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors between Asian and non-Asian patients with type 2 diabetes. (Meta-Analysis)
Meta-Analysis Review
AIMS/HYPOTHESIS
The aim of this work was to compare the glucose-lowering efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors between Asian and non-Asian patients with type 2 diabetes.
METHODS
We searched MEDLINE, EMBASE, LILACS, CENTRAL, ClinicalTrials.gov and conference proceedings. Studies were eligible if they were randomised controlled trials with a treatment duration of at least 12 weeks, compared a DPP-4 inhibitor with a placebo as either monotherapy or oral combination therapy, had information on ethnicity and HbA1c values and were published or described in English. A systematic review and meta-analysis with a meta-regression analysis was conducted.
RESULTS
Among 809 potentially relevant studies, 55 trials were included. A meta-analysis revealed that DPP-4 inhibitors lowered HbA1c to a greater extent in studies with ≥50% Asian participants (weighted mean difference [WMD] -0.92%; 95% CI -1.03, -0.82) than in studies with <50% Asian participants (WMD -0.65%; 95% CI -0.69, -0.60). The between-group difference was -0.26% (95% CI -0.36, -0.17, p < 0.001). The baseline BMI significantly correlated with the HbA1c-lowering efficacy of DPP-4 inhibitors. The RR of achieving the goal of HbA1c <7.0% (53.0 mmol/mol) was higher in studies with ≥50% Asian participants (3.4 [95% CI 2.6, 4.7] vs 1.9 [95% CI 1.8, 2.0]). The fasting plasma glucose-lowering efficacy was higher with monotherapy in the Asian-dominant studies, but the postprandial glucose-lowering efficacy and changes in body weight were comparable between the two groups.
CONCLUSIONS/INTERPRETATION
DPP-4 inhibitors exhibit a better glucose-lowering efficacy in Asians than in other ethnic groups; this requires further investigation to understand the underlying mechanism, particularly in relation to BMI.
Topics: Administration, Oral; Asian People; Blood Glucose; Body Mass Index; Body Weight; Diabetes Mellitus, Type 2; Dipeptidyl-Peptidase IV Inhibitors; Humans; Postprandial Period; Randomized Controlled Trials as Topic; Regression Analysis; Treatment Outcome
PubMed: 23344728
DOI: 10.1007/s00125-012-2827-3 -
Sports Medicine (Auckland, N.Z.) Oct 2018The aim was to conduct a systematic review and meta-analysis analyzing the impact of up to 24 h of prolonged sitting on postprandial glucose, insulin and triglyceride... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim was to conduct a systematic review and meta-analysis analyzing the impact of up to 24 h of prolonged sitting on postprandial glucose, insulin and triglyceride responses, blood pressure and vascular function, in comparison to sitting interrupted with light- to moderate-intensity physical activity.
METHODS
To be included, studies had to examine the impact of prolonged sitting lasting < 24 h in apparently healthy males or females of any age. Studies were identified from searches of the MEDLINE, CINAHL and SportDISCUS databases on July 6, 2016. Study quality was assessed using the Downs and Black Checklist; publication bias was assessed via funnel plot.
RESULTS
Forty-four studies met the inclusion criteria for the systematic review; of these, 20 were included in the meta-analysis, which compared prolonged sitting to the effects of interrupting sitting with regular activity breaks on postprandial glucose, insulin and triglycerides. When compared to prolonged sitting, regular activity breaks lowered postprandial glucose (d = - 0.36, 95% confidence interval [CI] - 0.50 to - 0.21) and insulin (d = - 0.37, 95% CI - 0.53 to - 0.20), but not triglyceride responses (d = 0.06, 95% CI - 0.15 to 0.26). Subgroup analyses indicated reductions in postprandial triglyceride responses only occurred 12-16 h after the intervention. The magnitude of the reductions in glucose, insulin or triglyceride response was not modified by the intensity of the activity breaks, the macronutrient composition of the test meal, or the age or body mass index of participants.
CONCLUSION
Prolonged sitting results in moderate elevations in postprandial glucose and insulin responses when compared to sitting interrupted with activity breaks.
PROSPERO ID
CRD42015020907.
Topics: Blood Glucose; Blood Pressure; Humans; Insulin; Meals; Postprandial Period; Randomized Controlled Trials as Topic; Sedentary Behavior; Sitting Position; Triglycerides; Vascular Stiffness
PubMed: 30078066
DOI: 10.1007/s40279-018-0963-8 -
Molecular Nutrition & Food Research Dec 2023Metabolic flexibility is essential for a healthy response to a high fat meal, and is assessed by measuring postprandial changes in blood markers including peripheral...
Systematic Review and Quantitative Data Synthesis of Peripheral Blood Mononuclear Cell Transcriptomics Reveals Consensus Gene Expression Changes in Response to a High Fat Meal.
SCOPE
Metabolic flexibility is essential for a healthy response to a high fat meal, and is assessed by measuring postprandial changes in blood markers including peripheral blood mononuclear cells (PBMCs; lymphocytes and monocytes). However, there is no clear consensus on postprandial gene expression and protein changes in these cells.
METHOD AND RESULTS
The study systematically reviews the literature reporting transcriptional and proteomic changes in PBMCs after consumption of a high fat meal. After re-analysis of the raw data to ensure equivalence between studies, ≈85 genes are significantly changed (defined as in the same direction in ≥3 studies) with about half involved in four processes: inflammation/oxidative stress, GTP metabolism, apoptosis, and lipid localization/transport. For meals consisting predominantly of unsaturated fatty acids (UFA), notable additional processes are phosphorylation and glucocorticoid response. For saturated fatty acids (SFA), genes related to migration/angiogenesis and platelet aggregation are also changed.
CONCLUSION
Despite differences in study design, common gene changes are identified in PBMCs following a high fat meal. These common genes and processes will facilitate definition of the postprandial transcriptome as part of the overall postcibalome, linking all molecules and processes that change in the blood after a meal.
Topics: Dietary Fats; Transcriptome; Leukocytes, Mononuclear; Consensus; Proteomics; Meals; Postprandial Period; Cross-Over Studies; Triglycerides
PubMed: 37817369
DOI: 10.1002/mnfr.202300512 -
Advances in Nutrition (Bethesda, Md.) Nov 2020The use of postprandial triglyceride (ppTG) as a cardiovascular disease risk indicator has gained recent popularity. However, the influence of different foods or food... (Meta-Analysis)
Meta-Analysis
The Influence of Different Foods and Food Ingredients on Acute Postprandial Triglyceride Response: A Systematic Literature Review and Meta-Analysis of Randomized Controlled Trials.
The use of postprandial triglyceride (ppTG) as a cardiovascular disease risk indicator has gained recent popularity. However, the influence of different foods or food ingredients on the ppTG response has not been comprehensively characterized. A systematic literature review and meta-analysis was conducted to assess the effects of foods or food ingredients on the ppTG response. PubMed, MEDLINE, Cochrane, and CINAHL databases were searched for relevant acute (<24-h) randomized controlled trials published up to September 2018. Based on our selection criteria, 179 relevant trials (366 comparisons) were identified and systematically compiled into distinct food or food ingredient categories. A ppTG-lowering effect was noted for soluble fiber (Hedges' giAUC = -0.72; 95% CI: -1.33, -0.11), sodium bicarbonate mineral water (Hedges' gAUC = -0.42; 95% CI: -0.79, -0.04), diacylglycerol oil (Hedges' giAUC = -0.38; 95% CI: -0.75, -0.00), and whey protein when it was contrasted with other proteins. The fats group showed significant but opposite effects depending on the outcome measure used (Hedges' giAUC = -0.32; 95% CI: -0.61, -0.03; and Hedges' gAUC = 0.16; 95% CI: 0.06, 0.26). Data for other important food groups (nuts, vegetables, and polyphenols) were also assessed but of limited availability. Assessing for oral fat tolerance test (OFTT) recommendation compliance, most trials were ≥4 h long but lacked a sufficiently high fat challenge. iAUC and AUC were more common measures of ppTG. Overall, our analyses indicate that the effects on ppTG by different food groups are diverse, largely influenced by the type of food or food ingredient within the same group. The type of ppTG measurement can also influence the response.
Topics: Food Ingredients; Humans; Outcome Assessment, Health Care; Postprandial Period; Randomized Controlled Trials as Topic; Triglycerides
PubMed: 32609800
DOI: 10.1093/advances/nmaa074 -
BMJ Open Aug 2022Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. To... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. To evaluate effectiveness of thiamine supplementation on glycaemic outcomes in patients with T2DM.
METHODS
Studies that assessed effect of thiamine supplementation in adults with T2DM which measured glycaemic outcomes-HbA1c, fasting blood glucose (FBG) and/or postprandial blood glucose (PPG) were included. PUBMED, Tripdatabase, the Cochrane Central Register, National Institute of Health Clinical Database and Google Scholar were searched until December 2021 for RCTs. It was assessed using standardised critical appraisal instruments from the Joanna Briggs Institute for RCTs. Where possible, studies were pooled in a meta-analysis. Results were presented in a narrative format if statistical pooling was not possible.
RESULTS
Six trials involving 364 participants. : No significant beneficial effects were observed on glycaemic outcomes with 100-900 mg/day of thiamine or benfotiamine for up to 3 months (HbA1c: MD, -0.02%, 95% CI: -0.35 to 0.31; FBG: MD,-0.20 mmol/L; 95% CI: -0.69 to 0.29; PPG: MD, - 0.20 mmol/L, 95% CI: -2.05 to 1.65 (mean difference, MD)). There was a significant increase in high-density lipoprotein (HDL) (MD, 0.10; 95% CI: 0.10 to 0.20) at 3-month follow-up. Benfotiamine reduced triglyceride level (MD, -1.10; 95% CI: -1.90 to -0.30) in 120 mg/day dose as compared with placebo 150 mg/day, however this was not demonstrated in higher doses.
DISCUSSION
Inclusion of single-centre trials published only in English, small sample sizes of included studies, lack of trials investigating outcomes for same comparisons and varying follow-up periods. Thiamine supplementation does not affect glycaemic outcomes, however reduces triglycerides while increasing HDL. Multicentre well-designed RCT with higher doses of thiamine and a follow-up period of 1-2 years will provide better evidence.
PROSPERO REGISTRATION NUMBER
CRD42020170520.
Topics: Adult; Blood Glucose; Diabetes Mellitus, Type 2; Dietary Supplements; Glycated Hemoglobin; Humans; Thiamine
PubMed: 36008064
DOI: 10.1136/bmjopen-2021-059834 -
Nutrients Oct 2021Carbohydrate counting (CHC) is the established form of calculating bolus insulin for meals in children with type 1 diabetes (T1DM). With the widespread use of continuous...
Carbohydrate counting (CHC) is the established form of calculating bolus insulin for meals in children with type 1 diabetes (T1DM). With the widespread use of continuous glucose monitoring (CGM) observation time has become gapless. Recently, the impact of fat, protein and not only carbohydrates on prolonged postprandial hyperglycaemia have become more evident to patients and health-care professionals alike. However, there is no unified recommendation on how to calculate and best administer additional bolus insulin for these two macronutrients. The aim of this review is to investigate: the scientific evidence of how dietary fat and protein influence postprandial glucose levels; current recommendations on the adjustment of bolus insulin; and algorithms for insulin application in children with T1DM. A PubMed search for all articles addressing the role of fat and protein in paediatric (sub-)populations (<18 years old) and a mixed age population (paediatric and adult) with T1DM published in the last 10 years was performed. Conclusion: Only a small number of studies with a very low number of participants and high degree of heterogeneity was identified. While all studies concluded that additional bolus insulin for (high) fat and (high) protein is necessary, no consensus on when dietary fat and/or protein should be taken into calculation and no unified algorithm for insulin therapy in this context exists. A prolonged postprandial observation time is necessary to improve individual metabolic control. Further studies focusing on a stratified paediatric population to create a safe and effective algorithm, taking fat and protein into account, are necessary.
Topics: Adolescent; Algorithms; Blood Glucose; Child; Diabetes Mellitus, Type 1; Dietary Fats; Dietary Proteins; Drug Dosage Calculations; Eating; Female; Glycemic Control; Humans; Hyperglycemia; Hypoglycemic Agents; Insulin; Insulin Infusion Systems; Male; Postprandial Period
PubMed: 34684559
DOI: 10.3390/nu13103558 -
Korean Journal of Women Health Nursing Jun 2021This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). (Review)
Review
PURPOSE
This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM).
METHODS
The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality.
RESULTS
Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels.
CONCLUSION
Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.
PubMed: 36313133
DOI: 10.4069/kjwhn.2021.05.13 -
The American Journal of Clinical... Oct 2018Whole grains are often referred to collectively, despite differences in their composition, physical structure, processing, and potential health benefits. (Comparative Study)
Comparative Study Meta-Analysis
The effects of whole-grain compared with refined wheat, rice, and rye on the postprandial blood glucose response: a systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Whole grains are often referred to collectively, despite differences in their composition, physical structure, processing, and potential health benefits.
OBJECTIVE
The aim of this study was to compare the postprandial blood glucose response of whole-grain with refined wheat, rice, or rye, while controlling for the food delivery matrix and the processing of the grain (e.g., grinding, germination).
DESIGN
Eleven electronic databases were systematically searched to identify studies published up to and including November 2017. Randomized controlled trials comparing the effects of whole-grain wheat, rice, or rye with those of each grain's refined counterpart on postprandial blood glucose area under the curve (AUC) were included. Pooled effect sizes were computed by using the difference in the blood glucose AUC after the consumption of the whole compared with the refined grain.
RESULTS
Twenty publications were included, with 10, 14, and 5 strata (or active-control comparisons) on whole-grain wheat, rice, and rye, respectively. The consumption of ground (wholemeal) wheat, compared with white wheat, was not associated with a significant reduction in blood glucose AUC (-6.7 mmol/L ⋅ min; 95% CI: -25.1, 11.7 mmol/L ⋅ min; P = 0.477). The consumption of wholemeal rye, compared with endosperm rye, was not associated with a significant reduction in blood glucose AUC (-5.5 mmol/L ⋅ min; 95% CI: -24.8, 13.8 mmol/L ⋅ min; P = 0.576). The consumption of intact (whole-grain) rice, compared with white rice, was associated with a significant reduction in blood glucose AUC (-40.5 mmol/L ⋅ min; 95% CI: -59.6, -21.3 mmol/L ⋅ min; P < 0.001).
CONCLUSIONS
Compared with white rice, whole-grain rice significantly attenuates the postprandial blood glucose response. In most of the studies on wheat and rye, the postprandial blood glucose responses to foods formulated with wholemeal compared with refined flours were compared. Whether reductions in the blood glucose AUC can be achieved with whole-grain (as opposed to wholemeal) wheat and rye requires further investigation.
Topics: Adult; Aged; Blood Glucose; Bread; Dietary Fiber; Female; Flour; Humans; Male; Middle Aged; Oryza; Postprandial Period; Secale; Triticum; Whole Grains; Young Adult
PubMed: 30321274
DOI: 10.1093/ajcn/nqy112 -
Journal of Pediatric Gastroenterology... Jul 2021Electrogastrography (EGG) is a non-invasive method of measuring gastric electrophysiology. Abnormal gastric electrophysiology is thought to contribute to disease... (Meta-Analysis)
Meta-Analysis
Electrogastrography (EGG) is a non-invasive method of measuring gastric electrophysiology. Abnormal gastric electrophysiology is thought to contribute to disease pathophysiology in patients with gastroduodenal symptoms but this has not been comprehensively quantified in pediatric populations. This study aimed to quantify the abnormalities in gastric electrophysiology on EGG in neonatal and pediatric patients.Databases were systematically searched for articles utilizing EGG in neonatal and pediatric patients (≤18 years). Primary outcomes were prevalence of abnormality, percentage of time in normal rhythm, and power ratio. Secondary outcomes were correlations between patient symptoms and abnormal gastric electrophysiology on EGG.A total of 33 articles (1444 participants) were included. EGG methodologies were variable. Pooled prevalence of abnormalities on EGG ranged from 61% to 86% in patients with functional dyspepsia (FD), gastro-esophageal reflux disease (GERD), and type 1 diabetes mellitus (T1DM). FD patients averaged 20.8% (P = 0.011) less preprandial and 21.6% (P = 0.031) less postprandial time in normogastria compared with controls. Electrophysiological abnormalities were inconsistent in GERD. T1DM patients averaged 46.2% (P = 0.0003) less preprandial and similar (P = 0.32) postprandial time in normogastria compared with controls, and had a lower power ratio (SMD -2.20, 95% confidence interval [CI]: -4.25 to -0.15; P = 0.036). Symptom correlations with gastric electrophysiology were inconsistently reported.Abnormalities in gastric electrophysiology were identifiable across a range of pediatric patients with gastroduodenal symptoms on meta-analysis. However, techniques have been inconsistent, and standardized and more reliable EGG methods are desirable to further define these findings and their potential utility in clinical practice.
Topics: Child; Dyspepsia; Gastric Emptying; Humans; Infant, Newborn; Postprandial Period; Stomach; Stomach Diseases
PubMed: 33797449
DOI: 10.1097/MPG.0000000000003140