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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 -
Nutrients Dec 2015The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23... (Meta-Analysis)
Meta-Analysis Review
The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c) (MD, -0.42%; 95% CI, -0.61% to -0.23%), fasting blood glucose (FBG) (MD, -0.39 mmol/L; 95% CI, -0.58 to -0.19 mmol/L), total cholesterol (TC) (MD, -0.49 mmol/L; 95% CI, -0.86 to -0.12 mmol/L), low-density lipoprotein cholesterol (LDL-C) (MD, -0.29 mmol/L; 95% CI, -0.48 to -0.09 mmol/L). Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required.
Topics: Avena; Blood Glucose; Cholesterol, HDL; Cholesterol, LDL; Databases, Factual; Diabetes Mellitus, Type 2; Diet; Glycated Hemoglobin; Humans; Insulin; Observational Studies as Topic; Postprandial Period; Randomized Controlled Trials as Topic; Triglycerides
PubMed: 26690472
DOI: 10.3390/nu7125536 -
The British Journal of Nutrition Oct 2015Rice is an important staple food for more than half of the world's population. Especially in Asian countries, rice is a major contributor to dietary glycaemic load (GL).... (Review)
Review
Rice is an important staple food for more than half of the world's population. Especially in Asian countries, rice is a major contributor to dietary glycaemic load (GL). Sustained consumption of higher-GL diets has been implicated in the development of chronic diseases such as type 2 diabetes mellitus. Given that a reduction in postprandial glycaemic and insulinaemic responses is generally seen as a beneficial dietary change, it is useful to determine the variation in the range of postprandial glucose (PPG) and insulin (PPI) responses to rice and the primary intrinsic and processing factors known to affect such responses. Therefore, we identified relevant original research articles on glycaemic response to rice through a systematic search of the literature in Scopus, Medline and SciFinder databases up to July 2014. Based on a glucose reference value of 100, the observed glycaemic index values for rice varieties ranged from 48 to 93, while the insulinaemic index ranged from 39 to 95. There are three main factors that appear to explain most of the variation in glycaemic and insulinaemic responses to rice: (1) inherent starch characteristics (amylose:amylopectin ratio and rice cultivar); (2) post-harvest processing (particularly parboiling); (3) consumer processing (cooking, storage and reheating). The milling process shows a clear effect when compared at identical cooking times, with brown rice always producing a lower PPG and PPI response than white rice. However, at longer cooking times normally used for the preparation of brown rice, smaller and inconsistent differences are observed between brown and white rice.
Topics: Amylopectin; Amylose; Blood Glucose; Chemical Phenomena; Cooking; Food Handling; Glycemic Index; Glycemic Load; Humans; Insulin; Oryza; Postprandial Period; Randomized Controlled Trials as Topic; Starch; Whole Grains
PubMed: 26310311
DOI: 10.1017/S0007114515001841 -
Polskie Archiwum Medycyny Wewnetrznej 2015Prandial insulin is a key component in insulin treatment of type 1 diabetes mellitus (T1DM) and in many patients with type 2 diabetes mellitus (T2DM). The evidence-based... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Prandial insulin is a key component in insulin treatment of type 1 diabetes mellitus (T1DM) and in many patients with type 2 diabetes mellitus (T2DM). The evidence-based data supporting the choice of an insulin preparation are still limited.
OBJECTIVES
We performed a systematic review to summarize and update the evidence on relative efficacy and safety of insulin aspart (IAsp) and regular human insulin (RHI) in both types of diabetes.
METHODS
Randomized controlled trials comparing IAsp with RHI in patients with either T1DM or T2DM and conducted until May 2013 were retrieved from a systematic search of MEDLINE, EMBASE, and Cochrane Library.
RESULTS
Of 16 relevant trials, 11 involved patients with T1DM and 5--with T2DM. In the T1DM population, IAsp, when compared with RHI, provided a greater reduction in hemoglobin A₁c (HbA₁c) levels (weighted mean difference [WMD], -0.11%; 95% confidence interval [CI], -0.16 to -0.05; WMD, -1.2 mmol/mol; 95% CI, -1.7 to -0.5), and improved postprandial glucose levels following breakfast (WMD, -1.40 mmol/l; 95% CI, -1.72 to -1.07), lunch (WMD, -1.01 mmol/l; 95% CI, -1.61 to -0.41), and dinner (WMD, -0.89 mmol/l; 95% CI, -1.19 to -0.59). The risk of nocturnal hypoglycemia was lower in T1DM patients receiving IAsp (relative risk, 0.76; 95% CI, 0.64-0.91), while no difference was observed for severe hypoglycemia. In T2DM patients, IAsp led to a greater reduction in HbA₁c levels (WMD, -0.22%; 95% CI, -0.39 to -0.05; -2.4 mmol/mol, -4.3 to -0.5) and postprandial blood glucose. The risk of overall hypoglycemia and severe adverse effects was comparable between the groups.
CONCLUSIONS
IAsp provides better glycemic control when compared with RHI in patients with T1DM and T2DM. Fewer T1DM patients treated with IAsp experienced nocturnal hypoglycemia, while both interventions showed a comparable risk of severe hypoglycemic events in both types of diabetes.
Topics: Blood Glucose; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Drug Therapy, Combination; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Insulin; Insulin Aspart; Postprandial Period; Randomized Controlled Trials as Topic
PubMed: 25644227
DOI: 10.20452/pamw.2705 -
Evaluation of the role of enteral nutrition in managing patients with diabetes: a systematic review.Nutrients Nov 2014The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the... (Review)
Review
The aim of this systematic review is to evaluate the role of enteral nutrition in managing patients with diabetes on enteral feed. The prevalence of diabetes is on the increase in the UK and globally partly due to lack of physical activities, poor dietary regimes and genetic susceptibility. The development of diabetes often leads to complications such as stroke, which may require enteral nutritional support. The provision of enteral feeds comes with its complications including hyperglycaemia which if not managed can have profound consequences for the patients in terms of clinical outcomes. Therefore, it is essential to develop strategies for managing patients with diabetes on enteral feed with respect to the type and composition of the feed. This is a systematic review of published peer reviewed articles. EBSCOhost Research, PubMed and SwetsWise databases were searched. Reference lists of identified articles were reviewed. Randomised controlled trials comparing enteral nutrition diabetes specific formulas with standard formulas were included. The studies which compared diabetes specific formulas (DSF) with standard formulas showed that DSF was more effective in controlling glucose profiles including postprandial glucose, HbA1c and insulinemic response. The use of DSF appears to be effective in managing patients with diabetes on enteral feed compared with standard feed.
Topics: Diabetes Mellitus; Enteral Nutrition; Glycated Hemoglobin; Humans; Hyperglycemia; Nutritional Status; Postprandial Period; Randomized Controlled Trials as Topic
PubMed: 25412151
DOI: 10.3390/nu6115142 -
Obesity (Silver Spring, Md.) Aug 2014To assess the effect of dietary pulses (beans, peas, chickpeas, lentils) on acute satiety and second meal intake, a systematic review and meta-analysis was conducted. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the effect of dietary pulses (beans, peas, chickpeas, lentils) on acute satiety and second meal intake, a systematic review and meta-analysis was conducted.
METHODS
MEDLINE, EMBASE, CINAHL, and the Cochrane Registry (through May 6, 2013) were searched for acute controlled trials examining the effect of dietary pulses on postprandial satiety or second meal intake compared with isocaloric controls. Two independent reviewers extracted data and assessed methodological quality and risk of bias. Data were pooled by generic inverse variance random effects models and expressed as ratio of means (RoMs) for satiety and mean differences (MDs) for second meal food intake, with 95% confidence intervals (95% CIs). Heterogeneity was assessed (Q statistic) and quantified (I(2) statistic). Protocol registration: clinicaltrials.gov identifier, NCT01605422.
RESULTS
Nine trials met the eligibility criteria. Dietary pulses produced a 31% greater satiety incremental area under the curve (IAUC) (RoM = 1.31, 95% CI: 1.09 to 1.58, P = 0.004; Phet = 0.96; I(2) = 0%) without affecting second meal intake (MD = -19.94, 95% CI: -75-35, P = 0.48; Phet = 0.01; I(2) = 63%). Our data are limited by the small sample sizes, narrow participant characteristics and significant unexplained heterogeneity among the available trials.
CONCLUSIONS
Pooled analyses show that dietary pulses contribute to acute satiety but not second meal intake.
Topics: Diet; Energy Intake; Fabaceae; Humans; Postprandial Period; Randomized Controlled Trials as Topic; Satiation
PubMed: 24820437
DOI: 10.1002/oby.20782