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Nutrients, Volume 11, Issue 2 (February 2019)

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Open AccessArticle New Insights on the Nutrition Status and Antioxidant Capacity in Multiple Sclerosis Patients
Nutrients 2019, 11(2), 427; https://doi.org/10.3390/nu11020427 (registering DOI)
Received: 14 January 2019 / Revised: 13 February 2019 / Accepted: 14 February 2019 / Published: 18 February 2019
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Abstract
Background: Multiple sclerosis (MS) is a multifactorial disease with unknown etiology. It is assumed to result from interplay between genetic and environmental factors, including nutrition. We hypothesized that there are differences in nutritional parameters between MS patients and healthy controls. Methods: We examined [...] Read more.
Background: Multiple sclerosis (MS) is a multifactorial disease with unknown etiology. It is assumed to result from interplay between genetic and environmental factors, including nutrition. We hypothesized that there are differences in nutritional parameters between MS patients and healthy controls. Methods: We examined 63 MS patients and 83 healthy controls. Nutritional status was determined by a dietary questionnaire, blood tests, quantification of cell membrane fatty acids, and serum antioxidant capacity. Results: We found that MS patients consumed a more limited diet compared with the healthy group, indicated by a lower average of 31 nutrients and by consumption levels of zinc and thiamine below the recommended daily intake. Both consumption and measured iron values were significantly lower in MS patients, with the lowest measures in the severe MS group. Long saturated fatty acids (>C16) were significantly lower in MS patients, while palmitic and palmitoleic acids were both higher. Serum total antioxidant capacity was significantly lower in the MS group compared with healthy controls, with the lowest measures in patients with severe MS. Conclusions: This study points to a possible correlation between nutritional status and MS. Understanding the clinical meaning of these findings will potentially allow for the development of future personalized dietary interventions as part of MS treatment. Full article
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Open AccessArticle Eucommia ulmoides Leaf Extract Ameliorates Steatosis Induced by High-fat Diet in Rats by Increasing Lysosomal Function
Nutrients 2019, 11(2), 426; https://doi.org/10.3390/nu11020426 (registering DOI)
Received: 8 January 2019 / Revised: 13 February 2019 / Accepted: 14 February 2019 / Published: 18 February 2019
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Abstract
The recent discovery that the impairment of autophagic flux in non-alcoholic fatty liver disease (NAFLD) might be a strong determining factor in steatosis suggests the potential of therapeutic control of autophagic flux with natural agents in restoring NAFLD. We investigated the potential of [...] Read more.
The recent discovery that the impairment of autophagic flux in non-alcoholic fatty liver disease (NAFLD) might be a strong determining factor in steatosis suggests the potential of therapeutic control of autophagic flux with natural agents in restoring NAFLD. We investigated the potential of Eucommia ulmoides leaf extract (EUL) to control dyslipidemia in NAFLD. EUL supplementation (200 mg/kg) promoted recovery from high fat diet (HFD)-induced lipid dysmetabolism. This hepatoprotective efficacy was accompanied by suppression of endoplasmic reticulum (ER) stress, enhancing lysosomal functions, and thereby increasing autophagic flux. We found a strong indication that inhibition of the mTOR-ER stress pathway was related to the enhanced autophagic flux. However, the direct antioxidative effect of EUL on cytoprotection cannot be ruled out as a significant contributing factor in NAFLD. Our findings will aid in further elucidating the mechanism of the anti-steatosis activity of EUL and highlight the therapeutic potential of EUL in the treatment of NAFLD. Full article
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Open AccessConcept Paper Triple Adaptation of the Mediterranean Diet: Design of A Meal Plan for Older People with Oropharyngeal Dysphagia Based on Home Cooking
Nutrients 2019, 11(2), 425; https://doi.org/10.3390/nu11020425 (registering DOI)
Received: 15 January 2019 / Revised: 8 February 2019 / Accepted: 12 February 2019 / Published: 18 February 2019
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Abstract
Background: Oropharyngeal dysphagia (OD) and malnutrition are highly prevalent in older patients that are discharged from general hospitals (47% and 30%, respectively). Aims: To develop a nutritional plan for these patients involving a triple adaptation of their traditional diet: (a) rheological adaptation (texture [...] Read more.
Background: Oropharyngeal dysphagia (OD) and malnutrition are highly prevalent in older patients that are discharged from general hospitals (47% and 30%, respectively). Aims: To develop a nutritional plan for these patients involving a triple adaptation of their traditional diet: (a) rheological adaptation (texture and viscosity) for safe deglutition, (b) nutritional adaptation (water, calories, and proteins), and (c) organoleptic adaptation to improve compliance. Methods: Two fluid viscosities (250 and 800 mPa·s) were selected according to previous studies on optimal viscosities in older patients. The British Dietetic Association food texture classification based on common clinical practice selected two food textures (thick purée and fork-mashable. Two levels of calorie protein enrichment were selected according to previous studies using the Mini Nutritional Assessment (MNA®). Results: The daily caloric-protein and hydric needs were established at 1750 kcal, 70 g protein, and 1750 mL water in patients with MNA® ≥ 17; and, 2037 kcal, 90 g protein, and 2000 mL water/day in malnourished patients. Sixteen weekly menus (296 recipes) were developed while using two textures, two levels of viscosity, two nutritional phenotypes (normal/at-risk vs. malnourished), and two seasons of the year (spring/summer-autumn/winter) based on Mediterranean cuisine. Conclusion: This concept paper demonstrates that traditional Mediterranean cooking can be adapted to meet the rheological, nutritional, and hydration needs of older patients with OD. The recipes that we have developed meet the needs of patients with varying degrees of OD and malnutrition are reproducible in patient’s homes and they could have a major impact on the clinical outcomes of these patients. Full article
(This article belongs to the Special Issue Older Individuals' Nutrition)
Open AccessEditorial Brain Aging and Gut–Brain Axis
Nutrients 2019, 11(2), 424; https://doi.org/10.3390/nu11020424 (registering DOI)
Received: 12 February 2019 / Accepted: 15 February 2019 / Published: 18 February 2019
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Abstract
In the last decade, the microbiome in general and the gut microbiome in particular have been associated not only to brain development and function, but also to the pathophysiology of brain aging and to neurodegenerative disorders such as Alzheimer’s disease (AD), Parkinson’s disease [...] Read more.
In the last decade, the microbiome in general and the gut microbiome in particular have been associated not only to brain development and function, but also to the pathophysiology of brain aging and to neurodegenerative disorders such as Alzheimer’s disease (AD), Parkinson’s disease (PD), depression, or multiple sclerosis (MS) [...] Full article
(This article belongs to the Special Issue Brain Aging and Gut-Brain Axis)
Open AccessArticle 25-Hydroxyvitamin D Measurement in Human Hair: Results from a Proof-of-Concept study
Nutrients 2019, 11(2), 423; https://doi.org/10.3390/nu11020423 (registering DOI)
Received: 8 January 2019 / Revised: 3 February 2019 / Accepted: 14 February 2019 / Published: 18 February 2019
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Abstract
Vitamin D deficiency has been implicated in numerous human diseases leading to an increased interest in assessing vitamin D status. Consequentially, the number of requests for vitamin D measurement keeps dramatically increasing year-on-year. Currently, the recognised best marker of vitamin D status is [...] Read more.
Vitamin D deficiency has been implicated in numerous human diseases leading to an increased interest in assessing vitamin D status. Consequentially, the number of requests for vitamin D measurement keeps dramatically increasing year-on-year. Currently, the recognised best marker of vitamin D status is the concentration of the 25-hydroxyvitamin D (25(OH)D3) in the blood circulation. While providing an accurate estimate of vitamin D status at the point in time of sampling, it cannot account for the high variability of 25(OH)D3 concentration. In this proof of concept study we set out to provide evidence that 25(OH)D3 can be extracted from hair samples in a similar fashion to steroid hormones. Two of the authors (L.Z. and M.H.) provided hair samples harvested from the crown area of the scalp and the third author (E.L.) provided beard samples. These samples, cut into 1 cm lengths, were weighed, washed and dried. 25(OH)D was extracted using a previously published steroid hormones extraction procedure. Blood samples were taken from the subjects at the same time all tissue samples were analysed using liquid-chromatography mass spectrometry. Hair samples showed presence of quantifiable 25(OH)D3 with concentrations ranging from 11.9–911 pg/mg. The beard sample had a concentration of 231 pg/mg. Serum levels of 25(OH)D3 ranged from 72–78 nmol/L. The results presented here confirm the feasibility of measuring 25(OH)D3 in hair samples. The findings warrant further validation and development and have the potential to yield valuable information relating to temporal trends in vitamin D physiology. Full article
(This article belongs to the Special Issue Nutrients 2009–2019: The Present and the Future of Nutrition)
Open AccessArticle Diurnal Patterns of Energy Intake Derived via Principal Component Analysis and Their Relationship with Adiposity Measures in Adolescents: Results from the National Diet and Nutrition Survey RP (2008–2012)
Nutrients 2019, 11(2), 422; https://doi.org/10.3390/nu11020422
Received: 31 December 2018 / Revised: 11 February 2019 / Accepted: 12 February 2019 / Published: 17 February 2019
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Abstract
Mounting evidence points towards the existence of an association between energy intake in the evening and an increased prevalence and risk of being overweight and of obesity. The present study aimed to describe diurnal eating patterns (DEP) in a nationally representative sample of [...] Read more.
Mounting evidence points towards the existence of an association between energy intake in the evening and an increased prevalence and risk of being overweight and of obesity. The present study aimed to describe diurnal eating patterns (DEP) in a nationally representative sample of UK adolescents and to relate the derived DEP to anthropometrical measures. Data from four-day food records of adolescents aged 11–18 years participating in the 2008–2012 UK National Diet and Nutrition Survey Rolling Programme (NDNS RP) was utilised. The DEP were derived using a principal component analysis on the correlation matrix. Three orthogonal diurnal patterns were interpretable as (i) a linear contrast (8% of total system variation) between breakfast and an earlier lunch vs. a later lunch, late dinner, and evening/night snack, renamed “phase shift” DEP; (ii) a linear contrast (6.0% of system variation) between midmorning snacks, late lunch, and early dinner vs. breakfast, early and late morning snacks, early lunch, midafternoon snacks, and late dinner, renamed “early eating and grazing” DEP; (iii) a linear contrast (6.0% of system variation) between late main meals vs. early main meals and night snacks which was renamed “early main meals and night snacks vs. late main meals” DEP. After the adjustment for confounders, every 1 unit increase in the “early main meals and night snacks vs. late main meals”’ DEP score was significantly associated with a 0.29 kg/m2 and 11.6 mm increase in Body Mass Index (BMI) and waist circumference, respectively. There were no significant associations with the other two main DEPs. In conclusion, adolescents who tended to eat large early main meals and night snacks rather than slightly later main meals without night snacks had higher BMI and waist circumference. Further research is required to explore the determinants of DEP and to explore the impact of the context of eating and socioecological factors in the development of specific DEP. Full article
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Open AccessReview Sprouted Grains: A Comprehensive Review
Nutrients 2019, 11(2), 421; https://doi.org/10.3390/nu11020421
Received: 22 January 2019 / Revised: 2 February 2019 / Accepted: 13 February 2019 / Published: 17 February 2019
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Abstract
In the last decade, there has been an increase in the use of sprouted grains in human diet and a parallel increase in the scientific literature dealing with their nutritional traits and phytochemical contents. This review examines the physiological and biochemical changes during [...] Read more.
In the last decade, there has been an increase in the use of sprouted grains in human diet and a parallel increase in the scientific literature dealing with their nutritional traits and phytochemical contents. This review examines the physiological and biochemical changes during the germination process, and the effects on final sprout composition in terms of macro- and micro-nutrients and bioactive compounds. The main factors affecting sprout composition are taken into consideration: genotype, environmental conditions experimented by the mother plant, germination conditions. In particular, the review deepens the recent knowledge on the possible elicitation factors useful for increasing the phytochemical contents. Microbiological risks and post-harvest technologies are also evaluated, and a brief summary is given of some important in vivo studies matching with the use of grain sprouts in the diet. All the species belonging to Poaceae (Gramineae) family as well as pseudocereals species are included. Full article
(This article belongs to the Special Issue Grains and Human Health)
Open AccessArticle Iron Status of Kenyan Pregnant Women after Adjusting for Inflammation Using BRINDA Regression Analysis and Other Correction Methods
Nutrients 2019, 11(2), 420; https://doi.org/10.3390/nu11020420
Received: 27 December 2018 / Revised: 7 February 2019 / Accepted: 13 February 2019 / Published: 16 February 2019
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Abstract
Serum ferritin concentration is the preferred biomarker to assess population iron status in the absence of inflammation. Interpretation of this biomarker is complicated in populations with a high burden of infection, however, because inflammation increases serum ferritin concentration independently of iron status. We [...] Read more.
Serum ferritin concentration is the preferred biomarker to assess population iron status in the absence of inflammation. Interpretation of this biomarker is complicated in populations with a high burden of infection, however, because inflammation increases serum ferritin concentration independently of iron status. We aimed to compare estimates of iron status of Kenyan pregnant women, with circulating ferritin concentrations adjusted for inflammation using newly proposed methods by the BRINDA project, or using previously proposed adjustment methods. We re-analyzed data from pregnant Kenyan women living in a rural area where malaria is highly endemic (n = 470) or in an urban area (n = 402). As proposed by the BRINDA group, we adjusted individual ferritin concentration by internal regression for circulating concentrations of C-reactive protein (CRP) and α1-acid glycoprotein (AGP). Other adjustment methods comprised: (a) arithmetic correction factors based on CRP or AGP; (b) exclusion of subjects with inflammation (CRP >5 mg/L or AGP >1 g/L); and (c) higher ferritin cut-off value (<30 μg/L). We additionally adjusted for Plasmodium infection as appropriate. Lastly, we assessed iron status without adjustment for inflammation. All correction methods increased prevalence of iron deficiency compared to the unadjusted estimates. This increase was more pronounced with the internal regression correction method. The iron deficiency prevalence estimate increased from 53% to 87% in rural Kisumu study and from 30% to 41% in the urban Nairobi study after adjusting for inflammation (CRP and AGP) using the BRINDA internal regression method. When we corrected for both inflammation and Plasmodium infection using the regression correction, it resulted in lower prevalence estimates compared to uninfected women. Application of linear regression methods to adjust circulating ferritin concentration for inflammation leads to markedly decreased point estimates for ferritin concentration and increased estimates for the prevalence of iron deficiency in pregnancy. Full article
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Open AccessArticle The Obemat2.0 Study: A Clinical Trial of a Motivational Intervention for Childhood Obesity Treatment
Nutrients 2019, 11(2), 419; https://doi.org/10.3390/nu11020419
Received: 24 December 2018 / Revised: 11 February 2019 / Accepted: 12 February 2019 / Published: 16 February 2019
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Abstract
The primary aim of the Obemat2.0 trial was to evaluate the efficacy of a multicomponent motivational program for the treatment of childhood obesity, coordinated between primary care and hospital specialized services, compared to the usual intervention performed in primary care. This was a [...] Read more.
The primary aim of the Obemat2.0 trial was to evaluate the efficacy of a multicomponent motivational program for the treatment of childhood obesity, coordinated between primary care and hospital specialized services, compared to the usual intervention performed in primary care. This was a cluster randomized clinical trial conducted in Spain, with two intervention arms: motivational intervention group vs. usual care group (as control), including 167 participants in each. The motivational intervention consisted of motivational interviewing, educational materials, use of an eHealth physical activity monitor and three group-based sessions. The primary outcome was body mass index (BMI) z score increments before and after the 12 (+3) months of intervention. Secondary outcomes (pre-post intervention) were: adherence to treatment, waist circumference (cm), fat mass index (z score), fat free mass index (z score), total body water (kg), bone mineral density (z score), blood lipids profile, glucose metabolism, and psychosocial problems. Other assessments (pre and post-intervention) were: sociodemographic information, physical activity, sedentary activity, neuropsychological testing, perception of body image, quality of the diet, food frequency consumption and foods available at home. The results of this clinical trial could open a window of opportunity to support professionals at the primary care to treat childhood obesity. The clinicaltrials.gov identifier was NCT02889406. Full article
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Open AccessArticle Gut Mucosal Proteins and Bacteriome Are Shaped by the Saturation Index of Dietary Lipids
Nutrients 2019, 11(2), 418; https://doi.org/10.3390/nu11020418
Received: 11 January 2019 / Revised: 1 February 2019 / Accepted: 13 February 2019 / Published: 16 February 2019
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Abstract
The dynamics of the tripartite relationship between the host, gut bacteria and diet in the gut is relatively unknown. An imbalance between harmful and protective gut bacteria, termed dysbiosis, has been linked to many diseases and has most often been attributed to high-fat [...] Read more.
The dynamics of the tripartite relationship between the host, gut bacteria and diet in the gut is relatively unknown. An imbalance between harmful and protective gut bacteria, termed dysbiosis, has been linked to many diseases and has most often been attributed to high-fat dietary intake. However, we recently clarified that the type of fat, not calories, were important in the development of murine colitis. To further understand the host-microbe dynamic in response to dietary lipids, we fed mice isocaloric high-fat diets containing either milk fat, corn oil or olive oil and performed 16S rRNA gene sequencing of the colon microbiome and mass spectrometry-based relative quantification of the colonic metaproteome. The corn oil diet, rich in omega-6 polyunsaturated fatty acids, increased the potential for pathobiont survival and invasion in an inflamed, oxidized and damaged gut while saturated fatty acids promoted compensatory inflammatory responses involved in tissue healing. We conclude that various lipids uniquely alter the host-microbe interaction in the gut. While high-fat consumption has a distinct impact on the gut microbiota, the type of fatty acids alters the relative microbial abundances and predicted functions. These results support that the type of fat are key to understanding the biological effects of high-fat diets on gut health. Full article
(This article belongs to the Special Issue Diet as Means for studying gut-related Inflammation)
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Open AccessArticle Impact of a Usual Serving Size of Flavanol-Rich Cocoa Powder Ingested with a Diabetic-Suitable Meal on Postprandial Cardiometabolic Parameters in Type 2 Diabetics—A Randomized, Placebo-Controlled, Double-Blind Crossover Study
Nutrients 2019, 11(2), 417; https://doi.org/10.3390/nu11020417
Received: 12 January 2019 / Revised: 6 February 2019 / Accepted: 7 February 2019 / Published: 16 February 2019
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Abstract
Randomized controlled trials indicate that flavanol-rich cocoa intake may improve postprandial glucose and lipid metabolism in patients with type 2 diabetes (T2D), based on studies with meals that impose a strong metabolic load. Hence, the aim of the present study was to investigate [...] Read more.
Randomized controlled trials indicate that flavanol-rich cocoa intake may improve postprandial glucose and lipid metabolism in patients with type 2 diabetes (T2D), based on studies with meals that impose a strong metabolic load. Hence, the aim of the present study was to investigate whether flavanol-rich cocoa powder ingested as part of a diabetic-suitable meal may beneficially affect glucose, lipid metabolism, and blood pressure (BP) in patients with T2D. Twelve adults with T2D, overweight/obesity, and hypertension ingested capsules with 2.5 g of flavanol-rich cocoa or microcrystalline cellulose with a diabetic-suitable breakfast in a randomized, placebo-controlled, double-blind crossover study. BP was measured and blood samples were taken before, 2 and 4 h after breakfast and capsule intake. Cocoa treatment did not affect glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), triglycerides, total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol, and BP. For glucose, insulin and HOMA-IR, only effects by time were observed after both treatments. Thus, 2.5 g of flavanol-rich cocoa powder ingested as part of a diabetic-suitable meal does not seem to affect postprandial glucose and lipid metabolism and BP in stably-treated diabetics. Nevertheless, future studies with close-meshed investigations are desirable, providing realistic amounts of cocoa together with realistic meals rich in carbohydrates to subjects with T2D or metabolic syndrome, which do not afford pharmacological treatment. Full article
(This article belongs to the Special Issue Cocoa, Chocolate and Human Health)
Open AccessEditorial The Impact of Caffeine and Coffee on Human Health
Nutrients 2019, 11(2), 416; https://doi.org/10.3390/nu11020416
Received: 11 February 2019 / Accepted: 13 February 2019 / Published: 16 February 2019
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Abstract
Coffee is one of the most widely consumed beverages in the world and is also a major source of caffeine for most populations [...] Full article
(This article belongs to the Special Issue The Impact of Caffeine and Coffee on Human Health)
Open AccessArticle Health Star Rating in Grain Foods—Does It Adequately Differentiate Refined and Whole Grain Foods?
Nutrients 2019, 11(2), 415; https://doi.org/10.3390/nu11020415
Received: 21 December 2018 / Revised: 3 February 2019 / Accepted: 7 February 2019 / Published: 15 February 2019
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Abstract
The Australian front-of-pack labelling system, Health Star Rating (HSR), does not include whole grain (WG) in its algorithm, but uses dietary fibre (DF), despite Dietary Guidelines recommending WG over refined grain (RG) foods. This study aimed to determine how effectively HSR differentiates WG [...] Read more.
The Australian front-of-pack labelling system, Health Star Rating (HSR), does not include whole grain (WG) in its algorithm, but uses dietary fibre (DF), despite Dietary Guidelines recommending WG over refined grain (RG) foods. This study aimed to determine how effectively HSR differentiates WG and RG foods. Product label data were collected 2017–18 from bread, rice, pasta, noodles, flour and breakfast cereals (n = 1127). Products not displaying HSR, DF per 100 g, and %WG ingredients were excluded, leaving a sample of 441 products; 68% were WG (≥8 g/manufacturer serving). There was a significant difference (p < 0.001) in HSR between WG bread and breakfast cereal over RG varieties, yet the mean difference in stars depicted on the pack was only 0.4 for bread and 0.7 for breakfast cereal. There was no difference for rice (p = 0.131) or flour (p = 0.376). Median HSR also poorly differentiated WG. More WG foods scored 4–5 stars compared to RG, yet there was notable overlap between 3.5–5 stars. DF content between RG and WG subcategories was significantly different, however wide variation and overlap in DF highlights that this may not be a sufficient proxy measure, raising concerns that the HSR algorithm may not adequately communicate the benefits for consumers of swapping to WG foods. Full article
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Open AccessArticle Exclusive Enteral Nutrition: Clinical Effects and Changes in Mucosal Cytokine Profile in Pediatric New Inflammatory Bowel Disease
Nutrients 2019, 11(2), 414; https://doi.org/10.3390/nu11020414
Received: 27 December 2018 / Revised: 11 February 2019 / Accepted: 12 February 2019 / Published: 15 February 2019
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Abstract
Exclusive Enteral Nutrition (EEN) is the first-line treatment in children with Crohn’s disease (CD) for induction of remission. However, the mode of action remains conjectural. The aim of this study was to investigate whether the effect of EEN is paralleled by changes in [...] Read more.
Exclusive Enteral Nutrition (EEN) is the first-line treatment in children with Crohn’s disease (CD) for induction of remission. However, the mode of action remains conjectural. The aim of this study was to investigate whether the effect of EEN is paralleled by changes in the mucosal cytokine profiles (MCP). Twelve children with new onset inflammatory bowel disease (IBD) received induction treatment with a polymeric EEN. We assessed clinical, endoscopic and histologic scoring before and after EEN. Twelve colonic cytokines were analyzed by Polymerase Chain Reaction (PCR) in six of the IBD patients at onset and after EEN as well as in six non-IBD control children at the diagnostic colonoscopy. Twelve children completed 6 weeks of EEN, except from one child who completed 4 weeks. At the control colonoscopy, 83% were in complete clinical remission. Changes were found in the MCPs of individual patients after EEN. In particular, children with IBD showed significantly higher values of Interleukin (IL)-12β (p = 0.008) and IL-23α (p = 0.02) compared to non-IBD controls at the diagnostic colonoscopy. Furthermore, an overall change in proinflammatory cytokines was noted in the IBD-group after treatment. Further studies are warranted to understand the role of EEN in MCP. Full article
(This article belongs to the Special Issue Nutrition in Inflammatory Bowel Disease (IBD))
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Open AccessArticle Poor Iodine Knowledge, Coastal Region, and Non-Iodized Salt Consumption Linked to Low Urinary Iodine Excretion in Zhejiang Pregnant Women
Nutrients 2019, 11(2), 413; https://doi.org/10.3390/nu11020413
Received: 26 December 2018 / Revised: 13 February 2019 / Accepted: 13 February 2019 / Published: 15 February 2019
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Abstract
Background: Iodine deficiency in pregnant women, defined as a median urinary iodine concentration (UIC) of less than 150 μg/L, is an important public health issue. To improve their iodine intake, it is important to understand the knowledge and practices regarding iodine. Methods: A [...] Read more.
Background: Iodine deficiency in pregnant women, defined as a median urinary iodine concentration (UIC) of less than 150 μg/L, is an important public health issue. To improve their iodine intake, it is important to understand the knowledge and practices regarding iodine. Methods: A cross-sectional investigation was conducted on 2642 pregnant women during 2016–2017 in Zhejiang province, China. A 3-point Likert scale questionnaire was used to record knowledge. The UIC and iodine content in household salt were determined. Results: Coastal participants were iodine deficient (median UIC 127.6 μg/L) while inland participants were iodine sufficient (median UIC 151.0 μg/L). The average knowledge scores were significantly lower for the coastal participants (24.2 points vs. 25 points for the inland participants; p < 0.001). The percentage for iodized salt consumption was significantly lower for the coastal participants (88.9% vs. 96.0% for those inland; p < 0.001). A generalized linear model analysis showed that non-iodized salt consumption, coastal region, and low knowledge scores were independently associated with a low UIC. Conclusions: Comprehensive interventional strategies are needed to develop to achieve an optimal iodine status. We recommend that coastal pregnant women should take iodine supplements based on the consumption of iodized salt, and improvement of iodine-related knowledge. Full article
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Open AccessArticle (−)-Oleocanthal Combined with Lapatinib Treatment Synergized against HER-2 Positive Breast Cancer In Vitro and In Vivo
Nutrients 2019, 11(2), 412; https://doi.org/10.3390/nu11020412
Received: 28 December 2018 / Revised: 30 January 2019 / Accepted: 11 February 2019 / Published: 15 February 2019
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Abstract
Dysregulation of epidermal growth factor receptor (EGFR)/human epidermal growth factor-2 (HER2) family is a hallmark of aggressive breast cancer. Small-molecule tyrosine kinase inhibitors are among the most effective cancer targeted treatments. (−)-Oleocanthal (OC) is a naturally occurring phenolic secoiridoid lead from extra-virgin olive [...] Read more.
Dysregulation of epidermal growth factor receptor (EGFR)/human epidermal growth factor-2 (HER2) family is a hallmark of aggressive breast cancer. Small-molecule tyrosine kinase inhibitors are among the most effective cancer targeted treatments. (−)-Oleocanthal (OC) is a naturally occurring phenolic secoiridoid lead from extra-virgin olive oil with documented anti-cancer activities via targeting mesenchymal epithelial transition factor (c-Met). Dysregulation of c-Met promotes aggressiveness to breast cancer-targeted therapies. Lapatinib (LP) is an FDA-approved dual EGFR/HER2 inhibitor for HER2-amplified breast cancer. HER2-Positive tumor cells can escape targeted therapies like LP effects by overexpressing c-Met. Combined OC-LP treatment is hypothesized to be mechanistically synergistic against HER2-overexpressing breast cancer. Combined sub-effective treatments of OC-LP resulted in synergistic anti-proliferative effects against the HER2-positive BT-474 and SK-BR-3 breast cancer cell lines, compared to OC or LP monotherapy. Antibody array and Western blot analysis showed that combined OC-LP treatment significantly inhibited EGFR, HER2, and c-Met receptor activation, as well as multiple downstream signaling proteins, compared to individual OC or LP treatment. OC-LP Combination significantly inhibited invasion and migration of breast cancer cells through reduced activation of focal adhesion kinase (FAK) and paxillin. Combined treatment of OC-10 mg/kg with LP-12.5 mg/kg suppressed more than 90% of BT-474 tumor cells growth in a nude mouse xenograft model, compared to individual OC or LP treatment. Activated c-Met, EGFR, HER2, and protein kinase B (AKT) were significantly suppressed in combination-treated mice tumors, compared to OC or LP monotherapy. This study reveals the OC future potential as combination therapy to sensitize HER2-overexpressing breast cancers and significantly reduce required doses of targeted HER family therapeutics. Full article
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Open AccessArticle Assessment of Packaged Foods and Beverages Carrying Nutrition Marketing against Canada’s Food Guide Recommendations
Nutrients 2019, 11(2), 411; https://doi.org/10.3390/nu11020411
Received: 24 January 2019 / Revised: 10 February 2019 / Accepted: 13 February 2019 / Published: 15 February 2019
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Abstract
Canadians’ food purchases consist largely of packaged processed and ultra-processed products, which typically fall outside the “core” foods recommended by Canada’s Food Guide (CFG). Almost half of packaged products in Canada carry nutrition marketing (i.e., nutrient content and health claims). This study assessed [...] Read more.
Canadians’ food purchases consist largely of packaged processed and ultra-processed products, which typically fall outside the “core” foods recommended by Canada’s Food Guide (CFG). Almost half of packaged products in Canada carry nutrition marketing (i.e., nutrient content and health claims). This study assessed whether packaged foods carrying nutrition marketing align with recommendations outlined in the 2007 CFG. Label data (n = 9376) were extracted from the 2013 Food Label Information Program (FLIP). Label components (including nutrition marketing) were classified using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) labelling taxonomy. The Health Canada Surveillance Tool (HCST) was used to assess the alignment of products to CFG. Each food or beverage was classified into one of five groups (i.e., Tier 1, Tier 2, Tier 3, Tier 4, “Others”). Products in Tier 1, 2 or water were considered “in line with CFG”. Most products in the analyzed sample were classified as Tier 2 (35%) and Tier 3 (27%). Although foods with nutrition marketing were significantly more likely to align to CFG recommendations (p < 0.001), many products not “in line with CFG” still carried nutrition marketing. This study provides important baseline data that could be used upon the implementation of the new CFG. Full article
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Open AccessArticle Curcumae Radix Extract Decreases Mammary Tumor-Derived Lung Metastasis via Suppression of C-C Chemokine Receptor Type 7 Expression
Nutrients 2019, 11(2), 410; https://doi.org/10.3390/nu11020410
Received: 18 January 2019 / Revised: 11 February 2019 / Accepted: 11 February 2019 / Published: 15 February 2019
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Abstract
Curcumae radix is the dry root of Curcuma longa L. (turmeric) that can be used either as a spice or traditional medicine. The aim of this study was to investigate the survival benefits and the anti-metastatic activity of curcumae radix extract (CRE) in [...] Read more.
Curcumae radix is the dry root of Curcuma longa L. (turmeric) that can be used either as a spice or traditional medicine. The aim of this study was to investigate the survival benefits and the anti-metastatic activity of curcumae radix extract (CRE) in MCF7 cells and in MMTV-PyMT transgenic mice—a mouse model of breast cancer metastasis. In vitro wound scratch assay revealed that CRE treatment inhibited cell motility and cell migration in a dose-dependent manner. To investigate the effect of CRE in breast cancer metastasis, MMTV-PyMT transgenic female virgin mice were used and randomly divided into two groups. For survival curve analysis, CRE was administered in a dose of 50 mg/kg to 8–20-week-old mice. Interestingly, CRE treatment significantly increased the median and prolonged survival of MMTV-PyMT mice. Furthermore, CRE treatment decreased tumor burden and inhibited cell proliferation in primary breast tumor, and also suppressed mammary tumor-derived lung metastasis. The size of the lung metastases substantially decreased in the CRE-treated group compared with the ones in the control group. Curcumae radix extract showed anti-metastatic activity through regulating the expression of metastasis markers including C-C Chemokine Receptor Type 7, Matrix Metalloproteinase 9 and the proto-oncogenes c-fos and c-jun. We demonstrated that these metastatic regulators were decreased when CCR7 expression was suppressed in MCF7 cells transfected with CCR7 siRNA. The results of this study show that curcumae radix exerts antitumor and anti-metastatic activities, and we suggest that curcumae radix might be a potential supplement for the treatment and prevention of breast cancer metastasis. Full article
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Open AccessArticle Requirements of an Application to Monitor Diet, Physical Activity and Glucose Values in Patients with Type 2 Diabetes: The Diameter
Nutrients 2019, 11(2), 409; https://doi.org/10.3390/nu11020409
Received: 23 December 2018 / Revised: 6 February 2019 / Accepted: 11 February 2019 / Published: 15 February 2019
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Abstract
Adherence to a healthy diet and regular physical activity are two important factors in sufficient type 2 diabetes mellitus management. It is recognized that the traditional treatment of outpatients does not meet the requirements for sufficient lifestyle management. It is hypothesised that a [...] Read more.
Adherence to a healthy diet and regular physical activity are two important factors in sufficient type 2 diabetes mellitus management. It is recognized that the traditional treatment of outpatients does not meet the requirements for sufficient lifestyle management. It is hypothesised that a personalized diabetes management mHealth application can help. Such an application ideally measures food intake, physical activity, glucose values, and medication use, and then integrates this to provide patients and healthcare professionals insight in these factors, as well as the effect of lifestyle on glucose values in daily life. The lifestyle data can be used to give tailored coaching to improve adherence to lifestyle recommendations and medication use. This study describes the requirements for such an application: the Diameter. An iterative mixed method design approach is used that consists of a cohort study, pilot studies, literature search, and expert meetings. The requirements are defined according to the Function and events, Interactions and usability, Content and structure and Style and aesthetics (FICS) framework. This resulted in 81 requirements for the dietary (n = 37), activity and sedentary (n = 15), glycaemic (n = 12), and general (n = 17) parts. Although many applications are currently available, many of these requirements are not implemented. This stresses the need for the Diameter as a new personalized diabetes application. Full article
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Open AccessReview Targeting the Zinc Transporter ZIP7 in the Treatment of Insulin Resistance and Type 2 Diabetes
Nutrients 2019, 11(2), 408; https://doi.org/10.3390/nu11020408
Received: 20 December 2018 / Revised: 13 January 2019 / Accepted: 12 February 2019 / Published: 15 February 2019
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Abstract
Type 2 diabetes mellitus (T2DM) is a disease associated with dysfunctional metabolic processes that lead to abnormally high levels of blood glucose. Preceding the development of T2DM is insulin resistance (IR), a disorder associated with suppressed or delayed responses to insulin. The effects [...] Read more.
Type 2 diabetes mellitus (T2DM) is a disease associated with dysfunctional metabolic processes that lead to abnormally high levels of blood glucose. Preceding the development of T2DM is insulin resistance (IR), a disorder associated with suppressed or delayed responses to insulin. The effects of this response are predominately mediated through aberrant cell signalling processes and compromised glucose uptake into peripheral tissue including adipose, liver and skeletal muscle. Moreover, a major factor considered to be the cause of IR is endoplasmic reticulum (ER) stress. This subcellular organelle plays a pivotal role in protein folding and processes that increase ER stress, leads to maladaptive responses that result in cell death. Recently, zinc and the proteins that transport this metal ion have been implicated in the ER stress response. Specifically, the ER-specific zinc transporter ZIP7, coined the “gate-keeper” of zinc release from the ER into the cytosol, was shown to be essential for maintaining ER homeostasis in intestinal epithelium and myeloid leukaemia cells. Moreover, ZIP7 controls essential cell signalling pathways similar to insulin and activates glucose uptake in skeletal muscle. Accordingly, ZIP7 may be essential for the control of ER localized zinc and mechanisms that disrupt this process may lead to ER-stress and contribute to IR. Accordingly, understanding the mechanisms of ZIP7 action in the context of IR may provide opportunities to develop novel therapeutic options to target this transporter in the treatment of IR and subsequent T2DM. Full article
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Open AccessArticle Next-Generation Sequencing Identifies Polyunsaturated Fatty Acid Responsive Genes in the Juvenile Rat Cerebellum
Nutrients 2019, 11(2), 407; https://doi.org/10.3390/nu11020407
Received: 20 December 2018 / Revised: 6 February 2019 / Accepted: 7 February 2019 / Published: 15 February 2019
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Abstract
Dietary n-3 polyunsaturated fatty acids (PUFA) influence postnatal brain growth and development. However, little data exist regarding the impacts of dietary n-3 PUFA in juvenile animals post weaning, which is a time of rapid growth. We tested the hypothesis that depleting [...] Read more.
Dietary n-3 polyunsaturated fatty acids (PUFA) influence postnatal brain growth and development. However, little data exist regarding the impacts of dietary n-3 PUFA in juvenile animals post weaning, which is a time of rapid growth. We tested the hypothesis that depleting dietary n-3 PUFA would result in modifications to the cerebellar transcriptome of juvenile rats. To test this hypothesis, three week old male rats (an age that roughly corresponds to an 11 month old child in brain development) were fed diets containing either soybean oil (SO) providing 1.1% energy from α-linolenic acid (ALA; 18:3n-3; ALA-sufficient) or corn oil (CO) providing 0.13% energy from ALA (ALA-deficient) for four weeks. Fatty acids (FAs) in the cerebellum were analyzed and revealed a 4-fold increase in n-6 docosapentaenoic acid (DPA; 22:5n-6), increases in arachidonic acid (AA; 20:4n-6) and docosatetraenoic acid (DTA; 22:4n-6), but no decrease in docosahexaenoic acid (DHA; 22:6n-3), in animals fed CO versus SO. Transcript abundance was then characterized to identify differentially expressed genes (DEGs) between the two diets. Upper quartile (UQ) scaling and transcripts per million (TPM) data normalization identified 100 and 107 DEGs, respectively. Comparison of DEGs from the two normalization methods identified 70 genes that overlapped, with 90% having abundance differences less than 2-fold. Nr4a3, a transcriptional activator that plays roles in neuroprotection and learning, was elevated over 2-fold from the CO diet. These data indicate that expression of Nr4a3 in the juvenile rat cerebellum is responsive to dietary n-3 PUFA, but additional studies are needed clarify the neurodevelopmental relationships between n-3 PUFA and Nr4a3 and the resulting impacts. Full article
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Open AccessReply Reply: “Letter to the Editor Re: Billeaud et al. Nutrients 2018, 10, 690”
Nutrients 2019, 11(2), 406; https://doi.org/10.3390/nu11020406
Received: 11 February 2019 / Accepted: 12 February 2019 / Published: 15 February 2019
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Abstract
We thank Bernard and colleagues for their careful reading and interest in our article Effects on Fatty Acid Metabolism of a New Powdered Human Milk Fortifier Containing Medium-Chain Triacylglycerols and Docosahexaenoic Acid in Preterm Infants [...] Full article
Open AccessArticle Dietary Patterns during Pregnancy Are Associated with the Risk of Gestational Diabetes Mellitus: Evidence from a Chinese Prospective Birth Cohort Study
Nutrients 2019, 11(2), 405; https://doi.org/10.3390/nu11020405
Received: 20 December 2018 / Revised: 31 January 2019 / Accepted: 1 February 2019 / Published: 15 February 2019
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Abstract
Dietary patterns during pregnancy have been shown to influence the development of gestational diabetes mellitus (GDM). However, evidence from Asian populations is limited and inconsistent. We conducted a prospective cohort study in China to assess the relationship between dietary patterns and GDM. We [...] Read more.
Dietary patterns during pregnancy have been shown to influence the development of gestational diabetes mellitus (GDM). However, evidence from Asian populations is limited and inconsistent. We conducted a prospective cohort study in China to assess the relationship between dietary patterns and GDM. We administered three-day food diaries (TFD) and food frequency questionnaires (FFQ) at the second trimester. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 24–28 weeks of gestation. We identified dietary patterns using principal components analysis and used multivariable logistic regression to investigate associations of dietary patterns with GDM. Of the 1014 participants, 23.5% were diagnosed with GDM. Both the TFD and FFQ identified a “traditional pattern”, consisting of high vegetable, fruit, and rice intake, which was associated with a lower GDM risk (odds ratio (OR) for quartile 4 versus quartile 1: 0.40, 95% CI: 0.23–0.71 for traditional pattern (TFD); OR: 0.44, CI: 0.27–0.70 for traditional pattern (FFQ)). The protective associations were more pronounced among women ≥35 years old. A whole grain–seafood TFD pattern was associated with higher risk of GDM (OR: 1.73, 95% CI: 1.10–2.74). These findings may provide evidence for making dietary guidelines among pregnant women in Chinese populations to prevent GDM. Full article
(This article belongs to the Special Issue Nutrition and Gestational Diabetes)
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Open AccessArticle HM-Chromanone Isolated from Portulaca Oleracea L. Protects INS-1 Pancreatic β Cells against Glucotoxicity-Induced Apoptosis
Nutrients 2019, 11(2), 404; https://doi.org/10.3390/nu11020404
Received: 26 December 2018 / Revised: 31 January 2019 / Accepted: 11 February 2019 / Published: 14 February 2019
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Abstract
In this study, we investigated whether (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone, a homoisoflavonoid compound isolated from Portulaca oleracea L., protects INS-1 pancreatic β cells against glucotoxicity-induced apoptosis. Treatment with high glucose (30 mM) induced apoptosis in INS-1 pancreatic β cells; however, the level of cell [...] Read more.
In this study, we investigated whether (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone, a homoisoflavonoid compound isolated from Portulaca oleracea L., protects INS-1 pancreatic β cells against glucotoxicity-induced apoptosis. Treatment with high glucose (30 mM) induced apoptosis in INS-1 pancreatic β cells; however, the level of cell viability was significantly increased by treatment with (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone. Treatment with 10–20 µM of (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone dose-dependently increased cell viability and significantly decreased the intracellular level of reactive oxygen species (ROS), thiobarbituric acid reactive substances (TBARS), and nitric oxide levels in INS-1 pancreatic β cells pretreated with high glucose. These effects were associated with increased anti-apoptotic Bcl-2 protein expression, while reducing pro-apoptotic Bax, cytochrome C, and caspase 9 protein expression. Treatment with (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone reduced the apoptosis previously induced by high-level glucose-treatment, according to annexin V/propidium iodide staining. These results demonstrate that (E)-5-hydroxy-7-methoxy-3-(2′-hydroxybenzyl)-4-chromanone may be useful as a potential therapeutic agent to protect INS-1 pancreatic β cells against high glucose-induced apoptosis. Full article
(This article belongs to the Special Issue Nutrition, Genes and Signaling Pathways)
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Open AccessArticle Setting Policy Priorities for Front-of-Pack Health Claims and Symbols in the European Union: Expert Consensus Built by Using a Delphi Method
Nutrients 2019, 11(2), 403; https://doi.org/10.3390/nu11020403
Received: 27 December 2018 / Revised: 29 January 2019 / Accepted: 4 February 2019 / Published: 14 February 2019
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Abstract
Despite the fact that front-of-pack nutrition labels such as health claims and symbols have received growing attention in consumer behavior research, comprehensive conclusions could not yet be drawn to develop concrete policy actions, owing to the complexity of the subject and a constantly [...] Read more.
Despite the fact that front-of-pack nutrition labels such as health claims and symbols have received growing attention in consumer behavior research, comprehensive conclusions could not yet be drawn to develop concrete policy actions, owing to the complexity of the subject and a constantly changing market environment. In this study, evidence-based policy recommendations and communication guidelines have been derived from the findings of the EU FP7 project CLYMBOL (“Role of health-related CLaims and sYMBOLs in consumer behavior”, Grant Agreement 311963), and have been evaluated and prioritized by European stakeholders using a three-round Delphi method. A moderate level of consensus was achieved and results suggest that policy priority should focus on ways to improve consumer motivation and interest in healthy eating. Consumers’ interest in healthy eating could be increased by adopting appropriate communication strategies such as using innovative ways to communicate the importance of healthy eating, which may aim to change the possible negative association between healthiness and tastiness. The highest-rated finding was related to consumers’ favorable attitude towards health claims with shorter and less complex messages and health symbols with a visible endorsement. Meanwhile, there was a clear consensus that health claims need to be scientifically substantiated and credible but phrased without using overly complex scientific wordings, in order to be meaningful for consumers. Furthermore, stakeholders from academia and industry believe that consumer awareness about existing health claims should be increased. The identified policy recommendations and communication guidelines stem from recent empirical evidence and provide useful insights that guide future policy development aligning consumer protection issues as well as public health and food marketing communication interests. Full article
(This article belongs to the Special Issue Front-of-Pack Nutrition Label and Public Health)
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Open AccessReview Deciphering the Nutraceutical Potential of Raphanus sativus—A Comprehensive Overview
Nutrients 2019, 11(2), 402; https://doi.org/10.3390/nu11020402
Received: 11 January 2019 / Revised: 8 February 2019 / Accepted: 11 February 2019 / Published: 14 February 2019
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Abstract
Raphanus sativus (Radish) belongs to the Brassicaceae family and is a widely consumed root vegetable all around the world. The nutritional and medicinal values of radishes have been proven by several researches. Extracts prepared from the aerial and underground parts of radishes have [...] Read more.
Raphanus sativus (Radish) belongs to the Brassicaceae family and is a widely consumed root vegetable all around the world. The nutritional and medicinal values of radishes have been proven by several researches. Extracts prepared from the aerial and underground parts of radishes have been used in the treatment of stomach disorders, urinary infections, hepatic inflammation, cardiac disorders and ulcers in folk medicine since the ancient times. The pharmaceutical potential of radishes is attributed to the presence of its beneficial secondary metabolites, such as glucosinolates, polyphenols and isothiocyanates. The present review has focused on the impact of radish extract administration under pathological complications, such as cancer, diabetes, hepatic inflammation and oxidative stress. In addition, a comprehensive view of molecular mechanism behind the regulation of molecular drug targets associated with different types of cancers and diabetes by the bioactive compounds present in the radish extracts have been discussed in detail. Full article
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Open AccessArticle Influence of Eating Schedule on the Postprandial Response: Gender Differences
Nutrients 2019, 11(2), 401; https://doi.org/10.3390/nu11020401
Received: 9 January 2019 / Revised: 11 February 2019 / Accepted: 12 February 2019 / Published: 14 February 2019
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Abstract
Ingestion of a meal induces conscious sensations depending of the characteristics of the meal and the predisposition of the eater. We hypothesized that the eating schedule plays a conditioning role, specifically, that an extemporaneous meal is less rewarding than when eaten at the [...] Read more.
Ingestion of a meal induces conscious sensations depending of the characteristics of the meal and the predisposition of the eater. We hypothesized that the eating schedule plays a conditioning role, specifically, that an extemporaneous meal is less rewarding than when eaten at the habitual schedule. We conducted a randomized parallel trial in 10 women and 10 men comparing the responses to a consistent savoury lunch-type meal (stewed beans) eaten at the habitual afternoon schedule or at an unconventional time in the morning. Schedule and gender differences were analyzed by repeated measures analysis of covariance. In women, the sensory experience induced by the probe meal, particularly postprandial satisfaction, was weaker when eaten at an unconventional time for breakfast. Men were resilient to the schedule effect and experienced the same sensations regardless of the timing of ingestion; the effect of the eating schedule was significantly more pronounced in women for fullness (F(1,55) = 14.9; p < 0.001), digestive well-being (F(1,36.8) = 22.3; p < 0.001), mood (F(1,12.4) = 13.8; p < 0.001), and anxiety (F(1,11.9) = 10.9; p = 0.001). No differences in the physiological responses induced by the afternoon and morning meals were detected either in women or men. Our data indicate that women are more susceptible to changes in meal schedule than men. Full article
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Open AccessArticle Communicating Risk Regarding Food Consumption: The Case of Processed Meat
Nutrients 2019, 11(2), 400; https://doi.org/10.3390/nu11020400
Received: 17 January 2019 / Revised: 8 February 2019 / Accepted: 11 February 2019 / Published: 14 February 2019
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Abstract
The present research combines real data and parameters found in recent literature that were used to design realistic scenarios demonstrating the potential effects (benefits and costs) of the World Health Organization (WHO)’s risk communication regarding the consumption of processed meat, which was proven [...] Read more.
The present research combines real data and parameters found in recent literature that were used to design realistic scenarios demonstrating the potential effects (benefits and costs) of the World Health Organization (WHO)’s risk communication regarding the consumption of processed meat, which was proven to be associated with an increased risk of colorectal cancer (CRC) in an International Agency for Research on Cancer (IARC)/WHO report. The impact of the risk communication of processed meat consumption was simulated using Monte Carlo microsimulation models. The results showed that a 1% reduction in the number of high-level processed meat consumers may lead to a yearly decrease in CRC cases of 406.43 (IC 95%: −243.94, 1056.81), while the more extreme scenario of a 15% reduction may lead to 2086.62 fewer cases (IC 95%: 1426.66, 2746.57). On the other hand, if demand contraction in the processed meat sector resulted in a 0.1% loss in employment, one could expect 27.23 all-cause mortalities attributable to job loss (IC 95%: 16.55, 37.80). This simulation study demonstrates that caution should be taken when implementing public awareness campaigns, particularly when the prevention message is not straightforward. Full article
Open AccessArticle Persistent Economic Burden of the Gluten Free Diet
Nutrients 2019, 11(2), 399; https://doi.org/10.3390/nu11020399
Received: 27 January 2019 / Revised: 7 February 2019 / Accepted: 12 February 2019 / Published: 14 February 2019
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Abstract
Gluten free (GF) products have been reported to be more expensive and less available than their gluten containing counterparts. We examined the current U.S. cost and availability of GF products and made comparisons to the marketplace over a decade ago. Cost, determined by [...] Read more.
Gluten free (GF) products have been reported to be more expensive and less available than their gluten containing counterparts. We examined the current U.S. cost and availability of GF products and made comparisons to the marketplace over a decade ago. Cost, determined by price per ounce and availability of a “market basket” of regular and GF products across four venues and five geographic regions was compared using a student’s t test. GF products were more expensive (overall 183%), and in all regions and venues (p < 0.001). GF products from mass-market producers were 139% more expensive than the wheat-based version of the same product. Availability of GF products was greatest (66%) in the health food and upscale venues. In contrast to the results of the 2006 study, the cost of GF products has declined from 240% to 183% (adjusted for inflation). The introduction of mass-market production of GF products may have influenced the increase in availability and overall reduction of cost since 2006. The extent to which the cost of GF products impacts dietary adherence and quality of life for those on a GFD warrants exploration. Full article
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Open AccessArticle Role of Front-of-Package Gluten-Free Product Labeling in a Pair-Matched Study in Women with and without Celiac Disease on a Gluten-Free Diet
Nutrients 2019, 11(2), 398; https://doi.org/10.3390/nu11020398
Received: 31 December 2018 / Revised: 11 February 2019 / Accepted: 11 February 2019 / Published: 14 February 2019
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Abstract
Gluten-free (GF) product labeling is one of the most important determinants of food product choices by patients with celiac disease, due to the need for following a GF diet. The aim of this study was to assess the role of front-of-package GF product [...] Read more.
Gluten-free (GF) product labeling is one of the most important determinants of food product choices by patients with celiac disease, due to the need for following a GF diet. The aim of this study was to assess the role of front-of-package GF product labeling in pair-matched celiac and non-celiac women on a GF diet in a choice experiment (CE). In subgroups of celiac (n = 77) and non-celiac pair-matched respondents on a GF diet, but with no gluten-related diseases diagnosed (n = 77), the influence of front-of package labeling of GF bread on the choice of products was assessed. The labeling assessed in a CE included for all the products crossed grain logotype and additional logotypes of European Union (EU) organic production, “dairy-free” product, wheat starch-free product, quality and vegan product, as well as additional “gluten-free” written information. It was stated that the frequency of selection of products with “gluten-free” written information did not differ between subgroups of celiac and non-celiac respondents, as well as in subgroups stratified by age, body mass index (BMI), place of residence, and economic status. The frequency of selection of products with “vegan” logotype was higher for non-celiac respondents than for celiac ones (p = 0.0011). The frequency of selection of a product with additional logotypes was influenced by BMI and place of residence, but not by age and economic status of assessed women. Full article
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