Search Results (174)

Background: Low-glycemic index (GI) carbohydrates like isomaltulose (ISO) are known to enhance incretin release and to improve postprandial glucose control at the following meal (an effect known as second meal effect, or SME), which is particularly beneficial for individuals with metabolic syndrome (MetS). This study aimed to assess the most effective preprandial interval of ISO- or saccharose (SUC) snacks (1 h vs. 3 h preload) to enhance prandial incretin responses to a subsequent meal. Methods: In a randomized crossover design, 15 participants with MetS completed four experimental conditions on four non-consecutive days, combining two preload types (ISO or SUC) and two preload timings (Intervention A: 3 h preload; Intervention B: 1 h preload). Specifically, the four conditions were (1) ISO + Intervention A, (2) SUC + Intervention A, (3) ISO + Intervention B, and (4) SUC + Intervention B. The order of conditions was randomized and separated by a 3–7-day washout period to minimize carryover effects. On each study day, participants consumed two mixed meal tests (MMT-1 and MMT-2) with a standardized preload (50 g ISO or SUC) administered either 3 h or 1 h prior to MMT-2. Blood samples were collected over 9 h at 15 predefined time points for analysis of glucose, insulin, C-peptide, and incretin hormones (GLP-1, GIP, and PYY). Results: The unique digestion profile of ISO resulted in a blunted glucose ascent rate (ΔG/Δt: 0.28 vs. 0.53 mmol/L/min for SUC, p < 0.01), paralleled by synonyms PYY elevation over 540 min monitoring, compared with SUC. ISO also led to higher and more sustained GLP-1 and PYY levels, while SUC induced a stronger GIP response. Notably, the timing of ISO consumption significantly influenced PYY secretion, with the 3 h preload showing enhanced PYY responses and a more favorable SME compared to the 1 h preload. Conclusions: ISO, particularly when consumed 3 h before a meal (vs. 1 h), offers significant advantages over SUC by elevating PYY levels, blunting the glucose ascent rate, and sustaining GLP-1 release. This synergy enhances the second meal effect, suggesting ISO’s potential for managing postprandial glycemic excursions in MetS. Full article

After the first release of synthalin B (dodecamethylenbiguanide) in 1928 and its later retraction in the 1940s in Germany, the retraction of phenformin (N-Phenethylbiguanide) and of Buformin in the USA (but not outside) because of the lethal complication of acidosis seemed to have put an end to the era of the biguanides as oral antidiabetics. The strongly hygroscopic metformin (1-1-dimethylbiguanide), first synthesized 1922 and resuscitated as an oral antidiabetic (type 2 of the elderly) compound first released in 1959 in France and in other European countries, was used in the first large multicenter prospective long-term trial in England in the UKPDS (1977–1997). It was then released in the USA after a short-term prospective trial in healthy overweight “young” type 2 diabetics (mean age 53 years) in 1995 for oral treatment of type 2 diabetes. It was, however, prescribed to mostly multimorbid older patients (above 60–65 years of age). Metformin is now the most used oral drug for type 2 diabetes worldwide. While intravenous administration of biguanides does not have any glucose-lowering effect, their oral administration leads to enormous increase in their intestinal concentration (up to 300-fold compared to that measured in the blood), to reduced absorption of glucose from the diet, to increased excretion of glucose through the stool, and to decrease in insulin serum level through increased hepatic uptake and decreased production. Intravenously injected F18-labeled glucose in metformin-treated type 2 diabetics accumulates in the small and even more in the large intestine. The densitometry picture observed in metformin-treated overweight diabetics is like that observed in patients after bowel-cleansing or chronically taking different types of laxatives, where the accumulated radioactivity can even reach values observed in colon cancer. The glucose-lowering mechanism of action of metformin is therefore not only due to inhibition of glucose uptake in the small intestine but also to “attraction” of glucose from the hepatocyte into the intestine, possibly through the insulin-mediated uptake in the hepatocyte and its secretion into the bile. Furthermore, these compounds have also a diuretic effect (loss of sodium and water in the urine) Acute gastrointestinal side effects accompanied by fluid loss often lead to the drugs’ dose reduction and strongly limit adherence to therapy. Main long-term consequences are “chronic” dehydration, deficiency of vitamin B12 and of iron, and, as observed for all the biguanides, to “chronic” increase in fasting and postprandial lactate plasma level as a laboratory marker of a clinical condition characterized by hypotension, oliguria, adynamia, and evident lactic acidosis. Metformin is not different from the other biguanides: synthalin B, buformin, and phenformin. The mechanism of action of the biguanides as antihyperglycemic substances and their side effects are comparable if not even stronger (abdominal pain, nausea, vomiting, diarrhea, fluid loss) to those of laxatives. Full article

Dietary protein is an essential macronutrient derived from both plant and animal sources required for muscle building, immune function, and wound healing. However, in the United States, protein consumption worsens as individuals age, with 30% of men and 50% of women over 71 consuming inadequate dietary protein due to a variety of factors, including changes in gut function, loss of appetite, tooth loss, financial concerns, and social isolation. The aim of this review is to underscore the need for increased protein requirements in aging populations, highlight potential barriers, synthesize these protein requirements, and also recommend strategies to meet these increased protein needs. Achieving adequate protein status, especially when facing chronic or acute health concerns, is essential to promote muscle and bone strength (because aging is associated with significant decreases in postprandial muscle protein synthesis), to support immune health (due to immunosenescence), and to maintain a good quality of life. For older adults, the literature suggests that a dietary protein intake of at least 1.0–1.2 g/kg/day is required in healthy, aging populations, and intakes of 1.2–1.5 g/kg/day are necessary for those with chronic or acute conditions. These protein intake recommendations can increase to 2.0 g/kg/day in more severe cases of illness, malnutrition, and chronic conditions. The reviewed literature also suggests that evenly balanced protein distributions of 25–30 g of dietary protein (0.4 g/kg) per meal from animal and plant protein sources alike are sufficient to maximize muscle protein synthesis (MPS) rates in older populations. Additionally, pre-sleep protein feeds of 40 g/night may be another strategy to improve daily MPS and amino acid utilization. Full article

Background: Dyspeptic symptoms are very common in the general population, with an estimated prevalence of 14% to 41%, and the majority of patients experience symptoms without an organic cause for them (so-called functional dyspepsia). While the pathophysiology of functional dyspepsia remains elusive, the impact of functional dyspepsia on quality of life is detrimental. The treatment involves a change in lifestyle—a healthy diet and physical activity—in combination with pharmacological treatments. However, currently, there is no standard therapy for this condition, although a nutritional approach appears to be feasible and well accepted by patients. In this context, the intake of some mineral water types might be able to play an important role. Objective: The aim of the present study was to evaluate whether the regular intake of bicarbonate natural mineral water (Aqua Carpatica from source “F2 Păltiniș”) is able to positively influence the symptomatic process of dyspepsia, promoting digestion and improving the quality of life of patients. Methods: The patients enrolled in this open-label study had diagnosis of functional dyspepsia formulated in accordance with the Rome III criteria. During the 4-week study, patients had to ingest tap water at 1.5 L/day (wash-out period: 2 weeks), and in the 2-week subsequent period, they had to ingest alkaline natural mineral water at 1.5 L/day. The primary efficacy endpoint of this study includes a statistically significant improvement (p < 0.05) in the “heartburn”, “regurgitation”, and “dyspepsia” subscales and the total Reflux Disease Questionnaire’s (RDQ) score with respect to the effects of alkaline natural mineral water. As secondary endpoints, we considered statistically significant improvements (p < 0.05) in quality-of-life scores (Psychological General Well-Being Index—Short form; PGWB-S), the patient’s self-assessment of the state of efficiency of their digestion, and their sense of post-prandial fullness, as well as the use of antacids. Results: Forty-five patients were enrolled: all were Caucasian and mostly women (25, 55.6% vs. 20 men, 44.4%), and they were aged between 25 and 75 years (50.6 ± 13.5 years; mean ± SD). The results of this preliminary study show a significant improvement in functional dyspepsia symptoms—as assessed via the RDQ—and an improvement in quality of life—as assessed using the PGWB-S score—after the intake of alkaline natural mineral water. Conclusions: This preliminary study provides clinical evidence for a recommendation of alkaline natural mineral water as a symptomatic treatment of dyspepsia. Full article

Background: N^ε-(carboxymethyl)-lysine (CML) is formed in the human body by non-enzymatically driven reactions including glycation, oxidation, and lipoxidation. CML is a ubiquitous product of normal physiology, but its levels are increased under disease conditions like chronic kidney disease (CKD) and diabetes mellitus (DM). Free CML is eliminated from the human body mainly through kidney excretion, and its accumulation in the kidney tissue is linked to CKD pathogenesis. Aim: The main goal of this study was to evaluate the relative contribution of CKD and Type 2 DM (T2DM) to the accumulation of CML in patients’ sera. Methods: The study included 22 patients with CKD without DM, 55 with CKD and comorbid T2DM, and 21 with T2DM without CKD. Serum CML levels were measured by ELISA. The Kruskal-Wallis test was used to detect differences among groups. Spearman correlation analysis was performed, and the one-tailed Dunn test was considered to indicate statistical significance at p < 0.05. Results: The median serum CML levels (CKD, 658.4 ± 434.3 ng/mL; CKD + T2DM, 431.3 ± 327.9 ng/mL; T2DM, 273.9 ± 134.2 ng/mL) differed significantly (p < 0.05) among the three patient groups. A positive correlation was observed between serum CML and microalbuminuria (p = 0.004; r = 0.58), proteinuria (p = 0.002; r = 0.6), and age (p = 0.007; r = 0.52) only in the CKD patients. In all T2DM patients, independent of CKD status, serum CML correlated negatively (p < 0.05) with postprandial glucose and duration of diabetes, while its correlation with fasting glucose and HbA1c was negative only in the T2DM cohort without CKD. Conclusions: In patients with CKD, higher levels of CML were observed compared to those with T2DM. Serum CML correlated positively with proteinuria, albuminuria, and patient age in non-diabetic CKD patients, and negatively with blood glucose, HbA1c, and DM duration of T2DM in patients without CKD. Full article

Bioactive compounds have shown significant potential in the management of obesity and metabolic syndrome (MetS). This study investigates the effects of antioxidant lipids (ALω-3), synthetized through enzymatic acidolysis using non-specific lipase B from Candida antarctica under supercritical CO₂ conditions. These lipids were derived from a concentrate of rainbow trout (Oncorhynchus mykiss) belly oil, rich in long-chain polyunsaturated omega-3 fatty acids (LCPUFAn-3), and cold-pressed maqui seed oil (MO, Aristotelia chilensis (Mol.) Stuntz). Their effects were then evaluated in a murine high-fat diet (HFD) model. The fatty acid profile, tocopherol and tocotrienol content, and thin-layer chromatography of ALω-3 were analyzed. After 8 weeks on an HFD, male C57BL/6 mice were divided into four groups and switched to a control diet (CD) with the following supplements for 3 weeks: Glycerol (G), commercial marine Omega-3 (CMω-3), a mixture of LCPUFAn-3 concentrate + MO (Mω-3), or ALω-3. The total body and organ weights, serum markers, and liver and visceral fat pro-inflammatory marker expression levels were assessed. ALω-3 contained 13.4% oleic, 33.9% linoleic, 6.3% α-linolenic, 10.7% eicosapentaenoic, and 16.2% docosahexaenoic fatty acids. The β, γ, δ-tocopherol, and β, γ-tocotrienol values were 22.9 ± 1.4, 24.9 ± 0.2, 6.8 ± 0.7, 22.9 ± 1.7, and 22.4 ± 4.7 mg·kg⁻¹, respectively, with α-tocopherol detected in traces. ALω-3 supplementation increased serum Trolox equivalent capacity, significantly reduced serum GPT levels (p < 0.01), and enhanced postprandial glucose tolerance (p < 0.001), although it did not alter insulin resistance (HOMA-IR). These findings indicate ALω-3′s potential for mitigating the glucose intolerance, liver damage, and oxidative stress associated with obesity and MetS, highlighting the need for additional research to explore its potential health benefits. Full article

This study investigates a noninvasive continuous glucose monitoring (NI-CGM) system optimized for earlobe application, leveraging the site’s anatomical advantages—absence of bone, muscle, and thick skin—for enhanced optical transmission. The system integrates multimodal sensing, combining near-infrared (NIR) diffuse transmission with temperature and pressure sensors. A novel Multi-Wavelength Slope Efficiency Near-Infrared Spectroscopy (MW-SE-NIRS) method is introduced, enhancing noise robustness through the slope efficiency-based parameterization of NIR signal dynamics. By employing three NIR wavelengths with distinct scattering and absorption properties, the method improves glucose detection reliability, addressing tissue heterogeneity and physiological noise in noninvasive monitoring. To validate the feasibility, a pilot clinical trial enrolled five participants with normal or pre-diabetic glucose profiles. Continuous glucose data capturing pre- and postprandial variations were analyzed using a 1D convolutional neural network (Conv1D). For three subjects under stable physiological conditions, the model achieved 97.0% Clarke error grid (CEG) A-Zone accuracy and a mean absolute relative difference (MARD) of 5.2%. Across all participants, results showed 90.9% CEG A-Zone accuracy and a MARD of 8.4%, with performance variations linked to individual factors such as earlobe thickness variability and physical activity. These outcomes demonstrate the potential of the MW-SE-NIRS system for noninvasive glucose monitoring and highlight the importance of future work on personalized modeling, sensor optimization, and larger-scale clinical validation. Full article

Volatile anesthetics, while increasingly utilized in intensive care medicine, are associated with significant renal adverse effects. A critical safety concern—particularly with sevoflurane—involves its potential impact on renal function. Pathophysiologically, inorganic fluoride levels exceeding 50 µmol/L are recognized as a threshold for nephrogenic diabetes insipidus, a condition generally considered reversible. Additionally, the sevoflurane degradation product “compound A” has been implicated in direct renal tubular and glomerular toxicity. Specifically, exposure has been correlated with glomerular damage, evidenced by albuminuria, as well as injury to both proximal and distal tubules, indicated by elevated levels of α-glutathione-S-transferase. Postprandial glycosuria may also be observed. Unlike nephrogenic diabetes insipidus, the structural damage induced by compound A may result in irreversible renal impairment. Full article

For over a century, critics have postulated that a judge’s state of hunger or post-prandial mental state is a determinant of judicial outcomes. This idea, known in contemporary discourse as the ‘judicial breakfast,’ is used as a surrogate of the larger ways in which biases, even if the individual is not aware of them, influence judicial outcomes. In 2011, the publication of a landmark study paired parole decisions with judicial meal breaks, inviting a literal interpretation of the judicial breakfast. Since that publication, the literature on nutritional neuropsychology has grown rapidly. The findings of these studies are highly relevant to judges experiencing high stress levels, including workload demands and activities within the adversarial system. This stress represents significant harm to an individual judge’s wellbeing, and based on updated findings within neuropsychology, has potential relevance to judicial outcomes. Emergent research indicates that dietary choices and blood/brain glucose have the potential to act as important mediators of decision-making under conditions of stress and fatigue. With proper evidence-based attention, we can better understand the extent to which diet and lifestyle can positively influence judicial wellness and, by extension, support or refute the longstanding assumptions surrounding the “hungry judge effect” and gastronomic jurisprudence. Full article

Background/Objectives: Gastrointestinal disorders include a broad spectrum of clinical conditions due to various symptoms. Abdominal pain claims attention as it can be associated with multiple diseases, and some of them can lead to chronic abdominal pain, such as chronic gastritis and irritable bowel syndrome. Moreover, dyspepsia is also a prevalent condition, and its symptoms are postprandial fullness, epigastric pain or burn, and early satiety. Conventional therapeutic approaches for gastrointestinal disorders exist, but the Mentha plant has a millenary tradition. Mentha aerial parts and leaves hold therapeutic and pharmacological value, and its components are characterized as non-essential oil with superabundant phenolic compounds, and essential oil classified as volatile secondary metabolites like menthol and menthone. Studies have shown that Mentha species can exert benefits by modulating the inflammatory process and scavenging free radicals, which can benefit gastrointestinal tract disorders. The aim of this review was to systematically investigate the effects of Mentha species on gastrointestinal disorders. Methods: Sixteen clinical trials included patients diagnosed with irritable bowel syndrome, functional dyspepsia, and functional abdominal pain, as well as some healthy volunteers. The COCHRANE tool was utilized to assess the bias of the included studies. Results: Most studies reported significant outcomes for Mentha oil-treated groups, such as better control of abdominal pain and discomfort, even though two trials did not report superior outcomes. Conclusions: Due to the increasing interest in natural compounds, further clinical trials are necessary to confirm the status of Mentha for improvement in gastrointestinal disorders. Full article

Background/Objectives: Time spent in sedentary pursuits is associated with adverse metabolic profiles. Adolescents spend 65–75% of their day in sedentary pursuits; however, evidence among youth is less conclusive. This study examined the effects of an acute 4 h bout of sedentary behaviors on cardiometabolic outcomes and energy expenditure in Hispanic adolescents (12–16 years old) with obesity (BMI% ≥ 95th). Methods: This study used a randomized cross-over design to engage participants (N = 12) in two sedentary conditions, an active condition where youth were engaged in two hours of ‘active’ sitting activities (e.g., reading and puzzles) and two hours of passive movie-watching. Whole-room calorimetry was used to assess energy expenditure. Fasting measures of insulin, adiponectin, leptin, and TNF-alpha were collected, followed by post-prandial measures 30 min, 2 h, and 4 h after a standardized meal. Adiposity was assessed using DXA. Results: There was no overall impact of the 4 h sedentary bout on energy expenditure or cardiometabolic risk factors; however, energy expenditure in the active sedentary condition was higher compared to the passive sedentary condition (p = 0.0635, ß estimate = 0.1538). Sex and adiposity did not moderate the relationships among sedentary time, cardiometabolic outcomes, and energy expenditure. Conclusions: Due to power limitations, these results are exploratory; however, they suggest that different types of sedentary behaviors may be more deleterious than others. More studies are needed to understand the context in which sedentary activities occur and the mechanisms by which sedentary pursuits contribute to the development of cardiometabolic disease. Full article

Median Arcuate Ligament Syndrome, also known as Dunbar’s syndrome, is a rare condition caused by stenosis of the celiac artery (CAS) through the fibrous arch connecting the diaphragmatic branches. It manifests as postprandial abdominal pain, nausea, vomiting, weight loss and increased epigastric tenderness. The condition most commonly affects young females without coexisting vascular comorbidities. Diagnosis is difficult due to the non-specific symptoms, often overlapping with other gastrointestinal diseases. Standard investigations include duplex ultrasound, computed tomography angiography (CTA) and contrast-enhanced magnetic resonance imaging (CE-MRA). Treatment mainly consists of surgical release of the arch ligament, which can be performed by open, laparoscopic or robotic methods. Surgery is often supported by celiac truncal stenting for residual stenosis, which significantly improves vascular flow. Alternative approaches include visceral plexus blocks and novel hybrid techniques, such as a combination of ligament release and endovascular treatment of the celiac trunk. In severe cases, vascular by-passes are recommended. The aim of this paper is to discuss the clinical manifestations, diagnostic possibilities, therapeutic options and directions for further research on MALS from the perspective of a vascular surgeon. It emphasizes the need for a multidisciplinary approach, including collaboration between the surgeon, radiologist, gastroenterologist and psychologist, which enables comprehensive disease management and improved quality of life for patients. In addition, the need for further development of diagnostic and therapeutic methods for early diagnosis and effective treatment was pointed out. Full article

This study aimed to evaluate the acute effects of consuming in a full-course meal manner over one hour, with intervals between courses, on glycemic and insulin parameters in young healthy women, with a randomized controlled crossover study design. Experiment 1: Fifteen participants consumed a test meal under two eating conditions: fast eating manner for 10 min, and eating in a full-course meal manner for 60 min. In both conditions, the food order was standardized: vegetables first, followed by the main dish, and carbohydrates last. Blood glucose and insulin concentrations were measured at 0, 40, 80, 120, and 180 min on two separate days. Postprandial blood glucose and insulin levels at 40 min, as well as the incremental area under the curve (IAUC) at 40 min for glucose and the IAUC at both 40 and 80 min for insulin, were significantly lower for the full-course meal manner compared to the fast eating manner, due to delayed consumption of the carbohydrate dish in the former condition at these time points. To continuously monitor postprandial blood glucose responses over a 24 h period, Experiment 2 was conducted using an intermittent continuous glucose monitoring system (isCGM). Eighteen participants wore isCGM devices and consumed the same test meals under the two different eating conditions as in Experiment 1. The mean amplitude of glycemic excursions (MAGE; p < 0.05) and IAUC for glucose were significantly lower for the full-course meal manner compared to the fast eating manner. These findings suggest that consuming meals in a full-course meal manner, with intervals between courses, is associated with a reduced MAGE in young healthy women. Full article

Obesity and type 2 diabetes mellitus (T2DM) are major health concerns worldwide, often managed with treatments that have significant limitations and side effects. This study examines the potential of sodium alginates, extracted from Ecklonia radiata and Sargassum elegans, to inhibit digestive enzymes involved in managing these conditions. We chemically characterized the sodium alginates and confirmed their structural integrity using FTIR, NMR, and TGA. The focus was on evaluating their ability to inhibit key digestive enzymes relevant to T2DM (α-amylase, α-glucosidase, sucrase, maltase) and obesity (pancreatic lipase). Enzyme inhibition assays revealed that these sodium alginates moderately inhibit α-glucosidase, maltase, and lipase by up to 43%, while showing limited effects on sucrase and α-amylase. In addition, the sodium alginates did not affect glucose uptake in human colorectal cells (HCT116), indicating they do not impact cellular glucose absorption. In summary, while the observed enzyme inhibition was moderate, the targeted inhibition of α-glucosidase, maltase, and lipase suggests that sodium alginates could be beneficial for managing postprandial hyperglycemia and lipid absorption in the context of T2DM and obesity. Full article

Serum proteins are essential for maintaining osmotic pressure, regulating pH, transporting metabolites, and supporting immune responses. Studying the effects of plant-based diets on these proteins is crucial to understanding their impact on fish health and immune function. Methods: This study was conducted in a recirculation system, with rainbow trout distributed across nine tanks and fed three diets: fishmeal (control), medium plant meal (MPM; 40% of fishmeal replacement), and high plant meal (HPM; 80% of fishmeal replacement). Plasma protein and plasma glucose levels were measured at the initial and final stages, under both fasting (24 h after fast) and postprandial (6 h after fed) conditions, to assess dietary impacts. Additionally, the hepatosomatic index (HSI) was calculated at the end of the experiment to evaluate potential liver adaptations to the diets. Results: The initial protein and glucose levels were similar across all groups. However, by the end of the treatment, the fishmeal-fed group showed significantly higher total protein and globulin levels, while the albumin levels remained consistent across diet types. A significant interaction between sampling time and dietary treatment in fish reduced the clarity of dietary effects on postprandial plasma glucose levels. Furthermore, the HSI was significantly lower in fish fed the high plant meal (HPM) diet compared to the fishmeal and medium plant meal (MPM) groups, suggesting potential metabolic adaptation in response to plant-based diets. Conclusions: Replacing fishmeal with plant-based proteins in rainbow trout diets reduces total globulin and protein concentrations but leaves albumin unaffected, alongside reductions in fasting and postprandial glucose levels. The low growth and different HSI in fish fed plant-based diets highlights potential liver stress, emphasizing the need for further research to optimize sustainable aquaculture feeds while maintaining fish health and performance. Full article