Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes

Diet quality and cardiometabolic health in breast cancer survivors: the Pathways Study

PURPOSE

Breast cancer (BC) survivors experience higher rates of cardiometabolic conditions, partly due to treatment. While healthy eating decreases the risk of these conditions in the general population, its association in BC survivors is unclear.

METHODS

We included 3415 participants from the Pathways Study, a prospective cohort of women diagnosed with invasive BC between 2005 and 2013 and followed through 2021. Concordance of food intakes from food frequency questionnaires was estimated for five healthy eating patterns at BC diagnosis: Dietary Approaches to Stop Hypertension (DASH), healthy Plant-based Dietary Index (hPDI), 2020 Healthy Eating Index (HEI), American Cancer Society nutrition guidelines (ACS), and the alternate Mediterranean Diet Index (aMED). Incident hypertension, diabetes, and dyslipidemia were identified through electronic health records. Cumulative incidence rates (CIRs) were estimated accounting for the competing risk of death. Covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Fine and Gray regression models, stratified by BC treatment status.

RESULTS

Over an average 11.5 years (range = 0.3-16.3) of follow-up, 554 (16.2%) participants developed hypertension, 362 (10.6%) developed diabetes, and 652 (19.1%) developed dyslipidemia. CIRs for any cardiometabolic condition 15 years after BC diagnosis were 39.2% for women in the highest HEI quartile compared to 49.3% in the lowest. After adjustment, women in the highest HEI quartile had lower risks of any cardiometabolic condition (HR = 0.70, 95% CI 0.54-0.91, Ptrend = 0.006), including hypertension (HR = 0.71, 95% CI 0.54-0.94, Ptrend = 0.007), diabetes (HR = 0.57, 95% CI 0.41-0.79, Ptrend < 0.001), and dyslipidemia (HR = 0.77, 95% CI 0.59-0.99, Ptrend = 0.04). Similar associations were observed for DASH, hPDI, and ACS with diabetes incidence.

CONCLUSION

Healthier diets at BC diagnosis, particularly those aligned with the HEI, were associated with lower cardiometabolic risks.

Modification of black soybean (Glycine max(L.)merr.) residue insoluble dietary fiber with ultrasonic, microwave, high temperature and high-pressure, and extrusion

Recent studies have emphasized the modification of Insoluble Dietary Fiber (IDF) to enhance its physicochemical properties and functional performance. This study systematically examined the effects of ultrasonic treatment, microwave irradiation, high-temperature and high-pressure processing, and screw extrusion on the physicochemical characteristics, in vitro antioxidant activity, and adsorption capacities of High-Purity Insoluble Dietary Fiber (HPIDF) derived from black bean residues. Although these physical modifications did not alter the functional group composition or crystalline structure of HPIDF, they significantly enhanced its porosity, water-holding capacity (WHC), oil-holding capacity (OHC), and adsorption capacities for glucose, cholesterol, bile salts, and metal ions. Notably, HPIDF treated under high-temperature and high-pressure conditions exhibited the highest adsorption capacities: 9.86 mmol/g for glucose, 8.69 mg/g (pH 2) and 9.69 mg/g (pH 7) for cholesterol, 0.183 g/g (pH 2) and 0.127 g/g (pH 7) for sodium cholate, and 0.699 mg/g (pH 2) and 0.774 mg/g (pH 7) for Cr2+.

Gluten-free diets for metabolic control of type 1 diabetes mellitus in children and adolescents: a systematic review and meta-analysis

The aim of this review is to comprehensively assess the association between a gluten-free diet (GFD) and metabolic control of type 1 diabetes mellitus (T1DM) in children and adolescents with T1DM and with T1DM plus coeliac disease (CD). PubMed, Embase, Cochrane Library, and Web of Science were searched until June 19, 2023. Primary outcomes were hemoglobin A1c (HbA1c), insulin dose, insulin dose adjusted A1c (IDAA1c), blood glucose (B-glu) at 90 min during Mixed Meal Tolerance Test (MMTT), C-peptide area under the curve (AUC), and C-peptide. Seven studies involving 355 T1DM patients were included. Three studies involving 141 patients compared a GFD to a standard diet in children and adolescents withT1DM without CD. Additionally, two studies with 164 patients examined the same diet comparison in those with T1DM and concurrent CD. A comparison between T1DM with CD and T1DM alone, using a GFD, was conducted in two studies encompassing 50 patients. Patients withT1DM alone had similar HbA1c [pooled weighted mean difference (WMD) = -0.5, 95% confidence interval (CI): -1.0 to 0.1, P = 0.079] and IDAA1c (pooled WMD = -0.4, 95%CI: -0.9 to 0.1, P = 0.095) levels after a GFD and a standard diet. In children and adolescents withT1DM and CD, a GFD was associated with a significantly lower HbA1c compared with a standard diet (pooled WMD = -0.64, 95%CI: -1.22 to -0.05, P = 0.034). Insulin dose was significantly lower in T1DM combined with CD patients having a GFD vs a standard diet (pooled WMD = -0.34, 95%CI: -0.66 to -0.03, P = 0.032). Our study suggests that a GFD may offer significant benefits for children and adolescents with both T1DM and CD over a standard diet. While the evidence indicates improved glycemic control with a GFD, the quality of this evidence is low, highlighting the need for rigorous, randomized trials to confirm these preliminary findings. In the interim, enhancing dietary awareness and providing tailored nutritional guidance could be pivotal for optimizing glucose management in this patient population.

Association of dietary glycemic index and glycemic load with pancreatic steatosis: a case control study

BACKGROUND

Carbohydrate intake, its type and characteristics including glycemic index (GI) and glycemic load (GL) may be associated with the risk of pancreatic steatosis (PS), but there is no conclusive evidence. The aim of the present study was to investigate whether the intake of carbohydrates, GI and GL were associated with an increased risk of PS.

METHODS

To conduct this study, 278 patients with common bile duct stones (CBD) underwent endoscopic ultrasound, including 89 patients with PS (case group) and 189 healthy individuals (control group). In addition to demographic and anthropometric information, a 168-item questionnaire of food frequency was completed to calculate GL and GI.

RESULTS

With the increase of GI and GL, the number of patients with PS increased significantly (P = 0.013, P < 0.001, respectively) and the risk of PS increased significantly. A similar increase in risk of PS was found with increased risk of carbohydrate, simple sugar and fructose intake. After adjusting all the confounders, the risk of PS with increasing simple sugar and fructose intake was 4.3 times (OR T3 vs. T1 = 4.3, 95% CI: 1.7-10.6, P trend < 0.001) and 5.3 times (OR T3 vs. T1 = 5.3, 95% CI: 2.2-12.9, P trend < 0.001), respectively, compared to the first tertile. Conversely, increased fiber intake showed a reverse association with the PS, so that those in the second and third tertiles of fiber intake were 84% (OR = 0.16, 95% CI: 0.05-0.45) and 87% (OR = 0.13, 95% CI: 0.04-0.39) less at risk of developing PS, respectively (P trend = 0.001).

CONCLUSIONS

These findings support the hypothesis of direct associations between GI and GL increased risk of PS.

Impact of Dietary Fiber on Inflammation in Humans

Cohort studies consistently show that a high intake of cereal fiber and whole-grain products is associated with a decreased risk of type 2 diabetes (T2DM), cancer, and cardiovascular diseases. Similar findings are also reported for infectious and chronic inflammatory disorders. All these disorders are at least partially caused by inflammaging, a chronic state of inflammation associated with aging and Metabolic Syndrome. Surprisingly, insoluble (cereal) fiber intake consistently shows stronger protective associations with most long-term health outcomes than soluble fiber. Most humans consume soluble fiber mainly from sweet fruits, which usually come with high levels of sugar, counteracting the potentially beneficial effects of fiber. In both observational and interventional studies, high-fiber diets show a beneficial impact on inflammation, which can be attributed to a variety of nutrients apart from dietary fiber. These confounders need to be considered when evaluating the effects of fiber as part of complex dietary patterns. When assessing specific types of fiber, inulin and resistant starch clearly elicit anti-inflammatory short-term effects, while results for pectins, beta-glucans, or psyllium turn out to be less convincing. For insoluble fiber, promising but sparse data have been published so far. Hypotheses on putative mechanisms of anti-inflammatory fiber effects include a direct impact on immune cells (e.g., for pectin), fermentation to pleiotropic short-chain fatty acids (for fermentable fiber only), modulation of the gut microbiome towards higher levels of diversity, changes in bile acid metabolism, a differential release of gut hormones (such as the glucose-dependent insulinotropic peptide (GIP)), and an improvement of insulin resistance via the mTOR/S6K1 signaling cascade. Moreover, the contribution of phytate-mediated antioxidative and immune-modulatory means of action needs to be considered. In this review, we summarize the present knowledge on the impact of fiber-rich diets and dietary fiber on the human inflammatory system. However, given the huge heterogeneity of study designs, cohorts, interventions, and outcomes, definite conclusions on which fiber to recommend to whom cannot yet be drawn.

Effects of incorporating green leafy vegetables with meals on starch and lipid digestibility under simulated gastrointestinal digestion

Green leafy vegetables (GLV) are known for their cardiovascular health benefits. However, the effects of their serving size on delaying carbohydrate and lipid digestion remain unclear. This study investigated the impact of varying MyPlate-recommended GLV serving sizes on the digestibility of carbohydrates and lipids and antioxidant activity during in vitro gastrointestinal digestion. Eight GLV including Asteraceae (cos, green oak, red oak, loose-leaf) and Brassicaceae (cabbage, cauliflower, broccoli, Chinese cabbage) vegetables were incorporated into mixed meals at 0.5, 1.0, and 1.5 times the MyPlate recommendation. The results showed that the total phenolic content (TPC) ranged from 5.77 to 9.46 mg GAE/g extract. Nitrate accumulation exhibited a higher content in Asteraceae (590.90-1155.04 mg NO3-NE/g extract) than in Brassicaceae families (244.96-726.20 mg NO3-NE/g extract). Incorporating ≥ 1 serving of all GLV significantly decreased rapidly and slowly digestible starch fractions, while undigestible starch significantly increased, resulting in delaying glucose release. Antioxidant activity was significantly enhanced with ≥ 1 serving and free fatty acid concentrations decreased with higher vegetable servings. Post-digestion nitrate concentrations ranged from 127.3 to 188.5 µg NO3-N/mL, positively correlating with GLV serving size. These effects were dose-dependent and varied across species. These findings suggest that incorporating GLV at or above the MyPlate recommendation may have protective effects on cardiovascular health.

The inflammatory bowel disease and gut microbiome are restored by employing metformin-loaded alginate-shelled microcapsules

Inflammatory bowel disease (IBD) is a chronic or recurrent inflammatory disorder affecting various parts of the gastrointestinal tract. Metformin, a widely prescribed hypoglycemic drug for type 2 diabetes, has shown potential in reducing IBD risk. However, its oral administration faces significant challenges due to the harsh gastrointestinal environment, requiring higher or more frequent doses to achieve therapeutic effects, which increases the risk of side effects. To address this, we developed alginate-shelled hydrogel microcapsules with a thin oil layer for targeted intestinal delivery of metformin. The oil layer protects metformin from gastric acid and ensures its release specifically in the intestines. In a dextran sulfate sodium-induced colitis mouse model, metformin-loaded hydrogel microcapsules (MHM) significantly reduced disease activity, intestinal epithelial damage, and macrophage infiltration linked to pro-inflammatory cytokine factors. Additionally, MHM improved dysbiosis of specific bacterial genera, including Bacteroides vulgatus, Lactobacillus (L.) gasseri, L. reuteri, and L. intestinalis, optimizing the abundance and composition of microorganisms. These findings indicate that encapsulating metformin within alginate shelled-microcapsules with a thin oil layer presents a potential delivery system for IBD treatment.

Applications of bacterial cellulose in the food industry and its health-promoting potential

Bacterial cellulose (BC) is a naturally occurring biomaterial with a wide range of potential applications in the food industry because of its exceptional mechanical qualities, unique nanofiber structure, high purity, and outstanding biocompatibility. Beyond its physical attributes, BC has gained interest recently due to research demonstrating its potential health benefits as a functional food ingredient. This article examines the many uses of BC in the food business, with a focus on how it may enhance food texture, operate as a bioactive carrier, and have promise in the packaging sector. Further research was done on the health-promoting properties of BC in functional foods, particularly with regard to its functions as a blood glucose regulator, and gastrointestinal health. This review seeks to bring fresh ideas for the study of bioactive components in the food industry by providing a summary of the existing research and demonstrating the possible role of BC in food. It also suggests future paths for research.

Effects of soybean insoluble dietary fiber and CaCl2 on the structure and properties of low-moisture extruded products

BACKGROUND

Texturized vegetable protein is currently a leading alternative to animal meat. This study examined the effects of soybean insoluble dietary fiber (SIDF) (0% to 20%) and CaCl2 (0% to 1%) on the structure and properties of extruded products made from a soybean protein isolate-wheat gluten (SPI-WG) composite.

RESULTS

The study showed that SIDF (4% to 8%) increased the viscosity of extruded products, enhanced their specific mechanical energy, and improved their rehydration rate and tensile strength compared with a control group. The rehydration rate of the extruded products reached a maximum value of 331.67% in the 8% SIDF, 0.5% CaCl2 groups. The addition of excess SIDF prevented the cross-linking of protein molecules to form a loose network structure. Analysis of the infrared spectrum and intermolecular forces showed that physical interactions between fibers and proteins were the dominant forces, with hydrophobic interactions and hydrogen bonds primarily maintaining the structure of the extruded products. The addition of CaCl2 (0.5%) led to protein aggregation and further improved the rehydration and tensile strength of extruded products.

CONCLUSION

Soybean insoluble dietary fiber can improve the rehydration rate and quality of extruded products. The addition of CaCl2 mitigated the weakening of the protein structure caused by excess SIDF. These results provide a basis for the improvement of the quality of low-moisture-extruded texturized vegetable protein products with a high dietary fiber concentration and a high rehydration rate. © 2024 Society of Chemical Industry.

Adherence to the Mediterranean diet and its protective effects against colorectal cancer: a meta-analysis of 26 studies with 2,217,404 participants

Colorectal cancer (CRC) is a major global health concern and represents a significant public health challenge in Hungary, where it exhibits some of the highest morbidity and mortality rates in the European Union. The Mediterranean diet has been suggested to reduce the incidence of CRC, but comprehensive evidence from diverse study designs is needed to substantiate this effect. A systematic literature search was conducted in PubMed, ClinicalTrials.gov, CENTRAL, and the Web of Science to identify randomized controlled trials and human clinical trials from 2008 to 2024 to identify relevant studies. Statistical analysis was performed using the https://metaanalysisonline.com web application using a random effects model to estimate the pooled hazard rates (HRs). Forest plots, funnel plots, and Z-score plots were utilized to visualize results. We identified 15 clinical trials and 9 case-control studies, encompassing a total of 2,217,404 subjects. The pooled analysis indicated that adherence to the Mediterranean diet significantly reduced the prevalence of CRC (HR = 0.84, 95% CI = 0.78-0.91, p < 0.01). This protective effect was consistent across sexes, with HRs of 0.85 (95% CI = 0.75-0.97, p = 0.01) for males and 0.88 (95% CI = 0.79-0.99, p = 0.03) for females. Case-control studies specifically showed a substantial effect (HR = 0.51, 95% CI = 0.38-0.68, p < 0.01). Notable heterogeneity was observed across studies, yet the a priori information size was substantially below the cumulative sample size, ensuring sufficient data for reliable conclusions. The findings from this meta-analysis reinforce the protective role of the Mediterranean diet against CRC. The results of this meta-analysis will inform dietary interventions designed to mitigate CRC risk, which are conducted within the framework of the Semmelweis Study, an ongoing comprehensive cohort study at Semmelweis University, designed to explore the multifaceted causes of unhealthy aging in Hungary. These interventions aim to explore the practical application of Mediterranean dietary patterns in reducing CRC incidence among the Hungarian population.

Diet quality patterns and chronic kidney disease incidence: a UK Biobank cohort study

BACKGROUND

Only a few studies have investigated the role of diet on the risk of chronic kidney disease (CKD) in European populations and have mainly focused on the Mediterranean diet. This is the first study to evaluate the association between various diet quality indices and CKD incidence in British adults.

OBJECTIVE

To study the relationship between a set of 6 different diet quality indices and CKD incidence among British adults.

METHODS

A prospective cohort with 106,870 participants from the UK Biobank, followed from 2009 to 2012 through 2021. Food consumption was obtained from ≥2 24-h dietary assessments. Dietary patterns were assessed using previously established indices: Alternate Mediterranean Index (aMED), Alternative Healthy Eating Index 2010, dietary approaches to stop hypertension (DASH), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI), and dietary inflammatory index (DII). Incident CKD was obtained from clinical records, death registries, and self-reports. Analyses were performed with Cox regression models and adjusted for the main confounders.

RESULTS

After a median follow-up of 9.27 y, 2934 cases of CKD were ascertained. Hazard ratios (95% confidence interval) of CKD for the highest compared with lowest tertile of adherence to each diet score were 0.84 (0.76, 0.93) for aMED, 0.94 (0.85, 1.03) for alternative healthy eating index 2010, 0.77 (0.70, 0.85) for DASH, 0.79 (0.72, 0.87) for hPDI, 1.27 (1.16, 1.40) for uPDI, and 1.20 (1.18, 1.33) for DII. The results were robust in sensitivity analyses.

CONCLUSIONS

In British adults, higher adherence to the aMED, DASH, and hPDI patterns was associated with lower risk of CKD, whereas greater adherence to the uPDI and DII patterns was associated with greater risk.

Effects of Dietary Fiber Interventions on Glycemic Control and Weight Management in Diabetes: A Systematic Review of Randomized Controlled Trials

This systematic review explores the impact of dietary fiber interventions on glycemic control and weight management in individuals with diabetes or at risk for diabetes. A comprehensive search was conducted across PubMed, Embase, and Cochrane Library following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, identifying randomized controlled trials published in the last five years. Ten studies met the inclusion criteria, evaluating various types of dietary fiber, including soluble, insoluble, viscous fiber, and resistant starch. The findings demonstrated significant improvements in key glycemic markers such as fasting plasma glucose, glycated hemoglobin (HbA1c), and postprandial glucose levels, as well as weight management outcomes such as reductions in body weight and waist circumference. Secondary benefits included improvements in lipid profiles, insulin sensitivity, and gut microbiota composition. The quality assessment revealed a low risk of bias in most studies, ensuring robust evidence. Despite these promising results, gaps in long-term effects and variations in intervention efficacy warrant further research. These findings emphasize the potential of dietary fiber as a practical and accessible intervention in diabetes management and prevention.

Moringa oleifera in a modern time: A comprehensive review of its nutritional and bioactive composition as a natural solution for managing diabetes mellitus by reducing oxidative stress and inflammation

Globally, diabetes mellitus (DM) and its complications are considered among the most significant public health problems. According to numerous scientific studies, Plants and their bioactive compounds may reduce inflammation and oxidative stress (OS), leading to a reduction in the progression of DM. Moringa oleifera (MO), widely used in Ayurvedic and Unani medicine for centuries because of its health-promoting characteristics, particularly its ability to control DM and its related complications. MO is a multi-purpose plant that has an impressive range of nutritional components including proteins, amino acids (Essential and non-essential amino acids), carbs, fats, fiber, vitamins, and phenolic compounds. In the modern era, scientists have paid close attention to the anti-diabetic, anti-oxidative and anti-inflammatory attributes and other medicinal properties, of MO leaves and seeds. MO leaves and seeds have modulatory effects on DM that are likely influenced by multiple mechanisms. Some of these mechanisms include direct effects, but other mechanisms involve inhibition the production of inflammatory markers, modulation of the gut microbiome, reduction of OS, enhancement of glucose metabolism through hexokinase and glucose 6-phosphate dehydrogenase, improve insulin sensitivity and glucose uptake in the liver and muscles. Overall, these findings suggest that MO may play a role in lowering the risk of DM and its related outcomes. The purpose of this review is to provide a comprehensive overview of the nutritional and bioactive profiles of MO leaves and seeds, as well as to investigate their possible anti-diabetic effects by modulating oxidative stress and inflammation. Our results indicate that MO may be a beneficial natural resource for management of DM and related issues by lowering oxidative stress and inflammation. Furthermore, studies on MO has yielded promising findings in diabetic animal models, indicating antioxidant and anti-inflammatory properties. However, human trials have shown less solid results, most likely due to a lack of studies, different techniques, and dosages. More clinical research is needed to fully understand MO's anti-diabetic potential, notably in lowering oxidative stress and inflammation, both of which are critical in controlling diabetes complications.

High β-Glucan Whole Grain Barley Reduces Postprandial Glycemic Response in Healthy Adults-Part One of a Randomized Controlled Trial

BACKGROUND/OBJECTIVES

The effects of sweetened and unsweetened high β-glucan whole grain barley on postprandial blood glucose response in normoglycemic human subjects were evaluated in a randomized, controlled, crossover clinical trial.

METHODS

Sixteen healthy, over-night fasted participants were studied on four or eight separate occasions. Participants consumed an unsweetened preload condition (n = 16): white glutinous rice (WR; 0 g β-glucan), low β-glucan barley (LB; ~4 g), medium β-glucan barley (MB; ~5 g), or high β-glucan barley (HB; ~6 g); or a sweetened condition with high fructose corn syrup (HFCS; n = 8): WR + 50 g HFCS, LB + 50 g HFCS, MB + 50 g HFCS, or HB + 50 g HFCS. After consuming the preload as a breakfast food, participants self-administered blood glucose tests every 15 min for four hours.

RESULTS

In both sweetened and unsweetened conditions, higher β-glucan content was associated with lower blood glucose peak response and incremental area under the curve estimates (iAUC). In comparison to the unsweetened conditions, the sweetened conditions resulted in less prominent decreases in mean blood glucose response and iAUC blood glucose as β-glucan content increased.

CONCLUSIONS

By attenuating postprandial glycemic response, high β-glucan whole grain barley foods could play a role in helping to control blood glucose.

Valorizing Agro‐Food Waste for Nutraceutical Development: Sustainable Approaches for Managing Metabolic Dysfunction‐Associated Steatotic Liver Disease and Related Co‐Morbidities

This comprehensive investigation delves into the interconnectedness of different features of cardiometabolic syndrome, such as metabolic dysfunction‐associated steatotic liver disease (MASLD), atherosclerotic cardiovascular disease (ASCVD), and gut dysbiosis, highlighting the crucial role of nutraceuticals in their management and prevention. Given the significant overlap in the pathophysiology of these conditions, the treatment with nutraceuticals, especially those derived from agro‐food waste, offers a promising, sustainable, and innovative approach to healthcare. The 2030 Agenda for Sustainable Development and the One Health concept are key frameworks for selecting the most interesting supply chain for the production of nutraceuticals from agro‐food waste, ensuring environmental sustainability, and innovative agricultural practices. In this review, the therapeutic potential of kiwifruit and apples has been explored, detailing how their bioactive compounds, like polyphenols, fiber, pectin, kaempferol, phloretin, and phlorizin, may contribute to the management of MASLD, ASCVD, and gut dysbiosis. Various extraction methods for active ingredients, including chemical, water, and enzyme extractions, are analyzed for their respective benefits and drawbacks. By integrating scientific research, sustainable agricultural practices, and innovative extraction methods, we can develop effective strategies to combat these pervasive health issues. This holistic approach not only enhances individual health outcomes but also supports broader environmental and societal goals, promoting a healthier future for all.

Plant-Based Diet and Sports Performance

Recently, interest in plant-based diets has grown significantly, driven by health and environmental concerns. Plant-based diets offer potential health benefits, including decreased risk of cardiovascular disease, weight management, and blood glucose regulation. This diet profile is rich in complex carbohydrates, antioxidants, dietary fiber, and phytochemicals. However, antinutrients in some plant foods can make nutrient absorption difficult, necessitating careful dietary planning. Plant-based diets can also improve sports performance; in addition, they can positively influence the intestinal microbial community, which can promote health and performance. The present study covered a review from 1986 to 2024 and involved an experimental design with human participants. The main objective was to evaluate the impact of plant-based diets on sports performance. Recent research suggests that plant-based diets do not harm athletic performance and may positively impact sports performance by improving blood flow and reducing oxidative stress. These findings have potential clinical significance, particularly for athletes seeking to optimize their physical capabilities through dietary interventions.

Managing Cardiovascular Risk in Patients with Autoimmune Diseases: Insights from a Nutritional Perspective

PURPOSE OF REVIEW

Autoimmune diseases manifest as an immune system response directed against endogenous antigens, exerting a significant influence on a substantial portion of the population. Notably, a leading contributor to morbidity and mortality in this context is cardiovascular disease (CVD). Intriguingly, individuals with autoimmune disorders exhibit a heightened prevalence of CVD compared to the general population. The meticulous management of CV risk factors assumes paramount importance, given the current absence of a standardized solution to this perplexity. This review endeavors to address this challenge from a nutritional perspective.

RECENT FINDINGS

Emerging evidence suggests that inflammation, a common thread in autoimmune diseases, also plays a pivotal role in the pathogenesis of CVD. Nutritional interventions aimed at reducing inflammation have shown promise in mitigating cardiovascular risk. The integration of nutritional strategies into the management plans for patients with autoimmune diseases offers a holistic approach to reducing cardiovascular risk. While conventional pharmacological treatments remain foundational, the addition of targeted dietary interventions can provide a complementary pathway to improve cardiovascular outcomes.

Postprandial hyperglycemia in patients with type 2 diabetes is reduced by raw insoluble fiber: A randomized trial

BACKGROUND AND AIMS

A lower risk of type 2 diabetes mellitus (T2DM) is associated with the intake of insoluble fiber. This contradicts the postulate that insoluble fibers do not decrease postprandial glycemic response and that only viscous gel-forming soluble fibers would do this. This study aimed to investigate the effect of a dose of insoluble fibers that meets dietary recommendations on postprandial hyperglycemia in T2DM patients.

METHODS AND RESULTS

This is a randomized crossover clinical trial. Nineteen T2DM men randomly ate a balanced breakfast either without (Control) or with prior consumption of insoluble fibers (5.8 g) in the form of 15 g of raw wheat bran (RWB). Glycemia was measured at fasting and 15, 30, 45, 60, 90, and 120 min postprandially. Markers of taste intensity and palatability were assessed after breakfast intake. The glucose peak rise of 87 mg/dL and the incremental area under the curve (AUC) elicited by the breakfast were decreased by RWB (15.80 % and 23.14 %, respectively). Time-to-glucose-peak did not differ between groups. The addition of the RWB to the meal decreased its level of creaminess and tasty and increased the sourness and bitterness.

CONCLUSIONS

The postprandial hyperglycemia in T2DM patients in response to complex carbohydrates was decreased by prior intake of a recommended dose of raw insoluble fibers. This antihyperglycemic effect is in accordance with the acarbose-like property of raw insoluble fibres, but not of heated ones (e.g., bread and pasta), to inhibit the activities of the carbohydrate-digesting enzymes alpha-glucosidase/alpha-amylase.

REGISTRATION NUMBER FOR CLINICAL TRIALS

RBR-98tx28b (https://ensaiosclinicos.gov.br/rg/RBR-98tx28b).

Long-term clinical efficacy of dietary fiber supplementation in middle-aged and elderly prediabetic patients

AIMS

Dietary fiber (DF) can be separated from food and convenient to take, and has an important role in diabetes prevention, but long-term intervention data are lacking. This study evaluated the long-term benefits of DF supplementation on body composition, glucose-lipid metabolism, and clinical regression in middle-aged and elderly patients with prediabetes.

METHODS

A randomized, controlled, open clinical study was conducted. Participants were randomized into a control group receiving health education and an intervention group consuming DF supplements daily before meals (15 g of mixed fiber per serving) for 6 consecutive months based on health education. Follow-up was 1 year with a 6-month cycle. Blood and anthropometric parameters were assessed at baseline and 6 months and 12 months of follow-up.

RESULTS

Fifty-four participants were included in the study, 27 in each group. After 6 months, waist circumference, waist-to-hip ratio, fasting plasma glucose (FPG), 2 hour plasma glucose (2h PG), and postprandial insulin levels were significantly lower in the intervention group compared to baseline. FPG, 2h PG, glycosylated hemoglobin, triglyceride/high-density lipoprotein cholesterol values and diabetes incidence were lower than in the control group. After 12 months, blood glucose and diabetes incidence remained lower in the intervention group.

CONCLUSIONS

DF supplementation can reduce the degree of central obesity, the levels of FPG and 2h PG, and the incidence of diabetes in middle-aged and older patients with prediabetes.

Advancements in modifying insoluble dietary fiber: Exploring the microstructure, physicochemical properties, biological activity, and applications in food industry-A review

Recent research has primarily focused on strategies for modifying insoluble dietary fiber (IDF) to enhance its performance and functionality. IDF is obtained from various inexpensive sources and can be manipulated to alter its biological effects, making it possible to revolutionize food processing and nutrition. In this review, multiple IDF modification techniques are thoroughly examined and discussed, with particular emphasis on the resulting changes in the physicochemical properties, biological activities, and microstructure of the fiber. An extensive overview of the practical applications of modified IDF in food processing is provided. Our study aims to raise awareness about the vast possibilities presented by modified IDF and encourage further exploration and utilization of this field in the realm of food production.

Diabetes risk reduction diet and risk of liver cancer and chronic liver disease mortality: A prospective cohort study

BACKGROUND

We aimed to prospectively evaluate the association between a diabetes risk reduction diet (DRRD) score and the risk of liver cancer development and chronic liver disease-specific mortality.

METHODS

We included 98,786 postmenopausal women from the Women's Health Initiative-Observational Study and the usual diet arm of the Diet Modification trial. The DRRD score was derived from eight factors: high intakes of dietary fiber, coffee, nuts, polyunsaturated fatty acids, low intakes of red and processed meat, foods with high glycemic index, sugar-sweetened beverages (SSBs), and trans fat based on a validated Food-Frequency Questionnaire administered at baseline (1993-1998). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for liver cancer incidence and chronic liver disease mortality were estimated using Cox proportional hazards regression models.

RESULTS AND CONCLUSION

After a median follow-up of 22.0 years, 216 incident liver cancer cases and 153 chronic liver disease deaths were confirmed. A higher DRRD score was significantly associated with a reduced risk of developing liver cancer (HRTertile 3 vs. Tertile 1 = 0.69; 95% CI: 0.49-0.97; Ptrend = 0.03) and chronic liver disease mortality (HRT3 vs. T1 = 0.54; 95% CI: 0.35-0.82; Ptrend = 0.003). We further found inverse associations with dietary fiber and coffee, and positive associations with dietary glycemic index, SSBs, and trans fat. A higher DRRD score was associated with reduced risk of developing liver cancer and chronic liver disease mortality among postmenopausal women.

The association of fructose and fiber consumption and physical activity with non-alcoholic fatty liver disease in children and adolescents: a cross-sectional study

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is emerging as the most prevalent liver disease in overweight and obese children. While no cure exists, dietary and lifestyle modifications have been shown to improve the condition. This study investigates the relationship between fructose and fiber consumption, physical activity, and NAFLD in children.

METHODS

A cross-sectional study was conducted on 378 overweight and obese children aged 6-13 years. NAFLD diagnosis was confirmed via ultrasound, and dietary intake was assessed using a 147-item food frequency questionnaire (FFQ). Physical activity was evaluated using the Modifiable Activity Questionnaire (MAQ). Multivariable logistic regression models were applied to determine the associations.

RESULTS

After excluding 53 participants due to incomplete data, 325 were included in the final analysis. The mean age was 9.2 ± 1.7 years, and 35% had NAFLD. No significant association was found between fructose intake and NAFLD (OR: 0.67, 95% CI: 0.35-1.29, P = 0.221). However, higher intake of legume fiber (OR: 0.48, 95% CI: 0.26-0.90, P = 0.03) and nut fiber (OR: 0.52, 95% CI: 0.28-0.95, P = 0.04) was significantly associated with a reduced risk of NAFLD. Physical activity showed a trend towards reduced NAFLD risk but was not statistically significant after adjustments (OR: 0.53, 95% CI: 0.22-1.04, P = 0.07).

CONCLUSIONS

While fructose intake was not significantly linked to NAFLD in this population, fiber from legumes and nuts appeared protective. Further prospective studies are needed to confirm these findings and clarify the role of physical activity in NAFLD prevention.

Molecular Structure and Properties of Resistant Dextrins from Potato Starch Prepared by Microwave Heating

The dextrinization of potato starch was performed using a sophisticated single-mode microwave reactor with temperature and pressure control using 10 cycles of heating with stirring between cycles. Microwave power from 150 to 250 W, a cycle time from 15 to 25 s, and two types of vessels with different internal diameters (12 and 24 mm) and therefore different thicknesses of the heated starch layer were used in order to estimate the impact of vessel size used for microwave dextrinization. The characteristics of resistant dextrins (RD) including solubility in water, total dietary fiber (TDF) content, color parameters, the share of various glycosidic bonds, and pasting and rheological properties were carried out. The applied conditions allowed us to obtain RDs with water solubility up to 74% at 20 °C, as well as TDF content up to 47%, with a predominance of low-molecular-weight soluble fiber fraction, with increased content of non-starch glycosidic bonds, negligible viscosity, and a slightly beige color. The geometry of the reaction vessel influenced the properties of dextrins obtained under the same heating power, time, and repetition amounts. Among the conditions used, the most favorable conditions were heating 10 times for 20 s at 200 W in a 10 mL vessel and the least favorable were 15 s cycles.

Exploring Food Preferences as a Pre-Step for Developing Diabetes-Friendly Options in Adults with Diabetes and Prediabetes

Given the low compliance with healthy eating among patients with diabetes, personalized dietary plans incorporating their food preferences are urgently needed. However, few studies have explored the food preferences of adults with diabetes or prediabetes (AdDMP). We aimed to examine taste and food preferences among AdDMP, comparing them by sex, age, and weight status. A total of 415 AdDMP completed the survey via Amazon Mechanical Turk in 2023 (53% women, 47% men; 20-70 years old). Food/taste preferences were measured using Likert-type scales for six taste-cluster food groups, as well as basic tastes/spicy flavor. Open-ended questions assessed comfort, favorite, and least favorite foods, which were then categorized into five groups. Independent t-tests, analysis of variance, and Tukey-HSD were performed to compare outcomes across the groups. Men, the 41-70-year-old group, and the obese group regarded warm food as a comfort food more than in other comparable groups, while women and the 20-30-year-old group tend to prefer fruits and vegetables. Additionally, men expressed a significantly higher preference for salty-/umami-/fat-tasting foods compared to women. These findings underscore the need to align dietary expectations with reality for AdDMP. Future research should focus on strategies to accommodate their preferences within a healthy eating framework.

The Role of Dietary Ingredients and Herbs in the Prevention of Non-Communicable Chronic Liver Disease

BACKGROUND

Liver diseases are among the most commonly diagnosed conditions, with the main risk factors being inappropriate lifestyles, including poor diet, excessive alcohol consumption, low physical activity and smoking, including electronic cigarettes. Non-communicable chronic liver diseases also often develop as a result of accompanying overweight and obesity, as well as type 2 diabetes.

METHODS

The literature on risk factors for non-communicable chronic liver diseases, which show a high strong influence on their occurrence, was analysed.

RESULTS

Measures to prevent non-communicable chronic liver disease include the selection of suitable food ingredients that have proven protective effects on the liver. Such ingredients include dietary fibre, probiotics, herbs, various types of polyphenols and fatty acids (omega-3).

CONCLUSIONS

Because of their liver-protective effects, nutritionists recommend consuming vegetables, fruits, herbs and spices that provide valuable ingredients with anti-inflammatory and anti-cancer effects. These components should be provided with food and, in the case of probiotics, supplementation appears to be important. As a preventive measure, a diet rich in these nutrients is therefore recommended, as well as one that prevents overweight and other diseases that can result in liver disease.

Suppression of the postprandial hyperglycemia in patients with type 2 diabetes by a raw medicinal herb powder is weakened when consumed in ordinary hard gelatin capsules: A randomized crossover clinical trial

INTRODUCTION

Contradictory claims about the efficacy of several medicinal plants to promote glycemic control in patients with type 2 diabetes mellitus (T2DM) have been explained by divergences in the administration form and by extrapolation of data obtained from healthy individuals. It is not known whether the antidiabetic effects of traditional herbal medicines are influenced by gelatin capsules. This randomized crossover trial aimed to evaluate the acute effect of a single dose of raw cinnamon consumed orally either dissolved in water as a beverage or as ordinary hard gelatin capsules on postprandial hyperglycemia (>140 mg/dL; >7.8 mmol/L) in T2DM patients elicited by a nutritionally-balanced meal providing 50 g of complex carbohydrates.

METHODS

Fasting T2DM patients (n = 19) randomly ingested a standardized meal in five experimental sessions, one alone (Control) and the other after prior intake of 3 or 6 g of crude cinnamon in the form of hard gelatin capsules or powder dissolved in water. Blood glucose was measured at fasting and at 0.25, 0.5, 0.75, 1, 1.5 and 2 hours postprandially. After each breakfast, its palatability scores for visual appeal, smell and pleasantness of taste were assessed, as well as the taste intensity sweetness, saltiness, bitterness, sourness and creaminess.

RESULTS

The intake of raw cinnamon dissolved in water, independently of the dose, decreased the meal-induced large glucose spike (peak-rise of +87 mg/dL and Δ1-hour glycemia of +79 mg/dL) and the hyperglycemic blood glucose peak. When cinnamon was taken as capsules, these anti-hyperglycemic effects were lost or significantly diminished. Raw cinnamon intake did not change time-to-peak or the 2-h post-meal glycaemia, but flattened the glycemic curve (lower iAUC) without changing the shape that is typical of T2DM patients.

CONCLUSIONS

This cinnamon's antihyperglycemic action confirms its acarbose-like property to inhibit the activities of the carbohydrate-digesting enzymes α-amylases/α-glucosidases, which is in accordance with its exceptionally high content of raw insoluble fiber. The efficacy of using raw cinnamon as a diabetes treatment strategy seems to require its intake at a specific time before/concomitantly the main hyperglycemic daily meals. Trial registration: Registro Brasileiro de Ensaios Clínicos (ReBEC), number RBR-98tx28b.

High-fiber diet reduces bone formation but does not affect bone microarchitecture in type 2 diabetes individuals

Bone fragility is a recognized complication of type 2 diabetes mellitus (T2DM), increasing patient morbidity. Thus, the development of an effective intervention to prevent diabetic bone fragility is urgently needed. As lifestyle intervention represents an effective option for diabetes management, it may have an impact on bone health. While studies have shown a beneficial effect of dietary fiber in T2DM management, its effect on bone health is still unclear. Thus, we investigated the impact of a high-fiber diet on bone and glucose control in men and women with T2DM. Forty-five T2DM patients (HbA1c: 6.5% ± 0.49%, age: 74 ± 7.29 yr) scheduled for hip arthroplasty were randomly assigned to follow a high-fiber diet (38 g/day) or to make no diet changes for 12 wk. Interestingly, BMI decreased by 4% (p <.0001) and HbA1c by 3.4% (p <.0001) in the high-fiber diet group, but did not decrease in the control group. However, serum concentration of the bone formation marker procollagen type 1 amino-terminal propeptide (P1NP) decreased by 8.6 % in the high-fiber diet group (p =.0004), whereas it remained unchanged in the control group. In contrast, similar to the control group, serum concentration of the bone resorption marker C-terminal telopeptide of type I collagen (CTX) concentrations did not change in the high-fiber diet group. Bone microCT analysis revealed no changes in trabecular and cortical bone parameters between the high-fiber diet and control groups. Similarly, real-time (RT)-PCR analysis in bone tissue showed no changes in the gene expression of Wnt pathway-related genes (Sost, Dkk-1, Wnt10b, and Lef-1), bone formation markers (Runx2, Col1a1, and Ocn), and inflammatory cytokines (IL-6, IL-8, TNF-α, and IL-10) between the two groups. Our findings suggest that 12-wk high-fiber diet intervention improves metabolic outcomes in patients with T2DM. However, it may reduce bone formation without affecting bone microarchitecture or Wnt pathway regulation.

Associations between whole grains intake and new-onset hypertension: a prospective cohort study

IMPORTANCE

Epidemiological evidences regarding the association between whole grain intake and the risk of new-onset hypertension are still controversial.

OBJECTIVE

We aimed to investigate the relationship between whole grain intake and new-onset hypertension and examine possible effect modifiers in the general population.

METHODS

A total of 10,973 participants without hypertension from the China Health and Nutrition Survey were enrolled, with follow-up beginning in 1997 and ending in 2015. Whole grain intake was assessed by 3 consecutive 24-h dietary recalls combined with a household food inventory. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression model after adjusting for potential risk factors.

RESULTS

During a median follow-up of 7.0 years, 3,733 participants developed new-onset hypertension. The adjusted HRs (95% CIs) were as follows: for quartile 2 (HR: 0.52; 95% CI: 0.47-0.57), quartile 3 (HR: 0.46; 95% CI: 0.42-0.51), and quartile 4 (HR: 0.35; 95% CI: 0.31-0.38), compared with quartile 1. Different types of whole grain types, including wheat (adjusted HR, 0.35; 95% CI, 0.32-0.39), maize (adjusted HR, 0.50; 95% CI, 0.42-0.59), and millet (adjusted HR, 0.38; 95% CI, 0.30-0.48), showed significant associations with a reduced risk of hypertension. The association between whole grain intake and new-onset hypertension was stronger in individuals with older age (P for interaction < 0.001) and higher BMI (P for interaction < 0.001).

CONCLUSION

Higher consumption of whole grains was significantly associated with a lower risk of new-onset hypertension. This study provides further evidence supporting the importance of increasing whole grain intake for hypertension prevention among Chinese adults.

Assessing metabolic flexibility response to a multifibre diet: a randomised-controlled trial

INTRODUCTION

Metabolic flexibility (MetF), defined as the ability to switch between fat and glucose oxidation, is increasingly recognised as a critical marker for assessing responses to dietary interventions. Previously, we showed that the consumption of multifibre bread improved insulin sensitivity and reduced low-density lipoprotein cholesterol (LDLc) levels in overweight and obese individuals. As a secondary objective, we aimed to explore whether our intervention could also improve MetF.

METHODS

In this study, 39 subjects at cardiometabolic risk participated in a double-blind, randomised, crossover trial lasting 8 weeks, repeated twice. During each phase, participants consumed either 150 g of standard bread daily or bread enriched with a mixture of seven dietary fibres. MetF response was assessed using a mixed-meal tolerance test (MMTT), analysing changes in respiratory quotient (∆RQ) measured using indirect calorimetry.

RESULTS

Although there were no significant differences in ∆RQ changes induced by dietary fibre between the two diets, these changes were positively correlated with postprandial triglyceride excursion (∆TG) at baseline. Subgroup analysis of baseline fasting and postprandial plasma metabolites was conducted to characterise MetF responders. These responders exhibited higher baseline fasting LDLc levels and greater post-MMTT ∆TG.

CONCLUSION

In conclusion, although dietary fibres did not directly impact MetF in this study, our findings highlight potential determinants of MetF response, warranting further investigation in dedicated future interventions.

Effect of whole grain and fiber consumption on chronic liver diseases: a systematic review and meta-analysis

Objective: The aim of the present study was to conduct a meta-analysis of observational studies to explore the latest evidence on the influence of whole grain and fiber consumption on total chronic liver diseases. Methods: We searched the PubMed and Web of Science online databases and reference lists of eligible articles up to June, 2024. Results: The odds ratio (OR) between whole grain intake and total chronic liver disease risk was 0.90 (95% confidence interval (CI): 0.81 to 0.99, p < 0.001) and indicated an OR of 0.65 (95% CI: 0.57 to 0.74, p < 0.001) between fiber intake and total chronic liver disease risk when comparing the highest and lowest total intake, both indicating a significant negative correlation. Furthermore, subgroup analysis revealed that the protective effect of whole grains on chronic liver diseases was the most significant in cirrhosis (OR = 0.65; 95% CI: 0.57 to 0.74) and mortality (OR = 0.37; 95% CI: 0.29 to 0.47). Conclusion: Whole grain and fiber intake has a protective effect on the risk of chronic liver diseases.

Carbohydrate quality index and risk of non-alcoholic fatty liver disease in Iranian adults

BACKGROUND/AIM

In the current study, we aimed to assess the association of carbohydrate quality index (CQI) with the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults.

METHODS

This case-control study was conducted on 225 newly diagnosed NAFLD patients and 450 controls, aged 20-60 years. A food frequency questionnaire was used to calculate the CQI and its components, including fiber intake, glycemic index, whole grains: total grains ratio, and solid carbohydrates: total carbohydrates ratio. Multivariable logistic regression was used to estimate the odds ratio (OR) of NAFLD across the tertile of CQI and its components.

RESULTS

The participant's mean ± SD of body mass index and age were 26.8 ± 4.3 kg/m2 and 38.1 ± 8.8 years, respectively. The median (interquartile) CQI score in participants of the case and control groups was 20 (15-25) and 23 (18-28), respectively. In the multivariable-adjusted model, the risk of NAFLD decreased significantly across the tertiles of the CQI [(OR: 0.20; %95CI: 0.11-0.39), Ptrend <0.001)]. Also, the odds of NAFLD decreased across tertiles of solid carbohydrates to total carbohydrates ratio [(OR: 0.39; 95%CI: 0.22-0.69), Ptrend <0.001)]. However, a high dietary glycemic index (GI) was associated with increased odds of NAFLD [(OR:7.47; 95%CI: 3.89-14.33, Ptrend<0.001)]. There was no significant relationship between other CQI components, including fiber intake and whole grain/total grains and the risk of NAFLD.

CONCLUSIONS

Our results revealed that a diet with a high quality of carbohydrates, characterized by higher intakes of solid carbohydrates, whole grain, and low GI carbohydrates, can be related to a reduced risk of NAFLD.

Construction and characterization of stable multi-species biofilms formed by nine core gut bacteria on wheat fiber

Microbial aggregation mainly occurs on the intestinal epithelium, mucosal layer and undigested food particles in the gastrointestinal tract (GIT). Undigested food particles are usually insoluble dietary fiber (IDF), which can be easily obtained through daily diet, but there are few studies investigating whether the gut bacteria adhering to undigested food particles can form multi-species biofilms. In this study, we prepared mono- and multi-species biofilms using 18 core gut bacteria via a dynamic fermentation method, and it was found that multi-species composed of nine core gut bacteria (M9) showed the best biofilm formation ability. Cell counts of the nine bacteria in multi-species biofilms were 9.36, 11.85, 10.17, 9.93, 12.88, 11.39, 10.089, 9.06, and 13.21 Log10 CFU mL-1. M9 was tightly connected and regularly stacked on wheat fiber and had larger particle sizes than mono-species biofilms. M9 retained biofilm formation ability under pH and bile salt stresses. A human feces invasion experiment demonstrated that M9 can stably adhere to wheat fiber under the interference of complex gut bacteria, and the M9 multi-species biofilm had positions that can be filled by various gut bacteria. Metabolome results indicated that the M9 multi-species biofilm had more metabolic productions and more complex interspecies interactions than mono-species biofilms. This study provides a dynamic fermentation method to prepare multi-species biofilms on wheat fiber in vitro. It will also offer a research basis for clarifying whether gut bacteria can utilize IDF to form biofilm structures in vivo and the possible interspecific interactions and physiological functions of bacteria in biofilms.

Manipulation of Post-Prandial Hyperglycaemia in Type 2 Diabetes: An Update for Practitioners

This review paper explores post-prandial glycemia in type 2 diabetes. Post-prandial glycemia is defined as the period of blood glucose excursion from immediately after the ingestion of food or drink to 4 to 6 hours after the end of the meal. Post-prandial hyperglycemia is an independent risk factor for cardiovascular disease with glucose "excursions" being more strongly associated with markers of oxidative stress than the fasting or pre-prandial glucose level. High blood glucose is a major promoter of enhanced free radical production and is associated with the onset and progression of type 2 diabetes. Oxidative stress impairs insulin action creating a vicious cycle where repeated post-prandial glucose spikes are key drivers in the pathogenesis of the vascular complications of type 2 diabetes, both microvascular and macrovascular. Some authors suggest post-prandial hyperglycemia is the major cause of death in type 2 diabetes. Proper management of post-prandial hyperglycemia could yield up to a 35% cut in overall cardiovascular events, and a 64% cut in myocardial infarction. The benefits of managing post-prandial hyperglycemia are similar in magnitude to those seen in type 2 diabetes patients receiving secondary prevention with statins - prevention which today is regarded as fundamental by all practitioners. Given all the evidence surrounding the impact of post-prandial glycemia on overall outcome, it is imperative that any considered strategy for the management of type 2 diabetes should include optimum dietary, pharma, and lifestyle interventions that address glucose excursion. Achieving a low post-prandial glucose response is key to prevention and progression of type 2 diabetes and cardiometabolic diseases. Further, such therapeutic interventions should be sustainable and must benefit patients in the short and long term with the minimum of intrusion and side effects. This paper reviews the current literature around dietary manipulation of post-prandial hyperglycemia, including novel approaches. A great deal of further work is required to optimize and standardize the dietary management of post-prandial glycemia in type 2 diabetes, including consideration of novel approaches that show great promise.

Journey of dietary fiber along the gastrointestinal tract: role of physical interactions, mucus, and biochemical transformations

Dietary fiber-rich foods have been associated with numerous health benefits, including a reduced risk of cardiovascular and metabolic diseases. Harnessing the potential to deliver positive health outcomes rests on our understanding of the underlying mechanisms that drive these associations. This review addresses data and concepts concerning plant-based food functionality by dissecting the cascade of physical and chemical digestive processes and interactions that underpin these physiological benefits. Functional transformations of dietary fiber along the gastrointestinal tract from the stages of oral processing and gastric emptying to intestinal digestion and colonic fermentation influence its capacity to modulate digestion, transit, and commensal microbiome. This analysis highlights the significance, limitations, and challenges in decoding the complex web of interactions to establish a coherent framework connecting specific fiber components' molecular and macroscale interactions across multiple length scales within the gastrointestinal tract. One critical area that requires closer examination is the interaction between fiber, mucus barrier, and the commensal microbiome when considering food structure design and personalized nutritional strategies for beneficial physiologic effects. Understanding the response of specific fibers, particularly concerning an individual's physiology, will offer the opportunity to exploit these functional characteristics to elicit specific, symptom-targeting effects or use fiber types as adjunctive therapies.

General Dietary Recommendations for People with Down Syndrome

Down syndrome (DS) is caused by trisomy of chromosome 21 and is associated with characteristic features of appearance, intellectual impairment to varying degrees, organ defects, and health problems typical of this syndrome. Studies on the frequency of consumption of food products in this group show many irregularities, in particular too low consumption of vegetables and fruits, wholegrain cereal products and dairy products, and excessive consumption of meat products and sweets. It is necessary to correct eating habits. The diets of people with trisomy 21 should be consistent with the recommendations of rational nutrition for the general population and take into account specific dietary modifications related to the occurrence of diseases and health problems characteristic of this syndrome.

Grains in a Modern Time: A Comprehensive Review of Compositions and Understanding Their Role in Type 2 Diabetes and Cancer

Globally, type 2 diabetes (T2D) and Cancer are the major causes of morbidity and mortality worldwide and are considered to be two of the most significant public health concerns of the 21st century. Over the next two decades, the global burden is expected to increase by approximately 60%. Several observational studies as well as clinical trials have demonstrated the health benefits of consuming whole grains to lower the risk of several chronic non-communicable diseases including T2D and cancer. Cereals grains are the primary source of energy in the human diet. The most widely consumed pseudo cereals include (quinoa, amaranth, and buckwheat) and cereals (wheat, rice, and corn). From a nutritional perspective, both pseudo cereals and cereals are recognized for their complete protein, essential amino acids, dietary fibers, and phenolic acids. The bran layer of the seed contains the majority of these components. Greater intake of whole grains rather than refined grains has been consistently linked to a lower risk of T2D and cancer. Due to their superior nutritional compositions, whole grains make them a preferred choice over refined grains. The modulatory effects of whole grains on T2D and cancer are also likely to be influenced by several mechanisms; some of these effects may be direct while others involve altering the composition of gut microbiota, increasing the abundance of beneficial bacteria, and lowering harmful bacteria, increasing insulin sensitivity, lowering solubility of free bile acids, breaking protein down into peptides and amino acids, producing short-chain fatty acids (SCFAs), and other beneficial metabolites that promote the proliferation in the colon which modulate the antidiabetic and anticancer pathway. Thus, the present review had two aims. First, it summarized the recent knowledge about the nutritional composition and bioactive acids in pseudo cereals (quinoa, amaranth, and buckwheat) and cereals (wheat, rice, and corn); the second section summarized and discussed the progress in recent human studies, such as observational (cross-sectional studies, case-control studies, and cohort studies) and intervention studies to understand their role in T2D and cancer including the potential mechanism. Overall, according to the scientific data, whole grain consumption may reduce the incidence of T2D and cancer. Future studies should carry out randomized controlled trials to validate observational results and establish causality. In addition, the current manuscript encourages researchers to investigate the specific mechanisms by which whole grains exert their beneficial effects on health by examining the effects of different types of specific protein, dietary fibers, and phenolic acids that might help to prevent or treat T2D and cancer.

Investigating the physicochemical characteristics and importance of insoluble dietary fiber extracted from legumes: An in-depth study on its biological functions

Legumes are widely appreciated for their abundant reserves of insoluble dietary fiber, which are characterized by their high fiber content and diverse bioactive compounds. Insoluble dietary fiber in leguminous crops is primarily localized in the structural cell walls and outer integument and exhibits strong hydrophilic properties that enable water absorption and volumetric expansion, resulting in increased food bulk and viscosity. This contributes to enhanced satiety and accelerated gastrointestinal transit. The benefits of legume insoluble dietary fiber extend to its notable antioxidant, anti-inflammatory, and anti-cancer properties, as well as its ability to modulate the composition of the intestinal microbiota, promoting the growth of beneficial bacteria while suppressing the proliferation of harmful pathogens, thereby promoting optimal intestinal health. It is highly valued as a valuable thickening agent, stabilizer, and emulsifier, contributing to the texture and stability of a wide range of food products.

[Bioactive components of whole grain and their effect on health]

Introduction

Non-communicable diseases represent a global health burden with increasing prevalence. To prevent or improve this type of diseases, dietary strategies based on healthy foods have been suggested. Cereals are the most consumed foods in the world and preventive effects of whole grains on health have been described. The germ and bran of cereals are abundant in bioactive compounds, including phytochemicals, vitamins, minerals and fibers, and these compounds are effective in preventing and improving non-communicable diseases. This review analyzes the content and distribution of the primary components of whole grains (wheat, barley, oats, rice and black wheat) and their fractions, focusing on the mechanisms by which phenolic acids and dietary fiber contribute to reducing the risk of metabolic and cardiovascular diseases and cancer. There is clear evidence of the broad cellular and physiological effects of bioactive compounds in whole grains, supporting the health value of a diet rich in whole grains.

Improvement of insulin sensitivity by dietary fiber consumption during late pregnant sows is associated with gut microbiota regulation of tryptophan metabolism

BACKGROUND

Dietary fiber (DF) consumption was reported to improve insulin sensitivity, change the tryptophan metabolism, and alter the gut microbiota. Herein, this study aimed to investigate the effects of DF consumption on insulin sensitivity, tryptophan metabolism, and gut microbiota composition in sows during late pregnancy, and explore the relationship between tryptophan metabolites and insulin sensitivity regulated by DF supplementation.

RESULTS

Twelve sows were randomly assigned to two dietary treatment groups (six/group): the low-fiber (LF) group, which was fed a basal diet, and the high-fiber (HF) group, which was fed the basal diet supplemented with 22.60 g/kg inulin and 181.60 g/kg cellulose. During late pregnancy, meal test, glucose tolerance test, and insulin challenge test were used to investigate the insulin sensitivity of sows, using the percutaneous brachiocephalic vein catheterization technique. High DF consumption resulted in improved insulin sensitivity, especially during the second and third trimesters, and promoted serotonin production from tryptophan. Additionally, plasma serotonin concentration was positively correlated with the insulin sensitivity index during late pregnancy. Moreover, DF consumption elevated fecal short-chain fatty acid (SCFA) concentrations, altered fecal microbial diversity, and increased the abundances of Rikenellaceae_RC9_gut_group, Alloprevotella, Parabacteroides, Roseburia, and Sphaerochaeta, which were positively correlated to plasma serotonin concentration.

CONCLUSIONS

DF consumption improved insulin sensitivity during late pregnancy in sows, which improved microbial diversity in fecal samples and increased fecal SCFA concentrations, resulting in a positive correlation with plasma serotonin level.

Effects of germinated brown rice and germinated black rice on people with type 2 diabetes mellitus combined with dyslipidaemia

Objective: This study aimed to observe the effects of germinated brown rice and germinated black rice on blood lipid levels, blood glucose levels and lipid metabolism-related enzymes in T2DM patients with dyslipidaemia and to study their effects on the gut microbiome and short-chain fatty acids. Methods: According to the inclusion and exclusion criteria, 68 subjects were randomly divided into a germinated brown rice group, a germinated black rice group and a white rice group. At the end of the intervention, relevant anthropometric indices, blood biochemistry, and levels of adipokines and lipid metabolism-related enzymes were measured. Faecal samples were collected for 16S rDNA high-throughput sequencing and for an analysis of short-chain fatty acids. Results: After 3 months of intervention with germinated brown rice, germinated black rice or white rice, 21 people in each group completed the intervention as required. At the end of the intervention, the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the germinated brown rice group and germinated black rice group were significantly lower than those in the white rice group. The levels of adiponectin (ADPN) and lecithin cholesterol acyltransferase (LCAT) in the germinated brown rice group were significantly higher than those in the white rice group (P < 0.05). At the genus level, interventions with germinated brown rice and germinated black rice significantly increased the relative abundance of Megamonas, Muribaculaceae and Alloprevotella and significantly decreased the relative abundance of Veillonella (P < 0.05). After 3 months of intervention, a significant decrease in waist circumference was observed within the germinated brown rice group compared to that at baseline (P < 0.05). Conclusions: Compared with the consumption of white rice, the consumption of germinated brown rice and germinated black rice can effectively regulate the glucose and lipid metabolism of this population. In addition, interventions involving the use of germinated brown rice and germinated black rice may further improve intestinal diversity and abundance, increase the relative abundance of Megamonas and decrease the relative abundance of Veillonella.

Combined associations of visceral adipose tissue and adherence to a Mediterranean lifestyle with T2D and diabetic microvascular complications among individuals with prediabetes

BACKGROUND

It's unclear if excess visceral adipose tissue (VAT) mass in individuals with prediabetes can be countered by adherence to a Mediterranean lifestyle (MEDLIFE). We aimed to examine VAT mass, MEDLIFE adherence, and their impact on type 2 diabetes (T2D) and diabetic microvascular complications (DMC) in individuals with prediabetes.

METHODS

11,267 individuals with prediabetes from the UK Biobank cohort were included. VAT mass was predicted using a non-linear model, and adherence to the MEDLIFE was evaluated using the 25-item MEDLIFE index, encompassing categories such as "Mediterranean food consumption," "Mediterranean dietary habits," and "Physical activity, rest, social habits, and conviviality." Both VAT and MEDLIFE were categorized into quartiles, resulting in 16 combinations. Incident cases of T2D and related DMC were identified through clinical records. Cox proportional-hazards regression models were employed to examine associations, adjusting for potential confounding factors.

RESULTS

Over a median follow-up of 13.77 years, we observed 1408 incident cases of T2D and 714 cases of any DMC. High adherence to the MEDLIFE, compared to the lowest quartile, reduced a 16% risk of incident T2D (HR: 0.84, 95% CI: 0.71-0.98) and 31% for incident DMC (0.69, 0.56-0.86). Conversely, compared to the lowest quartile of VAT, the highest quartile increased the risk of T2D (5.95, 4.72-7.49) and incident any DMC (1.79, 1.36-2.35). We observed an inverse dose-response relationship between MEDLIFE and T2D/DMC, and a dose-response relationship between VAT and all outcomes (P for trend < 0.05). Restricted cubic spline analysis confirmed a nearly linear dose-response pattern across all associations. Compared to individuals with the lowest MEDLIFE quartile and highest VAT quartile, those with the lowest T2D risk had the lowest VAT and highest MEDLIFE (0.12, 0.08-0.19). High MEDLIFE was linked to reduced T2D risk across all VAT categories, except in those with the highest VAT quartile. Similar trends were seen for DMC.

CONCLUSION

High adherence to MEDLIFE reduced T2D and MDC risk in individuals with prediabetes, while high VAT mass increases it, but MEDLIFE adherence may offset VAT's risk partly. The Mediterranean lifestyle's adaptability to diverse populations suggests promise for preventing T2D.

Comprehensive Strategies for Metabolic Syndrome: How Nutrition, Dietary Polyphenols, Physical Activity, and Lifestyle Modifications Address Diabesity, Cardiovascular Diseases, and Neurodegenerative Conditions

Several hallmarks of metabolic syndrome, such as dysregulation in the glucose and lipid metabolism, endothelial dysfunction, insulin resistance, low-to-medium systemic inflammation, and intestinal microbiota dysbiosis, represent a pathological bridge between metabolic syndrome and diabesity, cardiovascular, and neurodegenerative disorders. This review aims to highlight some therapeutic strategies against metabolic syndrome involving integrative approaches to improve lifestyle and daily diet. The beneficial effects of foods containing antioxidant polyphenols, intestinal microbiota control, and physical activity were also considered. We comprehensively examined a large body of published articles involving basic, animal, and human studie, as well as recent guidelines. As a result, dietary polyphenols from natural plant-based antioxidants and adherence to the Mediterranean diet, along with physical exercise, are promising complementary therapies to delay or prevent the onset of metabolic syndrome and counteract diabesity and cardiovascular diseases, as well as to protect against neurodegenerative disorders and cognitive decline. Modulation of the intestinal microbiota reduces the risks associated with MS, improves diabetes and cardiovascular diseases (CVD), and exerts neuroprotective action. Despite several studies, the estimation of dietary polyphenol intake is inconclusive and requires further evidence. Lifestyle interventions involving physical activity and reduced calorie intake can improve metabolic outcomes.

No benefit of soluble fiber on liver function

Background: To conduct a systematic review and dose-response meta-analysis of current findings from randomized controlled trials (RCTs) on the effect of soluble fiber supplementation on liver function in both healthy individuals and people with specific health conditions, PubMed, Scopus, and ISI Web of Science were systematically searched for relevant RCTs published prior to April 2022. Methods: We estimated the change in liver function parameters for each 5 g/d increment in soluble fiber in each trial and then calculated the mean difference (MD) and 95%CI. A total of 25 RCTs with 27 treatment arms (1744 subjects; 884 cases, 860 controls) were included. Results: A total of 25 RCTs with 27 treatment arms were included. The intervention duration of the included studies ranged from 3 to 52 weeks and the dose of soluble fiber supplementation varied from 0.0025 to 40 g/d. Soluble fiber supplementation could not significantly affect serum alanine transaminase (MD: -0.02 U/L, 95% CI: -1.06 to 1.01), aspartate transaminase (MD: -0.34 U/L, 95% CI: -0.84 to 0.15), alkaline phosphatase (MD: 0.29 U/L, -0.14 to 0.71), gamma-glutamyl transferase (MD: 0.12 U/L; 95% CI: -0.81 to 1.05), serum bilirubin (MD: 0.42μmol/L, 95% CI: -0.08 to 0.93) and albumin (MD: 0.64 g/dl, 95% CI: -0.42 to 1.70) levels. Conclusions: Findings from this study did not support the beneficial effects of soluble fiber supplementation on liver function biomarkers. There is a need for long-term high-quality interventions to examine the effects of different types and doses of soluble fibers on liver function as primary outcome.

The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.

Relationship between gut microbiota and the pathogenesis of gestational diabetes mellitus: a systematic review

Introduction

Gestational diabetes mellitus (GDM) is a form of gestational diabetes mellitus characterized by insulin resistance and abnormal function of pancreatic beta cells. In recent years, genomic association studies have revealed risk and susceptibility genes associated with genetic susceptibility to GDM. However, genetic predisposition cannot explain the rising global incidence of GDM, which may be related to the increased influence of environmental factors, especially the gut microbiome. Studies have shown that gut microbiota is closely related to the occurrence and development of GDM. This paper reviews the relationship between gut microbiota and the pathological mechanism of GDM, in order to better understand the role of gut microbiota in GDM, and to provide a theoretical basis for clinical application of gut microbiota in the treatment of related diseases.

Methods

The current research results on the interaction between GDM and gut microbiota were collected and analyzed through literature review. Keywords such as "GDM", "gut microbiota" and "insulin resistance" were used for literature search, and the methodology, findings and potential impact on the pathophysiology of GDM were systematically evaluated.

Results

It was found that the composition and diversity of gut microbiota were significantly associated with the occurrence and development of GDM. Specifically, the abundance of certain gut bacteria is associated with an increased risk of GDM, while other changes in the microbiome may be associated with improved insulin sensitivity. In addition, alterations in the gut microbiota may affect blood glucose control through a variety of mechanisms, including the production of short-chain fatty acids, activation of inflammatory pathways, and metabolism of the B vitamin group.

Discussion

The results of this paper highlight the importance of gut microbiota in the pathogenesis of GDM. The regulation of the gut microbiota may provide new directions for the treatment of GDM, including improving insulin sensitivity and blood sugar control through the use of probiotics and prebiotics. However, more research is needed to confirm the generality and exact mechanisms of these findings and to explore potential clinical applications of the gut microbiota in the management of gestational diabetes. In addition, future studies should consider the interaction between environmental and genetic factors and how together they affect the risk of GDM.

Dietary fiber: Still alive

Dietary fiber (DF) was established as a key dietary constituent some decades ago, as were some of its mechanisms of action and health effects. Although there is consolidated evidence on many features regarding DF, at the same time there are still many aspects to be explored in the field, e.g., deeper explorations of the contribution of phenolic compounds linked to cell walls to the biological activities of DF, or of the relevance of the gut-brain axis. At the same time, increasing DF intake should be seen as a major public health problem since worldwide intakes are quite far from recommendations. The awareness of this fact by public bodies should lead, among others, to the assessment of effective strategies for promoting DF intake among general population or specific groups; and to consider potential regulatory modifications in order to clarify several aspects potentially misleading for consumers.

Total dietary fiber intake is inversely associated with metabolically unhealthy status in adolescents with excess weight

Little is known about the relationship between dietary fiber and metabolic health status in adolescents. This study was performed to investigate total dietary fiber intake and metabolic health status in a sample of Iranian adolescents with overweight/obesity. We hypothesized that higher total dietary fiber intake would reduce odds of metabolically unhealthy status. In this cross-sectional study, 203 adolescents (aged 12-18 years) with overweight/obesity were randomly recruited from several educational areas with different socioeconomic statuses using a multistage cluster sampling approach. Dietary intakes were evaluated by a validated food frequency questionnaire. Demographic, anthropometric, and cardiometabolic data were gathered through standard methods. Adolescents were categorized as having either metabolically healthy overweight/obesity or metabolically unhealthy overweight/obesity (MUO) phenotypes according to the International Diabetes Federation (IDF) and IDF/Homeostasis Model Assessment Insulin Resistance (HOMA-IR) criteria. Subjects had mean age of 13.97 (years) and mean fiber intake of 19.5 (g/d). After considering potential confounders, adolescents with the highest fiber intake, compared with the lowest intake, had decreased odds of MUO based on IDF (odds ratio [OR] = 0.14; 95% confidence interval [CI], 0.04-0.46) and IDF/HOMA-IR (OR = 0.16; 95% CI, 0.04-0.56) definitions. Also, each additional unit of total dietary fiber intake (1 g/d) was associated with lower chance of MUO phenotype considering IDF and IDF/HOMA-IR criteria. Individuals with higher intakes of dietary fiber were also less likely to have hyperglycemia (in fully adjusted model: OR = 0.17; 95% CI, 0.06-0.52). We found that consumption of total dietary fiber was inversely associated with odds of MUO among Iranian adolescents. Further prospective studies are required for confirming our results.

High-protein high-konjac glucomannan diets changed glucose and lipid metabolism by modulating colonic microflora and bile acid profiles in healthy mouse models

High protein and fiber diets are becoming increasingly popular for weight loss; however, the benefits or risks of high protein and fiber diets with a normal calorie level for healthy individuals still need to be elucidated. In this study, we explored the role and mechanisms of long-term high protein and/or konjac glucomannan diets on the metabolic health of healthy mouse models. We found that high konjac glucomannan contents improved the glucose tolerance of mice and both high protein and high konjac glucomannan contents improved the serum lipid profile but increased the TNF-α levels. In the liver, high dietary protein contents reduced the expression of the FASN gene related to fatty acid synthesis. Interactions of dietary protein and fiber were shown in the signaling pathways related to lipid and glucose metabolism of the liver and the inflammatory status of the colon, wherein the high protein and high konjac glucomannan diet downregulated the expression of the SREBF1 and FXR genes in the liver and downregulated the expression of TNF-α genes in the colon compared to the high protein diet. High konjac glucomannan contents reduced the colonic secondary bile acid levels including DCA and LCA; this was largely associated with the changed microbiota profile and also contributed to improved lipid and glucose homeostasis. In conclusion, high protein diets improved lipid homeostasis and were not a risk to metabolic health, while high fiber diets improved glucose and lipid homeostasis by modulating colonic microbiota and bile acid profiles, and a high protein diet supplemented with konjac glucomannan might improve hepatic lipid homeostasis and colonic inflammation in healthy mouse models through long-term intervention.

Role of dietary fiber and lifestyle modification in gut health and sleep quality

Dietary fiber has an immense role in the gut microbiome by modulating juvenile growth, immune system maturation, glucose, and lipid metabolism. Lifestyle changes might disrupt gut microbiota symbiosis, leading to various chronic diseases with underlying inflammatory conditions, obesity, and its associated pathologies. An interventional study of 16 weeks examined the impact of psyllium husk fiber with and without lifestyle modification on gut health and sleep quality in people with central obesity (men = 60 and women = 60), those aged from 40 to 60 years, those having WC ≥ 90 cm (men) and WC ≥ 80 cm (women), and no history of any chronic disease or regular medication. The participants were subgrouped into three intervention groups, namely, the psyllium husk fiber (PSH) group, the lifestyle modification (LSM) group, and the LSM&PSH group and control group with equal gender bifurcation (men = 15 and women = 15). A 24-h dietary recall, gastrointestinal tract (GIT) symptoms, and sleep quality analysis data were collected on validated questionnaires. The analyses of variance and covariance were used for baseline and post-intervention, respectively. Student's t-test was applied for pre- and post-intervention changes on the variable of interest. The intervention effect on GIT health was highly significant (P < 0.001). The mean GIT scores of the LSM, PSH, and LSM&PSH groups were 2.99 ± 0.14, 2.49 ± 0.14, and 2.71 ± 0.14, respectively, compared to the mean GIT scores of the control group. No significant (P = 0.205) effect of either intervention was observed on sleep quality. The study concluded that psyllium husk fiber significantly improved the GIT symptoms, while no significant effect of the intervention was observed on sleep quality analysis.