Clinical evidence on dietary supplementation with chia seed (Salvia hispanica L.): a systematic review and meta-analysis

Use of ancient grains for the management of diabetes mellitus: A systematic review and meta-analysis

AIMS

A systematic review and meta-analysis of published randomized controlled trials was conducted to collate evidence from studies implementing ancient grains and investigate the impact of ancient grain consumption on health outcomes of patients with Diabetes Mellitus (DM).

DATA SYNTHESIS

Twenty-nine randomized controlled trials were included, and 13 were meta-analyzed. Interventions ranged from 1 day to 24 weeks; most samples were affected by DM type 2 (n = 28 studies) and the ancient grains used were oats (n = 10 studies), brown rice (n = 6 studies), buckwheat (n = 4 studies), chia (n = 3 studies), Job's Tears (n = 2 studies), and barley, Khorasan and millet (n = 1 study). Thirteen studies that used oats, brown rice, and chia provided data for a quantitative synthesis. Four studies using oats showed a small to moderate beneficial effect on health outcomes including LDL-c (n = 717, MD: 0.30 mmol/l, 95% CI: 0.42 to -0.17, Z = 4.61, p < 0.05, I2 = 0%), and TC (n = 717, MD: 0.44 mmol/l, 95% CI: 0.63 to -0.24, Z = 4.40, p < 0.05, I2 = 0%). Pooled analyses of studies using chia and millet did not show significant effects on selected outcomes.

CONCLUSIONS

For adults affected by DM type 2, the use of oats may improve lipidic profile. Further experimental designs are needed in interventional research to better understand the effects of ancient grains on diabetes health outcomes.

PROSPERO REGISTRATION

CRD42023422386.

Nuts and seeds - a scoping review for Nordic Nutrition Recommendations 2023

Background

Nuts and seeds have been part of diets in most of the world for millenniums, and they have also been consumed in the Nordic and Baltic countries for centuries. Consumption of nuts and seeds is linked with various health outcomes. Therefore, when updating the Nordic Nutrition Recommendations (NNR), summarizing the best evidence on key health outcomes from the consumption of nuts and seeds is essential.

Objectives

This study aims to evaluate the updated evidence on the consumption of nuts and seeds and health outcomes regarded relevant for the Nordic and Baltic countries, as well as their dose-response relationship presented in updated systematic reviews and meta-analyses.

Method

The scoping review is built on a de novo systematic review and an umbrella review published in 2022 on the consumption of nuts and seeds and its various health outcomes, including cardiovascular disease and diabetes.

Results

Intake of nuts and seeds is associated with a lower risk of cardiovascular diseases, with evidence assessed as probable. This conclusion is mirrored by evidence from trials on biomarkers for chronic diseases. An intake of a serving of nuts of 28-30 g/day compared to not eating nuts is estimated to translate into approximately 20% relative reduction in the risks of cardiovascular disease and premature deaths. For cancers, consumption of a serving of nuts is inversely associated with cancer mortality. However, for type 2 diabetes, there are mixed and inconclusive results. Additionally, there are inverse associations between nut consumption and respiratory and infectious disease mortality. Allergies for nuts are seen among 1-2% of the population.

Conclusion

Overall, the current evidence supports dietary recommendations to increase nut consumption to a serving of nuts and seeds per day for people without allergies to these foods.

Variation observed in consensus judgments between pairs of reviewers when assessing the risk of bias due to missing evidence in a sample of published meta-analyses of nutrition research

OBJECTIVES

To evaluate the risk of bias due to missing evidence in a sample of published meta-analyses of nutrition research using the Risk Of Bias due to Missing Evidence (ROB-ME) tool and determine inter-rater agreement in assessments.

STUDY DESIGN AND SETTING

We assembled a random sample of 42 meta-analyses of nutrition research. Eight assessors were randomly assigned to one of four pairs. Each pair assessed 21 randomly assigned meta-analyses, and each meta-analysis was assessed by two pairs. We calculated raw percentage agreement and chance corrected agreement using Gwet's Agreement Coefficient (AC) in consensus judgments between pairs.

RESULTS

Across the eight signaling questions in the ROB-ME tool, raw percentage agreement ranged from 52% to 100%, and Gwet's AC ranged from 0.39 to 0.76. For the risk-of-bias judgment, the raw percentage agreement was 76% (95% confidence interval 60% to 92%) and Gwet's AC was 0.47 (95% confidence interval 0.14 to 0.80). In seven (17%) meta-analyses, either one or both pairs judged the risk of bias due to missing evidence as "low risk".

CONCLUSION

Our findings indicated substantial variation in assessments in consensus judgments between pairs for the signaling questions and overall risk-of-bias judgments. More tutorials and training are needed to help researchers apply the ROB-ME tool more consistently.

The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies

High blood pressure (BP) is a major pathological risk factor for the development of several cardiovascular diseases. Diet is a key modifier of BP, but the underlying relationships are not clearly demonstrated. This is an umbrella review of published meta-analyses to critically evaluate the wide range of dietary evidence from bioactive compounds to dietary patterns on BP and risk of hypertension. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception until October 31, 2021, for relevant meta-analyses of randomized controlled trials or meta-analyses of observational studies. A total of 175 publications reporting 341 meta-analyses of randomized controlled trials (145 publications) and 70 meta-analyses of observational studies (30 publications) were included in the review. The methodological quality of the included publications was assessed using Assessment of Multiple Systematic Reviews 2 and the evidence quality of each selected meta-analysis was assessed using NutriGrade. This umbrella review supports recommended public health guidelines for prevention and control of hypertension. Dietary patterns including the Dietary Approaches to Stop Hypertension and the Mediterranean-type diets that further restrict sodium, and moderate alcohol intake are advised. To produce high-quality evidence and substantiate strong recommendations, future research should address areas where the low quality of evidence was observed (for example, intake of dietary fiber, fish, egg, meat, dairy products, fruit juice, and nuts) and emphasize focus on dietary factors not yet conclusively investigated.

Nut and seed consumption is inversely associated with metabolic syndrome in females but not males: findings from the 2005-2018 NHANES data

PURPOSE

To assess the association between nut and seed consumption, both combined and separately, and metabolic syndrome and its components, including fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, central obesity, and blood pressure.

METHODS

This cross-sectional analysis used data from 22,687 adults (aged ≥ 18 years) involved in seven cycles (2005-2018) of the National Health and Nutrition Examination Survey (NHANES). Habitual nut and seed intakes were estimated by the Multiple Source Method using data from two 24-h dietary recalls. Metabolic syndrome was ascertained using biochemical data and self-reported medication use. Sex-specific effect estimates were obtained using logistic and linear regressions adjusting for lifestyle and socioeconomic confounders.

RESULTS

Compared to non-consumers, female, but not male, habitual consumers of either nuts or seeds had lower odds of having metabolic syndrome (OR: 0.83, 95% CI 0.71, 0.97). Both nut intake alone and seed intake alone were inversely associated with high fasting glucose and low HDL-cholesterol in females compared to non-consumers. When restricted to habitual consumers only, the combined intake of nuts and seeds at 6 g/day was associated with the lowest triglycerides and highest HDL-cholesterol in females. Combined consumption of nuts and seeds up to one ounce-equivalent (15 g) per day, but not in higher intake levels, was inversely associated with metabolic syndrome, high fasting glucose, central obesity, and low HDL-cholesterol in females.

CONCLUSIONS

Nut and seed consumption, both separately or combined, below 15 g/day was inversely associated with metabolic syndrome and its component conditions in females but not males.

'Superfoods': Reliability of the Information for Consumers Available on the Web

The term 'superfoods', used frequently with marketing purposes, is usually associated with foodstuffs with beneficial health properties. 'Superfoods' appears in many information sources, including digital media. The information they provide is easily accessible for consumers through Internet search engines. The objective of this work is to investigate the data that web pages offer to consumers and their accuracy according to current scientific knowledge. The two main search engines were utilized for English language websites search, introducing the term 'superfoods'. In total, 124 search results were found. After applying the selection criteria, 45 web pages were studied. A total of 136 foods were considered as 'superfoods' by sites; 10 of them (kale, spinach, salmon, blueberries, avocado, chia, walnuts, beans, fermented milks and garlic) were mentioned on at least 15 sites. Nutritional and healthy properties displayed on sites were compared to scientific information. In conclusion, websites present the information in a very simplified manner and it is generally not wrong. However, they should offer to consumers comprehensible information without raising false expectations regarding health benefits. In any case, 'superfoods' consumption can have salutary effects as part of a balanced diet.

Oil Bodies from Chia (Salvia hispanica L.) and Camelina (Camelina sativa L.) Seeds for Innovative Food Applications: Microstructure, Composition and Physical Stability

Exploring and deciphering the biodiversity of oil bodies (OBs) recovered from oilseeds are of growing interest in the preparation of sustainable, natural and healthy plant-based food products. This study focused on chia (Salvia hispanica L.) and camelina (Camelina sativa L.) seed OBs. A green refinery process including ultrasound to remove mucilage, aqueous extraction by grinding and centrifugation to recover OBs from the seeds was used. The microstructure, composition and physical stability of the OBs were examined. Confocal laser scanning microscopy images showed that chia and camelina seed OBs are spherical assemblies coated by a layer of phospholipids and proteins, which have been identified by gel electrophoresis. The mean diameters determined by laser light scattering measurements were 2.3 and 1.6 µm for chia and camelina seed OBs, respectively. The chia and camelina seed OBs were rich in lipids and other bioactive components with, respectively, 64% and 30% α-linolenic acid representing 70% and 53% of the total fatty acids in the sn-2 position of the triacylglycerols, 0.23% and 0.26% phospholipids, 3069 and 2674 mg/kg oil of β-sitosterol, and lipophilic antioxidants: 400 and 670 mg/kg oil of γ-tocopherol. Phenolic compounds were recovered from the aqueous extracts, such as rutin from camelina and caffeic acid from chia. Zeta-potential measurements showed changes from about -40 mV (pH 9) to values that were positive below the isoelectric points of pH 5.1 and 3.6 for chia and camelina seed OBs, respectively. Below pH 6.5, physical instability of the natural oil-in-water emulsions with aggregation and phase separation was found. This study will contribute to the development of innovative and sustainable food products based on natural oil-in-water emulsions containing chia and camelina seed OBs for their nutritional and health benefits.

Consumption of Nuts and Seeds and Health Outcomes Including Cardiovascular Disease, Diabetes and Metabolic Disease, Cancer, and Mortality: An Umbrella Review

Consumption of nuts and seeds is associated with a range of health outcomes. Summarizing the best evidence on essential health outcomes from the consumption of nuts is essential to provide optimal recommendations. Our objective is to comprehensively assess health outcome associations related to the consumption of nuts and seeds, using a culinary definition including tree nuts and peanuts (registered in PROSPERO: CRD42021258300). Health outcomes of interest include cardiovascular disease, cancer, diabetes, obesity, respiratory disease, mortality, and their disease biomarkers. We present associations for high compared with low consumption, per serving, and dose-response relations. MEDLINE, Embase, Cochrane, and Epistemonikos were searched and screened for systematic reviews and meta-analyses. Evidence was extracted from 89 articles on the consumption of nuts and relevant health outcomes, including 23 articles with meta-analysis on disease and mortality, 66 articles on biomarkers for disease, and 9 articles on allergy/adverse outcomes. Intake of nuts was associated with reduced risk of cardiovascular diseases and related risk factors, with moderate quality of evidence. An intake of 28 g/d nuts compared with not eating nuts was associated with a 21% RR reduction of cardiovascular disease (including coronary heart disease incidence and mortality, atrial fibrillation, and stroke mortality), an 11% risk reduction of cancer deaths, and 22% reduction in all-cause mortality. Nut consumption was also inversely associated with mortality from respiratory diseases, infectious diseases, and diabetes; however, associations between nut consumption and diabetes incidence were mixed. Meta-analyses of trials on biomarkers for disease generally mirrored meta-analyses from observational studies on cardiovascular disease, cancers, and diabetes. Allergy and related adverse reactions to nuts were observed in 1-2% of adult populations, with substantial heterogeneity between studies. Overall, the current evidence supports dietary recommendations to consume a handful of nuts and seeds per day for people without allergies to these foods.

The Potential of Lamiaceae Herbs for Mitigation of Overweight, Obesity, and Fatty Liver: Studies and Perspectives

Numerous plants, plant extracts, and plant-derived compounds are being explored for their beneficial effects against overweight and liver diseases. Obesity is associated with the increased prevalence of non-alcoholic fatty liver disease (NAFLD), becoming the most common liver disease in Western countries. Obesity and NAFLD are closely associated with many other metabolic alternations such as insulin resistance, diabetes mellitus, and cardiovascular diseases. Many herbs of the Lamiaceae family are widely employed as food and spices in the Mediterranean area, but also in folk medicine, and their use for the management of metabolic disorders is well documented. Hereby, we summarized the scientific results of the medicinal and nutraceutical potential of plants from the Lamiaceae family for prevention and mitigation of overweight and fatty liver. The evidence indicates that Lamiaceae plants may be a cost-effective source of nutraceuticals and/or phytochemicals to be used in the management of metabolic-related conditions such as obesity and NAFLD. PubMed, Google Scholar, Scopus, and SciFinder were accessed to collect data on traditional medicinal plants, compounds derived from plants, their reported anti-obesity mechanisms, and therapeutic targets.

Effects of Diet, Lifestyle, Chrononutrition and Alternative Dietary Interventions on Postprandial Glycemia and Insulin Resistance

As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and keeping consistent number of daily meals and relative times of eating occasions seem to play a pivotal role for postprandial glycemia and insulin sensitivity. Sequence of meals and nutrients also play a significant role, as foods of low density such as vegetables, salads, or soups consumed first, followed by protein and then by starchy foods lead to ameliorated glycemic and insulin responses. There are several dietary schemes available, such as intermittent fasting regimes, which may improve glycemic and insulin responses. Weight loss is important for the treatment of insulin resistance, and it can be achieved by many approaches, such as low-fat, low-carbohydrate, Mediterranean-style diets, etc. Lifestyle interventions with small weight loss (7–10%), 150 min of weekly moderate intensity exercise and behavioral therapy approach can be highly effective in preventing and treating type 2 diabetes. Similarly, decreasing carbohydrates in meals also improves significantly glycemic and insulin responses, but the extent of this reduction should be individualized, patient-centered, and monitored. Alternative foods or ingredients, such as vinegar, yogurt, whey protein, peanuts and tree nuts should also be considered in ameliorating postprandial hyperglycemia and insulin resistance. This review aims to describe the available evidence about the effects of diet, chrononutrition, alternative dietary interventions and exercise on postprandial glycemia and insulin resistance.

Assessment of the Phytochemical and Nutrimental Composition of Dark Chia Seed (Salvia hispánica L.)

Chia seeds are rich sources of different macro and micronutrients associated with health benefits; thus, they may be considered as a functional food. However, the composition depends on the variety, origin, climate and soil. Here, we show a comprehensive characterization of extractable and non-extractable phenolic compounds of dark chia seed Salvia hispanica L. using high-performance liquid chromatography-electrospray ionization-quadrupole time-of-flight (HPLC-ESI-QTOF) and discuss potential health benefits associated with the presence of a number of nutritional and bioactive compounds. We report that dark chia from Jalisco is a high-fiber food, containing omega-3 polyunsaturated fatty acids, essential amino acids (phenylalanine and tryptophan), and nucleosides (adenosine, guanidine and uridine), and rich in antioxidant phenolic compounds, mainly caffeic acid metabolites. Our data suggest that chia seeds may be used as ingredients for the development of functional foods and dietary supplements.

Methods used to select results to include in meta-analyses of nutrition research: a meta-research study

OBJECTIVES

To investigate how often review authors encounter multiple results from included studies that are eligible for inclusion in a particular meta-analysis, and how often methods to select results are specified.

METHODS

MEDLINE and Epistemonikos were searched (January 2018 - June 2019) to identify systematic reviews with meta-analysis of the association between food/diet and health-related outcomes. A random sample of these reviews was selected, and for the first presented ('index') meta-analysis, rules used to select effect estimates to include in this meta-analysis were extracted from the reviews and their protocols. All effect estimates from the primary studies that were eligible for inclusion in the index meta-analyses were extracted (e.g. when a study report presented effect estimates for blood pressure at 3 weeks and 6 weeks, both unadjusted and adjusted for covariates, and all were eligible for inclusion in a meta-analysis of the effect of red meat consumption on blood pressure, we extracted all estimates and classified the study as having "multiplicity of results").

RESULTS

Forty-two systematic reviews with 325 studies (104 randomized, 221 non-randomized) were included; 14 reviews had a protocol. In 29% of review protocols and 69% of reviews, authors specified at least one decision rule to select effect estimates when multiple were available. In 68% of studies included in the index meta-analyses, there was at least one type of multiplicity of results.

CONCLUSIONS

Authors of systematic reviews of nutrition studies should anticipate encountering multiplicity of results in the included primary studies. Specification of methods to handle multiplicity when designing reviews is therefore recommended.

Chia seed (Salvia hispanica L.) consumption and lipid profile: a systematic review and meta-analysis

Chia (Salvia hispanica L.) is an annual herbaceous plant, originally from southern Mexico and northern Guatemala - nowadays grown all over the world. In recent years, there has been an increase in demand for plant foods with health-promoting properties, and chia is a main actor in this process due to its high nutritional and functional value and its chemical composition rich in PUFAs, mainly ω-3, as well as protein, dietary fiber, and bioactive compounds. Chia has been explored in different research models for health and the prevention of human diseases. Evidence has suggested potential for improving insulin resistance, disordered lipid profiles, glucose tolerance and even adiposity. The aim of this study was to evaluate the effect of consumption of chia seeds on the lipid profile, triglycerides, and serum ω-3 fatty acids in adults. This systematic review included all randomized controlled trials (parallel or crossover design) published up to August 2020 in the main databases Medline, Embase, Scopus, Web of Science, and Scielo. Two independent authors selected and extracted data from those articles. After the selection process, 10 clinical trials were included. Forest plots and summary tables were constructed to present data and sensitivity subgroup analyses were performed for some of the outcomes. The results showed that chia consumption suggests a protective effect on the lipid profile, decreasing TC (MD = -2.98, 95% CI = [-9.98; 4.02]), TG (MD = -14.09 mg dL-1, 95% CI = [-33.46; 5.28]), and LDL (MD = 2.07 mg dL-1; 95% CI = [-5.05; 9.19]) and increasing HDL (MD = -2.92 mg dL-1, 95% CI = [-5.91; 0.06]). Regarding serum fatty acids, chia reduced FFA and SFA and increased PUFAs, ALA, EPA, and LA. It has also reduced DHA while not changing DPA. The intake of chia appears to have a neutral or beneficial effect on some markers of the lipid and fatty acid profile.

Targeting dyslipidemia by herbal medicines: A systematic review of meta-analyses

ETHNOPHARMACOLOGICAL RELEVANCE

The worldwide increasing prevalence of dyslipidemia has become a global health concern. Various herbal remedies have been claimed to be effective for the treatment of dyslipidemia in traditional and folkloric medicine of different regions clinical trials have been conducted to investigate their efficacy. The aim of the current systematic review is to critically assess the meta-analyses of controlled trials (CT) evaluated herb medicines for dyslipidemia.

MATERIALS AND METHODS

Relevant studies from Web of Science, PubMed, Scopus, and Cochrane Library databases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist until January 2021 have been searched. All meta-analyses which pooled studies on the effect of herbal medicines on lipid profile including total cholesterol (TC), triglyceride (TG), and low- or high-density lipoprotein cholesterol (LDL-C, HDL-C) were also included. Meta-analyses of in vitro, animal or observational studies were excluded.

RESULTS

The overall of 141 meta-analyses were revealed. Vegetable oils, phytosterols, tea, soy protein, nuts, and curcumin have been studied frequently among the herbal medicines. Among 13 meta-analyses on vegetable oils, the greater reduce of TC (18.95 mg/dl), LDL-C (16.24 mg/dl) and TG (13.69 mg/dl) were exhibited from sunflower oil. Furthermore, rice bran oil (6.65 mg/dl) increased HDL-C significantly. Phytosterols in 12 meta-analyses demonstrated significant improvements in reducing TC, LDL-C and TG as 16.4, 23.7, and 8.85 mg/dl, respectively, and rise in HDL-C as 10.6 mg/dl. The highest reduction in serum level of TC, LDL-C and TG was reported while intake Green tea; 27.57, 24.75, and 31.87 mg/dl, accordingly within 9 meta-analyses. Average improvement of lipid profiles by 6 meta-analyses on plant proteins were 23.2, 21.7, 15.06, and 1.55 mg/dl for TC, LDL-C, TG, and HDL-C, respectively. Among 11 meta-analyses on nuts, almond showed better and significant alleviations in TC (10.69 mg/dl), walnut in LDL-C (9.23 mg/dl), pistachio in TG (22.14 mg/dl), and peanut in HDL-C (2.72 mg/dl). Overall, Curcumin, Curcuminoid, and Turmeric have resulted in the reduction of TC (25.13 mg/dl), LDL-C (39.83 mg/dl), TG (33.65 mg/dl), and an increase in the HDL-C (4.31 mg/dl).

CONCLUSION

The current systematic review shed light on the use of herbal medicines for the management of dyslipidemia. However, more well-conducted CTs are required to determine effective doses of herbal medicines.

Physicochemical, Antioxidant, and Anti-Inflammatory Properties of Rapeseed Lecithin Liposomes Loading a Chia (Salvia hispanica L.) Seed Extract

Vegetal waste materials were used to produce liposomes with both antioxidant and anti-inflammatory properties. Differences in the chemical composition of rapeseed lecithin (LEC) and a partially purified phospholipid fraction (PPL) were studied in terms of fatty acids (neutral lipids, free fatty acids, and phospholipids), sterols, tocopherols, and amino acid composition. Neutral lipids, campesterol, β-sitosterol, and γ-tocopherol were the most depleted compounds in PPL. Qualitative differences between LEC and PPL were revealed by infrared spectroscopy and differential scanning calorimetry. An ethanol/water antioxidant extract from chia seeds (ChE), with a high content in rosmarinic acid and rosmarinic acid 3-O-glucoside, along with other minor phenolic acids determined by HPLC-MS, was encapsulated in liposomes made of LEC (L-LEC) and PPL (L-PPL) with an entrapment efficiency of 61.3% and 69.3%, respectively. L-PPL suspensions showed smaller particle size and lower ζ potential than their L-LEC counterparts, along with noticeable particle destabilization after 7 days of storage. Antioxidant properties were greater in L-LEC than in L-PPL suspensions. L-LEC, ChE, and lecithin empty liposomes (L-E) showed no cytotoxic effect in either Caco-2 or THP-1 cells and induced downregulation of the inflammation response.

Consumer Preferences and Willingness to Pay for Nutraceuticals: A Discrete Choice Experiment

OBJECTIVES

Globally, nutraceuticals have been increasingly used. Nevertheless, the consumer preferences for nutraceuticals have not been quantitatively investigated. This study used discrete choice experiment (DCE) to examine consumer preferences and willingness to pay for nutraceuticals.

METHODS

Four attributes (ie, the scientific proof of effectiveness, the scientific proof of safety, the source of recommendation, and cost) were identified from a systematic review and focus group interviews. They were used to develop a DCE questionnaire. Consumers at community pharmacies in Malaysia were asked to respond to 8 DCE choice sets. A conditional logit model was employed to obtain the relative importance of each attribute and to estimate respondents' WTP for nutraceuticals.

RESULTS

A total of 111 valid responses were analyzed. A negative constant term in the developed model indicated that generally the respondents preferred not to use nutraceuticals before they considered the study attributes. The respondents preferred nutraceuticals with no side effect, clear evidence of effectiveness, and recommendation of a healthcare professional. The respondents were willing to pay $252/month more for nutraceuticals proven with no side effect than for those without proof of safety, and $102/month more for nutraceuticals proven with clear effectiveness than for those without proof of effectiveness.

CONCLUSIONS

Consumers weighed relatively high on the availability of safety and effectiveness proofs when they chose nutraceuticals. The study highlights on the crucial need to inform consumers using clinical evidences of nutraceuticals as the information is highly preferred by consumers.

Specialty seeds: Nutrients, bioactives, bioavailability, and health benefits: A comprehensive review

Seeds play important roles in human nutrition and health since ancient time. The term "specialty" has recently been applied to seeds to describe high-value and/or uncommon food products. Since then, numerous studies have been conducted to identify various classes of bioactive compounds, including polyphenols in specialty seeds. This review discusses nutrients, fat-soluble bioactives, polyphenols/bioactives, antioxidant activity, bioavailability, health benefits, and safety/toxicology of commonly consumed eight specialty seeds, namely, black cumin, chia, hemp, flax, perilla, pumpkin, quinoa, and sesame. Scientific results from the existing literature published over the last decade have been compiled and discussed. These specialty seeds, having numerous fat-soluble bioactives and polyphenols, together with their corresponding antioxidant activities, have increasingly been consumed. Hence, these specialty seeds can be considered as a valuable source of dietary supplements and functional foods due to their health-promoting bioactive components, polyphenols, and corresponding antioxidant activities. The phytochemicals from these specialty seeds demonstrate bioavailability in humans with promising health benefits. Additional long-term and well-design human intervention trials are required to ascertain the health-promoting properties of these specialty seeds.

Use of GRADE in evidence syntheses published in high-impact-factor nutrition journals: A methodological survey

OBJECTIVE

To identify and describe the use of the GRADE approach for rating the certainty of evidence in nutrition systematic reviews (SRs).

STUDY DESIGN AND SETTING

We systematically searched for SRs using GRADE that were published between 2015 and 2019 in the 10 "nutrition" journals with the highest impact factor according to the JCR 2018.

RESULTS

Out of 800 SRs, 55 SRs of randomized control trials (RCTs) and/or nonrandomized studies (NRSs) used GRADE. Forty-seven SRs (5.9%) rated the outcome specific certainty of evidence (n = 36 in 2018/2019). We identified a total of 465 certainty of evidence outcome ratings (n = 335 RCT ratings), ranging from very-low (28.8%) to low (41%), moderate (26.5%), and high (3.7%). Very-low and high certainty of evidence ratings accounted for 61.4% and 0.8% of ratings in SRs of NRSs, compared to 16.1% and 4.8% in SRs of RCTs. Certainty of evidence was downgraded mostly for risk of bias (37.8%) and imprecision (33%) in SRs of RCTs and for imprecision (32.7%), risk of bias (29.4%) and inconsistency (29%) in SRs of NRSs.

CONCLUSION

Our study suggests a need for directing more attention toward strengthening acceptance of GRADE as well as building knowledge of the GRADE methodology in nutrition evidence synthesis.

Co-administration of viscous fiber, Salba-chia and ginseng on glycemic management in type 2 diabetes: a double-blind randomized controlled trial

PURPOSE

Viscous dietary fiber, functional seeds and ginseng roots have individually been proposed for the management of diabetes. We explored whether their co-administration would improve glycemic control in type 2 diabetes beyond conventional therapy.

METHODS

In a randomized, double-blind, controlled trial conducted at two academic centers (Toronto, Canada and Zagreb, Croatia), individuals with type 2 diabetes were assigned to either an active intervention (10 g viscous fiber, 60 g white chia seeds, 1.5 g American and 0.75 g Korean red ginseng extracts), or energy and fiber-matched control (53 g oat bran, 25 g inulin, 25 g maltodextrose and 2.25 g wheat bran) intervention for 24 weeks, while on conventional standard of care. The prespecified primary endpoint was end difference at week 24 in HbA1c, following an intent-to-treat analysis adjusted for center and baseline.

RESULTS

Between January 2016 and April 2018, 104 participants (60M:44F; mean ± SEM age 59 ± 0.8 years; BMI 29.0 ± 0.4 kg/m²; HbA1c 7.0 ± 0.6%) managed with antihyperglycemic agent(s) (n = 98) or lifestyle (n = 6), were randomized (n = 52 test; n = 52 control). At week 24, HbA1c levels were 0.27 ± 0.1% lower on test compared to control (p = 0.03). There was a tendency towards an interaction by baseline HbA1c (p = 0.07), in which a greater reduction was seen in participants with baseline HbA1c > 7% vs ≤ 7% (- 0.56 ± 0.2% vs 0.03 ± 0.2%). Diet and body weight remained unchanged. The interventions were well tolerated with no related adverse events and with high retention rate of 84%.

CONCLUSIONS

Co-administration of selected dietary and herbal therapies was well-tolerated and may provide greater glycemic control as add-on therapy in type 2 diabetes. Registration: Clinicaltrials.gov NCT02553382 (registered on September 17, 2015).

Amaranth, quinoa and chia bioactive peptides: a comprehensive review on three ancient grains and their potential role in management and prevention of Type 2 diabetes

Worldwide prevalence of Type 2 Diabetes (T2D) has become a major concern with several implications for public health, economy, and social well-being, especially in developing countries. Conventional pharmacological management of T2D have proved effective, but possess underlying side effects, leading the scientific community to research alternative compounds that exert beneficial effects on current therapeutic targets of T2D. Bioactive peptides (BAPs) from food sources, have shown relative advantages in this matter, moreover, BAPs have proved to impart anti-diabetic activity through one or more mechanisms such as enzymatic inhibition of α-glucosidase, α-amylase and DPP-IV. Several plants and animal have been used as protein sources of anti-diabetic BAPs, in the sense of this matter, the pseudo-cereals amaranth and quinoa, along with the ancestral grain chia, have gained attention. Due, to their high protein content and balanced amino-acid composition, along with proved anti-diabetic features, the three seeds are top choices for the obtention of anti-diabetic BAPs. With a comprehensive overview of the most recent reported in silico and in vitro anti-diabetic studies in relation to biomarkers α-glucosidase, α-amylase and DPP-IV, the present review aims to examine the current knowledge of amaranth, quinoa and chia derived anti-diabetic BAPs and their effects on T2D therapeutic markers.

Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series

Background: We describe for the first time the use of chia seeds (Salvia hispanica L.) as a non-pharmacological solution in managing feline idiopathic hypercalcemia when dietary change alone fails. Case Summary: Over a 2-year period of time, three female spayed, middle-aged, Domestic Shorthair cats were diagnosed with idiopathic hypercalcemia. Reason for consultation were lethargy and dysorexia, with a single episode of vomiting described in one cat and dysuria in another. Thorough diagnostic work-up included complete blood count, serum biochemistry, urinalysis, ionized calcium, calcemic hormones, parathyroid hormone-related protein, and imaging of chest and abdomen. Based on different nutritional reasons, each cat was switched to a different high-moisture pet food as first-step in managing the disorder: a high-fiber diet, a diet formulated for chronic kidney disease management and a diet designed to prevent calcium oxalate urolithiasis. In the three cats, 6 weeks of dietary change alone did not result in normocalcemia. Before resorting to any pharmacological solution, supplementation to the diet of chia seeds (2 g/cat/day) was started. After 4 weeks from the introduction of Salvia hispanica L., all cats achieved normalization of ionized calcium concentration. Conclusion: Chia seeds (Salvia hispanica L.) supplementation could be a useful tool in managing feline idiopathic hypercalcemia.

Evaluation of Aflatoxin Concentrations and Occurrence of Potentially Toxigenic Fungi in Imported Chia Seeds Consumed in Thailand

ABSTRACT

This study was conducted to investigate possible contamination by aflatoxins (AFs) and aflatoxigenic fungi in imported chia seeds consumed in Thailand. A survey was performed on 100 samples of imported chia seeds collected from supermarkets and health food stores in Bangkok from May 2017 to February 2018. Ten mold species belonging to Aspergillus and Penicillium were isolated, and Aspergillus flavus was the most prevalent aflatoxigenic fungi. Chia seed samples were cleaned with an immunoaffinity column and analyzed for AFs by high-performance liquid chromatography with fluorescence detection using precolumn derivatization. AFs were detected in 40% of total samples at concentrations of 0.4 to 10.99 ng/g. Among the positive samples, three were contaminated with total AFs at concentrations higher than the European Union regulatory limit (4 ng/g). The most commonly found AF found in chia seeds was AFB1.

HIGHLIGHTS

Effect of pycnogenol supplementation on blood pressure: A systematic review and meta-analysis of clinical trials

Several studies investigated the impact of pycnogenol on blood pressure. Nevertheless, the results are inconclusive. The aim of the present systematic review and meta-analysis was to clarify the effect of pycnogenol supplementation on blood pressure. PubMed, Scopus, Web of Science, and Google Scholar were systematically searched until March 2018 to find clinical trials, which examined the effect of pycnogenol supplementation on systolic and diastolic blood pressure in adults. A subgroup analysis was applied to find out potential sources of interstudy heterogeneity. A total of 12 clinical trials (922 participants) were included in the meta-analysis. Pooled analysis suggested that pycnogenol supplementation can reduced systolic blood pressure (SBP) of (-3.22 mmHg; 95% CI [-5.52, -0.92]) and diastolic blood pressure (DBP; -1.91 mmHg; 95% CI [-3.64, -0.18]). Effect of pycnogenol on SBP was more pronounce in subgroup in which pycnogenol was administered along with other treatments. A significant effect of pycnogenol on DBP in studies with >12-week duration, whereas this favorable effect was not observed in subgroup with ≤12-week supplementation. The present systematic review and meta-analysis suggest that pycnogenol had a favorable effect on SBP and DBP. Further, high quality randomized clinical trials are needed to confirm this result.

The Chemical Composition and Nutritional Value of Chia Seeds-Current State of Knowledge

Chia (Salvia hispanica) is an annual herbaceous plant, the seeds of which were consumed already thousands of years ago. Current research results indicate a high nutritive value for chia seeds and confirm their extensive health-promoting properties. Research indicates that components of chia seeds are ascribed a beneficial effect on the improvement of the blood lipid profile, through their hypotensive, hypoglycaemic, antimicrobial and immunostimulatory effects. This article provides a review of the most important information concerning the potential application of chia seeds in food production. The chemical composition of chia seeds is presented and the effect of their consumption on human health is discussed. Technological properties of chia seeds are shown and current legal regulations concerning their potential use in the food industry are presented.

Safety of chia seeds (Salvia hispanica L.) as a novel food for extended uses pursuant to Regulation (EU) 2015/2283

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel foods and Food Allergens (NDA) was asked to deliver an opinion on overall safety assessment for chia seeds (Salvia hispanica L.) as a novel food (NF) pursuant to Regulation (EU) 2015/2283 in the light of the increasing dietary intake from the growing number of authorised uses in recent years. The safety assessment of this NF is based on data supplied in seven applications, previous safety assessments of chia seeds and information retrieved from an extensive literature search done by EFSA. Since none of the applications addressed the possible formation of process contaminants, the present assessment is limited to those proposed extended uses which do not raise safety concerns regarding the formation of such contaminants. These include the use of whole and ground chia seeds added to chocolate, fruit spreads, fruit desserts, mixed fruit with coconut milk in twin pot, fruit‐preparations to underlay a dairy product, fruit‐preparations to be mixed with dairy products, confectionary (excluding chewing gums), dairy products and analogues, edible ices, fruit and vegetables products, non‐alcoholic beverages and compotes from fruit and/or vegetables and/or with cereals. In addition, this assessment also concerns uses of chia seeds without specific restrictions and precautions regarding their use levels in other foods which usually do not include heat treatment during processing and cooking. Apart from allergenicity, the Panel did not identify any hazard which causes safety concerns. Lacking the basis and need to establish safe maximum intake levels for chia seeds, no exposure assessment was conducted. The Panel concludes that chia seeds are safe under the assessed conditions of use.

Bread Enrichment with Oilseeds. A Review

The use of oilseeds in bakery products has gained popularity in recent years, both for their organoleptic and nutritional characteristics. The aim of this work is to provide an overview of the studies centered on the use of oilseeds (flaxseed, chia, sunflower, pumpkin, sesame and poppyseed) in breads and other bakery products. This review highlights the effect of oilseeds on the mechanical and physical properties of bread according to the enrichment level, origin and way of addition (whole, crushed, oil or mucilage). In general, the incorporation of oilseeds improves the nutritional profile of bakery products with and without gluten, and provides several health benefits. Mucilages of oilseeds can also act as a fat replacer thanks to their properties. The incorporation of oilseeds modifies the rheology of the doughs, the volume of the products and their texture, affecting their organoleptic characteristics and their acceptability. Nevertheless, these changes will depend on the type of seed used, as well as on the method of addition.