Methylxanthine Content in Commonly Consumed Foods in Spain and Determination of Its Intake during Consumption

Effect of Coffee and Chocolate Ingestion on Clozapine Dose and on Plasma Clozapine and Norclozapine Concentrations in Clinical Practice

BACKGROUND

Some reports point to dietary caffeine intake as a cause of increased plasma clozapine concentrations in certain patients.

METHODS

We compared clozapine dose and plasma clozapine and N-desmethylclozapine (norclozapine) concentrations in male and female smokers and nonsmokers in relation to reported (i) coffee (caffeine) and (ii) chocolate (caffeine and theobromine) intake in samples submitted for clozapine therapeutic drug monitoring, 1993-2017.

RESULTS

There was information on coffee ingestion for 16,558 samples (8833 patients) from males and 5886 samples (3433 patients) from females and on chocolate ingestion for 12,616 samples (7568 patients) from males and 4677 samples (2939 patients) from females. When smoking was considered, there was no discernible effect of either coffee or chocolate ingestion either on the median dose of clozapine or on the median plasma clozapine and norclozapine concentrations in men and in women. However, cigarette smoking was associated with higher coffee and chocolate consumption. Although male nonsmokers who reported drinking 3 or more cups of coffee daily had significantly higher median plasma clozapine and norclozapine concentrations than those who drank less coffee, they were also prescribed a significantly higher clozapine dose. There was no clear effect of coffee ingestion on plasma clozapine and norclozapine in female nonsmokers.

IMPLICATIONS

Inhibition of clozapine metabolism by caffeine at the doses of caffeine normally encountered in those treated with clozapine is unlikely even in male nonsmokers. Measurement of plasma caffeine in an appropriate sample should be considered in any future investigation into a presumed clozapine-caffeine interaction.

Drugs targeting adenosine signaling pathways: A current view

Adenosine is an endogenous nucleoside that regulates many physiological and pathological processes. It is derived from either the intracellular or extracellular dephosphorylation of adenosine triphosphate and interacts with cell-surface G-protein-coupled receptors. Adenosine plays a substantial role in protecting against cell damage in areas of increased tissue metabolism and preventing organ dysfunction in pathological states. Targeting adenosine metabolism and receptor signaling may be an effective therapeutic approach for human diseases, including cardiovascular and central nervous system disorders, rheumatoid arthritis, asthma, renal diseases, and cancer. Several lines of evidence have shown that many drugs exert their beneficial effects by modulating adenosine signaling pathways but this knowledge urgently needs to be summarized, and most importantly, actualized. The present review collects pharmaceuticals and pharmacological or diagnostic tools that target adenosine signaling in their primary or secondary mode of action. We overviewed FDA-approved drugs as well as those currently being studied in clinical trials. Among them are already used in clinic A2A adenosine receptor modulators like istradefylline or regadenoson, but also plenty of anti-platelet, anti-inflammatory, or immunosuppressive, and anti-cancer drugs. On the other hand, we investigated dozens of specific adenosine pathway regulators that are tested in clinical trials to treat human infectious and noninfectious diseases. In conclusion, targeting purinergic signaling represents a great therapeutic challenge. The actual knowledge of the involvement of adenosinergic signaling as part of the mechanism of action of old drugs has open a path not only for drug-repurposing but also for new therapeutic strategies.

Alkaloids in food: a review of toxicity, analytical methods, occurrence and risk assessments

Alkaloids have been utilized by humans for years. They have diverse applications in pharmaceuticals. They have been proven to be effective in treating a number of diseases. They also form an important part of regular human diets, as they are present in food items, food supplements, diet ingredients and food contaminants. Despite their obvious importance, these alkaloids are toxic to humans. Their toxicity is dependent on a range of factors, such as specific dosage, exposure time and individual properties. Mild toxic effects include nausea, itching and vomiting while chronic effects include paralysis, teratogenicity and death. This review summarizes the published studies on the toxicity, analytical methods, occurrence and risk assessments of six major alkaloid groups that are present in food, namely, ergot, glycoalkaloids, purine, pyrrolizidine, quinolizidine and tropane alkaloids.

Determination of Caffeine, Theobromine, and Theophylline by HPLC-DAD in Beverages Commonly Consumed in Lima, Peru

The purpose of this study was to determine the content of caffeine, theobromine, and theophylline by high-performance liquid chromatography with diode-array detection (HPLC-DAD) in beverages commonly consumed in Lima, Peru. The samples were divided into 6 groups (herbal teas, coffee powder, chocolate milks, soft drinks, sports drinks, and energy drinks) which included the five most commonly consumed beverages of the different groups. Caffeine was mainly identified in the soft drink and energy drink groups, with the latter having a more significant value (10.38 ± 0.01 vs. 95.50 ± 3.48 mg/L, respectively). In herbal teas, caffeine showed the highest content (0.47 ± 0.01 to 4.91 ± 0.05 mg/L), despite theophylline being a characteristic compound of tea leaves. Sports drinks presented very low caffeine levels (0.03 ± 0.01 to 0.05 ± 0.01 mg/L), and theobromine (0.48 ± 0.01 to 6.00 ± 0.02) was also identified. Caffeine (4.09 ± 0.01 to 5.70 ± 0.01 mg/L) and theobromine (1.70 ± 0.01 to 12.24 ± 0.01 mg/L) were found in the five commercial brands of chocolate milk evaluated. Moreover, the group of coffee powder samples had the highest level of caffeine content (49.25 ± 0.24 to 964.40 ± 4.93 mg/100 g). The results obtained in this study provide reliable information on the composition and quantification of methylxanthines in the beverages most consumed in Lima and impact consumer knowledge.

Development of a Caffeine Content Table for Foods, Drinks, Medications and Supplements Typically Consumed by the Brazilian Population

Background: The lack of a national table informing the caffeine contents in foods, drinks, dietary supplements, and medications sold in Brazil added to the noncompulsory disclosure of caffeine contents on labels of food products makes it difficult to estimate caffeine consumption in the Brazilian population. Therefore, this study aimed to develop the Brazilian Caffeine Content Table (BraCaffT). Methods: A systematic search for caffeine levels in foods, drinks, recipes, supplements, and medications was performed through a literature review, afterward collecting data from the United States Department of Agriculture Food Data Central, information from manufacturers’ and websites, and the Brazilian official medication guide. Subsequently, data systematization was performed in a spreadsheet with standardized values presented in mg of caffeine per 100 g or 100 mL of food or drink and a capsule or pill for medications and some dietary supplements. Results: The BraCaffT presents 57 items, divided into 11 categories: coffees, teas and infusions, cocoa powder, chocolates, cocoa-based beverages, desserts, soft drinks, energy drinks, guaraná powder, dietary supplements, and medications. Conclusions: The BraCaffT emerges as an instrument of great relevance and wide applicability in clinical contexts, in academic research, and as a database for the Brazilian population to better understand the amounts of caffeine in foods, drinks, dietary supplements, and medications consumed daily favoring a safe intake.

Caffeine intake improves the cognitive performance of patients with chronic kidney disease

Objective

Cognitive impairment is a common complication of chronic kidney disease (CKD). Caffeine intake has been reported to improve cognitive performance in several studies. However, whether the benefits of caffeine intake on cognitive function apply to patients with CKD remains unknown.

Methods

We performed a retrospective cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). The data of CKD subjects and non-CKD subjects from NHANES 2011−2014 were analyzed. Propensity score matching (PSM) was performed based on age, sex, diabetes, cancer, educational level, energy intake and protein intake to select subjects. The Consortium to Establish a Registry for Alzheimer’s Disease Word Learning Test (CERAD-WL), the CERAD Word List Recall Test (CERAD-DR), the Animal Fluency Test (AF) and the Digit Symbol Substitution Test (DSST) were used, whereby the occurrence of cognitive impairment was identified. Logistic regression models were performed to evaluate the association between caffeine intake and cognitive performance in CKD and non-CKD participants. Stratified analyses according to the stage of CKD and the urinary albumin/creatinine ratio levels were performed. Plot curves were then generalized to present a non-linear relationship, and the inflection point for each non-linear model was obtained by using a recursive algorithm.

Results

Cognitive impairment was more prevalent in CKD patients than in non-CKD subjects. For CKD patients, caffeine intake was associated with higher CERAD-WL, CERAD-DR, AF and DSST scores. For non-CKD subjects, caffeine intake was associated with higher DSST scores only. Subgroup analysis revealed that caffeine only benefited the cognitive function of patients with CKD stages 2 and 3. The analysis showed non-linear relationships of caffeine intake and cognitive function for both CKD and non-CKD subjects. The inflection point of caffeine intake for CKD patients was 279 mg/day.

Conclusion

The recommended dose of caffeine intake to improve the cognitive function of CKD patients is ≤279 mg/day.

Influence of methylxanthines isolated from Bancha green tea on the pharmacokinetics of sildenafil in rats

BACKGROUND

Sildenafil is used to treat erectile dysfunction and pulmonary arterial hypertension and is metabolized in the liver mainly by CYP3A4, thus co-administration with drugs or herbal extracts that affect CYP3A4 activity may lead to drug-drug or drug-herb interactions, respectively. The aim of the present study was to evaluate the influence of single and multiple oral doses of methylxanthine fraction, isolated from Bancha green tea leaves on the pharmacokinetics of sildenafil in rats.

METHODS

Rats were given sildenafil alone as well as simultaneously with methylxanthines or ketoconazole. The plasma concentrations of sildenafil were measured with high-performance liquid chromatography method with ultraviolet detection. The pharmacokinetic parameters of sildenafil were calculated by non-compartmental analysis.

RESULTS

Concomitant use of sildenafil with a single oral dose of methylxanthines resulted in a decrease in C_max (p > 0.05), AUC_0-t (p < 0.05) and AUC_0-inf (p < 0.05), while the administration of sildenafil after methylxanthines pretreatment resulted in an increase in C_max (p < 0.0001), AUC_0-t (p < 0.0001) and AUC_0-inf (p < 0.001) compared to the sildenafil group. After co-administration of sildenafil and ketoconazole, a significant increase in C_max, AUC_0-t and AUC_0-inf was observed in both of the experiments.

CONCLUSION

Drug-herb interactions were observed when sildenafil was co-administered with Bancha methylxanthines in rats. Further in vivo studies about the potential drug interactions between sildenafil and methylxanthines, especially caffeine, are needed to clarify mechanisms underlying the observed changes in sildenafil pharmacokinetics.

Tailoring Chlorthalidone Aqueous Solubility by Cocrystallization: Stability and Dissolution Behavior of a Novel Chlorthalidone-Caffeine Cocrystal

A cocrystal of the antihypertensive drug chlorthalidone (CTD) with caffeine (CAF) was obtained (CTD-CAF) by the slurry method, for which a 2:1 stoichiometric ratio was found by powder and single-crystal X-ray diffraction analysis. Cocrystal CTD-CAF showed a supramolecular organization in which CAF molecules are embedded in channels of a 3D network of CTD molecules. The advantage of the cocrystal in comparison to CTD is reflected in a threefold solubility increase and in the dose/solubility ratios, which diminished from near-unit values for D_0D to 0.29 for D_0CC. Furthermore, dissolution experiments under non-sink conditions showed improved performance of CTD-CAF compared with pure CTD. Subsequent studies showed that CTD-CAF cocrystals transform to CTD form I where CTD precipitation inhibition could be achieved in the presence of pre-dissolved polymer HPMC 80–120 cPs, maintaining supersaturation drug concentrations for at least 180 min. Finally, dissolution experiments under sink conditions unveiled that the CTD-CAF cocrystal induced, in pH-independent manner, faster and more complete CTD dissolution when compared to commercial tablets of CTD. Due to the stability and dissolution behavior of the novel CTD-CAF cocrystal, it could be used to develop solid dosage forms using a lower CTD dose to obtain the same therapeutic response and fewer adverse effects.

Plasma metabolomic profiles associated with chronic distress in women

Several forms of chronic distress including anxiety and depression are associated with adverse cardiometabolic outcomes. Metabolic alterations may underlie these associations. Whether these forms of distress are associated with metabolic alterations even after accounting for comorbid conditions and other factors remains unclear. Using an agnostic approach, this study examines a broad range of metabolites in relation to chronic distress among women. For this cross-sectional study of chronic distress and 577 plasma metabolites, data are from different substudies within the Women's Health Initiative (WHI) and Nurses' Health Studies (NHSI, NHSII). Chronic distress was characterized by depressive symptoms and other depression indicators in the WHI and NHSII substudies, and by combined indicators of anxiety and depressive symptoms in the NHSI substudy. We used a two-phase discovery-validation framework, with WHI (N = 1317) and NHSII (N = 218) substudies in the discovery phase (identifying metabolites associated with distress) and NHSI (N = 558) substudy in the validation phase. A differential network analysis provided a systems-level assessment of metabolomic alterations under chronic distress. Analyses adjusted for potential confounders and mediators (demographics, comorbidities, medications, lifestyle factors). In the discovery phase, 46 metabolites were significantly associated with depression measures. In validation, six of these metabolites demonstrated significant associations with chronic distress after adjustment for potential confounders. Among women with high distress, we found lower gamma-aminobutyric acid (GABA), threonine, biliverdin, and serotonin and higher C16:0 ceramide and 3-methylxanthine. Our findings suggest chronic distress is associated with metabolomic alterations and provide specific targets for future study of biological pathways in chronic diseases.

No Association Observed Between Coffee Intake and Risk of Non-Hodgkin's Lymphoma among Postmenopausal Women

BACKGROUND

Some preliminary studies indicate that components in coffee may have anticarcinogenic effects. However, the association between coffee-drinking habits and the risk of NHL remain controversial.

OBJECTIVE

To examine the relationship between coffee intake and non-Hodgkin's lymphoma (NHL) incidence in a large prospective study of postmenopausal US women.

DESIGN AND PARTICIPANTS/SETTING

The participants included 74,935 women from the Women's Health Initiative Observational Study (WHI-OS) who were recruited from 1993 through 1998. Information about coffee-drinking habits was collected at baseline via self-administered questionnaires.

MAIN OUTCOME MEASURES

Newly diagnosed NHL was validated by medical records and pathology records. Separate analyses were performed for the following three subtypes of NHL: diffuse large B-cell lymphoma (DLBCL (n=244)), follicular lymphoma (FL (n=166)), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL (n=64)).

STATISTICAL ANALYSES PERFORMED

Age-adjusted and multivariable-adjusted Cox proportional hazards models were used to determine associations of coffee intake (specifically, the total amount of coffee consumed daily, coffee types, and coffee preparation methods) with risk of NHL.

RESULTS

A total of 851 women developed NHL during a median 18.34 years of follow-up (range, 0.01 to 24.30 years; SD ± 6.63 years). Overall, no associations were observed between coffee intake and risk of NHL regardless of the total amount of daily coffee intake (P-value for trend test = 0.90), caffeinated (P-value=0.55) or decaffeinated coffee intake (P-value=0.78), and filtered or unfiltered coffee intake (P-value=0.91) after controlling for sociodemographic factors, lifestyle risk factors, and clinical risk factors/current medical conditions. No significant associations were observed between coffee intake with specific subtypes of NHL. A statistically significant interaction was found between alcohol intake, coffee intake, and incident NHL (P-value for interaction=0.02) based on the adjusted analysis. Specifically, among women who frequently consumed alcohol (>7 drinks/week), those who had moderate coffee intake (2-3 cups coffee/day) had a significantly reduced risk of developing NHL (HR:0.61, 95%CI: 0.36-0.98), compared to those who did not drink coffee.

CONCLUSION

The findings from this study do not support an association between coffee consumption and NHL risk, irrespective of the total amount of daily coffee intake, coffee types, or coffee preparation methods.

The New Challenge of Green Cosmetics: Natural Food Ingredients for Cosmetic Formulations

Nowadays, much attention is paid to issues such as ecology and sustainability. Many consumers choose “green cosmetics”, which are environmentally friendly creams, makeup, and beauty products, hoping that they are not harmful to health and reduce pollution. Moreover, the repeated mini-lock downs during the COVID-19 pandemic have fueled the awareness that body beauty is linked to well-being, both external and internal. As a result, consumer preferences for makeup have declined, while those for skincare products have increased. Nutricosmetics, which combines the benefits derived from food supplementation with the advantages of cosmetic treatments to improve the beauty of our body, respond to the new market demands. Food chemistry and cosmetic chemistry come together to promote both inside and outside well-being. A nutricosmetic optimizes the intake of nutritional microelements to meet the needs of the skin and skin appendages, improving their conditions and delaying aging, thus helping to protect the skin from the aging action of environmental factors. Numerous studies in the literature show a significant correlation between the adequate intake of these supplements, improved skin quality (both aesthetic and histological), and the acceleration of wound-healing. This review revised the main foods and bioactive molecules used in nutricosmetic formulations, their cosmetic effects, and the analytical techniques that allow the dosage of the active ingredients in the food.

Analysis of the Relationship between Asthma and Coffee/Green Tea/Soda Intake

This study aimed to evaluate the association between asthma and the intake of coffee/green tea/soda. We used Health Examinee data from the Korean Genome and Epidemiology Study (2004–2016). The participants (n = 3146 with asthma; n = 158,902 non-asthma) were asked about the frequency and amount of their coffee/green tea/soda intake. Multiple logistic regression analyses were used to calculate the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for asthma according to the frequency and amount of coffee/green tea/soda intake. Compared to the group consuming no coffee, the aORs for asthma were 0.82 (95% CI = 0.73–0.93, p = 0.002) in the group consuming coffee 1–2 times/day and 0.87 (95% CI = 0.78–0.97, p = 0.011) in the group consuming coffee in quantities of 1 cup, respectively. However, the frequency and amount of green tea and soda consumption were not significantly associated with asthma after adjusting for coffee consumption (all p > 0.05). These findings were consistent in the female subgroup (1–2 times/day: aOR = 0.76, 95% CI = 0.66–0.87, p < 0.001, and 1 cup each time: aOR = 0.79, 95% CI = 0.70–0.90, p < 0.001) but not in the male subgroup. Drinking 1 cup of coffee each time and 1–2 times per day may have protective effects against asthma in a Korean population. However, the associations between asthma and green tea/soda cannot be clearly established.

Protective Effect of Methylxanthine Fractions Isolated from Bancha Tea Leaves against Doxorubicin-Induced Cardio- and Nephrotoxicities in Rats

Doxorubicin is an anthracycline antibiotic that is used for the treatment of various types of cancer. However, its clinical usage is limited due to its potential life-threatening adverse effects, such as cardio- and nephrotoxicities. Nonetheless, simultaneous administration of doxorubicin and antioxidants, such as those found in green tea leaves, could reduce cardiac and renal tissue damage caused by oxidative stress. The methylxanthine fraction isolated from Bancha tea leaves were tested in vitro for its antioxidant activity and in vivo for its organoprotective properties against doxorubicin-induced cardio- and nephrotoxicities in a rat model. The in vivo study was conducted on male Wistar rats divided into 6 groups. Methylxanthines were administered at high (5 mg/kg body weight) and low (1 mg/kg body weight) doses, while doxorubicin was administered at a cumulative dose of 20 mg/kg body weight. Serum creatinine, uric acid, and urea concentrations, as well as serum enzyme levels (creatinine kinase (CK), creatinine kinase MB fraction (CK-MB), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH)) and electrolytes (Na⁺, K⁺, and Cl⁻), were analysed. In addition, histological analysis was performed to assess cardiac and renal tissue damage. The concomitant administration of Bancha methylxanthines and doxorubicin showed a dose-dependent reduction in the serum biochemical parameters, indicating a decrease in the cardiac and renal tissue damage caused by the antibiotic. Histological analysis showed that pretreatment with methylxanthines at the dose of 5 mg/kg resulted in an almost normal myocardial structure and a significant decrease in the morphological kidney changes caused by doxorubicin exposure compared with the group that received doxorubicin alone. The putative mechanism is most likely related to a reduction in the oxidative stress caused by doxorubicin.

Solvent and temperature effect of accelerated solvent extraction (ASE) coupled with ultra-high-pressure liquid chromatography (UHPLC-PDA) for the determination of methyl xanthines in commercial tea and coffee

BACKGROUND

Methyl xanthines (MX), known for its psychostimulant effect, occurs mostly in tea and coffee samples. However most of the market available products does not mention the proper amount and quality of MX present where, its consumption in high amount may pose health risks.

AIM OF THE STUDY

To develop and validate a fast, efficient and reliable method of MX extraction along with a sensitive, rapid and precise method for simultaneous analysis of MX i.e. Theobromine (TB), Theophylline (TH) and Caffeine (C), with application in commercial tea and coffee samples.

MATERIALS AND METHODS

Accelerated Solvent Extraction (ASE) was utilized for the first time to extract MX, whereas UHPLC-DAD was applied in order to quantify MX.

RESULTS

ASE resulted a high extract yield (940.22 ± 192.28 mg/g) with optimized conditions of temperature (100 °C) and solvent (MeOH). UHPLC-DAD showed retention time (min) of 1.51 (TB), 1.81 (TH), 2.30 (C) with r² values (0.980-0.988). Average MX (μg/mL) was as; TB (14.73 ± 20.9), TH (32.05 ± 55.5), C (121.87 ± 32.3). The method application in commercial samples showed a high extract yield with MX concentration (mg/g) as; TB (0.13-0.38), TH (0-0.55), C (7.14-11.20). Temperature and solvent variation showed important correlation with samples in terms of extraction yield.

CONCLUSION

ASE-UHPLC/DAD revealed a fast and sensitive method of MX extraction, quantification and quality determination in market available tea and coffee samples.

Isolation, analysis and in vitro assessment of CYP3A4 inhibition by methylxanthines extracted from Pu-erh and Bancha tea leaves

Methylxanthines, purine alkaloids found in plants, are found in beverages (coffee, tea, cocoa) and foods (chocolate and other cocoa-containing foods) commonly consumed worldwide. Members of this family include caffeine, theophylline and theobromine. Methylxanthines have a variety of pharmacological effects, and caffeine and theophylline are used as pharmaceuticals. Methylxanthines are metabolized in the liver predominantly by the enzyme CYP1A2. Their co-administration with CYP1A2 inhibitors may lead to pharmacokinetic interactions. Little is known about the possible drug interactions between caffeine and substrates of other CYP450 enzymes. In our study, methylxanthine fractions inhibited CYP3A4 in a concentration-dependent manner. Concomitant consumption of green tea with CYP3A4 substrates could increase the possibility of interactions, and this requires further clarification. The inhibition of CYP3A4 is not only due to the presence of catechin derivatives but methylxanthines may also contribute to this effect.

Caffeine Intake During Pregnancy and Neonatal Anthropometric Parameters

Caffeine is a psychoactive substance that may affect the normal course of pregnancy, therefore its intake during that time should not exceed 200 mg/day. The aim of this study was to evaluate caffeine intake among pregnant women from the Warsaw region. The study was conducted among 100 pregnant women who delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Caffeine intake from coffee, tea, and energy drinks was measured using a questionnaire. Direct interviewing was used, with all interviews conducted by the same dietitian. Multiple regression analysis was used to investigate the relationship between caffeine intake and anthropometric measurements of the newborns. Mean caffeine intake among pregnant women was 68 ± 51 mg/day. Only 2% of the respondents exceeded the safe dose of 200 mg. Tea (mostly black) was the source of 63% of all caffeine. No relationships were found between caffeine intake and neonatal weight, length, or head and chest circumference (p > 0.05). Caffeine intake in our study population was relatively low and did not negatively affect fetal growth.

Caffeine in the Diet: Country-Level Consumption and Guidelines

Coffee, tea, caffeinated soda, and energy drinks are important sources of caffeine in the diet but each present with other unique nutritional properties. We review how our increased knowledge and concern with regard to caffeine in the diet and its impact on human health has been translated into food-based dietary guidelines (FBDG). Using the Food and Agriculture Organization list of 90 countries with FBDG as a starting point, we found reference to caffeine or caffeine-containing beverages (CCB) in 81 FBDG and CCB consumption data (volume sales) for 56 of these countries. Tea and soda are the leading CCB sold in African and Asian/Pacific countries while coffee and soda are preferred in Europe, North America, Latin America, and the Caribbean. Key themes observed across FBDG include (i) caffeine-intake upper limits to avoid risks, (ii) CCB as replacements for plain water, (iii) CCB as added-sugar sources, and (iv) health benefits of CCB consumption. In summary, FBDG provide an unfavorable view of CCB by noting their potential adverse/unknown effects on special populations and their high sugar content, as well as their diuretic, psycho-stimulating, and nutrient inhibitory properties. Few FBDG balanced these messages with recent data supporting potential benefits of specific beverage types.

Biases Inherent in Studies of Coffee Consumption in Early Pregnancy and the Risks of Subsequent Events

Consumption of coffee by women early in their pregnancy has been viewed as potentially increasing the risk of miscarriage, low birth weight, and childhood leukemias. Many of these reports of epidemiologic studies have not acknowledged the potential biases inherent in studying the relationship between early-pregnancy-coffee consumption and subsequent events. I discuss five of these biases, recall bias, misclassification, residual confounding, reverse causation, and publication bias. Each might account for claims that attribute adversities to early-pregnancy-coffee consumption. To what extent these biases can be avoided remains to be determined. As a minimum, these biases need to be acknowledged wherever they might account for what is reported.

Gluten-free breads and cookies of raw and popped amaranth flours with attractive technological and nutritional qualities

Gluten-free bakery foodstuffs are a challenge for technologists and nutritionists since alternative ingredients used in their formulations have poor functional and nutritional properties. Therefore, gluten-free bread and cookies using raw and popped amaranth, a grain with high quality nutrients and promising functional properties, were formulated looking for the best combinations. The best formulation for bread included 60-70% popped amaranth flour and 30-40% raw amaranth flour which produced loaves with homogeneous crumb and higher specific volume (3.5 ml/g) than with other gluten-free breads. The best cookies recipe had 20% of popped amaranth flour and 13% of whole-grain popped amaranth. The expansion factor was similar to starch-based controls and the hardness was similar (10.88 N) to other gluten-free cookies. Gluten content of the final products was around 12 ppm. The functionality of amaranth-based doughs was acceptable although hydrocolloids were not added and the final gluten-free products had a high nutritional value.