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Lu LW, Silvestre MP, Sequeira IR, Plank LD, Foster M, Middleditch N, Acevedo-Fani A, Hollingsworth KG, Poppitt SD. A higher-protein nut-based snack product suppresses glycaemia and decreases glycaemic response to co-ingested carbohydrate in an overweight prediabetic Asian Chinese cohort: the Tū Ora postprandial RCT. J Nutr Sci 2021; 10:e30. [PMID: 34094511 PMCID: PMC8141680 DOI: 10.1017/jns.2021.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/27/2022] Open
Abstract
Nut-based products may aid low-glycaemic dietary strategies that are important for diabetes prevention in populations at increased risk of dysglycaemia, such as Asian Chinese. This randomised cross-over trial assessed the postprandial glycaemic response (0-120 min) of a higher-protein nut-based (HP-NB) snack formulation, in bar format (1009 kJ, Nutrient Profiling Score, NPS, -2), when compared with an iso-energetic higher-carbohydrate (CHO) cereal-based bar (HC-CB, 985 kJ, NPS +3). It also assessed the ability to suppress glucose response to a typical CHO-rich food (white bread, WB), when co-ingested. Ten overweight prediabetic Chinese adults (mean, sd: age 47⋅9, 15⋅7 years; BMI 25⋅5, 1⋅6 kg/m2), with total body fat plus ectopic pancreas and liver fat quantified using dual-energy X-ray absorptiometry and magnetic resonance imaging and spectroscopy, received the five meal treatments in random order: HP-NB, HC-CB, HP-NB + WB (50 g available CHO), HC-CB + WB and WB only. Compared with HC-CB, HP-NB induced a significantly lower 30-120 min glucose response (P < 0⋅05), with an approximately 10-fold lower incremental area under the glucose curve (iAUC0-120; P < 0⋅001). HP-NB also attenuated glucose response by approximately 25 % when co-ingested with WB (P < 0⋅05). Half of the cohort had elevated pancreas and/or liver fat, with 13-21 % greater suppression of iAUC0-120 glucose in the low v. high organ fat subgroups across all five treatments. A nut-based snack product may be a healthier alternative to an energy equivalent cereal-based product with evidence of both a lower postprandial glycaemic response and modulation of CHO-induced hyperglycaemia even in high-risk, overweight, pre-diabetic adults.
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Key Words
- AUC, area under the curve
- BF, body fat
- BMI, body mass index
- CHO, carbohydrate
- DXA, dual-energy X-ray absorptiometry
- Dried fruits
- GI, glycaemic index
- MRI
- MRI, magnetic resonance imaging
- MRS, magnetic resonance spectroscopy
- Nuts
- Postprandial glycaemia
- Prediabetes
- SAT, subcutaneous adipose tissue
- T2D, type 2 diabetes
- VAS, visual analogue scales
- VAT, visceral adipose tissue
- WB, white bread
- iAUC, incremental area under the curve
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Affiliation(s)
- Louise W. Lu
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
- High-Value Nutrition National Science Challenge, Auckland, New Zealand
| | - Marta P. Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
- High-Value Nutrition National Science Challenge, Auckland, New Zealand
| | - Ivana R. Sequeira
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
- High-Value Nutrition National Science Challenge, Auckland, New Zealand
| | - Lindsay D. Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Meika Foster
- Edible Research Ltd, Christchurch, New Zealand
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Nikki Middleditch
- High-Value Nutrition National Science Challenge, Auckland, New Zealand
- Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Alejandra Acevedo-Fani
- High-Value Nutrition National Science Challenge, Auckland, New Zealand
- Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Kieren G. Hollingsworth
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Sally D. Poppitt
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
- High-Value Nutrition National Science Challenge, Auckland, New Zealand
- Riddet Centre of Research Excellence (CoRE) for Food and Nutrition, Palmerston North, New Zealand
- Department of Medicine, University of Auckland, Auckland, New Zealand
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Vuijk R, Arntz A. Schema therapy as treatment for adults with autism spectrum disorder and comorbid personality disorder: Protocol of a multiple-baseline case series study testing cognitive-behavioral and experiential interventions. Contemp Clin Trials Commun 2017; 5:80-5. [PMID: 29740624 DOI: 10.1016/j.conctc.2017.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/05/2016] [Accepted: 01/03/2017] [Indexed: 12/27/2022] Open
Abstract
Background To our knowledge treatment of personality disorder (PD) comorbidity in adults with ASD is understudied and is still in its infancy. This study investigates the effectiveness of schema therapy for PD-psychopathology in adult patients with both ASD and PD. Methods/design Twelve adult individuals (age > 18 years) with ASD and at least one PD are given a treatment protocol consisting of 30 weekly offered sessions. A concurrent multiple baseline design is used with baseline varying from 4 to 9 weeks, after which weekly supportive sessions varying from 1 to 6 weeks start with the study therapist. After baseline and 1 to 6 supportive sessions, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, and schema modes are explored, and information about the treatment is given. This is followed by 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions: patients are vice versa and randomly assigned to the interventions. Finally, there is a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and report weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs, and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after supportive sessions, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II is administered during screening procedure, at 5- and at 10-month follow-up. Trial registration The Netherlands National Trial Register NTR5788. Registered 01 April 2016.
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Key Words
- ABA, Applied Behavior Analysis
- APA, American Psychiatric Association
- AS, Asperger's disorder
- ASD, autism spectrum disorder
- Autism spectrum disorder
- CBT, Cognitive behavioral therapy
- CET, Cognitive enhancement therapy
- DSM, Diagnostic and Statistical Manual of mental disorders
- IQ, Intelligence quotient
- Multiple-baseline case series study
- N.S., not significant
- PD, personality disorder
- PDs, personality disorders
- Personality disorder
- RCT, randomized controlled trial
- SCID-II, Structured Clinical Interview for Axis II Personality Disorders
- SCL-90, Symptom Check List
- SMI, Schema Mode Inventory
- SRS-A, Social Responsiveness Scale – Adult version
- Schema therapy
- VAS, visual analogue scales
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