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Background: Structure and protein-starch interactions in pasta products can be responsible for lower postprandial glycemic responses compared with other cereal foods.Objectives: We tested the effect on postprandial glucose metabolism induced by 2 pasta products, couscous, and bread, through their structural changes during mastication and simulated gastric digestion.Methods: Two randomized controlled trials (n = 30/trial) in healthy, normal-weight adults (mean BMI of 23.9 kg/m2 (study 1) and 23.0 kg/m2 (study 2)) evaluated postprandial glucose metabolism modulation to portions of durum wheat semolina spaghetti, penne, couscous, and bread each containing 50 g available carbohydrate. A mastication trial involving 26 normal-weight adults was conducted to investigate mastication processes and changes in particle size distribution and microstructure (light microscopy) of boluses after mastication and in vitro gastric digestion.Results: Both pasta products resulted in lower areas under the 2-h curve for blood glucose (-40% for spaghetti and -22% for penne compared with couscous; -41% for spaghetti and -30% for penne compared with bread), compared with the other grain products (P < 0.05). Pasta products required more chews (spaghetti: 34 ± 18; penne: 38 ± 20; bread: 27 ± 13; couscous: 24 ± 17) and longer oral processing (spaghetti: 21 ± 13 s; penne: 23 ± 14 s; bread: 18 ± 9 s; couscous: 14 ± 10 s) compared with bread or couscous (P < 0.01). Pastas contained more large particles (46-67% of total particle area) compared with bread (0-30%) and couscous (1%) after mastication and in vitro gastric digestion. After in vitro gastric digestion, pasta samples still contained large areas of nonhydrolyzed starch embedded within the protein network; the protein in bread and couscous was almost entirely digested, and the starch was hydrolyzed.Conclusions: Preservation of the pasta structure during mastication and gastric digestion explains slower starch hydrolysis and, consequently, lower postprandial glycemia compared with bread or couscous prepared from the same durum wheat semolina flour in healthy adults.The postprandial in vivo trials were registered at clinicaltrials.gov as NCT03098017 and NCT03104686. [ABSTRACT FROM AUTHOR]

Background Coffee consumption is associated with a reduced risk of several chronic diseases in a dose-dependent manner. Chronic intake results in the transient appearance of bioactive phenolic metabolites in the circulatory system. However, there is a lack of information on the impact of different patterns of coffee consumption on plasma and urinary profiles of phenolic metabolites. Objectives Plasma and urinary phenolic metabolites were investigated following regular consumption of different daily dosages of coffee or cocoa-based products containing coffee (CBPCC) under a real-life setting. Methods A repeated-dose, randomized, crossover human intervention was conducted with 21 healthy volunteers. For 1 mo, participants consumed 1) 1 cup of coffee (1C), 2) 3 cups of coffee (3C), or 3) 1 cup of coffee + 2 CBPCC twice daily (PC). Plasma and urine samples were collected over a 24-h period after each treatment. The nutrikinetics and urinary excretion of native, human phase II, and colonic metabolites were assessed. Results A total of 51 (poly)phenolic metabolites were quantified, with 41 metabolites being strictly related to coffee consumption. Significant differences were observed among treatments for most of the metabolites. The metabolites present in the highest amounts were the hydroxycinnamate, phenylpropanoic acid, benzaldehyde, and benzene classes, along with (–)-epicatechin and phenyl-γ-valerolactone derivatives after PC treatment. Daily average concentrations did not exceed 200 nmol/L and were <100 nmol/L for most of the metabolites. The excretion of coffee phenolics ranged from 40% to 70% of intake, indicating that coffee hydroxycinnamates are notably more bioavailable than previously thought. Interindividual variability was also investigated. Conclusions The absorption, metabolism, nutrikinetic profile, and bioavailability of coffee phenolics were established for different patterns of coffee consumption under real-life conditions. This work provides the basis for further nutritional epidemiology research and mode-of-action cell-based studies. This study was registered at clinicaltrials.gov as NCT03166540. [ABSTRACT FROM AUTHOR]

Background Plasma trimethylamine N-oxide (TMAO) has drawn much attention as a marker of several chronic diseases. Data on the relation between diet and TMAO are discordant and few human intervention studies have assessed causality for this association. Objectives We aimed to evaluate the effects on plasma TMAO of diets based on foods rich in polyphenols (PP) and/or long-chain n–3 fatty acids (LCn3) or whole-grain cereals (WGCs), in individuals at high cardiometabolic risk. Methods An ancillary study was performed within 2 randomized controlled trials, aimed at evaluating the medium-term effects on cardiometabolic risk factors of diets naturally rich in PP and/or LCn3 (Etherpaths Project) or WGCs (HealthGrain Project). Results In the Etherpaths study (n = 78), the changes in TMAO (8-wk minus baseline) were statistically significant for the diets rich in LCn3 (+1.15 ± 11.58 μmol/L) (P = 0.007), whereas they were not for the diets rich in PP (−0.14 ± 9.66 μmol/L) (P  = 0.905) or their interaction (P  = 0.655) (2-factor ANOVA). In the HealthGrain Study (n  = 48), the TMAO change (12-wk minus baseline) in the WGC group (+0.94 ± 3.58 μmol/L) was significantly different from that in the Refined Cereal group (−1.29 ± 3.09 μmol/L) (P  = 0.037). Considering the pooled baseline data of the participants in the 2 studies, TMAO concentrations directly correlated with LCn3, EPA (20:5n–3), and protein intake, but not SFAs, fiber, MUFAs, and PP intake. Among food groups, TMAO directly correlated with the intake of fish, vegetables, and whole-grain products, but not meat, processed meat, and dairy products. Conclusions Diets rich in LCn3 of marine origin or WGCs significantly increased plasma TMAO concentration. These changes mirrored the direct associations between TMAO concentrations and intakes of fish and WGCs, suggesting that TMAO reflects intakes of these healthy foods and, therefore, it is not a universally valid biomarker of cardiometabolic risk independent of the background diet. These trials were registered at clinicaltrials.gov as NCT01154478 and NCT00945854. [ABSTRACT FROM AUTHOR]

Background: Synbiotic foods, which combine the action of prebiotics and probiotics along the gastrointestinal tract, can affect inflammatory and glucose-related markers.Objective: The aim of this study was to investigate the effects on inflammatory and glycemia-related markers of a whole-grain pasta containing barley β-glucans and Bacillus coagulans BC30, 6086 in healthy overweight or obese volunteers.Methods: A single-blind, parallel, randomized, placebo-controlled dietary intervention study was carried out. Forty-one healthy sedentary overweight (body mass index [BMI] 25-29.9 kg/m2) and obese (BMI ≥30) volunteers, aged 30-65 y and low consumers of fruit and vegetables, ate 1 serving/d of whole-grain control (CTR) or innovative (INN) pasta for 12 wk and maintained their habitual diets. Biological samples were collected at baseline and every 4 wk for primary (plasma high-sensitivity C-reactive protein [hs-CRP] and fasting plasma lipid profile) and secondary outcomes (glycemia-related markers, blood pressure, fecal microbiota composition, and body weight). Between (CTR compared with INN) and within (among weeks) group differences were tested for the whole population and for subgroups stratified by baseline values of BMI (≥30) and glycemia (≥100 mg/dL).Results: INN or CTR pasta consumption had no effect on primary and secondary outcomes over time, except for a significant increase in plasma γ-glutamyltransferase (GGT) after 12 wk of CTR pasta consumption. Comparisons between intervention groups revealed differences only at 12 wk: plasma GGT was higher in the CTR group; plasma hs-CRP, plasma LDL/HDL cholesterol ratio, and Bifidobacterium spp. were lower in the INN subgroup of obese volunteers; plasma resistin was lower and Faecalibacterium prausnitzii abundance was higher in the INN subgroup of hyperglycemic volunteers.Conclusions: A daily serving of a synbiotic whole-grain pasta had limited effects on primary and secondary outcomes in the entire group of volunteers but affected glycemia- and lipid-related markers and resistin in a subgroup of healthy obese or hyperglycemic volunteers. This trial was registered at clinicaltrials.gov as NCT02236533. [ABSTRACT FROM AUTHOR]

Background: Regular breakfast consumption is associated with better health status and healthier food intake throughout the day, but this association is a complex interaction of several factors.Objective: This study aimed to investigate the effect of nutritional and cognitive-perceived characteristics of breakfast on metabolic and behavioral variables related to food intake.Methods: The study was a randomized, crossover, controlled trial, with 4 experimental conditions consisting of 3 iso-energetic breakfasts and 1 energy-free control meal. Breakfasts had similar nutritional profiles but differed for glycemic index (GI), glycemic load (GL), and perceived healthiness, satiety, palatability, or energy content. Fifteen healthy normal-weight men [means ± SDs; age: 24 ± 2 y; body mass index (BMI; kg/m2) 23.4 ± 1.6] underwent each experimental condition in random order during 4 different weeks, separated by ≥1-wk washout. On the third day of each intervention week, postprandial blood variables (with insulin as primary outcome), satiety ratings, and food intake during an ad libitum lunch consumed 4 h after breakfast (secondary outcomes) were measured for each experimental condition.Results: A main effect of time, treatment, and time × treatment was found for postprandial insulin, glucose, and nonesterified fatty acids (P < 0.001 for all) after having the 3 iso-energetic breakfasts or the energy-free control one. Postprandial satiety was similar for the 3 energy-containing breakfasts, but higher when compared with the energy-free control (P < 0.001). No difference in energy intake was observed for the ad libitum lunch, whereas prolonged breakfast skipping was compensated by an increase (around +10%) in the average energy intake during the rest of the day, resulting in no differences in the total daily energy intake among the 4 conditions.Conclusions: Although other advantages might exist for breakfasts based on low-GI/low-GL foods, our findings support the hypothesis that minor differences in nutritional and perceived characteristics of breakfast are of limited importance regarding medium-term energy intake in healthy men. This trial was registered at clinicaltrials.gov as BRNN-014 NCT02516956. [ABSTRACT FROM AUTHOR]

Diabetic cardiomyopathy (DCM) develops independently of common cardiovascular co-morbidities and is initiated by the metabolic derangements accompanying diabetes mellitus, including hyperglycaemia, which may cause a mild inflammatory state able to negatively affect myocardial biochemistry, structure, and function. This work shows how different urolithins, ellagitannin-derived metabolites, were able to modulate the pro-inflammatory mediators and growth factors secreted by rat cardiac myocytes and fibroblasts exposed to high glucose concentrations. At 1 µM concentration, coherent with dietary exposure to ellagitannin-rich foods, urolithins B and B-glucuronide succeeded in preventing inflammatory responses in cardiomyocytes, while in fibroblasts urolithin D was the most effective in controlling the overexpression of fractalkine, among the tested inflammatory mediators. Urolithins underwent extensive biotransformations in both cell types, including (de)glucuronidation, methylation, and sulphation. This suggests that the inflammatory bulk produced by hyperglycaemia could be attenuated by the regular intake of ellagitannin-rich foodstuffs such as pomegranates, raspberries, blackberries, strawberries, and walnuts. [ABSTRACT FROM AUTHOR]

Background: Palm oil (PO) may be an unhealthy fat because of its high saturated fatty acid content. Objective: The objective was to assess the effect of substituting PO for other primary dietary fats on blood lipid-related markers of coronary heart disease (CHD) and cardiovascular disease (CVD). Design: We performed a systematic review and meta-analysis of dietary intervention trials. Studies were eligible if they included original data comparing PO-rich diets with other fat-rich diets and analyzed at least one of the following CHD/CVD biomarkers: total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, TC/HDL cholesterol, LDL cholesterol/HDL cholesterol, triacylglycerols, apolipoprotein A-I and B, very-low-density lipoprotein cholesterol, and lipoprotein(a). Results: Fifty-one studies were included. Intervention times ranged from 2 to 16 wk, and different fat substitutions ranged from 4% to 43%. Comparison of PO diets with diets rich in stearic acid, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) showed significantly higher TC, LDL cholesterol, apolipoprotein B, HDL cholesterol, and apolipoprotein A-I, whereas most of the same biomarkers were significantly lower when compared with diets rich in myristic/lauric acid. Comparison of PO-rich diets with diets rich in trans fatty acids showed significantly higher concentrations of HDL cholesterol and apolipoprotein A-I and significantly lower apolipoprotein B, triacylglycerols, and TC/HDL cholesterol. Stratified and meta-regression analyses showed that the higher concentrations of TC and LDL cholesterol, when PO was substituted for MUFAs and PUFAs, were not significant in young people and in subjects with diets with a lower percentage of energy from fat. Conclusions: Both favorable and unfavorable changes in CHD/CVD risk markers occurred when PO was substituted for the primary dietary fats, whereas only favorable changes occurred when PO was substituted for trans fatty acids. Additional studies are needed to provide guidance for policymaking. [ABSTRACT FROM AUTHOR]

Abstract: This study evaluated the absorption and metabolism of milk thistle flavonolignans silychristin, silydianin, silybin and isosilybin isomers (all together known as silymarin) in humans. Fourteen volunteers consumed an extract of milk thistle and urine was collected up to 48h after consumption. Thirty-one metabolites were identified in urine by means of HPLC–MS/MS, monoglucuronides being the most common excreted form, followed by sulphate–glucuronides and diglucuronides, respectively. The excretion of monoglucuronides peaked 2h after consumption, whereas sulphate–glucuronide and diglucuronide excretion peaked at 8h. The bioavailability of milk thistle flavanolignans was 0.45±0.28% (mean±SD). In conclusion, milk thistle flavonolignans are extensively modified after ingestion and recovered in urine as sulpho- and glucuronyl-conjugates, indicating a strong affinity for hepatic phase II enzymes. All future studies (in vitro and in vivo) dealing with the effects of milk thistle should start by considering the modification of its flavonolignans after ingestion by humans. [Copyright &y& Elsevier]

Experimental studies suggest that oxidative stress and systemic inflammation are involved in the pathogenesis of ischemic stroke. Consuming a diet with a high total antioxidant capacity IT AC) has been related to reduced inflammation and increased circulating antioxidants in cross-sectional and randomized intervention studies. This study investigates the relation between dietary TAC and risk of ischemic and hemorrhagic stroke in 41,620 men and women not previously diagnosed with stroke or myocardial infarction, representing the Italian segment of the European Prospective Investigation into Cancer and Nutrition. Controlling for potential confounders, a diet rich in TAC was associated with a reduction in HR for all types of stroke, but this association was only marginally significant (P-trend = 0.0541. When only ischemic stroke cases were considered, data suggest a stronger inverse association with dietary TAC, with HR = 0.41 (95% Cl = 0.23-0.74). Regarding single antioxidants, data from subanalyses on stroke types suggest that vitamin C is significantly associated with a decreased risk of ischemic stroke [HR = 0.58 (95% Cl = 0.34-0.99)], whereas vitamin E was associated with increased HR of hemorrhagic stroke in the highest tertile of intake [HR = 2.94 (95% Cl = 1.13-7.62(1. In conclusion, our findings suggest that antioxidants may play a role in reducing the risk of cerebral infarction but not hemorrhagic stroke. However, a high intake of vitamin E could be positively associated to the risk of brain hemorrhagic events; therefore, more focused investigations about this observation are needed. [ABSTRACT FROM AUTHOR]

Associations between the glycemic index (GI) or glycemic load (GL) and diseases are heterogeneous in epidemiological studies. Differences in assigning GI values to food items may contribute to this inconsistency. Our objective was to address methodological issues related to the use of current Gland GL values in epidemiological studies. We performed ecological comparison and correlation studies by calculating dietary Gl and GL from country-specific dietary questionnaires (DQ) from 422,837 participants from 9 countries participating in the European Prospective Investigation into Cancer and Nutrition study and single standardized 24-h dietary recalls (24-HDR) obtained from a representative sample (n = 33,404) using mainly Foster Powell's international table as a reference source. Further, 2 inter-rater and 1 inter-method comparison were conducted, comparing DQ GI values assigned by independent groups with values linked by us. The ecological correlation between DQ and 24-HDR was good for GL (overall r= 0.76; P< 0.005) and moderate for GI (r= 0.57; P < 0.051. Mean Gl/GL differences between DO and 24-HDR were significant for most centers. GL but not GI from DO was highly correlated with total carbohydrate (r= 0.98 and 0.15, respectively; P< 0.0001) and this was higher for starch (r = 0.72; P < 0.0001) than for sugars (r = 0.36; P < 0.0001). The inter-rater and inter-method variations were considerable for GI (weighted κ coefficients of 0.49 and 0.65 for inter-rater and 0.25 for inter-method variation, respectively) but only mild for GL (weighted κ coefficients > 0.80). A more consistent methodology to attribute GI values to foods and validated DO is needed to derive meaningful GI/GL estimates for nutritional epidemiology. [ABSTRACT FROM AUTHOR]

Background: It is unknown whether diets with a high dietary total antioxidant capacity (TAC) can modify oxidative stress, low-grade inflammation, or liver dysfunction, all of which are risk factors for type 2 diabetes and cardiovascular disease. Objective:Westudied the effect of high- and low-TAC (HT and LT, respectively) diets on markers of antioxidant status, systemic inflammation, and liver dysfunction. Design: In a crossover intervention, 33 healthy adults (19 men, 14 women) received the HT and LT diets for 2 wk each. Dietary habits were checked with a 3-d food record during both diet periods and the washout period. Results: Fruit and vegetable, macronutrient, dietary fiber, and alcohol intakes did not differ significantly between the 2 diets, whereas dietary TAC, α-tocopherol, and ascorbic acid were significantly (P <0.001) higher during theHTdiet. Plasma-αtocopherol rose during the HT and decreased during the LT diet (P < 0.02 for difference) without changes in markers of oxidative stress except plasma malondialdehyde, which decreased unexpectedly during the LT diet (P <0.05). Plasma high-sensitivity C-reactive protein, alanine aminotransferase, gamma-glutamyltranspeptidase, and alkaline phosphatase concentrations decreased during the HT compared with the LT diet (mean ± SEM for pre-post changes: -0.72 ± 0.37 compared with 1.05±0.60 mg/L, P<0.01;-1.73±1.02 compared with 2.33 ± 2.58 U/L, P < 0.01; -2.12 ± 1.45 compared with 5.15 ± 2.98 U/L, P < 0.05; and 1.36 ± 1.34 compared with 5.06 ± 2.00 U/L, P < 0.01, respectively). Conclusion: Selecting foods according to their TAC markedly affects antioxidant intake and modulates hepatic contribution to systemic inflammation without affecting traditional markers of antioxidant status. [ABSTRACT FROM AUTHOR]

Convincing evidence indicates that the intake of inulin-type fructans, inulin and oligofructose, has beneficial effects on blood lipid changes in animals, although data in humans have been considered contradictory. We conducted a meta- analysis of available literature to quantify the effects in humans of dietary inulin-type fructans on serum triacylglycerols. Fifteen eligible randomized, controlled trials published from 1995 to 2005, for a total of 16 comparisons, were identified from the PubMed (National Library of Medicine, Bethesda, MD) and SCOPUS (Elsevier B.V., Amsterdam, NL) databases. Standardized mean effect sizes were calculated for net changes in serum triacyiglycerol concentrations using random-effect model. The intake of inulin-type fructans was associated with significant decreases in serum triacylglycerols by 0.17 mmol/L(95%Cl -0.33, -0.01; Z= 2.12, P= 0.04) or 7.5%. Given the limited number of studies, no specific effects for gender, amount fed, duration of the study, background diet, overweight, hyperlipidemia, or diabetes were further formally investigated, but, from the test for heterogeneity [x2 = 13.34, df = 15, (P = 0.55), l² = 0%], it appears that the effect of inulin-type fructans on circulating triacylglycerols is consistent across conditions. In conclusion, dietary inulin-type fructans significantly reduced serum triacylglycerols. The mechanisms, possibly related to colonic fermentation and/or incretin re- lease from the distal gut, warrant further studies. [ABSTRACT FROM AUTHOR]

The total antioxidant capacity (TAC) of the diet may be an important tool to monitor the protective effect of plant foods in epidemiological studies. We developed a semi-quantitative FFQ for the assessment of dietary TAC by 3 different assays, i.e., Trolox equivalent antioxidant capacity (TEAC), total radical-trapping antioxidant parameter (TRAP) and ferric reducing-antioxidant power (FRAP). The FFQ consists of 53 questions about the major sources of dietary TAC in Northern Italy and was validated against a 3-d weighed food record (3D-WR) in 285 individuals (159 males and 126 females) aged 35-88 y and living in the province of Parma (Italy). Plasma TAC was also evaluated in a subgroup of subjects using the TEAC and FRAP assays. The FFQ was associated with 3D-WR (quadratic-weighted kappa = 0.49 for TEAC, 0.53 for TRAP, and 0.49 for FRAP; P < 0.0001) and proved reasonably accurate to classify individuals into quartiles of TAC intake. The FFQ had a good repeatability when readministered after 1 y in 55 subjects (quadratic-weighted kappa for intertertile agreement = 0.66 for TEAC, 0.70 for TRAP and 0.68 for FRAP; P < 0.0001). With both dietary instruments, the main contributors to TAC intake were coffee and tea in women and alcoholic beverages in men, followed by fruits and vegetables in both sexes. Plasma TAC and dietary TAC were not associated. In conclusion, our FFQ has the potential for being used to rank subjects on the basis of their antioxidant intake as determined by dietary TAC in large epidemiological studies. The FFQ should be validated in external populations before being used for research purposes. [ABSTRACT FROM AUTHOR]

Strategies that decrease postprandial glucose excursions, including digestive enzyme inhibition, and low glycemic index diets result in lower diabetes incidence and coronary heart disease (CHD) risk, possibly through lower postprandial oxidative damage to lipids and proteins. We therefore assessed the effect of decreasing postprandial glucose excursions on measures of oxidative damage. Fifteen healthy subjects ate 2 bread control meals and 3 test meals: almonds and bread; parboiled rice; and instant mashed potatoes, balanced in carbohydrate, fat, and protein, using butter and cheese. We obtained blood samples at baseline and for 4 h postprandially. Glycemic indices for the rice (38 +/- 6) and almond meals (55 +/- 7) were less than for the potato meal (94 +/- 11) (P < 0.003), as were the postprandial areas under the insulin concentration time curve (P < 0.001). No postmeal treatment differences were seen in total antioxidant capacity. However, the serum protein thiol concentration increased following the almond meal (15 +/- 14 mmol/L), indicating less oxidative protein damage, and decreased after the control bread, rice, and potato meals (-10 +/- 8 mmol/L), when data from these 3 meals were pooled (P = 0.021). The change in protein thiols was also negatively related to the postprandial incremental peak glucose (r = -0.29, n = 60 observations, P = 0.026) and peak insulin responses (r = -0.26, n = 60 observations, P = 0.046). Therefore, lowering postprandial glucose excursions may decrease the risk of oxidative damage to proteins. Almonds are likely to lower this risk by decreasing the glycemic excursion and by providing antioxidants. These actions may relate to mechanisms by which nuts are associated with a decreased risk of CHD. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance (IR) and liver steatosis (LS) are interlinked metabolic derangements whose prevalence is rapidly increasing, but the effect of dietary carbohydrate quality on LS is unknown. Objective: The objective was to describe the relation of IR and LS to total carbohydrate, total dietary fiber, and the glycemic index (GI) and glycemic load of the diet. Design: The study was a cross-sectional evaluation of 247 apparently healthy subjects who had no evidence of viral, toxic, or autoimmune hepatitis and who were unselected for alcohol intake. The homeostasis model assessment index was used as a surrogate measure of IR, and a liver echography was used as a proxy for LS grading. Dietary data were collected by using 3-d food records. Total carbohydrate intake, total dietary fiber, GI, and glycemic load were calculated by using a semiquantitative food-frequency questionnaire concerning the dietary sources of carbohydrates. Results: The prevalence of high-grade LS (HG-LS) increased significantly across quartiles of dietary GI (P for trend < 0.034): HG-LS in the 4th quartile (high GI) was twice that in the first 3 quartiles (low to medium GIs), whereas no relation was observed with total carbohydrates, total dietary fiber, or glycemic load. In insulin-sensitive subjects (first 3 quartiles of homeostasis model assessment index of IR), the prevalence of HG-LS did not differ significantly between GI groups, but, in insulin-resistant subjects (4th quartile of homeostasis model assessment index of IR), it was twice as high in those with high GI as in those with low to medium GIs (P = 0.005). Conclusions: High-GI dietary habits are associated with HG-LS, particularly in insulin-resistant subjects. Dietary advice on the quality of carbohydrate sources therefore may be a complementary tool for preventing or treating LS of metabolic origin. [ABSTRACT FROM AUTHOR]

Background: Low postprandial blood glucose is associated with low risk of metabolic diseases. A meal's ability to diminish the glucose response to carbohydrates eaten during the following meal is known as the "second-meal effect" (SME). The reduced glycemia elicited by low-glycemic-index (LGI) foods consumed during the first meal has been suggested as the main mechanism for SME. However, LGI foods often increase colonic fermentation because of the presence of fiber and resistant starch. Objective: The objective was to study the SME of greater fermentation of high-glycemic-index (HGI) and LGI carbohydrates eaten during a previous meal. Design: Ten healthy volunteers ate 3 breakfast test meals consisting of sponge cakes made with rapidly digestible, nonfermentable amylopectin starch plus cellulose (HGI meal), amylopectin starch plus the fermentable disaccharide lactulose (HGI-Lac meal), or slowly digestible, partly fermentable amylose starch plus cellulose (LGI meal). Five hours later, subjects were fed the same standard lunch containing 93 g available carbohydrates. Blood was collected for measurement of glucose, insulin, and nonesterified fatty acids (NEFAs). Breath hydrogen was measured as a marker of colonic fermentation. Postlunch gastric emptying was measured by using ultrasonography. Results: Both the HGI-Lac and LGI meals improved glucose tolerance at lunch. In the case of the HGI-Lac meal, this effect was concomitant with low NEFA concentrations and delayed gastric emptying. Conclusion: Fermentable carbohydrates, independent of their effect on a food's glycemic index, have the potential to regulate postprandial responses to a second meal by reducing NEFA competition for glucose disposal and, to a minor extent, by affecting intestinal motility. [ABSTRACT FROM AUTHOR]

Epidemiologic studies have demonstrated an inverse association between consumption of fruits and vegetables and morbidity and mortality from degenerative diseases. The antioxidant content of fruits and vegetables may contribute to the protection they offer from disease. Because plant foods contain many different classes and types of antioxidants, knowledge of their total antioxidant capacity (TAC), which is the cumulative capacity of food components to scavenge free radicals, would be useful for epidemiologic purposes. To accomplish this, a variety of foods commonly consumed in Italy, including 34 vegetables, 30 fruits, 34 beverages and 6 vegetable oils, were analyzed using three different assays, i.e., Trolox equivalent antioxidant capacity (TEAC), total radical-trapping antioxidant parameter (TRAP) and ferric reducing-antioxidant power (FRAP). These assays, based on different chemical mechanisms, were selected to take into account the wide variety and range of action of antioxidant compounds present in actual foods. Among vegetables, spinach had the highest antioxidant capacity in the TEAC and FRAP assays followed by peppers, whereas asparagus had the greatest antioxidant capacity in the TRAP assay. Among fruits, the highest antioxidant activities were found in berries (i.e., blackberry, redcurrant and raspberry) regardless of the assay used. Among beverages, coffee had the greatest TAC, regardless of the method of preparation or analysis, followed by citrus juices, which exhibited the highest value among soft beverages. Finally, of the oils, soybean oil had the highest antioxidant capacity, followed by extra virgin olive oil, whereas peanut oil was less effective. Such data, coupled with an appropriate questionnaire to estimate antioxidant intake, will allow the investigation of the relation between dietary antioxidants and oxidative stress-induced diseases. [ABSTRACT FROM AUTHOR]

• A hazelnut skin drink was tested in a single-blind, non-randomised unilateral cross-over trial. • Ten plasma and twenty-four urine hazelnut phenolic metabolites were identified and quantified. • Hazelnut skin phenolics were highly bioavailable. • No acute beneficial effect of the test drink on endothelial function was observed. Evidence supports an inverse association between nut consumption and cardiovascular disease (CVD) risk and (poly)phenols have been identified as potential co-mediators of these beneficial effects. This study investigated the acute absorption and the bioavailability of (poly)phenols of a hazelnut skin drink in healthy subjects and assessed its acute impact on vascular/endothelial function. A single-blind, non-randomised unilateral cross-over trial involved 41 healthy adults. Blood and urine were collected resulting in the detection of ten plasma and twenty-four urine metabolites. Bioavailability was estimated about 27%. The acute ingestion of the test drink did not show any statistically significant changes to vascular/endothelial function, although a trend was observed with high-producers of certain secondary metabolites. These results indicate that the hazelnut skin drink contains an important fraction of bioavailable bioactive compounds. However, no significant acute effects of the test drink on vascular/endothelial function were observed. The study has been registered on http://www.isrctn.com. [ABSTRACT FROM AUTHOR]

A response by Nicoletta Pellegrini, Daniele Del Rio and Furio Brighenti to a letter to the editor about their article on dietary total antioxidant capacity (TAC) that was published in the previous issue.

Vending machines (VMs) have been pointed out as an obesogenic factor contributing to increase the availability of unhealthy foods throughout the day. They usually offer nutrient-poor and energy-dense products, while healthy options are scarce or even absent. This study was carried out between April 2014 and December 2015 at the University of Parma (North Italy) to increase purchases of healthy foods in VMs through the enhancement of healthy product availability and the promotion of healthier food options through nutrition communication. Choices were retrospectively measured by comparing the amount of sales for 24 weeks at baseline and after improving the nutritional quality of products, with or without additional nutrition communication. Purchase of healthy foods increased after improving the nutritional quality of the available products. Product replacement was successful in increasing healthy product sales, while decreasing unhealthy choices. Differently, the addition of a point-of-sales nutrition information service only discouraged choices of less favourable foods without impacting notably on consumer behaviour. Iconographic labels in VMs were able to change only partially consumers’ choices, reducing the purchase of less recommendable products but not substantially enhancing healthier choices. Overall, this study yielded useful information for the implementation of nutrition interventions through VMs, addressing food choices and promoting healthy dietary patterns without limitation of consumers’ freedom. This kind of environmental interventions could lead to improvements in body weight management and consequent health outcomes. [ABSTRACT FROM AUTHOR]

Background To date, it is unclear whether individuals with celiac disease following a gluten-free (GF) diet for several years have adequate intake of all recommended nutrients. Lack of a food frequency questionnaire (FFQ) for individuals with celiac disease could be partly responsible for this still-debated issue. Objective The aim of the study is to evaluate the performance of a modified European Prospective Investigation into Cancer and Nutrition (EPIC) FFQ in estimating nutrient and food intake in a celiac population. Design In a cross-sectional study, the dietary habits of individuals with celiac disease were reported using a modified Italian EPIC FFQ and were compared to a 7-day weighed food record as a reference method. Participants/setting A total of 200 individuals with histologically confirmed celiac disease were enrolled in the study between October 2012 and August 2014 at the Center for Prevention and Diagnosis of Celiac Disease (Milan, Italy). Main outcome measures Nutrient and food category intake were calculated by 7-day weighed food record using an Italian food database integrated with the nutrient composition of 60 GF foods and the modified EPIC FFQ, in which 24 foods were substituted with GF foods comparable for energy and carbohydrate content. Statistical analyses performed An evaluation of the modified FFQ compared to 7-day weighed food record in assessing the reported intake of nutrient and food groups was conducted using Spearman’s correlation coefficients and weighted κ. Results One hundred individuals completed the study. The Spearman's correlation coefficients of FFQ and 7-day weighed food record ranged from .13 to .73 for nutrients and from .23 to .75 for food groups. A moderate agreement, which was defined as a weighted κ value of .40 to .60, was obtained for 30% of the analyzed nutrients, and 40% of the nutrients showed values between .30 and .40. The weighted κ exceeded .40 for 60% of the 15 analyzed food groups. Conclusions The modified EPIC FFQ demonstrated moderate congruence with a weighed food record in ranking individuals by dietary intakes, particularly food groups. [ABSTRACT FROM AUTHOR]

In the recent years, the pigmented rice varieties are becoming more popular due to their antioxidant properties and phenolic content. In this study, we characterized the antioxidant capacity (TAC) and the phenolic profile in white, red and black rice varieties, and evaluated the effect of two cooking methods (i.e. “risotto” and boiling) on these compounds. Before the cooking, all the varieties contained several phenolic acids, whereas anthocyanins and flavonols were peculiar of black rice and flavan-3-ols of red rice. Among the rice varieties, the black had the highest TAC value. The content of (poly)phenolic compounds and TAC decreased after cooking in all three varieties, but to a lesser extent after the risotto method. As a consequence, the risotto cooking, which allows a complete absorption of water, would be a good cooking method to retain (poly)phenolic compounds and TAC in pigmented and non-pigmented whole-meal rice. [ABSTRACT FROM AUTHOR]

Abstract: Coffea arabica silverskin (CSS), the inner fruit layer surrounding coffee beans, was analyzed for its (poly)phenolic and caffeine content by means of liquid chromatography–tandem mass spectrometry and evaluated for its antioxidant properties by means of the Folin–Ciocalteu and FRAP methods. The most abundant quantified phenolics were caffeoylquinic acids, with the 5- and 3-isomers being the most relevant (199mg/100g and 148mg/100g, respectively). The three caffeoylquinic acid isomers reached a total concentration of 432mg/100g, corresponding to 74% of the total chlorogenic acids detected in CSS. The level of the three feruloylquinic acids detected was 143mg/100g, corresponding to 23%, and the two identified coumaroylquinic acids plus the two caffeoylquinic acid lactones were only marginally contributing to the final figure (only 3% of total hydroxycinnamates). No unconjugated phenolic acid was detected. Caffeine content in CSS was equal to 10mg/g of product, 3.5 times lower than most coffee brews. The total antioxidant capacity (TAC) of CSS was 139mmol Fe2+/kg, a value similar to those of valuable sources of food antioxidants like dark chocolate, herbs and spices. Besides its potential as a food supplement, CSS may represent an innovative functional ingredient exploitable to increase the TAC of a wide range of food products. [Copyright &y& Elsevier]

Abstract: Objective: The biological effects of dietary polyphenols are linked to their bioavailability and catabolism in humans. The colon, with its symbiotic microbiota, is an active site where complex polyphenolic compounds are possibly modified to smaller and more absorbable molecules. The aim of this study was to identify the major metabolites derived from microbial colonic fermentation of some common polyphenol-rich foods. Methods: An in vitro fecal fermentation model was applied to 16 polyphenol-rich foods and polyphenolic precursors. Phenolic metabolites were identified by high-performance liquid chromatography coupled with tandem mass spectrometric detection. Results: Twenty-four phenolic fermentation metabolites were characterized. Some metabolites were common to several polyphenol-rich foods, whereas others were characteristic of specific sources. Conclusion: The metabolites identified in vitro likely are generated in the human colon after consumption of polyphenol-rich foods. Their occurrence in plasma and/or urine should be considered when evaluating the bioavailability of polyphenols from specific food groups in humans and in the definition of markers of exposure to specific foods or food groups in epidemiologic studies. However, the search for these and other microbial metabolites after a feeding study in vivo should consider their possible further conjugation at the level of the liver. [ABSTRACT FROM AUTHOR]

Experimental studies suggest that oxidative stress and systemic inflammation are involved in the pathogenesis of ischemic stroke. Consuming a diet with a high total antioxidant capacity IT AC) has been related to reduced inflammation and increased circulating antioxidants in cross-sectional and randomized intervention studies. This study investigates the relation between dietary TAC and risk of ischemic and hemorrhagic stroke in 41,620 men and women not previously diagnosed with stroke or myocardial infarction, representing the Italian segment of the European Prospective Investigation into Cancer and Nutrition. Controlling for potential confounders, a diet rich in TAC was associated with a reduction in HR for all types of stroke, but this association was only marginally significant (P-trend = 0.0541. When only ischemic stroke cases were considered, data suggest a stronger inverse association with dietary TAC, with HR = 0.41 (95% Cl = 0.23-0.74). Regarding single antioxidants, data from subanalyses on stroke types suggest that vitamin C is significantly associated with a decreased risk of ischemic stroke [HR = 0.58 (95% Cl = 0.34-0.99)], whereas vitamin E was associated with increased HR of hemorrhagic stroke in the highest tertile of intake [HR = 2.94 (95% Cl = 1.13-7.62(1. In conclusion, our findings suggest that antioxidants may play a role in reducing the risk of cerebral infarction but not hemorrhagic stroke. However, a high intake of vitamin E could be positively associated to the risk of brain hemorrhagic events; therefore, more focused investigations about this observation are needed. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate green tea flavan-3-ol catabolism and plasma pharmacokinetic and urinary excretion by high-performance liquid chromatography with tandem mass spectrometry to evaluate their absolute bioavailability by taking into account all known and some unknown catabolites deriving from their interaction with the gastrointestinal tract and its host microflora. Methods: A feeding study was carried out in 20 healthy human volunteers who ingested 400mL of a ready-to-drink green tea containing approximately 400μmol of flavan-3-ols. Urine and plasma were collected for 4 and 24h, respectively, and 39 relevant catabolites were identified in these biological fluids by tandem mass spectrometry. Results: In biological fluids, 39 relevant flavan-3-ol catabolites were identified. In plasma, (−)-epigallocatechin-3-gallate was the only unmetabolized compound and the highest in absolute concentration compared with (−)-epigallocatechin and (−)-epicatechin conjugates. Colonic microflora-derived polyhydroxyphenyl-γ-valerolactones were by far the main urinary catabolites, averaging 10 times greater concentratin than flavan-3-ol conjugates. The calculated bioavailability was equal to 39% and it is interesting to notice the great variability in urinary excretion of colonic metabolites among participants, probably related to differences in their own colonic microflora. Conclusion: This study demonstrates that green tea catechins are more bioavailable than previously observed when colonic ring fission metabolites are taken into consideration. Regular consumption of ready-to-drink green tea containing flavan-3-ols allows a non-marginal exposure of the human body to these catabolites, somehow justifying the numerous beneficial actions described as linked to green tea intake. [Copyright &y& Elsevier]

Abstract: Objective: Because consumption of teas may be associated with potential health benefits due to its content in polyphenols and in Western countries the consumption of tea is equally divided between the hot and the ready-to-drink (RTD) cold versions of this typical beverage, the aim of this work was to study the absorption and metabolism of flavan-3-ols in human volunteers after the ingestion of a commercial RTD tea. Methods: A feeding study was carried out in 20 healthy human volunteers and urine samples were collected for 24h after tea ingestion. Flavan-3-ols–derived molecules were identified and quantified in urine samples by high-performance liquid chromatography with tandem mass spectrometric detection. Results: Eight relevant metabolites were identified in urine, all modified flavan-3-ols with the exception of unmetabolized gallic acid. The urinary excretion of flavan-3-ols was equal to 7.2% of the intake with tea. Gallic acid, which was abundant in the RTD tea used in this study, reached a 4.5% of the drunken amount. Conclusions: The bioavailability values observed are in agreement with previous reports, although the dosage of polyphenols ingested in this study is remarkably lower. Moreover, the use of a group of 20 volunteers, more than the average number of subjects used for usual human acute-feeding studies involving polyphenols, provides additional credibility to the results. After drinking the RTD ice tea used in this study, the internal compartments are exposed to non-marginal doses of flavanols and flavanol metabolites up to 24h. [Copyright &y& Elsevier]

Abstract: Oxidative stress has been associated with motor neuron disease (MND). The human body has several antioxidant defense systems to repair the damage caused by oxidative stress. The activity of these systems is thought to be reduced in neurodegenerative diseases, which may increase the level of oxidative damage and be a contributing factor to motor neuron death. In the present study, we compared the total antioxidant capacity (TAC) of human serum and cerebrospinal fluid (CSF) of MND patients with that of a control group including patients with migraine, tension headache and psychiatric disorders. Within-subject serum and CSF TAC were strongly correlated (r =0.639; p =0.000), and CSF TAC was significantly lower in MND patients as compared to controls after adjustment for known influencing factors (112.7μmolFe/L±11.7 versus 135.2μmolFe/L±19.7; p =0.012). No differences in serum or CSF TAC were observed among the clinical forms of MND considered in this work. In conclusion, the CSF TAC was strongly correlated with serum TAC, and a decrease in CSF TAC was demonstrated in MND patients compared to controls that was not independent from serum antioxidants, this translating in a systemic (but prevailing in the CNS) oxidative damage in this pathology. [Copyright &y& Elsevier]