Efficacy of a Diabetes Specific Nutritional Supplement (DSNS) on Glycemic Response in Prediabetic Adults: A Two-Armed, Open-Labelled Randomized Controlled Study

It is well known that Diabetes Specific Nutritional Supplements (DSNSs) are linked to improved glycemic control in individuals with diabetes. However, data on efficacy of DSNSs in prediabetics is limited. This was a two-armed, open-labelled, randomized controlled six-week study on 199 prediabetics [30 - 65 years;Glycosylated Hemoglobin (HbA1c) 5.7% - 6.4% and/or Fasting Blood Glucose (FBG) 100-125 mg/dl]. Two parallel phases were conducted: Acute Blood Glucose Response (ABGR) and Intervention phase. Prediabetic participants were randomized into test (n = 100) and control (n = 99). The primary objective was to assess the ABGR of DSNS versus an isocaloric snack, measured by incremental Area under the Curve (iAUC). Test and control received 60 g of DSNS and 56 g of isocaloric snack (cornflakes) respectively, both in 250 ml double-toned milk on visit days 1, 15, 29 and 43. Postprandial Blood Glucose (PPG) was estimated at 30, 60, 90, 120, 150 and 180 minutes. During the 4 weeks intervention phase, the test group received DSNS with lifestyle counselling (DSNS + LC) and was compared with the control receiving lifestyle counselling alone (LC alone). Impact was studied on FBG, HbA1C, anthropometry, body composition, blood pressure, nutrient intake, and physical activity. The impact of DSNS was also studied using CGM between two 14-day phases: CGM1 baseline (days 1 - 14) and CGM2 endline (days 28 - 42). DSNS showed significantly lower PPG versus isocaloric snack at 30 (p 12, and chromium were reported by DSNS + LC versus LC alone. No other significant changes were reported between groups. It may be concluded that DSNS may be considered as a snack for prediabetic or hyperglycemic individuals requiring nutritional support for improved glycemic control.

Glycemic Indices of Multiple Oral Nutritional Supplements: A Randomized Cross-Over Study in Indian Adults

Background: A randomized cross-over study was conducted to assess the glycemic index (GI) of seven Oral Nutritional Supplements (ONSs). These ONSs are designed to support the nutritional requirements of different age-groups, physiological states, or health conditions among Indian adults. Methods: The study had two phases viz., phase1 (n = 18) studied two ONSs: A1 and B1 and phase 2 (n = 20) studied five ONSs: A2, B2, C2, D2 & E2. The subjects were healthy, non-diabetic adults, aged between 20 - 44 years with a mean Body Mass Index of 21.2 ± 1.52 kg/m2 (Phase 1) and 21.0 ± 1.45 kg/m2 (Phase 2). All these ONSs were compared with reference drinks (glucose). The carbohydrates in one serving of each ONS were matched to carbohydrates from 25 grams of glucose following ISO 2010 guidelines. Capillary blood was assessed for blood glucose response at baseline, 15, 30, 45, 60, 90 and 120 minutes. GI was calculated as the incremental area under the curve (iAUC) for the test drinks and expressed as a percentage of the average iAUC from glucose. Results: Phase 1 indicated that the high fiber diabetes-specific nutrition supplement A1 with higher protein (23% energy), higher fat (25% energy) and reduced carbohydrates (40% energy) had a significantly (p = 0.002) lower GI [34 (±6)] as compared to B1 [63 (±7)] (protein 19%, fat 7% and carbohydrates 60% energy) even with similar amount (22%) and type of fiber. Phase 2 reported that all test products [A2 (32 ± 5), B2 (37 ± 4), C2 (31 ± 5), D2 (31 ± 5) and E2 (55 ± 4)] had a low GI. As compared to phase 1, ONSs in phase 2 had lower fiber content (1.6% - 4.6% energy). Conclusion: The glycemic index of oral nutrition supplements is influenced not only by their fiber content, but also by the overall macronutrient composition including protein (≥17% energy), fat (≥10% - 27% energy) and carbohydrates (40% - 57.5% energy).

Efficacy of a Diabetes Specific Nutrition Supplement on Glycemic, Anthropometric, Dietary and Gut Health Markers in Adults with Type 2 Diabetes: An RCT

With increasing incidence of diabetes, use of diabetes specific nutrition supplements (DSNS) is common for better management of the disease. To study effect of 12-week DSNS supplementation on glycemic markers, anthropometry, lipid profile, SCFAs, and gut microbiome in individuals with diabetes. Markers studied were glycemic [Fasting Blood Glucose (FBG), Post Prandial Glucose (PPG), HbA1c, Incremental Area under curve (iAUC), Mean Amplitude of Glycemic Excursions (MAGE), Time in/above Range (TIR/TAR)], anthropometry [weight, Body Mass Index (BMI), waist circumference (WC)], lipid profile, diet and gut health [plasma short chain fatty acids (SCFAs)]. N = 210 adults were randomized to receive either DSNS with standard care (DSNS + SC;n = 105) or standard care alone (SC alone;n = 105). After 12 weeks, significant differences between DSNS + SC versus SC alone was observed in FBG [−3 ± 6 vs 14 ± 6 mg/dl;p = 0.03], PPG [−35 ± 9 vs −3 ± 9 mg/dl;p = 0.01], weight [−0.6 ± 0.1 vs 0.2 ± 0.1 kg;p = 0.0001], BMI [−0.3 ± 0.1 vs 0.1 ± 0.1 kg/m2;p = 0.0001] and WC [−0.3 ± 0.2 vs 0.2 ± 0.2 cm;p = 0.01]. HbA1C and low-density lipoprotein (LDL) were significantly reduced in DSNS + SC [−0.2 ± 0.9;p = 0.04 and −5 mg/dl;p = 0.03] respectively with no change in control. Continuous Glucose Monitoring (CGM) reported significant differences between DSNS + SC versus SC alone for mean glucose [−12 ± 65 vs 28 ± 93 mg/dl;p < 0.01], TAR 180 [−9 ± 42 vs 7 ± 45 mg/dl;p = 0.04], TAR 250 [−3 ± 27 vs 9 ± 38 mg/dl;p = 0.05], iAUC [−192 (1.1) vs −48 (1.1) mg/dl;p = 0.03]. MAGE was significantly reduced for both DSNS + SC (−19 ± 67;p < 0.001) and SC alone (−8 ± 70;p = 0.04), with reduction being more pronounced for DSNS + SC. DSNS + SC reported a decrease in carbohydrate energy % [−9.4 (−11.3, −7.6) %;p < 0.0001] and amount [−47.4 (−67.1, −27.7) g;p < 0.0001], increased dietary fiber [9.5 (7.2, 11.8) g;p < 0.0001] and protein energy % [0.9 (0.5, 1.3) %;p < 0.0001] versus SC alone. DSNS + SC reported significant increases versus SC alone in total (0.3 ng/ml;p = 0.03) and individual plasma SCFAs. The consumption of DSNS significantly improves the glycemic, anthropometric, dietary, and gut health markers in diabetes.

Efficacy of Alzer^®and Diamel, Nutritional Supplements, in the Prevention of Severe Diabetic Macular Edema

Introduction: Macular edema is the main cause of low vision in diabetic patients. Laser photocoagulation continues to be the treatment of choice in conjunction with the use of steroids and anti-angiogenics, but these treatments include possible ocular complications. The nutritional supplement Alzer (whose primary active ingredient is Ginkgo biloba, a powerful antioxidant that acts on vascular factors and oxidative damage, which are two of the mechanisms implicated in the pathogenesis of diabetic macular edema), which has been used on other non-diabetic macular conditions, along with the Diamel nutritional supplement has been shown to be effective on glycemic control and could represent a treatment alternative for mild to moderate macular edema by reducing the thickness of the macular retina and preventing the progression of other more advanced clinical presentations that are harder to treat. Objective: Identify the effect of Alzer along with Diamel in reduction of the thickness of the macular retina among patients with mild to moderate diabetic macular edema. Materials and Methods: A phase II double-blind clinical trial was conducted in 64 patients with non-severe diabetic macular edema over the course of non-proliferative diabetic retinopathy, who attended the ophthalmology service of the Institute of Endocrinology of Havana from January 2016 to December 2016. The treatment was randomly assigned to two groups: one received Alzer plus Diamel (n = 32) and the other group received Alzer placebo + Diamel placebo (n = 32). All patients were given an initial clinical evaluation, blood testing and ophthalmological evaluation at the start of treatment and after one year of follow-up. Results: There was a clinical improvement in the macular thickness upon the conclusion of the study in the patients treated with Alzer and Diamel. This decrease in thickness was statistically significant in the left eye. There was no decrease in visual acuity one year after treatment. Adverse events were mild and uncommon. Conclusions: Severe macular edema did not evolve in the Alzer and Diamel group. The clinical, but not statistically significant, success obtained in the experimental group proves the protocol hypothesis regarding the efficacy of the product being researched. The positive results in this small sample lead to the suggestion of performing larger-scale studies (Phase III). The clinical trial was registered in Clinical Trials.gov Identifier: NCT03533478.

Exploring choices of early nutritional support for patients with sepsis based on changes in intestinal microecology

BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.

the role of nutrition and nutraceutical supplements in the treatment of hypertension

Vascular biology,endothelial and vascular smooth muscle and cardiac dysfunction play a primary role in the initiation and perpetuation of hypertension,cardiovascular disease and target organ damage.Nutrientgene interactions and epigenetics are predominant factors in promoting beneficial or detrimental effects in cardiovascular health and hypertension.Macronutrients and micronutrients can prevent,control and treat hypertension through numerous mechanisms related to vascular biology.Oxidative stress,inflammation and autoimmune dysfunction initiate and propagate hypertension and cardiovascular disease.There is a role for the selected use of single and component nutraceutical supplements,vitamins,antioxidants and minerals in the treatment of hypertension based on scientifically controlled studies which complement optimal nutrition,coupled with other lifestyle modifications.

Drug Seeking Behavior of Amphetamine Addicted Sprague-Dawley Rats Is Eliminated after Nutritional Supplementation

Aim: The effectiveness of nutritional supplementation on drug-seeking behavior of amphetamine-addicted rats during withdrawal was investigated using a biased conditioned place preference (CPP) paradigm. Method: Twenty-four male Sprague-Dawley rats exhibiting baseline preference for the black chamber during a 20-minute pre-conditioning exploration of the CPP box completed the study. On alternate days of an 8-day schedule, twelve rats (Group AMP) were randomly selected, given either amphetamine sulfate (5 mg/ml, i.p.) and confined to the white chamber;or vehicle (1 ml saline, i.p.) and confined to the black chamber. A significant increased percentage time spent and number of entries made by Group AMP to the drug-paired, white chamber on the test day confirmed amphetamine addiction. Group AMP subsequently received increasing doses of amphetamine over 6 days. Following acute drug withdrawal, their CPP performance was compared with that of vehicle treated rats (Group SAL). Groups AMP and SAL were equally divided and randomly assigned to animals fed chow reconstituted with the nutritional supplement (AMP-S and SAL-S) over 8 weeks or standard rat chow (AMP-N and SAL-N). CPP performances for all rats were determined blindly from video recordings following this period. Results: Nutritionally supplemented, amphetamine withdrawn rats (AMP-S) exhibited significantly decreased percentage entries and time spent in the white chamber (p ?ve, control animals. Conclusion: Drug-seeking behavior by amphetamine-addicted animals was eliminated after treatment with a nutritionally supplemented diet.

Nutritional supplementation on wound healing in diabetic foot:What is known and what is new?

Non-healing diabetic foot ulcers(DFU)are the most notable and striking complications of diabetes mellitus.More than 25% of nonhealing DFU can ultimately lead to amputation of the lower extremity within 6-18 mo after the first manifestation of the wound.Although wound healing is complex,nutritional status is crucial in soft tissue repair.Malnutrition is highly prevalent and overlooked in patients with diabetes and chronic wounds.Moreover,to date,we do not have clear recommendations or evidence about the use of nutritional supplements for improving wound healing in patients with DFU.In this article the authors briefly analyzed the current evidence on the use of nutritional supplements of proteins or amino acids,fatty acids,probiotics,vitamins,and trace elements in the wound healing process in patients with DFU.

Drug-Seeking Behavior Is Significantly Attenuated in Nutritionally Supplemented Cocaine Withdrawn Sprague-Dawley Rats

Aim: The effect of patented nutritional supplementation on drug-seeking behavior in cocaine addicted rats during acute drug withdrawal was investigated using a biased Conditioned Place Preference (CPP) paradigm. Method: Twenty-four (24) male Sprague-Dawley rats with pre-conditioned preference for the black chamber of the CPP box were randomly divided into Cocaine (COC) or Saline (SAL) treated groups. Rats (n = 12) treated with cocaine hydrochloride 20 mg/kg/ml, i.p. (COC group) were confined individually to the white chamber on days 1, 3, 5 and 7. On alternate days, they were given 1 ml saline vehicle, i.p. and confined to the black chamber. Control rats (SAL group, n = 12) received only vehicle on all 8 days and were confined on alternate days to the white or black chamber. Positive place preference was confirmed for COC rats, which subsequently received 6 increasing daily doses of cocaine. CPP performances of both COC and SAL rats were recorded following an acute 3-day withdrawal period. All animals were then randomly assigned to rats fed either chow reconstituted with the nutritional supplement (COC-S and SAL-S) or standard rat chow (COC-N and SAL-N) for 8 weeks, followed by final CPP performances. Results: Following supplementation, COC-S rats made significantly less entries and time spent in the white chamber (p < 0.05) compared with COC-N rats. COC-S rats exhibited significant place aversion to the white chamber similar to drug-naive animals;whereas COC-N continued to show positive place preference. Conclusion: Drug-seeking behavior that persisted during cocaine withdrawal was significantly diminished in the nutritionally supplemented.

Impact of Three-month Home Enteral Nutritional Supplementation on the Nutritional Status of Patients with Malignancy

Objective We analysed the impact of home nutritional interventions on the nutritional risk and the incidence and severity of malnutrition in patients with malignancy.Methods In this prospective interventional study,we recruited 60 patients with malignancy who were at nutritional risk(NRS 2002≥3 scores).These patients were given home enteral nutritional supplementation(HES)for 3 months.The HES included nutritional counselling,oral nutritional supplements(ONS)and tube feeding.The incidence and severity of nutritional risk and malnutrition,as well as the body composition and results of routine blood tests,were compared before and after the intervention.Results A total of 58 patients completed the study.After three months of home enteral nutritional intervention,the incidence and severity of nutritional risk and malnutrition were significantly reduced(the NRS 2002 score was reduced from 3 to 1,the PG-SGA score was reduced from 8.00 to 3.00,P<0.05).The patients’body mass index(BMI)and upper arm circumference increased(P<0.05),the muscle mass,appendicular skeletal muscle mass index(ASMI)and phase angle(PA)increased(P<0.05).The serum albumin,pre-albumin and haemoglobin levels increased significantly,while the neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)decreased significantly(P<0.05).The incidence of hypoproteinaemia and anaemia also decreased significantly(P<0.05).Conclusion HES can effectively improve the nutritional status of patients and reduce the risk and severity of malnutrition.

Effect of FFD-410 (HiOwna-Jr.), a Balanced Herbal Nutritional Supplement on Biochemical, Hematological, Immunological and Cognitive Parameters of Wistar Rats

Present study was aimed to evaluate the effect HiOwna-Jr. (FFD-410) on vital biochemical, hematological, immunological and cognitive functions in rats;also in vitro antioxidant studies were carried out to evaluate the antioxidant capacity of FFD-410. Animals of respective groups were treatment with FFD-410 for 90 days and blood samples were collected for the estimation of biochemical, hematological parameters and serum immunoglobulin levels;haemoagglutination assay was carried out using Sheep Red blood cells (SRBC’s). In addition, effect of FFD-410 on cognition and memory was evaluated by modified elevated plus maze test. Apart from in vivo studies, in vitro studies such as DPPH radical scavenging assay, reducing power assay and ORAC assays were carried out to evaluate the free radical scavenging and antioxidant activity of FFD-410. Pretreatment with FFD-410 for 90 days did not bring about any change in serum biochemical and hematological parameters and relative organ weights etc., which could account for its wide safety margin at tested dose levels (2.5 and 5.0 g/kg, p.o.). However, FFD-410 showed potent immunostimulant activity by elevating the serum immunoglobulins and haemoagglutination titer values, also the pretreatment with FFD-410 showed dose dependent improvement in short-term cognition and memory in elevated plus maze test. Furthermore, in vitro antioxidant studies FFD-410 exhibited significant and dose dependent free radical scavenging and antioxidant activity as assessed by DPPH (IC50 value of 1162.6 μg/ml), reducing power and ORAC assays (Trolox equivalence/g of 76.1). These findings suggest that, FFD-410 possess very good antioxidant, cognition improving and potent immunostimulant properties. Also, there was no significant change in the serum biochemical and hematological parameters and relative organ weights were observed after 90 days treatment with FFD-410, which could account for its wide safety of margin at tested dose levels (2.5 and5.0 g/kg. p.o.).

Determination of Alpha-Lipoic Acid in a Nutritional Supplement Using High Performance Liquid Chromatography

Alpha lipoic acid has the ability to react and neutralize reactive oxygen species (ROS) such as superoxide radicals, simple oxygen, hydroxyl radicals, hypochlorous acid and peroxyl radicals. A rapid high-performance liquid chromatographic method for determination of lipoic acid in a nutritional supplement was developed. The method involved sample preparation and the mobile phase comprised of 50 mM disodium hydrogen phosphate buffer (pH 2.5 adjusted with 1 M H3PO4): acetonitrile in the ratio of 50:50. The separation was done using a C18 column (150 mm) and detection was carried out using UV detection at 201 nm. The assay was found to be linear in the range of 1.56 - 50 μg/mL with the correlation coefficient of 0.9997. Method precision was determined while LOD was 0.05 μg/mL and LOQ 0.15 μg/mL. The chromatographic peak LA retention time was 6 min.

The Effects of Nutrition Lick Brick and Salt Brick as Supplement Feed on the Production Performance of Tan Sheep

In the paper, the effects of nutrition lick brick and salt brick as supple-ment feed on the performance of Tan sheep were studied. 36 fattening Tan sheep with the average weight of about 23 kg were chosen, they were randomly divided into 3 groups according to the weight, and each group had 12 sheep. Control group was fed with normal daily ration, experimental group 1 was fed with normal daily ration＋nutrition lick brick, experimental group 2 was fed with normal daily ration＋salt brick, the experimental period was 60 d. The results showed that 1） compared with CK, daily gain of group 1 improved 17.09%（P〈0.01）, feed conversion ratio reduced 11.69%（P〈0.05）, and average gross profit per sheep improved 51.65 yuan; daily gain of group 2 improved 7.03%（P〈0.05）, feed conversion ratio reduced 4.06%（P〉0.05）, and average gross profit per sheep improved 19.78 yuan; 2） compared with group 2, daily gain of group 1 improved 9.40%（P〈0.05）, feed conversion ratio re-duced 7.96%（P〈0.05）, and average gross profit per sheep improved 31.87 yuan;these indicated that nutrition lick brick and salt brick as supplement feed for Tan sheep both can improve the production performance of Tan sheep, and the supple-mentary feeding effect of nutrition lick brick was better.

Diet and nutritional factors in inflammatory bowel diseases

Inflammatory bowel disease(IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular periods of the disease may facilitate achieving or prolonging remissions and most of all, improve the quality of life for patients. During disease exacerbation, a low fiber diet is recommended for most patients. In the remission time, an excessive consumption of alcohol and sulfur products may have a negative effect on the disease course. Attempts are also made at employing diets composed in detail in order to supplement IBD therapy. A diet with a modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols are under investigation. Due to chronic inflammation as well as side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It should also be remembered that there is no single common diet suitable for all IBD patients; each of them is unique and dietary recommendations must be individually developed for each patient, depending on the course of the disease, past surgical procedures and type of pharmacotherapy.

Dietary supplements and pediatric non-alcoholic fatty liver disease: Present and the future

Non-alcoholic fatty liver disease(NAFLD) is the most common chronic liver disease in children.High prevalence of pediatric obesity and sedentary lifestyle has augmented the incidence of NAFLD in children.Obesity is associated with an increased risk of NAFLD through various mechanisms such as intensification of insulin resistance and increased levels of inflammatory markers.There is no approved medical intervention for treatment of pediatric NAFLD;the only proven strategy in management of pediatric NAFLD is lifestyle modification.Recently,the effects of nutritional supplements have been examined in the management of pediatric NAFLD.The purpose of this review is to summarize the studies evaluating the effects of nutritional supplements on pediatric NAFLD and explain the future direction in this field.

Nutritional Support of Dogs and Cats after Surgery or Illness

Nutritional support early during the postoperative period or after onset of illness decreases the mortality rate and shortens the duration of hospitalization of dogs and cats. The preferred feeding route is dependent on the condition of the patient. If there are no contraindications, every patient must receive nutritional support, at least consistent with the resting energy requirement (RER). Several nutrients may be beneficial during healing and recovery from illness or surgery, but further research is needed to empirically certify the effects of these nutrients in critically ill patients.

Hypo-activity induced skeletal muscle atrophy and potential nutritional interventions: A review

Periods of hypo-activity result in profound changes in skeletal muscle morphology and strength. This review primarily addresses the differential impact of de-training, bed-rest, limb immobilisation and unilateral lower limb suspension on muscle morphology, strength and fatigability. The degree of muscle atrophy differs depending on the hypo-activity model and the muscles in question, with the leg and postural muscles being the most susceptible to atrophy. Hypo-activity also results in the dramatic loss of strength that often surpasses the loss of muscle mass, and consequently, the nervous system and contractile properties adapt to adjust for this excessive loss of strength. In addition, the degree of muscle strength loss is different depending on the hypo-activity model, with immobilisation appearing to have a greater impact on strength than unloaded models. There is a step-wise difference in the magnitude of muscle loss so that, even after accounting for differential durations of interventions immobilisation ≥ unilateral lower limb suspension ≥ bed-rest ≥ de-training. Muscle fatigability varies between hypoactivity models but the results are equivocal and thismay be due to task-specific adaptations. This review also addresses potential nutritional interventions for attenuating hypo-activity induced muscle atrophy and strength declines, in the absence of exercise. Essential amino acid supplementation stands as a strong candidate but other supplements are good contenders for attenuating hypo-activity induced atrophy and strength losses. Several potential nutritional supplements are highlighted that could be used to combat muscle atrophy but extensive research is needed to determine the most effective.

Glycemic responses to glycemia-targeted specialized-nutrition beverages with varying carbohydrates compared to a standard nutritional beverage in adults with type 2 diabetes

Background: Postprandial plasma glucose concentration is an important diabetes management target. Glycemia-targeted specialized-nutrition (GTSN) beverages, containing various quantities and types of carbohydrates (CHO), have been formulated to blunt postprandial hyperglycemia. The objective of this research was to evaluate the effectiveness of these products on postprandial glycemic and hormonal responses based on comparisons of GTSN with differing carbohydrate quantities or types. Methods: In two randomized, double-blind, crossover studies, participants (mean age 61 years) with type 2 diabetes consumed GTSN in a meal tolerance test. In the CHO Quantity Study, a standard nutritional beverage (STD) was compared to a low carbohydrate nutritional beverage with tapioca dextrin (GTSN-TDX) and a balanced carbohydrate nutritional beverage containing a blend of the slowly-digesting carbohydrates maltodextrin and sucromalt (GTSN-SDC). In the CHO Type Study, the GTSN beverages had similar carbohydrate quantities but varied in carbohydrate composition with GTSN-SDC compared to a formula with tapioca starch and fructose (GTSN-TS&F), and one with isomaltulose and resistant starch (GTSN-I&RS). Postprandial (0-240 min) concentrations of blood glucose, insulin (CHO Quantity Study only) and glucagon-like-peptide (GLP)-1 (CHO Quantity Study only) were measured. Results: Despite having substantially different carbohydrate quantities, the GTSN blunted the glucose positive area under the curve (AUC0-240 min) by 65% to 82% compared to the STD formulation (p < 0.001). GTSN also elicited ~50% lower insulin positive AUC0-240 min (p < 0.05), while postprandial GLP-1 responses were increased (p = 0.018) vs. STD. In the CHO Type Study, glucose positive AUC0-240 min tended to be lower for GTSN-SDC (1477 ± 460) than GTSN-TS&F (2203 ± 412;p = 0.062) and GTSN-I&RS (2190 ± 412;p = 0.076). No differences were observed between GTSN-TS&F and GTSN-I&RS. Conclusions: These results demonstrate the effectiveness of several GTSN products and suggest that both CHO quantity and type play important roles in postprandial glycemic response in men and women with type 2 diabetes. Furthermore, GTSN products containing slow-digesting carbohydrates can blunt postmeal glucose and insulin concentration despite delivering greater total grams of CHO, which provides a dietary benefit for people with diabetes.

Nutritional Therapy in Patients Undergoing Elective Colorectal Cancer Surgery

The high incidence of malnutrition in patients with colorectal cancer directly affects their clinical outcomes,and is associated with increased postoperative complications,prolonged hospital stays,and decreased tolerance of chemotherapy and radiotherapy.Therefore,the nutritional management of patients with colorectal cancer is important.The perioperative nutritional management of patients includes preoperative education,nutritional screening and evaluation,preoperative intestinal preparation,and postoperative nutritional management.This article summarizes the current status of perioperative nutritional therapy and bowel preparation for patients with colorectal cancer.

Antioxidant,nutritional and anti-nutritional composition of Garcinia kola and Chrysophyllum albidum from rainforest ecosystem of Ondo State,Nigeria

Tropical forests contain many tree species that have supplied edible fruits for centuries.These fruits have contributed to human diets due to their richness in nutrients,vitamins,minerals,antioxidants and their low antinutrients content.We investigated the antioxidant,nutritional and anti-nutritional composition of Garcinia kola and Chrysophyllum albidum fruit parts.The nutritional,anti-nutritional and antioxidant compositions differed depending on the fruit part.Irrespective of fruit part,moisture content was high（72–93 %）.While the edible part（fruit pulp） of C.albidum proved a better source of protein（4）,fibre（17 %） and fat（2 %）,the seed kernel was a better source of ash（2 %） and carbohydrate（15 %）.Carbohydrate（22 %）,protein（2 %）,fat（1 %） and fibre（3 %） were higher in G.kola seed kernel（edible part） than in the pulp and pod.Anti-nutrient content in G.kola and C.albidum fruits was low,indicating that their consumption would not pose nutritional or health problems.The antioxidant compositions（especially phenolic content（10–21 mg g-1） and DPPH（1,1-diphenyl–2 picrylhydrazyl）（26–55 %）） of C.albidum fruit pulp and G.kola seed kernel were high,implying that they could be good sources of natural antioxidants and could be used as supplements in food manufacturing.