Legumes are a sustainable protein source and a recommended starchy food in healthy diets. Resistant starch has shown beneficial effects on glycemic control. However, the digestibility of the starch, indicating the amount of resistant starch, in legumes has been poorly studied in humans. We aimed to assess the ileal starch digestibility from faba beans in healthy volunteers and the associated glycemic response. Nine healthy volunteers were equipped with a naso-ileal tube. They ingested 250 g of dehulled, cooked mashed faba beans as a test meal. Ileal contents, plasma and urine samples were collected regularly over an 8 h postprandial period. Respiratory exchanges were measured every hour. Residual starch in ileal effluents was measured after hydrolyzing samples with α-amylase. Intestinal and plasma glucose, plasma insulin as well as glucose oxidation were determined. The amount of starch ingested was 30.7 ± 1.7 g. In the terminal ileum, 6.4 ± 2.4 g of starch was recovered, resulting in starch digestibility of 79.1 ± 8.0 %. Postprandial glycemic response was weak, with a maximal value of 1.02 ± 0.11 g/L occurring at 1.5 h. Insulinemia slightly peaked at 84.2 ± 77.3 pmol/L at 1.5 h. Respiratory Quotient was stable (∼0.9) over time. Glucose oxidation was constant during the 8 h and amounted 80 ± 32 g. The observed low glycemic response after ingestion of faba beans, combined with their high resistant starch content, supports the established health benefits of legumes and aligns with the current public health policies that increasingly recommend the consumption of pulses.

Pseudocereals like buckwheat are a significant source of health-promoting bioactive components. Consumption of pseudocereals may positively modify biomarkers associated with chronic conditions. The main objective of the research was to determine how adding buckwheat-containing bread to wheat flour affected gastrointestinal health, appetite, palatability, and postprandial glycemia in healthy individuals. In a randomized cross-over trial, 20 healthy subjects were given either control bread (CB) or 50% buckwheat bread (BB) at breakfast after a 10- to 12-h fast. The recommended daily bread intake was determined based on 50 g of available carbohydrates. Blood glucose levels and appetites were assessed before fasting and 15, 30, 45, 60, 90, and 120 min after bread intake. Standardized questionnaires were used to examine palatability and gastrointestinal well-being. Buckwheat bread significantly lowered postprandial blood glucose levels compared to control bread. While peak glucose level occurred at 45 min for both, BB showed a smaller glucose increase. Repeated measure ANOVA confirmed a significant reduction at 30, 45, and 60 min. Overall, BB resulted in a lower incremental area under the curve (iAUC), indicating improved postprandial glycemic control. Additionally, BB demonstrated a trend toward enhancing satiety during the early postprandial phase (15-60 min) as reflected in Figure 2, potentially indicating a role in promoting satiety. The participants enjoyed all the bread-containing buckwheat, and no gastrointestinal issues were noted. The study concluded that BB decreased appetite and enhanced postprandial glycemia compared to CB. Further research is suggested to investigate the process behind these reported impacts.

High carbohydrate intake leading to increased postprandial glycemia is associated with type-2 diabetes (T2D). Particularly in China, prediabetes is highly prevalent (>40%) in adults (>40 years old). Bioactive ingredients like mulberry leaf extract (MLE) lower glycemia and can be a good strategy to manage prediabetes, but its health effects when added to milk are poorly understood.

To investigate the effect of a milk powder supplemented with MLE, vegetable oil and inulin on glucose and insulin responses to a carbohydrate-rich meal compared to regular skimmed milk, in healthy middle-aged adults.

A 2-arm, cross-over, open-label, randomized controlled trial with 31 healthy adults (>45 years old) consuming either the supplemented milk (test product, TP) or regular skimmed milk (control) with a standardized breakfast. Blood samples were collected to assess postprandial responses.

Twenty-eight subjects were analyzed. TP did not change glucose iAUC0-180min (primary outcome) but significantly decreased glucose iAUC0-60min by 25% vs. control. TP also significantly decreased insulin and c-peptide iAUC0-60min by 22% and 18%, respectively, and for iAUC0-120min by 16% and 11%, respectively. Plasma GIP iAUC0-120min and 0-180min were also significantly decreased.

As compared with regular skimmed milk, milk supplemented with MLE, vegetable oil, and inulin, reduced early postprandial glucose and insulin responses in healthy adults of Chinese ethnicity, which could mitigate the risk of developing chronic diseases. NCT05570435, https://clinicaltrials.gov/study/NCT05570435.

Mulberry extracts can reduce postprandial blood glucose (PPG) and insulin (PPI) responses by slowing rates of glucose uptake following carbohydrate-rich meals. The presumed mechanism is the inhibition of intestinal alpha-glucosidase, mainly attributed to 1-deoxynojirimycin (DNJ) in the extracts. However, other components including other iminosugars or polyphenols might also contribute to these effects.

The primary objective was to test the bioequivalence of a mulberry fruit extract (MFE) and an equal dose of the DNJ component alone, for reducing the PPG positive incremental area under the curve over 2 h (+iAUC2hr) following a carbohydrate-rich test meal. A secondary objective was to assess the efficacy of MFE and DNJ for reducing PPG and PPI relative to a placebo.

Healthy adults (n = 84) participated in a balanced-order, double-blind, placebo-controlled study assessing PPG and PPI following the addition of MFE (0.75 g, containing 2.90 mg DNJ), pure DNJ (2.90 mg) or placebo to rice meals containing 50 g available carbohydrate. Using United States Food and Drug Administration guidance, bioequivalence was determined by whether the 90% confidence interval (CI) of the ratio of the geometric means of the effects of DNJ compared with MFE was between 0.80 and 1.25.

The ratio of the effect of DNJ relative to MFE was 0.903 (90% CI: 0.801, 1.019), meeting the prespecified criterion for bioequivalence. Although both MFE and DNJ produced absolute reductions in mean PPG and PPI relative to the control, these effects were more robust for MFE than DNJ. Mean plasma DNJ levels were also higher following MFE than DNJ.

This study confirms the bioequivalence of DNJ and MFE for reducing PPG responses in humans. However, although DNJ is largely responsible for this effect, other components of MFE, particularly 2-O-alpha-D-galactopyranosyl-deoxynojirimycin as a precursor of DNJ, may contribute to its observed efficacy for reducing PPG and PPI.

This trial was prospectively registered at clinicaltrials.gov as NCT02599740 (https://clinicaltrials.gov/study/NCT02599740).

Individuals with liver insulin-resistant (LIR) or muscle insulin-resistant (MIR) phenotypes may respond differently to dietary interventions. Given the interaction between insulin resistance and cardiovascular risk, this sub-analysis of the PERSON study examined whether a personalized diet according to MIR or LIR phenotypes improves vascular function and cardiovascular disease risk factors.

We randomized 119 participants to a 12-week low-fat, high-protein, high-fibre diet (LFHP; may be optimal for LIR) or Mediterranean diet (high in monounsaturated fat, HMUFA; may be optimal for MIR). Randomization linked the insulin-resistant (IR) phenotype to the proposed optimal diet, leading to PhenoDiet A (MIR-HMUFA and LIR-LFHP) and PhenoDiet B (MIR-LFHP and LIR-HMUFA). Before and after the intervention, vascular function (carotid artery reactivity) and cardiovascular risk factors (blood pressure, total cholesterol, HDL-cholesterol and Framingham risk score) were examined. A 7-point oral glucose tolerance test was performed to determine insulin resistance (Matsuda index and HOMA-IR) and disposition index.

Following drop-out (n = 18), 101 participants finished the intervention (54 women, 61 ± 7 years, 27.6 [26.4;30.0] kg/m2), with n = 80 available for the primary outcome of vascular function. Overall, the dietary interventions significantly decreased blood pressure, total cholesterol, HDL-cholesterol and the Framingham risk score (all p < 0.05), while vascular function was not affected (p = 0.485). Insulin resistance (p ≤ 0.001), but not disposition index (p = 0.362), was significantly improved after intervention. The Matsuda index (p = 0.078) tended to increase more and total cholesterol (p = 0.052) tended to decrease more in PhenoDiet group B than A, but other changes in outcome parameters were not significantly different between PhenoDiet groups. The LFHP diet resulted in more pronounced improvements in cholesterol, diastolic blood pressure (DBP) and insulin resistance compared with the HMUFA diet (all p < 0.05).

A 12-week diet improves metabolic and cardiovascular outcomes, but not vascular function in insulin-resistant adults with overweight or obesity. Whilst the LFHP diet resulted in greater improvements in cardiometabolic risk markers than the HMUFA diet, we found no significant differences between the PhenoDiet groups.

Curcumin, recognized for its antioxidant and anti-inflammatory properties, is a promising dietary supplement for liver protection. However, its role in preventing obesity-induced hepatic steatosis is not fully understood. This study aims to show that curcumin mitigates hepatic steatosis and promotes browning and thermogenesis in white adipose tissue (WAT) under obesity. Male C57BL/6 mice were assigned to four groups: standard diet (STD), STD supplemented with 100 mg/kg curcumin, high-fat diet (HFD), or HFD supplemented with 100 mg/kg curcumin, administered for 4 weeks. Compared to STD mice, HFD-fed mice exhibited significantly greater body weight, epididymal fat mass, liver weight, postprandial blood glucose (PBG), insulin, and plasma/hepatic alanine aminotransferase (ALT) and triglyceride (TG) levels, alongside an inflammatory response and macrophage infiltration. Additionally, HFD-fed mice showed reduced adiponectin, adiponectin receptor-1, and PI3K/AKT phosphorylation in liver tissue. Except for liver weight, these effects were reversed in curcumin-treated HFD mice. Curcumin inhibited adipocyte hypertrophy and elevated the expression of PGC-1α, PPARγ, and UCP-1 proteins, as well as Zic1, Prdm16, Tnfrsf9, and Tmem26 genes in epididymal fat pads (EFPs). It also significantly altered gut microbiota composition, reducing pro-inflammatory bacteria such as Helicobacter, Oscillospira, Parabacteroides, and Alistipes, thereby alleviating intestinal dysbiosis and improving obesity-related metabolic parameters. In conclusion, curcumin's protective effects against hepatic steatosis and adiposity in HFD-fed mice stem from its ability to upregulate adiponectin, enhance insulin signaling, promote WAT browning, increase thermogenesis, and modulate intestinal dysbiosis.

Adolescent girls often skip breakfast due to time constraints and reduced morning appetite. This study examined the acute impact of breakfast consumption timing v. breakfast omission (BO) on glycaemic and insulinaemic responses to lunch in infrequent breakfast-consuming girls. Fifteen girls (13·1 (sd 0·8) years) completed three conditions in a randomised crossover design: early-morning breakfast consumption (EM-BC; 08.30), mid-morning breakfast consumption (MM-BC; 10.30) and BO. A standardised lunch was provided at 12.30, followed by a 2-h post-lunch observation period. Blood and expired gas samples were collected periodically. Linear mixed models with Cohen's d effect sizes compared outcomes between conditions. Pre-lunch glucose and insulin incremental AUC (iAUC) were higher in the breakfast conditions v. BO (P ≤ 0·009), with no differences between breakfast conditions. MM-BC reduced post-lunch glucose iAUC by 36 % and 25 % compared with BO and EM-BC, respectively (P < 0·001, d = 0·92-1·44). A moderate, non-significant 15 % reduction in post-lunch glucose iAUC was seen with EM-BC v. BO (P = 0·077, d = 0·52). These reductions occurred without changes in post-lunch insulinemia (P ≥ 0·323) and were accompanied by increased post-lunch carbohydrate oxidation compared with BO (P ≤ 0·018, d = 0·58-0·75); with no differences between EM-BC and MM-BC. MM-BC lowered glycaemic response over the experimental period compared with BO (P = 0·033, d = 0·98) and EM-BC (P = 0·123, d = 0·93), with no difference between EM-BC and BO. Compared with BO, both breakfast conditions lowered post-lunch glycaemic responses with mid-morning breakfast eliciting a greater second-meal effect than early-morning breakfast. These findings indicate the breakfast-to-lunch meal interval may be a crucial factor affecting postprandial glycaemia in infrequent breakfast-consuming girls.

A core challenge in managing diabetes is predicting glycemic responses to meals. Prior work identified significant interindividual variation in responses and developed personalized forecasts. However, intraindividual variation is still not well understood, and the most accurate approaches require invasive microbiome data. We aimed to investigate (1) whether postprandial glycemic responses (PPGRs) can be predicted with limited data and (2) sources of intraindividual variation.

We used data collected from 397 people with Type 1 Diabetes (T1DEXI) and 100 people with Type 2 Diabetes (ShanghaiT2DM) who wore continuous glucose monitors (CGMs) and logged meals. Using dietary, demographic, and temporal features, we predicted 2 hours PPGR, and peak 2 hours postprandial glucose rise (Glumax). We evaluated the contribution of food features (eg, macronutrients, food category) and use of personal training data and investigated intraindividual variability in responses.

We achieved comparable accuracy to prior work for PPGR (T1DEXI R = 0.61, ShanghaiT2DM R = 0.72) and Glumax (T1DEXI R = 0.64, ShanghaiT2DM R = 0.73), without using invasive data like microbiome. Including food category features led to higher accuracy than macronutrients alone. Analysis of glycemic responses to duplicate meals identified time of day (PPGR: T1DEXI P < .05 for lunch, ShanghaiT2DM P < .001 for lunch and dinner) and menstrual cycle (Glumax: P < .05 for perimenstrual) as sources of variability.

We demonstrate that in individuals with T1D and T2D, glycemic responses to meals can be predicted without personalized training data or invasive physiological data.

This randomized clinical trial was conducted to investigate the effects of personalized nutrition counseling according to blood glucose response and dietary intake, which can be measured using a flash continuous glucose monitoring (CGM) device, on weight changes and eating habits in obese adults. The participants of this study comprised obese adults over 30 years of age, which were randomly assigned to either the (1) personalized nutrition group (PN) or (2) control group (CON) with a study period of up to 12 weeks. Body weight, body mass index, body fat mass, body fat percentage, and waist-to-hip ratio significantly decreased in the PN group when compared with the CON group (P < 0.05; P < 0.01). Based on the findings of the flash CGM, the PN group showed a significant decrease in both blood glucose levels, hemoglobin A1c (HbA1c), and time above range (P < 0.05). The levels of blood HbA1c and insulin were significantly decreased in both groups, but the PN group showed a greater decrease (HbA1c, P = 0.000; insulin, P = 0.000) than the CON group did (HbA1c, P = 0.001; insulin, P = 0.001). The blood triglyceride levels were significantly lowered only in the PN group (P = 0.026). It was confirmed that personalized nutrition counseling using a flash CGM device was effective in reducing body weight, abdominal fat, and blood HbA1c, insulin, and triglyceride levels and improving meal quantity and eating habits in obese adults.

To evaluate the effects of a novel grain variety 3 G rice compared to traditional white rice on postprandial glycemia, insulinemia, and gastrointestinal hormones in individuals with obesity and type 2 diabetes (T2D).

A non-randomized experimental study was conducted with 20 participants with obesity (without diabetes) and 20 patients with T2D. Each participant consumed meals containing 50 g of carbohydrates from either 3 G rice or white rice. Plasma glucose, insulin, and gastrointestinal hormone levels were measured at baseline and intervals up to 120 min post-consumption.

Among participants with obesity, plasma glucose levels were significantly lower at 90 and 120 after 3 G compared to white rice (0.52 ± 0.04 vs. 2.58 ± 0.37 mmol/L, p < 0.001 at 90 min and 0.06 ± 0.02 vs. 1.47 ± 0.26 mmol/L, p = 0.003 at 120 min). In contrast, plasma insulin levels were markedly higher following 3 G rice consumption at 90-120 min (p = 0.003). Gastrointestinal hormones were significantly elevated after 3 G rice intake compared to white rice, with GLP-1 levels showing sustained increases from 60 to 120 min (p = 0.019). In T2D patients, 3 G rice consumption led to a modest reduction in plasma glucose at 120 min (5.15 ± 0.49 mmol/L for white rice vs. 3.57 ± 0.35 mmol/L for 3 G rice, p = 0.0262) without significant effect on other parameters.

3 G rice significantly improved postprandial glycemic control and enhanced gastrointestinal hormone responses in individuals with obesity. These findings highlight the promise of 3 G rice as a dietary intervention for managing postprandial glycemia and insulin sensitivity.

Insulin responses to standardized meals differ between individuals. This variability may in part be explained by genotype. This systematic review evaluates associations between genotype and insulin response to an oral glucose tolerance test (OGTT) in terms of insulin area under the curve (AUC).

Three electronic databases (Web of Science, Embase, PubMed) were searched for studies investigating associations between insulin AUC after an OGTT and single nucleotide polymorphisms (SNPs) belonging to the transcription factor 7 like 2 (TCF7L2) gene, the peroxisome proliferator-activated receptor gamma (PPARγ) gene, or the potassium inwardly rectifying channel subfamily J member 11 (KCNJ11) gene in persons without diabetes. A total of 5199 articles were identified, of which 38 were included. Among them were family-based studies (9), twin studies (2), and studies with unrelated participants (27). Seventeen articles investigated TCF7L2 (7 SNPs), 14 investigated PPARγ (1 SNP), and 8 investigated KCNJ11 (5 SNPs). For all investigated SNPs, at least half of the reports indicated no statistically significant association with postprandial insulin AUC.

No evidence was found for associations between TCF7L2, PPARγ, and KCNJ11 genotypes and insulin AUC after an OGTT. Future studies should investigate the effect of genetic risk scores on postprandial insulin.

Cellulose and its derivatives have been utilized as additives and functional fibers in food industries. The solubility has been traditionally used to categorize cellulose derivatives, whilst their complex effects within food matrix are less understood. In this study, insoluble forms i.e., cellulose and ethyl cellulose (EC), and soluble forms i.e., methylcellulose (MC) and sodium carboxymethylcellulose (Na-CMC) were selected to investigate the mechanisms by which the two groups of cellulose ingredients regulate in vitro digestibility of starch-based foods. In the Michaelis-Menton analysis, the addition of insoluble cellulose or EC as inhibitors tended to decrease the Vmax of α-amylase at a non-significant level compared to the value without inhibitors (p > 0.05). Starch-based matrix with insoluble cellulose or EC became less porous, but did not consistently resulting in an increased level of resistant starch content. Soluble MC and Na-CMC as inhibitors not only significantly reduced the Vmax (decreased from 1.0 to 0.8 and 0.9 mg/min, respectively) and kcat/Km (catalytic efficiency, decreased from 30.9 to 22.2 and 23.3, respectively) of α-amylase (p < 0.05), but the formed matrices had higher level of short-range ordering (R1047/1022). The soluble forms of cellulose derivatives resulted in higher level of resistant starch (up to 6 %), compared to insoluble cellulose. In summary, this study provides new insights into the complexity in the effects of cellulose derivatives on the digestion of food matrix, and suggests that solubility is a limited indicator of their function on retarding starch digestion. The structural changes in starch-based food matrix induced by cellulose derivatives should be considered in the development of functional foods with low glycemic index.

Precise and timely forecasting of blood glucose levels is essential for effective diabetes management. While extensive research has been conducted on Type 1 diabetes mellitus, Type 2 diabetes mellitus (T2DM) presents unique challenges due to its heterogeneity, underscoring the need for specialized blood glucose forecasting systems. This study introduces a novel blood glucose forecasting system, applied to a dataset of 100 patients from the ShanghaiT2DM study. Our study uniquely integrates knowledge-driven and data-driven approaches, leveraging expert knowledge to validate and interpret the relationships among diabetes-related variables and deploying the data-driven approach to provide accurate forecast blood glucose levels. The Bayesian network approach facilitates the analysis of dependencies among various diabetes-related variables, thus enabling the inference of continuous glucose monitoring (CGM) trajectories in similar individuals with T2DM. By incorporating past CGM data including inference CGM trajectories, dietary records, and individual-specific information, the Bayesian structural time series (BSTS) model effectively forecasts glucose levels across time intervals ranging from 15 to 60 minutes. Forecast results show a mean absolute error of mg/dL, a root mean square error of mg/dL, and a mean absolute percentage error of , for a 15-minute prediction horizon. This study makes the first application of the ShanghaiT2DM dataset for glucose level forecasting, considering the influences of diabetes-related variables. Its findings establish a foundational framework for developing personalized diabetes management strategies, potentially enhancing diabetes care through more accurate and timely interventions.

The average fibre consumption of 4-10-year-old children in the UK is 14.6 g per day, with only 14% of these children reaching the 20 g recommended by the SACN (UK Scientific Advisory Committee on Nutrition), and this 'fibre gap' may be most pronounced in communities with the lowest socioeconomic status. School breakfast clubs target children from disadvantaged communities, but their provision may favour lower-fibre foods, due to perceptions that children will reject higher-fibre foods. Our research programme aims to increase the fibre density, digestive-metabolic quality and acceptability of school breakfast provision.

In Study 1, we examined the in vitro digestion of four novel bread products, to determine the relationship between fibre content and glucose release profile, and assess their suitability for sustaining school activity. In Study 2, we introduced the Prograins breads, alongside higher-fibre breakfast cereals and fresh fruit, to primary school breakfast clubs.

The Prograins bread products yielded lower peaks and more sustained glucose release curves than the 'standard' white bread control. Many children liked and chose the intervention foods, and the average fibre content of children's breakfasts increased.

We conclude from this study that nutritious, fibre-rich bread products can be acceptable to children and that higher-fibre breakfast provision is feasible, and we recommend larger-scale intervention and assessment to validate these real-world findings.

Height-adjustable workstations offer a practical strategy to reduce sedentary behaviour in student populations, but the effect of standing intervals on young adults' metabolic health remains uncertain. This study investigated the acute impact of breaking up sitting time with intermittent standing on postprandial metabolic responses in university students. Using a randomised, cross-over design, 23 participants (13 females, 10 males; age, 24 ± 5 years; BMI, 23.2 ± 3.1 kg/m2) completed two trials: 2 hours of uninterrupted sitting (SIT); and 2 hours alternating between sitting and standing every 30 minutes (STAND). During this period, participants underwent an oral glucose tolerance test, with [glucose] and [insulin] measured. Ad libitum food intake post intervention was also measured. No significant effects between trials nor trial × time interaction was found for [glucose] or [insulin] (all p > 0.05). The postprandial iAUC did not differ for [glucose] (p = 0.824; SIT: 222 ± 83 mmol/L; STAND: 225 ± 90 mmol/L) or [insulin] (p = 0.269; SIT: 17507 ± 9738 pmol/L; STAND: 15649 ± 10181 pmol/L). There were no differences in energy or macronutrient intake between trials. These findings indicate that interrupting sitting with 30-minute standing intervals does not improve postprandial metabolic responses in young, normal-weight adults.

Starch is the main source of dietary energy for humans. In order to understand the mechanisms governing native starch in vitro digestion, digestion data for six starches [wheat, maize, (waxy) maize, rice, potato and pea] of different botanical sources were fitted with the most common first-order kinetic models, i.e. the single, sequential, parallel and combined models. Parallel and combined models provided the most accurate fits and showed that all starches studied except potato starch followed a biphasic in vitro digestion pattern. The biological relevance of the kinetic parameters was explored by determining changes in crystallinity and molecular structure of the undigested starch residues during in vitro digestion. While the crystallinity of the undigested potato starch residues did not change substantially, a respectively small and large decrease in their amylose content and chain length during in vitro digestion was observed, indicating that amylose was digested slightly preferentially over amylopectin in native starch. However, the molecular structure of the starch residues changed too slowly and/or only to an insufficient extent to relate it to the kinetic parameters of the digested fractions predicted by the models. Such parameters thus need to be interpreted with caution, as their biological relevance still needs to be proven.

In recent years, there has been a lot of discussion over the impact of ultra-processed foods (UPFs) intake on overall health of subjects. However, the association between UPFs intake and metabolic unhealthy (MU) status is still in a state of ambiguity. The current study assessed the relationship between UPFs intake and MU status with regard to brain-derived neurotrophic factor (BDNF) and adropin levels.

A sample of Iranian adults (aged 20-65 years) was selected to participate in this cross-sectional study using a multistage cluster random-sampling method. UPFs intake was assessed by a validated food frequency questionnaire and NOVA classification. Concentrations of metabolic parameters, BDNF and adropin were determined through fasting blood samples. MU status was assessed according to the criteria proposed by Wildman.

The overall prevalence of MU phenotype among study participants (n = 527) was 42.5%. Higher intake of UPFs was associated with elevated odds of MU status in multivariable-adjusted model (ORT3 vs. T1=1.88; 95%CI: 1.02-3.45). Moreover, a positive association was observed between UPFs intake and hypertriglyceridemia after controlling all confounders (ORT3 vs. T1=2.07; 95%CI: 1.15-3.73). However, each tertile increase in UPFs intake was not significantly associated with serum BDNF ([Formula: see text]=0.15; 95%CI: -0.05, 0.34; P = 0.14) and adropin ([Formula: see text]=-1.37; 95%CI: -6.16, 3.42; P = 0.58) levels in multivariable-adjusted linear regression models.

Our findings suggested that higher consumption of UPFs was related to increased likelihood of MU status among a sample of Iranian adults. Further longitudinal studies are needed to verify the directionality and generalizability of the results to all adult populations.

Mycoprotein is a high-fibre food previously shown to reduce postprandial glucose concentrations when ingested within a mixed-meal. We applied a dual stable isotope tracer approach to determine whether this is due to a reduced rate of appearance of glucose, in participants of ranging BMI.

Twenty-four adults (F = 8, BMI 30 ± 6 kg·m-2) attended 2 trials in a double-blind, randomised, cross-over design. Participants ingested two energy and macronutrient matched milk-based drinks (enriched with 1000 mg [U-13C6] glucose in a subset of 12 participants), containing 50 g glucose and either 0 (CON) or 20 g (MYC) mycoprotein. A primed continuous intravenous infusion of D-[6,6-2H2] glucose determined plasma glucose kinetics over 6 h. Postprandial time-course, and AUC, of glucose and insulin concentration, rate of disappearance (RdT) and appearance of exogenous (RaEx), endogenous (EGP), and total (RaT) plasma glucose were assessed using two- and one-way ANOVA.

Drink ingestion increased blood glucose and serum insulin concentrations (P < 0.05) and were comparable between conditions (P > 0.05). Both RaT and RdT were higher with MYC compared with CON over 6 h (mean 6 h glucose appearance and disappearance increased by 5 and 9%, respectively, P < 0.05). RaEx was not affected by MYC ingestion over 6 h (P > 0.05). The mean contribution of EGP to total glucose appearance was 15% greater with MYC, with a trend towards significance (P = 0.05). There was no relationship between BMI and the response to MYC ingestion for any of the variables (P < 0.05).

The ingestion of mycoprotein within a mixed-meal impacted postprandial glucose kinetics, but not blood glucose or serum insulin concentrations, in individuals of ranging BMI.

This trial was registered at clinicaltrials.gov as NCT04084639 and can be accessed at https://clinicaltrials.gov/ct2/show/NCT04084639 .

Continuous glucose monitors (CGMs) have expanded their scope beyond indicated uses for diabetes management and are gaining traction among people not living with diabetes (PNLD). CGMs track in time glucose levels and are proposed as tools for the early detection of abnormal glucose and a potential solution for its normalisation through behavioural change, particularly, diet personalisation and motivation of physical activity. This becomes relevance given the growing incidence of metabolic conditions, such as type 2 diabetes mellitus (T2DM). Clinical guidelines, however, do not recommend CGMs in contexts outside type 1 diabetes (T1DM) or insulin-treated T2DM. Therefore, there is a visible disconnect between the indicated and real-world usage of these medical devices. While the commercial market for CGMs in PNLD is expanding rapidly, a comprehensive and evidence-based evaluation of the devices' utility in this population has not been done. Therefore, this review aims to formulate a working model for CGM utility in PNLD as proposed by the 'health and wellness' market that advertises and distributes it to these individuals.

We aim to critically analyse the available research addressing components of the working model, that is (1) detection of abnormal glucose; (2) behavioural change, and (3) metabolic health improvement.

We find a lack of consistent and high-quality evidence to support the utility of CGMs for these purposes. We identify significantly under-reserved areas including clinical benchmarks and scoring procedures for CGM measures, device acceptability, and potential adverse effects of CGMs on eating habits in PNLD. We also raise concerns about the robustness of available CGM research.

In the face of these research gaps, we urge for the commercial claims suggesting the utility of the device in PNLD to be labelled as misleading. We argue that there is a regulatory inadequacy that fuels 'off-label' CGM distribution and calls for the strengthening of post-market clinical follow-up oversight for CGMs. We hope this will help to avert the continued misinformation risk to PNLD and 'off-label' exacerbation of health disparities.

This review paper explores post-prandial glycemia in type 2 diabetes. Post-prandial glycemia is defined as the period of blood glucose excursion from immediately after the ingestion of food or drink to 4 to 6 hours after the end of the meal. Post-prandial hyperglycemia is an independent risk factor for cardiovascular disease with glucose "excursions" being more strongly associated with markers of oxidative stress than the fasting or pre-prandial glucose level. High blood glucose is a major promoter of enhanced free radical production and is associated with the onset and progression of type 2 diabetes. Oxidative stress impairs insulin action creating a vicious cycle where repeated post-prandial glucose spikes are key drivers in the pathogenesis of the vascular complications of type 2 diabetes, both microvascular and macrovascular. Some authors suggest post-prandial hyperglycemia is the major cause of death in type 2 diabetes. Proper management of post-prandial hyperglycemia could yield up to a 35% cut in overall cardiovascular events, and a 64% cut in myocardial infarction. The benefits of managing post-prandial hyperglycemia are similar in magnitude to those seen in type 2 diabetes patients receiving secondary prevention with statins - prevention which today is regarded as fundamental by all practitioners. Given all the evidence surrounding the impact of post-prandial glycemia on overall outcome, it is imperative that any considered strategy for the management of type 2 diabetes should include optimum dietary, pharma, and lifestyle interventions that address glucose excursion. Achieving a low post-prandial glucose response is key to prevention and progression of type 2 diabetes and cardiometabolic diseases. Further, such therapeutic interventions should be sustainable and must benefit patients in the short and long term with the minimum of intrusion and side effects. This paper reviews the current literature around dietary manipulation of post-prandial hyperglycemia, including novel approaches. A great deal of further work is required to optimize and standardize the dietary management of post-prandial glycemia in type 2 diabetes, including consideration of novel approaches that show great promise.

The relationship between carbohydrate quality intake and metabolic syndrome (MetS) is of growing interest.

We aimed to assess the association between the adherence to a dietary carbohydrate quality index (CQI) with the occurrence of MetS in a Spanish cohort of working adults.

A cross-sectional study was conducted of 2316 middle-aged men, aged 50.9 (SD 3.9) years, with no previous cardiovascular disease, and pertaining to the Aragon Workers' Health Study (AWHS) cohort. Diet was collected with a 136-item semiquantitative food-frequency questionnaire. The CQI (range 4-15) was based on: dietary fiber intake, a low glycemic index, the ratio of whole grains/total grains, and the ratio of solid carbohydrates/total carbohydrates. The higher the CQI, the healthier the diet. MetS was defined by using the harmonized National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) definition. The associations across 3-point categories of the CQI and the presence of MetS were examined using logistic regression.

An inverse and significant association between the CQI and MetS was found. Fully adjusted odds ratios (ORs) for MetS risk among participants in the 10- to 12-point category (second highest CQI category) was 0.64 (95% CI, 0.45-0.94), and in the 13- to 15-point category (highest category) was 0.52 (95% CI, 0.30-0.88), when compared with the 4- to 6-point category (lowest category). Participants with 10 to 12 and 13 to 15 points on the CQI showed a lower risk of hypertriglyceridemia: OR 0.61 (95% CI, 0.46-0.81), and 0.48 (95% CI, 0.32-0.71) respectively.

Among middle-aged men, a higher adherence to a high-quality carbohydrate diet is associated with a lower prevalence of MetS. Triglyceridemia is the MetS component that contributed the most to this reduced risk.

To determine if performing regular 3-min bouts of resistance exercise spread over 4 hours in an evening will impact subsequent sleep quantity and quality, sedentary time and physical activity compared with prolonged uninterrupted sitting.

In this randomised crossover trial, participants each completed two 4-hour interventions commencing at approximately 17:00 hours: (1) prolonged sitting and (2) sitting interrupted with 3 min of bodyweight resistance exercise activity breaks every 30 min. On completion, participants returned to a free-living setting. This paper reports secondary outcomes relating to sleep quality and quantity, physical activity and sedentary time which were assessed using wrist-worn ActiGraph GT3+ accelerometers paired with a sleep and wear time diary.

A total of 28 participants (women, n=20), age 25.6±5.6 years, body mass index 29.5±6.7 kg/m2 (mean±SD) provided data for this analysis. Compared with prolonged sitting, regular activity breaks increased mean sleep period time and time spent asleep by 29.3 min (95% CI: 1.3 to 57.2, p=0.040) and 27.7 min (95% CI: 2.3 to 52.4, p=0.033), respectively, on the night of the intervention. There was no significant effect on mean sleep efficiency (mean: 0.2%, 95% CI: -2.0 to 2.4, p=0.857), wake after sleep onset (1.0 min, 95% CI: -9.6 to 11.7, p=0.849) and number of awakenings (0.8, 95% CI: -1.8 to 3.3, p=0.550). Subsequent 24-hour and 48-hour physical activity patterns were not significantly different.

Performing bodyweight resistance exercise activity breaks in the evening has the potential to improve sleep period and total sleep time and does not disrupt other aspects of sleep quality or subsequent 24-hour physical activity. Future research should explore the longer-term impact of evening activity breaks on sleep.

Australian New Zealand Clinical Trials Registry (ACTRN12621000250831).

Plant extracts are increasingly recognized for their potential in modulating (postprandial) blood glucose levels. In this context, root extracts are of particular interest due to their high concentrations and often unique spectrum of plant bioactives. To identify new plant species with potential glucose-lowering activity, simple and robust methodologies are often required. For this narrative review, literature was sourced from scientific databases (primarily PubMed) in the period from June 2022 to January 2024. The regulatory targets of glucose homeostasis that could be modulated by bioactive plant compounds were used as search terms, either alone or in combination with the keyword "root extract". As a result, we present a comprehensive methodological toolbox for studying the glucose homeostasis modulating properties of plant extracts and its constituents. The described assays encompass in-vitro investigations involving enzyme inhibition (α-amylase, α-glucosidase, dipeptidyl peptidase 4), assessment of sodium-dependent glucose transporter 1 activity, and evaluation of glucose transporter 4 translocation. Furthermore, we describe a patch-clamp technique to assess the impact of extracts on KATP channels. While validating in-vitro findings in living organisms is imperative, we introduce two screenable in-vivo models (the hen's egg test and Drosophila melanogaster). Given that evaluation of the bioactivity of plant extracts in rodents and humans represents the current gold standard, we include approaches addressing this aspect. In summary, this review offers a systematic guide for screening plant extracts regarding their influence on key regulatory elements of glucose homeostasis, culminating in the assessment of their potential efficacy in-vivo. Moreover, application of the presented toolbox might contribute to further close the knowledge gap on the precise mechanisms of action of plant-derived compounds.

The increase in ultra-processed foods (UPFs) intake has raised concerns about its impact on public health. Prospective observational studies have reported significant associations between higher intake of UPFs and adverse health outcomes. The aim of this study is to determine whether these associations could be confirmed in randomized controlled trials (RCTs).

We conducted a systematic review to analyze the evidence on the effects of UPFs intake on health. A systematic search was conducted in Medline, Embase, Web of Science, Scopus, LILACS, and CENTRAL up to April 22, 2024. RCTs in English, Spanish, and Portuguese evaluating the health effects of interventions to modify UPFs intake were included. The certainty of evidence was determined using the GRADE methodology.

Three educational intervention studies and one controlled feeding trial were included, evaluating the effect of reducing the consumption of UPFs (455 participants, median follow-up, 12 weeks). No significant effects were observed in 30 out of the 42 outcomes evaluated. The controlled feeding trial in adults with stable weight showed a reduction in energy intake, carbohydrates, and fat (low certainty of evidence), as well as in body weight, total cholesterol, and HDL cholesterol (moderate certainty of evidence). In the educational intervention studies, a reduction in body weight and waist circumference was observed (low certainty of evidence) in women with obesity, as well as improvement in some dimensions of quality of life (very low certainty of evidence). No significant changes were observed in children and adolescents with obesity, while in overweight pregnant women, the consumption of UPFs was not reduced, so the observed benefits could be attributed to other components of the intervention.

Interventions aimed at reducing the consumption of UPFs showed benefits on some anthropometric and dietary intake outcomes, although significant effects were not observed for most of the evaluated outcomes. The limited number and significant methodological limitations of the studies prevent definitive conclusions. Further well-designed and conducted RCTs are needed to understand the effects of UPF consumption on health.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023469984.

The postprandial glucose response is an independent risk factor for type 2 diabetes. Observationally, early glucose response after an oral glucose challenge has been linked to intestinal glucose absorption, largely influenced by the expression of sodium-glucose cotransporter 1 (SGLT1). This study uses Mendelian randomization (MR) to estimate the causal effect of intestinal SGLT1 expression on early glucose response. Involving 1,547 subjects with class II/III obesity from the Atlas Biologique de l'Obésité Sévère cohort, the study uses SGLT1 genotyping, oral glucose tolerance tests, and jejunal biopsies to measure SGLT1 expression. A loss-of-function SGLT1 haplotype serves as the instrumental variable, with intestinal SGLT1 expression as the exposure and the change in 30-min postload glycemia from fasting glycemia (Δ30 glucose) as the outcome. Results show that 12.8% of the 1,342 genotyped patients carried the SGLT1 loss-of-function haplotype, associated with a mean Δ30 glucose reduction of -0.41 mmol/L and a significant decrease in intestinal SGLT1 expression. The observational study links a 1-SD decrease in SGLT1 expression to a Δ30 glucose reduction of -0.097 mmol/L. MR analysis parallels these findings, associating a statistically significant reduction in genetically instrumented intestinal SGLT1 expression with a Δ30 glucose decrease of -0.353. In conclusion, the MR analysis provides genetic evidence that reducing intestinal SGLT1 expression causally lowers early postload glucose response. This finding has a potential translational impact on managing early glucose response to prevent or treat type 2 diabetes.

This study investigated the interaction mechanism between corn starch (CS) and lingonberry polyphenols (LBP) during starch gelatinization, focusing on their effects on starch structure and physicochemical properties. Moreover, it explored the effect of this interaction on starch digestion and glucose transport. The results indicated that LBP interacted non-covalently with CS during starch gelatinization, disrupted the short-range ordered structure of starch, decreased gelatinization enthalpy of starch, and formed a dense network structure. Furthermore, the incorporation of LBP remarkably reduced the digestibility of CS. In particular, the addition of 10 % LBP decreased the terminal digestibility (C∞) from 77.87 % to 60.43 % and increased the amount of resistant starch (RS) by 21.63 %. LBP was found to inhibit α-amylase and α-glucosidase in a mixed manner. Additionally, LBP inhibited glucose transport in Caco-2 cells following starch digestion. When 10 % LBP was added, there was a 34.17 % decrease in glucose transport compared with starch digestion without LBP. This study helps establish the foundation for the development of LBP-containing starch or starch-based healthy foods and provides new insights into the mechanism by which LBP lowers blood glucose.

The aim of this study was to investigate the gastrointestinal tolerability, glycemic and insulinemic responses of Plant Fiber Extract (PFE), a mixture comprising of oligosaccharides and polysaccharides derived from cellulose and xylan.

Two double-blind, randomized, controlled, cross-over trials were conducted in healthy adults. In the first trial, participants (n = 29) consumed either 25, 35 or 45 g per day of PFE or resistant maltodextrin (Control) for 14 days. The occurrence and severity of gastrointestinal (GI) symptoms, stool parameters, and safety outcomes were evaluated with a combination of surveys and blood analysis respectively. In the second trial (n = 20), the post-prandial glycemic and insulinemic responses after the ingestion of 20 g of PFE diluted in water or incorporated into chocolate chips was measured and then compared to that of glucose and regular chocolate, respectively.

For all timepoints (0, 7 and 14 days), within any given dose group, there was no statistically significant difference in the GI symptoms score between PFE and Control. Further, for each test product (PFE or Control), no difference was observed in the same dose group from days 0 and 14. Stool consistency score and number of participants experiencing loose or watery stools was similar between products. No serious adverse events were reported and neither PFE nor Control significantly altered blood or urine safety parameters. The glycemic and insulinemic responses after PFE ingestion in comparison to glucose were 12% and 8% respectively. The glycemic and insulinemic responses after consuming chocolate containing PFE were 20% of that of regular chocolate.

PFE was well-tolerated by healthy volunteers in doses up to 45 g/day and it elicited comparatively low glycemic and insulinemic responses when consumed alone or when incorporated into a food product.

The challenges in the characterization of the nutritional quality of grain foods comprise obstacles to public health actions toward promotion of healthier grain-based foods. The present study investigated how carbohydrate metrics related to glycemic index (GI), glycemic load (GL), and warning labels of grain foods consumed by individuals living in São Paulo, Brazil. Information on intake of grain foods at individual level was obtained using 24 h recalls within a cross-sectional population-based survey conducted in 2015. There were 244 unique grain products reported by individuals in the survey, assessed through four metrics of carbohydrate quality, considering contents per 10 g of total carbohydrate: (1) ≥1 g fiber, (2) ≥1 g fiber and <1 g free sugars, (3) ≥1 g fiber and <2 g free sugars, and (4) ≥1 g fiber, and <2 g free sugars per 1 g of fiber. Outcomes included GI, GL, and inclusion of warning labels proposed by the Brazilian National Health Surveillance Agency (ANVISA), the Chilean Ministry of Health (1st and 3rd stages), and the Pan American Health Organization (PAHO). Metrics identified products with lower mean GI (-12.8 to -9.0 [p-values < 0.001]), and GL (-12.5 to -10.3 [p-values < 0.001]). Warning systems showed a certain degree of discrimination between products according to the metrics (p-value < 0.01 each); however, >50% of products with good nutritional quality according to the carbohydrate metrics still would receive warnings. Findings suggest that carbohydrate metrics identified products with lower GI and GL, and current warning labels may not adequately capture overall nutritional quality of grain foods.

The aim of this study was to examine the relationship of ultra-processed food (UPF) intake with the incidence of glaucoma in a large sample of Spanish university graduates followed prospectively.

Prospective cohort study using data from the SUN Project. A final sample of 19,225 participants (60.1% women) was included in this study, with a mean age of 38.2 years (standard deviation (SD) = 12.4). Participants were followed-up for a mean time of 12.9 years (SD = 5.4). Dietary intake was measured using a 136-item semiquantitative food-frequency questionnaire. UPFs were defined based on the NOVA classification system. Glaucoma diagnosis was determined by asking the participants if they had ever been diagnosed with glaucoma by an ophthalmologist. This self-reported diagnosis of glaucoma has been previously validated.

After adjusting for several covariates, participants with the highest UPF consumption were at higher risk of glaucoma (hazard ratio (HR) = 1.83; 95% confidence interval (CI) 1.06 to 3.17) when compared to participants in the lowest category of UPF consumption. Regarding subgroup analyses, a significant multiplicative interaction was found for age (p = 0.004) and omega 3:6 ratio (p = 0.040). However, an association between UPF consumption and glaucoma was only found in older participants (aged ≥ 55 years), in men, in the most physically active group, in the group of non- or former smokers, in those with a lower omega 3:6 ratio, and in those with a lower energy intake. Regarding the contribution of each type of UPF group, UPF coming from sweets showed a significant risky effect (HR = 1.51; CI 95% 1.07 to 2.12).

This prospective cohort study shows that participants with a greater UPF consumption have a higher risk of developing glaucoma when compared to participants with a lower consumption. Our findings emphasize the relevance of monitoring and limiting the consumption of UPFs as a means of preventing glaucoma incidence.

Culinary herbs and spices are primarily known as flavor enhancers, research suggests that black pepper (Piper nigrum) and turmeric (Curcuma longa) have now been proven to prevent many non-communicable chronic diseases such as diabetes. Bioactive components of black pepper and turmeric ameliorate glucose metabolism and appetite regulation. The present research was designed to investigate the impact of turmeric and black pepper on blood glycemia, gastrointestinal well-being, appetite, and palatability. In a randomized crossover study, four iso-caloric experimental meals each having 50 g of available carbohydrates were subjected to healthy human participants (N = 20). Turmeric and black pepper were incorporated in the breakfast meal, 1 g black pepper (BP), 1 g turmeric (TR), and combination of the (BP + TR) was added in the breakfast. Standard questionnaires were used to evaluate palatability, subjective appetite, and gastrointestinal well-being. Blood glycemia, subjective gastrointestinal well-being, and appetite were measured at 0, 30, 60, 120, and 180 min. Experimental meals BP and BP + TR resulted in lower blood glycemia (p < .05) significantly compared to control meal. A decrease in perceived eating ability and hunger, and an increase in satiety after BP + TR and BP meal was observed. No significant changes were observed after consuming test meals on gastrointestinal well-being. Compared to control and BP + TR meals, BP and TR meals had considerably lower palatability. Results showed that compared to the control intake of starchy meals supplemented with black pepper and turmeric reduced postprandial glycemia, hunger, and perceived eating ability without affecting gastrointestinal well-being.

Metabolic flexibility is the ability of the body to rapidly switch between fuel sources based on their accessibility and metabolic requirements. High metabolic flexibility is associated with improved health outcomes and a reduced risk of several metabolic disorders. Metabolic flexibility can be improved through lifestyle changes, such as increasing physical activity and eating a balanced macronutrient diet. Lumen is a small handheld device that measures metabolic fuel usage through exhaled carbon dioxide (CO2), which allows individuals to monitor their metabolic flexibility and make lifestyle changes to enhance it.

This retrospective study aims to examine the postprandial CO2 response to meals logged by Lumen users and its relationship with macronutrient intake and BMI.

We analyzed deidentified data from 2607 Lumen users who logged their meals and measured their exhaled CO2 before and after those meals between May 1, 2023, and October 18, 2023. A linear mixed model was fitted to test the association between macronutrient consumption, BMI, age, and gender to the postprandial CO2 response, followed by a 2-way ANOVA.

The model demonstrated significant associations (P<.001) between CO2 response after meals and both BMI and carbohydrate intake (BMI: β=-0.112, 95% CI -0.156 to -0.069; carbohydrates: β=0.046, 95% CI 0.034-0.058). In addition, a 2-way ANOVA revealed that higher carbohydrate intake resulted in a higher CO2 response compared to low carbohydrate intake (F2,2569=24.23; P<.001), and users with high BMI showed modest responses to meals compared with low BMI (F2,2569=5.88; P=.003).

In this study, we show that Lumen's CO2 response is influenced both by macronutrient consumption and BMI. The results of this study highlight a distinct pattern of reduced metabolic flexibility in users with obesity, indicating the value of Lumen for assessing postprandial metabolic flexibility.

Cardiovascular disease (CVD) is a major cause of death worldwide, although limited data are currently available regarding the impact of consuming ultra-processed food (UPF) on its incidence. Given the increased consumption of UPF in Iran, we aimed to investigate the association between UPF intake and CVD risk.

Individuals without CVD (n = 2050) aged ≥ 30 years old were recruited from the Tehran Lipid and Glucose Study (TLGS). Dietary data were collected using a validated food frequency questionnaire (FFQ) and UPF intakes were assessed based on the Nova food classification. Multivariable Cox proportional hazard models adjusted for potential confounders were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for the risk of CVD across tertiles of UPF intake.

A 10.1% incidence of CVD occurred over a median follow-up of 10.6 years, with a 22% increase in CVD risk per each 50 g/day UPF intake. Participants with the highest intake of UPF had a 68% greater incidence of CVD compared to those with the lowest intake (HR = 1.68, 95% CI=1.14-2.48) after controlling for potential confounders. Regarding sub-groups of UPF, participants in the 3rd tertile compared to the reference had a significantly increased risk of CVD (HR = 1.56, 95% CI=1.04-2.34). Nevertheless, intake of bread, fast food, sweetened beverages, sweets and desserts, high-fat dairy products, and other UPFs were not associated with greater CVD risk.

Our findings support the hypothesis that the incidence of CVD is enhanced with the higher consumption of UPF in a representative sample of the Iranian population.

Data suggest cannabis users have similar or lower levels of blood lipids compared to nonusers. However, the extent to which cannabis users experience postprandial lipemia is not known. Eleven cannabis users and 11 nonusers completed either rest or 1 h of exercise at their ventilatory threshold the evening before a meal tolerance test (MTT). Substrate oxidation, blood pressure, and capillary blood were obtained before and every 30-60 min post-meal for 3 h. Linear mixed models were utilized to examine differences in variables between groups, conditions, across time, and their interactions. Exercise led to increased fat oxidation post-MTT (p < 0.05), with cannabis users exhibiting higher AUC compared to the control trial (p < 0.05). Exercise also caused significantly lower levels of triglycerides (p < 0.05). Metabolic flexibility was improved in cannabis users in the exercise trial only (p < 0.05). No effect of group, trial, or interactions were detected for other variables of interest (all p > 0.05). This study indicated that prior exercise improves lipid metabolism in cannabis users and nonusers after a high-fat meal test. Cannabis users appear sensitive to the effects of exercise. Future studies should incorporate additional meals and variables related to cardiovascular health and metabolism.

Avocados are a rich source of nutrients including monounsaturated fats, dietary fibre and phytochemicals. Higher dietary quality is reported in studies of consumers with higher avocado intakes. The present study aimed to examine avocado consumption and cardiometabolic risk measures in a representative sample of Australian adults.

A cross-sectional analysis was performed using Australian Health Survey 2011-2013 (n = 2,736 observations). Day 1 24-hour recall data was used to examine reported avocado intake (whole avocados and avocado-containing products excluding avocado oil) and cardiometabolic risk measures (LDL, HDL, and total cholesterol, triglycerides, apolipoprotein B, HbA1c, plasma glucose, systolic and diastolic blood pressure). T-tests and chi square analyses were conducted between low (5.21 [95% CI: 4.63, 5.79] grams/day) and high (44.11 [95% CI: 35.89, 52.33] grams/day) consumers of avocado.

14.7% of Australians were 'avocado consumers' (n = 403 observations). Mean avocado intake was 24.63 (95% CI: 20.11, 29.15) grams per day, with a median intake of 10.40 (IQR: 4.49-26.00) grams per day for those considered 'avocado consumers'. Consumers of avocados had a lower BMI and waist circumference (each, p ≤ 0.001), lower plasma glucose level (p = 0.03), and higher HDL cholesterol (p ≤ 0.001) when compared with non-consumers. A trend towards lower plasma glucose, HbA1c (each, p = 0.04) and higher dietary fibre intake (p = 0.05) was found between high and low consumers of avocado.

Our study suggests favourable outcomes for avocado intake and cardiometabolic characteristics of consumers. Future studies should explore glucose homeostasis using a clinical trial design to understand potential relationships between avocado intake and cardiometabolic risk factors.

Given that rice serves as a crucial staple food for a significant portion of the global population and with the increasing number of individuals being diagnosed with diabetes, a primary objective in genetic improvement is to identify and cultivate low Glycemic Index (GI) varieties. This must be done while ensuring the preservation of grain quality.

25 Italian rice genotypes were characterized calculating their GI "in vivo" and, together with other 29 Italian and non-Italian genotypes they were studied to evaluate the grain inner structure through Field Emission Scanning Electron Microscopy (FESEM) technique. Using an ad-hoc developed algorithm, morphological features were extracted from the FESEM images, to be then inspected by means of multivariate data analysis methods.

Large variability was observed in GI values (49 to 92 with respect to glucose), as well as in endosperm morphological features. According to the percentage of porosity is possible to distinguish approximately among rice varieties having a crystalline grain (< 1.7%), those intended for the preparation of risotto (> 5%), and a third group having intermediate characteristics. Waxy rice varieties were not united by a certain porosity level, but they shared a low starch granules eccentricity. With reference to morphological features, rice varieties with low GI (<55) seem to be characterized by large starch granules and low porosity values. Our data testify the wide variability of Italian rice cultivation giving interesting information for future breeding programs, finding that the structure of the endosperm can be regarded as a specific characteristic of each variety.

We previously reported that the addition of a specified mulberry fruit extract (MFE) to rice consistently reduces post-prandial glycaemic (PPG) and post-prandial insulinemic (PPI) responses. This research tested whether this effect generalises to a broad range of rice types, reflecting the wide variation in rice characteristics known to influence glycaemic responses. In a randomised, balanced, partial factorial crossover design, Sona Masoori (SM), Bora Saul (BS), Gobindobogh (Gb) and Banskati (Bn) rices were tested with and without 0·37 g MFE. Healthy, normal-weight Indian adults (N 120) each consumed four of the eight possible boiled rice meals, all containing about 50 g available carbohydrate. The primary outcome was the effect of MFE on PPG, expressed as the percentage change in the positive, incremental AUC over 2 h. The mean effect of MFE on PPG for all rice types combined was -11·4 % (P < 0·003). The reduction in PPG was in a qualitatively similar range for all rice types (-9·8 to -15·1 %), and this was statistically significant for Bn. MFE also reduced the corresponding PPI response to all rice types combined by a mean of 10·1 % (P < 0·001; range -6·1 to -13·4 %), and the reduction in PPI was statistically significant for SM, Gb and BS. In conclusion, addition of 0·37 g MFE modestly reduced PPG and PPI responses to rices in general, and the effects were statistically significant for specific rice types.

An unbalanced diet increases the risk of developing a variety of chronic diseases and cancers, leading to higher morbidity and mortality rates worldwide. Low-grade systemic chronic inflammation mediated by the activation of the innate immune system is common to all these pathologies. Inflammation is a biological response of the body and a normal part of host defense to combat the effects of bacteria, viruses, toxins and macronutrients. However, when the innate immune system is constantly activated, it can promote the development of low-grade systemic chronic inflammation, which could play an important role in the development of chronic diseases and cancer. Since most chronic inflammatory diseases are associated with diet, a balanced healthy diet high in anti-inflammatory food components could prevent chronic diseases and cancer. The cells of the body's immune system produce chemokines and cytokines which can have pro-inflammatory and tumor-promoting as well as anti-inflammatory and tumor-fighting functions. A challenge in the future will be to assess whether polymorphisms in immune-related genes may play a role in promoting pro-inflammatory activity. Thanks to this duality, future research on immune regulation could focus on how innate immune cells can be modified to convert a pro-inflammatory and tumor-friendly microenvironment into an anti-inflammatory and anti-tumor one. This review describes inflammatory responses mediated by the innate immune system in various diseases such as hyperglycemia and/or hyperlipemia, obesity, type II diabetes, cardiovascular disease and cancer.