Flávia Galvão Cândido

Vitamin D: link between osteoporosis, obesity, and diabetes?

Vitamin D (1,25(OH)2D3) is a steroid hormone that has a range of physiological functions in skeletal and nonskeletal tissues, and can contribute to prevent and/or treat osteoporosis, obesity, and Type 2 diabetes mellitus (T2DM). In bone metabolism, vitamin D increases the plasma levels of calcium and phosphorus, regulates osteoblast and osteoclast the activity, and combats PTH hypersecretion, promoting bone formation and preventing/treating osteoporosis. This evidence is supported by most clinical studies, especially those that have included calcium and assessed the effects of vitamin D doses (≥800 IU/day) on bone mineral density. However, annual megadoses should be avoided as they impair bone health. Recent findings suggest that low serum vitamin D is the consequence (not the cause) of obesity and the results from randomized double-blind clinical trials are still scarce and inconclusive to establish the relationship between vitamin D, obesity, and T2DM. Nevertheless, there is evidence that vitamin D inhibits fat accumulation, increases insulin synthesis and preserves pancreatic islet cells, decreases insulin resistance and reduces hunger, favoring obesity and T2DM control. To date, there is not enough scientific evidence to support the use of vitamin D as a pathway to prevent and/or treat obesity and T2DM.

Impact of dietary fat on gut microbiota and low-grade systemic inflammation: mechanisms and clinical implications on obesity.

Abstract Dietary fat strongly affects human health by modulating gut microbiota composition and low-grade systemic inflammation. High-fat diets have been implicated in reduced gut microbiota richness, increased Firmicutes to Bacteroidetes ratio, and several changes at family, genus and species levels. Saturated (SFA), monounsaturated (MUFA), polyunsaturated (PUFA) and conjugated linolenic fatty acids share important pathways of immune system activation/inhibition with gut microbes, modulating obesogenic and proinflammatory profiles. Mechanisms that link dietary fat, gut microbiota and obesity are mediated by increased intestinal permeability, systemic endotoxemia, and the activity of the endocannabinoid system. Although the probiotic therapy could be a complementary strategy to improve gut microbiota composition, it did not show permanent effects to treat fat-induced dysbiosis. Based upon evidence to date, we believe that high-fat diets and SFA consumption should be avoided, and MUFA and omega-3 PUFA intake should be encouraged in order to regulate gut microbiota and inflammation, promoting body weight/fat control.

Addition of dietary fiber sources to shakes reduces postprandial glycemia and alters food intake

INTRODUCTION Obesity and Type 2 diabetes may be controlled by foods capable of modulating food intake and blood glucose. OBJECTIVES We investigated whether the addition of food sources of fiber or phaseolamin to shakes can control food intake and reduce postprandial glycemia. METHODS This was a randomized, single blind, crossover design study (food intake: n=22; glycemia: n=10). Five liquid meals presenting similar amounts of macronutrients (C - control shake, OB - oat bran shake, F - flaxseed shake, WB - white bean extract shake, and UB - unripe banana flour shake) were consumed in five non-consecutive days. Participants kept dietary records during the subsequent 24 hours. Blood glucose was measured at 0 (immediately before), 15, 30, 45, 60, 90 and 120 minutes after the ingestion of each shake and the incremental areas under the curves (iAUC) were calculated. RESULTS Compared to C, there was a significant increase in fiber intake after the consumption of OB (+17.9g), F (+19.1g), and UB (+12.6g), and in fat after the consumption of OB (+25,4g). There was a non-significant reduction of daily energy intake in F compared to C (1524kJ; P=0.10). There was a 43% reduction in the iAUC (P=0.03) in response to UB consumption. CONCLUSIONS Unripe banana flour reduced postprandial glycemic response of shakes almost by half. The effect of oat bran and flaxseed on food intake needs further investigation in long-term studies.

EFECTO DE DIFERENTES TIPOS DE PROTEÍNA EN LA GLICEMIA POSTPRANDIAL DE LA SEGUNDA COMIDA EN INDIVIDUOS DE PESO NORMAL Y NORMOGLICÉMICOS

BACKGROUND Diabetes mellitus is a global epidemic affecting 346 million people in the world. The glycemic control is the key for diabetes prevention and management. Some proteins can stimulate insulin release and modulate glycemic response. OBJECTIVES To assess the effect of the consumption of different types of protein (whey protein, soy protein and egg white) on a second meal postprandial glycaemia in normal weight and normoglycemic subjects. METHODOLOGY Randomized crossover clinical trial. After an overnight fast of 12-hours, ten subjects attended the laboratory to drink one of the protein shakes (whey, soy or egg white) or the control drink. Thirty minutes later, the subjects consumed a glucose solution (25 g glucose). Glycemic response was monitored at times 0 (before glucose solution) and 15, 30, 45, 60, 90 and 120 min (after glucose solution consumption). Incremental area under the glycemic curve (iAUC) was calculated by the trapezoidal method. Furthermore, glycemic response was assessed by a new method using iG equation. RESULTS Compared with control, whey and soy protein drinks reduced postprandial iAUC in 56.5% (p = 0.004) and 44.4% (p = 0.029), respectively. Whey protein was the only protein capable of avoiding great fluctuations and a peak in postprandial glycemia. The assessment of glycemic response by iG equation showed positive correlation with iAUC (Pearson 0.985, p < 0.05). CONCLUSION The consumption of whey and soy protein 30 minutes before a glucose load resulted in lower iAUC compared with control drink. Whey protein maintained postprandial glycemia more stable.Background: Diabetes mellitus is a global epidemic affecting 346 million people in the world. The glycemic control is the key for diabetes prevention and management. Some proteins can stimulate insulin release and modulate glycemic response. Objectives: To assess the effect of the consumption of different types of protein (whey protein, soy protein and egg white) on a second meal postprandial glycaemia in normal weight and normoglycemic subjects. Methodology: Randomized crossover clinical trial. After an overnight fast of 12-hours, ten subjects attended the laboratory to drink one of the protein shakes (whey, soy or egg white) or the control drink. Thirty minutes later, the subjects consumed a glucose solution (25 g glucose). Glycemic response was monitored at times 0 (before glucose solution) and 15, 30, 45, 60, 90 and 120 min (after glucose solution consumption). Incremental area under the glycemic curve (iAUC) was calculated by the trapezoidal method. Furthermore, glycemic response was assessed by a new method using iG equation. Results: Compared with control, whey and soy protein drinks reduced postprandial iAUC in 56.5% (p = 0.004) and 44.4% (p = 0.029), respectively. Whey protein was the only protein capable of avoiding great fluctuations and a peak in postprandial glycemia. The assessment of glycemic response by iG equation showed positive correlation with iAUC (Pearson 0.985, p < 0.05). Conclusion: The consumption of whey and soy protein 30 minutes before a glucose load resulted in lower iAUC compared with control drink. Whey protein maintained postprandial glycemia more stable.

Dairy products consumption versus type 2 diabetes prevention and treatment: a review of recent findings from human studies

INTRODUCTION It has been claimed that the appropriate consumption of dairy products can be beneficial for the prevention and treatment of type 2 diabetes mellitus (T2DM). OBJECTIVE The objective of this review is to critically analyze the main scientific evidence about this topic. METHODS MEDLINE, PubMEd, Science Direct, SCIELO and LILACS were searched for studies published over the past 12 years exploring the effects of the consumption of dairy products or its components (calcium, vitamin D and magnesium) on T2DM. RESULTS AND DISCUSSION Epidemiological studies indicate that consumption of at least three servings of low-fat dairy products per day as a part of a healthy diet is crucial to reduce the risk of developing T2DM. The majority of the analyzed intervention studies reported beneficial effects of increased calcium and vitamin D ingestion on insulin sensitivity improvement and T2DM prevention. CONCLUSIONS Although the impact of dairy consumption to treat T2DM needs further investigation, the consumption of low-fat dairy products may be an important strategy to prevent and control T2DM.

Use of the glycemic index in nutrition education

Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicatedas the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of theglycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic indexfoods. Studies published over the past 12 years, in addition to classic studies on this topic, found in thedatabases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and thefactors that affect the glycemic index were selected for this article. The preparation of lists grouping foodsaccording to their glycemic index should be based on information found in tables and specific web sites. Thisis an interesting strategy that must be very carefully conducted, considering the eating habits of the assistedpeople. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed inassociation with the following foods: high protein and low fat foods, good quality oils and unprocessed foodswith high fiber content. Caffeine should also be avoided. The glycemic index should be considered as anadditional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promotingand/or maintaining body weight and health.

Addition of pooled pumpkin seed to mixed meals reduced postprandial glycemia: a randomized placebo-controlled clinical trial

We investigated if pumpkin and flaxseeds could improve postprandial glycemic, food intake, and appetitive responses. Herein, we hypothesize based on the literature that pumpkin seed has potential to lower postprandial glycemic effects. Therefore, we conducted a randomized, single-blind, placebo-controlled, crossover design study involving normoglycemic adults (food intake: n = 25; glycemia: n = 15). Three high-carbohydrate mixed meals presenting no seed (control [C]) or 65 g of the tested seeds (pumpkin seed [P] or flaxseed [F]) were consumed in 3 nonconsecutive days. Test meals had similar nutritional composition. Blood glucose was measured by capillary finger blood at 0 (immediately before), 15, 30, 45, 60, 90, and 120 minutes after the ingestion of each meal, and the incremental area under glycemic response curves (iAUC) were calculated. Appetitive responses were assessed, and dietary records were used to evaluate food intake on testing days. Glucose iAUC was significantly lower in P compared with C (reduction of ~35%, P = .025). There was no significant differences in glucose iAUC between F and C (P = .257). Glycemic response at each time point did not differ between C, P, and F (Pgroup × time = .238). Fiber consumption was higher in F (P = .009) than in C, but there were no differences in appetitive responses, energy, or macronutrient consumptions between dietary interventions. Acute consumption of 65 g of pumpkin seed markedly reduced postprandial glycemia. Pumpkin seed has potential as a hypoglycemic food, which now deserves to be confirmed in long-term studies.

Dietary fat and gut microbiota: mechanisms involved in obesity control

ABSTRACT Obesity is a serious global health problem that is directly related to various morbidities manifestation. Intestinal dysbiosis has been implicated on obesity pathogenesis. Diet composition can alter gut microbiota, regardless of energy intake. Dietary fatty acids quality may affect gut microbiota composition, which in turn may affect host metabolic health. The mechanisms by which the different type of FFA modulate gut microbiota is yet poor elucidate and there is a lack of studies regard to this. Fatty acids may act in cell membrane, interfere with energy production, inhibit enzymatic activities, impair nutrient absorption and generate toxic compounds to cells, leading to growth inhibition or even bacterial death. The beneficial effect of the consumption of n-3 polyunsaturated fatty acids (PUFA) and conjugated linoleic acid (CLA) on microbiota, unlike n-6 PUFA and saturated fatty acids has been suggested. n-3 PUFA consumption promotes desirable changes on obese intestinal microbiota making it similar to that of normal weight individuals. More studies are needed to better understand the effect of CLA on microbiota and host health. Long term human controlled clinical trials must be conducted to allow us to understand the complex interaction between dietary fat, intestinal microbiota and obesity.

Increased Skim Milk Consumption Reduces Uricemia, Body Fat, and Body Weight in Excess Body Weight Women Pursuing Energy Restricted Diet

C acid (CA) is found in the seeds of coffee, apple, peanut and orange as well as in both seeds and cell walls of commelinid plants. This phenolic compound has been reported to possess antioxidant, anticancer and anti inflammatory activities. We have investigated the hepatoprotective effect of CA against carbon tetrachloride (CCl4)-induced acute liver injury. Mice were treated intraperitoneally with vehicle or CA (20, 40 and 80 mg/kg) 1 hour before and 2 hours after CCl4 (20 μl/ kg) injection. The serum activities of aminotransferases and the hepatic level of malondialdehyde were significantly higher after CCl4 treatment while the concentration of reduced glutathione was lower. These changes were attenuated by CA. The serum level and mRNA expression of TNF-α significantly increased after CCl4 treatment and CA attenuated these increases. The levels of i-NOS and COX-2 protein and mRNA expression after CCl4 treatment were significantly higher and CA reduced these increases. CCl4-treated mice showed increased nuclear translocation of NF-κB, and decreased levels of inhibitors of NFκB in cytosol. Also, CCl4 significantly increased the level of phosphorylated JNK and p38 mitogen-activated protein (MAP) kinase and nuclear translocation of activated c-Jun. CA significantly attenuated these changes. We also found that acute CCl4 challenge induced TLR4, TLR2 and TLR9 protein and mRNA expression and CA significantly inhibited TLR4 expression. These results suggest that CA protects from CCl4-induced acute liver injury through reduction of oxidative damage and inflammatory signaling pathways.H has been an important public health concern with a global prevalence of 26% among adults. Several studies reported that sugar-sweetened beverage consumption (SSBC) has been associated with higher blood pressure (BP) levels. These previous studies on the association between SSBC consumption and hypertension were conducted in Western countries. Therefore, we examined the association between hypertension prevalence and SSBC intake among Korean adults aged 19 through 65. This study used data from 2007-2009 Korea National Health and Nutrition Examination Surveys. We excluded subjects who had a diagnosis of or were receiving treatment for hypertension. Hypertension was defined as having a systolic blood pressure higher than 140 mmHg or a diastolic blood pressure higher than 90 mmHg. SSBC intakes were calculated using food frequency questionnaires for the past year. Odds ratios (ORs) for hypertension were assessed by using logistic regression and multivariable models. 14.5% of all subjects were classified as having hypertension. A high SSBC (>2.3 servings/week) was associated with a higher prevalence of hypertension after adjusting for confounding factors such as total daily energy intake, sodium intake and others. In the subgroup analysis by gender and obesity, SSBC was significantly associated with a higher prevalence of hypertension in obese women but was marginally associated in obese men. Further longitudinal and randomized clinical studies are warranted to confirm this causal relationship.S nanoparticles (SeNPs) have been proved to have biological activities along with low toxicity, but are quite unstable and poorly taken up by cells. In this paper, a new polysaccharide (DP1), purified from Dictyophora indusiata, was used to functionalize SeNPs to form high stable nanocomposites DP1-SeNPs with an average diameter of 89.14 nm. DP1-SeNPs showed notable antiproliferative effect on human cancer cell lines (HepG2, MCF-7, SGC-7901, A549, Hela and PC3). The antiproliferative effect of DP1-SeNPs was associated with nuclear condensation, DNA cleavage, S phase cell arrest. With the treatment of DP1-SeNPs, caspase-3, 8, 9 were triggered in a dose-dependent manner in HepG2 cells. Also, the expression level of FADD was increased dramatically, implying that DP1-SeNPs induced apoptotic pathways were mainly through the activation of FADD and caspase-3, 8, 9. Furthermore, ROS over generation and mitochondrial dysfunction were also involved in DP1-SeNPs-induced apoptosis. Therefore, the underlying antiproliferative activity mechanism of DP1-SeNPs was both via death receptor-mediated and mitochondria-mediated apoptotic pathways. This work could eventually lead to development of anti-cancer nutraceutical supplements using natural materials of food origin.T use of complementary and alternative medicine (CAM) in disease therapy has increased exponentially in recent years. Herbal plant decoctions, an integral component of CAM, are a veritable source of alternative medicine. Treatment using herbal extracts constitutes a tremendous resource for alternative remedy especially at disease onset. A scientific investigation of traditional herbal plants may provide valuable leads for the development of alternative drugs and therapeutic remedies. The dearth of valid ethnobotanical information on herbal plants used in disease therapy remains an impediment to the utilization of CAM by clinicians. Factors such as improper identification and standardization of these herbal plants constitute a potential reason for concern. Consequently, it is imperative that studies are undertaken to assure the quality, efficacy, and safety of these plants. Our plant of interest, Brickellia cavanillesii (Asteraceae), one of the more popular herbal plants consumed in Central America, Mexico, and the southwestern parts of the USA for the treatment of Type 2 diabetes mellitus, is believed to possess hypoglycemic and antioxidative properties. Unfortunately, little is known about its chemical composition. This study investigates the lyophilized extracts of B. cavanillesii in an attempt to elucidate its use as a therapeutic agent; chromatographic methods were utilized to analyze the methanolic extract of lyophilized Brickellia cavanillesii. The identified compounds were found to be the primary constituents of the essential oils of many plants and flowers. Essential oils are employed widely in traditional disease remedies.I this work we propose a statistical method here called SheNon (Shelf-life prediction for Non-accelerated studies). Such method is based on principal components and linear regression analysis. Here we present shelf-life estimation for minimally processed eggplants. Samples were stored without chemical preservatives and evaluated by appearance, color, aroma, overall acceptance (OA), purchase intention (PI), L, a *, b *, Hue angle (h), soluble solids (SS), acidity, pH, browning index (BI) and chromaticity. PC1 and PC5 presented the highest correlations with time, respectively and then moved on to regression fitting step. Eggplants showed to age mainly along PC1. Some attributes like aroma, appearance, color, OA, PI, L and h were related to fresh samples and a*, b*, SS, BI and chromaticity were associated to aged products. To predict the shelf-life, a linear regression model was selected considering these principal components. A borderline sample vector was provided by an expert in food technology, which, applied to in the adjusted regression model, yielded the shelf-life estimative of 9.6 days (±4 days, confidence level of 95%). By the results it was found that the proposed method is promising for estimating shelf-life.