Lorraine Weatherspoon

Effects of breakfast meal composition on second meal metabolic responses in adults with Type 2 diabetes mellitus.

Objective:We tested the relative importance of a low-glycemic response versus a high glycemic response breakfast meal on postprandial serum glucose, insulin and free fatty acid (FFA) responses after consumption of a standardized mid-day meal in adult individuals with Type 2 diabetes mellitus (DM).Design:Following an overnight fast of 8–10 h, a randomized crossover intervention using control and test meals was conducted over a 3-week-period. A fasting baseline measurement and postprandial measurements at various time intervals after the breakfast and mid-day meal were taken.Subjects:Forty-five Type 2 DM subjects completed the requirements and were included in the study results.Interventions:Two different breakfast meals were administered during the intervention: (A) a high glycemic load breakfast meal consisting of farina (kJ 1833; carbohydrate (CHO) 78 g and psylium soluble fiber 0 g), (B) a low-glycemic load breakfast meal consisting of a fiber-loop cereal (kJ 1515; CHO 62 g and psyllium soluble fiber 6.6 g). A standardized lunch was provided approximately 4 h after breakfast. Blood plasma concentrations and area under the curve (AUC) values for glucose, insulin and FFA were measured in response to the breakfast and mid-day lunch. Statistical analyses were performed using SAS software (8.02). Comparisons between diets were based on adjusted Bonferroni t-tests.Results:In post-breakfast analyses, Breakfast B had significantly lower area under the curve (AUC) values for plasma glucose and insulin compared to Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were higher for Breakfast B than for Breakfast A (P<0.05) (95% confidence level). Post-lunch analyses indicated similar glucose responses for the two breakfast types. Insulin AUC values for Breakfasts B were significantly lower than Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were unaffected by breakfast type.Conclusions:These data indicate that ingesting a low-glycemic load meal containing psyllium soluble fiber at breakfast significantly improves the breakfast postprandial glycemic, insulinemic and FFA responses in adults with Type 2 DM. These data revealed no residual postprandial effect of the psyllium soluble fiber breakfast meal beyond the second meal consumed. Thus, there was no evidence of an improvement postprandially in the glycemic, insulinemic and FFA responses after the consumption of the lunch meal.Sponsorship:This study was supported with an unrestricted grant from Kellogg Company, Battle Creek, Michigan.

Glycemic Control in a Sample of Black and White Clinic Patients with NIDDM

OBJECTIVE To compare glycemic control of black and white patients under treatment for non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS Medical records of patients with NIDDM were reviewed at 19 of 24 clinics or health centers in a specified area of north central Florida. Data were abstracted from the charts of all non-Hispanic black (n = 248) or white (n = 280) patients who met preset eligibility criteria. RESULTS The mean ± SD age was 58 ± 14 years; the mean ± SD duration of diabetes was 9 ± 7.5 years. Of 528 patients, 220 were treated with oral hypoglycemic agents, 269 were treated with insulin, 28 were treated with diet alone, and 11 were treated with a combination of oral agents, diet, and insulin. Glycosylated hemoglobin was ≥8% for 47% of black women, 41% of black men, 38% of white men, and 29% of white women. The less favorable control status of the black women persisted within categories of age (40–59 years or ≥60 years), treatment (insulin or oral hypoglycemic agents), time since diagnosis (less than versus greater than or equal to the median of 7 years), and obesity (noted versus not noted in chart). In multiple logistic regression analyses controlling simultaneously for these variables, the odds (95% confidence interval [CI]), compared with white women, of having glycosylated hemoglobin ≥8% were 2.2 (1.4, 3.4) for black women and 1.5 (0.8, 2.9) and 1.4 (0.8, 2.5) for black and white men, respectively. CONCLUSIONS Black women were more likely than white women or men to have glycosylated hemoglobin ≥8%. This difference was not readily explained by age, type of treatment, time since diagnosis, or a notation of obesity in the medical record, although an effect of obesity cannot be excluded on this basis.

Price and Expenditure Elasticities for Fresh Fruits in an Urban Food Desert

This study addresses the knowledge gap concerning the demand for fresh fruit in an urban food desert, where healthy foods are scarce by definition. Using register data from a non-profit greengrocer in Detroit—one of America’s largest and most severe food deserts—expenditure and price elasticities of fresh fruits are estimated. The results show that, if urban food desert consumers are given access to normally priced produce of acceptable quality, they will purchase it. Expenditure was found to play a major role in determining fruit demand. The food desert consumers were also found to be more price responsive than the average US consumer. The policy implications are clear: introducing neighbourhood stores providing access to good quality produce at competitive prices could be an important component of increasing fruit consumption.

Carnitine Treatment Improved Quality-of-Life Measure in a Sample of Midwestern Hemodialysis Patients

BACKGROUND Previously, we demonstrated that selected groups of hemodialysis patients might be more likely to have abnormalities of carnitine metabolism. The purpose of the present study was to examine the effects of carnitine therapy in these selected groups of hemodialysis patients on quality-of-life measures and erythropoietin dose. METHODS This was a double-blind, randomized, controlled trial, in which 50 hemodialysis patients were treated with either 2 g i.v. carnitine or placebo. The treatment period was for 24 weeks. RESULTS Thirty-four patients (15 in the treatment group) completed the study. The mean age was 69 +/- 15 years, 35% were women, and 44% had diabetes. Mean initial plasma total, free, short-chain acyl and long-chain acyl carnitine concentrations (micromol/L; mean +/- SEM) were 35.9 +/- 1.8, 18.2 +/- 1.1, 11.6 +/- 0.6, and 6.0 +/- 0.3, whereas the plasma acyl-to-free-carnitine ratio was 1.02 +/- 0.05. With respect to the Medical Outcomes Short Form-36 (SF-36), improvements from baseline were noted in the treatment group (n = 13) for role-physical (33.9 +/- 1.9 to 43.2 +/- 3.0, p < .05) and the SF-36 physical component summary score (36.1 +/- 2.7 to 39.7 +/- 2.3, p = .09) relative to changes in the control group (n = 14). The erythropoietin dose over the 24-week period was reduced from baseline in the treatment group relative to the placebo group (-1.62 +/- 0.91 vs 1.33 +/- 0.79 units erythropoietin/dry weight/hemoglobin concentration, respectively, p < .05). CONCLUSIONS After 24 weeks of i.v. carnitine therapy, SF-36 scores were improved and erythropoietin doses were reduced in hemodialysis patients, relative to the control group.

Age-dependent effects of food advergame brand integration and interactivity

Food marketing is under increased scrutiny for its implicated role in the childhood obesity epidemic. Free branded online advergames are ubiquitous. Using a customised online game, this study examined how food advergames exert their influence on children. The findings of the experiment demonstrate the effects of brand integration and interactivity (playing versus watching) on children’s brand recall, attitudes, taste expectations, purchase requests and health perceptions for brands placed in a game. The results offer evidence that younger children are responsive to advergames and warrant additional study in this domain.

Serum carnitine concentrations correlated to clinical outcome parameters in chronic hemodialysis patients

Carnitine metabolism and the therapeutic use of carnitine has been a major area of interest in dialysis patients. The purpose of this study was to determine whether any correlations exist between carnitine status and selected clinical parameters in hemodialysis (HD) patients. This study was an observational study of data from patients receiving HD at a Midwest dialysis center. The subjects (n=49) were 60+/-16 (mean+/-SD) years of age and 48% male. Fifteen percent of the subjects had type 1 diabetes mellitus (DM), 29% had type 2 DM, and 25% had left ventricular hypertrophy (LVH). The serum-free and total carnitine, and acylcarnitine concentrations were: 40.3+11.8 microm/l, 22.8+/-7.3, and 17.5+/-5.9 microm/l, respectively. The serum acylcarnitine to free carnitine ratio (A/F) was 0.80+/-0.27. Blood urea nitrogen (BUN), parathyroid hormone and ejection fraction were positively correlated and age and left atrial dilation (cm) were negatively correlated with serum total carnitine (P<0.05). BUN and hematocrit were positively correlated (P<0.05) and age was negatively correlated with free carnitine. Subjects who used mannitol or were male had significantly higher concentrations of both free and total carnitine, respectively (P<0.05). Subjects using aspirin had lower concentrations of serum total carnitine (P<0.10). These results suggest certain subgroups of patients may need to be targeted for further studies with carnitine replacement therapy, i.e. long-term patients, older patients, patients with left verticular hypertrophy and left atrial enlargement, females and patients on aspirin therapy.

Toddler feeding: Expectations and experiences of low-income African American mothers

Objective To ascertain maternal expectations and experiences with mealtimes and feeding of toddlers among low-income African American mothers in two mid- to large-size cities in the United States. Design Qualitative focus group study. Setting Two Early Head Start programme sites in a Midwestern state which serve low income families. Method Twenty-seven low-income African American mothers took part in two focus groups which were conducted by a facilitator, according to a semi-structured topic guide. Focus group data were supplemented with demographic family data. Results Four major themes emerged: (1) maternal perceptions of healthy toddlers, (2) maternal food choices for toddlers, (3) maternal expectations about toddler autonomy and self-regulation of feeding, and (4) mealtime context and interaction. Conclusions and implications Data provided examples of maternal expectations and experiences, suggesting the development of healthy feeding patterns among some toddlers and provided evidence of less healthy feeding patterns in others. Evidence of less healthy feeding patterns included limiting toddler autonomy and food regulation, and misinterpretation of normative toddler behaviours. Because parenting practices and perceptions have been reported to contribute to social and environmental influences of obesity, this research could aid development of culturally sensitive nutrition education interventions.

Nutrition Risk and Associated Factors in Congregate Meal Participants in Northern Florida: Role of Elder Care Services (ECS)

Abstract Nutrition is a key for extending quality of life of the elderly. Factors associated with nutritional risk in elders were identified with a modified nutrition screen initiative checklist. High, moderate and low nutritional risk was seen in 31, 46 and 23%, respectively, of 324 elders in six congregate meal sites in northern Florida. High nutritional risk was associated with urban residency, females, being African American, self-reported poor health and irregular visits to medical/health professionals. African American females living in urban areas with limited access to health care are most vulnerable.

Influences of a chronic disease risk reduction curriculum called "Live!" on fat and fiber knowledge and attitudes of black and white adolescents

Abstract A 6-week curriculum, “Live!”: Eat Less Fat and More Fiber, was tested in the food and consumer sciences classes of four middle schools in Tallahassee, Florida. The curriculum, composed of five lesson units, focused on building a knowledge base for the prevention of nutrition-related chronic diseases and also included a segment that emphasized the development of low-fat and high-fiber cooking skills. Content building within the curriculum followed a model published by the Society for Nutrition Education called “The Process of Nutrition Education (PNE),” in which five instructional strategies and eight behavioral change factors are recommended for achieving intended nutrition knowledge, attitudes, and practices. Results of pre- and post-tests, based on the eight study variables, showed that the “Live!” curriculum significantly (p

Sorghum bean composite porridge nutritional quality and acceptability

Purpose – The purpose of this paper is to study the quality of porridge made from cereal legume composite flour and to compare with a porridge that it is traditionally eaten.Design/methodology/approach – The nutritional composition as well as protein, microbiological, and sensory quality of porridge from a sorghum bean composite flour was assessed and compared with sorghum porridge (SP) that is traditionally eaten in Botswana.Findings – Results indicated that the nutrient composition and the protein quality of the sorghum bean composite porridge were significantly higher than that of the SP. The majority of children and adults rated the sensory attributes of the sorghum composite porridge highly and adult consumers indicated willingness to buy it.Originality/value – The study demonstrates that using traditionally consumed foods, which are culturally acceptable and low cost, such as sorghum and sugar beans, can improve nutritional and sensory attributes when composited. These composited foods can then be r...