The value of enhancing nutrient bioavailability of lentils: the Sri Lankan scenario

Lentil (Lens culinaris Medic.) is a pulse crop that belongs to the family Leguminosae. Lentils are rich in proteins, have 18 of the 20 amino acids including all 8 essential amino acids and provide a number of essential minerals and vitamins. Thus, lentils occupy an important place in the human diet, especially in developing countries, as a rich source of protein, vitamins and minerals. Although in many developing countries in Asia rice contributes significantly to human daily energy and nutritional requirements, its amino acid profile shows that rice lacks some essential amino acids. Therefore, given their rich composition of amino acids, lentils could act as an ideal supplement for rice-based diets. Although all red lentils are imported, they are the most widely consumed pulse among Sri Lankans. Red lentil consumption levels are significantly greater in the estate sector where the prevalence of under nutrition is high. Thus, this review was undertaken to understand the potential role of lentils in the Sri Lankan diet and how lentils can potentially be utilized to meet the nutritional needs of Sri Lankans. The study was based on an extensive literature review and information obtained through personal interviews with key participants in the red lentil industry of Sri Lanka. It was evident that red lentils are a rich source of nutrients, especially micro-nutrients, but their bioavailability is poor due to the presence of multiple anti-nutritive factors such as protease inhibitors, phenolic compounds and phytates. Although bioavailability of nutrients can be enhanced by changing food processing techniques, fortification and bio-fortification, lentil cooking patterns in Sri Lanka pose difficulties in adopting changed food processing techniques and fortification. Thus, bio-fortification would be the most viable option for enhancing nutrient availability in lentils. Since Sri Lanka does not produce lentils, such initiatives may have to be undertaken in exporting countries or in collaboration with international agricultural research centres. Any strategic investments in breeding new lentil varieties with high bioavailability would provide exporting countries a unique competitive edge in export markets. Such improvements would meet the nutritional needs, not only of Sri Lankans, but also of millions other Asian consumers who face similar nutritional challenges.Key words: Bioavailability, Consumption, Nutrition, lentils, Sri Lanka

MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy

Background Mucositis is a significant toxicity of cancer therapy with numerous systemic sequelae. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for the management of mucositis. Methods The literature was reviewed systematically to identify interventions for mucositis. Studies were rated according to the presence of major and minor flaws according to previously published criteria. The body of evidence for each intervention and in each treatment setting was assigned a level of evidence based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. Results The guideline covers evidence from 1197 publications related to oral or gastrointestinal mucositis. Thirteen new guidelines were developed for or against the use of various interventions in specific treatment settings, and 11 previous guidelines were confirmed after aa review of new evidence. Thirteen previously established guidelines were carried over because there was no new evidence for these interventions. Conclusions The updated MASCC/ISOO Clinical Practice Guidelines for mucositis provide professional health caregivers with a clinical setting-specific, evidence-based tool to help with the management of mucositis in patients who have cancer

MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy

Published online July 28, 2020 in Wiley Online Library (wileyonlinelibrary.com)Mucositis is a significant toxicity of cancer therapy with numerous systemic sequelae. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for the management of mucositis. METHODS: The literature was reviewed systematically to identify interventions for mucositis. Studies were rated according to the presence of major and minor flaws according to previously published criteria. The body of evidence for each intervention and in each treatment setting was assigned a level of evidence based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. RESULTS: The guideline covers evidence from 1197 publications related to oral or gastrointestinal mucositis. Thirteen new guidelines were developed for or against the use of various interventions in specific treatment settings, and 11 previous guidelines were confirmed after aa review of new evidence. Thirteen previously established guidelines were carried over because there was no new evidence for these interventions. CONCLUSIONS: The updated MASCC/ISOO Clinical Practice Guidelines for mucositis provide professional health caregivers with a clinical setting-specific, evidence-based tool to help with the management of mucositis in patients who have cancer. Cancer 2020;126:4423-4431.Sharon Elad, Karis Kin Fong Cheng, ajesh V. Lalla, Noam Yarom, Catherine Hong, Richard M. Logan, Joanne Bowen, Rachel Gibson, Deborah P. Saunders, Yehuda Zadik, Anura Ariyawardana, Maria Elvira Correa, Vinisha Ranna, and Paolo Bossi, for the Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) include: Praveen Arany, Abdul Rahman Al-Azri ... Emma H. Bateman ... Janet K. Coller, Noor Al-Dasooqi, and Hannah Wardill. Other contributors include (in alphabetic order): Suzanne Ameringer ... Dorothy Keefe ... Bronwen Mayo ... Andrea M. Stringer ... et al

Derivation and validation of a risk-factor model for detection of oral potentially malignant disorders in populations with high prevalence

Background:Oral and pharyngeal cancers constitute the sixth most common type of cancer globally, with high morbidity and mortality. In many countries, most cases of oral cancer arise from long-standing, pre-existing lesions, yet advanced malignancies prevail. A new approach to early detection is needed. We aimed to validate a model for screening so that only high-risk individuals receive the clinical examination.Methods:A community-based case-control study (n1029) in rural Sri Lanka assessed risk factors and markers for oral potentially malignant disorders (OPMD) by administering a questionnaire followed by an oral examination. We then developed a model based on age, socioeconomic status and habits of betel-quid chewing, alcohol drinking and tobacco smoking, with weightings based on odds ratios from the multiple logistic regression. A total, single score was calculated per individual. Standard receiver-operator characteristic curves were plotted for the total score and presence of OPMD. The model was validated on a new sample of 410 subjects in a different community.Results:A score of 12.0 produced optimal sensitivity (95.5%), specificity (75.9%), false-positive rate (24.0%), false-negative rate (4.5%), positive predictive value (35.9%) and negative predictive value (99.2%).Conclusion:This model is suitable for detection of OPMD and oral cancer in high-risk communities, for example, in Asia, the Pacific and the global diaspora therefrom. A combined risk-factor score of 12.0 was optimal for participation in oral cancer/OPMD screening in Sri Lanka. The model, or local adaptations, should have wide applicability