Dietary Education Provision Within a Cardiac Rehabilitation Programme in the UK: A Pilot Study Evaluating Nutritional Intakes Alongside Physical Activity Levels

Background/aims: The primary aim of this study was to evaluate the effectiveness of two 30-minute dietary education sessions, within cardiac rehabilitation (CR), as a means to optimise nutrient and energy intakes (EI). A secondary aim was to evaluate patients’ habitual physical activity (PA) levels. Methods: Thirty patients (males: n = 24, 61.8 ± 11.2 years; females: n = 6, 66.7 ± 8.5 years) attended a six-week early outpatient CR programme in the UK and received two 30-minute dietary education sessions emphasising Mediterranean diet principles. EI and nutrient intakes were measured through completion of three-day food diaries in weeks one and six (before and after the dietary education sessions) to assess the impact of these sessions on nutrient intakes. At the same time-points, a sub-group (n = 13) of patients had their PA levels assessed via accelerometery to assess the impact of the CR programme on PA. Findings: Estimated energy requirements (EER) at week one (1988 ± 366 kcal . d -1 ) were not matched by actual EI (1785 ± 561 kcal . d -1 ) ( P = 0.047, d = -0.36). EI reduced to 1655 ± 470 kcal . d -1 at week six ( P = 0.66, d = -0.33) whereas EER increased as a function of increased activity (CR sessions). Nutrient intakes remained suboptimal, while no significant increases were observed in healthy fats and fibre, which consist core elements of a Mediterranean diet. Statistically significant increases were not observed in PA however patients decreased sedentary time by 11 ± 12% in week six compared to week one ( P = 0.009; d = -0.54). Conclusion : The present study findings suggest that two 30-minute dietary education sessions did not positively influence EI and nutrient intakes, while habitual PA levels were not significantly increased as a result of the CR programme. Future research should explore means of optimising nutrition and habitual PA within UK CR

Ability of lactobacilli isolated from traditional cereal-based fermented food to produce folate in culture media under different growth conditions

Folates are essential vitamins (B9). Lactic acid bacteria (LAB) can be used to increase the folate levels in foods during fermentation. Here, 151 LAB strains isolated from fermented food were screened for folate production. Folates were extracted by heat treatment coupled with enzymatic extraction. Total, extra and intracellular folate were quantified by microbiological assay. Most Lactobacillus plantarum and Lactobacillus fermentum strains synthesized folate, Pediococcus pentosaceus strains consumed folate, and Pediococcus acidilactici strains either consumed or produced. Seven strains were further examined for their ability to synthesize or consume folate during growth in rich folate medium (MRS) and folate-free medium (FACM). For most strains, the differences observed in MRS were attenuated in FACM. L. fermentum 8.2 and L. plantarum 6.2 produced the highest levels of folates in MRS (97 and 93 ng.mL(-1)) and FACM (29 and 44 ng.mL(-1)). In most cases, production reached a maximum from 9 or 11 h to 24 h. Incubations in FACM with mixed LAB cultures showed that folate production is not additive. We demonstrated how biosynthesis of folate by LAB depends on species, strains, and is highly influenced by time and medium composition. Characterized LAB strains can be further explored for novel folate bioenriched functional food