The Impact of Almonds and Almond Processing On Gastrointestinal Physiology, Luminal Microbiology and Gastrointestinal Symptoms: a Randomized Controlled Trial and Mastication Study.

BACKGROUND: Almonds contain lipid, fiber and polyphenols and possess physicochemical properties that impact nutrient bioaccessibility, which are hypothesized to impact gut physiology and microbiota. OBJECTIVES: Investigate the impact of whole almonds and ground almonds (almond flour) on fecal bifidobacteria (primary outcome), gut microbiota composition and transit time. DESIGN: Healthy adults (n = 87) participated in a parallel, 3-arm randomized controlled trial. Participants received whole almonds (56 g/d), ground almonds (56 g/d) or an isocaloric control muffin in place of habitual snacks for 4 weeks. Gut microbiota composition and diversity (16S rRNA gene sequencing), short-chain fatty acids (gas-chromatography), volatile organic compounds (gas-chromatography mass-spectrometry), gut transit time (wireless motility capsule), stool output and gut symptoms (7-day diary) were measured at baseline and endpoint. The impact of almond form on particle size distribution (PSD) and predicted lipid release was measured in a subgroup (n = 31). RESULTS: Modified intention-to-treat analysis was performed on 79 participants. There were no significant differences in abundance of fecal bifidobacteria following consumption of whole almonds (8.7%, SD 7.7%), ground almonds (7.8%, SD 6.9%) or control (13.0%, SD 10.2%; q = 0.613). Consumption of almonds (whole and ground pooled) resulted in higher butyrate (24.1 μmol/g, SD 15.0 μmol/g) in comparison to control (18.2 μmol/g, SD 9.1 μmol/g; p = 0.046). There was no effect of almonds on gut microbiota at the phylum level or diversity, gut transit time, stool consistency or gut symptoms. Almond form (whole versus ground) had no effect on study outcomes. Ground almonds resulted in significantly smaller PSD and higher predicted lipid release (10.4%, SD 1.8%) in comparison to whole almonds (9.3%, SD 2.0%; p = 0.017). CONCLUSIONS: Almond consumption has limited impact on gut microbiota composition but increases butyrate concentrations in adults, suggesting positive alterations to microbiota functionality. Almonds can be incorporated into the diet to increase fiber consumption without triggering gut symptoms. Clinical trial registry: ClinicalTrials.gov identifier - NCT03581812

A higiene das mãos: as competências profissionais e as áreas de melhoria

El objetivo fue analizar los conocimientos sobre la higiene de las manos de los profesionales del Sistema Sanitario Público Andaluz (España). Estudio mediante encuestas en 2011, utilizando el Hand Hygiene Knowledge Questionnaire for Health-Care Workers con la técnica de análisis de clases latentes. La media de respuestas correctas fue de 17,51 ± 3,68. Las preguntas con porcentajes de respuestas correctas más bajos son las referidas a la prevención, mediante la higiene de las manos, de la transmisión de microorganismos después de la exposición al paciente y aquellas relacionadas con la utilización de preparados de base alcohólica. Se obtuvo un modelo de 7 clases latentes. Principales diferencias socio-demográficas: los profesionales con conocimientos más bajos suelen ser hombres, jóvenes y no sanitarios; el haber recibido formación previa no discrimina a los que presentan excelentes conocimientos. Concluimos que la revisión de los programas de formación en higiene de las manos es necesaria para mejorar los conocimientos sobre aspectos conceptuales de la transmisión de microorganismos a través de las manos.The objective of this study was to analyze knowledge on hand hygiene among staff workers in the Andalusian Public Health System (Spain). This was a cross-sectional study with surveys (2011) using the Hand Hygiene Knowledge Assessment Questionnaire for Healthcare Workers with the latent class analysis technique. The average number of questions answered correctly was 17.51±3.68. Questions with lower percentages of correct responses were those on hand hygiene for prevention of microorganism transmission to patients and those on hand- rubbing versus hand-washing. We obtained a model with 7 latent classes. Workers with lower knowledge tended to be younger, males, and non-healthcare workers. Having received previous training did not necessarily ensure excellent knowledge. The study concludes that hand hygiene training programs need to be revised in order to improve knowledge on conceptual characteristics involved in the transmission of microorganisms via the hands.O objetivo foi analisar o conhecimento sobre a higiene das mãos dos profissionais do Sistema de Saúde Andaluz (Espanha). Os inquéritos foram realizados em 2011, por meio do questionário Hand Hygiene Knowledge Questionnaire for Health-Care Workers, usando a técnica da análise de classe latente. Questões com porcentagens mais baixas de acertos são as relacionadas com a prevenção da transmissão de micro-organismos após exposição ao paciente por higiene das mãos e aquelas relacionadas com a utilização de preparações à base de álcool. Obtivemos um modelo de sete classes latentes. Principais diferenças sociodemográficas: os profissionais de conhecimentos mais baixos são homens, jovens e profissionais não relacionados à saúde; ter recebido treinamento anterior e não discriminar as pessoas com grande conhecimento. Concluímos que é necessária a revisão dos programas de formação de higiene das mãos para melhorar o conhecimento sobre aspectos conceituais da transmissão de micro-organismos pelas mãos

Almonds and their impact on gastrointestinal physiology, luminal microbiology and gastrointestinal function: a randomised controlled trial

OBJECTIVES: The objective of this study was to investigate the impact of almonds, and almond form (whole, ground) on fecal Bifidobacteria (primary outcome) and gut microbiology, physiology, and symptoms in healthy adults. METHODS: Eighty-seven healthy adults with moderate fiber intake (<22g/d) were randomized to receive whole almonds (56 g/d), ground almonds (56 g/d) or a control muffin (2/d) in place of their habitual snacks for 4 weeks. Fecal Bifidobacteria, gut microbiota composition and diversity (16S rRNA sequencing), short-chain fatty acids (SCFA; gas-chromatography), volatile organic compounds (gas-chromatography mass-spectrometry), gut transit time (wireless motility capsule), and stool output and symptoms (7-day diary) were measured at baseline and at end of intervention. Differences between groups were assessed by analysis of covariance (ANCOVA) or a non-parametric equivalent and corrected for multiple testing (Bonferroni (p) or Benjamini-Hochberg FDR (q)) where appropriate. RESULTS: There were no differences in relative abundance of fecal bifidobacteria following 4-weeks consumption of whole almonds (8.7%, SD 7.7), ground almonds (7.8%, SD 6.9) or control (13.0%, SD 10.2; q = 0.613). There was no effect of almonds on gut microbiota at the phylum level or on diversity. At the genus level, almonds (whole and ground pooled) increased relative abundance of Lachnospiraceae_NK4A136_group, Phascolarctobacterium and decreased Tyzerella (all p < 0.05), however these were no longer significant following FDR adjustment. Pre-specified analysis comparing almonds (whole and ground pooled) demonstrated higher concentrations of butyrate (24.1 μmol/g, SD 15.0) versus control (18.2, SD 9.1; p = 0.046). There was no effect of almonds on gut transit time, stool consistency or gut symptoms. Almond form as either whole (low nutrient bioaccessibility) or ground (higher nutrient bioaccessibility) did not affect any outcome. CONCLUSIONS: Almonds are a high fibre snack that can be incorporated into the diet of moderate fibre consumers with no adverse gastrointestinal symptoms. Almonds do not have major impact on global microbiota composition but may exert a prebiotic effect on microbial metabolism in healthy adults. FUNDING SOURCES: The Almond Board of California