In vitro faecal fermentation of monomeric and oligomeric flavan‐3‐ols: catabolic pathways and stoichiometry

Scope: The study evaluated the influence of flavan-3-ol structure on the production of phenolic catabolites, principally phenyl-γ-valerolactones (PVLs) and phenylvaleric acids (PVAs). Methods and results: A set of 12 monomeric flavan-3-ols and proanthocyanidins (degree of polymerisation (DP) of 2–5), were fermented in vitro for 24 h using human faecal microbiota, and catabolism was analysed by UHPLC-ESI-MS/MS. Up to 32 catabolites strictly related to microbial catabolism of parent compounds were detected. (+)-Catechin and (−)-epicatechin had the highest molar mass recoveries, expressed as a percentage with respect to the incubated concentration (75 μmol L–1) of the parent compound, for total PVLs and PVAs, both at 5 h (about 20%) and 24 h (about 40%) of faecal incubation. Only A-type dimer and B-type procyanidins underwent the ring fission step, and no differences were found in total PVL and PVA production (≃ 1.5% and 6.0% at 5 h and 24 h faecal incubation, respectively) despite the different DPs. Conclusion: The flavan-3-ol structure strongly affected the colonic catabolism of the native compounds, influencing the profile of PVLs and PVAs produced in vitro. This study opens new perspectives to further elucidate the colonic fate of oligomeric flavan-3-ols and their availability in producing bioactive catabolites

A systematic review and comprehensive evaluation of human intervention studies to unravel the bioavailability of hydroxycinnamic acids

Significance: Hydroxycinnamic acids (HCAs) are the main phenolic acids in the western diet. Harmonizing the available information on the absorption, distribution, metabolism, and excretion (ADME) of HCAs is fundamental to unraveling the compounds responsible for their health effects. This work systematically assessed pharmacokinetics, including urinary recovery, and bioavailability of HCAs and their metabolites, based on literature reports.Recent Advances: Forty-seven intervention studies with coffee, berries, herbs, cereals, tomato, orange, grape products, and pure compounds, as well as other sources yielding HCA metabolites, were included. Up to 105 HCA metabolites were collected, mainly acyl-quinic and C-6-C-3 cinnamic acids. C-6-C-3 cinnamic acids, such as caffeic and ferulic acid, reached the highest blood concentrations (maximum plasma concentration [C-max] = 423 nM), with time to reach C-max (T-max) values ranging from 2.7 to 4.2 h. These compounds were excreted in urine in higher amounts than their phenylpropanoic acid derivatives (4% and 1% of intake, respectively), but both in a lower percentage than hydroxybenzene catabolites (11%). Data accounted for 16 and 18 main urinary and blood HCA metabolites, which were moderately bioavailable in humans (collectively 25%).Critical Issues: A relevant variability emerged. It was not possible to unequivocally assess the bioavailability of HCAs from each ingested source, and data from some plant based-foods were absent or inconsistent.Future Directions: A comprehensive study investigating the ADME of HCAs derived from their most important dietary sources is urgently required. Eight key metabolites were identified and reached interesting plasma C-max concentrations and urinary recoveries, opening up new perspectives to evaluate their bioactivity at physiological concentrations

Withdrawal of mechanical ventilation in amyotrophic lateral sclerosis patients: a multicenter Italian survey

Background: Law 219/2017 was approved in Italy in December 2017, after a years-long debate on the autonomy of healthcare choices. This Law, for the first time in Italian legislation, guarantees the patient's right to request for withdrawal of life-sustaining treatments, including mechanical ventilation (MV). Objective: To investigate the current status of MV withdrawal in amyotrophic lateral sclerosis (ALS) patients in Italy and to assess the impact of Law 219/2017 on this practice. Methods: We conducted a Web-based survey, addressed to Italian neurologists with expertise in ALS care, and members of the Motor Neuron Disease Study Group of the Italian Society of Neurology. Results: Out of 40 ALS Italian centers, 34 (85.0%) responded to the survey. Law 219/2017 was followed by an increasing trend in MV withdrawals, and a significant increase of neurologists involved in this procedure (p 0.004). However, variations across Italian ALS centers were observed, regarding the inconsistent involvement of community health services and palliative care (PC) services, and the intervention and composition of the multidisciplinary team. Conclusions: Law 219/2017 has had a positive impact on the practice of MV withdrawal in ALS patients in Italy. The recent growing public attention on end-of-life care choices, along with the cultural and social changes in Italy, requires further regulatory frameworks that strengthen tools for self-determination, increased investment of resources in community and PC health services, and practical recommendations and guidelines for health workers involved

Effect of the Pasta Making Process on Slowly Digestible Starch Content

The rate at which starch is digested in the human intestine elicits different glycemic responses and reflects the glycemic index (GI) of foods. In vitro measurement of starch digestibility can reflect the GI of food. Differences in starch digestibility among four durum wheat pasta samples, couscous, and bread were evaluated to better describe the role of the pasta making process in affecting starch digestibility. Statistical differences in RDS (rapidly digestible starch), SDS (slowly digestible starch), and RS (resistant starch) of products were found (p < 0.05). As expected, pasta samples showed the highest value of SDS/av starch compared to couscous and bread. Fusilli and cavatelli samples presented the highest SDS/av starch ratio (55.80 +/- 3.06% and 53.91 +/- 3.50%, respectively), then came spaghetti 49.39 +/- 2.83% and penne 45.93 +/- 1.19%, while couscous presented the lowest value of SDS/av starch (2.64 +/- 0.50%), followed by bread (11.78 +/- 2.63%). Our study confirmed that the pasta making process efficiently mediates an increase in SDS/Av starch content, which has been specifically quantified above 40%, therefore strongly related to a lowered glycemic response in vivo. Our results strengthened the concept that pasta is a good source of SDS, which makes it useful for glycemic control

Optimal energy control for smart charging infrastructures with ESS and REG

The adoption of the smart and sustainable charging infrastructures for electric vehicles (EVs) represents a key-point to accelerate the electro-mobility uptake. This paper presents an optimal power flow management for a smart charging micro-grid that minimizes the cost and reduces the impact on the grid of EVs requests. This goal is achieved by means of an optimal integration and control of renewable energy, stationary energy storage system, and V2G into the charging infrastructure. In particular, the optimal power flow management solves a stochastic multilayer optimization problem based on the definition of different priority levels representing the coordination of the ESS with the other sources. The output of the algorithm is the day-ahead prediction of the energy generation and, thus, the optimization of energy flow during the entire day. Possible variation of energy sources during the operation are also taken into account by means of a real time control adaptation

Human colonic catabolism of dietary flavan-3-ol bioactives

Understanding the fate of ingested polyphenols is crucial in elucidating the molecular mechanisms underlying the beneficial effects of a fruit and vegetable-based diet. This review focuses on the colon microbiota-mediated transformation of the flavan-3-ols and the structurally related procyanidins found in dietary plant foods and beverages, plus the flavan-3-ol-derived theaflavins of black tea, and the post-absorption phase II metabolism of the gut microbiota catabolites. Despite significant advances in the last decade major analytical challenges remain. Strategies to address them are presented