Influence of processing on the volatile profile of strawberry spreads made with isomaltulose

[EN] A new strawberry spread formulated with fructose and isomaltulose (replacing sucrose partially or totally) and a high percentage of fruit was developed in line with the new trend of healthier products. This work studies the influence of some process variables (percentage of sugar, pectin and citric acid, and time of thermal treatment) on the volatile profile of these spreads with different formulations. The ripeness of the raw strawberries influences the concentrations of some of the compounds in the spreads, such as isobutyl acetate, butyl butyrate, 3-hexen-1-yl acetate or propan-2-ol. The process conditions have an important effect on the volatile profiles. Most of the esters and alcohols decreased whereas 13 new compounds appear, mostly furans (furfural, 2-acetylfurane, 5-methyl furfural, mesifurane) and aldehydes (octanal, nonanal, decanal and benzaldeyhde). In general, the spreads formulated with sucrose-isomaltulose that contained higher levels of pectin and citric acid gave better results in the preservation of the original aromatic compounds in raw strawberries.Authors would like to thank Direccion General de Investigacion del Ministerio de Ciencia y Tecnologia (AGL2008-01745/ALI) as well as the Universitat Politecnica de Valencia for the financial support given to this investigation.Peinado Pardo, I.; Rosa Barbosa, EM.; Heredia Gutiérrez, AB.; Escriche Roberto, MI.; Andrés Grau, AM. (2013). Influence of processing on the volatile profile of strawberry spreads made with isomaltulose. Food Chemistry. 138(1):621-629. https://doi.org/10.1016/j.foodchem.2012.09.104S621629138

Accumulation of Polychlorinated Biphenyls in Adipocytes: Selective Targeting to Lipid Droplets and Role of Caveolin-1

Background : Polychlorinated biphenyls (PCBs) are persistent environmental pollutants that preferentially accumulate in lipid-rich tissues of contaminated organisms. Although the adipose tissue constitutes a major intern reservoir of PCBs and recent epidemiological studies associate PCBs to the development of obesity and its related disorders, little is known about the mechanisms involved in their uptake by the adipose tissue and their intracellular localization in fat cells

Fasting-based estimates of insulin sensitivity in overweight and obesity: A critical appraisal

Objective: To identify simple methods to estimate the degree of insulin resistance. Research Methods and Procedures: The performance of a wide range of fasting-based index estimates of insulin sensitivity was compared by receiver operating characteristic analysis (area under curves and their 95% confidence intervals) against the M value from euglycemic insulin clamp studies collected in the San Antonio (non-Hispanic whites and Hispanic residents of San Antonio, TX) and European Group for the Study of Insulin Resistance (non-diabetic white Europeans) databases (n = 638). Results: Insulin resistance differed substantially between lean (BMI = 25 kg/m(2)), and type 2 diabetic individuals. Estimates of insulin resistance were, therefore, assessed in each group separately. In the overweight and obese subgroup (n = 302), the receiver operating characteristic performance of fasting-based indices varied from 0.72 (0.62 to 0.82), in the case of the insulin/glucose ratio, to 0.80 (0.72 to 0.88) in the case of Belfiore free fatty acids. One superior method could not be identified; the confidence intervals overlapped, and no statistically significant differences emerged. All indices performed better when using the whole study population, with fasting plasma insulin, homeostatic model assessment insulin/glucose ratio, quantitative insulin sensitivity check index, glucose/insulin ratio, Belfiore glycemia, revised quantitative insulin sensitivity check index, McAuley index, and Belfiore free fatty acids showing area under curves of 0.83, 0.90, 0.66, 0.90, 0.66, 0.90, 0.85, 0.83, and 0.86, respectively, because of the inclusion of very insulin sensitive (lean) and very insulin resistant cases (diabetic subjects). Discussion: In conclusion, a superior fasting-based index estimate to distinguish between the presence and absence of insulin resistance in overweight and obesity could not be identified despite the use of the large datasets

Glycemic Control after Sleeve Gastrectomy and Roux-En-Y Gastric Bypass in Obese Subjects with Type 2 Diabetes Mellitus

Background Roux-en-Y gastric bypass (LRYGB) has weight-independent effects on glycemia in obese type 2 diabetic patients, whereas sleeve gastrectomy (LSG) is less well characterized. This study aims to compare early weight-independent and later weight-dependent glycemic effects of LRYGB and LSG. Methods Eighteen LRYGB and 15 LSG patients were included in the study. Glucose, insulin, GLP-1, and GIP levels were monitored during a modified 30 g oral glucose tolerance test before surgery and 2 days, 3 weeks, and 12 months after surgery. Patients self-monitored glucose levels 2 weeks before and after surgery. Results Postoperative fasting blood glucose decreased similarly in both groups (LRYGB vs. SG; baseline—8.1 ± 0.6 vs. 8.2 ± 0.4 mmol/l, 2 days—7.8 ± 0.5 vs. 7.4 ± 0.3 mmol/l, 3 weeks—6.6 ± 0.4 vs. 6.6 ± 0.3 mmol/l, respectively, P < 0.01 vs. baseline for both groups; 12 months—6.6 ± 0.4 vs. 5.9 ± 0.4, respectively, P < 0.05 for LRYGB and P < 0.001 for LSG vs. baseline, P = ns between the groups at all times). LSG, but not LRYGB, showed increased peak insulin levels 2 days postoperatively (mean ± SEM; LSG + 58 ± 14%, P < 0.01; LRYGB − 8 ± 17%, P = ns). GLP-1 levels increased similarly at 2 days, but were higher in LRYGB at 3 weeks (AUC; 7525 ± 1258 vs. 4779 ± 712 pmol × min, respectively, P < 0.05). GIP levels did not differ. Body mass index (BMI) decreased more after LRYGB than LSG (− 10.1 ± 0.9 vs. − 7.9 ± 0.5 kg/m2, respectively, P < 0.05). Conclusion LRYGB and LSG show very similar effects on glycemic control, despite lower GLP-1 levels and inferior BMI decrease after LSG

Sex differences in diabetic foot ulcer severity and outcome in Belgium

Background Sex differences are increasingly recognized to play an important role in the epidemiology, treatment and outcomes of many diseases. This study aims to describe differences between sexes in patient characteristics, ulcer severity and outcome after 6 months in individuals with a diabetic foot ulcer (DFU). Methods A total of 1,771 patients with moderate to severe DFU participated in a national prospective, multicenter cohort study. Data were collected on demographics, medical history, current DFU and outcome. For data analysis, a Generalized Estimating Equation model and an adjusted Cox proportional hazards regression were&nbsp;used. Results The vast majority of patients included were male (72%). Ulcers in men were deeper, more frequently displaying probe to bone, and more frequently deeply infected. Twice as many men presented with systemic infection as women. Men demonstrated a higher prevalence of previous lower limb revascularization, while women presented more frequently with renal insufficiency. Smoking was more common in men than in women. No differences in presentation delay were observed. In the Cox regression analysis, women had a 26% higher chance of healing without major amputation as a first event (hazard ratio 1.258 (95% confidence interval&nbsp;1.048–1.509)). Conclusions Men presented with more severe DFU than women, although no increase in presentation delay was observed. Moreover, female sex was significantly associated with a higher probability of ulcer healing as a first event. Among many possible contributing factors, a worse vascular state associated with a higher rate of (previous) smoking in men stands&nbsp;out.</p

The COVID-19 pandemic minimally interfered with delivery of care and did not result in worse outcomes of diabetic foot ulcers in Belgium

Aim: The Belgian government introduced a national COVID-19 lockdown from 14/03 until 03/05/2020 during which only urgent medical care was allowed. In a first phase of this study, we showed that diabetic foot clinics (DFC) remained accessible to patients and that the impact of the lockdown on DFU severity was limited to larger lesions. This second phase investigates the impact of the lockdown on the treatment and outcome of DFU. Method: Within the national care quality improvement initiative (IQED-Foot), a prospective cohort study was conducted among 21 DFC. 910 consecutive patients with DFU of Wagner grade ≥ 2 were included between 01/01 and 30/09/2020. Patients were divided based on their first contact into the pre-lockdown (A, n=324), lockdown (B,&nbsp; n=94) or post-lockdown group (C, n=492). Groups were compared with each other and with 2018 data. Competing risks for healing, major amputation or death as first event were assessed by Cox proportional hazards&nbsp;regression. Results: &nbsp;Although overall offloading rates for plantar DFU did not differ, patients that presented during lockdown received more often ankle-high offloading using a shoe (B: 60% vs. C: 42%; p&lt;0.05). Revascularization rates of patients with (sub)critical ischemia were similar, however less patients that presented during lockdown underwent open vascular surgery compared to the same period in 2018 (B: 3.3% vs. 31.3% in 2018; p&lt;0.001). No differences were observed regarding minor or major amputation rates. The overall probability of DFU healing (HR=1.03, 95%CI 0.88-1.21), major amputation (HR=0.77, 95%CI 0.58-1.01) or death (HR=1.26, 95%CI 0.79-1.99) as a first event was not different compared to&nbsp;2018. Conclusion: Organization of multidisciplinary diabetic foot care into specialized tertiary DFC has shown to be a robust system. DFC guaranteed continued access and delivery of DFU care during the COVID-19 crisis. This resulted in similar outcomes of DFU compared to the 2018 IQED-Foot&nbsp;audit.</p

The COVID-19 pandemic strongly reduced the presentation rate of diabetic foot ulcers in Belgium, but the impact on severity was limited to slightly larger lesions

Aim: The Belgian government introduced a national COVID-19 lockdown from 14/03 until 03/05/2020. Free movement was restricted and only urgent medical care was allowed. Although diabetic foot clinics (DFC) were advised to treat all foot problems as urgent, patients were reluctant to visit the hospital. This study investigates the impact of the lockdown on presentation rate and diabetic foot ulcer (DFU) severity at&nbsp;presentation. Method: Within the ongoing national care quality improvement initiative (IQED-Foot), a prospective cohort study was conducted among 22 DFC. 887 consecutive patients with DFU of Wagner grade ≥ 2 were included. Patients were divided based on their first contact: pre-lockdown group (A, first contact between 01/01 and 13/03/2020, n=322) or (post-)lockdown group (B,&nbsp; first contact between 14/03 and 30/09/2020,&nbsp;&nbsp;n=565). Results: &nbsp;All DFC, except one, remained open for active foot problems with implementation of COVID-19 measures. During lockdown, the average weekly presentation rate was strongly reduced (0.6 vs. 1.4 patients/week/DFC in 2018; p&lt;0.001). However, median patient-reported presentation delay did not increase (A: 3 [1-8] vs. B: 3 [1-7] weeks; p=0,81). Demographic data such as gender, age, diabetes type and duration were not different. Patients that presented during/after lockdown had less frequently a prior DFU (B: 50% vs. A: 60%; p=0,005). Regarding DFU severity, patients seen during/after lockdown had less frequently critical ischemia (B: 11% vs. A: 18%; p=0.0103) and presented with slightly larger lesions (&lt; 1cm2 B: 32% vs. A: 38%; p=0.0003, 1-3cm2 B: 45% vs. A: 40%; p=0.0152). No differences in depth, infection or loss of protective sensation were&nbsp;observed. Conclusion: DFC in Belgium remained accessible to patients with foot problems. Although patient inclusion was strongly reduced, overall presentation delay did not increase. The impact on DFU severity was limited to slightly larger lesions. Follow-up is ongoing and outcome data will be available by&nbsp;September.</p