Metabolic responses to starch in oat and wheat products. On the importance of food structure, incomplete gelatinization or presence of viscous dietary fibre

Objective: Evaluate the impotrtance of incomplete gelatinization, food structure and presence of viscous dietary fibre for the postprandial glycaemic and insulinaemic responses to oat and wheat products. Design: Three common breakfast meals were tested, "raw" rolled oats (muesli), boiled rolled oats (oat porridge) and white wheat bread. Boiled intact oat and wheat kernels (kernel porridges) were also included. For comparison, glycemic indices (GIs) were calculated both from analysis of capillary and venous blood samples. Subjects: Nine healthy male volunteers between 65 and 70 years of age participated in the study. Results: The rolled oats and oat porridge elicited high metabolic responses. No differences in glycaemic and insulinaemic indices (IIs) were seen between these products and white bread. In contrast, the kernel porridges produced low glucose and insulin responses. No differences were obtained in GI values whether based on capillary or venous blood. However, with some products capillary blood allowed smaller differences to be detected. Conclusions: Neither incompleate gelatinization in rolled oats nor naturally occuring viscous dietary fibre in oats affect postprandial glycaemia, whereas enclosure if intact kernels significantly blunt metabolic responses

Colicky infants according to maternal reports in telephone interviews and diaries: a large Scandinavian study.

In this population-based study the colic incidence was 9.4%, according to telephone interviews with the parents made when the infants were 5 weeks of age (n = 1628), and parental concern about infant crying was common. However, 7-day diaries of colicky and control infants (n = 116 + 119) revealed low distress amounts in colicky infants in general. In the subgroup of Wessel-colicky infants (n = 37), distress episodes were frequent and long lasting, and there was a high proportion of colicky crying versus fussing and normal crying. Even if there may be a reduction in the infantile colic incidence and support for the hypothesis that infantile colic is at least partially "in the eye of the beholder," that is, the concerned parent, a subgroup of infants may be more "genuinely colicky." Women who had stated in late-pregnancy interviews that there is a risk of spoiling an infant with too much physical contact were more likely to have infants with colic, and their infants were more distressed, even when given the same amount of physical contact. This finding warrants further elucidation

Early patient contact in primary care: a new challenge

Background The Medical School of Lund University, Sweden, has introduced an early patient contact course, including training in communication and examination skills. The course runs parallel with theoretical subjects during the students' first two-and-a-half years. General practitioner (GP) participation is gradually increasing, and in the last half-year of the course GPs in all health centres in the area are involved. Little is known about the GPs' interest, competence and time for this new task. Aim To describe the GPs' attitudes towards teaching and the rewards and problems they experience. Subjects 30 GPs teaching third-year medical students. Method Semistructured interview study. Data analysis by a method described by Malterud. Results The attitude towards teaching was mostly positive and the teachers were confident about teaching examination procedure. Among rewards of teaching, improved quality of, clinical practice was the main theme, but imparting knowledge to others, contact with enthusiastic students, and gains in self-esteem were also mentioned. Problems with teaching were mostly due to external factors such as lack of time and space, but concern about a negative effect on patient care was also recognized. Educational objectives of the course were not completely accepted. GPs were not fully aware about what to expect from the students, with subsequent problems concerning how to assess students' performance and how to give effective feedback. Conclusions The teaching of junior medical students is maintained by the GPs' enthusiasm for teaching. However, teacher training is required and the crucial issues of time and space have to be considered

Higher risk of colic in infants of nonmanual employee mothers with a demanding work situation in pregnancy.

In this population-based study, we assessed the relation between socioeconomic and psychosocial conditions in 1,094 pregnant women and subsequent infantile colic by means of self-administered questionnaires measuring exposures in the 17th pregnancy week and telephone interviews at infant age 5 weeks. There was a higher risk of colic in infants born to younger mothers, mothers with low instrumental support in pregnancy, and mothers with nonmanual occupations. Having an "active" job situation, that is, high demands and high decision latitude at work, acted synergistically with a nonmanual occupation, yielding even higher odds ratios for colic as did concomitant low instrumental support and nonmanual occupation. An expected synergy between low social participation and nonmanual occupation could not be demonstrated. Findings from gender-related research may partly explain some of these results

Satiety effects of spinach in mixed meals : comparison with other vegetables

The effects of vegetables in mixed meals on satiety were evaluated by varying the dose (portions 150 and 250 g containing 4.3 and 7.2 g of dietary fibre, respectively) and structure (cut and minced) of microwaved spinach. A control meal without spinach and the test meals with spinach were balanced regarding energy (2000 kJ) and digestible carbohydrates (59 g, 51 E%) and with protein and fat as far as possible similar. The meals were served in the morning, after an overnight fast, to ten healthy male volunteers. Satiety was registered and blood glucose as well as plasma insulin and C-peptide were analysed at regular intervals until 3.5 h postprandially. The largest spinach portions augmented satiety and reduced the postprandial glucose response. The total satiety scores seemed to be correlated positively to both the dietary fibre and the water content in the vegetable. Differences in structure had no influence on satiety scores

Dietary fiber decreases fasting blood glucose levels and plasma LDL concentration in noninsulin-dependent diabetes mellitus patients

Realistic high-fiber and regular low-fiber diets were given for 8 wk each to noninsulin-dependent diabetes mellitus (NIDDM) patients whose diabetes was being controlled satisfactorily by diet alone. The purpose of the study was to evaluate the metabolic effects of dietary fiber without changing energy intake or proportions of protein, fat, and carbohydrates. The high-fiber diet induced lower fasting blood glucose levels (p less than 0.01) and decreased the ratio of low-density lipoproteins to high-density lipoproteins (p less than 0.025); no difference was found in HbA1c between the two diet periods. Continuous glucose monitoring also showed a difference in fasting glucose levels that remained after identical low-fiber test meals. The incremental glucose responses did not differ. The fasting and incremental postprandial levels of insulin, C-peptide, glucagon, and somatostatin did not change, whereas the mean triglyceride concentrations were lower after the high-fiber diet. The results suggest a beneficial effect of dietary fiber in the metabolic control of NIDDM

Infantile colic, maternal smoking and infant feeding at 5 weeks of age.

BACKGROUND: Many parents seek help from health professionals because of their infants' persistent crying in the early months. The aetiology of this condition, often labelled ;;infantile colic'', is still unclear. AIMS: To assess whether smoking during pregnancy, and/or smoking at infant age 5 weeks, is associated with infantile colic, and to describe how feeding at infant age 5 weeks and smoking are related to colic. METHODS: This was a community-based study, with telephone interviews in late pregnancy, and at infant age 5 weeks, covering 1,625 mother-infant dyads, i.e. 86% of the eligible population. RESULTS: Daily maternal smoking in pregnancy was related to subsequent colic, with an age-adjusted odds ratio (OR) of 1.74 (95% confidence interval 1.08-2.82). In the multivariate model, the OR was largely unaltered. The association between smoking at infant age 5 weeks and colic did not reach statistical significance. The subgroups based on smoking and infant feeding were small, but the results suggest that exclusive breast-feeding was protective against colic, including for infants of smoking mothers. CONCLUSIONS: This study presents yet another argument why smoking in pregnancy should be discouraged - some cases of infantile colic may be avoided. With regard to mothers who are not able to give up smoking, the results add some support for the conclusion that if a mother is worried about colic, she certainly should not refrain from breast-feeding even if she smokes