Effect of sugar-sweetened beverage taxation on sugars intake and dental caries : an umbrella review of a global perspective

Background As part of the Global Strategy on Oral health, the World Health Organization (WHO) is exploring cost-effective interventions for oral health, including taxation on sugar-sweetened beverages (SSBs). To inform this process, this umbrella review aimed to identify the best available estimates pertaining to the impact of SSB taxation on the reduction of sugars intake, and the sugars-caries dose–response, such that estimates of the impact of SSB taxation on averting dental caries in both high (HIC) and low and middle (LMIC) countries be available. Methods The questions addressed were: (1) what are the effects of SSB taxation on consumption of SSBs and (2) sugars? (3) What is the effect on caries of decreasing sugars? and (4) what is the likely impact of a 20% volumetric SSB tax on the number of active caries prevented over 10 years? Data sources included PubMed, Embase, Web of Science, Scopus, CINAHL, Dentistry and Oral Sciences Source, Cochrane Library, Joanna Briggs Institute (JBI) Systematic Review Register, and PROSPERO. The review was conducted with reference to JBI guidelines. The quality of included systematic reviews was assessed using AMSTAR to identify best evidence. Results From 419 systematic reviews identified for questions 1 & 2, and 103 for question 3, 48 (Questions 1 & 2) and 21 (Question 3) underwent full text screening, yielding 14 and five included reviews respectively. Best available data indicated a 10% tax would reduce SSB intake by 10.0% (95% CI: -5.0, 14.7%) in HIC and by 9% (range -6.0 to 12.0%) in LMIC, and that a 20% tax would reduce free sugars intake on average by 4.0 g/d in LMIC and 4.4 g/d in HIC. Based on best available dose response data, this could reduce the number of teeth with caries per adults (HIC and LMIC) by 0.03 and caries occurrence in children by 2.7% (LMIC) and 2.9% (HIC), over a 10-year period. Conclusion Best available data suggest a 20% volumetric SSB tax would have a modest impact on prevalence and severity of dental caries in both HIC and LMIC

The effects of the amino acid, L-tryptophan, alone or with the fatty acid, lauric acid, on energy intake and postprandial glycaemia in health, obesity and type 2 diabetes

The studies reported in this thesis investigated whether specific dietary nutrients, including amino acids and fatty acids, when administered intraduodenally or intragastrically, reduce energy intake and/or blood glucose in healthy people and those with obesity and type 2 diabetes. These studies also investigated whether the effects are associated with modulation in GI functions, i.e. gut hormones, gut motility and gastric emptying. Moreover, they quantified extra-intestinal factors, including circulating amino acid concentrations, that may be surrogate markers for activity in central pathways in the brain. The key findings of the studies are: 1. Intragastric L-tryptophan, in a dose of 3 g, increased the plasma tryptophan/large neutral amino acids ratio more in lean participants than those with obesity, and in the lean the suppression of energy intake in response to tryptophan was related to the plasma tryptophan/LNAA ratio in the lean (Chapter 2). 2. Intragastric L-tryptophan, in a dose of 3 g, potently reduced energy intake, in both lean individuals and those with obesity. Suppression of energy intake was related to circulating tryptophan and the plasma tryptophan/LNAA ratio. L-tryptophan also suppressed appetite for 2 hours after the meal, despite the reduced energy intake. In the lean, appetite suppression was related to circulating tryptophan and the plasma tryptophan/LNAA ratio in lean participants (Chapter 3). 3. In individuals with type 2 diabetes, intragastric administration of L-tryptophan, in a dose of 3 g, before a carbohydrate-containing drink delayed the rise in plasma glucose, probably as a result of slowing of gastric emptying, but did not affect the overall blood glucose response (Chapter 4). 4. Intraduodenal infusion of lauric acid in combination with L-tryptophan, and lauric acid alone delayed the rise in postprandial plasma glucose in healthy men, probably by slowing of gastric emptying and GLP-1 stimulation, while L-tryptophan was ineffective (Chapter 5). In conclusion, the research presented in this thesis has established that while L-tryptophan potently suppresses energy intake in lean people and those with obesity, its effect on postprandial blood glucose differs between health, obesity and type 2 diabetes. GI factors, including gastric emptying and gut and pancreatic hormones, contribute to these effects, but apparently to varying extents, and other post-absorptive factors also play a role. Finally, the combination of lauric acid and L-tryptophan, each in doses that individually do not reduce postprandial glycaemia, has a potent effect to delay the early rise in postprandial glucose, reflecting slowing of gastric emptying. Further research is indicated to investigate the sustained effects of L-tryptophan on appetite, energy intake and body weight. Moreover, studies to assess the effect of the combination of lauric acid and L-tryptophan on postprandial glycaemia in obesity and/or type 2 diabetes are also indicated. Broadly, the purpose of these studies would be to determine whether these nutrients have the potential to offer a novel, nutrient-based treatment option for the management of obesity and/or type 2 diabetes.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 202

Gastrointestinal Sensing of Meal-Related Signals in Humans, and Dysregulations in Eating-Related Disorders

The upper gastrointestinal (GI) tract plays a critical role in sensing the arrival of a meal, including its volume as well as nutrient and non-nutrient contents. The presence of the meal in the stomach generates a mechanical distension signal, and, as gastric emptying progresses, nutrients increasingly interact with receptors on enteroendocrine cells, triggering the release of gut hormones, with lipid and protein being particularly potent. Collectively, these signals are transmitted to the brain to regulate appetite and energy intake, or in a feedback loop relayed back to the upper GI tract to further adjust GI functions, including gastric emptying. The research in this area to date has provided important insights into how sensing of intraluminal meal-related stimuli acutely regulates appetite and energy intake in humans. However, disturbances in the detection of these stimuli have been described in a number of eating-related disorders. This paper will review the GI sensing of meal-related stimuli and the relationship with appetite and energy intake, and examine changes in GI responses to luminal stimuli in obesity, functional dyspepsia and anorexia of ageing, as examples of eating-related disorders. A much better understanding of the mechanisms underlying these dysregulations is still required to assist in the development of effective management and treatment strategies in the future

Soy product consumption and association with health characteristics and dietary quality indices in Isfahan, Iran

BACKGROUND: To determine the average intake of soy products and its association with socio-demographic, general and health characteristics, and dietary quality indices among the population of Isfahan, Iran. METHODS: In this descriptive cross-sectional study conducted on 491 subjects in 2013-2014, grocery stores, nuts stores, chain stores, and supermarkets from different areas of Isfahan Municipality were visited. Shop owners were asked to report the amounts of soy products sales (soy nut, processed soy protein, soy milk and soy yogurt). Furthermore, a food frequency questionnaire was completed from 496 customers by an experienced nutritionist. Mean sales and intake of soy products and dietary intakes including dietary quality indices and mean adequacy ratio (MAR) as well as anthropometric and socio-demographic variables were assessed. RESULTS: Soy protein and soy yogurt are the highest [673 &plusmn; 81 (g/month)] and lowest [420 &plusmn; 148 (g/month)] purchased soy products, respectively. While soy nut [63 &plusmn; 10 (g/month)] was consumed to the lowest amount, soy protein [236 &plusmn; 39 (g/month)] was the most consumed soy product. Subjects with higher consumption of soy products were older and had higher intake of protein, vitamin C, zinc and iron, and lower intake of whole grains, legumes, and vegetables as well as greater values of MAR and dietary diversity score as well as nutrient adequacy ratio for vitamin C. CONCLUSION: Soy protein is the most purchased and consumed soy product among people living in Isfahan. More intakes of whole grains and vegetables among those with higher consumption of soy foods could define greater quantities of zinc, iron and vitamin C in the diet. Soy consumption had a reverse correlation with body mass index.&nbsp;</div

Influence of ginger and cinnamon intake on inflammation and muscle soreness endued by exercise in Iranian female athletes

Background: Ginger rhizomes (rich in gingerols, shogaols, paradols and zingerone) have been used in Asia for the treatment of asthma, diabetes, and pain, and have shown potent anti-inflammatory attributes. Common spices such as Cinnamon (including cinnamic aldehyde and cinnamyl aldehydeis) are used in food and many studies have focused on its anti-inflammatory components. Intense exercise can result in an inflammatory response to cell damage and also muscle soreness. The efficacy of dietary ginger and cinnamon as anti-inflammatory agents and their effectiveness in reducing muscle soreness has been investigated in limited studies on humans. Therefore, we have studied the effects of dietary ginger and cinnamon on inflammation and muscle soreness in Iranian female taekwondo players. Methods: Sixty healthy, trained women, aged 13-25 years, were enrolled in the six-week investigation and randomly categorized into three groups (cinnamon, ginger or placebo) and received 3 g of ginger, cinnamon or placebo powder each day, depending on the group they belonged to. The IL-6 level and Likert Scale of Muscle Soreness were evaluated at the beginning and the end of the study and compared among the groups. Results: Forty-nine of the participants completed the six-week intervention. There were no significant changes in the IL-6 cinnamon and ginger group when compared with the placebo group, whereas, there was a significant fall in muscle soreness in the cinnamon group and placebo ( P < 0.1) and ginger group and placebo ( P < 0.01). Conclusions: Administration of ginger and cinnamon in athlete women for six weeks did not show any significant change in the IL-6 level, but showed a decrease in muscle soreness in the cinnamon and ginger groups

Quercetin and vitamin c supplementation: effects on lipid profile and muscle damage in male athletes

Background: Quercetin, which is considered as a health-promoting antioxidant, belongs to the broad flavonoids group. Numerous experimental studies have proved that quercetin and vitamin C provide anti-inflammatory and antioxidant properties. The aim of this study is to assess the effects of both quercetin and vitamin C on lipid profile and muscle damage in human subjects. Methods: A randomized, placebo-controlled, double-blind clinical trial was carried out on 60 males for eight weeks. The subjects were randomly assigned to one of the four groups: 1) quercetin + vitamin C (500 mg/day quercetin + 200 mg/day vitamin C) 2) quercetin (500 mg/day quercetin + 200 mg/day placebo) 3) vitamin C (500 mg/day vitamin C + 200 mg/day placebo) and 4) placebo (500 mg/day placebo + 200 mg/day placebo). Blood samples, body weight and percent of body fat were measured before and after intervention. In addition, dietary intake was estimated using 24-h recall. Results: No significant changes occurred in high-density lipoprotein levels between groups and in the four groups before and after supplementation. Low density lipoprotein values decreased significantly ( P = 0.048) in the "Quercetin + Vit C" group but decrease was not considerable in other groups before and after intervention and among groups. Fat-soluble vitamins′ intake was significantly high among 4 groups. Conclusions: Quercetin and vitamin C supplementation may not be beneficial in lipid profile improvement, although it may reduce induce muscle damage and body fat percent