Distinct Characteristics of Rye and Wheat Breads Impact on Their in Vitro Gastric Disintegration and in Vivo Glucose and Insulin Responses

Disintegration of rye and wheat breads during in vitro gastric digestion and its relation to the postprandial glucose and insulin responses of the breads was studied. Breads with distinct composition and texture characteristics were prepared with refined or wholegrain wheat and rye flour by using either straight dough or sourdough process. After chewing and gastric digestion in vitro, 100% wholemeal and refined rye breads prepared by sourdough method were disintegrated to a much lower extent than the wheat breads, having more bread digesta particles with size over 2 or 3 mm. Microstructure of the digesta particles of rye sourdough bread revealed more aggregated and less degraded starch granules when compared to refined wheat bread. The postprandial insulin responses, but not those of glucose, to the 100% rye breads made with sourdough method were lower than the responses to the refined wheat bread. Addition of gluten or bran in rye sourdough bread increased insulin response. PCA (Principal Component Analysis) analysis confirmed that the insulin response had a negative correlation with the number of larger particles after in vitro digestion as well as amount of soluble fiber and sourdough process. Since the high relative proportion of large sized particles after chewing and in vitro gastric digestion was associated with low postprandial insulin responses, the analysis of structural disintegration in vitro is proposed as a complementary tool in predicting postprandial physiology.Peer reviewe

Variability of enterprise architecture elements in Finnish ePrescription projects

The governance of large eHealth initiatives is complicated by multiple viewpoints and autonomy of numerous different stakeholder organizations. In addition, the lifecycle of goals and requirements spans multiple different organizations, as well as various specification, development and deployment projects, application systems and products. Governance requires traceability of requirements and design decisions in the lifecycle of large-scale initiatives and between various levels of abstraction. Enterprise architecture (EA) approaches have been used for governance of complex and long-term intra- and inter-enterprise initiatives. We provide a model which we use to conceptually analyze variability of several EA elements throughout the extended lifecycle of development goals of projects related to national ePrescription in Finland. The analysis is based on case experience, material and interpretive methods in relation to nine projects. The analyzed elements and EA artefacts have been proposed as being especially central and relevant for many enterprise architecture initiatives. The results illustrate the differences in presence, plurality and abstraction level of central EA elements throughout the project continuum of ePrescription. The results highlight dependencies and transformations which are likely to be encountered in large-scale eHealth efforts in general. The results may be used to support the traceability and refinement of EA elements in the planning and governance of interdependent projects

Status of Interoperability Requirements related to IHE Integration Profiles in Finland

IHE (Integrating the Healthcare Enterprise) integration profiles provide means for uniform application of central interoperability standards for specific use cases in healthcare. The IHE model involves global development and local deployment of integration profiles. This paper reports the results of a national survey and a set of expert interviews which explored the current integration needs of healthcare organizations, application vendors and national health IT initiatives in relation to the requirements covered by IHE integration profiles. For several integration needs, the use cases of IHE integration profiles match the current needs of the respondents. IT infrastructure and radiology profiles received most responses, but also other domains or profiles such as laboratory, patient care devices and personal health records received interest. Based on the results, factors influencing the adoption of external profiles or implementation guides of standards for local or national projects are discussed

Comprehensive two-dimensional gas chromatography–mass spectrometry analysis of exhaled breath compounds after whole grain diets

Exhaled breath is a potential noninvasive matrix to give new information about metabolic effects of diets. In this pilot study, non-targeted analysis of exhaled breath volatile organic compounds (VOCs) was made by comprehensive two-dimensional gas chromatography–mass spectrometry (GCxGC-MS) to explore compounds relating to whole grain (WG) diets. Nine healthy subjects participated in the dietary intervention with parallel crossover design, consisting of two high-fiber diets containing whole grain rye bread (WGR) or whole grain wheat bread (WGW) and 1-week control diets with refined wheat bread (WW) before both diet periods. Large interindividual differences were detected in the VOC composition. About 260 VOCs were detected from exhaled breath samples, in which 40 of the compounds were present in more than half of the samples. Various derivatives of benzoic acid and phenolic compounds, as well as some furanones existed in exhaled breath samples only after the WG diets, making them interesting compounds to study further.</p

Impact of Dietary Polyphenols on Carbohydrate Metabolism

Polyphenols, including flavonoids, phenolic acids, proanthocyanidins and resveratrol, are a large and heterogeneous group of phytochemicals in plant-based foods, such as tea, coffee, wine, cocoa, cereal grains, soy, fruits and berries. Growing evidence indicates that various dietary polyphenols may influence carbohydrate metabolism at many levels. In animal models and a limited number of human studies carried out so far, polyphenols and foods or beverages rich in polyphenols have attenuated postprandial glycemic responses and fasting hyperglycemia, and improved acute insulin secretion and insulin sensitivity. The possible mechanisms include inhibition of carbohydrate digestion and glucose absorption in the intestine, stimulation of insulin secretion from the pancreatic β–cells, modulation of glucose release from the liver, activation of insulin receptors and glucose uptake in the insulin-sensitive tissues, and modulation of intracellular signalling pathways and gene expression. The positive effects of polyphenols on glucose homeostasis observed in a large number of in vitro and animal models are supported by epidemiological evidence on polyphenol-rich diets. To confirm the implications of polyphenol consumption for prevention of insulin resistance, metabolic syndrome and eventually type 2 diabetes, human trials with well-defined diets, controlled study designs and clinically relevant end-points together with holistic approaches e.g., systems biology profiling technologies are needed

Needs for Open Interfaces in Personal Health Record Systems and Citizen eServices – Results from a National Survey

Electronic services for supporting self-care, personal wellbeing management, communication between citizens and service providers, and citizen-centric care processes are developed in many countries and initiatives. Interoperability between these services and between them and information systems for service provision is increasingly needed. Open and standardized interfaces to support such interoperability must be selected or specified according to the needs of stakeholders in each project and environment. We report the results of a national survey related to the needs of open interfaces for self-care, citizen services and personal health records. The survey was performed using a web-based questionnaire focusing on the needs for open interface specifications. Interface needs were classified in nine categories. Respondents (n=23) represented health care solution providers / vendors, health service providers and research organizations. The majority of answers regarding the interface needs were in the category “great need for open interface specifications”. Most highly ranked were the interfaces for personal health record (PHR) information exchange and various needs related to identity and access management and care processes. The results are used as one basis for selecting topics for national collaboration related to open interfaces for self-care, personal health records and citizen-centric care pathways

<em>In vitro</em> microbiotic fermentation causes an extensive metabolite turnover of rye bran phytochemicals

The human gut hosts a microbial community which actively contributes to the host metabolism and has thus remarkable effect on our health. Intestinal microbiota is known to interact remarkably with the dietary constituents entering the colon, causing major metabolic conversions prior to absorption. To investigate the effect of microbial metabolism on the phytochemical pool of rye bran, we applied an in vitro simulated colonic fermentation where samples were collected with intervals and analyzed by LC-MS based non-targeted metabolite profiling. The analyses revealed extensive metabolic turnover on the phytochemical composition of the bran samples, and showed effects on all the metabolite classes detected. Furthermore, the majority of the metabolites, both the precursors and the conversion products, remained unidentified indicating that there are numerous yet unknown phytochemicals, which can potentially affect on our health. This underlines the importance of comprehensive profiling assays and subsequent detailed molecular investigations in order to clarify the effect of microbiota on phytochemicals present in our everyday diet