Harnessing the power of resistant starch: a narrative review of its health impact and processing challenges

Starch is a primary energy storage for plants, making it an essential component of many plant-based foods consumed today. Resistant starch (RS) refers to those starch fractions that escape digestion in the small intestine and reach the colon where they are fermented by the microflora. RS has been repeatedly reported as having benefits on health, but ensuring that its content remains in food processing may be challenging. The present work focuses on the impact RS on health and explores the different processes that may influence its presence in foods, thus potentially interfering with these effects. Clinical evidence published from 2010 to 2023 and studying the effect of RS on health parameters in adult populations, were identified, using PUBMED/Medline and Cochrane databases. The search focused as well on observational studies related to the effect of food processes on RS content. While processes such as milling, fermentation, cooking and heating seem to have a deleterious influence on RS content, other processes, such as cooling, cooking time, storage time, or water content, may positively impact its presence. Regarding the influence on health parameters, there is a body of evidence suggesting an overall significant beneficial effect of RS, especially type 1 and 2, on several health parameters such as glycemic response, insulin resistance index, bowel function or inflammatory markers. Effects are more substantiated in individuals suffering from metabolic diseases. The effects of RS may however be exerted differently depending on the type. A better understanding of the influence of food processes on RS can guide the development of dietary intake recommendations and contribute to the development of food products rich in RS

Evaluierung der Design-Charakteristika eines Europaeischen Ernaehrungshauefigkeitsfragebogen (European Food Propensity Questionnaire/EFPQ) hinsichtlich ihrer Einsetzbarkeit und Leistungsfaehigkeit

Problemstellung: Standardisierte Ernährungsdaten auf individueller Ebene sind erforderlich, um Zusammenhänge zwischen Ernährung und Krankheiten in multizentrischen prospektiven Studien untersuchen zu können. Ein standardisierter Häufigkeitsfragebogen (Food Propensity Questionnaire/FPQ) könnte die Bereitstellung von vergleichbaren und validen Daten verbessern. Eine Evaluierung seiner Design-Charakteristika hinsichtlich ihrer Einsetzbarkeit und Leistungsfähigkeit ist daher erforderlich. Methoden: Der mehrsprachige nicht-quantitative Europaeische FPQ (EFPQ) erfragt die Verzehrshäufigkeit von 116 Lebensmitteln der letzten 12 Monate. Je 80 zufällig ausgewählte Teilnehmer von 5 Europäischen Kohortenstudien in Spanien (EPIC-San Sebastian), Italien (EPIC-Florence), Deutschland (EPIC-Potsdam), Estland (Estonian Genome Centre/EGC) und Norwegen (Norwegian Women and Cancer Study/NOWAC) wurden eingeladen, den EFPQ sowie drei monatlich telefonisch durchgeführte 24-Stunden-Erinnerungsprotokolle (24-HDRs) zu beantworten. Die Teilnehmer konnten zwischen einer web- und Papier-basierten EFPQ-Version wählen (Web- und Papier-EFPQ). Die Einsetzbarkeit dieser Administrationsmodi und der Lebensmittelliste wurden deskriptiv in 261 Männern und Frauen im Alter von 19-75 Jahren (mittleres Alter: 55 Jahre) untersucht. Die Analyse zur Leistungsfähigkeit basiert auf den Angaben von 241 Personen, die zusätzlich zum EFPQ mindestens zwei 24-HDRs beantworteten. Einheitliche Portionsgrößen und studienzentrumspezifische Portionsgrößen, abgeleitet aus den 24-HDRs-Daten, wurden hinsichtlich ihrer Effekte auf die geschätzte Lebensmittelaufnahme, Korrelationen und Missklassifizierung in allen Teilnehmern und stratifiziert nach Studienzentrum oder Europäischer Region verglichen. Referenzdaten wurden hierzu mittels statistischer Modellierung zur Schätzung der individuellen üblichen Ernährung (Multiple Source Method (MSM) generiert. Zur Überprüfung der Fähigkeit des EFPQs, wahre Konsumenten zu identifizieren und die Schätzwerte von selten konsumierten Lebensmitteln zu verbessern, wurde getestet, ob eine höhere EFPQ-Verzehrshäufigkeitsangabe eines Lebensmittels mit der Verzehrsswahrscheinlichkeit dieses Lebensmittels als auch mit der mittleren berichteten Aufnahmemenge an einem 24-HDR-Verzehrsstag assoziiert ist. Ergebnisse: Die Antwortraten für den Web-EFPQ variierten zwischen 30% in EPIC-San Sebastian, 70% in NOWAC und 93% in EGC. Web-EFPQ-Nutzer waren in allen Studienzentren jünger und höher gebildet als Papier-EFPQ-Nutzer. 67% der Items der standardisierten Lebensmittelliste hatten mehr als 65% Personen mit positiver Verzehrshäufigkeitsangabe und insgesamt wurden 27 Lebensmittel von 90% aller Teilnehmer konsumiert. Im Vergleich zu den Schätzwerten der MSM führte die Verwendung von studienzentrumspezifischen Portionsgrößen zu einer verbesserten Leistungsfähigkeit des EFPQs, die Teilnehmer hinsichtlich ihrer Lebensmittel-Aufnahme zu kategorisieren, aber dieser Effekt war für Lebensmittelgruppen nicht mehr vorhanden. Der EFPQ mit zentrumspezifischen Portionsgrößen klassifizierte weniger Personen in die gleichen Quartile (insgesamt: 36.7%) als der EFPQ mit einheitlichen Portionsgrößen (insgesamt: 39.7%) und missklassifizierte mehr (insgesamt: 4.2% mit zentrumspezifischen vs. 3.3% mit einheitlichen Portionsgrößen). Der Effekt der Portionsgrößen auf Lebensmittelaufnahme, Korrelationen und Missklassifizierung variierte in Abhängigkeit von Lebensmittelgruppe und Europäischer Region. Für 27 der 74 selten konsumierten Lebensmittel (37%) in den 24-HDRs waren signifikant positive Zusammenhänge zwischen EFPQ-Häufigkeitsangabe und Verzehrsswahrscheinlichkeit vorhanden und für 32 dieser Lebensmittel (43%) positive Zusammenhänge mit der mittleren berichteten Aufnahmemenge an einem 24-HDR-Verzehrsstag. Schlussfolgerung: Die Ergebnisse sprechen für eine gute Einsetzbarkeit des EFPQs in der multizentrischen Studienpopulationen, einschließlich seiner web-basierten Version. Die moderate Leistungsfähigkeit des EFPQs, die Teilnehmer hinsichtlich ihrer üblichen Ernährung korrekt zu klassifizieren, unterstützt neue Konzepte der Ernährungserhebung, die mehrere 24-HDRs mit einem FPQ kombinieren.Background: Standardized dietary data on the individual level is needed to reliably compare and investigate diet-disease relationships in multi-centre prospective studies. A standardized long-term instrument (Food Propensity Questionnaire/FPQ) might improve the provision of comparable and valid usual dietary intake data. An evaluation of its standardized design characteristics with respect to the feasibility of use and performance is therefore warranted. Methods: The multilingual non-quantitative European FPQ (EFPQ) inquires the frequency of consumption of 116 foods and beverages during the preceding year. 80 participants from each of five ongoing European cohorts in Spain (EPIC-San Sebastian), Italy (EPIC-Florence), Germany (EPIC-Potsdam), Estonia (Estonian Genome Centre/EGC) and Norway (Norwegian Women and Cancer Study/NOWAC) were randomly selected and invited to complete either a web-based or a paper-based EFPQ (Web-EFPQ and Paper-EFPQ) in combination with three monthly telephone-administered 24-hour dietary recalls (24-HDRs) using EPIC-SOFT software. The analysis of the feasibility of use included 261 men and women aged 19-75 y (mean age: 55 y), who fully completed the EFPQ. The performance analysis was carried out in 241 subjects that responded to at least two 24-HDRs, in addition to the EFPQ. Uniform portion sizes for all centres and centre-specific portion sizes being fitted from the 24-HDRs were compared regarding their effects on the EFPQ’s performance in food intake estimation, correlational ranking and misclassification. The comparative analyses were performed in the whole study population and separately by study centre or European region using nonparametric statistics. Reference data was obtained by the means of a statistical modelling method that originally aimed to estimate individual usual intake (Multiple Source method (MSM). Furthermore, the potential of the EFPQ in identifying habitual consumers of foods and in supplementing usual intake estimates of less commonly consumed foods on repeat 24-HDRs was explored by assessing whether or not increasing EFPQ-reported frequency was associated with both the probability of consuming a given food on a 24-HDR and the ranked average amount consumed on a 24-HDR-consumption-day. Results: Response rates for the Web-EFPQ varied among the study centres from 30% in EPIC-San Sebastian to 70% in NOWAC and 93% in EGC. Web-Users rarely requested support and were in all centres younger and higher educated than those who completed the paper-format. For 67% of the included food items on the standardized food list of the EFPQ, the consumer proportion was more than 65% and 27 food items were identified to be consumed from 90% of all study participants. Although at food item level the inclusion of centre-specific portion sizes remarkably improved the ranking among all participants according to their intake, compared to the ranking in the reference data the effect seemed to cancel out at food group level. Relative to the reference data, the EFPQ with centre-specific portion sizes classified fewer subjects correctly into the same quartile of food group intake (overall: 36.7%) compared to the EFPQ with uniform portion sizes (overall: 39.7%) and extremely misclassified more (overall: 4.2% with centre-specific portion sizes versus 3.3% with uniform portion sizes). Furthermore, a differential effect of the portion sizes types on food intakes, correlations and misclassification by food group and European region was found. In general, uniform portion sizes appeared to perform slightly better in the Central and Northern European centres, whereas centre-specific portion sizes tended to be more appropriate in the Southern ones. Furthermore, for 27 out of the 74 (37%) less commonly consumed food items on the 24-HDRs there were significant positive relationships between reported frequency-category on the EFPQ and the 24-HDR-probability of consumption on a random day. Positive relationships between the frequency-category on the EFPQ and the ranked average amount consumed on a 24-HDR-consumption-day were observed for 32 of these food items (43%). Conclusion: Overall, this study supports the feasibility to use the standardized EFPQ in culturally different European study populations, including its web-based version. The moderate ability to classify individuals correctly according to their intake calls into question the stand-alone application of long-term dietary assessment instruments in prospective studies and supports approaches that combine different dietary assessment instruments

La pleine conscience comme outil collaboratif dans un programme de recherche culinaire en onconutrition Auteurs

International audienceLe cancer est reconnu comme maladie chronique par l'OMS dans 70% des cas. L'efficacité des outils de la pleine conscience dans l'amélioration de nombreux paramètres bio-psycho-sociaux chez le patient atteint de cancer a été montrée. Cet article investigue les bienfaits de recourir à cette technique comme outil collaboratif pour préparer et accompagner une équipe de recherche translationnelle en onconutrition, composée d'experts en nutrition, en pratique culinaire et de malades référents en cours de traitement. Il fait le bilan de l'étude NEODIA qui a intégré « l'ouverture à l'expérience actuelle » comme moyen de créativité du groupe et de co-construction de recettes adaptées aux symptômes ressentis.</div

Les déterminants de la prise de poids des patients atteints de troubles de l’humeur, dépressifs ou bipolaires

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A Scoping Review on the Global Nutrition Transition: Mapping the Evidence on Dietary Changes in General Adult Populations

International audienceIntroduction: The ongoing nutrition transition poses a major public health challenge worldwide, requiring evidence-based policy interventions. However, a robust global evidence base on the subject is lacking, particularly with regard to dietary changes in general adult populations. This scoping review aims to identify, explore and map the literature on the nutrition transition based on dietary changes reported in general adult populations globally.Methods: A comprehensive search was conducted using PubMed, ScienceDirect and Web of Science databases between July 2019 and March 2022. The inclusion and exclusion criteria were predefined. The search strategy yielded 4820 potential studies, which were screened and assessed for eligibility. The included studies were subjected to a descriptive analysis to identify trends and patterns in the data.Results: The review identified 25 studies that met the inclusion criteria, with 11 based on Chinese populations, four on South African populations, four on South Korean populations, one on Australian populations and the rest on European and American populations. Overall, the data suggest an increase in healthy dietary behaviors on a global level over time, with some changes reported on the processed nature of foods.Conclusion: This scoping review highlights the need for more studies describing dietary changes in general adult populations, particularly in Europe, and larger scale studies using gold standard data collection methods to further understand the driving factors behind the changes and their impact on health outcomes

Determinants of weight gain in patients with depressive or bipolar disorders

International audienceAbstract Introduction: Mental health disorders constitute a growing disease burden in France. In particular, hospitalized patients with depressive or bipolar disorders suffer from weight gain impairing adherence to treatment and the quality of life. The objective of this preliminary study is to better understand determinants of weight gain and their synergetic effects, with the ultimate aim to develop a screening tool identifying at risk patients. Material and methods: Subjects were recruited at the private psychiatric clinic of Littoral, Rang-du-Fliers in the North of France according to pre-definite inclusion criteria. Data assessment has been based on 1) a retrospective case-control study using electronic medical records of depressive or bipolar patients (n = 207); 2) a prospective observational study (n = 20) using the medical records, and additional questionnaires at T0 (interview-administered) and T1 (self-administered) after an average length of hospital stay of 24.8 days (± 6.3) and 3) a cross-sectional study in depressive patients (n = 40) under psychotropic treatment at the day hospital, using the medical records and an interview-administered questionnaire. Descriptive and analytical statistics (Spearman rank correlations, binary logistic regression) were performed with SPSS statistics 17.0. Results: The mean age of all patients was 49.3 years (± 10.7). Patients’ weight change after hospital stay varied in the retrospective study from + 0.5 kg (± 1.98) [min: - 5.4 kg; max: + 8,4kg]. Patients at the day hospital had an mean psychotropic treatment duration of 7.8 years (± 7.8) and gained on average 17.6 kg (± 10,01). Weight gain was particularly related to the use of tricyclic antidepressants, classic antipsychotics and atypical antipsychotics. All psychotropic drugs were significantly associated with a change in eating behavior (r s = 0.37) which was significantly associated with weight gain (r s = 0.40). All studies observed significant associations between weight gain and a lower socio-economic profile (low financial resources, few social contacts, low level of education), polymedication and a sedentary lifestyle with a higher tobacco consumption and less sleeping hours. Discussion: This preliminary study confirms the complex interaction between psychotropic treatments, the modification of eating behavior which can be triggered by other determinants of weight gain in patients with depressive or bipolar disorders, such as tobacco consumption. The results provide new perspectives to create an innovative screening tool to improve the nutritional care in at risk patients. The development of such a tool is ongoing

Development and validation of a photographic food atlas of Middle Eastern Mediterranean diet: Toward improved understanding of traditional healthy and sustainable diets

Background Middle Eastern Mediterranean diet (MEMD) is a traditional plant-based diet that is commonly consumed and increasingly popular, but not well studied in nutrition research. To facilitate the dietary assessment of MEMD, we developed and validated a photographic food atlas depicting a variety of foods and dishes consumed in the MEM region. Methods The photographic food atlas included 1,002 photos of 400 types of foods and traditional dishes photographed characterizing MEMD. Foods and dishes were prepared by a professional cook and were subsequently photographed as a series of photos depicting portion size options. In a validation study, 45 individuals aged 20–50 years were recruited to assess portion size estimation of 25 representative food-photo series for each item. The validity of portion size estimation was assessed by comparing actual and reported estimates using Pearson or Spearman correlation tests. Sizes of the differences between estimated portions and the actual served portion sizes were calculate as mean differences and standard deviations. Results In the validation study, there was a strong correlation ( r &gt; 0.7) between estimated portion size of actual foods for 7 food items, such as pita bread, milk, labneh , and tomatoes, a moderate correlation (&lt; 0.5 | r | &lt; 0.7) for 12 items, such as meat, chicken, and grapes, and weak correlation ( r &lt; 0.3) for 6 items, such as seeds. Underestimation of portion sizes was more commonly observed for food items quantified when using “grams” or “milliliters” as a unit of measurement. In contrast, when household measurements were used, the participants tended to overestimate the portion sizes of respective foods and dishes. Conclusion We developed and validated a photographic food atlas depicting a wide variety of foods and dishes typical for the MEMD. The application of the photographic food atlas may facilitate the accurate assessment of adherence to MEMD and support the understanding of its health and sustainability aspects. Further methodological work is warranted to extend the list of food items and to evaluate the validity of the food atlas among larger and more heterogeneous groups of participants

Mapping the global evidence on nutrition transition: a scoping review protocol

INTRODUCTION: Nutrition transition has emerged as an important concept in health research used to describe shifts in dietary consumption and energy expenditure that coincide with economic, demographic and epidemiological changes at a population level. Better understanding of the shifts in dietary patterns across populations and their drivers could possibly hold the key to prevention of diet-related disease risk. An increasing number of studies have reported on nutrition transition in populations around the world, however, global evidence has not been summarised. OBJECTIVE: This scoping review is aimed to identify, explore and map the literature on nutrition transition with a specific focus on dietary changes in populations across the world. The review would allow better clarification around the concept of nutrition transition, classification of published studies and provide a framework for further research. METHODS AND ANALYSIS: The scoping review will be designed based on the methodology by Arksey and O'Malley, refined by Levac et al. and developed in conjunction with guidance on conducting systematic scoping reviews by Peters et al. The main research question addressed by the scoping review will be: 'What is the evidence on nutrition transition defined based on dietary changes reported in general adult population across the world?' Electronic databases (PubMed, ScienceDirect and Web of Science), grey literature sources and the reference lists of key studies will be searched to identify studies appropriate for inclusion in the review. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be abstracted into tables and logically organised according to items addressed in the specific research questions. ETHICS AND DISSEMINATION: Dissemination of results will be sought through a peer-reviewed publication, conference presentations and stakeholder meetings. The data used are from publicly available secondary sources, so no ethical review would be required for this study