β-cryptoxanthin–biofortified hen eggs enhance vitamin A status when fed to male Mongolian gerbils

Background Consumption of provitamin A carotenoid biofortified crops, such as maize, supports vitamin A (VA) status in animals and humans. Laying hens that consume β-cryptoxanthin–biofortified maize deposit β-cryptoxanthin into egg yolk. Objective We investigated whether β-cryptoxanthin–biofortified egg consumption would affect VA status of male Mongolian gerbils (Meriones unguiculatus) compared with white-yolked eggs. Methods β-Cryptoxanthin–biofortified egg yolk, produced in hens fed biofortified orange maize or tangerine-fortified maize feeds, was freeze-dried and fed to gerbils. White-yolked eggs were produced by feeding white maize to hens. Gerbils (n = 57) were fed VA-deficient feed for 28 d. After baseline (n = 7), treatments (n = 10/group) included oil control (VA−); 16.7% orange maize–biofortified, tangerine-fortified, or white-yolk egg feeds; or retinyl acetate as positive control (VA+) matched to daily preformed retinol intake from the eggs for 30 d. Preformed retinol did not differ between the egg yolks. Gerbil liver retinol, lipid, fatty acids, and cholesterol were determined. Results Liver retinol concentration (0.13 ± 0.03 µmol/g) and total hepatic VA (0.52 ± 0.12 µmol) were higher in gerbils fed orange maize–biofortified eggs than in all other groups. The VA− group was severely VA deficient (0.018 ±0.010 µmol/g; P \u3c 0.05). Liver retinol was similar among VA+, tangerine-egg–, and white-egg–fed gerbils, but retinol reserves were higher in tangerine-egg–fed gerbils (0.35 ± 0.11 μmol) than in VA+ or VA− gerbils or at baseline (P \u3c 0.05). Liver fat was 3.6 times (P \u3c 0.0001) and cholesterol was 2.1 times (P \u3c 0.004) higher in egg-fed groups that experienced hepatosteatosis. Liver fatty acid profiles reflected feed, but retinyl ester fatty acids did not. Conclusions The preformed retinol in the eggs enhanced gerbil VA status, and the β-cryptoxanthin–biofortified eggs from hens fed orange maize prevented deficiency. Biofortified maize can enhance VA status when consumed directly or through products from livestock fed orange maize

Biofortified orange maize enhances β-cryptoxanthin concentrations in egg yolks of laying hens better than tangerine peel fortificant

The xanthophyll β-cryptoxanthin provides vitamin A and has other purported health benefits. Laying hens deposit xanthophyll carotenoids into egg yolk. Hens (n = 8/group) were fed conventional-bred high β-cryptoxanthin biofortified (orange) maize, tangerine peel-fortified white maize, lutein-fortified yellow maize, or white maize for 40 d to investigate yolk color changes using L*a*b* scales, yolk carotenoid enhancement, and hen vitamin A status. Yolks from hens fed orange maize had scores indicating a darker, orange color and mean higher β-cryptoxanthin, zeaxanthin, and β-carotene concentrations (8.43 ± 1.82, 23.1 ± 4.8, 0.16 ± 0.08 nmol/g, respectively) than other treatments (P \u3c 0.0001). Yolk retinol concentrations (mean: 14.4 ± 3.42 nmol/g) were similar among groups and decreased with time (P \u3c 0.0001). Hens fed orange maize had higher liver retinol (0.53 ± 0.20 μmol/g liver) than other groups (P \u3c 0.0001). β-Cryptoxanthin-biofortified eggs could be another choice for consumers, providing enhanced color through a provitamin A carotenoid and supporting eggs’ status as a functional food

Hospital-Based, Community Teaching Kitchen Integrates Diabetes Education, Culinary Medicine, and Food Assistance: Case Study During the COVID-19 Pandemic.

BACKGROUND: Recent USDA Economic Research Service Population Survey cites a stabilization of food insecurity overall in the USA between 2019 and 2020, but Black, Hispanic, and all households with children cited increases - underscoring that the COVID-19 pandemic caused severe disruptions to food insecurity for historically disenfranchised populations. AIM: Describe lessons learned, considerations, and recommendations from the experience of a community teaching kitchen (CTK) in addressing food insecurity and chronic disease management among patients during the COVID-19 pandemic. SETTING: The Providence CTK is co-located at Providence Milwaukie Hospital in Portland, Oregon. PARTICIPANTS: Providence CTK serves patients who report a higher prevalence of food insecurity and multiple chronic conditions. PROGRAM DESCRIPTION: Providence CTK has five components: chronic disease self-management education, culinary nutrition education, patient navigation, a medical referral-based food pantry (Family Market), and an immersive training environment. PROGRAM EVALUATION: CTK staff highlight that they provided food and education support when it was needed most, leveraged existing partnerships and staffing to sustain operations and Family Market accessibility, shifted delivery of educational services based-on billing and virtual service considerations, and repurposed roles to support evolving needs. DISCUSSION: The Providence CTK case study provides a blueprint for how healthcare organizations could design a model of culinary nutrition education that is immersive, empowering, and inclusive

Cooking enhances but the degree of ripeness does not affect provitamin A carotenoid bioavailability from bananas

Banana is a staple crop in many regions where vitamin A deficiency is prevalent, making it a target for provitamin A biofortification. However, matrix effects may limit provitamin A bioavailability from bananas. The retinol bioefficacies of unripe and ripe bananas (study 1A), unripe high-provitamin A bananas (study 1B), and raw and cooked bananas (study 2) were determined in retinol-depleted Mongolian gerbils (n = 97/study) using positive and negative controls. After feeding a retinol-deficient diet for 6 and 4 wk in studies 1 and 2, respectively, customized diets containing 60, 30, or 15% banana were fed for 17 and 13 d, respectively. In study 1A, the hepatic retinol of the 60% ripe Cavendish group (0.52 ± 0.13 μmol retinol/liver) differed from baseline (0.65 ± 0.15 μmol retinol/liver) and was higher than the negative control group (0.39 ± 0.16 μmol retinol/liver; P < 0.0065). In study 1B, no groups differed from baseline (0.65 ± 0.15 μmol retinol/liver; P = 0.20). In study 2, the 60% raw Butobe group (0.68 ± 0.17 μmol retinol/liver) differed from the 60% cooked Butobe group (0.87 ± 0.24 μmol retinol/liver); neither group differed from baseline (0.80 ± 0.27 μmol retinol/liver; P < 0.0001). Total liver retinol was higher in the groups fed cooked bananas than in those fed raw (P = 0.0027). Body weights did not differ even though gerbils ate more green, ripe, and raw bananas than cooked, suggesting a greater indigestible component. In conclusion, thermal processing, but not ripening, improves the retinol bioefficacy of bananas. Food matrix modification affects carotenoid bioavailability from provitamin A biofortification targets

β-Cryptoxanthin–Biofortified Hen Eggs Enhance Vitamin A Status When Fed to Male Mongolian Gerbils

Background Consumption of provitamin A carotenoid biofortified crops, such as maize, supports vitamin A (VA) status in animals and humans. Laying hens that consume β-cryptoxanthin–biofortified maize deposit β-cryptoxanthin into egg yolk. Objective We investigated whether β-cryptoxanthin–biofortified egg consumption would affect VA status of male Mongolian gerbils (Meriones unguiculatus) compared with white-yolked eggs. Methods β-Cryptoxanthin–biofortified egg yolk, produced in hens fed biofortified orange maize or tangerine-fortified maize feeds, was freeze-dried and fed to gerbils. White-yolked eggs were produced by feeding white maize to hens. Gerbils (n = 57) were fed VA-deficient feed for 28 d. After baseline (n = 7), treatments (n = 10/group) included oil control (VA−); 16.7% orange maize–biofortified, tangerine-fortified, or white-yolk egg feeds; or retinyl acetate as positive control (VA+) matched to daily preformed retinol intake from the eggs for 30 d. Preformed retinol did not differ between the egg yolks. Gerbil liver retinol, lipid, fatty acids, and cholesterol were determined. Results Liver retinol concentration (0.13 ± 0.03 µmol/g) and total hepatic VA (0.52 ± 0.12 µmol) were higher in gerbils fed orange maize–biofortified eggs than in all other groups. The VA− group was severely VA deficient (0.018 ±0.010 µmol/g; P \u3c 0.05). Liver retinol was similar among VA+, tangerine-egg–, and white-egg–fed gerbils, but retinol reserves were higher in tangerine-egg–fed gerbils (0.35 ± 0.11 μmol) than in VA+ or VA− gerbils or at baseline (P \u3c 0.05). Liver fat was 3.6 times (P \u3c 0.0001) and cholesterol was 2.1 times (P \u3c 0.004) higher in egg-fed groups that experienced hepatosteatosis. Liver fatty acid profiles reflected feed, but retinyl ester fatty acids did not. Conclusions The preformed retinol in the eggs enhanced gerbil VA status, and the β-cryptoxanthin–biofortified eggs from hens fed orange maize prevented deficiency. Biofortified maize can enhance VA status when consumed directly or through products from livestock fed orange maize

Population Health Innovations and Payment to Address Social Needs Among Patients and Communities With Diabetes.

Policy Points Population health efforts to improve diabetes care and outcomes should identify social needs, support social needs referrals and coordination, and partner health care organizations with community social service agencies and resources. Current payment mechanisms for health care services do not adequately support critical up-front investments in infrastructure to address medical and social needs, nor provide sufficient incentives to make addressing social needs a priority. Alternative payment models and value-based payment should provide up-front funding for personnel and infrastructure to address social needs and should incentivize care that addresses social needs and outcomes sensitive to social risk. CONTEXT: Increasingly, health care organizations are implementing interventions to improve outcomes for patients with complex health and social needs, including diabetes, through cross-sector partnerships with nonmedical organizations. However, fee-for-service and many value-based payment systems constrain options to implement models of care that address social and medical needs in an integrated fashion. We present experiences of eight grantee organizations from the Bridging the Gap: Reducing Disparities in Diabetes Care initiative to improve diabetes outcomes by transforming primary care and addressing social needs within evolving payment models. METHODS: Analysis of eight grantees through site visits, technical assistance calls, grant applications, and publicly available data from US census data (2017) and from Health Resources and Services Administration Uniform Data System Resources data (2018). Organizations represent a range of payment models, health care settings, market factors, geographies, populations, and community resources. FINDINGS: Grantees are implementing strategies to address medical and social needs through augmented staffing models to support high-risk patients with diabetes (e.g., community health workers, behavioral health specialists), information technology innovations (e.g., software for social needs referrals), and system-wide protocols to identify high-risk populations with gaps in care. Sites identify and address social needs (e.g., food insecurity, housing), invest in human capital to support social needs referrals and coordination (e.g., embedding social service employees in clinics), and work with organizations to connect to community resources. Sites encounter challenges accessing flexible up-front funding to support infrastructure for interventions. Value-based payment mechanisms usually reward clinical performance metrics rather than measures of population health or social needs interventions. CONCLUSIONS: Federal, state, and private payers should support critical infrastructure to address social needs and incentivize care that addresses social needs and outcomes sensitive to social risk. Population health strategies that address medical and social needs for populations living with diabetes will need to be tailored to a range of health care organizations, geographies, populations, community partners, and market factors. Payment models should support and incentivize these strategies for sustainability