DEVELOPMENT AND PRESCRIPTION OF THE FUNCTIONAL FOOD DIET TO THE PATIENTS WITH DENTAL PROSTHESIS

Till present times nutritiology and dietology in dental practice are at rudimentary level. At the same time it is a well-known fact the chewing efficiency is much higher in case of having fixed prosthesis comparing with their removable denture counterpart. As for elderly population nourishment it is important to take into consideration the complexity of receiving of all the necessary nutrients. Quantity and quality of the food diet will directly affect their quality of life. Aim. Development of the functional food diet ration for specific groups of dental patients Materials and Methods. We surveyed 244 patients (84 males, 160 females) in the age range from 60 to 85 years (mean value 75.4+/-2.4) with different types of implant supported prostheses. We used clinical, sociological, nutritiological evaluation methods. Besides that we used GOHAI questionnaire and modified Wolfart questionnaire. Results. We defined basic groups of dental patients who have indications for prescribing functional food diet: a) patients utilizing removable dentures, especially full dentures, in the situation where antagonists would be intact dentition or dental arches with conventional or implant supported fixed bridges; b) patients treated with immediate removable dentures, fixed implant supported prostheses, especially in case of big span bridges with limited amount of fixtures; c) patients using removable implant supported overdentures; d) Patients older than 70 years of age. We established food rations based on intaking soft low viscosity liquid meal. High GOHAI scores (56.1+/-1.49) were the prove of the high efficiency and efficacy of the rehabilitation per se and also of the functional diet regimen recommended to the examined patients. Conclusions. We developed functional food diet taking into consideration the short and long term period after finishing the implant supported or conventional, immediate or delayed prosthetic rehabilitation with the use of total prosthesis predominately for edentulous patients. Incorporation of these types of diet regimen in the rehabilitation plan oriented towards increasing the efficiency of the main treatment arrangements.

Lecithin Inclusion by α-Cyclodextrin Activates SREBP2 Signaling in the Gut and Ameliorates Postprandial Hyperglycemia

Background: α-cyclodextrin (α-CD) is one of the dietary fibers that may have a beneficial effect on cholesterol and/or glucose metabolism, but its efficacy and mode of action remain unclear. Methods: In the present study, we examined the anti-hyperglycemic effect of α-CD after oral loading of glucose and liquid meal in mice. Results: Administration of 2 g/kg α-CD suppressed hyperglycemia after glucose loading, which was associated with increased glucagon-like peptide 1 (GLP-1) secretion and enhanced hepatic glucose sequestration. By contrast, 1 g/kg α-CD similarly suppressed hyperglycemia, but without increasing secretions of GLP-1 and insulin. Furthermore, oral α-CD administration disrupts lipid micelle formation through its inclusion of lecithin in the gut luminal fluid. Importantly, prior inclusion of α-CD with lecithin in vitro nullified the anti-hyperglycemic effect of α-CD in vivo, which was associated with increased intestinal mRNA expressions of SREBP2-target genes (Ldlr, Hmgcr, Pcsk9, and Srebp2). Conclusions: α-CD elicits its anti-hyperglycemic effect after glucose loading by inducing lecithin inclusion in the gut lumen and activating SREBP2, which is known to induce cholecystokinin secretion to suppress hepatic glucose production via a gut/brain/liver axis.

Genetic Studies of Metabolomics Change After a Liquid Meal Illuminate Novel Pathways for Glucose and Lipid Metabolism

Humans spend the greater part of the day in a postprandial state. However, the genetic basis of postprandial blood measures is relatively uncharted territory. We set out to examine the genetics of variation in concentrations of postprandial metabolites (t=150 min) in response to a liquid mixed meal through genome-wide association studies (GWAS) performed in the Netherlands Epidemiology of Obesity study (N=5,705). The metabolite response GWAS identified an association between glucose change and rs10830963:G in the melatonin receptor 1B (beta (SE): -0.23 (0.03), P-value: 2.15×10^-19). In addition, <i>ANKRD55</i> locus led by rs458741:C showed strong associations to extremely large VLDL particle (XXLVLDL) response (with XXLVLDLC: beta (SE): 0.17 (0.03) P-value: 5.76×10^-10and with XXLVLDLCE: beta (SE): 0.17 (0.03), P-value: 9.74×10^-10), which also revealed strong associations to body composition and diabetes in the UK Biobank (p-values<5×10^-8). Furthermore, the associations between XXLVLDL response and insulinogenic index, HOMA-β, ISI matsuda index and HbA1c in the NEO study further implied the role of chylomicron synthesis in diabetes (with FDR corrected q-value<0.05). To conclude, genetic studies of metabolomics change after a liquid meal illuminate novel pathways for glucose and lipid metabolism. Further studies are warranted to corroborate biological pathways of <i>ANKRD55</i> locus underlying diabetes.

Genetic Studies of Metabolomics Change After a Liquid Meal Illuminate Novel Pathways for Glucose and Lipid Metabolism

Humans spend the greater part of the day in a postprandial state. However, the genetic basis of postprandial blood measures is relatively uncharted territory. We set out to examine the genetics of variation in concentrations of postprandial metabolites (t=150 min) in response to a liquid mixed meal through genome-wide association studies (GWAS) performed in the Netherlands Epidemiology of Obesity study (N=5,705). The metabolite response GWAS identified an association between glucose change and rs10830963:G in the melatonin receptor 1B (beta (SE): -0.23 (0.03), P-value: 2.15×10^-19). In addition, <i>ANKRD55</i> locus led by rs458741:C showed strong associations to extremely large VLDL particle (XXLVLDL) response (with XXLVLDLC: beta (SE): 0.17 (0.03) P-value: 5.76×10^-10and with XXLVLDLCE: beta (SE): 0.17 (0.03), P-value: 9.74×10^-10), which also revealed strong associations to body composition and diabetes in the UK Biobank (p-values<5×10^-8). Furthermore, the associations between XXLVLDL response and insulinogenic index, HOMA-β, ISI matsuda index and HbA1c in the NEO study further implied the role of chylomicron synthesis in diabetes (with FDR corrected q-value<0.05). To conclude, genetic studies of metabolomics change after a liquid meal illuminate novel pathways for glucose and lipid metabolism. Further studies are warranted to corroborate biological pathways of <i>ANKRD55</i> locus underlying diabetes.

The Effect of Continuous Intake of Lactobacillus gasseri OLL2716 on Mild to Moderate Delayed Gastric Emptying: A Randomized Controlled Study

Probiotics have been suggested to be effective for functional dyspepsia, but their effect on gastric motility is not clear. We evaluated the effect of Lactobacillus gasseri OLL2716 (LG21 strain) on mild to moderate delayed gastric emptying by a double-blind, parallel-group, placebo-controlled, randomized trial. Participants (n = 28) were randomly assigned to ingest LG21 strain-containing yogurt (LG21 strain group) or LG21 strain-free yogurt (placebo group) for 12 weeks. The 13C gastric emptying breath test was performed to measure the gastric emptying rate over time following ingestion of a liquid meal, and the time to reach the peak (Tmax) was used as an indicator of gastric emptying. We also measured the salivary amylase concentration, an indicator of autonomic dysfunction under stress. The per-protocol population (n = 27, male n = 4, female n = 23) was evaluated for efficacy. When a ≥30% reduction in the difference between participant’s Tmax and the Japanese mean Tmax was defined as an improvement, the odds ratio of improvement in delayed gastric emptying compared to placebo after 12 weeks was 4.1 (95% confidence interval, 0.8 to 20.2). Moreover, salivary amylase concentrations were significantly lower than in the placebo group, indicating an improvement in autonomic function. The present data were not enough to support the beneficial effects of the LG21 strain on delayed gastric emptying. However, if we define the odds ratio in further study investigated with a larger number of participants, LG21 strain might be expected to have some impact on delayed gastric emptying.

Unacylated ghrelin, leptin, and appetite display diurnal rhythmicity in lean adults.

Constant routine and forced desynchrony protocols typically remove the effects of behavioural/environmental cues to examine endogenous circadian rhythms, yet this may not reflect rhythms of appetite regulation in the real world. It is therefore important to understand these rhythms within the same subjects under controlled diurnal conditions of light, sleep and feeding. Ten healthy adults (9M/1F, Mean ±SD: age: 30 ± 10 y; BMI: 24.1 ± 2.7 kg·m-2) rested supine in the laboratory for 37 hours. All data were collected during the final 24 hours of this period (i.e. 0800 - 0800 h). Participants were fed hourly isocaloric liquid meal replacements alongside appetite assessments during waking before a sleep opportunity from 2200-0700 h. Hourly blood samples were collected throughout the 24-h period. A diurnal rhythm in mean plasma unacylated ghrelin concentration was identified (p=0.04), with the acrophase occurring shortly after waking (08:19 h), falling to a nadir in the evening with a relative amplitude of 9%. Plasma leptin concentration also exhibited a diurnal rhythm (p<0.01), with the acrophase occurring shortly after lights-out (00:32 h) and the lowest concentrations at midday. The amplitude for this rhythm was 25%. Diurnal rhythms were established in all dimensions of appetite except for sweet preference (p=0.29), with both hunger (21:03) and prospective food consumption (19:55) reaching their peak in the evening before falling to their nadir shortly after waking. Under controlled diurnal conditions, simultaneous measurement of leptin, unacylated ghrelin, and subjective appetite over a 24-hour period revealed rhythmicity in appetite regulation in lean, healthy humans.

Gastric Accommodation Influences Proximal Gastric and Total Gastric Emptying in Concurrent Measurements Conducted in Healthy Volunteers

Gastric emptying and gastric accommodation play roles in generation of upper gastrointestinal symptoms. Whereas, both functions have been measured simultaneously using MRI or 99mTc- SPECT methodology, correlation of these two functions has not been evaluated simultaneously using solid and liquid meals. To study relationships of whole or proximal stomach volumes to emptying, we concurrently measured postprandial gastric accommodation and emptying (over 4 hours) of a 111In-labeled mixed solid and liquid meal. A semi-automated method allowing selection of a segmentation threshold based on greyscale image was used to measure volume of the proximal half of stomach, defined as the top half of axial slices along the vertical length of stomach. A correction factor derived from phantom studies was applied for up-scatter from 99mTc to 111In window. Relationships of time to emptying 10, 25 50 and 75% of the meal to fasting and postprandial gastric volumes were evaluated using Spearman correlation. Whole stomach fed and accommodation volumes were significantly correlated with all gastric emptying times 10%, 25%, 50%. Proximal stomach fed volumes were similarly associated with 50% and 75% proximal gastric emptying. Fed proximal gastric volume was associated with 50% and 75% whole gastric emptying. Fed proximal accommodation volume was associated with 50% gastric emptying. Fasting gastric volumes were not significant determinants of emptying rates. In conclusion, postprandial gastric accommodation is significantly associated with the rate of gastric emptying, with higher gastric volumes associated with prolongation of emptying. Novel methods to measure proximal gastric accommodation and correct for radioisotope up-scatter are described.

Expected values for gastrointestinal and pancreatic hormone concentrations in healthy volunteers in the fasting and postprandial state

Background Gastrointestinal hormones regulate intestinal transit, control digestion, influence appetite and promote satiety. Altered production or action of gut hormones, including glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and peptide YY (PYY), may contribute to the biological basis of obesity and altered glucose homeostasis. However, challenges in analytical methodology and lack of clarity on expected values for healthy individuals have limited progress in this field. The aim of this study was to describe expected concentrations of gastrointestinal and pancreatic hormones in healthy volunteers following a standardized meal test (SMT) or 75 g oral glucose tolerance test (OGTT). Methods A total of 28 healthy volunteers (12 men, 16 women; mean age 31.3 years; mean body mass index 24.9 kg/m2) were recruited to attend a hospital clinic on two occasions. Volunteers had blood sampling in the fasting state and were given, in randomized order, an oral glucose tolerance test (OGTT) and standardized mixed liquid meal test with venepuncture at timed intervals for 4 h after ingestion. Analytical methods for gut and pancreatic hormones were assessed and optimized. Concentrations of gut and pancreatic hormones were measured and used to compile ranges of expected values. Results Ranges of expected values were created for glucose, insulin, glucagon, GLP-1, GIP, PYY and free fatty acids in response to a standardized mixed liquid meal or OGTT. Intact proinsulin and C-peptide levels were also measured following the OGTT. Conclusions These ranges of expected values can now be used to compare gut hormone concentrations between healthy individuals and patient groups.

Vitamin E catabolism in women, as modulated by food and by fat, studied using 2 deuterium-labeled α-tocopherols in a 3-phase, nonrandomized crossover study

ABSTRACT Background Human vitamin E (α-tocopherol) catabolism is a mechanism for regulating whole-body α-tocopherol. Objectives To determine the roles of the intestine and liver on α-tocopherol catabolism as affected by fat or fasting, 2 deuterium-labeled (intravenous d6- and oral d3-) forms of α-tocopherol were used. Methods Healthy women received intravenous d6-α-tocopherol and consumed d3-α-tocopherol with a 600-kcal defined liquid meal (DLM; 40% or 0% fat, n = 10) followed by controlled meals; or the 0% fat DLM (n = 7) followed by a 12-h fast (0% fat-fast), then controlled meals ≤72 h. The order of the 3-phase crossover design was not randomized and there was no blinding. Samples were analyzed by LC/MS to determine the α-tocopherol catabolites and α-carboxyethyl hydroxychromanol (α-CEHC) in urine, feces, and plasma that were catabolized from administered oral d3- and intravenous d6-α-tocopherols. Results Urinary and plasma d3- and d6-α-CEHC concentrations varied differently with the interventions. Mean ± SEM cumulative urinary d6-α-CEHC derived from the intravenous dose excreted over 72 h during the 40% fat (2.50 ± 0.37 μmol/g creatinine) and 0% fat (2.37 ± 0.37 μmol/g creatinine) interventions were similar, but a ∼50% decrease was observed during the 0% fat-fast (1.05 ± 0.39 μmol/g creatinine) intervention (compared with 0% fat, P = 0.0005). Cumulative urinary d3-α-CEHC excretion was not significantly changed by any intervention. Total urinary and fecal excretion of catabolites accounted for &lt;5% of each of the administered doses. Conclusions Differential catabolism of the intravenous d6-α-tocopherol and oral d3-α-tocopherol doses shows both liver and intestine have roles in α-tocopherol catabolism. During the 40% fat intervention, &gt;90% of urinary d3-α-CEHC excretion was estimated to be liver-derived, whereas during fasting &lt;50% was from the liver with the remainder from the intestine, suggesting that there was increased intestinal α-tocopherol catabolism while d3-α-tocopherol was retained in the intestine in the absence of adequate fat/food for α-tocopherol absorption. This trial was registered at clinicaltrials.gov as NCT00862433.