The effect of resistant starch (RS) on postprandial plasma concentrations of glucose, lipids, and hormones, and on subjective satiety and palatability ratings was investigated in 10 healthy, normal-weight, young males. The test meals consisted of 50 g pregelatinized starch (0% RS) (S) or 50 g raw potato starch (54% RS) (R) together with 500 g artificially sweetened syrup. After the R meal postprandial plasma concentrations of glucose, lactate, insulin, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1, and epinephrine were significantly lower compared with after the S meal. Moreover, subjective scores for satiety and fullness were significantly lower after the R meal than after the S meal. Differences in GIP, texture, and palatability may have been involved in these findings. In conclusion, the replacement of digestible starch with RS resulted in significant reductions in postprandial glycemia and insulinemia, and in the subjective sensations of satiety.

High adiposity in middle age is associated with higher dementia risk. The association between weight loss and cognitive function in older adults is still controversial. A meta-analysis was undertaken to estimate the effectiveness of intentional weight loss on cognitive function in overweight and obese adults. A structured strategy was used to search randomized and non-randomized studies reporting the effect of intentional and significant weight loss on cognitive function in overweight and obese subjects. Information on study design, age, nutritional status, weight-loss strategy, weight lost and cognitive testing was extracted. A random-effect meta-analysis was conducted to obtain summary effect estimates for memory and attention-executive domains. Twelve studies met inclusion criteria. Seven were randomized trials and the remaining five included a control group. A low-order significant effect was found for an improvement in cognitive performance with weight loss in memory (effect size 0.13, 95% CI 0.00-0.26, P=0.04) and attention/executive functioning (effect size 0.14, 95% CI 0.01-0.27, P<0.001). Studies were heterogeneous in study design, sample selection, weight-loss intervention and assessment of cognitive function. Weight loss appears to be associated with low-order improvements in executive/attention functioning and memory in obese but not in overweight individuals.

No abstract

Microbiota-gut brain axis involvement in neuropsychiatric disorders Background The microbiota-gut brain (MGB) axis is the bidirectional communication between the intestinal microbiota and the brain. An increasing body of preclinical and clinical evidence has revealed that the complex gut microbial ecosystem can affect neuropsychiatric health. However, there is still a need of further studies to elucidate the complex gene-environment interactions and the role of the MGB axis in neuropsychiatric diseases, with the aim of identifying biomarkers and new therapeutic targets, to allow early diagnosis and improving treatments. Areas covered To review the role of MGB axis in neuropsychiatric disorders, prediction and prevention of disease through exploitation, integration and combination of data from existing gut microbiome/microbiota projects and appropriate other International "-Omics" studies. We also evaluated the new technological advances to investigate the microbiome and evidence-based treatment modulating the gut microbiota through nutritional and other interventions. Expert Opinion The clinical studies have documented an association between alterations in gut microbiota composition and/or function, whereas the preclinical studies support a role for the gut microbiota in impacting behaviours which are of relevance to psychiatry and other central nervous system (CNS) disorders. Targeting MGB axis could be an additional approach for treating CNS disorders and all conditions in which alterations of the gut microbiota are involved.

The relationship between total body water (TBW) and extracellular water (ECW), measured by deuterium oxide dilution and bromide dilution respectively, and impedance and impedance index (height2/impedance) at 1, 5, 50 and 100 kHz was studied. After correction for TBW, ECW was correlated only with the impedance index at 1 and 5 kHz. After correction for ECW, TBW was best correlated with the impedance index at 100 kHz. The correlation of body-water compartments with impedance values obtained with modelling programs was lower than with measured impedance values.Prediction formulas for ECW (at 1 and 5 kHz) and TBW (at 50 and 100 kHz) were developed. The prediction errors for ECW and TBW were 1.0 and 1.7 kg respectively (coefficient of variation 5 YO). The residuals of both ECW and TBW were related to the ECW/TBW value. Application of the prediction formulas in a population, independently measured, revealed a slight overestimation of TBW and ECW, which could be largely explained by differences in the validation group in body-water distribution and in body build. The ratio of impedance at 1 kHz to impedance at 100 kHz was correlated with body-water distribution (ECW/TBW). The relation is however not strong enough to be useful as a predictor. It is concluded that an independent prediction of ECW and TBW, using impedance at low and high frequency respectively, is possible, but that the bias depends on the body-water distribution and body build of the measured subject.

No abstract

Although subjective appetite scores are widely used, studies on the reproducibility of this method are scarce. In the present study nine healthy, normal weight, young men recorded their subjective appetite sensations before and during 5 h after two different test meals A and B. The subjects tested each meal twice and in randomized order. Visual analogue scale (VAS) scores, 10 cm in length, were used to assess hunger, satiety, fullness, prospective food consumption and palatability of the meals. Plasma glucose and lactate concentrations were determined concomitantly. The repeatability was investigated for fasting values, A-mean 5 h and mean 5 h values, A-peaklnadir and peaklnadir values. Although the profiles of the postprandial responses were similar, the coefficients of repeatability (CR=2SD) on the mean differences were large, ranging from 2.86 to 5.24 cm for fasting scores, 1-36 to 1.88 cm for mean scores, 2-98 to 5-42 cm for A-mean scores, and 3.16 to 6.44 cm for peak and A-peak scores. For palatability ratings the CR values varied more, ranging from 2.38 (taste) to 8.70cm (aftertaste). Part of the difference in satiety ratings conld be explained by the differences in palatability ratings. However, the low reproducibility may also be caused by a conditioned satiation or hunger due to the subjects' prior experience of the meals and therefore not just be a reflection of random noise. It is likely, however, that the variation in appetite ratings is due both to methodological day-to-day variation and to biological dayto-day variation in subjective appetite sensations.

BackgroundAttrition is an important but understudied issue that plays a vital role in the successful treatment of obesity. To date, most studies focusing on attrition rates and/or its predictors have been based on pretreatment data routinely collected for other purposes. Our study specifically aims at identifying the predictors of drop-out focusing on empirically or theoretically-based factors.MethodsWe conducted a retrospective observational study in an academic outpatient clinical nutrition service in Pavia, Italy. We examined a total of 98 adult obese patients (36 males, 62 females) who underwent a 6-month dietary behavioral weight-loss treatment at our Center. Pre-treatment and treatment-related variables were collected or calculated from clinical charts in order to discriminate those subjects who completed treatment from those who abandoned it before its completion. Multivariable regression analysis was used to identify the independent predictors of drop-out.ResultsThe drop-out rates were 21% at 1 month and 57% at 6 months. Compared with completers, noncompleters were significantly younger in terms of age at first dieting attempt (24.0 ± 10.7 vs. 31.3 ± 11.2 years, P = 0.005), had lower diastolic blood pressure (87.8 ± 9.7 vs. 92.7 ± 11.4 mmHg, P = 0.022), had a lower baseline body fat percentage (38.5 ± 6.4 vs. 41.2 ± 4.4% weight, P = 0.015), and had a lower percentage of early weight loss (-1.8 ± 1.8% vs. -3.1 ± 2.1%, P = 0.035). Moreover, noncompleters significantly differed from completers with regard to type of referral (34.1% vs. 53.3% sent by a physician, P = 0.036) and SCL-90 anger-hostility subscale (0.83 ± 0.72 vs. 0.53 ± 0.51, P = 0.022). A multivariable logistic regression analysis including pre-treatment variables showed that body fat percentage (P = 0.030) and SCL-90 anger-hostility subscale (P = 0.021) were independently associated with attrition. In a multivariable model considering both pre-treatment and treatment-related factors, attrition was found to be independently related to the age at first dieting attempt (P = 0.016) and the achievement of early weight loss (P = 0.029).ConclusionsOur data confirm that psychopathological tracts, early dieting attempts, and a poor initial treatment response are key independent predictors of drop-out from obesity treatment.