The aim of this study was to evaluate the effects of skimmed milk as a recovery drink following moderate–vigorous cycling exercise on subsequent appetite and energy intake in healthy, female recreational exercisers. Utilising a randomised cross-over design, nine female recreational exercisers (19.7 ± 1.3 years) completed a V˙O2peak test followed by two main exercise trials. The main trials were conducted following a standardised breakfast. Following 30 min of moderate-vigorous exercise (65% V˙O2peak), either 600 mL of skimmed milk or 600 mL of orange drink (475 mL orange juice from concentrate, 125 mL water), which were isoenergetic (0.88 MJ), were ingested, followed 60 min later with an ad libitum pasta meal. Absolute energy intake was reduced 25.2% ± 16.6% after consuming milk compared to the orange drink (2.39 ± 0.70 vs. 3.20 ± 0.84 MJ, respectively; p = 0.001). Relative energy intake (in relation to the energy content of the recovery drinks and energy expenditure) was significantly lower after milk consumption compared to the orange drink (1.49 ± 0.72 vs. 2.33 ± 0.90 MJ, respectively; p = 0.005). There were no differences in AUC (× 1 h) subjective appetite parameters (hunger, fullness and desire to eat) between trials. The consumption of skimmed milk following 30 min of moderate-vigorous cycling exercise reduces subsequent energy intake in female recreational exercisers.

Poor diet quality influences cardiometabolic risk. Although potatoes are suggested to adversely affect cardiometabolic health, controlled trials that can establish causality are limited. Consistent with potatoes being rich in micronutrients and resistant starch, we hypothesized that their inclusion in a Dietary Guidelines for Americans (DGA)-based dietary pattern would improve cardiometabolic and gut health in metabolic syndrome (MetS) persons. In a randomized cross-over trial, MetS persons (n = 27; 32.5 ± 1.3 year) consumed a DGA-based diet for 2 weeks containing potatoes (DGA + POTATO; 17.5 g/day resistant starch) or bagels (DGA + BAGEL; 0 g/day resistant starch) prior to completing oral glucose and gut permeability tests. Blood pressure, fasting glucose and insulin, and insulin resistance decreased (p < 0.05) from baseline regardless of treatment without any change in body mass. Oral glucose-induced changes in brachial artery flow-mediated dilation, nitric oxide homeostasis, and lipid peroxidation did not differ between treatment arms. Serum endotoxin AUC0–120 min and urinary lactulose/mannitol, but not urinary sucralose/erythritol, were lower in DGA + POTATO. Fecal microbiome showed limited between-treatment differences, but the proportion of acetate was higher in DGA + POTATO. Thus, short-term consumption of a DGA-based diet decreases cardiometabolic risk, and the incorporation of resistant starch-containing potatoes into a healthy diet reduces small intestinal permeability and postprandial endotoxemia.

Background Milk fat globule membrane (MFGM) is a phospholipid-rich component of dairy fat that may explain the benefits of full-fat dairy products on cardiometabolic risk. Preclinical studies support MFGM to decrease gut permeability, which may attenuate gut-derived endotoxin translocation and consequent inflammatory responses that impair cardiometabolic health. Objective To describe the rationale, study design, and planned outcomes that will evaluate the efficacy of MFGM-enriched milk versus a comparator beverage on health-promoting gut barrier functions in persons with metabolic syndrome (MetS). Methods We plan a double-blind, randomized cross-over trial (ClinicalTrials.gov: NCT03860584) in which MetS persons will receive a rigorously controlled eucaloric diet for 2-wk that contains 3 daily servings of an MFGM-enriched bovine milk beverage or a comparator beverage that is formulated with non-fat dairy powder, coconut and palm oils, and soy phospholipids. Compliance will be monitored by assessing urinary para-aminobenzoic acid that is added to all test beverages. After the intervention, participants will ingest a high-fat/high-carbohydrate meal challenge to assess metabolic excursions at 30 min intervals for 3 h. Non-digestible sugar probes also will be ingested prior to collecting 24-h urine to assess region-specific gut permeability. Intervention efficacy will be determined based on circulating endotoxin (primary outcome) and glycemia (secondary outcome). Tertiary outcomes include: gut and systemic inflammatory responses, microbiota composition and short chain fatty acids, gut permeability, and circulating insulin and incretins. Expected Results MFGM is expected to decrease circulating endotoxin and glycemia without altering body mass. These improvements are anticipated to be accompanied by decreased gut permeability, decreased intestinal and circulating biomarkers of inflammation, increased circulating incretins, and beneficial antimicrobial and prebiotic effects in the gut microbiome. Conclusions Demonstration of improvements in gut barrier functions that limit endotoxemia and glycemia could help to establish direct evidence by which full-fat dairy lowers cardiometabolic risk, especially among MetS persons. The clinical trial associated with this paper has been registered at ClinicalTrials.gov, registry number NCT03860584.

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pp 7+95 £3.60 USA: Medical Examination 1973 London: Henry Kimpton This handbook of ENT emergencies is the first of its kind, according to the authors. It is clearly and on the whole concisely written, but rather uneven in content, some sections being better covered than others. Insufficient emphasis is given to methods of treatment, whereas symptomatology, physical signs, and differential diagnosis are dealt with comprehensively. It is difficult to see, however, why so many conditions (e.g. geographical tongue, hiatus hernia) are classified as emergency conditions.As the book is written for a wide audience ranging from medical students to oral and plastic surgeons, the complete absence of illustrations is a serious drawback.OMAR SHAHEEN

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Objectives Observational studies suggest that the regular ingestion of potatoes adversely affects cardiometabolic health, but controlled studies in humans are needed to establish causality. Our objective was to assess whether daily inclusion of non-fried potato foods as part of a Dietary Guidelines for Americans (DGA)-based dietary pattern would impair cardiometabolic health in adults with metabolic syndrome (MetS). Methods In a 2-arm, randomized controlled, crossover trial separated by a 2-wk washout period, MetS adults were provided a eucaloric DGA-based dietary pattern containing potato (350 g with 17.5 g/d resistant starch; POTATO) or an energy-matched bagel (0 g/d resistant starch; CON) for 14 d. Fasting blood was collected on d 0 and 14. On d 14, after a 75 g oral glucose tolerance test, brachial artery flow-mediated dilation (FMD) was measured and blood was collected at 30 min intervals for 2 h to assess vascular endothelial function and metabolic excursions, respectively. Circulating endotoxin, glucose, insulin, and nitric oxide metabolites (NOx) were assessed by spectrophotometry, and malondialdehyde (MDA) and arginine and its metabolites by HPLC. Data were analyzed using two-way repeated measures ANOVA. Results MetS adults (n = 27; 32.5 ± 1.3 y; 35.0 ± 1.0 kg/m2) completed the study with no adverse effects or significant changes in body weight. The 14-d DGA-based dietary pattern had a small but significant effect to decrease glucose (107 ± 1.9 vs. 102 ± 1.7 mg/dL; P = 0.04) and insulin (19 ± 2.9 vs. 14 ± 1.5 μIU/mL; P = 0.03), but these were unaffected by POTATO. Fasting endotoxin, NOx, and MDA and FMD were also unaffected by POTATO compared to CON, as were postprandial AUC0–2h of FMD, insulin, glucose, arginine, MDA, endotoxin, and NOx. Conclusions Findings of this acute controlled trial, which require long-term validation, support that a DGA-based dietary pattern may help to improve insulin resistance and that potatoes can be effectively incorporated into the diet without compromising vascular endothelial function or cardiometabolic health in persons with MetS. Funding Sources Alliance for Potato Research and Education.