BackgroundWhole grain rye products have been shown to increase satiety and elicit lower postprandial insulin response without a corresponding change in glucose response compared with soft refined wheat bread. The underlying mechanisms for these effects have not been fully determined The primary aim of the study was to investigate if whole grain rye crisp bread compared to refined wheat crisp bread, elected beneficial effects on appetite and postprandial insulin response, similarly as for other rye products.MethodsIn a randomized cross-over trial, 23 healthy volunteers, aged 27-70 years, BMI 18-31.4 kg/m2, were served a standardized breakfast with unfermented whole grain rye crisp bread (uRCB), fermented whole grain rye crisp bread (RCB) or refined wheat crisp bread (WCB), Appetite was measured using a visual analogue scale (VAS) until 4 h after breakfast. Postprandial glucose and insulin were measured at 0-230 min. Breads were chemically characterized including macronutrients, energy, dietary fiber components, and amino acid composition, and microstructure was characterized with light microscopy.ResultsReported fullness was 16% higher (P<0.001), and hunger 11% and 12% lower (P<0.05) after ingestion of uRCB and RCB, respectively, compared with WCB. Postprandial glucose response did not differ significantly between treatments. Postprandial insulin was 10% lower (P<0.007) between 0-120 min but not significantly lower between 0-230 min for RCB compared with WCB. uRCB induced 13% (P<0.002) and 17% (P<0.001) lower postprandial insulin response between 0-230 min compared with RCB and WCB respectively.ConclusionWhole grain rye crisp bread induces higher satiety and lower insulin response compared with refined wheat crisp bread. Microstructural characteristics, dietary fiber content and composition are probable contributors to the increased satiety after ingestion of rye crisp breads. Higher insulin secretion after ingestion of RCB and WCB compared with uRCB may be due to differences in fiber content and composition, and higher availability of insulinogenic branched chain amino acids.Trial RegistrationClinicalTrials.gov NCT02011217
Whole-grain rye foods reduce appetite, insulin and sometimes glucose responses. Increased gut fermentation and plant protein may mediate the effect. The aims of the present study were to investigate whether the appetite-suppressing effects of whole-grain rye porridge could be enhanced by replacing part of the rye with fermented dietary fibre and plant protein, and to explore the role of gut fermentation on appetite and metabolic responses over 8 h. We conducted a randomised, cross-over study using two rye porridges (40 and 55 g), three 40-g rye porridges with addition of inulin:gluten (9:3; 6:6; 3:9 g) and a refined wheat bread control (55 g), served as part of complete breakfasts. A standardised lunch and an ad libitum dinner were served 4 and 8 h later, respectively. Appetite, breath hydrogen and methane, glucose, insulin and glucagon-like peptide-1 (GLP-1) responses were measured over 8 h. Twenty-one healthy men and women, aged 23-60 years, with BMI of 21-33 kg/m 2 participated in this study. Before lunch, the 55-g rye porridges lowered hunger by 20 % and desire to eat by 22 % and increased fullness by 29 % compared with wheat bread (P < 0·05). Breath hydrogen increased proportionally to dietary fibre content (P < 0·05). Plasma glucose after lunch was 6 % lower after the 55-g rye porridges compared with wheat bread (P < 0·05) and correlated to breath hydrogen (P < 0·001). No differences were observed in ad libitum food intake, insulin or GLP-1. We conclude that no further increase in satiety was observed when replacing part of the rye with inulin and gluten compared with plain rye porridges.
Differences in protein and fiber contents in breakfasts altered postprandial plasma amino acids and short chain fatty acids, respectively, but were unrelated to appetite and glucose responses. Further studies are warrant to identify the underlying mechanisms for the beneficial effects on appetite and second meal glucose responses after rye-based foods.
This is the Pre-Published Version.2 Objectives: This study tested the effectiveness of a schizophrenia care management program for family caregivers of Chinese patients with schizophrenia in Hong Kong.Methods: A multisite controlled trial was conducted with 92 patient-caregiver dyads. They were randomly assigned to either the schizophrenia care management program or to usual care. The patients' symptoms, functioning, and length of rehospitalization and their families' perceived social support, expressed emotion, and functioning were measured at recruitment and at one month and 15 months after the intervention. Other limitations of family intervention studies are the paucity of controlled trials of needsbased interventions with a broad range of outcome measures, poor study power and high attrition rates, and insufficient interdisciplinary collaboration (2,4).A few integrated multidisciplinary and multicomponent educational programs, such as a family psychoeducation group program in Hong Kong (5) and a needs-based psychosocial intervention in the United Kingdom (6), reported significant effects on families' management of patients' problem behaviors and families' general health. These programs 3 consist of multiple supportive strategies, such as schizophrenia care education, stress management, and problem-solving skills. However, only a few family intervention studies have been conducted in Asian populations, where great importance is attached to intimate interpersonal relationships and collective behaviors among family members (1). To address gaps in knowledge about the quality of family interventions, this trial was designed to test the effects of an interdisciplinary, needs-based schizophrenia care management program (SCMP) for family caregivers of Chinese patients with schizophrenia on patients' and families' psychosocial health and functioning. MethodsThe study was a randomized controlled trial that used a repeated-measures design. patient-caregiver dyads agreed to participate. Of these, 92 (46%) were randomly selected to take part. Based on previous studies of family intervention (4,5), this sample size was required to detect any significant difference between the groups at a 5% significance level with a power of 90%, and the size would allow 15% attrition (7).Patient-caregiver dyads were eligible for the study. Caregivers were eligible for the study if they were 18 years or older, if they were the main caregiver for the relative with schizophrenia, and if they lived with the relative with schizophrenia. Patients had to be diagnosed as having schizophrenia according to DSM-IV criteria and be 18 years or older.Caregivers who had mental illness themselves or cared for more than one relative with mental illness were excluded. After written consent of caregivers and patients had been obtained following a full explanation of the study, the participants were randomly assigned to the usual care or the SCMP group. (experience sharing and problem solving), family caregivers were guided to discuss their situations in m...
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