The current state of understanding of protein structure as it relates to its function in foaming has proven to be of sufficient accuracy to predict the effects of particular modifications in soy proteins. Comparative whipping studies performed on egg white, casein, Bovine serum albumin and soy protein showed important differences both in the development and subsequent stability of foams produced from these proteins. Our understanding of the structures of soy proteins and the alterations induced by reductive modification and heating implied that similar modifications would have dramatic impact on the foaming properties specifically of the 11S protein. The foaming ability and stability of the 11S protein were enhanced dramatically by cleavage of intersubunit disulfide bridging. Computerized lamellar measurement techniques developed in this laboratory indicated that these modifications enhanced the ability of the protein to foam rapidly and then to stabilize surface films at the rate typically encountered in the whipping of foams.

No abstract

A direct saponification method was developed to determine cholesterol quantitatively in turkey meat and its processed products at a detection limit of 10 ppm. Five solvents and two derivatizing agents were evaluated. The method involved direct saponification with ethanolic KOH, homogeneous-phase toluene extraction of unsaponifiables, derivatization of cholesterol to a trimethylsilyl ether and quantitation by gas chromatography with flame ionization detection using 5␣-cholestane as internal standard. Compounds were confirmed by gas chromatography-mass spectrometry.

Key Points Question Did health care use among undocumented residents change with increasing anti-immigrant rhetoric during the 2016 presidential campaign? Findings In this cohort study based on a single-center analysis of health care use among 20 211 adults and children, there was a 34.5% decrease in completed primary care visits among undocumented children and 43.3% decrease in completed primary care visits among undocumented adults between June 16, 2015 (the start of the Trump campaign for presidency, associated with an increase in anti-immigrant rhetoric), and May 31, 2018, which was significantly greater than patients in the Medicaid group. Meaning A significant decrease was noted in this cohort study in the use of primary health care services among a sample of predominantly undocumented patients compared with those in a Medicaid control group in the setting of rising anti-immigrant rhetoric associated with the 2016 presidential campaign.

No abstract

Objective-To assess the adequacy of polyunsaturated fatty acid intake by rural Bangladeshi children 24-48 months of age in relation to their breastfeeding status.Methods-Multi-stage sampling was used to select a representative sample of children 24-48 mo of age from two rural districts in Bangladesh (n=479). Two non-consecutive 24 h periods of dietary data were collected via 12 h daytime in-home observations and recall. Breast milk intake was estimated using test weighing. The National Cancer Institute method for episodically consumed foods was used to estimate distributions of usual food and nutrient intakes.Results-Based on the estimated intake distributions, more than 95% of the children had usual fat intakes less than 30% of total energy. Among 24-35 mo (younger) and 36-48 mo (older) children, respectively, 4% and 16% of breastfeeding children and 31% and 41% of nonbreastfeeding children were estimated to consume less than 10% of total energy from fat. An estimated 80% of all children consumed less than 4% of total energy as linoleic acid, and 99% consumed less than 1% of energy as alpha-linolenic acid. Younger breastfeeding children had higher estimated average docosahexaenoic acid (DHA) intakes (0.04 g DHA/d) than their nonbreastfeeding counterparts (0.01 g DHA/d; p = 0.0005). Both breastfeeding and non-breastfeeding older children had estimated mean DHA intakes of 0.02 g/d (p=0.74). Conclusions-RuralBangladeshi children 24-48 months of age, and especially those who have discontinued breastfeeding, may benefit from increased fat consumption.

Evidence suggests that low carbohydrate (<130 g/day of carbohydrate) (LCD) and very low carbohydrate, ketogenic diets (typically <50 g/day of carbohydrate) (VLCKD) can be effective tools for managing diabetes given their beneficial effects on weight loss and glycemic control. VLCKD also result in favorable lipid profile changes. However, these beneficial effects can be limited by poor dietary adherence. Cultural, religious, and economic barriers pose unique challenges to achieving nutritional compliance with LCD and VLCKD. We review the various methods for assessing adherence in clinical studies and obstacles posed, as well as potential solutions to these challenges.

Individuals with type 2 diabetes (T2DM) are at high risk for nonalcoholic fatty liver disease (NAFLD), and evidence suggests that poor glycemic control is linked to heightened risk of progressive NAFLD. We conducted an observational study based on data from a telehealth trial conducted in 2018-2020. Our objectives were to: 1) characterize patterns of NAFLD testing/care in a cohort of individuals with poorly-controlled T2DM; and 2) explore how lab-based measures of NAFLD (e.g., liver enzymes, fibrosis-4 [FIB-4]) vary by glycemic control. We included individuals with poorly-controlled T2DM (n=228), defined as hemoglobin A1c (HbA1c) ≥ 8.5% despite clinic-based care. Two groups of interest were: 1) T2DM without known NAFLD; and 2) T2DM with known NAFLD. Demographics, medical history, medication use, glycemic control (HbA1c) and NAFLD testing/care patterns were obtained by chart review. Among those without known NAFLD (n=213), most were male (78.4%) and self-identified as Black race (68.5%). Mean HbA1c was 9.8%. Most had liver enzymes (85.4%) and platelets (84.5%) ordered outpatient over a 2-year period that would allow for FIB-4 calculation, yet only 2 individuals had FIB-4 documented in clinical notes. Approximately one third had abnormal liver enzymes at least once over a 2-year period, yet only 7% had undergone liver ultrasound and 4.7% had referral placed to Hepatology. Among those with known NAFLD (n=15), mean HbA1c was 9.5%. Only 4 individuals had undergone transient elastography, half of whom had advanced fibrosis. NAFLD is underrecognized in poorly-controlled T2DM, even though this is a high-risk group for NAFLD and its complications.