Aims Safety and tolerability of prolonged supplementation with a vitamin D, calcium and leucine-enriched whey protein medical nutrition drink (WP-MND) was evaluated in sarcopenic older adults. Methods A 13-week double-blinded, randomized, isocaloric placebo-controlled trial (PROVIDE study; n = 380) was extended with a voluntary 13-week open-label extension (OLE). OLE participants were randomized to receive daily 1 or 2 servings of WP-MND (21 g protein, 3 g leucine, 10 µg vitD and 500 mg calcium per serving). Gastro-intestinal tolerability, kidney function and serum levels of calcidiol, parathyroid hormone (PTH) and calcium were evaluated at week 0, 13 and 26. Results and discussion In response to the high daily protein intake (median1.5; IQR: 1.3, 1.7 g/kg BW/day), the estimated glomerular filtration rate (eGFR) increased in the test group during the RCT (p = 0.013). The same trend was observed for those participants with moderate chronic kidney disease. During OLE no eGFR change was observed in any of the groups. Serum calcidiol and calcium reached a plateau after 13-week WP-MND supplementation. As expected, PTH significantly changed in the opposite direction, decreasing during RCT in the test group (T vs C: p < 0.001) and during OLE in former control groups. During RCT, 20/366 participants with normal baseline calcidiol reached levels ≥ 100 nmol/L (T: n = 18; C: n = 2) and 6 developed albumin-corrected calcium levels > 2.55 mmol/L (T: n = 3; C: n = 3), without associated adverse events. Conclusion A 6 months intervention with up to 2 servings of WP-MND did neither result in kidney function deterioration nor symptoms of vitamin D or calcium toxicity. The product was overall well tolerated.

Metabolic syndrome represents a clustering of risk factors related to an elevated danger of cardiovascular diseases and type 2. diabetes. The high incidence of obesity, the key risk factor in metabolic syndrome, and the lack of safe pharmaceutical agents have fuelled an increase in research related to anti-metabolic syndrome drugs. Phytochemicals have biological properties such as antioxidant, modulation of detoxifi cation enzymes, stimulation of the immune system, reduction of platelet aggregation and modulation of hormone metabolism. These compounds include vitamins, comprising of vitamin C, D and E, fl avonoids, phenolic acids, omega-3 and omega-6 fatty acids. Furthermore, the latest discoveries and studies on the molecular mechanism of these phytochemicals suggested their potential positive effect in the prevention and treatment of obesity and other risk factors associated with the metabolic syndrome. They should be incorporated in food ingredients, dietary supplements, or drug preparations. The main focus of this article is to review the available information on various aspects of phytochemicals, with special reference to their effectiveness in risk reduction of the metabolic syndrome and obesity-related diseases.

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New wheat-rye bread fortified with cereal dietary fibre, β-glucan hydrogel, and sourdough starter culture was designed in this study. The impact of these additives on nutritional composition and antioxidant properties was investigated. Functional bread with extruded wheat bran (10.0 %), cereal β-glucan hydrogel (12.5 %), and lactobacilli starter culture was compared with traditional wheat-rye bread (control). The contents of basic nutrients (protein, fat, etc.), dietary fibre, biologically active compounds (polyphenols and flavonoids), qualitative and quantitative analysis of simple saccharides and phenolic acids (by HPLC) were analysed in both bread types. Antioxidant activity, measured by two spectrophotometric methods (2,2′-azinobis-(3-ethylbenzthiazoline-6-sulphonic acid); ABTS and di(phenyl)-(2,4,6-trinitrophenyl)iminoazanium (2,2-diphenyl-1-picrylhydrasyl); DPPH, was also evaluated. The effect of the addition of the above ingredients, as compared with traditionally prepared bread, was examined in the postprandial study, in which glucose and insulin levels were determined. In comparison with the control bread, higher amounts of dietary fibre, flavonoid content, and antioxidant activity were attained in the designed bread. Consumption of the designed bread led to reduced glucose levels in healthy males (n = 10) 120 min after the ingestion of the functional bread compared with the control (p < 0.048). No statistically significant change in the insulin response in the volunteers was observed after consumption of the designed bread compared with the control.

Consumption of nutritionally enhanced wheat-oat bread naturally rich in β-glucans originating from extra-wholemeal oat flour with improved digestibility by lactic fermentation provides unambiguous health benefits associated with a slower blood glucose release and a higher subjective satiety determined by a postprandial study. However, an undesirable elevated acrylamide formation in the crust of bread was observed due to a high level of a main precursor amino acid L-asparagine in oat flour. Lactic fermentation of oat flour by Lactobacillus plantarum and 30% substitution of extra-wholemeal oat flour with fermented oat sourdough led to more attractive organoleptic quality of wheat-oat fermented bread and to a decrease of pH value which suppressed acrylamide level up to 10%. As a more effective tool of acrylamide reduction a commercial asparaginase enzyme was used, applied on a surface of the bread loaf during proofing and before baking. This enzyme treatment resulted in a more than 46% decrease of acrylamide in the crust from 390 µg/kg to the level of 210 µg/kg without any alterations to the expected quality of the newly designed bread.

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