A number of epidemiological studies have suggested that diets rich in whole grains are linked to lower cardiovascular disease (CVD) risk and mortality. Quinoa, a pseudo-cereal, is included in the “whole grain” category but the effects of quinoa consumption in humans is not widely studied. Our aim was to undertake a dietary intervention study to investigate the effects of daily consumption of quinoa-enriched bread (providing 20 g quinoa flour) on CVD risk markers compared with a 100% refined wheat bread control. Thirty-seven healthy overweight men (35–70 years, body mass index >25 kg/m2) completed a 4-week cross-over intervention, separated by a 4-week washout period. Fasting blood samples were collected at the beginning and end of each intervention period. Continuous glucose monitoring was undertaken at the end of each intervention period. After 4 weeks of intervention, blood glucose and low density lipoprotein (LDL) cholesterol were significantly lower than baseline in both groups but there was no difference between quinoa and control. Anthropometric measures and other blood metabolites were not different between the two treatments. The cumulative area under the blood glucose curve for the last 4 days of the quinoa intervention tended to be lower than the first 4 days of wash-out (p = 0.054), and was significantly lower than the corresponding period of the wheat treatment (p = 0.039). In conclusion, daily consumption of quinoa in this short-term intervention appears to modify glucose response, but has minimal effects on other CVD risk biomarkers.

Neonatal heart undergoes metabolic conversion and cell cycle arrest preparing for the increased workload during adulthood. Herein, we report that neonatal ketone body elevation is a critical regulatory factor for postnatal heart development. Through multiomics screening, we found that the expression of 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), the rate-limiting enzyme of ketogenesis, was transiently induced by colostrum in the neonatal heart. Hmgcs2 knockout caused mitochondrial maturation defects. Meanwhile, postnatal heart development was compromised and cardiomyocytes reacquired proliferation capacity in Hmgcs2 knockout mice. Consequently, over 40% of newborn Hmgcs2 knockout mice died before weaning. The heart function of surviving Hmgcs2 knockout mice was also impaired, which could be rescued by ketone body supplementation during the suckling stage. Mechanistically, ketone body deficiency inhibited β-hydroxybutyrylation but enhanced acetylation of mitochondrial proteins, which might be responsible for the inhibition of the enzyme activity in mitochondria. These observations suggest that ketone body is critical for postnatal heart development through regulating mitochondrial maturation and metabolic reprogramming.

Quinoa, a gluten-free pseudocereal, has a nutrient and phytochemical profile which may benefit health. Our aim was to investigate the variability in the phenolic and apparent antioxidant content of different quinoa varieties to identify a variety with a high phytochemical content to use in a quinoa-enriched bread. The results showed that free phenolics contributed most (50-83%) to total phenolic content compared with conjugated or bound forms. Apparent antioxidant activities measured by FRAP, ABTS+• and DPPH of free, conjugated and bound extracts were broadly similar, except for free antioxidants when determined by FRAP, which were higher. Phenolic content was positively correlated with FRAP and ABTS+• apparent antioxidant activity. Quinoa samples had a high protein content (13.5 g/100 g dry weight), with a well-balanced amino acid profile. Incorporation of quinoa into baked products such as bread is proposed as a way to deliver this healthy whole-grain cereal into the diet.

The effects of buckwheat intake on cardiovascular diseases (CVDs) have not been systematically investigated. The aim of the present study was to comprehensively summarize studies in humans and animals, evaluating the impact of buckwheat consumption on CVD risk markers and to conduct a meta-analysis of relevant data. Thirteen randomized, controlled human studies, two cross-sectional human studies and twenty-one animal studies were identified. Using random-effects models, the weighted mean difference of post-intervention concentrations of blood glucose, total cholesterol and triglycerides were significantly decreased following buckwheat intervention compared with controls [differences in blood glucose: −0.85 mmol/L (95% CI: −1.31, −0.39), total cholesterol: 0.50 mmol/L (95% CI: −0.80, −0.20) and triglycerides: 0.25 mmol/L (95% CI: −0.49, −0.02)]. Responses of a similar magnitude were seen in two cross-sectional studies. For animal studies, nineteen of twenty-one studies showed a significant reduction in total cholesterol of between 12% and 54%, and fourteen of twenty studies showed a significant reduction in triglycerides of between 2% and 74%. All exhibited high unexplained heterogeneity. There was inconsistency in HDL cholesterol outcomes in both human and animal studies. It remains unclear whether increased buckwheat intake significantly benefits other markers of CVD risk, such as weight, blood pressure, insulin, and LDL-cholesterol, and underlying mechanisms responsible for any effects are unclear.

15The effects of buckwheat intake on cardiovascular diseases (CVD) have not been systematically 16 investigated. The aim of the present study was to comprehensively summarise studies in humans and 17 animals evaluating the impact of buckwheat consumption on CVD risk markers and to conduct a meta-18 analysis of relevant data. Thirteen randomised, controlled human studies, two cross-sectional human 19 studies and twenty-one animal studies were identified. Using random effects models, the weighted 20 mean difference of post-intervention concentrations of blood glucose, total cholesterol and 21 triglycerides were significantly decreased following buckwheat intervention compared with controls 22

Diets rich in whole grains are associated with improved health and a lower risk of non-communicable diseases, but the mechanisms through which these health benefits are conveyed are uncertain. One mechanism may be improvements in the gut environment by the delivery of fermentable substrates and associated phytochemicals to the lower gut and modification of the gut microbiome. Quinoa is included in the whole-grain category because of its structural similarities to cereals but the effects of its consumption on the gut microbiome have not been investigated to date. Our aim was to examine the impact of daily quinoa consumption on the gut microbiome in a 4-week randomised cross-over intervention separated by a 4-week wash-out period involving 28 adult males. Participants consumed either a quinoa-enriched wheat-bread roll providing 20 g quinoa flour each day, or a control wheat-only bread roll. Stool samples were collected in sterile collection tubes immediately before and at the end of each intervention period. DNA was then extracted, and the 16S rRNA V4 region of extracted DNA was amplified and sequenced. For both the control and quinoa bread periods, there were no changes at the phyla or genus level between baseline and week 4 (all p > 0.05). Diversity in the microbiome profile was not different from baseline after either intervention arms. The results show that small changes in the type of cereal consumed—substituting 20 g of refined wheat flour with whole-grain quinoa flour—was not able to significantly modulate the gut microbiome. Further studies with higher levels of quinoa or longer exposure periods are needed to ascertain if there is a dose–response effect of quinoa, and if these effects are able to translate into clinical outcomes.

A systematic review identified eight human intervention studies and thirteen animal experiments investigating associations between quinoa consumption and biomarkers of CVD risk. In humans, lipid profiles were improved following quinoa consumption compared with baseline or control. Weighted mean differences (WMD) for total-and LDLcholesterol concentrations were −0.27 mmol/L (95% CI: −0.41, −0.12, P < 0.001), and −0.21 mmol/L (95% CI: −0.39, −0.03, P = 0.023), respectively. For triglycerides WMD were −0.08 mmol/L (95% CI: −0.13, -0.03, P = 0.002). Glucose concentrations were also significantly decreased by quinoa (WMD −0.14 mmol/L (95% CI: −0.39, 0.10, P = 0.24). Except for triglycerides, results showed no evidence of bias (Begg's and Egger's test P < 0.05). Results from animal experiments were more variable but overall showed similar effects for total cholesterol and triglycerides. Overall, the systematic review and meta-analysis supports potential beneficial impacts of quinoa consumption for CVD prevention but identifying mechanisms for the effects requires further investigation.

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