Kuruppu Mudiyanselage Swarna Wimalasiri

Summary: Fructans are water soluble, non‐digestible fructose polymers found as storage polysaccharides in certain plants. They are classified as inulin‐type, graminan‐type and branched‐type, while the former being the most extensively researched fructan type. Inulin fructans vary in different plants, with respect to the chain length, degree of polymerisation and molecular weight. Being one of the most versatile functional food ingredients, inulin fructans are well known for their unique bifidogenic and prebiotic properties as well as techno‐functional properties including fibre enhancing, fat and sugar replacing and viscosity and texture modifying attributes in food systems. Therefore, incorporation of inulin fructans into more frequently consumed dairy and non‐dairy products has become an emerging trend in the food industry. Despite the commercial manufacture of inulin fructans from chicory, a growing interest has emerged to extract this functional ingredient from inulin‐rich alternative plant sources including jerusalem artichoke, globe artichoke, yacon, burdock, asparagus species, garlic, agave and dandelion, which can potentially be good sources of inulin for food and nutraceutical applications in future. This review provides an in‐depth insight of inulin fructans including the chemistry, food applications and health benefits, and also giving special reference to alternative plant sources.

Fluoride is a beneficial trace element for human health as its deficiency and excess levels can cause detrimental health effects. In Sri Lanka, dry zone regions can have excessive levels of fluoride in drinking water and can cause dental and skeletal fluorosis. In addition to drinking water, traditional habits of tea consumption can cause an additional intake of fluoride in the population. A total number of 39 locally blended black tea samples were collected from a village where chronic kidney disease with undetermined origin (CKDu) is prevalent. In addition, unblended tea samples were obtained from tea-producing factories. The fluoride contents in infusions of 2% weight per volume (w/v) were measured using calibrated ion-selective fluoride electrodes. The mean fluoride content was 2.68±1.03 mg/L in loose tea, 1.87±0.57mg/L in packed tea samples, and 1.14±0.55 mg/L in unblended tea. Repeated brewing of the same tea leaves showed that over 50% of fluoride leached into the solution in the first infusion. An estimate of the daily total average fluoride intake via tea consumption per person is 2.68 mg per day. With groundwater in many dry zone regions in Sri Lanka showing high fluoride levels that exceed 0.5 mg/L, the additional daily intake can rapidly exceed recommended thresholds of 2 mg/day. This can add to adverse health impacts that might also relate to CKDu.

Iron deficiency anaemia during pregnancy is a common public health problem that negatively affects maternal and newborn health. This study aims to identify the rate of maternal compliance with the recommended iron and folic acid (IFA) supplementation during pregnancy and to identify factors associated with maternal compliance and non-compliance. A hospital-based cross-sectional study was conducted among 703 women at 0–4 days postpartum. The prevalence of anaemia at the initial antenatal clinic (ANC) visit and at the third trimester were 20.8% and 44.9%, respectively. The rate of IFA supplementation compliance during pregnancy was 80.1%. Forgetfulness (66.9%) was the major reason for non-compliance, followed by side effects (15.7%). Maternal employment [OR (95%CI): 1.7 (1.00–2.89)], history of a low birth weight infant [OR (95%CI): 0.4 (0.19–0.9)] and history of anaemia [OR (95%CI): 0.4 (0.12–0.98] were significantly associated with maternal compliance with IFA supplementation. Only 26.6% of the participants adhered to dietary recommendations during the period when IFA supplements were provided. The rate of maternal compliance with IFA supplementation was high. However, the prevalence of maternal anaemia during pregnancy was also high, which was presumably due to poor dietary compliance despite high IFA supplementation compliance.

Research background. Food proteins and polysaccharides can be used for the synthesis of nano-scale biopolymer particles with potential applications in the fields of food and pharmaceuticals. This study focuses on utilizing legume proteins for the production of biopolymer particles via regulation of their electrostatic interactions with carrageenan. Experimental approach. Protein isolates were obtained from mung bean (Vigna radiata), cowpea (Vigna unguiculata) and black gram (Vigna mungo) and their protein profiles were determined. Next, these isolates were allowed to interact with carrageenan at pH=5.0-7.0 to determine optimum conditions for obtaining nano-scale biopolymer particles. Selected biopolymer mixtures were then subjected to a heat treatment (85 °C for 20 min) to enhance the interactions among biopolymers. Results and conclusions. Nano-scale biopolymer complexes were obtained at pH=6.5. They were roughly spherical in shape with a majority having a diameter in the range of approx. 100-150 nm. Heating of the biopolymer mixtures increased the diameter of the biopolymer particles by approx. 2.5-fold. In addition, their negative surface charge was increased, stabilizing them against aggregation over a broader pH range (4.0-7.0), enhancing their potential to be utilized in food matrices. Novelty and scientific contribution. This study reports the applicability of mung bean, cowpea and black gram proteins for the synthesis of stable biopolymer particles. These biopolymer particles can be potentially used for the encapsulation and delivery of bioactive components.

Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life—Short Form (KDQOL-SF^TM) version 1.3 and CKD Symptom Index—Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min², and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3–7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL.

Low birth weight is a key public health problem in many developing countries, including Sri Lanka. Indoor air pollution from tobacco smoke and kitchen-fuel smoke are among the major contributors to low birth weight, factors of which there are little awareness of in Sri Lanka. We evaluated the effect of passive smoking and kitchen-fuel smoke exposure on birth weight. Seventy-six pregnant women were included in the study. Data were collected by questionnaire, and exposure assessment was conducted using a breath carbon monoxide monitor. Women exposed to second-hand tobacco smoke daily had a significantly lower mean gestational age at delivery (mean ± standard error [SE]: 38.0 ± 0.5 weeks) than women who were exposed to second-hand tobacco smoke only once a week (mean ± SE: 39.3 ± 0.3 weeks) (p < 0.05). Women who were exposed to tobacco smoke every day delivered neonates with significantly lower mean birth weight (mean ± SE: 2703 ± 135 g) than women who were only exposed once a week (mean ± SE: 3125 ± 147 g) (p < 0.05). A one-minute increase in cooking time in a kitchen without a chimney increased women’s expired air carbon monoxide concentration by 0.038 ppm (p = 0.006). Long-term exposure to wood-fuel smoke in a kitchen without a chimney can increase the risk of inhaling high concentrations of carbon monoxide.

Poor maternal nutrition is a major contributor to the high incidence of low birth weight deliveries in developing countries. This study aimed to assess the impact of second trimester maternal dietary intake on gestational weight gain and neonatal birth weight. A longitudinal study was conducted in a tertiary care hospital in Sri Lanka. Participants were 141 pregnant women at 18–24 weeks gestation who were followed up until delivery. Maternal dietary intake was assessed using a validated Food Frequency Questionnaire at 21.1 ± 1.8 gestational weeks. Gestational weight gain was examined at the end of 28 weeks gestation and at the end of pregnancy. Energy and nutrient intakes were calculated using NutriSurvey 2007 (EBISpro, Willstaett, Germany) nutrient analysis software, modified for Sri Lankan foods. The mean total gestational weight gain of women with low carbohydrate intake (229–429 g/day) was 2.2 kg less than that of women with moderate carbohydrate intake (430–629 g/day) (95% confidence interval (CI) 0.428–4.083 kg; p = 0.016). Similarly, babies of women with low carbohydrate intake were 312 g lighter compared with those of women with a moderate carbohydrate intake (95% CI 91–534 g; p = 0.006). Our results suggest that second trimester maternal carbohydrate intake has significant impacts on total gestational weight gain and neonatal birth weight.