Sara Thomas

Introduction: Minimizing postprandial glucose response is an important goal for overall diabetes management. Diabetes-specific nutritional shakes (DSNS) have been clinically shown to minimize postprandial glucose response in people with type 2 diabetes (T2DM) compared to high-glycemic foods. However, it is unknown how a high-protein, low-fat DSNS impacts the GLP-1 response.Methods: We tested the postprandial glucose, insulin, and GLP-1 response to a high-protein, low-fat diabetes-specific nutritional shake (DSNS-HP) compared to isocaloric instant oatmeal (IOM) in a randomized, controlled, crossover study in adults with T2DM (n = 24). Participants were randomly selected to receive IOM or DSNS-HP on two test days. Glucose, insulin, and total GLP-1 concentration were measured at baseline and 15, 30, 45, 60, 90, 120, 180, and 240 min postprandially.Results: Compared to IOM, the glucose-positive area under the curve (pAUC) was significantly lower (P = .021). DSNS-HP significantly increased GLP-1 pAUC response by 213% (P <.001) with a corresponding increase in insulin pAUC (P = .033) compared to IOM.Discussion: A high-protein, low-fat DSNS leads to favorable changes in GLP-1 response and is a suitable option to minimize blood glucose response in people with type 2 diabetes.

Malnutrition is prevalent among oncology patients and can adversely affect clinical outcomes, prognosis, quality of life, and survival. This review evaluates current trends in the literature and reported evidence around the timing and impact of specific nutrition interventions in oncology patients undergoing active cancer treatment. Previous research studies (published 1 January 2010–1 April 2020) were identified and selected using predefined search strategy and selection criteria. In total, 15 articles met inclusion criteria and 12/15 articles provided an early nutrition intervention. Identified studies examined the impacts of nutrition interventions (nutrition counseling, oral nutrition supplements, or combination of both) on a variety of cancer diagnoses. Nutrition interventions were found to improve body weight and body mass index, nutrition status, protein and energy intake, quality of life, and response to cancer treatments. However, the impacts of nutrition interventions on body composition, functional status, complications, unplanned hospital readmissions, and mortality and survival were inconclusive, mainly due to the limited number of studies evaluating these outcomes. Early nutrition interventions were found to improve health and nutrition outcomes in oncology patients. Future research is needed to further evaluate the impacts of early nutrition interventions on patients’ outcomes and explore the optimal duration and timing of nutrition interventions.

Carotenoids are plant pigments commonly found in fruits and vegetables. They are made up of 2 classes, xanthophylls and carotenes. Whereas carotenes are composed of only carbon and hydrogen, xanthophylls include hydroxyl groups, making them slightly more hydrophilic than carotenes. Carotenoids are found throughout the body. Among the carotenoids, the xanthophylls lutein and zeaxanthin selectively accumulate in the eye and brain. In the eye, lutein and zeaxanthin are responsible for the yellow pigment of the macula lutea, along with the nondietary lutein metabolite meso-zeaxanthin (1). Xanthophylls have properties similar to lipids, being insoluble in water, and thus share similar transport mechanisms in the aqueous environment of the body. Many factors affect their bioavailability from the diet, including processing, meal composition and digestive enzyme activity (2). In the digestive tract, xanthophylls are incorporated into micelles and cross the enterocyte by simple passive diffusion or via several proposed lipid transporters. β-Cryptoxanthin, the only provitamin A xanthophyll, is partially cleaved to vitamin A by β-carotene-15,15′-oxygenase, while the other xanthophylls are incorporated into chylomicrons and secreted from the lymph into the blood. Xanthophylls are exclusively transported intact through the blood via lipoproteins and are taken up by tissues via membrane-bound lipid transporters. Very small amounts of the cleavage products of lutein and zeaxanthin are present in human plasma and are called “apocarotenoids” (1). Apocarotenoids are present in foods and there is evidence that they are bioactive in the body. Their presence in the body is either from the diet or by enzymatic activity of β, β-carotene-9′,10′-dioxygenase.

The percent absorption of lutein from supplements falls well below that from lutein enriched egg yolk, a rich source of phospholipids. Therefore, a supplement of lutein plus phospholipids was tested for effects on serum accumulation. A 10 day supplementation with a solid-lipid particle (SLP™) lutein complex or conventional lutein ester was done in apparently healthy people (both supplement types taken with fat containing meals). Plasma lutein was measured pre- and post-supplementation as well as 7 days after supplementation stopped. Changes within each supplement group were analyzed by paired t-test; group comparisons were done by unpaired t-test. The solid-lipid particle complex lutein gave much higher plasma lutein values than conventional lutein ester. The lutein complex showed superior effects based on absolute mean value after 10 days of supplementation, change in value from baseline to 10 days, and value at 7 days after supplement discontinuation. A solid lipid lutein complex strongly increased plasma lutein levels compared to a conventional form.