Background:Children's eating habits are formed at an early age, making childhood a crucial period for introducing novel foods, such as pulse-based food products. Pulse Discovery Toolkit (PDTK) intervention was designed to increase familiarity with pulses and to eventually contribute to the consumption of pulse-based foods among preschool children in childcare centers (CCs). Objective:To determine PDTK's impact on knowledge, acceptability, and consumption of pulse-based foods among preschool children attending CCs, and to assess its feasibility and acceptability by early childhood educators (ECE) and cooks. The nutrient contents and food group servings of pulse-based intervention recipes in the PDTK were also compared with regular CC recipes. Methods:The PDTK intervention was delivered over a 3-month period in 2 CCs in Saskatoon (50 children, 8 staff). The intervention, which integrated taste exposure and nutrition education, consisted of 12 child-friendly weekly lessons, a food service guide for cooks, 15 recipes for pulse-based foods, 4 intervention recipes incorporated in the CC menu, and 4 parent newsletters. Mixed methods were used with pre- and postintervention knowledge tests, plate waste measurement, sensory evaluation, ECE and cook's perspective, and nutrient content comparison of the intervention and control foods from the regular childcare menu to evaluate the intervention's impact. Unlabelled:Improvements in correct identification of chickpeas (2/21 [10%] at preintervention to 7/21 [33%] at postintervention, P=.074), beans (8/21 [38%] to 11/21 [52%], P=.68), and peas (6/21 [27%] to 8/21 [38%], P=.61) were not statistically significant. Children consumed higher amounts of the regular recipes (293.54, SD 27.65; 178.46, SD 24.33) than the intervention recipes (211.56, SD 25.61; 108.83, SD 21.97) at both times, respectively. However, at the end of the intervention, significant differences were only observed in the amount of total food consumption (P=.049) and the protein content (P=.04) when consumption proportion was examined, with both being higher for the control recipes in comparison to the intervention recipes. The majority (92% and 72%) of the children rated the refried bean wrap and lentil smoothie, "yummy," respectively. Most of the intervention recipes have lower energy, fat, and sodium content compared with the regular CC recipes. Findings from ECE semistructured interviews and the lesson plan evaluations revealed that the ECEs reacted favorably to the curriculum. The cooks from the participating CCs did not report any barriers to cooking pulses in their facility. However, the need for modification to make the recipes easier to cook in CCs was noted in our study. Conclusions:With a few modifications to make some of the lessons more age-appropriate and some of the recipes easier to cook, it is feasible to implement the PDTK in CCs in order to promote regular consumption of pulses.

Osteoporosis is a major global public health concern, and optimizing peak bone mass during young adulthood is a main preventive strategy for reducing fracture risk later in life. Dairy foods, including milk and yogurt, provide nutrients, including calcium and protein, that support bone health. However, their long-term comparative effects on bone, body composition, and the gut microbiome in Canadian young adults are unknown. This study aims to evaluate the effects of two-year supplementation with fermented (yogurt) and non-fermented (milk) dairy products, compared to a habitual diet, on femoral neck bone mineral density (BMD) in Canadian adults aged 19 to 30 years. Secondary objectives include changes in BMD at other skeletal sites, including the total hip, lumbar spine, and whole body, as well as body composition, hormonal and bone turnover markers, gut microbiota composition and diversity following the intervention. The Fermented-Non-Fermented-Dairy (FNFD) trial is a two-year, prospective, randomized, three-arm, parallel-group controlled trial. In this study, 120 eligible healthy adults aged 19-30 years living in Saska-toon, Canada, with calcium intake <800 mg/day were randomized to one of three arms: 1) milk (375 mL) with habitual diet, 2) yogurt (350 g) with habitual diet, or 3) control (habitual diet). Data is collected at five time points; baseline, month 6, month 12, month 18, and month 24. The primary outcome is the change in femoral neck BMD. Secondary outcomes include BMD at other skeletal sites (total hip, lumbar spine, whole body), BMC (total hip, femoral neck, lumbar spine, whole body), bone structure and geometry, biochemical markers of bone turnover (osteocalcin, bone-specific alkaline phosphatase (BALP), C-terminal telopeptide of type 1 collagen (CTx-1), transforming growth factor-beta 1 (TGF-β1), TGF-β2, TGF-β3, and TGF-β receptor II (TGF-β RII), hormonal markers related to bone metabolism (parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D], and serum and salivary insulin-like growth factor-1 (IGF-1)), anthropometrics, body composition (total fat and lean mass), and gut microbiota. Recruitment was conducted between July 2024 and July 2025, with an allocation ratio of 1:1:1 for the three study arms. All participants have completed all measurements until the month 6 time point, while month 12 follow-ups are ongoing. Month 24 assessments will take place from November 2026 to July 2027, followed by data analysis and dissemination through peer-reviewed publications and the trial registry. This study uses a robust methodology and multidimensional outcome assessment to evaluate the effects of milk and yogurt supplementation on skeletal and metabolic health in young adults. The findings will contribute to evidence on dairy-based nutritional strategies to optimize long-term bone health in young Canadian adults. This trial is registered at ClinicalTrials.gov (Identifier: NCT06265246).

Background/Objectives: Liver fat represents an early metabolic lesion in the development of diabetes and its cardiometabolic complications. Diets high in free sugars, particularly from sugar-sweetened beverages (SSBs), are associated with abdominal obesity and increased cardiometabolic risk, prompting global guidelines to limit SSBs as a major public health strategy. Low-fat cow's milk is promoted as the preferred caloric replacement strategy for SSBs due to its high nutritional value and cardiometabolic advantages. Fortified soymilk is a plant-based alternative with approved health claims for cholesterol and coronary heart disease risk reduction that offers an equivalent nutritional value to cow's milk. However, given concerns about its classification as an ultra-processed food (UPF), it is unclear whether soymilk offers comparable metabolic health benefits to milk as part of clinical and public health strategies to reduce SSB intake. The Soy Treatment Evaluation for Metabolic (STEM) health trial seeks to evaluate the impact of replacing SSBs with either 2% soymilk or 2% cow's milk on liver fat and other cardiometabolic risk factors in habitual adult consumers of SSBs with obesity. Methods: The STEM trial is a 24-week, pragmatic, 3-arm, parallel, randomized trial. We recruited adults with obesity (high BMI plus high waist circumference based on ethnic specific cut-offs) consuming ≥1 SSB/day. Participants were randomized to one of three groups based on their usual SSB intake at baseline (servings/day): continued SSB (355 mL can) intake; replacement with fortified, sweetened 2% soymilk (250 mL); or replacement with 2% cow's milk (250 mL). The primary outcome is the change in intrahepatocellular lipid (IHCL) measured by 1H-MRS at 24 weeks. Hierarchical testing will be done to reduce the familywise error rate. The superiority of cow's milk to SSBs will be assessed first to establish assay sensitivity. If superiority is established, then the non-inferiority of soymilk to cow's milk will be assessed using a pre-specified non-inferiority margin of 1.5% IHCL units (assessed by difference of means using a 90% confidence interval [CI]). Analyses will be conducted according to the intention-to-treat (ITT) principle using inverse probability weighting (IPW) for superiority testing and per-protocol analyses for non-inferiority testing, using ANCOVA adjusted for age, sex, metabolic dysfunction-associated steatotic liver disease (MASLD) status, medication use, intervention dose, and baseline levels. We hypothesize that soymilk will be non-inferior to cow's milk (Clinicaltrials.gov NCT05191160). Results: Recruitment began in November 2021. A total of 3050 individuals were screened. We randomized 186 participants (62 per group) between 19 April 2022 and 16 April 2024. Participants are 57% male; with a mean [SD] age of 39.9 [11.8] years; BMI of 34.6 [6.1] kg/m2, waist circumference of 112.6 [13.8] cm; IHCL of 10.0 [8.2] % with 64.1% meeting the criteria for MASLD; and SSBs intake of 2.3 [1.3] servings/day. Conclusions: Baseline characteristics were balanced across the study arms, with participants representing adults with a high-risk metabolic phenotype, and 64.1% meeting the criteria for MASLD. Findings will contribute to evidence on the cardiometabolic benefits of soymilk, informing clinical practice guidelines and public health policy.

Pulses, the dried seeds of leguminous plants, form an important part of the diets of many cultures, including Caribbean cuisine, and are a rich source of protein, carbohydrates, and antioxidants while being low in fats. This study examined the effect of a traditional home-cooking method on the nutritional characteristics of pulses commonly consumed in the Caribbean: red kidney beans and cranberry beans (Phaseolus vulgaris L.), cowpeas (Vigna unguiculata L.), and pigeon peas (Cajanus cajan L.). Protein quality, determined via three in vitro protein digestibility methods, starch, and phenolic content were determined in pre- and post-cooked samples using established methods. Pulses contained 20–26% protein, and cooking improved protein digestibility on average by 14.0 ± 2.5% (p < 0.05). However, notable differences in digestibility were observed: it was higher in static assays (pH-Drop and pH-Stat) than in the two-step digestibility assay. Average protein digestibility-corrected amino acid score (IVPDCAAS) among cooked pulses was 0.81 ± 0.14, with the highest in cranberry bean (0.82) and cowpea (0.88). Cooking modified pulse starch profiles by increasing total digestible starch. However, resistant starch and slowly digestible starch fractions accounted for approximately 20–25% of total cooked starch content. While total phenolic content (TPC) and antioxidant activity were reduced with cooking, they were within expected ranges for cooked pulse flours; however, they were higher in bean (P. vulgaris) varieties than cowpea and pigeon pea. These findings support the promotion of increased pulse consumption in Caribbean diets. Home cooking is a simple method to enhance pulse protein quality through enhancing digestibility; however, in vitro protein digestibility assays may require further standardization.

Phenolic and amino acid profiles along with organic acid, vitamin and mineral contents, major and minor sugars and enzyme activities of selected honey samples collected in North America were analyzed using different methods and potential markers of their botanical origin were identified. Among the 29 detected phenolic compounds, and some were found to be a good chemical markers to distinguish a genuine honey given its propolis origin. Quantitative data and principal component analysis showed that hesperidin, caffeic acid/isoferulic acid, and p-hydroxybenzoic acid/p-coumaric acid have the most positive relationship to the orange, alfalfa, and buckwheat honey, respectively, indicating their potential roles as chemical markers of these floral honeys. Free amino acid profiles were similar in all other honeys except buckwheat which not only had significantly higher branched-chain amino acids but was the only floral honey that contained L-norvaline that was identified for the first time. The enzyme activities and the major and rare sugar composition helped explain the presence of the various organic acids in the honeys. Compositional data of these bioactives and other nutrients will not only serve as database information for honey derived from North America but also provide insightful knowledge for the underlining potential health benefits.

Objectives: This study aimed to assess postprandial blood glucose response (PBGR), relative glycemic response (RGR) and insulin response when 25 g available carbohydrates (AC) is replaced with cooked lentils in the formulation of muffins, chilies and soups. Methods: In randomized, crossover studies, healthy adults consumed foods containing 25 g AC from green lentils, red lentils or a control (wheat muffin, n = 24; rice chili, n = 24; potato soup, n = 20). Blood collected at fasting and at 15, 30, 45, 60, 90 and 120 min was analyzed to derive the incremental area under the response curve (iAUC) for glucose, insulin, RGR and maximum concentration (CMAX). Treatment effects were assessed with repeated measures ANOVA. Results: A replacement of 25 g AC with green lentils significantly decreased glucose iAUC compared to chili and soup (p < 0.0001), but not muffin (p = 0.07) controls, while also eliciting a significantly lower insulin iAUC for all three foods (muffin p = 0.03; chili p = 0.0002; soup p < 0.0001). Red lentil foods significantly decreased glucose iAUC (muffin p = 0.02; chili p < 0.0001; soup p < 0.0001) compared to controls, with a significantly lower insulin iAUC for chili and soup (p < 0.0001) but not muffins (p = 0.09). The RGR for muffins, chilies and soups was 88, 58 and 61%, respectively, for green lentils, and 84, 48 and 49%, respectively, for red lentils. Conclusions: PBGR, insulin and RGR are decreased when lentils are incorporated into food products, providing credible evidence to promote carbohydrate replacement with lentil-based foods.

In the present study, we assessed the antioxidant activity of the phenolic extracts and major phenolic compounds of alfalfa, buckwheat, clover and orange honeys collected in North America using chemical-based and cell-based antioxidant assays (CAA). Cell culture models using Caco-2 BBe1 were established to evaluate the effect of honey phenolics on antioxidant enzyme activities and secretion of interleukin 8 (IL-8). Moreover, bioaccessibility, transmembrane transport and cellular uptake of honey phenolics were also studied. Based on the same quantity of the honey studied, phenolic extract of buckwheat honey showed the highest FRAP, DPPH, ORAC and CAA values, and strongest activity in restoring activities of antioxidant enzymes (GR, SOD and CAT) and in reducing TNF-u03B1-induced IL-8 secretion. Our results showed that compared to the major phenolic component of honey of plant origin, minor phenolics or combination of different phenolic compounds, particularly those derived from propolis, and their phase u2161 metabolites may play contribute more to the overall antioxidant and anti-inflammatory effects. Future research will focus on bioavailability of honey phenolics and their metabolites, and the molecular mechanism of the antioxidant, anti-inflammatory activities.

Societies with exposure to preindustrial diets exhibit improved markers of health. Our study used a comprehensive multi-omic approach to reveal that the gut microbiome of the Ju/'hoansi hunter-gatherers, one of the most remote KhoeSan groups, exhibit a higher diversity and richness, with an abundance of microbial species lost in the western population. The Ju/'hoansi microbiome showed enhanced global transcription and enrichment of complex carbohydrate metabolic and energy generation pathways. The Ju/'hoansi also show high abundance of short-chain fatty acids that are associated with health and optimal immune function. In contrast, these pathways and their respective species were found in low abundance or completely absent in Western populations. Amino acid and fatty acid metabolism pathways were observed prevalent in the Western population, associated with biomarkers of chronic inflammation. Our study provides the first in-depth multi-omic characterization of the Ju/'hoansi microbiome, revealing uncharacterized species and functional pathways that are associated with health.

The growing global interest in healthy and clean ingredients has prompted a shift in the composition of gluten-free products. This study specifically directed its focus towards Bazlama bread due to its simple ingredient list. The aim of this study was to investigate if clean label hydrocolloids can replace xanthan gum to produce high-quality gluten-free bread. The functional ingredients evaluated were psyllium husk gum (P5), xanthan gum (X5), and fenugreek gum (F5), each at 5.0 g addition level (on 100 g rice/chickpea flour base), as well as a mixture of xanthan and fenugreek gums in a 50:50 weight ratio, used at 3.0 (XF3), 5.0 (XF5), and 6.0 (XF6) g addition levels. The pasting properties of hydrocolloid-flour slurries, the rheological behavior of the gluten-free batters, and the overall quality of the gluten-free bazlama bread (GFBB) were investigated. Results showed that adding P5 increased RVA slurry viscosities and bread thickness comparable to the X5 recipe. However, no significant synergistic effect was observed when combining xanthan and fenugreek gum in any of the tests. GFBB with P5 and X5 stood out for their desirable characteristics such as high thickness and springiness values, while GFBB with F5 and XF3 distinguished themselves from other GFBBs in terms of their higher spread ratio, hardness, diameter, and chewiness. Principle Component Analysis revealed negative correlations between bread thickness and pasting temperature, while the viscoelastic modulus of the batter samples correlated positively with bread thickness. The inclusion of hydrocolloids did not significantly alter the starch digestibility of the GFBB.

Beans elicit lower glycemic responses (GRs) than other starchy foods, but the minimum effective dose (MED) to reduce GR is unknown. We sought to determine the MED of beans compared to common starchy foods. Overnight-fasted healthy volunteers consumed ¼c (phase 1, n = 24) or ½c (phase 2, n = 18) of black, cranberry, great northern, kidney, navy and pinto beans and corn, rice, pasta and potato (controls), with blood glucose measured before and for 2 h after eating. GRs (incremental areas under the curves, iAUCs) after beans were consumed were compared to those of controls by ANOVA followed by Dunnett’s test. To qualify for MED, beans had to elicit an effective reduction in GR, defined as a statistically significant reduction in iAUC of ≥20% (i.e., a relative glycemic response, RGR, ≤80). Outcomes from in vitro digestion were compared with in vivo RGR. Both doses of all six beans effectively reduced GR versus all four starchy controls, except for ¼c and ½c cranberry and pinto vs. corn, ¼c great northern and navy vs. corn and ¼c navy and pinto vs. potato. MED criteria were met for 18 comparisons of the ¼c servings, with four of the remaining six met by the ½c servings. The overall mean ± SEM RGR vs. controls was similar for the ¼c and ½c servings: 53 ± 4% and 56 ± 3%, respectively. By multiple regression analysis, RGR = 23.3 × RDS + 8.3 × SDS − 20.1 × RS + 39.5 × AS − 108.2 (rapidly digested starch, p < 0.001; slowly digested starch, p = 0.054; resistant starch, p = 0.18; available sugars, p = 0.005; model r = 0.98, p = 0.001). RGR correlated with in vitro glucose release (r = 0.92, p < 0.001). The MED of beans is ¼ cup. For n = 30 comparisons (n = 24 beans vs. controls, n = 6 controls vs. each other), an effective reduction in GR was predicted from in vitro carbohydrate analysis with 86% sensitivity and 100% specificity.

IntroductionSmall Island Developing States have disproportionately high food insecurity rates, related to complex challenges and vulnerabilities. The COVID-19 pandemic highlighted that within these settings, crises often overlap. We aimed to assess the impact of the concurrent COVID-19 pandemic and volcanic eruption on food production and security in St. Vincent and the Grenadines (SVG).MethodsAn interpretive mixed-methods study was conducted among a convenience sample of consenting adults ≥18 years from 100 households in SVG through a cross-sectional survey and participant interviews (10 households) between September 2021 and March 2022. Food insecurity prevalence over the past year was assessed using the Food Insecurity Experience Scale (FIES; Rasch modeling) and impacts to livelihoods from the pandemic and volcanic eruption was assessed using an adapted Caribbean COVID-19 Food Security and Livelihoods Impact Survey (Caribbean COVID-19 FS&L Survey). Data were analyzed using logistic regression.ResultsDuring the pandemic, 59% of the participants reported decreased income, 63% had no access to markets, 81% had no access to food aid; 34% of the participants had a change in food sources, and 81% reported that food production was negatively impacted by the volcanic eruptions, of which 68% reported decreased food production. The interviews highlighted that access to markets were restricted by fear of leaving home and contracting the COVID-19 virus, and participants who received food aid stated that the number of items were not sufficient for larger families. Almost half of the participants were severely food insecure [48% (95% C.I. 31.2,57.8)]; almost two thirds were moderately to severely food insecure [64% (95% C.I. 50.0, 74.2)]; mean FIES score 5.31 (95% C.I. 5.0,5.6). After adjusting for gender, age, education, and household size, moderate to severe food insecurity was associated with no access to food aid during the pandemic and post-eruptions (odds ratio 3.7; 95% confidence interval 1.5, 9.1; p = 0.004).ConclusionFood insecurity rates were high during the COVID-19 pandemic, exacerbated by volcanic eruptions and insufficient access to food aid. Our results suggest the need for the development of strategies and interventions aimed at increasing the resilience of food systems to mitigate the effects of future disasters.

Women with gestational diabetes (GD) have reduced antioxidant capacity; however, the relationship between maternal diet, maternal biochemical capacity, breast milk concentration, and infant intake has not been adequately explored in the literature. An exploration of underlying mechanism(s) is warranted, particularly for nutrient antioxidants impacted by maternal intake. These nutrients may provide a means for modifying maternal and infant antioxidant capacity. Oxygen radical absorbance capacity (ORAC), alpha-tocopherol, ascorbic acid, and beta-carotene concentrations were measured in breast milk of women with and without GD. Plasma, three-day diet records, and breast milk were collected at 6 to 8 weeks postpartum. Student's t-test was used to compare breast milk ORAC, nutrient antioxidant concentration and plasma ORAC between women with and without GD. Pearson correlations were used to determine associations among antioxidant concentrations in breast milk and dietary antioxidant intake. Breast milk antioxidant concentrations were associated with maternal intake of beta-carotene (r = 0.629, p = 0.005). Breast milk and plasma ORAC and antioxidant vitamin concentrations were not significantly different between GD and NG women. Breast milk ORAC associated with breast milk alpha-tocopherol for NG (r = 0.763, p = 0.010), but not GD women (r = 0.385, p = 0.35), and with breast milk ascorbic acid for GD (r = 0.722, p = 0.043) but not NG women (r = 0.141, p = 0.70; interaction p = 0.041). In GD participants, breast milk ORAC was significantly associated with plasma ORAC (r = 0.780, p = 0.039). ORAC and antioxidant vitamin concentrations in breast milk in women with GD were comparable to women with NG; however, the relationships between breast milk ORAC and vitamin concentrations differed in GD versus NG women for alpha-tocopherol and ascorbic acid.

Background Small Island Developing States have high levels of food insecurity and nutrition-related disease. One determinant is a dietary shift from consumption of local foods high in nutritional quality to nutrient poor imported food. A community intervention was designed to support the recovery of backyard gardens in St. Vincent and the Grenadines post volcanic-eruption and the impact of the intervention on food security in relation to dietary diversity (DD) and BMI was evaluated. Methods A mixed-method prospective study was conducted with adults from 100 households within rural areas. The survey was administered at baseline, six and 12 months (September 2021-September 2022); included the Food Insecurity Experience Scale (FIES); adapted Minimum Dietary Diversity (MDD) for Women of Reproductive Age; and measured BMI. Food insecurity status was assigned using Rasch analysis in R. Stata 17 was used for descriptive and inferential analyses. Semi-structured monthly interviews over six months with a representative from 10 purposely chosen households aimed to gain contextual insights on the intervention and experiences of food security through thematic analysis. Results A total of 177 adults participated. Food insecurity increased incrementally over 12 months e.g. moderate to severe from 35% to 57% and severe from 16% to 39%. FIES score increased overtime from 2.57 to 4.31 (md= -1.74 (-2.79, -0.44). Mean DD score (consuming ≥5 of 10 food groups) decreased overtime from 3.33 (95% C.I. 2.93,3.73) to 2.47 (95% C.I. 1.84, 3.11), md=0.86 (-0.14, 1.46). However , there was an increase in daily fruit and vegetable consumption from 1.87 to 2.36, (md=-0.49 (-0.88,-0.11). Mean BMI decreased from 28 to 25.7 over 12 months, (md=2.3 (1.02, 4.79). BMI ≥25 decreased from 64% to 48%. Adjusting for age, sex, education; household size, there was a significant cross-sectional association between the FIES score and BMI, (p=0.034, 95% C.I. 0.00,0.03) at baseline. Significant longitudinal associations were observed between the FIES score and DD (p=0.015), and the FIES score and BMI (p=0.016) when adjusted for time. The qualitative data point to complex concurrent impacts of the volcanic-eruption and the COVID-19 pandemic, including food insecurity through job losses, displacement of usual food sources and limited access to market and food-aid. Conclusion Our quantitative results suggest that the backyard garden intervention was not associated with a decrease in food insecurity or increase in DD, but qualitative insights highlighted complex concurrent challenges to food access experienced by households. This study highlights the need for the development of food security strategies post crises.

Management of type 2 diabetes mellitus (T2DM) is a pressing global healthcare challenge. Innovative strategies that integrate superior medical and nutritional practices are essential for holistic care. As such, pulse consumption is encouraged for its potential benefit in reducing hypercholesterolaemia, dyslipidaemia, and triglyceride levels, as well as enhancing glycaemic control. This scoping review aims to assess the depth of evidence supporting the recommendation for pulse consumption in T2DM management and to identify gaps in the existing literature. We conducted a comprehensive search across the databases MEDLINE, Global Health, EMBASE, CINAHL, Web of Science, and the Cochrane Library (up to July 2023). We included population-based studies of any design, and excluded review-style articles. Articles published in languages other than English were also excluded. From the 2449 studies initially identified, 28 met our inclusion criteria. Acute postprandial trials demonstrated improved glucose responses and enhanced insulin responses to pulse-based intervention. Meanwhile, long-term trials reported meaningful improvements in T2DM indicators such as haemoglobin A1C (HbA1c), fasting glucose, fasting insulin, C-peptide, and markers of insulin resistance like homeostatic model assessment (HOMA). Integrating more pulses into the diets of diabetic individuals might offer an efficient and cost-effective strategy in the global initiative to combat T2DM.

Context Excess calories from free sugars are implicated in the epidemics of obesity and type 2 diabetes. Honey is a free sugar but is generally regarded as healthy. Objective The effect of honey on cardiometabolic risk factors was assessed via a systematic review and meta-analysis of controlled trials using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Data Sources MEDLINE, Embase, and the Cochrane Library databases were searched up to January 4, 2021, for controlled trials >= 1 week in duration that assessed the effect of oral honey intake on adiposity, glycemic control, lipids, blood pressure, uric acid, inflammatory markers, and markers of nonalcoholic fatty liver disease. Data Extraction Independent reviewers extracted data and assessed risk of bias. Data were pooled using the inverse variance method and expressed as mean differences (MDs) with 95%CIs. Certainty of evidence was assessed using GRADE. Data Analysis A total of 18 controlled trials (33 trial comparisons, N = 1105 participants) were included. Overall, honey reduced fasting glucose (MD = -0.20 mmol/L, 95%CI, -0.37 to -0.04 mmol/L; low certainty of evidence), total cholesterol (MD = -0.18 mmol/L, 95%CI, -0.33 to -0.04 mmol/L; low certainty), low-density lipoprotein cholesterol (MD = -0.16 mmol/L, 95%CI, -0.30 to -0.02 mmol/L; low certainty), fasting triglycerides (MD = -0.13 mmol/L, 95%CI, -0.20 to -0.07 mmol/L; low certainty), and alanine aminotransferase (MD = -9.75 U/L, 95%CI, -18.29 to -1.21 U/L; low certainty) and increased high-density lipoprotein cholesterol (MD = 0.07 mmol/L, 95%CI, 0.04-0.10 mmol/L; high certainty). There were significant subgroup differences by floral source and by honey processing, with robinia honey, clover honey, and raw honey showing beneficial effects on fasting glucose and total cholesterol. Conclusion Honey, especially robinia, clover, and unprocessed raw honey, may improve glycemic control and lipid levels when consumed within a healthy dietary pattern. More studies focusing on the floral source and the processing of honey are required to increase certainty of the evidence. Systematic Review Registration PROSPERO registration number CRD42015023580.

BACKGROUND:Health authorities are near universal in their recommendation to replace sugar-sweetened beverages (SSBs) with water. Non-nutritive sweetened beverages (NSBs) are not as widely recommended as a replacement strategy due to a lack of established benefits and concerns they may induce glucose intolerance through changes in the gut microbiome. The STOP Sugars NOW trial aims to assess the effect of the substitution of NSBs (the "intended substitution") versus water (the "standard of care substitution") for SSBs on glucose tolerance and microbiota diversity. DESIGN AND METHODS:The STOP Sugars NOW trial (NCT03543644) is a pragmatic, "head-to-head", open-label, crossover, randomized controlled trial conducted in an outpatient setting. Participants were overweight or obese adults with a high waist circumference who regularly consumed ≥1 SSBs daily. Each participant completed three 4-week treatment phases (usual SSBs, matched NSBs, or water) in random order, which were separated by ≥4-week washout. Blocked randomization was performed centrally by computer with allocation concealment. Outcome assessment was blinded; however, blinding of participants and trial personnel was not possible. The two primary outcomes are oral glucose tolerance (incremental area under the curve) and gut microbiota beta-diversity (weighted UniFrac distance). Secondary outcomes include related markers of adiposity and glucose and insulin regulation. Adherence was assessed by objective biomarkers of added sugars and non-nutritive sweeteners and self-report intake. A subset of participants was included in an Ectopic Fat sub-study in which the primary outcome is intrahepatocellular lipid (IHCL) by 1H-MRS. Analyses will be according to the intention to treat principle. BASELINE RESULTS:Recruitment began on 1 June 2018, and the last participant completed the trial on 15 October 2020. We screened 1086 participants, of whom 80 were enrolled and randomized in the main trial and 32 of these were enrolled and randomized in the Ectopic Fat sub-study. The participants were predominantly middle-aged (mean age 41.8 ± SD 13.0 y) and had obesity (BMI of 33.7 ± 6.8 kg/m2) with a near equal ratio of female: male (51%:49%). The average baseline SSB intake was 1.9 servings/day. SSBs were replaced with matched NSB brands, sweetened with either a blend of aspartame and acesulfame-potassium (95%) or sucralose (5%). CONCLUSIONS:Baseline characteristics for both the main and Ectopic Fat sub-study meet our inclusion criteria and represent a group with overweight or obesity, with characteristics putting them at risk for type 2 diabetes. Findings will be published in peer-reviewed open-access medical journals and provide high-level evidence to inform clinical practice guidelines and public health policy for the use NSBs in sugars reduction strategies. TRIAL REGISTRATION:ClinicalTrials.gov identifier, NCT03543644.

Using cross-sectional data from the 2015 Canadian Community Health Survey–Nutrition, we aimed to identify and characterize the top 10 most frequently consumed plant-based foods and red/processed meat dishes in the Canadian population. Plant-based foods and red/processed meat dishes categories included 659 and 265 unique food codes, respectively, from the Canadian Nutrient File. A total of 20,176 Canadian individuals aged ≥1 year were included in our analysis. The most frequently consumed plant-based food was “Cooked regular long-grain white rice”, which made a significant contribution to energy (12.1 ± 0.3%) and protein (6.1 ± 0.2%) intake among consumers. The most frequently consumed red/processed meat dish in Canada was “Cooked regular, lean or extra lean ground beef or patty”. Among red/processed meat dishes, “ham and cheese sandwich with lettuce and spread” made the most significant contribution to the intake of energy (21.8 ± 0.7%), saturated fat (31.0 ± 1.0%), sodium (41.8 ± 1.3%), and sugars (8.2 ± 0.5%) among the consumers. Ground beef is the most frequently consumed red/processed meat dish and white rice is the most frequently consumed plant-based food among Canadians. Red/processed meat dishes are major drivers of the excessive intake of nutrients-to-limit.

Pulse consumption has been shown to confer beneficial effects on blood glucose and insulin levels. Lentil consumption, in particular, consistently lowers acute blood glucose and insulin response when compared to starchy control foods. The mechanism by which lentils lower postprandial blood glucose response (PBGR) and insulin levels is unclear; however, evidence suggests that this effect may be linked to macronutrients and/or the amount of lentils consumed. This review attempts to consolidate existing studies that examined lentil consumption and glycemic and/or insulinemic responses and declared information on macronutrient composition and dietary fibre content of the foods tested. Collectively, these studies suggest that consumption of lentils reduces PBGR, with the minimum effective serving being ~110g cooked to reduce PBGR by 20%. Reductions in PBGR show modest-to-strong correlations with protein (45–57 g) and dietary fibre (22–30 g) content, but has weaker correlations with available carbohydrates. Increased lentil serving sizes were found to moderately influence relative reductions in peak blood glucose concentrations and lower the area under the blood glucose curve (BG AUC). However, no clear relationship was identified between serving and relative reductions in the BG AUC, making it challenging to characterize consistent serving–response effects.