Epidemiological studies have clearly shown that whole-grain cereals can protect against obesity, diabetes, CVD and cancers. The specific effects of food structure (increased satiety, reduced transit time and glycaemic response), fibre (improved faecal bulking and satiety, viscosity and SCFA production, and/or reduced glycaemic response) and Mg (better glycaemic homeostasis through increased insulin secretion), together with the antioxidant and anti-carcinogenic properties of numerous bioactive compounds, especially those in the bran and germ (minerals, trace elements, vitamins, carotenoids, polyphenols and alkylresorcinols), are today well-recognised mechanisms in this protection. Recent findings, the exhaustive listing of bioactive compounds found in whole-grain wheat, their content in whole-grain, bran and germ fractions and their estimated bioavailability, have led to new hypotheses. The involvement of polyphenols in cell signalling and gene regulation, and of sulfur compounds, lignin and phytic acid should be considered in antioxidant protection. Whole-grain wheat is also a rich source of methyl donors and lipotropes (methionine, betaine, choline, inositol and folates) that may be involved in cardiovascular and/or hepatic protection, lipid metabolism and DNA methylation. Potential protective effects of bound phenolic acids within the colon, of the B-complex vitamins on the nervous system and mental health, of oligosaccharides as prebiotics, of compounds associated with skeleton health, and of other compounds such as alpha-linolenic acid, policosanol, melatonin, phytosterols and para-aminobenzoic acid also deserve to be studied in more depth. Finally, benefits of nutrigenomics to study complex physiological effects of the 'whole-grain package', and the most promising ways for improving the nutritional quality of cereal products are discussed.

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New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre?

Glycemic index: overview of implications in health and disease : Is the glycemic index important in human nutrition?

In this review, recent reports on in vitro starch hydrolysis kinetics are reviewed with regard to the structural characteristics of starches. Factors such as starch granule morphology, amylose to amylopectin ratio, molecular structure, degree of branching in terms of steric hindrance and consequently mass transfer resistance and their effects on the digestibility and absorption of digested carbohydrates have been examined. The physical state of the starch ingested has a major impact on the digestibility therefore effects of processing techniques (thermal processing, extrusion cooking, autoclaving etc.) and starch modification have been discussed. The other constituents of the food matrix, such as proteins, lipids and polysaccharides, play a significant role during processing which affects the physico-chemical characteristics of digesta and the final digestibility of starch. Some molecules naturally occurring in food sources may confer an inhibitory effect during starch hydrolysis.

Starch digestibility in food matrix: a review

Impact of heat-moisture treatment and annealing in starches: A review

Composition, molecular structure, properties, and modification of pulse starches: A review

Starch is the main carbohydrate in human nutrition and offers a range of desired technological properties. The nutritional quality of starch strongly depends on starch structure and on its processing. Starch digestibility in the human small intestine can vary from a rapid digestion to indigestibility. However, the structural properties of the intermediate fraction of starch with slow digestibility and its potential health benefits are not well understood. The present review highlights current knowledge on starch structures causing a slow digestibility and explores their health implications.

Slowly digestible starch – its structure and health implications: a review

Muscle parameters are recommended as diagnostic criteria for malnutrition and sarcopenia in various guidelines. However, little is known about the application of muscle parameters in daily practice of nutritional care. The aim of this study was to investigate the current practice of the application of muscle parameters, along with its promoting factors and barriers by dietitians in Switzerland. A 29-item literature-based online survey was developed and distributed via the Swiss professional association of dietitians. The data were analyzed descriptively, and relationships between demographic data and usage were examined. Dietitians (n = 117) from all three language regions completed the survey and were included in the analysis. Musculature was classified as important for the assessment of nutritional status. Body weight (89.7%), handgrip strength (87.2%), bioimpedance analysis (BIA) (87.1%) and Body Mass Index (66.7%) were considered as most significant for evaluation of nutritional status. Seventy-point nine percent (70.9%) of dietitians include at least one muscle parameter in their assessment; BIA was the parameter most often included (73.5%). However, the frequency of use of muscle parameter in daily practice was rather low. Only 23.1% applied BIA on a weekly basis. Lack of knowledge (78.6%), practical experience (71.8%) and lack of equipment (77.8%) were most frequently stated as barriers for usage. The general application of muscle parameters in nutritional care is still lacking. There is an opportunity to further strengthen diagnosis and patient monitoring via a stronger application of muscle parameters in daily practice. Practical training and education could help promote their application.

/pdf/current-practice-of-assessing-and-monitoring-muscle-strength-14m6tmny.pdf

Current Practice of Assessing and Monitoring Muscle Strength, Muscle Mass and Muscle Function during Nutritional Care by Dietitians in Switzerland—An Online Survey

U. Lehmann

Papers

Slowly digestible starch – its structure and health implications: a review

Current Practice of Assessing and Monitoring Muscle Strength, Muscle Mass and Muscle Function during Nutritional Care by Dietitians in Switzerland—An Online Survey