Clinical Nutrition Research Center


Clinical Nutrition Research Center

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Leow M.K.-S.,Agency for Science, Technology and Research Singapore | Leow M.K.-S.,Clinical Nutrition Research Center | Leow M.K.-S.,Tan Tock Seng Hospital | Leow M.K.-S.,National Healthcare Group NHG | And 2 more authors.
International Journal of Medical Sciences | Year: 2017

Background: Modern medicine recognizes that salient, inherent variations between Caucasians and Asians exist. Radical changes are occurring in the health scene with increasing emphasis centered on the recognition of inter-individual variations unique to Asians that impact on medical management and outcomes. Aim: This review analyzes distinct features or outcomes in terms of epidemiology, disease thresholds, diagnostic cutoffs and treatment responses of Asian people compared with non-Asians. Methods: This review is based on a literature search via PubMed and MEDLINE for relevant articles related to the Asian phenotype and its impact on health and disease. Results: An ‘Asian phenotype’ could be characterized across the spectrum of biomedical disciplines and underscores the major challenges clinicians must face in their daily management of a cosmopolitan population and their extrapolation of research outcomes. Conclusion: Interventions for various ailments that have traditionally ignored population differences have now entered the age of personalized, stratified or precision medicine requiring an individualized approach being adopted as a new standard of care. Factoring in Asian phenotypes is essential for the medical research community and the development of improved clinical practice guidelines across a continuum of disciplines that will ultimately translate to better human health round the world. © Ivyspring International Publisher.

Lau E.R.L.,Clinical Nutrition Research Center | Lau E.R.L.,Agency for Science, Technology and Research Singapore | Henry C.J.,Clinical Nutrition Research Center | Henry C.J.,Agency for Science, Technology and Research Singapore | Henry C.J.,National University of Singapore
Nutrition | Year: 2017

Objective The aim of this study was to examine the effect of carbonation of sweetened beverages on glycemic response, gastric emptying, and satiety. Methods After an overnight fast, 15 healthy individuals (6 women, 9 men) consumed a 500 mL beverage containing 50 g glucose that was noncarbonated (NC), low carbonated (LC), or high carbonated (HC) at a standardized rate of consumption (100 mL/min). Blood glucose was measured at baseline and at 15, 30, 45, 60, 90, and 120 min after beverage consumption. Antral cross-sectional area was measured using ultrasound at baseline, 5, 10, 20, 30, 40, 50, 60, 90, and 120 min; for the estimation of gastric volume and gastric emptying rate. Satiety was assessed using electronic visual analog scales at the same time points as the blood glucose measurement. Results There were no significant differences in glycemic response among the test beverages. Higher carbonation levels significantly increased antral cross-sectional area during the first 20 min after beverage consumption (P < 0.010) but did not translate into significant differences in gastric volume or gastric emptying rates. There was no significant effect of carbonation on satiety, but the area under the curve for thirst was significantly lower for HC compared with NC (P = 0.009). Conclusions The carbonation of a simple glucose solution did not increase glycemic response nor alter gastric emptying and subjective feelings of satiety (with the exception of thirst). The present study suggests that carbonation does not alter glycemic response. © 2017 Elsevier Inc.

Mccrickerd K.,Clinical Nutrition Research Center | Mccrickerd K.,Agency for Science, Technology and Research Singapore | Forde C.G.,Clinical Nutrition Research Center | Forde C.G.,Agency for Science, Technology and Research Singapore | Forde C.G.,National University of Singapore
Obesity Reviews | Year: 2016

The sensory experience of eating is an important determinant of food intake control, often attributed to the positive hedonic response associated with certain sensory cues. However, palatability is just one aspect of the sensory experience. Sensory cues based on a food's sight, smell, taste and texture are operational before, during and after an eating event. The focus of this review is to look beyond palatability and highlight recent advances in our understanding of how certain sensory characteristics can be used to promote better energy intake control. We consider the role of visual and odour cues in identifying food in the near environment, guiding food choice and memory for eating, and highlight the ways in which tastes and textures influence meal size and the development of satiety after consumption. Considering sensory characteristics as a functional feature of the foods and beverages we consume provides the opportunity for research to identify how sensory enhancements might be combined with energy reduction in otherwise palatable foods to optimize short-term energy intake regulation in the current food environment. Moving forward, the challenge for sensory nutritional science will be to assess the longer-term impact of these principles on weight management. © 2016 World Obesity.

Lau E.,Clinical Nutrition Research Center | Lau E.,Agency for Science, Technology and Research Singapore | Zhou W.,National University of Singapore | Henry C.J.,Clinical Nutrition Research Center | And 2 more authors.
British Journal of Nutrition | Year: 2016

The formation of amylose-lipid complexes (ALC) had been associated with reduced starch digestibility. A few studies have directly characterised the extent of ALC formation with glycaemic response. The objectives of this study were to investigate the effect of using fats with varying degree of saturation and chain length on ALC formation as well as glycaemic and insulinaemic responses after consumption of bread. Healthy men consumed five test breads in a random order: control bread without any added fats (CTR) and breads baked with butter (BTR), coconut oil (COC), grapeseed oil (GRP) or olive oil (OLV). There was a significant difference in glycaemic response between the different test breads (P=0·002), primarily due to COC having a lower response than CTR (P=0·016), but no significant differences between fat types were observed. Insulinaemic response was not altered by the addition of fats/oils. Although BTR was more insulinotropic than GRP (P<0·05), postprandial β-cell function did not differ significantly. The complexing index (CI), a measure of ALC formation, was significantly higher for COC and OLV compared with BTR and GRP (P<0·05). CI was significantly negatively correlated with incremental AUC (IAUC) of change in blood glucose concentrations over time (IAUCglucose) (r -0·365, P=0·001). Linear regression analysis showed that CI explained 13·3 % of the variance and was a significant predictor of IAUCglucose (β=-1·265, P=0·001), but IAUCinsulin did not predict IAUCglucose. Our study indicated that a simple way to modulate glycaemic response in bread could lie in the choice of fats/oils, with coconut oil showing the greatest attenuation of glycaemic response. © The Authors 2016.

Smith D.L.,Clinical Nutrition Research Center | Elam C.F.,University of Alabama at Birmingham | Mattison J.A.,U.S. National Institute on Aging | Lane M.A.,MedImmune LLC | And 4 more authors.
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2010

Calorie restriction (CR) has been known for more than 70 years to extend life span and delay disease in rodent models. Metformin administration in rodent disease models has been shown to delay cancer incidence and progression, reduce cardiovascular disease and extend life span. To more directly test the potential of metformin supplementation (300 mg/kg/day) as a CR mimetic, life-span studies were performed in Fischer-344 rats and compared with ad libitum feeding and CR (30%). The CR group had significantly reduced food intake and body weight throughout the study. Body weight was significantly reduced in the metformin group compared with control during the middle of the study, despite similar weekly food intake. Although CR significantly extended early life span (25th quantile), metformin supplementation did not significantly increase life span at any quantile (25th, 50th, 75th, or 90th), overall or maximum life span (p >. 05) compared with control. © 2010 The Author.

Henry J.,Clinical Nutrition Research Center | Shu-Fen C.L.,Clinical Nutrition Research Center
Lipid Technology | Year: 2013

Most diets worldwide are composed of high carbohydrate foods. Their consumption is associated with a rapid rise in blood glucose. The potential role that the degree of saturation of fatty acids may have in glycaemic response forms the basis of this paper. The addition of butter, olive oil or grapeseed oil significantly reduced the glycaemic index of white bread (white bread GI = 71; bread + butter GI = 53, bread + grapeseed oil GI = 58; bread+ olive oil GI = 50. The addition of olive oil had the greatest impact on GI. Olive oil has been widely recommended for its impact on blood lipids and cholesterol. Olive oil's influence on glycaemic response spawns a new line of research that should examine the role of lipids in carbohydrate metabolism. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

PubMed | Clinical Nutrition Research Center
Type: | Journal: European journal of nutrition | Year: 2015

Milk protein ingestion reduces post-meal glycemia when consumed either before or together with carbohydrate foods. The aim of this study was to compare the effects of dairy and soy milk consumed either before (preload) or together with (co-ingestion) a carbohydrate (bread), on postprandial blood glucose, insulin and gastric emptying in healthy participants.Twelve healthy Chinese male participants were studied on five separate occasions using a randomized crossover design. White wheat bread consumed with water was used as a reference meal. Capillary and venous bloods were sampled pretest and 3.5h post-test meal for glucose and insulin measurement. Gastric emptying was measured using real-time ultrasonography.Co-ingestion of dairy milk or soy milk with bread lowered postprandial blood glucose response and glycemic index. Co-ingesting soy milk with bread increased insulin response and insulinemic index significantly compared to co-ingestion of dairy milk and preload treatments. Preloads (30min prior to bread) significantly lowered postprandial glycemia and insulinemia compared to co-ingestion. Gastric emptying was slower after co-ingesting dairy milk with bread than after reference meal.Preloading either soy milk or dairy milk results in greater reduction in glycemic response compared to co-ingestion alone. This dietary practice may have therapeutic advantage in communities consuming high GI diets. Optimal glucose control may have the potential for increasing the time of transition from prediabetes to type 2 diabetes in Asian communities.This trial was registered at as NCT 02151188.

PubMed | Agency for Science, Technology and Research Singapore and Clinical Nutrition Research Center
Type: Comparative Study | Journal: Journal of food science | Year: 2015

Limited research exists on how different oil types and time of addition affect starch digestibility of rice. This study aimed to assess the starch digestibility of white and red rice prepared with 2 oil types: vegetable oil (unsaturated fat) and ghee (clarified butter, saturated fat) added at 3 different time points during the cooking process (before: frying raw rice in oil before boiling, during: adding oil during boiling, and after: stir-frying cooked rice in oil). Red rice produced a slower digestion rate than white rice. White rice digestibility was not affected by oil type, but was affected by addition time of oil. Adding oil after (stir-frying) to white or red rice resulted in higher slowly digestible starch. Red rice cooked using ghee showed the lowest amount of glucose release during in vitro digestion. The addition of ghee during (that is boiling with ghee) or before (that is frying rice raw with ghee then boiling) cooking showed potential for attenuating the postprandial glycemic response and increasing resistant starch content. This is the first report to show healthier ways of preparing rice. White rice with oil added after (stir-fried) may provide a source of sustained glucose and stabilize blood glucose levels. Boiling red rice with ghee or cooking red rice with ghee pilaf-style may provide beneficial effects on postprandial blood glucose and insulin concentrations, and improve colonic health. The encouraging results of the present study justify extending it to an in vivo investigation to conclusively determine the effect of time of addition of fat when rice is cooked on blood glucose homeostasis.Rice is a predominant source of energy in most of Asia with excessive consumption of rice being implicated in the rise of type 2 diabetes. Stir-frying white rice can be a source of sustained glucose and provide a stabilizing effect on blood glucose levels. Boiling red rice with ghee or cooking red rice with ghee pilaf-style may provide beneficial effects on postprandial blood glucose and insulin concentrations. This suggests how a single technique of adding fat in the cooking of rice at certain time points may be a useful method in providing taste and lowering glycemia.

PubMed | Clinical Nutrition Research Center
Type: Journal Article | Journal: PloS one | Year: 2016

Vitamin D deficiency is a global health challenge and has been linked to type 2 diabetes and other chronic diseases. However, the relationship between vitamin D status, body composition, and cardiovascular risks has not been well characterized in Asian populations. The objectives of this study were to examine the factors associated with the low vitamin D levels in a sunny tropical region and to assess the role of vitamin D status in cardiovascular risk factors.This was a cross-sectional study. One hundred and fourteen healthy participants (59 males and 55 females) residing in Singapore took part in this study. Plasma 25OH-D3 concentration was measured by using LC-MS/MS. Body fat (%) was measured by using three different techniques including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Basic anthropometric measurements, fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were obtained using standard protocols.Approximately 42% of the participants were vitamin D deficient (< 20 ng/mL). Vitamin D status was inversely associated with body fat (%), homeostasis model assessment of insulin resistance (HOMA-IR), and total cholesterol/high density lipoprotein (TC/HDL) ratio, while positively associated with lean body mass (LBM) and hand grip strength (HGS).The high prevalence of vitamin D deficiency in a sunny tropical region reinforces the need to recognize that sunlight alone is not the precursor for optimal vitamin D status. This raises the need to investigate public health measures that will encourage exposure to sunlight without overexposure that is harmful to skin. More importantly, vitamin D deficiency is associated with increased cardiovascular risks, i.e. HOMA-IR, TC/HDL, and LDL/HDL. Future studies should attempt to elucidate the potential mechanisms.

PubMed | Clinical Nutrition Research Center
Type: | Journal: Journal of nutritional science and vitaminology | Year: 2015

Food intake studies have a long history. However, until a few decades ago, there was limited quantitative data on feeding patterns and food intake in infants and children living in South Asia. The recent SEANUT study and MING study have provided several new insights into the dietary patterns of children living in China, Indonesia, Malaysia, Thailand and Vietnam. The complexity and variety of Asian diets makes the collation of dietary information a challenge. The double burden of under-nutrition and over-nutrition is prevalent in many Asian countries. Compared to obesity, stunting is widespread in South East Asia. Our future challenge is to develop food intake assessment techniques which can be refined and made available as a common dietary assessment tool across this region. Successful nutritional intervention can only be achieved if we know what Asian children eat. Dietary intake research will be a key factor in realizing our goal to eradicate malnutrition in this region.

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