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Ho H.,Clinical Nutrition and Risk Factor Modification Center | Lee A.S.,University of Toronto | Jovanovski E.,Clinical Nutrition and Risk Factor Modification Center | Jenkins A.L.,Clinical Nutrition and Risk Factor Modification Center | And 6 more authors.
European Journal of Clinical Nutrition | Year: 2013

Objective:Incorporation of seeds into food products may attenuate postprandial glycemia. Whether these should be consumed as whole or in ground form is not known.Subjects/Methods:Using an acute, randomized controlled crossover design, the glycemic response of 13 healthy participants (6M:7F; 25.4±2.6 kg/m 2) was studied on nine separate occasions. Test meals consisted of 7, 15 or 24 g of whole or ground Salba baked into white bread, and three control breads matched for energy, and macronutrient profile. Capillary blood samples were collected at fasting and over 2 h post consumption.Results:A significant effect of dose (P=0.04), but no effect of form (P=0.74) or dose-form interaction (P=0.98) was found. No adverse events were reported.Conclusion:This study demonstrates that both ground and whole Salba are equally effective in attenuating blood glucose levels in a dose-dependent manner when incorporated into bread. Flexibility in the use of either the ground or whole seed may increase the ease of incorporation and acceptability as a dietary supplement. © 2013 Macmillan Publishers Limited All rights reserved. Source


Ha V.,Knowledge Factor | Ha V.,University of Toronto | Jayalath V.H.,Knowledge Factor | Jayalath V.H.,University of Toronto | And 8 more authors.
Current Hypertension Reports | Year: 2013

Excessive fructose intake from high-fructose corn syrup (HFCS) and sucrose has been implicated as a driving force behind the increasing prevalence of obesity and its downstream cardiometabolic complications including hypertension, gout, dyslidpidemia, metabolic syndrome, diabetes, and non-alcoholic fatty liver disease (NAFLD). Most of the evidence to support these relationships draws heavily on ecological studies, animal models, and select human trials of fructose overfeeding. There are a number of biological mechanisms derived from animal models to explain these relationships, including increases in de novo lipogenesis and uric acid-mediated hypertension. Differences between animal and human physiology, along with the supraphysiologic level at which fructose is fed in these models, limit their translation to humans. Although higher level evidence from large prospective cohorts studies has shown significant positive associations comparing the highest with the lowest levels of intake of sugar-sweetened beverages (SSBs), these associations do not hold true at moderate levels of intake or when modeling total sugars and are subject to collinearity effects from related dietary and lifestyle factors. The highest level of evidence from controlled feeding trials has shown a lack of cardiometabolic harm of fructose and SSBs under energy-matched conditions at moderate levels of intake. It is only when fructose-containing sugars or SSBs are consumed at high doses or supplement diets with excess energy that a consistent signal for harm is seen. The available evidence suggests that confounding by excess energy is an important consideration in assessing the role of fructose-containing sugars and SSBs in the epidemics of hypertension and other cardiometabolic diseases. © 2013 Springer Science+Business Media New York. Source


Kim S.J.,Toronto | De Souza R.J.,Toronto | Choo V.L.,Toronto | Ha V.,Toronto | And 20 more authors.
American Journal of Clinical Nutrition | Year: 2016

Background: Obesity is a risk factor for developing several diseases, and although dietary pulses (nonoil seeds of legumes such as beans, lentils, chickpeas, and dry peas) are well positioned to aid in weight control, the effects of dietary pulses on weight loss are unclear. Objective: We summarized and quantified the effects of dietary pulse consumption on body weight, waist circumference, and body fat by conducting a systematic review and meta-analysis of randomized controlled trials. Design: We searched the databases MEDLINE, Embase, CINAHL, and the Cochrane Library through 11 May 2015 for randomized controlled trials of $3 wk of duration that compared the effects of diets containing whole dietary pulses with those of comparator diets without a dietary pulse intervention. Study quality was assessed by means of the Heyland Methodologic Quality Score, and risk of bias was assessed with the Cochrane Risk of Bias tool. Data were pooled with the use of generic inverse-variance random-effects models. Results: Findings from 21 trials (n = 940 participants) were included in the meta-analysis. The pooled analysis showed an overall significant weight reduction of 20.34 kg (95% CI: 20.63, 20.04 kg; P = 0.03) in diets containing dietary pulses (median intake of 132 g/d or w1 serving/d) compared with diets without a dietary pulse intervention over a median duration of 6 wk. Significant weight loss was observed in matched negative-energy-balance (weight loss) diets (P = 0.02) and in neutral-energy-balance (weightmaintaining) diets (P = 0.03), and there was low evidence of between-study heterogeneity. Findings from 6 included trials also suggested that dietary pulse consumption may reduce body fat percentage. Conclusions: The inclusion of dietary pulses in a diet may be a beneficial weight-loss strategy because it leads to a modest weight-loss effect even when diets are not intended to be calorically restricted. Future studies are needed to determine the effects of dietary pulses on long-term weight-loss sustainability. This protocol was registered at clinicaltrials.gov as NCT01594567. Source


Ha V.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit | Ha V.,Clinical Nutrition and Risk Factor Modification Center | Ha V.,McMaster University | Cozma A.I.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit | And 13 more authors.
Advances in Nutrition | Year: 2015

Sugars have replaced fat as the dominant public health nutrition concern. A fructose-centric view of cardiometabolic disease has emerged whereby fructose-containing sugars are thought to have deleterious effects on body weight, fasting and postprandial blood lipids, glycemia, blood pressure, uric acid, and markers of nonalcoholic fatty liver disease. Long-term prospective cohort studies have not supported these associations when assessing the relation between total fructose-containing sugars at any amount of intake and incident cardiometabolic disease. Conversely, a consistent signal for harm has been reported for sugary beverages when comparing the highest with the lowest intakes. These associations, however, do not hold at moderate intakes, which are more reflective of real-world intakes, are subject to important collinearity effects, and have small risk estimates with modest population-attributable risk fractions. Higher-level evidence from controlled feeding trials shows that fructose-containing sugars in either liquid or solid form have adverse cardiometabolic effects only when they supplement diets with excess calories compared with the same diets without the excess calories. In the absence of harm when fructose-containing sugars are exchanged for other sources of carbohydrate under energy-matched conditions, excess calories appear to be the dominant consideration. Like with the earlier fat story, it is difficult to separate the contribution of fructose-containing sugars from that of other sources of excess calories in the epidemic of obesity and cardiometabolic disease. Attention needs to remain focused on reducing the overconsumption of all caloric foods associated with obesity and cardiometabolic disease, including sugary beverages and foods, and promoting greater physical activity. © 2015 American Society for Nutrition. Source

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