Journal of the American Nutrition Association最新文献

{"title":"Microbial Imbalance and Intestinal Permeability in the Pathogenesis of Rheumatoid Arthritis: A Mechanism Review with a Focus on Bacterial Translocation, Citrullination, and Probiotic Intervention.","authors":"Holly C Blenkinsopp, Karin Seidler, Michelle Barrow","doi":"10.1080/27697061.2023.2211129","DOIUrl":"10.1080/27697061.2023.2211129","url":null,"abstract":"<p><p>This review aims to investigate the role of intestinal permeability (IP) in rheumatoid arthritis (RA), following the hypotheses that leakage of intestinal microbes can influence increased citrullination of peptides leading to anti-citrullinated protein antibody (ACPA) production and inflammation in RA; and that leaked microbes can migrate to the peripheral joints, leading to immune responses and synovitis in peripheral joints. This review explored the evidence for the link between microbial dysbiosis and increased IP in the inflammatory state in RA, as well as the role of increased citrullination and bacterial translocation in the link between microbiota and immune responses in RA. Furthermore, this research aims to evaluate the potential effect of probiotics on RA symptoms and pathogenesis <i>via</i> proposed mechanisms, including the support of microbial balance and suppression of inflammatory factors in RA. A systematic literature search was conducted in three tranches (review, mechanism, intervention). 71 peer-reviewed papers met the inclusions criteria and are summarized in a narrative analysis. Primary studies were critically appraised, synthesized and their relevance to clinical practice evaluated. Evidence found in this mechanism review consistently supported intestinal dysbiosis and increased IP in arthritis. An altered intestinal microbiome was demonstrated in RA with specific microbes such as <i>Collinsella</i> and <i>Eggerthella</i> correlating with increased IP, mucosal inflammation, and immune responses. Hypercitrullination and ACPA production correlated with arthritic symptoms and intestinal microbes were shown to influence hypercitrullination. Some <i>in vitro</i> and animal studies demonstrated a link between leakage of microbes and bacterial translocation, but further research is needed to elucidate the link between IP and citrullination. Probiotic intervention studies evidenced reductions in inflammatory markers IL-6 and TNFα, associated with proliferation of synovial tissue and pain perception in RA joint inflammation. Despite some conflict in the literature, probiotics may present a promising nutritional intervention in the suppression of both, disease activity and inflammatory markers.Key teaching pointsThere is evidence for a dysbiotic profile of the RA gut with specific RA-associated microbes.Increased intestinal permeability and leakage of PAD enzyme facilitates citrullination of peptides.Hypercitrullination and ACPA production correlate to arthritic signs.Microbial leakage and translocation plays a role in the pathogenesis of RA.Probiotics (e.g. L. Casei 01) may reduce inflammation and ameliorate RA symptoms.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9967901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy balance and energy availability of female basketball players during the preparation period.","authors":"Bengisu Çetiner-Okşin,&nbsp;Yasemin Güzel,&nbsp;Selin Aktitiz,&nbsp;Şükran Nazan Koşar,&nbsp;Hüseyin Hüsrev Turnagöl","doi":"10.1080/27697061.2023.2183432","DOIUrl":"10.1080/27697061.2023.2183432","url":null,"abstract":"<p><strong>Objective: </strong>To determine the level of energy balance and energy availability (EA) in female basketball players during the preparation period.</p><p><strong>Methods: </strong>Fifteen basketball players (age: 19.53 ± 1.3 years; height: 173.6 ± 8.95 cm; weight: 67.55 ± 14.34 kg; training experience: 9.6 ± 2.7 years) and 15 age and body mass index-matched controls (age: 19.53 ± 1.1 years; height: 169.4 ± 5.06 cm; weight: 63.10 ± 6.14 kg) participated in the study. Resting metabolic rate (RMR) and body composition were measured by the indirect calorimetric method and dual-energy x-ray absorptiometry, respectively. A 3-day food diary was used to determine macronutrients and energy intake while a 3-day physical activity log was used to determine energy expenditure. Independent Samples t-test was used for data analysis.</p><p><strong>Results: </strong>The daily energy intake and expenditure of female basketball players were 2136.5 ± 594.9 kcal·day^-1 and 2953.8 ± 614.5 kcal·day^-1, respectively, indicating 817 ± 779 kcal·day^-1 of negative energy balance. One hundred percent and 66.6% of the athletes failed to meet the carbohydrate and protein intake recommendations, respectively. EA of female basketball players was 33.04 ± 15.69 kcal·fat free mass^-1·day^-1 and the percentages of athletes who had negative energy balance, low EA, and reduced EA were 80%, 40%, and 46.7%, respectively. However, despite the low and decreased EA, the measured RMR to predicted RMR ratio (RMR_ratio) was 1.31 ± 0.17 and the body fat percentage (BF%) was 31.00 ± 5.21%.</p><p><strong>Conclusion: </strong>This study shows that female basketball players have a negative energy balance during the preparation period which can be partly explained by insufficient carbohydrate intake. Although most of the athletes experienced low or reduced EA during the preparation period, the physiologically normal RMR_ratio and relatively high BF% indicate that this is a transient situation. In this regard, strategies to prevent the development of low EA and negative energy balance during the preparation period will contribute to positive training adaptations throughout the competition period.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caffeine Consumption in Polish Adults: Development and Validation of a Polish Questionnaire for Assessing Caffeine Intake.","authors":"Ewa M Bulczak, Agata U Chmurzyńska","doi":"10.1080/27697061.2023.2172749","DOIUrl":"10.1080/27697061.2023.2172749","url":null,"abstract":"<p><p><b>Objective:</b> Caffeine is one of the oldest natural substances consumed by people. Its consumption in Poland has not been well described. The aim of this study was to design and validate an online food frequency questionnaire (FFQ) on caffeine intake and to use it to estimate caffeine consumption in Polish adults.<b>Method:</b> The FFQ was prepared and validated in a pilot study. The intake assessment was conducted in 2019-2020 on 372 respondents, aged 18 to 60 years. The FFQ included products such as coffee, tea, energy drinks, and carbonated drinks, as well as supplements and chocolate.<b>Results:</b> We showed good repeatability of the FFQ and it was considered a valid tool. The mean total caffeine intake among all participants was 426.7 mg ± 283.4 mg/day of all sources; in women, it was 446.4 mg ± 306.2 mg/day, while in men, it was 394.1 ± 236.4 mg/day. Forty-three percent of the respondents consumed more than 400 mg of caffeine/day. Coffee was the main source of caffeine and contributed to 65% of total caffeine consumption. Women consumed 90% more green tea than men (<i>p</i> < 0.01). Overweight and obese people have 20% greater total caffeine intake (<i>p</i> = 0.01) and consumed 20% more coffee (<i>p</i> = 0.02) and 30% more black tea (<i>p</i> = 0.01) than people of normal weight.<b>Conclusions:</b> Average caffeine consumption among Polish adults slightly exceeds the safe consumption dose established by the European Food Safety Authority. Body weight status can differentiate caffeine intake.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10593940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whey proteins as a functional food: Health effects, functional properties, and applications in food.","authors":"Aslı Yiğit,&nbsp;Paulina Bielska,&nbsp;Dorota Cais-Sokolińska,&nbsp;Gülhan Samur","doi":"10.1080/27697061.2023.2169208","DOIUrl":"10.1080/27697061.2023.2169208","url":null,"abstract":"<p><p>Functional foods are defined as foods and ingredients that exhibit health benefits beyond their nutritional value. Research on functional foods is increasing rapidly as they may help prevent and manage some non-communicable diseases. Whey proteins are recognized as a high-quality nutrient source and known to contain some bioactive components. They are rich in essential amino acids such as cysteine, branched-chain amino acids such as leucine, valine, and isoleucine, and bioactive peptides. Whey proteins look promising as a potential functional food, given its antioxidant, anti-inflammatory, blood pressure lowering, anti-obesity, and appetite suppressing effects that is discussed in the literature. Whey proteins also show functional properties that play an essential role in food processing as an emulsifier, fat-replacer, gelling and encapsulating agent and are known to improve sensory and textural characteristics of food. This review focuses on the functional food aspects of whey proteins, associated health effects, and current food applications.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10593941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of the Paleo Diet on Autoimmune Thyroid Disease: A Mixed Methods Review.","authors":"J B Hollywood,&nbsp;D Hutchinson,&nbsp;N Feehery-Alpuerto,&nbsp;M Whitfield,&nbsp;K Davis,&nbsp;L M Johnson","doi":"10.1080/27697061.2022.2159570","DOIUrl":"10.1080/27697061.2022.2159570","url":null,"abstract":"<p><p>The aim of this systematic review was to examine the characteristics of Paleolithic diet (PD) interventions designed for adult patients with autoimmune thyroid disease (AITD) in order to determine if diet elements have the potential to successfully reduce thyroid antibodies (Ab) such as thyroglobulin (Tg), thyroid peroxidase (TPO), and thyroid stimulating hormone receptor (TSHR), and improve thyroid hormones (thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH)) or resolve AITD pathogenesis. Randomized controlled trials (RCTs) with an adult population of 18 years and older, diagnosed with Hashimoto's thyroiditis (HT) or Graves' disease (GD) (Basedow's), who were placed on a diet of Paleolithic or ancestral nature, and achieved reduction of AITD Abs, improvement of thyroid hormones, and, or resolution of AITD were searched. Various electronic databases were used. Bias was assessed using critical appraisal tools from the Scottish Intercollegiate Guidelines Network (SIGN) and Joanna Briggs Institute (JBI). Studies were excluded according to exclusion criteria and results analyzed. One randomized controlled trial (RCT), a pilot study, and six case studies were found. In total, eight AITD studies focusing on Paleolithic or ancestral interventions were located. In highlight, females were the predominant gender. Case studies solely focused on AITD with protocols ranging from 8-60 weeks. All studies showed clinical improvements, one had significant improvement, two showed AITD resolution. After structured evaluation of nutritional interventions utilizing the PD on the effects of AITD, it was concluded foods of ancestral nature along with the addition of specific supplements, food components, exercise and mindfulness meditation, and exclusion of modern day foods have a considerable impact on thyroid Ab and hormones. The relevant studies suggest while this dietary protocol can be useful in clinical practice, larger-scale studies need to be conducted. Key teaching pointsThere are currently no dietary interventions recommended for the treatment of autoimmune thyroid disease. The Paleo diet has been documented to improve AITD antibodies and thyroid hormones in both Hashimoto's thyroiditis and Graves' disease.The Paleo diet can provide a natural source of nutrients similar to supplemental nutrients that have shown positive results on AITD.The paleo diet provides specific macronutrient percentages that may be beneficial in reducing AITD antibodies, while improving thyroid hormones.Methylation supplementation may be useful in AITD cases.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10842776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Initiation of Breastfeeding (EIBF) and Its Associated Factors Among Mothers With Infants Aged 0 to 6 Months in Jashore District, Bangladesh: A Cross-Sectional Study.","authors":"Suzon Ahmed,&nbsp;Niaz Mahmud,&nbsp;Nisat Farzana,&nbsp;Mst Irin Parvin,&nbsp;Md Alauddin","doi":"10.1080/27697061.2022.2161663","DOIUrl":"10.1080/27697061.2022.2161663","url":null,"abstract":"<p><strong>Objective: </strong>Early initiation of breastfeeding (EIBF) is one of the most successful interventions for minimizing newborn morbidity and death. According to the database (Bangladesh Demographic Health Survey 2014), only around half of babies begin breastfeeding during the first hour of life in Bangladesh. The goal of this study was to determine the prevalence of EIBF in the Jashore area while also investigating its associated factors among mothers of infants aged 0 to 6 months in order to better understand the variables that impacted breastfeeding initiation.</p><p><strong>Method: </strong>A cross-sectional study was conducted in the maternity wards of the 3 busiest hospitals in the Jashore district of Bangladesh from May to July 2019. Using random sampling, a total of 423 mother-infant pairs were chosen. Pearson chi-square test and bivariable and multivariable logistic regression statistical analysis were used to identify factors linked to EIBF.</p><p><strong>Results: </strong>The prevalence of EIBF was 46.3% (196/423). Mothers who had skin-to-skin contact after delivery (adjusted odds ratio [AOR], 2.25; 95% confidential interval [CI], 1.40-3.59), who did not deliver prelacteal food (AOR, 3.68; 95% CI, 1.65-8.21), and who provided colostrum (AOR, 5.89; 95% CI, 1.62-21.49) were more likely to begin breastfeeding within 1 hour than were their counterparts.</p><p><strong>Conclusions: </strong>EIBF was found to be strongly linked with skin-to-skin contact after delivery, avoidance of prelacteal feeding, and colostrum feeding practice. As a result, we strongly urge public health officials and health care practitioners to encourage these feeding behaviors in order to increase EIBF.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9078861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition Knowledge of Elderly Women: Effect of Two Food and Nutrition Education Programs.","authors":"Estela Lopes Scariot,&nbsp;Adriana da Silva Lockmann,&nbsp;Caroline Buss","doi":"10.1080/27697061.2023.2182384","DOIUrl":"10.1080/27697061.2023.2182384","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effect of two programs of Food and Nutrition Education (FNE) on the Nutrition knowledge of elderly women, Brazil.</p><p><strong>Methods: </strong>Randomized field trial. Community-based elderly women over 60 years (n = 36) participated in a twelve-week intervention in either of two FNE programs: Psychopedagogical Program (PP) or Culinary Workshop Program (CWP). There were three moments of data collection in the study; pre-intervention knowledge data); post intervention and follow up (after 6 months upon intervention completion). A questionnaire about knowledge of food and Nutrition was administered at every data collection moment.</p><p><strong>Results: </strong>In the analysis performed by the Generalized Estimation Equation Models (GEE) there was a significant interaction effect (P = 0.033) in the diabetes block in which the percentage of correct answers in the follow-up moment was higher compared to the pre-intervention moment in the CWP group (65.65% and 45.66%, respectively). In the knowledge blocks: total percentage of correct answers, hypertension, food processing, the evaluation effect was observed, regardless of the intervention performed.</p><p><p>Three blocks of knowledge, including the block of the total percentage of correct answers in knowledge in Nutrition, presented a significant evaluation effect, which suggests that the interventions were important for the gain of knowledge, regardless of the type of intervention performed. Elderly-focused FNE programs should include a methodology that encompasses recreational education activities, and practical activities, such as culinary workshops.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9093005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discovery of Alpha-Tocopheryl Succinate as a Cancer Treatment Agent Led to the Development of Methods to Potentially Improve the Efficacy of Cancer Therapy.","authors":"Kedar N Prasad","doi":"10.1080/27697061.2023.2175389","DOIUrl":"10.1080/27697061.2023.2175389","url":null,"abstract":"<p><p>The discovery of alpha-tocopheryl succinate (alpha-TS) as a cancer therapeutic agent markedly stimulated research with or without tumor therapeutic agents on cancer cells and normal cells. Results showed that alpha-TS treatment induced apoptosis in cancer cells and enhanced the apoptotic effects of tumor therapeutic agents on tumor cells in a synergistic manner without affecting the growth of normal cells. Liposomal alpha-TS was more effective than alpha-TS. Some tumors are difficult to treat with chemotherapeutic agents while some become resistant of such treatment. Using a nanotechnology technique, it was demonstrated that alpha-TS conjugated with a chemotherapeutic agent enhanced the levels of apoptosis and restored the sensitivity of tumor cells to that chemotherapeutic agent. The mechanisms of action of alpha-TS alone or in combination with therapeutic agents include the following: (a) inhibition of the expression of oncogenes C-myc and H-ras; (b) alterations in the levels of expression of numerous genes; (c) activation of caspases; (d) inhibition of angiogenesis; (e) destabilization of mitochondria and lysosomes; (f) inhibition of production of production of prostaglandin E2 (PGE2) and PGE2-mediated pro-inflammatory responses; (g) reduction of survivin signaling pathway; and (h) reduction of CD47 expression on the tumor cell surface causing enhancement of phagocytic activity of macrophages leading to engulfment of tumor cells. Despite impressive results in cell culture and in animal models, no studies with alpha-TS alone or in combination with cancer therapeutic agents in human cancer resistant to these therapies have been performed.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9213184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Problems Related to Oropharyngeal and Esophageal Changes in Aging: A Narrative Review.","authors":"Elif Adanur Uzunlar","doi":"10.1080/27697061.2023.2179553","DOIUrl":"10.1080/27697061.2023.2179553","url":null,"abstract":"<p><p>Today, it is known that the elderly population is increasing rapidly with the quality of life. The United Nations estimate that one in six people will be 65 years or older by 2050. This situation causes interest in the old age period to increase day by day. In parallel with this, studies on the aging process have grown rapidly. Especially the health problems accompanying extended life expectancy and its treatment have become the focus of researchers in recent years. It is a known fact that some sensory and physiological changes in old age affect the quality of oral food intake and food taste. This may lead to inadequate nutritional intake and even rejection of food intake in the elderly. Therefore, severe malnutrition and sarcopenia occur in these individuals, and their life span is shortened. In this review, the effects of aging-related oropharyngeal and esophageal changes and problems on oral food intake will be evaluated. Our increasing knowledge on this subject will contribute to healthcare professionals in the prevention and treatment of health problems such as malnutrition that may occur during the aging process. In this review, a literature search was conducted with the keywords \"older\" or \"elderly\" or \"geriatrics\" and \"nutrition\" or \"malnutrition\" and \"oropharyngeal functions\" or \"esophageal functions\" in PubMed, ScienceDirect, and Google Scholar electronic databases. KEY TEACHING POINTSSome changes may occur in oropharyngeal and esophageal functions with aging.Sensory and physiological changes in the aging process affect oral food intake and nutritional status.Impairments in oral food intake in elderly individuals can lead to malnutrition and sarcopenia.Age-related changes affecting oral food intake increase the importance of nutritionists with the increase in the elderly population.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10776746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ordered Eating and Its Effects on Various Postprandial Health Markers: A Systematic Review.","authors":"Brian K Ferguson,&nbsp;Patrick B Wilson","doi":"10.1080/27697061.2022.2161664","DOIUrl":"10.1080/27697061.2022.2161664","url":null,"abstract":"<p><strong>Objective: </strong>Aberrations in glucose, insulin, and other postprandial (PP) markers are common in obesity and cardiometabolic disorders. One potentially simple lifestyle/dietary modification to manage these issues is to change the order in which foods are consumed within meals. Carbohydrate exerts the largest effect on PP glucose, and there is some evidence that ingesting dietary fat or protein before carbohydrate delays gastric emptying of carbohydrate and reduces PP glucose. Additionally, certain dietary proteins may augment insulin release if ingested with carbohydrate, thereby improving blood glucose clearance. This review aimed to systematically evaluate evidence from acute experiments that modified the order in which foods were consumed in isocaloric meals.</p><p><strong>Methods: </strong>Outcomes of interest were PP glucose and insulin (including area under the curve for both), C-peptide, gut hormones, and perceptual responses. Three databases were searched (PubMed, Cochrane CENTRAL, Web of Science) in February 2022. Additionally, reference lists of identified reports were searched, and an author of several studies was consulted to verify that relevant literature was included. The review included acute interventions that administered isocaloric meals of the same foods but with foods eaten in different orders. Studies were not excluded based on participant characteristics.</p><p><strong>Results: </strong>Eleven reports were identified. All reports that assessed glucose and insulin showed a tendency toward lower levels, at least over parts of the PP period, by consuming carbohydrates last. GLP-1 tended to be higher in carbohydrate-last conditions, though this was only measured in a few studies. Perceptual responses (hunger, fullness, etc.) were not consistently different between conditions in two studies, but the certainty of evidence was very low.</p><p><strong>Conclusions: </strong>Findings indicate that, at least acutely, there may be benefits to eating carbohydrate after vegetable and/or protein-rich foods. The most consistent effect (judged as moderate certainty) is that carbohydrate-last meal orders tend to lower blood glucose and insulin excursions.</p>","PeriodicalId":29768,"journal":{"name":"Journal of the American Nutrition Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10445319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}