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Demand for dietary fibre-enriched and low sugar bakery products is increasing rapidly due to current high incidence of type 2 diabetes mellitus. Overripe banana has been discarded due to its low quality and appearance. However, overripe banana exhibits rich sources of natural sweetener and dietary fibre which could potentially be used as a novel food ingredient in bakery product. Thus, the study aims to determine the nutritional properties, sensory acceptability and glycaemic index (GI) value of chocolate cookies formulated with overripe banana sweetener (OBS) as partial replacement (10, 15 and 20%) for table sugar and utilization of overripe banana residue (OBR) as partial replacement (8%) for wheat flour.

Nutritional composition was analysed using AOAC methods and sensory acceptability using 7-point hedonic scaling method. In Vivo GI determination was continued according to FAO/WHO method.

Incorporation of OBR and OBS significantly (p < 0.05) increased nutritional values of chocolate cookies. Chocolate cookies formulated with 8% OBR +20% OBS recorded the highest TDF (7.80%) and ash (1.47%) content. Sucrose content of chocolate cookies was reduced significantly with increasing level of OBS. Sensory scores for control and 8% OBR-incorporated cookie were not significant difference for all the sensory attributes. Moreover, incorporation of OBS up to 15% produced higher scores in term of aroma, flavour and overall acceptance. Three formulations of chocolate cookies (control, 8% OBR and 8% OBR +15% OBS) were selected for GI testing and recorded GI values of 63, 56 and 50, respectively.

Overripe banana can be used as a food ingredient in developing high fibre and low-GI cookie.

The purpose of this paper is to examine the effect of the intensive lifestyle modification program on weight and metabolic syndrome risk reduction in rural obese women who have no underlying non-communicable diseases in Thailand.

A randomized controlled trial was conducted. In total, 60 healthy obese women aged 30-50 years were recruited and randomly assigned to either the intervention (n=30) or control (n=30) group after health screening. Tailored nutritional counseling, health education and exercise training were included in the lifestyle modification program. Behavioral modification techniques were also incorporated. The intervention was conducted weekly for the first eight weeks, then biweekly until week 16.

The student’s t-test was used to compare mean difference between groups. The total weight loss in the intervention group (n=29) was significantly higher, 7.6±2.9 kg, compared with the control group (n=30) who lost 0.7±1.4 kg (p<0.001). The intervention group lost weight 10.2 percent from baseline which was significantly higher than that in the control group (p<0.001). Systolic and diastolic blood pressures, fasting blood sugar, and waist circumference were significantly improved. Triglyceride levels slightly improved while high density lipoprotein cholesterol was slightly lowered. The intervention group showed a statistical reduction in abnormal components of metabolic syndrome compared with the control group, with the relative risk=0.24, 95% confidence interval=0.072-0.791, and p=0.018.

Compatibility of the program activities conducted by a health professional who had achieved healthy weight loss and accepted as a role model was a key to achieving effective weight loss and metabolic syndrome risk reduction in obese women in rural areas. The program should be integrated into the conventional practice of health care centers.

Increasingly, interest in and the uptake of herbal infusions has advanced, namely, owing to their bioactive properties and potential links to health. Given this, the purpose of the present review was to collate evidence from human trials for five popular herbal infusions.

The systematic review comprised ten human trials (560 participants), investigating inter-relationships between herbal infusions consumption and health. Only human studies involving German chamomile (Matricaria chamomilla L. Asteraceae), ginger (Zingiber officinale Roscoe Zingiberaceae), lemon balm (Melissa officinalis L. Lamiaceae), peppermint (Mentha x spicata L. Lamiaceae)/spearmint (Mentha spicata L. Lamiaceae) and rosehip (Rosa canina L. Rosaceae) teas were included in the present paper.

Most herbal infusions serve as a good source of flavonoids and other polyphenols in the human diet. Studies included in this paper indicate that herbal infusions (1-3 cups tended to be drank daily; infusion rates up to 15 min) could benefit certain aspects of health. In particular, this includes aspects of sleep quality and glycaemic control (German chamomile), osteoarthritic stiffness and hormone control (spearmint), oxidative stress (lemon balm) and primary dysmenorrhea (rosehip).

Ongoing research is needed using homogenous herbal infusion forms, brewing rates and volumes of water to further reinforce these findings. In the meantime, herbal infusions could provide a useful supplementary approach to improving certain aspects of well-being.

The present paper collates evidence from human trials for five popular herbal infusions.

Background/Objectives: Protein-based meal replacements (MR) with viscous soluble fibre are known aids for weight loss. This study aims to compare the effects of new whey and vegan MR containing different amounts of PGX (PolyGlycopleX) on weight loss over 12 weeks, along with a calorie-restricted diet.

Subjects/Methods: Sixty-eight healthy adults of both sexes (53 women; 15 men; average age 47.1 years; BMI 31 ± 7.1 kg/m² and weight 85.05 ± 23.3 kg) were recruited. Participants consumed a whey or vegan MR twice/d (5–10 g/day PGX) with a low-energy diet (1,200 kcal/day), over 12 weeks. Weight, height, waist and hip circumference were recorded (four time periods).

Results: Forty-four participants completed the study. Results showed significant reductions in average body weight and at week 12, whey group was [−7.7 kg ± 0.9 (8.3%), p < 0.001] and vegan group was [−4.5 kg ± 0.8 (6.2%), p < 0.001)]. All participants (n = 44; BMI 27 to 33 kg/m²) achieved significant reductions in body measurements from baseline to week 12; p < 0.001. Conclusions: Supplementation of protein-based MR with PGX and a balanced, low-energy diet, appears to be an effective approach for short-term weight loss.

As the authors were evaluating if the MR as a whole (i.e. with PGX) caused weight loss from baseline over the 12 weeks, no comparators, i.e. just the MR without PGX, were used. Formulation of these new MRs resulted in a whey product with 5 g PGX and a vegan product with 2.5 g PGX. Only 2.5 g PGX could be formulated with the vegan protein due to taste and viscosity limitations. Study participants were not randomized and no control groups (e.g. no MR or MR without PGX but with energy restricted diet) were used. Furthermore, it is not clear whether the sort of protein alone or the combination with a higher amount of PGX (whey with 5 g PGX/serving vs vegan with 2.5 g PGX/serving) has contributed to these significant greater weight-loss effects. This was something the authors were testing, i.e. could only 2.5 g PGX/serving have an effect on weight loss for a vegan MR. These limitations would be somethings to evaluate in a subsequent randomized controlled study. Hence, the results of this study may serve as a good starting point for further sophisticated randomized controlled trials that can demonstrate causality – which the authors acknowledge as one of the fundamental limitations of an observational study design. Participants tracked their calories but adherence and compliance were self-assessed and they were encouraged to keep their exercise routine consistent throughout the study. Hence, these are further limitations. No control group was used in this study to observe the effect of the dietary intervention and/or physical activity on weight loss alone. However, a goal of the authors was to keep this study as close to a real-life situation as possible, where people would not be doing any of these measurements, to see if with minimal supervision or intervention, people can still lose weight and alter their body composition. Furthermore, differences in gender and the corresponding weight loss effects in response to MR-protein-based treatments could be evaluated in follow-up studies.

This study indicates that the consumption of protein-based (animal, whey or plant, pea protein) MR incorporating the highly soluble viscous PGX is beneficial for weight loss when combined with a healthy-balanced, calorie-restricted diet. MRs at either 2.5 g or 5 g per serving (RealEasy^TM with PGX) proved to be a highly effective as a short-term solution for weight loss. The observed results are encouraging, however, further long-term studies (i.e. randomized clinical trials RCT) are needed to confirm the clinical relevance. RCTs should focus on the individual effects of PGX and/or the different protein sources used in MRs, on weight loss and the maintenance of the reduced body weight, and should measure detailed blood parameters (lipid profiles, glucose etc.) as well as collect detailed exercise and food consumption diaries.

To the authors’ knowledge, this is the first study comparing a whey versus vegan, (as pea) protein-based MR that is supplemented with fibre PGX; thus, this work adds information to the already existing literature on fibre (such as PGX) and MRs regarding their combined weight loss effects. The purpose of this study was to observe if the novel protein-based (either whey or vegan versions) MR RealEasy^TM with PGX at 2.5 or 5 g in addition to a calorie-restricted diet (total of 1,200 kcal/day) would aid in weight loss in individuals over a 12-weeks period. Adding increasing amounts of whey protein and soluble fibre can help reduce subsequent ad libitum energy intake which could help adherence to energy restricted diets, but whether similar effects are seen with vegan protein is unclear – this study does aim to address this.

Following the standard practice of using nutrition claims to denote food functionality, this study empirically explores Chinese consumers’ willingness-to-pay for functional processed meat products by using three nutrition claims (namely “increased calcium,” “containing omega-3”, and “reduced salt”) made on pork sausages. It also aims to outline the typical characteristics of Chinese consumer segments based on preferences.

A choice-based choice experiment is utilized to investigate Chinese consumers’ valuation on attributes of interest regarding functional sausage products. First-hand data was collected in the two cities of Xi'an and Beijing.

There are market potentials for domestic and/or imported functional processed meat products among Chinese consumers. Nutrition claims made on pork sausages are appealing to Chinese consumers, and therefore, monetarily rewarded by them. Being imported from a more developed country of origin could both positively and negatively impact consumers’ WTP for nutrition claims made on pork sausages. Furthermore, specific functional modification strategies should be taken into account when addressing different segments of the Chinese market. In addition, regional impacts between Xi'an and Beijing are implied in terms of consumers’ valuation for functional pork sausages.

Limitations in the current study are mainly two folds. First, the WTP estimation magnitudes are subject to a hypothetical bias by using a stated preference approach. Second, this study only focuses on pork sausages to explore consumers’ perceptions and selects three nutrition claims among many other relevant options.

Implications are provided for meat marketers and for Chinese official food policymakers, such that promoting meat products with a nutrition claim is an attractive marketing strategy for foreign food manufacturers in China, and more reformulated meat products with better nutritional compositions should be allowed in the Chinese market.

To the best of the author’s knowledge, this research is the first to fill in the literature blank on investigating the consumers’ valuation for functional meat in the emerging market of China. Because when taking Chinese consumers as a target market and evaluating their perceptions of food quality-related labeling and certifications, the existing literature is mainly limited to topics of product safety, organic/green products, and geographical origins. However, nutrition claims, as marketable credence attributes that associate closely to the main characteristics of the functional food products, have been explored to a much lesser extent among Chinese consumers.

A global trend of type 2 diabetes prevalence is rising. Preventing and managing of systemic and dental complications is crucial to decrease negative effects on glycemic control. The purpose of this paper is to estimate the efficacy of Brief Lifestyle Change in conjunction with Dental Care (Brief-LCDC) Programs to decrease glycemic level and improve periodontal status in patients with type 2 diabetes.

Health Center 54 conducted randomized controlled trial among 192 patients (96 intervention and 96 control) from February to August 2018. Group education for lifestyle modification, individual oral hygiene instruction and lifestyle counseling by motivational interviewing was provided to the intervention group at baseline. Motivation of lifestyle modification every month by multimedia was also provided to the intervention group. The usual program was provided to the control group. At baseline and a six-month follow-up, glycemic level and periodontal status were assessed from participants. Data were analyzed by descriptive statistic, t-test, χ² test, Fisher’s exact test, Repeated measure ANOVA and multiple linear regression.

Glycemic level and periodontal status were lower in the intervention group than the control group at the sixth-month followed up with statistical significances. Glycemic level and periodontal status had negatively correlated to intervention group with statistically significant.

Brief-LCDC Program which incorporated lifestyle modification and oral health care had efficacious to decrease glycemic level and improve periodontal status in patients with type 2 diabetes. Early prevention program by Brief-LCDC Program is crucial to prevent dental complications.

Diabetes is a major metabolic disorder which can affect entire body system adversely. Undiagnosed diabetes can increase the risk of cardiac stroke, diabetic nephropathy and other disorders. All over the world millions of people are affected by this disease. Early detection of diabetes is very important to maintain a healthy life. This disease is a reason of global concern as the cases of diabetes are rising rapidly. Machine learning (ML) is a computational method for automatic learning from experience and improves the performance to make more accurate predictions. In the current research we have utilized machine learning technique in Pima Indian diabetes dataset to develop trends and detect patterns with risk factors using R data manipulation tool. To classify the patients into diabetic and non-diabetic we have developed and analyzed five different predictive models using R data manipulation tool. For this purpose we used supervised machine learning algorithms namely linear kernel support vector machine (SVM-linear), radial basis function (RBF) kernel support vector machine, k-nearest neighbour (k-NN), artificial neural network (ANN) and multifactor dimensionality reduction (MDR).

To construct a risk score using both clinical and intra-oral variables and to determine a risk score to screen individuals according to their risk of hyperglycemia.

A cross-sectional study was carried out among 690 Thai dental patients who visited the Special Clinic, Faculty of Dentistry, Mahidol University and a mobile dental unit of His Majesty the King of Thailandss Dental Service Unit. Participants aged ≥25 years without a previous history of type 2 diabetes mellitus were included in the study. Participants diagnosed with severe anemia and polycythemia were excluded. Questionnaires were used to collect demographic data. Point-of-care HbA1c, body mass index (BMI), blood pressure and periodontal status were analyzed.

A total of 690 participants were included in the study. A risk scoring system including five variables was developed. It exhibited fair discrimination (area under the curve = 0.72, 95%CI 0.68–0.71). The risk score value of 9 was used as the cut-off point for increased risk of abnormal HbA1c. Subjects that had a total risk score of 9 or more had a high probability of having abnormal HbA1c and were identified for referral to physicians for further investigation and diagnosis.

A risk score to predict hyperglycemia using a dental parameter was developed for convenient evaluation in dental clinics.

The purpose of this paper is to explain why the high quality cassava flour (HQCF) value chain in Nigeria has not performed as well as expected. The specific objectives are to: analyse important sources of uncertainty influencing HQCF value chains; explore stakeholders’ strategies to respond to uncertainty; and highlight the implications of different adaptation strategies for equity and the environment in the development of the value chain.

The authors used a conceptual framework based on complex adaptive systems to analyse the slow development of the value chain for HQCF in Nigeria, with a specific focus on how key stakeholders have adapted to uncertainty. The paper is based on information from secondary sources and grey literature. In particular, the authors have drawn heavily on project documents of the Cassava: Adding Value for Africa project (2008 to present), which is funded by the Bill & Melinda Gates Foundation, and on the authors’ experience with this project.

Policy changes; demand and supply of HQCF; availability and price of cassava roots; supply and cost of energy are major sources of uncertainty in the chain. Researchers and government have shaped the chain through technology development and policy initiatives. Farmers adapted by selling cassava to rival chains, while processors adapted by switching to rival cassava products, reducing energy costs and vertical integration. However, with uncertainties in HQCF supply, the milling industry has reserved the right to play. Vertical integration offers millers a potential solution to uncertainty in HQCF supply, but raises questions about social and environmental outcomes in the chain.

The use of the framework of complex adaptive systems helped to explain the development of the HQCF value chain in Nigeria. The authors identified sources of uncertainty that have been pivotal in restricting value chain development, including changes in policy environment, the demand for and supply of HQCF, the availability and price of cassava roots, and the availability and cost of energy for flour processing. Value chain actors have responded to these uncertainties in different ways. Analysing these responses in terms of adaptation provides useful insights into why the value chain for HQCF in Nigeria has been so slow to develop.

Recent developments suggest that the most effective strategy for the milling industry to reduce uncertainty in the HQCF value chain is through vertical integration, producing their own cassava roots and flour. This raises concerns about equity. Until now, it has been assumed that the development of the value chain for HQCF can combine both growth and equity objectives. The validity of this assumption now seems to be open to question. The extent to which these developments of HQCF value chains can combine economic growth, equity and environmental objectives, as set out in the sustainable development goals, is an open question.

The originality lies in the analysis of the development of HQCF value chains in Nigeria through the lens of complex adaptive systems, with a particular focus on uncertainty and adaptation. In order to explore adaptation, the authors employ Courtney et al.’s (1997) conceptualization of business strategy under conditions of uncertainty. They argue that organisations can assume three strategic postures in response to uncertainty and three types of actions to implement that strategy. This combination of frameworks provides a fresh means of understanding the importance of uncertainty and different actors’ strategies in the development of value chains in a developing country context.

This study aimed to assess the sleep quality and its associated factors among patients with type 2 diabetes mellitus (T2DM) in a private hospital in Yangon, Myanmar.

A cross-sectional study was conducted. A total of 289 T2DM patients were interviewed using a structured questionnaire. An English version of the Pittsburgh Sleep Quality Index (PSQI) was translated into Myanmar and used for assessing sleep quality.

Approximately 48.4% of T2DM patients had poor sleep quality (PSQI score > 5). The mean ± SD of the PSQI global score was 5.97 ± 3.45. About 36.0% of participants reported the presence of diabetes complications, and 14.9% used sleep medication. About 27.7% had depression and 8.3% had poor family relationships. Multiple logistic regression analysis revealed that the presence of complications (AOR = 1.86; 95%CI; 1.04–3.35), poor family relationships (AOR = 5.09; 95%CI; 1.55–16.68) and depression (AOR = 7.52; 95%CI; 3.83–14.76) were significantly associated with poor sleep quality.

The prevalence of poor sleep quality is rather high among T2DM patients. Healthcare personnel and hospital administrators should focus on the complication status, family relationships and depression status of T2DM patients by providing regular screening for sleep quality and depression and by providing a program of sleep health education and counselling at diabetic clinics