Older adults, mealtime-related emotions, and functionalities : tailoring protein-enriched meals
Uijl, Louise C. den - \ 2016
Wageningen University. Promotor(en): Kees de Graaf, co-promotor(en): Stefanie Kremer; Gerry Jager. - Wageningen : Wageningen University - ISBN 9789462578920 - 178
meals - emotions - elderly nutrition - elderly - smell - food preferences - protein - proteins - questionnaires - young adults - chocolate - maaltijden - emoties - ouderenvoeding - ouderen - reuk - voedselvoorkeuren - eiwit - eiwitten - vragenlijsten - jongvolwassenen - chocolade
Background and aim
Dietary proteins are of special interest for the heterogeneous group of older adults, since these people do not always have an adequate protein intake. When protein-rich products are better aligned with the requirements of older persons, an adequate nutrient intake is more likely. In this thesis we therefore explored two approaches for tailoring protein-enriched meals to older consumer subgroups; emotion-based and functionality-based. We expected a better ‘product-cluster fit’ (i.e. a more positive meal experience) when the clusters’ meal associations are congruent to their mealtime expectations.
We conducted an online survey in which vital community-dwelling older adults (n=392) reported their mealtime-related emotions and mealtime functionality. Using a hierarchical clustering analysis we described clusters within our population. Subsequently, we explored the extent to which the expectations of these clusters can be applied for the development of tailored protein-enriched meals. For the emotion-based approach, we conducted two central location tests (CLTs, n=461) to explore older adults’ food-evoked emotions. For the functionality-based approach we conducted in-depth interviews in order to get further insights regarding functional mealtime expectations and attitudes towards proteins and protein-enrichment. Based on the latter insights we tailored PE meal concepts to two functionality-based segments. In a final home-use test, the members of the functionality-based segments (n=91) prepared and evaluated the tailored PE meal concepts.
The emotion-based approach resulted in four clusters; pleasurable averages, adventurous arousals, convivial indulgers, and indifferent restrictives. These emotions that these segments associated with their mealtimes varied along the two dimensions valence and arousal. However, from both CLTs we learned that the variation in valence-arousal as observed for mealtime-related emotions was not observed for emotions related to actual foods. The latter makes it challenging to identify products that evoke emotions congruent to the mealtime expectations of the emotion-based clusters.
With regard to the functionality-based approach, we encountered three clusters; physical nutritioners, cosy socialisers, and thoughtless averages. The cosy socialisers value the social interactions and cosiness during their mealtimes, whereas the physical nutritioners focus more on the health and nutrient aspects of meals. Thoughtless averages have the least distinctive mealtime expectations. We translated these functional mealtime expectations into two PE meal concepts; one tailored to cosy socialisers and one tailored to physical nutritioners. These meal concepts were well-accepted by the participants. However, congruency between mealtime expectations and functional meal associations did not result in a better ‘product-cluster fit’.
Given the challenge to identify congruency between the meal associations and the mealtime expectations of the emotion-based clusters, we consider the emotion-based approach to be not yet actionable enough as a basis for tailoring PE products to older consumers. In contrast, the functionality-based approach appeared to be more promising, since the functional meal expectations could be translated to well-accepted tailored PE meal concepts. However, the effectivity of our functionality-based approach was not yet confirmed in this thesis, since congruency between functional meal associations and functional meal expectations did not necessarily result in a better ‘product-cluster fit’. Future studies, focussing on e.g. other meal types, are recommended to further explore mealtime functionality as a basis for tailoring PE meals to older consumer subgroups.
Dietary epicatechnin and quercetin in cardiovascular health and disease
Dower, J.I. - \ 2016
Wageningen University. Promotor(en): Daan Kromhout; Marianne Geleijnse, co-promotor(en): Peter Hollman. - Wageningen : Wageningen University - ISBN 9789462577862 - 164
cardiovascular disorders - cardiovascular diseases - epicatechin - quercetin - epidemiological surveys - genome analysis - chocolate - hart- en vaatstoornissen - hart- en vaatziekten - epicatechine - quercetine - epidemiologische onderzoeken - genoomanalyse - chocolade
Epidemiological studies showed that the consumption of flavonoid-rich foods such as cocoa and tea is associated with a lower risk of cardiovascular disease (CVD). Randomised controlled trials (RCTs) showed that cocoa and tea improved markers of cardiometabolic health including blood pressure, endothelial function, insulin resistance, arterial stiffness and inflammation.
Cocoa is particularly rich in the flavan-3-ol epicatechin and tea is the main dietary source of epicatechin and of the major flavonol quercetin. However, evidence on the individual roles of epicatechin and quercetin in the health effects of cocoa and tea is still scarce. Therefore, we estimated the strength of the association between epicatechin intake and CVD mortality in a prospective cohort study. Furthermore, we also investigated the effects of epicatechin and quercetin on markers of cardiometabolic health and gene expression, by means of two RCTs.
In Chapter 2, the association between epicatechin intake and CVD mortality was studied using data from the Zutphen Elderly Study, a cohort of 744 elderly Dutch men. During 25 years of follow-up, 329 men died from CVD and 148 from coronary heart disease (CHD). Results from this study showed that men in the highest tertile of epicatechin intake had a 38% lower risk of CHD mortality compared to men in the lowest tertile. For men with prevalent CVD, the risk of CVD mortality was 46% lower for men in the highest tertile of intake, compared to men in the lowest tertile. This is the first epidemiological study to have investigated the association between epicatechin intake and CVD mortality. Hence, more and larger cohort studies are required to confirm this association, possibly with a focus on populations with a high risk of CVD.
In Chapter 3, the chronic effects of pure epicatechin and quercetin on markers of cardiometabolic health were investigated by means of a RCT. Thirty-seven apparently healthy men and women aged 40–80 years consumed (-)-epicatechin (100 mg/d), quercetin-3-glucoside (160 mg/d), or placebo capsules for 4 weeks, in random order. Markers of cardiometabolic health were measured before and after each 4-week intervention. The results of this study showed that epicatechin improved insulin resistance and had a borderline significant effect on endothelial function. This suggests that epicatechin contributes to the cardioprotective effects of cocoa and tea, however, larger long-term RCTs are required to confirm these effects. Pure quercetin supplementation did not affect any of these markers of cardiometabolic health.
Using data from the same study, we investigated the effects of supplementation of pure epicatechin and quercetin on a comprehensive set of biomarkers of endothelial dysfunction and inflammation (Chapter 4). With the exception of sE-selectin (a biomarker of endothelial dysfunction), epicatechin supplementation did not beneficially influence any of the biomarkers, suggesting a lack of evidence for a role of epicatechin in inflammation. Quercetin also lowered sE-selectin as well as the inflammatory biomarker IL-1β and the overall z-score for inflammation. This suggests that quercetin may contribute to the cardioprotective effects of tea by reducing inflammation and possibly by improving endothelial function.
In the same study, the effects of pure epicatechin supplementation on whole genome gene expression profiles of circulating immune cells were also assessed (Chapter 5). Pure epicatechin supplementation modestly reduced gene expression related to inflammation signalling routes in circulating immune cells – routes which are known to play a role in cardiovascular health. However, there was no evidence that epicatechin affected pathways related to insulin resistance or endothelial function.
To directly compare the acute effects of pure epicatechin and epicatechin from dark chocolate on vascular function, we carried out an acute RCT in 20 apparently healthy men aged 40-80 years (Chapter 6). On three separate occasions, subjects consumed: 1) 70g dark chocolate (150 mg epicatechin) with two placebo capsules; 2) two pure epicatechin capsules (100 mg epicatechin) with 75g white chocolate and 3) two placebo capsules with 75g white chocolate (0 mg epicatechin). Endothelial function and arterial stiffness were measured before and two hours after each intervention. To determine epicatechin bioavailability, epicatechin metabolites were measured in blood samples taken at repeated intervals over a period of 8 hours. There was no significant difference in improvement in endothelial function or arterial stiffness between pure epicatechin and dark chocolate. There was also no difference in bioavailability of pure epicatechin and epicatechin from dark chocolate, when standardised per 100 mg of epicatechin. This suggests that epicatechin may contribute to the vascular effects of cocoa and that the bioavailability of pure epicatechin and epicatechin from dark chocolate is similar.
In the general discussion, the main findings of this thesis were first summarised. Methodological considerations related to cohort studies, such as the assessment of flavonoid intake and the possibility of residual confounding were also discussed. Issues related to the relevance of cardiometabolic markers in RCTs and the effect of cocoa flavan-3-ol bioavailability were addressed. Finally, suggestions for future research were put forward.
In conclusion, the results of this thesis suggest that epicatechin contributes to the cardioprotective effects of cocoa and tea. Epicatechin intake was inversely related to CHD mortality in elderly men, and to CVD mortality in men with prevalent CVD. The cardioprotective effects of epicatechin are likely mediated through improvements in insulin resistance and possibly endothelial function. In contrast, quercetin is unlikely to play a major role in the cardioprotective effects of tea. Results for quercetin from cohort studies are inconclusive, and based on the results of our chronic RCT, quercetin did not affect vascular function or insulin resistance, but may help to lower inflammation. Evidence of the role that individual flavonoids play in the aetiology of CVD is still limited. More studies with pure flavonoids are required to elucidate their role.
High fat challenges and detection of early perturbations in endothelial health : the use of a comprehensive phenotyping approach
Esser, D. - \ 2013
Wageningen University. Promotor(en): Michael Muller, co-promotor(en): Lydia Afman. - S.l. : s.n. - ISBN 9789461735911 - 168
endotheel - vetconsumptie - voedingsvet - lipidenmetabolisme - chocolade - endothelium - fat consumption - dietary fat - lipid metabolism - chocolate
Background:Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality worldwide. One of the pathophysiology’s that play a pivotal role in the development and progression of CVD is a dysfunctional endothelium. An important lifestyle risk factor for endothelial dysfunction is the diet and several nutrients have been classified to be either beneficial or harmful for the endothelium. Although CVD usually affects middle-aged or older adults, the onset of endothelial dysfunction begins in early life, emphasising the need for primary prevention. We therefore aimed to identify markers of early perturbations in endothelial health by using dietary stressors, e.g. high fat (HF) challenge test. Thereafter we aimed to evaluate if the potential early markers are reversible and can be improved after an intervention with a dietary anti-stressor.
Methods:First we validated the HF challenge test as a tool to trigger the endothelial response capacity. For that purpose, we compared the postprandial response after a HF shake with an average breakfast shake in young healthy men by assessing several plasma markers and functional measures of endothelial function. To identify new markers for early perturbations in endothelial health and to optimized the HF challenge test we applied three HF challenges differing in fatty acid type in two populations of middle-aged men, i.e. one at high- and one at low risk for developing CVD and characterized the postprandial response by applying high-throughput metabolomic and transcriptomic tools next to an extensive phenotyping of vascular function and vascular health parameters. Lastly, we evaluated if the, in the studies above, identified potential early biomarker profile is reversible and can be improved after an intervention with a dietary anti-stressor by means of a high flavanol chocolate intervention.
Results:In young men, we observed that a HF challenge decreased flow mediated dilation (FMD), but this decrease was also found after the consumption of an average breakfast shake. IL-8 concentrations were more pronouncedly increased after HF shake consumption compared to an average breakfast control shake. In middle-aged men, a HF challenge decreased the augmentation index (AIX) and elicited an activated state of cellular adherence in the circulation as determined by increased plasma soluble adhesion molecules, increased leukocyte cell surface integrin and selectin expression and increased number of leukocytes. A challenge high in mono-unsaturated fatty acids (MUFAs) elicited the highest postprandial triglyceride (TG) concentrations and the most pronounced effects on AIX. By applying high-throughput metabolomic tools, we observed that oxylipin profiles were affected by the HF challenge and that these changes were depended on dietary fatty acid composition. Application of transcriptome profiling revealed that changes in peripheral blood mononuclear cell (PBMC) gene expression profiles after a HF challenge test were different between lean and obese subjects, with the most deviating effect after MUFA intake. The saturated fatty acid (SFA) shake decreased the expression of genes involved in cholesterol uptake and cholesterol biosynthesis and increased expression of genes involved in cholesterol efflux. MUFA increased expression of inflammatory genes and of peroxisome proliferator-activated receptor α (PPARα) target genes involved in β-oxidation. 4-week daily intake of a dietary anti-stressor, e.g. dark chocolate, increased fasting FMD and decreased AIX, and elicited a less activated state of cellular adherence, as determined by a decrease in plasma soluble adhesion molecules, a decrease in leukocyte cell surface integrin and selectin expression and a decrease in the number of leukocytes.
Conclusions:In this thesis we extensively characterized the postprandial response to a HF challenge in human subjects with different disease risk profiles and optimized the HF challenge test. We identified MUFAs as most potent fatty acids to trigger the vascular and cellular response capacity, which makes it the optimal fatty acid type to use in a HF challenge test. We demonstrated that besides functional measures of vascular function, also plasma and cellular factors involved in leukocyte adhesion to the endothelium are adversely affected by dietary stressors and are beneficially affected by a dietary anti-stressor. Therefore, we conclude that endothelial health can be more comprehensively measured by means of a biomarker profile consisting not only of the vascular function measures FMD and AIX, but also of a subset of soluble adhesion molecules in the plasma, leukocyte counts and cell surface integrin and selectin expression. To identify potential new leads for biomarkers, we applied whole genome gene expression profiling, combined with the HF challenge test which enabled us to detect small differences in health status. Furthermore, we identified metabolic and inflammatory pathways that are specifically affected by either MUFAs or SFAs. These findings increased our understanding on how a SFA or MUFA challenge exert their distinct effects on stress related and metabolic compensatory cellular processes and provided us with new potential leads to detect early perturbations in endothelial health.
|Cacao, flavanolen, en hart- en vaatziekten: Stand van de wetenschap
Buijsse, B. ; Kromhout, D. - \ 2010
Voeding Nu 12 (2010)3. - ISSN 1389-7608 - p. 15 - 17.
chocolade - flavanoïden - hart- en vaatziekten - hypertensie - ziektepreventie - gezondheidsvoedsel - onderzoek - voeding en gezondheid - chocolate - flavanoids - cardiovascular diseases - hypertension - disease prevention - health foods - research - nutrition and health
De gedachte dat cacao gezondheidseffecten bezit is niet nieuw. Al in de 18e eeuw werd verondersteld dat cacao een veelvoud aan kwalen kon verlichten, alleen ontbrak hiervoor lange tijd de wetenschappelijke onderbouwing. Nadat halverwege de jaren negentig van de vorige eeuw werd ontdekt dat cacao rijk is aan flavanolen werd het een populair onderzoeksonderwerp. Vooral de effecten op hart en bloedvaten staan hierbij in de belangstelling. Wat is de stand van de wetenschap?
De jacht op het geheim van cacao
Hollman, P.C.H. - \ 2008
Kennis Online 5 (2008)dec. - p. 9 - 9.
cacao - chocolade - hart- en vaatziekten - ziektepreventie - voeding en gezondheid - cocoa - chocolate - cardiovascular diseases - disease prevention - nutrition and health
Je kans op een dodelijke hartaanval halveert als je elke dag een groot paaseitje pure chocolade eet, blijkt uit een recente Nederlandse epidemiologische studie. En ook andere studies laten zien dat consumptie van cacao beschermt tegen hart- en vaatziekten. Maar het is nog een raadsel hoe dat precies komt, zegt Peter Hollman van RIKILT – Instituut voor voedselveiligheid. "Het menselijk lichaam neemt de bioactieve stoffen in cacao nauwelijks op"
Onderzoek naar de kwaliteit van chocoladerepen
Sledsens, A.M.J. ; Herstel, H. - \ 1989
Wageningen : RIKILT (Rapport / RIKILT 89.12) - 14
chocolade - voedselkwaliteit - chocolate - food quality
Om de kwaliteit van in willekeurige winkels gekochte chocoladerepen te kunnen beoordelen heeft Konsumenten Kontakt het RIKILT verzocht 24 monsters chocoladerepen te onderzoeken. Alle monsters zijn onderzocht op nettogewicht, totaal vet, vocht, saccharose, lactose, theobromine, triglyceridensamenstelling en salmonella. Alle monsters zijn ook sensorisch beoordeeld.
Methode - ontwikkeling voor het bepalen van het gehalte aan cacaoboterequivalente vetten in chocoladeprodukten
Kamp, H.J. van der; Muuse, B.G. - \ 1985
Wageningen : RIKILT (Rapport / RIKILT 85.42) - 8
cacao - chocolade - vetten - oliën - bakoliën - bakvetten - kwantitatieve analyse - spijsoliën - spijsvetten - cocoa - chocolate - fats - oils - cooking oils - cooking fats - quantitative analysis - edible oils - edible fats
De Europese Commissie (EC) bestudeert de mogelijkheden om cacaoboteralternatieve vetten (CDA) toe te staan in chocolade tot een gehalte van 5% van de waar zonder declaratleverplichting. Voorwaarde is de controleerbaarheid met een betrouwbare analysemethode. De CAODISCO ontwikkelde een triglyceridemethode waarmee cacaoboter equivalente vetten kunnen worden bepaald. Dit verslag gaat in op de CAOBISComethode en de daarop gebaseerde EEG ringtest. Tot slot wordt het resultaat vermeld van onderzoek naar de samenstelling van Nederlandse chocolade geanalyseerd met deze CAOBISCQ-methode.
Onderzoek naar de kwaliteit van chocoladevla en - toetjes
Oortwijn, H. ; Herstel, H. - \ 1983
Wageningen : RIKILT (Verslag / RIKILT 83.50) - 23
desserts - custardpudding - chocolade - voedselsamenstelling - voedselkwaliteit - kwaliteitscontroles - monsters - desserts - custard - chocolate - food composition - food quality - quality controls - samples
Er werden 20 monsters chocoladevla en 13 monsters chocoladetoetjes chemisch, microbiologisch en sensorisch onderzocht.
|Voederwaardeaspekten van cacaoschroot
Steg, A. ; Rijpkema, Y.S. - \ 1975
Hoorn : [s.n.] (Intern rapport / Instituut voor veevoedingsonderzoek Hoorn no. 81) - 30
bijproducten - chocolade - cacao - voedselindustrie - byproducts - chocolate - cocoa - food industry
|Onderzoek naar de noodzaak van voorbehandeling van cacao - afvalkalk bij toepassing in de tuinbouw
Boon, J. van der; Kolenbrander, G.J. ; Wiersum, L.K. - \ 1963
Groningen : [s.n.] (Rapport / Instituut voor bodemvruchtbaarheid, Groningen 1963, no. 11) - 28
chocolade - cacao - kunstmeststoffen - vliegas - fruitgewassen - industrieel afval - mest - plantenvoeding - vuilnis - residuen - afval - chocolate - cocoa - fertilizers - fly ash - fruit crops - industrial wastes - manures - plant nutrition - refuse - residues - wastes