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Table 4 The use of biscuit in clinical trial

From: Biscuits: a systematic review and meta-analysis of improving the nutritional quality and health benefits

Health concern

Additional product

Additional product properties

Administration mode

Result

References

Micronutrient deficiency

Multi-Micronutrient

Improvement of micronutrient status

30 g biscuits, 5 days/week /4 months

Improvement of the concentrations of hemoglobin (+ 1.87 g/L), plasma ferritin (+ 7.5 mg/L), body iron (+ 0.56 mg/kg body weight), plasma zinc (+  0.61 mmol/L), plasma retinol (+  0.041 mmol/L), and urinary iodine (+  22.49 mmol/L); reduction of the risk of anemia (40%) and deficiencies of zinc (40%) and iodine (40%).

Nga et al. 2009

Iron fortification

2 or 3 biscuits / 6 d/week/ 28 weeks

Improved iron status and reduction of blood lead concentrations (4.3 μg/dL to 2.9 μ g/dL for NaFeEDTA)

Bouhouch et al. 2016

Roasted almonds

Monounsaturated fatty acids, polyunsaturated fatty acids, fiber, and vitamin E

56 g of almonds biscuits / day / 4 weeks

Decreased total cholesterol (5.5%), low-density lipoprotein cholesterol (4.6%), and non- high-density lipoprotein cholesterol (6.4%) and increased plasma α-tocopherol (8.5%) compared to the biscuit control.

Jung et al. 2018

Weight loss

Whey protein and wheat bran

Highest satiety feeling

50 g / day / 8 weeks

Control appetite (Composite appetite score: − 3.12), more decrease of energy intake (− 1531.13 KJ/day), body weight (− 2.91 Kg), waist circumference (− 4.44 cm), and serum insulin (− 2.31 mIU/L); more increase GLP-1 (+ 0.05) and more attenuate reduction of HDL-C level (+ 1.18 mg/dl) comparatively to control biscuits.

Hassanzadeh-Rostami et al. 2020

Soy fiber

Rich source of dietary fiber

100 g/day / 12 weeks

Significant decrease of body weight (− 1.39 kg), body mass index (− 0.51), waist circumference (− 1.75 cm), diastolic blood pressure (−  3.82 mmHg), serum levels of total cholesterol (− 0.58 mmol/L), LDL-C (− 0.41 mmol/L), and glucose (− 0.95 mmol/L), body fat (− 0.71 kg), and trunk fat (− 0.64 kg) for those who consumed the supplemented biscuits comparatively to those who consumed the control biscuit.

Hu et al. 2013

Flaxseed flour

Rich source of dietary fiber

100 g of biscuits / day / 60 days

Decrease body weight (− 0.83) and lower triacylglycerol levels (− 0.04 mmol/L) comparatively to control group

Kuang et al. 2020

Type 2 diabetes

Carbohydrate

Rich source of bioactive components

56 g /day / 8 weeks

Significant reduction of serum total cholesterol/HDL-C ratio in women those consumed almond snack compared to those who consumed biscuit snack (− 0.36 mmol/L vs. -0.14 mmol/L)

Bowen et al. 2019

Glucomannan and xanthan

High fiber content

10 g / biscuit

Reduction of the glycemic index by 74% in healthy participants and by 63% in participants with diabetes

Jenkins et al. 2008

Post-prandial folate bioavailability

Folic acid

Folate plasma availability

_

Biscuit and custard have presented comparable folate bioavailability

Buffière et al. 2020

Serum cholesterol reduction efficacy

Plant stanol ester

Low-density lipoprotein cholesterol -(LDL-C-) lowering efficacy

1 biscuit / day / 2 weeks

Compared to the control, the total cholesterol, LDL-C, and the LDL/HDL ratio had serum reductions of 4.9, 6.1, and 4.3%, respectively

Kriengsinyos et al. 2015

Birth weight and perinatal mortality

groundnut

Reduce the retardation of fetal growth

2 biscuit (4.3 MJ*2)/day / 20 weeks

Increased weight gain in pregnancy (136 g) over the whole year and significantly increased birth weight (11.1% of babies with low birth weight for the intervention group against (17% for the control group).

Ceesay et al. 1997

Parasitic infections

Multi-Micronutrient

Decreased parasite load and improved cognitive outcomes

30 g biscuits, 5 days/week / 4 months

Decrease of Ascaris (− 2328 eggs per gram of feces) and Hookworm (− 156 eggs per gram of feces) and improve cognitive outcomes. These values are higher than those of the group consumed placebo (− 1200 for Ascaris and − 144 for Hookworm).

Nga et al. 2011

Gastrointestinal symptoms and autism spectrum disorders

Gluten-free biscuit (GFB)

Reduction of the prevalence of gastrointestinal symptoms and autism spectrum disorders behaviors

Gluten-free diet / 6 weeks

Significant (P < 0.05) decrease of the prevalence of gastrointestinal symptoms after intake of GFB (40.57% vs. 17.10%) against an insignificant increase in the regular diet group (RD) (42.45% vs. 44.05%). GFB also induces a significant decrease in behavioral disorders (80.03 vs. 75.82) against an insignificant increase in the regular diet group (79.92vs. 80.92).

Ghalichi et al. 2016

Prebiotics effect

Partially hydrolysed guar gum and fructo-oligosaccharides

Prebiotic effects

37.5 g / day / 21 days

Bifidobacterial numbers increased from pretreatment levels of 9. 10 log 10 cells/g faeces and placebo levels of 9. 18 log10 cells/g faeces, to 9. 59 log10 cells/g faeces after ingestion of the experimental biscuits.

Tuohy et al. 2001

Neurocognitive outcomes

Soy protein

Protein dietary supplementation

Biscuits 5 days / week / 18 months

Improvements of nonverbal cognitive (fluid intelligence) performance for children who received soy protein than those who received ASFs. For example, beery visual-motor integration for children who received soy protein is 7.44 and 6.70 for children who received beef.

Loo et al. 2017