bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood pressure by age group in type 2 diabetics mellitus users of primary health care centres in Copiapó (Chile): a cross-sectional study
Authors: Rojas J , Fernández-Cao JC. , Doepking C. , Aguirre C , Fernández G. , Trigo D. , Cremer K. , Vergara G. , Varas N. , Cuadra C. , Garrido V. , Quinteros M , Rojas C
Published: December 2024

Diabetes mellitus is a serious worldwide public health problem due to its high prevalence. In Chile, 1.7 million people have been diagnosed with diabetes mellitus, of which 90% are type 2 diabetes mellitus (T2DM) cases(1). It is well known that blood pressure (BP) control is essential to prevent future complications and to ensure a positive prognosis for this disease (2). Moreover, studies in Chile have shown a significant increase in systolic and diastolic blood pressure (SBP, DBP) levels in T2DM subjects compared to the non-diabetic Chilean population (3). Therefore, this study aimed to determine and compare SBP and DBP levels according to age group in T2DM patients of primary health care centres (PHCC) in Copiapó, Chile.

Cross-sectional study within the CODIACO cohort. Data were collected from April to August 2023 on 161 patients with T2DM from eight PHCCs of Copiapó. Patients diagnosed with T2DM, of both sexes and aged between 30 and 65 years were included. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer and severe inflammatory or infectious diseases were excluded. To estimate BP, three measurements were taken every five minutes. Three age groups were established: ≤ 50 (n = 36), 50-60 (n = 74) and ≥ 60 years old (n = 51). Blood pressure results were expressed as mean and standard deviation of mmHg unit. Normal distribution was analysed using the Kolmogorov-Smirnov test corrected for Lilliefors. In addition, the one-way ANOVA test was used to compare SBP and DBP between age groups. Bonferroni was used for post hoc testing. A P-value < 0.050 was considered statistically significant. Data were analysed using SPSS software. The study was conducted according to the ethical standards of the Declaration of Helsinki and its subsequent modifications. The CODIACO study was approved by the Scientific Research Ethics Committee of the University of Atacama. The project was funded by FONDECYT N° 11180794

The mean of systolic blood pressure (SBP) for the ≤ 50, 50-60 and ≥ 60 year groups, was 123.92 ± 14.38; 133.23 ± 18.36; 135.88 ± 15.02 mmHg (p = 0.003); respectively. Bonferroni test indicated a significant difference in SBP between the group ≤50 and 50-60 (p = 0.019) and ≥60 year groups (p = 0.003), but not between 50-60 and ≥60 year groups (p = 1.000). The ANOVA did not show a significant difference in diastolic blood pressure (DBP) between groups (p = 1.000).

The results suggest that SBP levels of T2DM patients in PHCCs of Copiapó are higher in older age groups (50-60 and ≥60y) compared to the younger age group ≤50y). No significant differences were found in DBP.
Understanding Searches for ‘Weight Loss’ Using Google Trends
Authors: Iqbal M. , Morris M.A. , Cade J.E.
Published: December 2024

It is common for individuals to seek information online when facing health and nutritional problems, particularly those with lower education level and nutritional knowledge(1). One way to access such information is through search engines, with Google being the most popular, currently used by 92% of the world’s population, with an average of 85.59 billion monthly visits(2). Google Trends is a tool provided by Google, freely accessible, allowing users to observe patterns in internet searches(3). The aim of this study is to identify patterns to predict trends related to weight loss at specific times.

Data were extracted from Google Trends over the past 20 years, from 2004 to 2024, using the keywords “weight loss” and “diet.” In Google Trends, users may input a keyword consisting of words or phrases that are relevant to the chosen issue or cases. The duration of time that users wish to examine can be specified. Furthermore, users can explore geographical regions or search worldwide. Figures generated represent search interest based on the highest points on the graph for specific regions and times. The popularity of search terms is relative and depends on the category: search term or topic. Data is normalised and presented on a scale from 0-100, where each point on the graph is divided by the highest point, or 100. A value of 100 indicates peak popularity, 50 indicates half popularity, and 0 indicates insufficient data for the term.

Over the past 20 years, there has been an increasing trend in searches for websites using the keyword “weight loss,” with an average interest score of 31. This differs from the keyword “diet,” which has shown a tendency towards stagnation in popularity, although it briefly peaked with a score of 100 in early 2014 and has an average interest score of 53. Both keywords exhibit similar search patterns, reaching their highest peaks each year in January and lowest points in December.

For the keyword “weight loss,” the most searches were from South Africa (100), Romania (96), and Vietnam (91), while the lowest were from Italy (4), Japan (5), and the Netherlands (9). For the keyword “diet,” the most searches were from Poland (100), Kuwait (87), and Greece (85), while the lowest were from Japan (2), Thailand (7), and France (11). Users also searched for other related topics or queries including ozempic and intermitten fasting.

Our data indicates a consistent increasing trend in searches for weight loss over the last 20 years via Google Trends. New Year resolutions may be linked to peak searches which occur in January. While this data may prove useful for researchers and policymakers, further validation of its validity and reliability is necessary.
Pulse-rich diets and risk of cardiovascular diseases: findings from the UK Biobank prospective study
Authors: Olotu O.A , Kaimila Y , Clegg M.E , Jackson K.G , Lovegrove J.A
Published: December 2024

Cardiovascular diseases (CVDs), including ischemic heart diseases (IHD) and stroke, are a leading cause of death globally and significantly impact quality of life(1). Current guidance suggests increasing the consumption of pulses rich in fibre and iron, to reduce CVD risk(2). However, longterm observational studies investigating pulse consumption and CVD incidence are limited(3). In the current analysis, the UK Biobank, a prospective cohort study of over 500,000 UK adults was used to investigate the association between pulse consumption and CVD incidence(4).

A total of 119,914 (males: 51,540 and females: 68,374) participants with ≥ two 24-hour dietary recalls, not pregnant and free from CVD at baseline were included. Total CVD was defined as IHD and cerebrovascular diseases. Multivariable-adjusted Cox proportional hazard regression models were used to estimate the incidence of CVD by pulse consumption, reported as hazard ratios (HR) and 95% confidence intervals (CI). Pulse consumption was modelled as a categorical variable with non-consumers (0g/day, n = 76,531) and 3 tertiles (T) of pulse intake T1 (1-20.4g/day, n = 14,785); T2 (20.5-40g/day, n = 14,015); T3 (40.5-360g/day, n = 14,583). The fully adjusted model was controlled for sex, age, dietary energy, region, ethnicity, smoking status, physical activity level, education, income, employment, body mass index (BMI), alcohol intake, supplement use, processed red meat intake, sodium intake and trans-fatty acids intake, family history of stroke, heart disease and diabetes, insulin use, blood pressure or cholesterol-lowering medication use. The analysis was performed in STATA 18.

The cohort had a mean ± SD age of 55.9 ± 7.8 years, BMI of 26.6 ± 4.5 kg/m2 and pulse intake of 13.2 ± 24.3 g/day. There were 8,937 incidences of CVD after a mean follow-up of 12.4 years. Compared with non-consumers, pulse intake was not significantly associated with the incidence of total CVD, T1 (HR: 0.95, CI: 0.89–1.01),T2 (HR: 0.98, CI: 0.92–1.05), T3 (HR: 0.97; CI: 0.91–1.04).

In conclusion, pulse-rich diets were not significantly associated with a lower total CVD incidence in middle-aged adults participating in the UK Biobank compared to non-consumers. Further work will model the replacement of red and processed meat with pulses on CVD incidence and mortality.

Funding was received from BBSRC (BB/W017946) for the project “Raising the Pulse: Systems analysis of the environmental, nutritional and health balance of staple foods”. This research has been conducted using the UK Biobank Resource under application number [101928].
Diet quality according to age group of subjects with type 2 diabetes mellitus from primary health care centres in Copiapó (Chile)
Authors: Fernández-Cao JC , Doepking C , Rojas Calisto J , Aguirre C , Vigorena A , Quinteros M , Vergara G , Varas N , Cuadra C , Garrido V , Bustos M , Rojas C
Published: December 2024

Globally, 537 million adults (20-79 years) had diabetes mellitus in 2021 (10.5%), and the estimate is projected to rise to over 643 million (11.3%) by 2030 (1). The estimated prevalence for Chile was 12.7%, 90–95% of which were type 2 diabetes mellitus (T2DM) cases (1). In the last decades, it has been shown the importance of diet quality in the management and prognosis of T2DM (2). Therefore, this study aimed to evaluate diet quality in subjects with T2DM from primary health care centres (PHCC) in Copiapo according to age group.

A cross-sectional study was performed within the CODIACO cohort, with data collected on 160 participants during 2023. This population-based study involved women and men from 30 to 65 years, with T2DM, and users of PHCCs of Copiapo. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer, and severe infectious or inflammatory diseases were excluded. Sociodemographic data were recorded, and diet quality was measured through a Mediterranean dietary index (MDI) validated in the Chilean population (3). Participants were categorised by age (≤ 50 years, 50-60 years, ≥ 60 years). The following categories were considered for MDI score: high (9-14 points), moderate (5-8.5 points), and low (<5 points) adherence. One-factor analysis of variance with the Bonferroni correction test and Chi-square test were used to assess differences in MDI according to age groups. The results were expressed as percentages or mean and standard deviation. A p-value of less than 0.050 was considered statistically significant. The CODIACO study was approved by the Scientific Ethics Committee of the University de Atacama. The project was funded by FONDECYT (N° 11180794).

The mean age of the participants was 55.64 ± 7.48 years, and the MDI score was 6.28 (moderate diet quality). 19.4% of subjects (≤ 50 years, 13.7% of those aged 50-60 years, and 27.5% of those ≥ 60 years had low diet quality. Moderate diet quality was found in the majority of individuals from the three groups, with 72.2%, 78.1%, and 60.8%, respectively. Only 8.3% of the subjects ≤ 50 years, 8.2% of those aged 50-60 years, and 11.8% of those ≥ 60 years had high diet quality. No significant differences were observed between the means of the MDI scores of each group (p = 0.578), nor in the proportion of subjects with low, medium or high diet quality in each group (p = 0.325).

The findings of the present study showed subjects with T2DM and users of the PHCCs of Copiapo (Chile) had a moderate diet quality, mainly. The proportion of patients with low, moderate, and high diet quality was similar among those ≤ 50 years, those 50-60 years, and those ≥ 60 years. Further investigations are needed to evaluate in depth the diet in this population.
Food consumption frequency in patients with type 2 diabetes mellitus users from primary health care centres of Copiapo (Chile)
Authors: Fernández-Cao JC , Doepking C , Rojas J , Cayo V , Barraza A , Vigorena A , Correa G , Cremer K , Aguirre C , Rojas C
Published: December 2024

Currently, diabetes mellitus is a major health problem affecting 12.7% of people between ages 20 and 79 years in Chile, 90-95% of whom have type 2 diabetes mellitus(1). Diet is a cornerstone in the management of this pathology(2). Therefore, the aim of this study was to describe the food consumption frequency in subjects with type 2 diabetes mellitus and users of primary health care centres in Copiapo (Chile).

A cross-sectional study was conducted on 160 participants of the control of diabetes cohort (CODIACO) study in 2023. Women and men from 30 to 65 years with type 2 diabetes mellitus and users of primary health care centres of Copiapo were selected for the investigation. Pregnant and lactating women, and patients with diabetic neuropathy/nephropathy, cancer, and severe infectious or inflammatory diseases were excluded. It was administered a questionnaire about the frequency of consumption of certain food groups (fresh fruits; raw, cooked, precooked and frozen vegetables; nuts; legumes; blue and white fish; seafood; red and white meats; viscera; sausages; sweet ultra-processed foods; water; juices; carbonated drinks; coffee and tea), recording the frequency with which they were consumed (never, seldom, occasionally and usually). The results were expressed as mean and standard deviation or percentages. The CODIACO study was approved by the Scientific Ethics Committee of the University de Atacama. The project was funded by FONDECYT (N° 11180794).

The age of the 160 participants was 55.64 ± 7.48 years. Usual consumption of raw or cooked vegetables (80.0%), fresh fruit (71.3%), legumes (55.6%), and white meat (75.0%) was reported by the great majority of the individuals. To a lesser extent, nuts (36.3%), white fish (31.9%), blue fish (30.6%), and red meat (30.0%) were also widely consumed on a regular way in these subjects. In contrast, pre-cooked (66.9%), frozen vegetables (57.6%), seafood (55.0%), sausages (65.7%), offal (84.4%), juices (55.7%), carbonated beverages (65.0%) and coffee (57.2%) were seldom or never consumed, mostly.

The results suggest relatively regular consumption of fruits, vegetables, legumes, and white meats in subjects with type 2 diabetes mellitus, users of primary health care centres in Copiapo (Chile). Otherwise, viscera, sausages, and precooked and frozen vegetables, as well as juices and carbonated beverages seem to be relatively little consumed in this population. Additional studies are required to know in depth the dietary habits of subjects with type 2 diabetes mellitus from the north of Chile.
Characterisation of sedentary lifestyle in patients with Type 2 Diabetes Mellitus in Family Health Centres
Authors: Jiménez S , Fernández-Cao JC , Doepking C , López A , Vega F , Fernández G , Balboa K , Trigo D , Flores J , Bustos M
Published: December 2024

Diabetes Mellitus (DM) represents a significant public health concern with a global impact(1,2). According to the International Diabetes Federation, in 2021 the global prevalence of this pathology was 10.5% and 12.7% in Chile(3). Of these cases, 90% are cases of type 2 Diabetes Mellitus (DM2). One of the risk factors for its management and prognosis, once diagnosed, is a sedentary lifestyle(3). A sedentary lifestyle rate of 86.7% has been reported in Chile(4). However, to our knowledge, there is no data on sedentary lifestyles in the diabetic population of the commune of Copiapó. Therefore, this study aimed to describe and compare the level of sedentary lifestyle in women and men with DM2 in the Family Health Centres (CESFAM) of Copiapó (Chile).

A cross-sectional study was conducted using data obtained from participants in the CODIACO cohort. Twenty-five individuals, comprising both sexes and aged between 30 and 65 years, diagnosed with DM2 and users of the CESFAMs of Copiapó, were included. These individuals also had mobile devices capable of installing the accelerometry application ‘Physics Toolbox Sensor Suite’. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer, and severe inflammatory or infectious diseases were excluded. They were asked to activate and deactivate the application for 7 to 12 days, at waking and bedtime, respectively. Physical activity and sedentarism were determined when the accelerometer was over or below 0.6 mm/sec2 respectively from the total daily activity (%). WhatsApp transmitted the information recorded to estimate each participant’s sedentary lifestyle level. A Student’s t-test for independent samples was employed to compare the percentage of sedentary behaviour between women and men. The results were expressed as the mean and standard deviation. A P-value of less than 0.05 was considered statistically significant. The CODIACO study was approved by the Scientific Research Ethics Committee of the Universidad de Atacama. The project was funded by FONDECYT N° 11180794.

The number of women in the sample was 19 (76%) and the number of men was 6 (24%). The values of sedentary lifestyle for women were 85.32 ± 9.5%, which was similar to those found in men, 82.5 ± 10.31%. Although women show a higher tendency to increase sedentary lifestyle behaviour, The T-test did not determine differences between sexes (p>0.05), maybe, due to the high number of women compared with men in the sample.

The level of sedentary lifestyle in patients diagnosed with DM2 in the CESFAM of Copiapó is high and is in line with that observed in the general population in Chile. Furthermore, no differences are observed between men and women. Further studies are required to confirm this result and to investigate its cause to generate strategies to help reduce sedentary lifestyles in this population.
Prospective association between ultra-processed food consumption and incidence of type II diabetes: the UK Whitehall II cohort study
Authors: Wang M.E. , Iewellyn C. L , Kastoulis M. , Britton A.
Published: December 2024

Ultra-processed foods (UPFs) consumption, characterized by high levels of sugars, unhealthy fats, and additives, yet low in nutrients, has increased significantly in recent decades(1). Previous studies have demonstrated the link between UPF consumption and Type 2 diabetes (T2D)(2). Considering the variation in these food categories across studies and the scarcity of large-scale studies focusing on specific UPF subgroups, this study aims to explore the prospective association between UPFs, their subgroups, and the incidence of T2D in a UK based cohort study.

A total of 7,774 participants aged 40-69 years without T2D (69% men and 31% women) from the Whitehall II cohort, who had dietary intake data at baseline (1993/1994) and follow-up data on T2D incidence available, were included in the analyses. Food intake was assessed using a validated 127item food frequency questionnaire (FFQ). We applied the NOVA classification to categorize FFQ items into four classes based on the level of processing. The intake of UPFs per day was calculated as a percentage of the total daily food intake in grams to account for UPFs that do not provide energy. The incidence of T2D was evaluated from 1993/1994 to 2007/2009 through self- reports and oral glucose tolerance test results. Multivariate Cox regression models were employed to assess the prospective association between UPFs consumption (in quintiles) and T2D risk, adjusting for socioeconomic factors, family history of T2D, lifestyle characteristics, total energy intake, and indicators of nutritional quality.

During the 15-year follow-up, 954 cases of T2D were confirmed. In multivariable models adjusted for family history of T2D, socioeconomic, and lifestyle factors, the highest UPF consumption quintile [mean 33% of total daily intake (grams)] was associated with an increased risk of T2D [HR: 1.35, 95% CI: 1.06-1.71] compared to the lowest quintile [mean 9.6% of total daily intake (grams)]. Adjustment for total energy intake slightly increased the risk of T2D [HR: 1.46, 95% CI: 1.12-1.91].

Additional adjustments for sugar, sodium, and fat intake further increased the risk of T2D [HR: 1.51, 95% CI: 1.15-1.98]. Among UPFs subgroups, only the intake of soft drinks was significantly associated with an increased risk of T2D [HR: 1.02, 95% CI: 1.01-1.08], whereas no significant associations were found for other UPFs subgroups. Similar results were found after multiple imputation of missing values.

In UK midlife adults, higher UPF consumption tends to be prospectively associates with an increased risk of T2D, with notable variations across UPFs subgroups. These findings suggest that the association between UPFs intake and T2D might be independent of nutritional quality and energy intake, indicating that food processing itself could be a contributing factor. This study provides evidence to support efforts to limit UPF consumption as a strategy to alleviate the population burden of T2D.
Maternal and infant food insecurity: A qualitative investigation into women’s experiences during and after pregnancy in South London
Authors: Flynn A. , Marshall J , Davies L , Lambeth HDRC , Lavelle F. , Harding S. , Bell Z.
Published: December 2024

A period of the life course where optimal nutrition and food security are crucial for the life-long health and wellbeing of women/birthing parents and infants is preconception, pregnancy, and infancy.(1) It is estimated that nearly one in every four households with pre-school children (0-4 years) experience food insecurity (FI) in the UK.(2) Yet, we lack an evidence-base exploring experiences of FI in this life course stage.(3,4) This study aimed to explore women’s experiences of food insecurity during and after pregnancy, including its influence on infant feeding decisions.

This study was ethically approved (Ref No: LRS/DP-23/24-39437) and pre-registered on OSF Registries (https://osf.io/9hn6r). Semi-structured mixed format individual interviews were conducted between November 2023 and February 2024. Pregnant individuals, those who had given birth ≤12 months ago, ≥18 years old, food insecure, residing in South London and with recourse to public funds were recruited through purposive sampling. The topic guide was informed by FI, pregnancy and postpartum related literature and piloted (n = 2). Interviews were audiorecorded and professionally transcribed. Demographic data was summarised using SPSS. Inductive thematic analysis was used to analyse the data and was completed using NVivo.

Eleven food insecure participants (2 pregnant, 9 new mothers; 2 White European, 9 Black African/Caribbean/British women) participated in the study. Six women were 0-6 months postpartum, and 3 women were between 6-12 months postpartum. The preliminary findings are represented by three themes: 1) A dichotomy: knowing vs affording, 2) Adaptive food coping strategies, and 3) Infant feeding practices. Participants shared detailed accounts of valuing a healthy diet and adapting food practices, yet they still were unable to meet their dietary needs and desires during and after pregnancy. Participants described worry around breastmilk supply; quality and quantity. Complimentary feeding was also identified as a source of worry. “She is still breastfeeding fully. I don’t want to change to milk, which maybe, sometimes, I might not be able to afford it…I won’t stop until she is 1.”Whilst the cost of formula feeding was a driver of a more severe experience of FI.

Policy and practice recommendations include enhancing local breastfeeding support to address FI specific concerns around breastmilk supply and at national level, advocating for greater support for adequate healthy food provision and for a price cap on infant formula. Future interventions must support maternal mental health given the high cognitive stress identified with living with FI during and after pregnancy. Further high-quality research is needed 1) amongst asylum seekers and refugees and non-English speakers who may also experience FI, and 2) exploring cultural influences on breastfeeding and the relationship with FI.
Exploring the impact of cost-of-living-crisis on the dietary practices and health impact among immigrant Nigerians in the UK
Authors: Johnson B. , Sharma M. , Ellahi B.
Published: December 2024

Morbidity and mortality from preventable diseases among ethnic minority groups are higher when compared with white population group in the UK(1). Diet is a major modifiable disease risk factor and depends on several factors, including the affordability and availability of foods commonly consumed by these communities. With families now bearing the burden of inflation with an increase in the price of food, and with people adapting to this by adjusting their spending, the widening of health inequality is reported(2).

Understanding of the impact of the cost-of-living crisis (COLC) on the dietary practice and health of ethnic minority populations is limited(2). This study explored the impact of dietary choices in the immigrant Nigerian community living in the UK, within the context of a COLC.

Using hermeneutic phenomenological design and with the aid of purposive sampling, community networks, and snowballing were leveraged to assist in recruiting participants from the Nigerian population in Manchester and London based on age, gender, and socio-economic factors. Utilising an informed consent process, fifteen one-to-one telephone semi-structured interviews were undertaken, and detailed information about culture, dietary choices, and the cost-of-living crisis was collected.

The six-step guide Braun & Clark’s Reflexive thematic analysis of verbatim transcribed data from the audio-recorded interviews revealed adaptive and coping strategies have been adopted(3). Participants report what they now eat, and activities adopted to support eating. This includes purchasing cheap, low-quality, and reduced quantities of food, reducing wastage of food through preservation of any excess, bulk cooking, or preparation to minimise energy usage. Other cost savings are being made through, cutting down on social engagements (e.g. eating out and nightlife), A focus on food ‘’needs’’ and not ‘’wants’’, a reliance on social networks for support and assistance, the use of food banks, and skipping meals is also reported. One participant: ‘’This has affected our diet. So, it’s been very challenging. I mean generally, everywhere the cost of things is high’’. (GregM61). Another said, “I just cook enough for two days so that I can save some energy and reduce my energy bills”. (KhadijatF45). Illustrating the impact on health one participant suggested: ‘’When you have a cheap cost of meat and a cheap cost of carbohydrates, then you are eating badly’’. (EkongM51).

These findings cause concern since cheap and low-quality diets eaten by ethnic minority communities are known to be unhealthy and are high-risk factors for chronic diseases(4). The need for long-term support for individuals or groups most at risk of the COLC, and an ongoing need to develop culturally appropriate strategies to support healthy eating on a budget for this ethnic group are paramount to prevent poor health outcomes in this group.
Building belonging: the role of community cafés
Authors: Sumpter S. , Nancheva N. , Ranta R. , Bhakta D. , Mulrooney H.
Published: December 2024

Community cafés are non-profit ventures tackling food insecurity (FI) locally and equitably, primarily using pay-as-you-feel models(1). FI is most prevalent in low-income and other vulnerable groups(2), in whom poor diets and worse health also intersect(3). Despite recognition that FI is largely driven by poverty and inequity(4), FI individuals are often negatively judged(5), risking further marginalisation. Community approaches to tackling both food waste and FI include community cafés, which frequently utilise surplus foods(1) to produce fresh meals and/or donate surplus food to those in need. Beyond a nutritional impact, community cafés have the potential to offer marginalised groups a safe space and a feeling of inclusion, benefitting their mental health and wellbeing. The aim of this study was to explore the social impact of community cafés.

Two linked community cafés in a London borough were evaluated to explore their social impact on clients. Both operated using pay-as-you-feel; neither required proof of need. Evaluations were undertaken using mixed methods on 9 site visits (November 2022 - April 2023). Bespoke questionnaires (n = 72) and 4 interviews were completed by clients, and 40 interviews with volunteers. Thematic analysis of qualitative data and Kruskal Wallis analysis (posthoc Dunn’s and Bonferroni correction) of quantitative data were carried out.

Both cafés relied on surplus food. Their primary priorities were tackling food waste and the environment followed by addressing FI. Qualitative and quantitative data from interviews and questionnaires revealed that for many clients, social and food provision were equally important. This was especially true for older clients; significantly more of those aged ≥65 compared with those aged 18-24 yr visited for social reasons (p = 0.02). The most highly rated aspects of provision for clients were the friendliness of the people and the helpfulness of the staff (98.7 and 97.1% respectively). Being able to meet and talk was identified as important by 70.1% of clients. Anecdotally, this was especially important to marginalised groups like migrants and refugees. Since referral to the cafés was not needed, clients included individuals utilising them for environmental reasons as well as those affected by FI. This allowed mixing among groups who would not ordinarily meet. Volunteers also highlighted this as key to enable them to hear the stories of those they served. The mixed clientele not only helped build community but helped reduce stigma, since FI was not the sole reason for attending. For volunteers, the open and accepting nature of community provision which did not require referral or proof of need, was valued.

The data suggest that community cafés have important value beyond nutrition, enabling formation of community networks and increasing understanding of the lived experience of those with FI.
Associations of eating rate with postprandial glycaemic and insulin responses, gastric emptying, food and energy intake in older adults (aged ≥65 years)
Authors: Zannidi D. , Methven L. , Woodside J.V. , McKenna G. , Forde C. G. , Shafat A. , Clegg M. E.
Published: December 2024

The population of older individuals worldwide is increasing and achieving a good quality of life in older age is vital(1). However, anorexia of ageing, a phenomenon often associated with delayed gastric emptying and reduced oral processing abilities(2), can negatively affect older adults’ health, quality of life and contribute to undernutrition(2). In younger populations, slower gastric emptying has been associated with greater satiation and satiety(3), and slower eating rates with reduced food intake and postprandial euglycemia(4); however, little is known about these associations in the older adult population. This study investigated individual variations in food oral processing and their influence on postprandial glycaemic and insulin responses, gastric emptying, food and energy intake, in healthy adults, aged ≥65 years.

Participants attended a single visit day, after an overnight fast. A fixed-portion breakfast meal was provided and consumption was video-recorded for behavioural-annotation to quantify specific oral processing behaviours. Postprandial glucose and insulin responses were assessed via mixedcapillary fingerprick samples, and gastric emptying was measured with the 13C-octanoic acid breath test(5). Three hours post breakfast, an ad libitum lunch was provided, where eating rate and food intake were measured. Food and drink intake for the rest of the day was assessed using a weighed food diary. Participants were classified as slower and faster eaters using a median of eating rate (g/min) of the breakfast meal, with an even number of males and females in each group. Repeated measures ANOVA and multiple regression analysis were used to explore the relationship between ad libitum intake and the parameters outlined above.

Eighty-eight older adults were recruited, 44 males and 44 females, with mean age 73.7 ( ± 5.3) years.

For the three hours postprandially, both glucose and insulin changed significantly over time (Fglucose = 150.779, p <0.001 and Finsulin = 111.645, p <0.001), but no differences observed between faster and slower eaters (p >0.05). Similarly, gastric emptying did not differ between faster and slower eaters (p >0.05). At the ad libitum meal, eating rate of the meal was the only significant predictor of energy intake (r = 0.685, p <0.001), after accounting for age, gender and the postprandial (post breakfast) metabolic responses, gastric emptying and subjective satiety.

This study found no effect of eating rate on postprandial glycemia or gastric emptying in older adults, but showed significant association of eating rate during the meal on food and energy intake. These findings could provide implications in the design of texture-appropriate foods for this age group for future meal interventions.
Exploration of self-perceived masticatory ability and measured biting force on nutrient intakes in older Thai adults
Authors: Nitsuwat S. , Marshall L. , Sranacharoenpong K. , Sarkar A. , Cade J.
Published: December 2024

As the global population ages, understanding the factors influencing older adults’ health and wellbeing becomes increasingly important. Aging can lead to various health complications, including reduced muscle strength, affecting daily activities such as food consumption(1). The decline in oromasticatory muscle function can cause chewing difficulties that limit food choices(2). Given that adequate nutrition is essential for maintaining the quality of life, this study aims to examine the relationship between self-perceived chewing ability and objectively measured biting force to understand the extent of their effect on nutrient intake.

A total of 148 community-dwelling older adults aged 64 to 90 years old (median age 71 ± 8 years) from urban (Bangkok Metropolitan Region) and rural (Chonburi Province) areas of Thailand participated. Maximum biting force (Newtons, N) of the posterior teeth was instrumentally measured, and participants rated the chewing difficulty of 20 commonly consumed foods as easy, difficult, or cannot be chewed at all. Foods were grouped into five difficulty levels by principal component analysis of the ratings and masticatory ability scores (0 to 10) were calculated. Food intake was obtained from 24-hour dietary recalls through interviews and body mass index (BMI) data was obtained.

Participants were grouped into tertiles of low (median = 73 N; IQR = 37–127), moderate (median = 336 N; IQR = 241–387), and high (median = 512 N; IQR = 477–512) biting force. A Kruskal-Wallis test revealed that those with low biting force had significantly (p < 0.01) lower self-assessed masticatory ability scores (median = 7.69) compared to those with high biting force (median = 8.86). Significant differences in the daily intakes of dietary potassium, magnesium, and vitamins B1, B2, B6, and C were observed between the high and low biting force groups (p < 0.01).

However, multiple regression analyses adjusted for age, sex, education, and location did not show significant predictive power for any nutrient intake from either biting force or masticatory ability, except for positive associations with vitamins C and B2, and fruit intake. A unit increase in mastication ability was associated with an increase in daily intake of 0.21 milligrams of vitamin C (95% CI = 3.03, 33.64; p = 0.02) and 0.19 milligrams of vitamin B2 (95% CI = −0.01, 0.13; p = 0.03).

Additionally, a unit increase in biting force was associated with an increase in daily fruit intake of 0.17 grams (95% CI = −0.02, 0.28; p = 0.08). No relationships with BMI were observed for either biting force or masticatory ability.

Higher biting force in older adults improves self-perceived masticatory ability, leading to a higherquality diet with foods rich in vitamins B2 and C, such as meat and fruits. Targeted interventions to enhance biting force could help prevent malnutrition.
Whole Grain Intake in the United Kingdom Remains Unchanged from 2008/9 to 2018/19 and Well Below Recommended Levels
Authors: Kutepova Inga , Rehm Colin D , Joy Friend Samara
Published: December 2024

Whole grain (WG) consumption has been associated with many health benefits(1–4). However, in the UK, there is a lack of WG intake data with the most recent analysis available spanning the years 2008-2011(5–7). In this study, our aim is to assess the consumption of whole grains among the UK population using data from the National Diet and Nutrition Survey (NDNS) rolling programme covering the years 2008 to 2019.

WG intake trends and sociodemographic patterns from the UK NDNS Rolling Programme, 2008/09 to 2018/19, of 15,655 individuals aged ≥1.5 years who completed a four-day food diary were analysed. WG consumption was assessed by examining the WG content of foods in grams based on product ingredient information. Survey-weighted mean consumption of whole grains overall and by socio-demographic group and health status variables. Survey-weighted Wald tests (for categorical variables such as ethnicity) and trend tests (for ordered variables such as age group) will be used to determine whether intakes of whole grains differ within category.

No statistically significant trend was observed in total WG intake when comparing the intakes from 2008-2012 to 2016-2019, with mean intakes of 29.2g/day (95% CI: 27.8, 30.5) and 28.2g/day(95% CI: 26.8, 29.6), respectively. In 2016-2019 older adults (65y+) had the highest consumption (33.6 g/day [95% CI: 30.5, 36.8]), followed by 19-64y, with an intake of 29.1 g/day (95% CI: 27.1, 31.2). High-fibre cereals, bread, and other cereals including pasta and rice were the primary sources of WG. Between 2008-2012 and 2016-2019, the mean daily intake of high-fibre cereals and bread significantly declined from 11.1g (10.3, 11.9) to 9.3g (8.5, 10.1) and 12.4g (11.6, 13.1) to 10.0g (9.2, 10.8) respectively. Conversely, consumption of other cereals increased from 4.0g (3.3, 4.7) to 6.9g (6.1, 7.6) per day. Individuals with higher incomes, levels of education and healthy weights showed higher mean WG consumption.

Our study showed no statistically significant change in mean whole grain consumption in the UK from 2008/09 and 2018/19. Although, there is absence of dietary WG recommendations in the UK, whole grain intakes are below the recommended levels proposed by many countries.
Collecting regional data for public health focusing on diet and sustainability measures using myfood24
Authors: Cade J.E. , Rycroft C. , Beer S. , Corrigan N
Published: December 2024

There is no regular, routine measurement of food and nutrient intake undertaken regionally in the UK. This makes evaluation of local public health interventions challenging. Consumers want to be more sustainable in what they are eating. Social media penetration in the UK is 90%(1), with ∼47m people using Facebook, a potential route to study recruitment. Nutritional analysis software with accurate underpinning food composition and sustainability data could enable quick and easy large scale data collection. This study aimed to collect diet and sustainability measures using online tools and to test the feasibility of using social media to obtain a large, regionally focused sample in a short time.

We undertook a rapid, time limited, regional (Yorkshire and Humber) food and nutrient tracking survey ‘One day: Diet in Yorkshire and Humber’ for use with policy makers(2). A Facebook (FB) boost approach was used to recruit a regional sample of adults. Participants completed a brief online demographic survey and used myfood24® to give a detailed measure of their food intake for the previous day. myfood24® generic and branded databases were used(3) which include sustainability metrics.

The FB posts were boosted for 21 days and reached 76.9k individuals. Just under £1,000 was spent on 3 FB boosts and 1,428 participants completed the questionnaire. 673 participants also completed the one-day diet diary. Hull, Barnsley and Doncaster had the highest rates of overweight and obesity in the region. Overall nutrient values recorded were similar to national survey data for older women. Intakes of fibre (mean 18g, SD 11) and iron (mean 9.6mg, SD 5.0) were low. For the first time, measures of sustainability from the diet were calculated from myfood24®.

The mean greenhouse gas emissions (GHGE) were 5.9(kg CO2 eq/day) (95% CI 5.6, 6.1); land use 9.0 (m2year/day) (95% CI 7.6, 10.3) and water use 582 (l/day) (95% CI 551, 611). Regression analysis showed that for each additional 100kcal consumed there was a significant increase in GHGE of 0.9 (kg CO2 eq/day) (95% CI 0.8, 1.1). Land and water use were also significantly increased with increasing energy intake. Adjusting for total energy, protein intake was positively associated with all 3 metrics. Carbohydrate was inversely associated with GHGE and land use. However, fat intake was not associated with any of the sustainability measures. Portions of fruit and vegetables consumed were positively associated with water use only.

Diet is clearly linked to sustainability. The mean GHGE from diet is equivalent to driving an average car ∼22km/day. We successfully recruited a large sample in a short timeframe using FB. Participants were able to use online tools to report food intakes. This data is relevant to local and national policy makers to monitor and evaluate public health programmes.
From Bytes to Bites; Advancing Data Collection Methodologies for Enhanced Branded Food Insights
Authors: Kirwan L.B. , O’Sullivan E. , Hogan S. , Douglas F. , Kelly D’O
Published: December 2024

Nutrition research relies on food databases which are extensively used in dietary surveys, clinical practice, research, and policy development (1). Online data volume is expected to increase up to 180 zettabytes by 2025, due to a proliferation of internet-connected devices, the growth of social media platforms, and a digital transformation of industries (2). Webscraping, a method to extract data from websites, has been previously used in Ireland to evaluate online retailer information as a potential source for monitoring food reformulation efforts in the Irish retail market (3). This study aims to outline a process for, and evaluate the use of, webscraping on online supermarket websites to increase data availability to researchers.

An online supermarket website was selected to trial the new process. Octoparse software version 8 was downloaded. 12 data fields of interest were identified; cost, lifestyle, net weight, Directions for use, Storage instructions, Nutrition information, Front of pack information, legal name, brand name, manufacturer, ingredients, and allergy advice. A process was defined for data web scraping in four main steps; 1) collection of category level URL’s, 2) collection of product level URL’s, 3) collection of data at product level within defined fields and 4) data cleaning and re-structuring. A workflow was created in Octoparse for steps i - iii and step iv was completed using Excel version 16.69.1.

83 category level page links were generated and entered into Octoparse software. Webscraping was completed on 3,095 product level URLs. Data on 1,450 products (47%) were successfully scraped as they had data within the 12 defined data fields. A new dataset was created for the 1,450 products with data fields including information on nutrition (energy, fat, of which saturates, carbohydrate, of which sugars, fibre, protein and salt), costs per serving and per kg, lifestyle factors (e.g. whether a product was vegetarian or vegan), ingredient lists and allergy advice. 637 products (44%) were found to have vegetarian/vegan claims. Micronutrient level data was limited.

An increased availability of online data presents an opportunity for the development of new and more systematically updated datasets, and may increase the availability of information on branded products. Webscraping enables researchers to create new databases, and systematically update datasets, with less resources. This study enhances the availability of data and may enable researchers to explore new avenues for understanding food environments. Future research should test the process on additional websites to increase coverage of the Irish retail market and across different regions, identify sources with more in-depth nutritional data, and evaluate use case in mobile applications. Web scraping offers a promising tool for advancing research in food science and nutrition, and providing access to diverse datasets for research and innovation that change with the times.
Salivary redox biomarkers of overweight and obese adults in response to prebiotics intervention
Authors: Meng Xiangyu , Ke Lijing , Li Li
Published: December 2024

Overweight and obesity are fast-growing risk to health. Its occurrence and prevalence are positively correlated to oxidative stress and inflammation. Saliva, as a crucial biological fluid, contains numerous redox biomarkers related to overweight and obesity(1) and is consistent with the corresponding biomarkers in blood(2). The prebiotics have been found to regulate the energy metabolism and reduce the severity of obesity. Their influences on salivary redox homeostasis, however, remain unclear. This study set out to investigate the changes in salivary redox biomarkers of overweight/obese Chinese adults in response to prebiotic intervention.

In total 102 overweight and obese adults (BMI ≥ 26.5, male: female = 48:54) were recruited and randomly assigned to intervention group and placebo control. The intervention group received a prebiotics cocktail (10 g per serving, containing 3.6 g of inulin, 3.6 g of resistant dextrin, 0.8 g of oat fiber, 0.8 g of psyllium husk), while the control group received a placebo, 3 times per day for three months. Their saliva samples before and after intervention were collected by natural flow method and quantified for the salivary flow rate, total protein content, and salivary redox biomarkers, namely ferric-reducing antioxidant power (FRAP), thiol, uric acid, malondialdehyde, glutathione (GSH) levels, and superoxide dismutase (SOD) enzyme activity. There are 32 participants has completed the intervention while the other 70 participants are still ongoing.

The data collected to date showed an average weight reduction of 5.37 kg in the intervention group and 0.72 kg in the placebo control, with a significantly different BMI (p < 0.05). The intervention group showed significant decreases in salivary uric acid and malondialdehyde (p < 0.05), and significant increases in FRAP, GSH levels, and SOD enzyme activity (p < 0.05), while no significant differences were found among other biomarkers. It is worth noting that the salivary flow rate increased slightly while gaining the weight loss, although not significantly. Upon completion of the study, the salivary attributes will be correlated with gut microbiome profile to interpret the link between redox homeostasis in body fluids and prebiotics-caused gut microbial alternation.

This study provides new insights in the redox biomarkers of overweight or obese adults, particularly in response to the prebiotic intervention and the subsequent weight loss. It may facilitate the establishment of noninvasive methods for determination of the redox biomarkers of obese patients and evaluation of dietary intervention.