bluuebunny/crossref_metadata_2025 huggingface dataset:
Brief support and personalised feedback on food shopping to encourage saturated fat reduction: the PC-SHOP randomised controlled trial
Authors: Piernas Carmen , Aveyard Paul , Astbury Nerys , Oke Jason , Tsiountsioura Melina , Lee Charlotte , Noreik Michaela , Madigan Claire , Jebb Susan
Published: June 2020

Reducing saturated fat (SFA) intake can lower low-density lipoprotein (LDL)-cholesterol and thereby cardiovascular disease (CVD) but there are no brief interventions sufficiently scalable to achieve this. The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study developed and tested a behavioural intervention to provide health professional (HP) advice alone or in combination with personalised feedback on food shopping, which was delivered using a bespoke tool that created a nutritional profile of the grocery shopping based on loyalty card data from the UK largest supermarket.

Participants with raised LDL-cholesterol were randomly allocated to one of three groups: ‘No Intervention’ (n = 17), ‘Brief Support’ (BS, n = 48), ‘Brief Support plus Shopping Feedback’ (BSSF, n = 48). BS consisted of a 10-minute consultation with a nurse to inform and motivate participants to reduce their SFA intake. The BSSF group received brief support as well as personalised feedback on the SFA content of their grocery shopping including lower SFA swaps. The primary outcome was the between-group difference in the change between baseline and 3 months in SFA intake (% total energy intake) adjusted for baseline SFA intake and GP practice. The trial was powered to detect a reduction in SFA of 3% (SD3).

There was no evidence of a difference between the groups. Changes in SFA intake from baseline to follow-up were: -0.7% (SD3.5) in BS, -0.9% (SD3.6) in BSSF and -0.1% (SD3.3) with no intervention. Compared to no intervention, the adjusted difference in SFA intake was -0.33%; 95%CI -2.11, 1.44 with BS and -0.11%; 95%CI -1.92, 1.69 with BSSF. There was no significant difference in total energy intake (BS: -152kcal; 95%CI -513, 209; BSSF: -152kcal; 95%CI -516, 211); body weight (BS: -1.0 kg; 95%CI -2.5, 0.5; BSSF: -0.6 kg 95%CI -2.1, 1.0); or LDL-cholesterol (BS: -0.15mmol/L; 95%CI -0.47, 0.16; BSSF: -0.04mmol/L; 95%CI -0.28, 0.36) compared to no intervention.

This trial shows that it is feasible to deliver brief advice in primary care to encourage reductions in SFA intake and we have developed a system to provide personalised advice to encourage healthier choices using supermarket loyalty data. This small trial showed no evidence of large benefits but we are unable to exclude more modest benefits. Even a reduction of 1% in SFA intake when replaced by polyunsaturated fat may reduce CVD incidence by 8%, suggesting that a larger trial to assess whether benefits of this size may occur is now warranted.
Evaluating the UK takeaway food environment around secondary schools: comparison of different methods
Authors: Taher Ayyoub K. , Evans Charlotte E L. , Clarke Graham P
Published: June 2020

Takeaway shops are more clustered around secondary than primary schools and UK planning policies to limit takeaways show poor implementation against international examples and good practice statements. A major concern is that, worldwide, there are no standardised measures used to measure the food environment around homes, schools, work or any other facilities. This study aims to examine the differences in using different methods to evaluate the food environment particularly around secondary schools in the Avon region in the UK. Geographical Information System (GIS) was used to locate all schools and takeaways in the region and to measure the density and proximity scores, applying both road network and straight-line methods. In addition, the Hansen Index was used to measure the accessibility score of each schools to all takeaways in the region (not just the nearest). All of the nonparametric statistical analysis tests including Wilcoxon test, agreement (Kappa statistic) test and correlation test were carried out using Stata software version 15.0. It was observed that more than 50% of the schools had no takeaway shops within 200, 400, and 600 metres when the road network buffer was used. Statistical differences were observed between the road network and the straight-line methods. For example, the median of the difference between the straight-line and road network density within 1000 metres was 4.1 (CI 2.6, 5.9; P < 0.001). The median of the difference between the road network and straight-line proximity was 203.2 (CI 144.6, 261.9; P < 0.001). Also, the agreement between straight-line and road network densities within 800 (Kappa = 0.38) and 1000 (Kappa = 0.47) metres were fair and moderate, respectively. The agreement between both methods to measure the proximity was fair to moderate (Kappa = 0.40). In addition, the correlation results showed that both the straight-line and road network proximity were negatively correlated to the accessibility score measured. Our findings suggest that the 800 and 1000 metres road network density and proximity may be more appropriate to explore the real relationships between fast food accessibility and diet or health relationships. In addition, the Hansen index is another metric that may be used if the aim of the study is to consider multiple locations when calculating the accessibility score. The availability of best-practice methods would help to explore the food environment in a consistent way and therefore lead to the implementation of effective actions and policies targeting the food environments, particularly around secondary schools.
Digestible Indispensable Amino Acid Score (DIAAS) better Estimates the Protein Value of Pistachios than Digestibility Corrected Amino Acid Score (PDCAAS)
Authors: Bailey Hannah Marie , Carughi Arianna , Stein Hans-Henrik
Published: June 2020

Pistachios (Pistacia Vera) are nutrient-dense foods with a healthy nutritional profile that contains fiber, unsaturated fatty acids, essential nutrients, phytochemicals and protein. However, the nutritional quality of the protein has not been characterized to date. Therefore, the objective of this study was to determine the Protein Digestibility Corrected Amino Acid Score (PDCAAS) and Digestible Indispensable Amino Acid Score (DIAAS) for raw and roasted American pistachio nuts in growing pigs. The values for apparent ileal digestibility (AID) of crude protein (CP) and the standard ileal digestibility (SID) where calculated for these proteins. The CP content was greater for raw pistachios (27.1%) compared with roasted pistachios (25.1%). The amino acid (AA) in greatest concentrations for both types of pistachio were arginine followed by leucine. The AA in the lowest concentration were tryptophan followed by methionine. The AID of CP was greater (P < 0.05) for raw pistachios than for roasted pistachios, and the AID of most indispensable AA (IAA), except arginine, isoleucine, and phenylalanine, was greater (P < 0.05) for raw pistachios. The SID of CP was greater (P < 0.05) for raw than for roasted pistachios, and the SID of all IAA, except phenylalanine, was greater (P < 0.05) for raw than for roasted pistachios. The PDCAAS value calculated for both types of pistachios was based on the requirement for children from 2 to 5 years old (FAO, 1991), whereas the DIAAS value was calculated based on the requirement for children 3 years and older, adolescents, and adults (FAO, 2013). Both raw and roasted pistachios had a PDCAAS value of 75. In contrast, the DIAAS was numerically greater for raw pistachios than for roasted pistachios with values of 86 and 83, respectively. For PDCAAS, the first limiting AA in both raw and roasted pistachios when compared with the AA requirements for children 2 to 5 years was threonine. For DIAAS, lysine was the first limiting AA in both raw and roasted pistachios when compared with the AA requirements for children 3 years and older, adolescents, and adults. Based on the DIAAS cut-off values describing protein quality (FAO, 2013), raw pistachios and roasted pistachios can both be considered a ‘Good’ quality protein if consumed by children older than 3 year, adolescents, and adults.
Investigation of Blood Pressure during the First Trimester of Pregnancy in relation to the MTHFR C677T Polymorphism
Authors: Psara E. , O'Sullivan E. , Pentieva K. , Ward M. , Horigan G. , Strain J.J. , Hughes C.F. , Bendik I. , Doherty L. , Glackin K. , McNulty H.
Published: June 2020

The common C677T polymorphism in the MTHFR gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase is implicated in hypertension and hypertension in pregnancy. Hypertension affects up to 15% of all pregnancies and has been identified as a leading cause of maternal and neonatal morbidity and mortality worldwide. We previously reported higher systolic and diastolic blood pressure (BP) in non-pregnant women with the variant MTHFR 677TT genotype compared to CT/CC genotypes. In addition, randomised controlled trials (RCTs) in non-pregnant hypertensive adults from our Centre demonstrated that supplemental riboflavin (co-factor for MTHFR) lowers BP specifically in those with the TT genotype. However, the role of this common folate polymorphism and its interaction with riboflavin during pregnancy remains unclear. The aim of this study was to investigate the impact of MTHFR genotype and riboflavin status on BP in pregnancy. Data were generated from the ongoing Optimal Nutrition for the Prevention of Hypertension (OptiPREG) project. Pregnant women were recruited at the end of the first trimester from antenatal clinics in Northern Ireland and in the Republic of Ireland. Participants were screened for MTHFR genotype and BP was measured according to current clinical guidelines. Biomarker status of riboflavin was determined using the erythrocyte glutathione reductase activation coefficient (EGRac), a functional assay with higher EGRac values representing a lower status. Overall, 117 (11.6%) participants were identified with the variant MTHFR 677TT genotype. Both systolic and diastolic BP decreased from 8th to 16th gestational week (GW), however, this typical BP pattern was not observed in the TT genotype group. After adjusting for maternal age, GW and body mass index, women with the TT genotype at 12th GW had higher mean systolic (P 0.035) and diastolic (P 0.034) BP. When the results at the 12th GW were stratified by riboflavin status, the BP phenotype owing to this polymorphism was evident only among women with lower status (i.e. EGRac > 1.30), with mean (SEM) systolic BP of 120.4 (3.1) mmHg compared to 112.6 (2.5) mmHg in those with higher status (EGRac ≤ 1.30) within the TT genotype group; in contrast, low versus high riboflavin status had no impact on BP in CT/CC genotype groups. These results suggest that MTHFR genotype influences BP during pregnancy and that riboflavin can exert an important modulating effect on BP in women with TT genotype. An RCT is required to fully investigate the role of MTHFR genotype and its interactive effect with riboflavin in BP during pregnancy.
The association between maternal body weight and vitamin D status in early pregnancy: findings from the MO-VITD study
Authors: Alhomaid Raghad , Mulhern Maria , Cassidy Laura , Laird Eamon , Healy Martin , Strain Sean , Livingstone Barbara , Parker Michael , McCann Mary
Published: June 2020

Maternal BMI has been shown to be inversely correlated with vitamin D status (25-hydroxyvitamin D (25(OH)D) concentrations) during pregnancy. Pregnant women with obesity and with vitamin D deficiency are at risk of many adverse health outcomes in pregnancy.

The aim of this study was to examine differences in maternal vitamin D status across normal weight, overweight and obese pregnant women in early pregnancy.

Data collected at baseline from a double-blind randomised vitamin D intervention study (MO-VITD) were used. Pregnant women without pregnancy complications, aged > 18 years and having a singleton pregnancy were recruited between January 2016 and August 2017 at antenatal clinics in the Western Health and Social Care Trust, Northern Ireland. Non-fasting blood samples were collected at 12 weeks gestation and analysed for total serum 25(OH)D, using liquid chromatography tandem mass spectrometry. Data from 239 pregnant women (80 normal weight, 79 overweight, 80 obese) were included in the current analysis.

The mean ± SD 25(OH)D concentration of all pregnant women at 12 weeks gestation was 52.0 ± 21.6 nmol/L. Women classed as obese or overweight had significantly lower 25(OH)D concentrations compared to women of normal weight (48.8 ± 20.3 vs 49.8 ± 20.4 vs. 57.5 ± 23.1 nmol/L, P = 0.019; obese, overweight, normal weight respectively). A total of 45% of all pregnant women were found to be either vitamin D deficient (25(OH)D < 25nmol/L; 13%) or insufficient (25–50 nmol/L; 32%) in early pregnancy. BMI was significantly negatively correlated with 25(OH)D concentrations (r = -0.168; P = 0.009). Regression analyses showed that BMI (β = -0.165; P = 0.006), season (β = 0.220; P = < 0.0001), supplement use (β = -0.268; P < 0.0001) and a sun holiday within the previous 6 months (β = -0.180; P = 0.010) were significant predictors of 25(OH)D concentrations. In early pregnancy, 62% of pregnant women reported using a supplement containing vitamin D and 38% reported no supplement use. Supplement users had a significantly higher vitamin D status than non-supplement users in all BMI categories but overall, 37% of supplement users were still classified as vitamin D insufficient. Vitamin D status was significantly lower in winter months compared to summer months. In early pregnancy, especially during winter months, pregnant women with obesity, particularly non-supplement users, are at higher risk of low vitamin D status. Based on the lower vitamin D status observed in early pregnancy in obese women, the effect of BMI on vitamin D supplementation throughout pregnancy needs to be examined.
Polyunsaturated fatty acids and their relationship with bone mineral density and markers of bone turnover in post-menopausal women
Authors: Feehan O. , Slevin M.M. , Allsopp P.J. , Magee P.J. , Pourshahidi L.K. , Armstrong D.J. , McSorley E.M.
Published: June 2020

Age-related bone loss leads to a significant decline in bone formation and an increase in bone resorption resulting in a marked negative effect on bone mineral density (BMD). This bone turnover cycle can be further disrupted by estrogen deficiency during menopause which can lead to a great net loss of bone in post-menopausal women. Evidence suggests that n-3 polyunsaturated fatty acids (PUFA) may have a beneficial effect on the inflammatory regulation of bone remodelling and thus reducing bone loss. This study investigated the relationship between PUFA status, total body bone mineral density (BMD) and bone turnover markers in a cohort of post-menopausal women in Northern Ireland. Total body T-score and BMD were measured using dual energy x-ray absorptiometry (DEXA) in 300 non-osteoporotic post-menopausal women (45–75 years). The bone turnover markers serum osteocalcin, alkaline phosphatase, C-terminal telopeptides of type 1 collagen (CTX) and urinary deoxypyridinoline (DPD) were quantified. Total n6 PUFA (LA + AA) and n3 PUFA (ALA + EPA + DPA + DHA) were measured in serum using gas chromatography mass spectrometry. Total n3:n6 ratio was calculated. Dietary intake and lifestyle factors were determined by 4 day food diary and questionnaire, respectively. Spearman rank correlation analysis were conducted to investigate the relationship between PUFA and total body BMD. Secondary analysis investigated the relationship between PUFA and the bone turnover markers. Median (IQR) age was 61 (10) years, body mass index 27 (6) kg/m2, total body BMD, 1.3 (0.11) g/cm2 and age at menopause was 50 (6) years. Total median (IQR) serum n-3 PUFA status was 0.231 (0.128) mg/mL, total n6 PUFA was 1.248 (0.477) mg/mL and the n6:n3 PUFA ratio was 5.82 (2.63). Median (IQR) daily fish consumption was 25 (46) grams, calcium 702 (364) mg and vitamin D 2.21 (2.3) μg. There was no significant correlation between markers of total n3, n6, n6:n3 ratio and total body T-score, BMD or bone mineral content. PUFA was not significantly associated with total body BMD. There was a significant negative correlation between the urinary bone resorption marker DPD and total n3 PUFA (r = -0.137, P = 0018); EPA (r = -0.150, P = 0.009), and DPA (r = -0.118, P = 0.042). A significant negative correlation was observed between urinary CTX and the n-6 PUFA AA (r = -0.121, P = 0.036), the n3 PUFA ALA (r = -0.123, P = 0.033). PUFA were associated with less bone resorption therefore it is plausible that PUFA have a positive anti-inflammatory effect on bone resorption and warrants further investigation.
Change in overweight and obesity prevalence and adipose tissue distribution in seven-year-old Czech children (COSI project) 2008 to 2016
Authors: Kunesova Marie , Braunerová Radka Raxová , Procházka Bohuslav , Vignerova Jana , Metelcova Tereza , Parizkova Jana , Hill Martin , Zamrazilova Hana
Published: June 2020

Introduction:

Adipose tissue distribution is one of the factors influencing development of cardiometabolic complications associated with overweight and obesity. Waist circumference and waist/height ratio (WHtR) are markers of central adipose tissue distribution The aim of the study was to compare overweight/obesity and adipose tissue distribution in 7 year old Czech children and change in overweight/obesity and abdominal obesity from 2008 to 2016. WHO Europe initiated surveillance of childhood obesity (Childhood Obesity Surveillance Initiative COSI) in 2007/2008(1).

Methods:

In representative samples of 7 year old children weight, height, waist and hip circumference were measured and BMI and waist to height ratio were calculated in years 2008, 2010, 2013 and 2016. Statistical analysis was done using Statgraphics.

Results and discussion:

Since 2008 we found that overweight and obesity prevalence in 7- year-old children in the Czech Republic has been stable. In boys mild shift from overweight to obesity was observed. In 2016 preobesity was found in 7.6% of boys and in 6.5% of girls, obesity in 8.8% of boys and 6.5 % of girls (according to the Czech reference values). The main factors contributing to preobesity and obesity development were lower education of mother, less frequent consumption of breakfast, less frequent consumption of full milk and less time spent playing outside. Higher weight of parents, family history of obesity, higher birth weight and longer screen time were associated with higher prevalence of overweight and obesity.

Waist circumference and waist to height ratio in all children increased in period 2008–2016. WHtR > 0.5 was suggested as a marker of abdominal adipose tissue distribution in children(2). We evaluated percentage of children with WHtR higher than 0.5 in 2008–2016. The difference was statistically significant. In 2016, 24 per cent of children with WHtR > 0.5 had normal BMI. Assessment of waist and WHtR may contribute to identify children with increased health risk.

Conclusion:

Overweight and obesity prevalence in Czech 7-year-old children is not increasing in last years. Waist measurement and waist to height ratio assessment are simple indicators of adipose tissue distribution in children. Further studies are necessary for evaluation of their role in childhood obesity diagnostics.
Role of birth weight and predisposition for adverse body composition in early childhood: Findings from the ROLO study
Authors: Geraghty Aisling A. , O'Brien Eileen C. , Horan Mary , Donnelly Jean , Molloy Eleanor , McAuliffe Fionnuala M.
Published: June 2020

Introduction:

The early fetal environment during pregnancy is extremely important and research indicates that weight at birth can have crucial impacts for the individual's health later in life. With rates of childhood obesity estimated to be as high as 21% in some European countries, it is vital that early risk factors are identified so that interventions can be developed. We aimed to investigate if children born macrosomic (birth weight > 4kg) remained larger than normal birth weight babies up to 5 years of age.

Materials and Methods:

This is a longitudinal follow-up of 387 five-year-old children (53% born with macrosomia, 47% normal birth weight) born into the ROLO randomised control trial in the National Maternity Hospital, Dublin (ISRCTN54392969). Birth weight was previously recorded then at 6 months, 2 years, and 5 years of age child height, weight, anthropometric and skinfold measurements were collected. Body Mass Index (kg/m2) and centiles were calculated. Student t-tests and Mann-Whitney U tests were used to compare the two groups with multiple linear regression modelling to control for confounders.

Results:

Children with a birth weight > 4 kg had consistently higher weights, lengths, and BMI centiles, along with increased head and chest circumferences, compared to normal birth weight children from 6 months up to 5 years of age (p < 0.05). After controlling for child sex, intervention group, smoking during pregnancy, maternal education status, and maternal BMI, children with macrosomia were 0.61 kg heavier than non-macrosomic infants at 5 years of age (95% CI: 0.04–1.18, p < 0.05).

Discussion:

Children born with a high birth weight remain heavier and larger into childhood. These individuals are at a higher risk of obesity which highlights the need for monitoring and potential interventions, both during pregnancy and in infancy, to curb the current childhood obesity crisis.
Insufficient iodine status as a consequence of dietary changes
Authors: Adalsteinsdottir Solveig , Tryggvadottir Ellen Alma , Hrolfsdottir Laufey , Halldorsson Thorhallur Ingi , Birgisdottir Bryndis Eva , Hreidarsdottir Ingibjorg Th , Hardardottir Hildur , Arohonka Petra , Erlund Iris , Gunnarsdottir Ingibjorg
Published: June 2020

Historically, Iceland has been an iodine sufficient nation due to notably high fish and dairy consumption. Due to this fact the country does not have a strategy related to iodine status, such as fortification of salt. Iodine status of pregnant women has only been assessed once before in Iceland (in 2009). The median UIC was found to be 180 μg/L, which was in line with the recommended range of 150–249 μg/L defined by the World Health Organization (WHO). Intake of fish and dairy has decreased considerably in the past 10 years. The aim of the present study was to re-evaluate the iodine status of pregnant women in Iceland using data from the PREWICE study (PREgnant Women in ICEland). Subjects were women (n = 983; 73% of the eligible sample) attending their first ultrasound appointment in gestational weeks 11–14 in the period October 2017-March 2018. Spot urine samples were collected for assessment of urinary iodine concentration (UIC) and creatinine. The ratio of iodine to creatinine (I/Cr) was calculated. Diet was assessed using a semi-quantitative food frequency questionnaire (FFQ), which provided information on main dietary sources of iodine in the population studied (dairy and fish). The median UIC (95% CI) and I/Cr of the study population was 89 μg/L (42, 141) and 100 (94, 108) μg/g, respectively. UIC increased with higher frequency of dairy intake, ranging from median UIC of 55 (35, 79) μg/L for women consuming dairy products < 1 time per week to 124 (98, 151) μg/L in the group consuming dairy > 2 times per day (p for trend < 0.001). A small group of women reporting complete avoidance of fish (n = 18) had UIC of 50 (21, 123) μg/L and significantly lower I/Cr compared with those who did not report avoidance of fish (58 (34,134) μg/g vs. 100 (94, 108) μg/g, p = 0.041). Women taking supplements containing iodine (n = 34, 3.5%) had higher UIC compared with those who did not take supplements (141 (77, 263) vs. 87 (82, 94) μg/L, p = 0.037. For the first time, insufficient iodine status is being observed in an Icelandic population. There is an urgent need for a public health action aiming at improving iodine status of women of childbearing age in Iceland.
The global non-communicable diseases epidemic and association between dietary factors and non-communicable diseases by income levels
Authors: Lim Hyunjung , Kim Do-Yeon , Park Ju Hyun , Lim Hyunjung
Published: June 2020

Non-communicable diseases (NCDs) share common risk factors as poor dietary intakes, especially among low-income populations worldwide. However, the diet-related health burden by country income levels remains unclear. We assessed the current prevalence of NCDs and the association between selected dietary factors and NCDs by income levels. Data were obtained from the World Health Organization, Food and Agriculture Organization, and World Bank, and 151 countries were included in the analysis weighted by the total population size. Linear regression was used to find the association between metabolic risk factors and health-related behaviors by income levels. The prevalence of raised fasting blood glucose and total cholesterol, overweight, and obesity were lowest in lower and middle income countries, but prevalence of raised blood pressure and NCD deaths under age 70 were highest in lower and middle income countries (p for trend < 0.001). The proportion of carbohydrates and alcohol consumer were highest, and vegetable, milk supply, insufficient activity were lowest in lower and middle income countries. In high income countries, raised fasting blood glucose level were negatively associated with vegetable consumption (β = -0⋅05 CI [-0⋅08, -0⋅02]), and alcohol consumption, fat intake (7⋅94 [1⋅82, 14⋅06]), and sugar and sweetener supply (0⋅04 [0⋅01, 0⋅07]) were associated with overweight. In low income countries, overweight was associated with vegetable oil (0⋅03 [0⋅00, 0⋅05]),. In this study, different relationship between diets and NCDs trends were found across country income levels. Appropriate health policies for each group of countries by income are needed to solve the increasing challenges of NCDs.

This work was carried out with the support of “Cooperative Research Program for Agriculture Science and Technology Development (Project No. PJ PJ01317001)” Rural Development Administration, Republic of Korea.
Identifying the nutritional profile of outpatient haemodialysis patients in Beaumont Hospital
Authors: Forde Neasa
Published: June 2020

Beaumont Hospital Kidney Centre, Dublin is currently the largest provider of haemodialysis in Ireland. There is a dedicated renal dietetic team to address the nutritional needs of these patients. In order to provide an optimal service, a thorough understanding and insight of the service demands is needed. Currently there is no nutritional profile of these patients. Similarly the Renal dietetic team have not been in a position to identify if they are meeting current best practice guidelines, as outline by the National Kidney Foundation. E-Med, an online renal electronic notes system, was used to provide all dietetic notes during 2018. Using an audit template, an audit of these notes for outpatient haemodialysis patients was carried out to identify a number of nutritional issues. 75% (123/163) of outpatient haemodialysis patients received direct dietetic intervention in 2018. 76% of these patients demonstrated more than one nutritional issue and 16% displayed more than five nutritional issues. The most prevalent nutritional issues arising were hyperkalemia (41%) and hyperphosphatemia (33%). Currently guidelines, which recommend a dietetic review, every 3–4 months are not being met. 53% of patients received either none or only one direct dietetic intervention in this time period. The recommended ratio of 1:100 (dietitian: haemodialysis patient) is also not being met. Currently the ratio stands at 1:243 as the dietitian responsible for haemodialysis patients is also responsible for peritoneal dialysis patients. The average length of time recorded for each direct intervention was 1 hour. Beaumont Hospital haemodialysis outpatient cohort is a nutritionally complex group of patients, which require ongoing and frequent dietetic input. Beaumont Hospital renal dietitians are successfully providing at least one episode of direct intervention to the majority (75%) of the outpatient haemodialysis patients, suggesting efficient and effective use of available resources. An increase in dietetic staffing for the renal service could offer the potential to provide direct dietetic input to all haemodialysis patients within the hospital and to also provide an increased number of reviews to patients, as per guidelines. It is possible that the amount of time spent on dietetic patient assessments is being under-reported and further work is needed to cross-reference these figures using an alternative statistical package.
An investigation into the current practice of preparing, handling and reconstituting powdered infant milk in the domestic setting in Ireland
Authors: O'Neill Meabh , O'Neill Jennifer , Shannon Emma , O'Donovan Sinead , Dennehy Niamh , Regan Aileen
Published: June 2020

It is recommended that infants are exclusively breastfed for the first six months. As the gold-standard in infant feeding, it is the safest and best way of ensuring infants achieve optimal health and development(1). Powdered Infant Formula (PIF) is not sterile and so, can be associated with bacteria such as Cronobacter spp(1–2). This bacterium can have an adverse effect on health in all age groups. However, the FAO/WHO have identified infants 0–12 months as a vulnerable group, with infants less than two months old and all immunocompromised infants regardless of age, being particularly at risk of infection(1).

Guidance set out by the Food Safety Authority of Ireland on the safe preparation of PIF states that it is essential to boil one litre of fresh tap water and let it cool to 70°C, to kill any bacteria in the powder and retain sufficient amounts of nutrients. By preparing, handling and storing PIF in line with the guidance, parents can reduce potential risks of contamination(1–2).

The aim of this study was to determine the current practice of reconstituting PIF in the domestic setting in Ireland. A sample of parents with a child aged 0–12 months (n = 228) completed a 30-item questionnaire online. Most respondents were first time parents (55%), female (89%), aged 25–44 years (99%) and educated to tertiary level (79%).

The results revealed that 64% (n = 146) of respondents reported to fill the kettle with one litre of fresh tap water, but less than half (45%) follow the guidance, to cool the boiled water to the required 70oC(1–2). The majority 91% (n = 208), stated that they discard any unused feed within two hours. Furthermore, 29% (n = 67) of respondents reported to use an automatic bottle preparation machine, 75% (n = 171) said they are aware of safety aspects/risks associated with preparing PIF and most (97%, n = 221) felt confident in their ability to safely prepare their infant's PIF feed.

It is evident that there is a need to highlight to all parents the importance of why and how PIF should be prepared and reconstituted at 70oC in accordance with the guidance(1–2), to minimise potential risks of contamination.
Production of conjugated linoleic acid (CLA): effect of inulin on microbial composition and CLA concentration in a human intestinal model
Authors: Carafa Ilaria , Masuero Domenico , Vrhovsek Urska , Bittante Giovanni , Franciosi Elena , Tuohy Kieran M.
Published: June 2020

Conjugated linoleic acids (CLAs) show a number of putative health-promoting activities including anti-carcinogenic, anti-adipogenic, anti-diabetogenic, anti-inflammatory and antioxidant actions. CLAs are naturally produced by ruminal bacteria and several studies demonstrate that various lactobacilli and bifidobacteria are also able to produce CLAs in vitro from linoleic acid (LA). However, the ability of the human gut microbiota to produce CLA is less extensively studied. Our hypothesis is that the human gut microbiota is able to convert LA to CLA, and that the readily fermentable fiber inulin would positively modulate the growth of CLA-producing bacteria and, consequently increase the CLA content in the intestine.

The capability of the faecal microbiota from five healthy donors to produce CLA was tested in anaerobic batch cultures for 48 hours at pH 5.5 and 6.5. Test treatments were linoleic acid (LA; 1 mg/mL) + bovine serum albumin (BSA; 0.2 mg/mL), and LA (1 mg/mL) + BSA (0.2 mg/mL) + inulin (1%, w/v) compared to a control BSA (0.2 mg/mL) fermentation. The microbial composition was analyzed 0, 24 and 48 hours after starting the fermentation by 16S rRNA gene Illumina MiSeq sequencing (V3-V4 region). CLAs were quantified by Ultra performance liquid chromatography - tandem mass spectrometer (UPLC-MS/MS) and bi-dimensional gas chromatography (GC x GC).

The inclusion of LA + BSA + inulin at pH 5.5 significantly increased the relative abundance of Collinsella aerofaciens (p < 0.05), and tended to increase the relative abundance of bifidobacteria. LA + BSA + inulin at both pH 5.5 and 6.5 reduced the relative abundance of Parabacteroides, Bilophila, Clostridia and Enterobacteriaceae (p < 0.05). The concentration of CLA, in particular the isomer cis9,trans11 C18:2, was significantly higher in the LA + BSA + inulin group at pH 5.5 after 24 and 48 hours fermentation.

The data show that the treatment LA + BSA + inulin at pH 5.5 induce substantial changes in microbiota composition, including bifidogenesis and CLA production in a human intestinal microbiota model. The changes of relative abundance detected are consistent with changes in gut bacteria previously linked to human health. Collinsella aerofaciens has been reported for reducing bloating, in particular in subjects suffering from irritable bowel syndrome, while Clostridia, Bilophila and Enterobacteriaceae causes human infections. In addition, the increase of bifidobacteria and LAB, which have previously been shown in vitro to produce CLA, may also be involved in CLA production under simulated cecal microbiome. These preclinical observations warrant confirmation in suitably designed animal and human mechanistic studies.
Association of Vitamin D with Type 2 Diabetes in Postmenopausal Females in Saudi Arabia
Authors: Alharazy Shatha , Alissa Eman , Ardawi Mohammed , Lanham-New Susan , Denise Robertson M.
Published: June 2020

Vitamin D (vitD) deficiency has been suspected as a risk factor for type 2 diabetes mellitus (T2DM). It has been reported that an inverse relationship exists between vitD status and risk of T2DM. The aim of this study was to investigate whether there is an association between vitD status and glycemic profile and other metabolic parameters among postmenopausal women with T2DM (living in Saudi Arabia). A cross-sectional study was conducted at King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia. One thirty six (n = 136) postmenopausal females (age ≥ 50 years) living in Jeddah city, Saudi Arabia, with T2DM were randomly recruited in this study. Anthropometric measures, blood pressure readings and fasting blood samples were obtained fro all study participants. Several biochemical parameters were estimated in fasting serum samples including total 25(OH)D, HbA1c, insulin, glucose, c-peptide and lipid profile. Surrogate markers for insulin resistance were calculated using Homeostasis Model Assessment for insulin resistance and beta cell activity (HOMA-IR, HOMA-β), Quantitative insulin sensitivity check index (QUICK-I) and McAuley's index. VitD deficiency was defined as serum total 25(OH)D level below 20 ng/ml.The Mean (± SD) serum levels of total 25(OH)D were 13.8 ± 8.6 ng/ml with 79% of the study cohort being vitD deficient. Furthermore, serum total 25(OH)D levels were found to be inversely correlated with fasting insulin (r = -0.24, p = 0.029), HOMA-IR (r = -0.24, p = 0.03), and positively correlated with McAuley's index (r = 0.22, p = 0.048) and QUICK-I (r = 0.25, p = 0.024). In conclusion, vitD deficiency is highly prevalent among postmenopausal women with T2DM living in Jeddah, Saudi Arabia. VitD was found to be associated with insulin resistance. Whether vitD supplements are able to improve insulin sensitivity and other parameters in T2DM postmenopausal women should be further investigated.
Energy expenditure of flight crew of military transport aviation depending on function during typical training activities
Authors: Bertrandt Bartosz , Lakomy Roman , Kler Pawel , Bertrandt Jerzy
Published: June 2020

Introduction

The knowledge of energy expenditure during typical activities is the basic information to estimate nutritional requirements. This is especially important with irregular lifestyle, such as service in transport aviation. Aircraft personnel fly in every part of a day. Flights often take place with changes in climate and time zones. Time of flights fluctuated from a several dozen to a dozen hours.

Aim

The aim of the work was to assess and compare the energy expenditure of military aircraft crews – “CASA C-295”, “ C-130 Hercules” and helicopter “W-3 Sokol” during typical air training activities.

Material & Method

The study was conducted in a group of 31 members of flight crews. The energy expenditure was based on the examination of heart rate frequency with the Polar RS800 heart rate monitor.

Results

The study was conducted among crew members of various types of transports aircrafts. The average value of energy expenditure of the CASA pilots (n = 14) was 3,071 ± 0,84 kcal/min (training flight during the day, n = 10) and 5,64 ± 2,45 kcal/min (training flight during the night and in noctovision goggles, n = 4). In a group of flight technicians (n = 7) in aircraft Herules C-130 the average energy expenditure was 3,55 ± 1,83 kcal/min (passeneger reception and service). In a group of loadmasters (n = 6), in aircraft CASA and Hercules C-130 the average energy expenditure was 6,63 ± 1,55 kcal/min (baggage service, dropping paratroopers). The average energy expenditure in a group of paramedics (n = 4), which are members of helicopter W-3 Sokol crew was 8,51 ± 4,29 kcal/min (going down the rope, lifting wounded person from watercrafts).

Conclusion

The presented data show the variation in energy expenditure between groups, as well as within groups. The energy expenditure was varied depending on the function on board and on the conditions in which the tasks were performer. Obtained values of energy expenditures during flights allow to classify the work performed in the categories of work from light to heavy (according to the Christensen's classification). Nutrition in the study group should be adapted to the nature of the work performed.
Early insulin resistance is associated with alterations in gut permeability and microbial activity in rats fed a moderately westernized diet
Authors: Davila Anne-Marie , Blais Anne , Culetto Marta Grauso , Mathé Véronique , Lan Annaïg , Mariotti François , Blachier François , Hermier Dominique
Published: June 2020

In Western societies, unbalanced diets may lead to intestinal allostatic stress, with microbial dysbiosis and alteration of the gut barrier function. These local modifications may induce a low-grade inflammation via endotoxemic process, which contribute to systemic alterations clustering into the metabolic syndrome (MetS) and increasing the risk of cardiovascular diseases and type 2 diabetes. We investigated the sequence of events initiating the MetS in rats challenged with a diet that differed moderately from the dietary guidelines, regarding the proportions and nature of energy, carbohydrates, lipids and fibre.

Male Wistar rats (265 g upon arrival) were with either a standard diet (Con, n = 10, 3730 kcalkg, 4.0% lipids, 6.3% sucrose, 58.0% starch, 5.0% fibre) or a westernized induction diet (Ind, n = 10, moderately enriched in energy (4120 kcal/kg), lipid (24.0%), and sugars (15%, half sucrose-half fructose), and low in starch (25.5%) and fibre (1.25%). An oral glucose tolerance test (OGTT) was performed after 3 weeks. Rats were euthanized after a further week for body composition and collection of caecum content and tissue samples. LPS-binding protein (LPS-BP) was assayed in plasma; ileum and colon samples were used for measurement of wall barrier function (using Ussing chambers) and microbial activity was assessed in caecum (enzymes and metabolites).

Body weight did not differ between Con and Ind groups at any time, as well as the absolute masses and proportions of visceral adipose tissue and liver. Fasting triglyceride, glucose, insulin and LPS-BP concentrations, HOMA index and glucose AUC during the OGTT were similar in both groups. When compared to the Con group, Ind rats showed significantly higher risk markers, i.e.: (1) Insulin AUC (x2); (2) Hepatic triglyceride content (x2.8); (3) Wall permeability at both the para- and transcellular levels (x2.6 and 4.3, respectively) in the ileum (but not in the colon). In the caecum, H2S absolute and relative amounts were twice higher in the Ind group, in relation with 2–3-fold increases in specific and total activities of microbial cysteine desulfhydrase and proteases.

Multiple dietary changes mimicking a moderately westernized diet induced an increased ileal permeability and changes in the caecal microbial activity, without evidence of endotoxemia. These perturbations were associated with detrimental rupture of homeostasis at both the splanchnic (hepatic steatosis) and systemic (insulin resistance) levels. In this realistic model, these alterations preceded the occurrence of clinical markers of the MetS (obesity and elevated plasma concentrations of glucose and triglyceride).
Towards a novel marker of insulin resistance in obesity: S100A4 in girls along the puberty. The longitudinal study “PUBMEP”
Authors: Anguita-Ruiz Augusto , Méndez-Gutierrez Andrea , Ruperez Azahara I. , Leis Rosaura , Bueno Gloria , Gil-Campos Mercedes , Gil Angel , Aguilera Concepción M.
Published: June 2020

Introduction:

Insulin resistance (IR) is the major driver for the development of obesity-associated metabolic and cardiovascular complications. It is well known that IR increase physiologically during puberty; hence, pubertal maturation might favour this metabolic risk in obese children. Recently, a study carried out in adult women with obesity has identified a new adipokine, known as S100A4, strongly associated with IR and inflammation in adipose tissue. On the contrary, little is known about the implication of S100A4 in the development of such metabolic disturbances during the onset and course of pubertal development.

Materials and methods:

A longitudinal study was conducted on 53 Spanish girls distributed in six experimental conditions according to their obesity and IR status (before (T0) and after (T1) the onset of puberty). Anthropometric and biochemical parameters were evaluated in all samples and time points. Classification of pubertal stage was made according to the Tanner scale. S100A4 protein levels were quantified by ELISA CSB-EL02032HU in plasma samples (Cusabio Biotech, Wuhan, China). The statistical analysis of the results was carried out with the “nlme” package in R v3.4.4, using a mixed-effects linear model with random intercept and slope.

Results:

At a significance level of alpha = 0.05, a linear mixed-effects model reported a significant association (P = 0.03) between the interaction term “time*experimental group” and S100A4 levels. Post-hoc pairwise comparisons between experimental groups revealed a strong association between a worsening/improvement of the IR status and the increase/decrease of S100A4 levels (yielding significant results for 5 of the 15 comparisons (P = 0.008, P = 0.04, P = 0.02, P = 0.04 and P = 0.02)). Furthermore, a multiple linear regression model reported a positive correlation between the increase in S100A4 levels and the increase in HOMA values during the course of puberty (B = 6.03, SE = 2.66 and P = 0.028).

Discussion:

The S100A4 protein is strongly associated with the development of IR in girls with childhood obesity and this association is accentuated during pubertal development. Increase in S100A4 levels could be one of the molecular mechanisms by which pubertal maturation favour an increased metabolic risk in children with obesity.
An investigation into the correlation between pre-pregnancy body mass index and birth outcomes of newborn in Jersey
Authors: Sliwka Urszula , Przybylowicz Katarzyna , MacLachlan Neil , Morze Jakub , Danielewicz Anna , Surma Adam
Published: June 2020

The role of nutritional status of pregnant women and birth outcomes is ambiguous. Recent studies show that pre-pregnancy body weight is equally important as weight gain during pregnancy. Body mass index (BMI) is the most accessible and easy to check a nutritional status index, which may help to control the gestation and predict infant health outcome. This study aimed to examine the associations between pre-pregnancy body mass index and the infant birth parameters. A presented observational study was offered to 200 pregnant women from Antenatal Clinic at Jersey General Hospital in 2017. Total number of 83 women agreed to take part in this project. Diet, lifestyle, socio-economic, and demographic data were obtained from participants. Delivery and birth data were taken from hospital records. Offspring feeding data and selected anthropometric measurements for mothers and their newborns were also collected. Differences between BMI for delivery type and way of feeding were verified with chi-square test. Differences and correlation between maternal BMI and newborn outcomes were verified with Kruskal-Wallis’ test and Spearman's rank test. Mean BMI of mothers included to the study was 22.8 ± 4.4 with mean weight 61.9 ± 11.6. Before pregnancy BMI was normal in 67% women and about 23% was overweight or obese. We do not observed differences between delivery type and way of feeding during first 48 hours, and women in BMI categories. Also no differences and correlation were observed for the Apgar score, gestational age of birth, and newborn's weight and length at birth. However, newborn weight correlated with newborn length (r = 0.433) and gestational age (r = 0.568) at birth. Concluding, the maternal pre-pregnancy BMI was not correlated with type of delivery, way of feeding and newborn outcomes. Previous studies show that high pre-pregnancy maternal BMI may be associated with adverse offspring outcomes at birth and later life. Future extended research is needed to explain these relations, with inclusion of the specific factors as maternal diet, lifestyle and ethnicity.