bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D supplementation and bone health in menopausal women: a systematic review of randomised controlled trials
Authors: Riordan V. , Nally S. 
Published: December 2024

Serum 25(OH)D (vitamin D) plays an important role in skeletal and muscle function(1). Menopausal women are at an increased risk of reduced bone mineral density (BMD) and fracture due to a decline in oestrogen levels(2). A low circulating 25-hydroxyvitamin D (25(OH)D) level during menopause is a common problem and has been associated with changes in dietary intake and body composition(3). While vitamin D supplementation has been shown to increase serum 25(OH)D levels, its isolated effects on bone health in menopausal women is largely misunderstood. A systematic review was conducted to identify, appraise, and synthesise available studies to assess the impact of vitamin D supplements and bone health in menopausal women.Four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) were searched from inception to 8 December 2023. Only randomised controlled trials (RCTs) examining the efficacy of vitamin D supplementation in menopausal and/or post-menopausal women were included. Studies published in English and measuring BMD, fracture risk, calcium absorption, or serum 25(OH)D levels were eligible. Animal/lab trials, studies involving pharmaceutical co-treatments or vitamin K and/or calcium supplements were excluded. Two researchers independently extracted data according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines(4) and assessed possible bias using the Cochrane risk of bias tool v2. A narrative approach was used to synthesise the data.In total, 243 studies were retrieved through initial database searches. Following the elimination of duplicates and screening stages, six RCTs involving 696 menopausal women met the eligibility criteria. The studies varied in intervention length (range 4 wks-4 yrs) and were conducted across four different countries including: Brazil, Bangladesh, Japan, and the USA. Study samples ranged from 38 to 230 participants. A variety of vitamin D supplements (dosages/frequencies) were used across the included studies. Despite heterogeneity in study methods and vitamin D dosages, significant improvements were observed in BMD, risk of falls, and calcium absorption following vitamin D supplementation. Results also found that vitamin D supplementation may improve postural balance and muscle function, improving mobility for menopausal women.This systematic review demonstrates that vitamin D supplementation can enhance BMD, calcium absorption, reduce the risk of falls, and improve postural balance in menopausal women. However, the optimal dosage of vitamin D has not been determined. Limitations include methodological heterogeneity and lack of long-term follow-up, highlighting the need for further large-scale RCTs with rigorous methodology. These findings underscore the importance of ongoing research to better understand the role of vitamin D supplementation and bone health in menopausal women.
Iodised salt in the UK: a review of its availability and presence in processed foods
Authors: Tattersall Joanne , Rayman Margaret P. , Stergiadis Sokratis , Bath Sarah C. 
Published: December 2024

There is no salt iodisation policy in the UK, and the majority of iodine intake is from milk and dairy products(1). The availability of iodised table salt in the UK was last investigated in 2009, and was found to be low(2). As table salt contributes only approximately 15% to total salt intake, it is important to know whether any of the salt in processed foods is iodised. This study therefore aimed to update the availability of iodised table salt and review its use in processed foods that are available in the UK.Iodised table salt availability was investigated in ten supermarket chains (nine online and one instore), covering 96.6% of the market share(3). Data was collected on price per kilogram for iodised and own-brand table salt. A Google-site search of the supermarket wesbites was conducted between 28 February and 4 April 2024; both the terms “iodised” and “iodized” were searched to identify all processed foods containing iodised salt. Data on product name, ingredients, salt content per 100 g and per portion, and country of origin were extracted. Duplicate products and items no longer available were removed. Salt per portion was calculated using serving sizes on the product label or equivalent products, and estimated portion sizes were used if these were unavailable. Iodine per portion was then calculated by assuming that salt was iodised at a concentration of 20 mg/kg.Iodised table salt was available in three of the ten (30%) supermarkets (as one brand). Iodised salt was over four-times more expensive than own-brand table salt (£4.17/kg vs.£1.02/kg); the difference was smaller than in 2009 when it was six-times the price. The iodine concentration of the iodised table was 20 mg/kg, an increase from 2009 when it was 11.5 mg/kg(2).A total of 240 processed foods containing iodised salt were identified across all supermarkets. The country of origin was mostly unspecified (46.7%, n = 112) but where it was, most products were from Germany (19.6%, n = 47). The most common (35.4%, n = 85) food group containing iodised salt was meat products (including hot dogs, pâté, salami), followed by stock/sauce/spices/condiments (22.5%, n = 54) and pasta/noodle products (12.9%, n = 31). Average iodine per portion was 19.4 µg (range 0.44-94 µg), which would provide 13% (range 0.3-63%) of adult recommendations (150 µg/day).Iodised table salt is available at fewer supermarket chains than in 2009. Iodised salt is used in some processed foods available in the UK though the iodine content is not provided on the nutrition label. When estimating iodine intake in dietary assessments, the potential contribution from iodised salt in some processed foods should be considered. Salt intake, even if iodised, should not exceed recommendations.
Association between empirically driven dietary patterns and cardiometabolic disease risk factors: A cross-sectional analysis in UK adults
Authors: Yilmaz A. , Weech M. , Jackson K.G. , Lovegrove J.A. 
Published: December 2024

Extensive research has investigated the impact of individual foods and nutrients on development and progression of cardiometabolic disease (CMD)(1). However, there are only limited data on the influence of overall dietary patterns on CMD within the UK population. Therefore, this analysis aimed to empirically identify dietary patterns and explore their association with CMD risk factors in UK adults.For this secondary data analysis, habitual dietary data was collated from four randomised controlled trials (DIVAS, DIVAS-2, SATgenε, RESET) and one observational study (BODYCON) conducted at the Hugh Sinclair Unit of Human Nutrition, University of Reading. This dietary data was categorised into 38 food groups before performing principal component analysis to identify specific dietary patterns. After stratifying the principal components into increasing quartiles (Q) and determining the eNutri-DQS (a measure of diet quality), ANCOVA was performed to assess variations in estimated marginal means of CMD risk factors and eNutri-DQS between quartiles of dietary pattern adherence.The dataset included 646 individuals, 58% female with a mean ± SD age of 44 ± 14 years, and body mass index (BMI) of 25.2 kg/m2 (SD 4.0). Two main dietary patterns (DP) were identified which explained 11.7% of the total variance of food intake. Higher adherence to DP1 (Q4), characterised by diets rich in fermented dairy, fruits, wholegrains, vegetables and lower in red/processed meat products, was associated with lower BMI, waist circumference, diastolic blood pressure, fasting triacylglycerol, non-high-density lipoprotein (HDL)-cholesterol and higher HDL-cholesterol concentrations compared with the lowest quartile of adherence (Q1) (P<0.01). DP2, characterised by high consumption of sugar, honey and jam and other sweet spreads, refined grains and cereals with lower intakes of vegetables, nuts and wholegrains, was associated with lower HDLcholesterol concentrations compared to those with lower adherence (P = 0.006). Relative to Q1, diet quality, as measured by the eNutri-DQS, was significantly higher across increasing quartiles of adherence to DP1 (P<0.001), whereas the eNutri-DQS was significantly lower in Q4 versus Q1 of DP2 (P<0.001).This analysis has revealed two main dietary patterns in disease-free UK adults. Greater adherence to a diet higher in fermented dairy, fruits, wholegrains, and vegetables and lower in red and processed meat was associated with a higher diet quality and favourable associations with CMD risk markers.
Physical activity in users with Type 2 Diabetes in Family Health Centres in Copiapó
Authors: Jiménez S. , Fernández-Cao J. C. , Miranda-Krause R. , Berrios J , Correa G. , Trigo D. , Flores J , Vega F. , López A. , Rojas C. 
Published: December 2024

Physical activity has been demonstrated to be an effective intervention for the prevention and treatment of type 2 diabetes mellitus (DM2)(1,2). However, only 13.3% of the Chilean population are physically active(3,4). To our knowledge, there is no data on the physical activity performed by the diabetic population in Chile. Therefore, this study aimed to describe the level of physical activity in patients with DM2 in the Family Health Centres (CESFAM) of Copiapó (Chile).The study employed a cross-sectional design, utilizing data from 25 participants in the CODIACO cohort. The study population comprised individuals of both sexes, between 30 and 65 years of age, diagnosed with DM2 and users of the CESFAMs of Copiapó, and who 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, This mean the device had to be turned on at the beginning of an activity (waking) and off at the end of the day (bedtime), registering all daily activities. The percentages of time spent in each of the four body positions (upright, sitting, crouching, and lying down) were obtained from the total time spent using accelerometry(5). Once the Shapiro-Wilk test was P>0.05, all comparisons were made between times spent in each of the body positions using a one-factor ANOVA, with post-hoc analysis using Tukey’s test. 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 of Atacama. The project was funded by FONDECYT N° 11180794.There was an average daily activity of 9.6hr (upright = 2.2;sitting = 4.9;crouching = 0.7; supine = 1.6hr) in the sample. The one-factor ANOVA showed significant differences between all positions (P<0.001). The pos-Hoc test revealed a significantly longer time was observed in the sitting position, according to the z-axis position (51.32 ± 12.5% of the total time) compared to the upright (23.5 ± 8.7 %), supine (17.4 ± 3.2 %) or crouching (7.78 ± 0.6 %) positions (P < 0.050). Furthermore, differences were observed in the time spent in the upright position and the time spent in the supine (P<0.05) or crouching (P<0.05) positions, and between sitting and crouching positions (P<0.05).This study demonstrated that patients diagnosed with DM2 at the CESFAM of Copiapó spent a significant portion of their daily activity in a sedentary and low position, with minimal engagement in an upright one. Since upright positions are associated with physical activities such as walking, climbing stairs, toileting, and cooking, obtaining 23.5% in this position suggests a lack of engagement in these activities.
An examination of factors that influence infant growth in the first weeks of life
Authors: O’Dwyer F. , Murphy B. , Ali M. , Sanecka M. , O’Reilly S. , O’Sullivan A. 
Published: December 2024

Childhood obesity is a serious public health concern worldwide. One in five children are overweight or obese in Ireland1. Suboptimal growth, either in pregnancy or infancy, can increase the risk of obesity in childhood2. National policy fails to recognise early life exposures as potential contributors to Ireland’s obesity epidemic. This research examines the impact of ‘Labour and Birth’, ‘Birth Weight Status’, and ‘Maternal BMI’ on infant growth in the first weeks of life.This research is a secondary analysis of data collected as part of the WellFed study, a randomised placebo-controlled trial investigating the effect of a maternal dietary supplement comprised of a milk protein hydrolysate and yeast beta-glucan (Wellmune®) (LS-23-07-OSullivan). The supplement does not influence the present findings. Mother and infant anthropometrics were measured during two study visits, at approximately 4 and 8-weeks postpartum. Participants completed a series of questionnaires to obtain basic demographic, birth and lifestyle data. Infant weight and length percentiles were calculated using the UK-WHO 0-2 years: weight-for-age percentiles and the UK-WHO 0-2 Years: length-for-age percentiles for both males and females. Statistical analysis was performed using IBM SPSS Statistics (version 27).Data from 51 mother-infant dyads show infants delivered via cesarean section weighed less at the 4-week (4.1 ± 0.4 vs 4.5 ± 0.5 kg, p = 0.015) and 8-week follow-up (5.1 ± 0.5 vs 5.5 ± 0.6 kg, p = 0.021) and were shorter at the 8-week follow-up (56.3 ± 1.9 vs 57.7 ± 2.0 cm, p = 0.030) compared to infants born vaginally. Infants born following induction were significantly heavier at the 8-week follow-up compared to those not-induced (5.8 ± 0.7 vs 5.2 ± 0.5 kg, p = 0.006). In this cohort, 40% of infants were classified as large-for-gestational-age (LGA). Across the 8-week study period, 50% of LGA infants dropped two or more growth percentiles.Observations from this study highlight a high prevalence of LGA infants in this cohort which raises concern for the national prevalence of LGA infants in Ireland. Interventions during labour and birth were shown to influence infant growth in this study. These findings highlight the need for further investigation into the relationship between early life exposures and growth during infancy and childhood. Implementing healthcare policies focusing on reducing the number of elective birthing procedures performed and targeting obesity amongst women of reproductive age are possible measures that can be implemented to help tackle the obesity crisis in Ireland.
The prevalence of inadequate micronutrient intakes and risk of excessive intakes in adults in Ireland: Findings from the National Adult Nutrition Survey II
Authors: Kehoe L. , Buffini M. , McNulty B. , Kearney J.M. , Flynn A. , Walton J. 
Published: December 2024

Adequate nutrition is important for health at all life stages with micronutrients having an important role in long term health, cognition, healthy development and ageing(1). The aim of this study was to estimate the prevalence of inadequate intakes and risk of excessive intakes of micronutrients among adults aged 19-64 years and 65 years and over, from a nationally representative sample of adults in Ireland.Analyses were based on the National Adult Nutrition Survey II (NANS II) (2020-21) of 19-92 year olds in the Republic of Ireland (n 1000) (19-64y: 718, ≥65y: 282) (www.iuna.net). Food and beverage intake data (including nutritional supplements) were collected via two independent 24-hour telephone dietary recalls (at least 7 days apart, with each day of the week accounted for in the sampling plan). To assist with the recall, older adults (≥65years) were asked to record their foods the day before the dietary recall and all participants were provided with a photographic food atlas before the scheduled dietary recall. Nutrient intakes were estimated using Nutritics© based on UK food composition data which was updated to include recipes of composite dishes, nutritional supplements, fortified foods and generic Irish foods that were commonly consumed. Usual intakes of micronutrients were calculated via the NCI-method using SAS© Enterprise Guide. The prevalence of inadequate intakes of micronutrients (excluding energy under-reporters)(2) was estimated using estimated average requirements established by the US Institute of Medicine (IOM) (vitamin D)(3), the UK Department of Health (DOH) (thiamin, vitamin B12)(4) and the European Food Safety Authority (EFSA) (all other micronutrients)(5). The risk of excessive intake was evaluated by comparing intakes to tolerable upper intake levels (ULs) established by the US Food and Nutrition Board (vitamin C, iron)(6) and EFSA (all other micronutrients)(7).Among those aged 19-64 years, a large proportion of adults had inadequate intakes of vitamin D (61%), vitamin C (41%), folate (37%), calcium (32%), zinc (28%), vitamin B6 (26%), riboflavin (23%), vitamin A (16%) and iron (8%; up to 14% for females). Similarly, a large proportion of adults aged 65 years and over had inadequate intakes of vitamin D (48%), vitamin C (43%), folate (36%), zinc (35%), calcium (31%), vitamin B6 (29%), riboflavin (21%), vitamin A (13%) and iron (11%; up to 13% for females).The proportion of adults with intakes exceeding the UL was negligible for retinol, vitamins D, E, C, B6, preformed niacin, folic acid, calcium and iron (19-64y: <0.3%; ≥65y: <0.7%) and for zinc (19-64y: 2%; ≥65y: 1%).These findings indicate that based on current dietary patterns, significant numbers of adults in Ireland have inadequate intakes of key micronutrients and highlight the need to investigate targeted dietary strategies to address these low intakes among this population group.
Modified diet adherence to nutrition standards in long-term care facilities
Authors: Deasy E , Sheedy H. , Kent G. 
Published: December 2024

Dysphagia is more common in older age and is present in up to 70% in long-term care facilities (LTCFs)(1). Thus, the demand for texture-modified diets (TMDs), required to ensure safe nutrition for residents, is high. Individuals with dysphagia are at greater risk of malnutrition, poorer health outcomes and quality of life(2). Moreover, TMDs are less energy- and nutrient-dense due to necessary processing(3). Consequently, TMDs require additional planning and fortification to meet nutrient requirements for this cohort. The International Dysphagia Diet Standardisation Initiative (IDDSI) framework describes drink thickness (level 0-4) and food textures (level 3-7; liquidisedregular), to ensure standard textural characteristics of foods and drinks, however, there is little guidance for food providers in Ireland on how to prepare TMDs to meet nutritional requirements. Whether TMDs in LTCFs meet nutrition standards for food provision in Ireland is unknown. Our aim was to conduct a clinical audit, evaluating adherence of TMDs in a LTCF in Cork, Ireland, to the BDA Nutrition and Hydration Digest(4).Samples of the daily menu, i.e. all meals, snacks and drinks for IDDSI level 3,4,5 and 6 were weighed over a 2-day period, representing the maximum food and beverages available to residents. Recipes were confirmed with the catering department. Nutritional analysis was conducted using Nutritics©. Nutritional composition was compared to the nutrition standards of the BDA for food providers for nutritionally vulnerable individuals (total daily targets:1840-2772kcal, 79-92g protein; main courses: 800kcal, 27g protein).The daily TMDs of the LTCF provided [mean (SD)] 1928 (334) kcal, 73 (0.0) g protein (level 3); 1646 (62) kcal, 52 (2.0) g protein (level 4); 1323 (91) kcal, 45 (3.0) g protein (level 5); 1506 (75) kcal, 53 (5.0) g protein (level 6). On analysis of main courses, lunch meals provided 534 (99) kcal, 20 (3.0) g protein (level 3); 436 (0.3) kcal, 16 (0.8) g protein (level 4); 399 (16) kcal, 12 (1.0) g protein (level 5); 353 (13) kcal, 14 (0.3) g protein (level 6), while evening meals provided 770 (58) kcal, 33 (7.0) g protein (level 3); 561 (33) kcal, 19 (0.4) g protein (level 4); 305 (39) kcal, 9 (0.4) g protein (level 5); 379 (52) kcal, 18 (6.0) g protein (level 6).Across levels, there was poor adherence to energy and protein standards. Only level 3 provided sufficient daily energy and met protein targets for evening meal, potentially explained by the use of full fat milk as a dilutant to create the correct consistency. Guidance is needed for food providers of all LTCFs in Ireland on how to prepare TMDs for nutritionally vulnerable individuals. Future research should investigate actual food consumption, malnutrition risk, oral nutritional supplementation use and training of food providers in LTCFs.
Food growing: building community and food resilience
Authors: Nancheva N. , Mulrooney H. 
Published: December 2024

The Covid-19 pandemic exposed the fragility of the UK food system(1). Currently, 46% of fruit and vegetables are imported(1), making the UK vulnerable. Recent events such as war in Ukraine, volatile fuel prices and crop failures attributed to climate change have exacerbated this(1), with global food prices reflected in the cost-of-living crisis(2). Food is not just a source of nutrition, but of personal and cultural identity(3), with potential to impact on the extent to which people feel that they belong to a place or community. Community food growing schemes such as allotments remain popular in the UK(4). They could increase food resilience and security through growing produce, otherwise imported. The impact of a community growing scheme based in south London was explored. The scheme, a small farm allotment, was established by a Hong Kong farmer to grow produce including traditional Asian vegetables. It also aims to encourage collective efforts e.g. co-farming, through use of shared and private spaces. Focusing on traditional Asian vegetables, it offers bespoke advice, support and education via workshops, online mentoring and traineeships.Evaluation of this scheme was undertaken with ethics approval from Kingston University London. Using participatory non-extractive methods, qualitative and quantitative data were obtained using questionnaires and optional interviews with attendees of workshops (n = 52), online mentees (n = 2), and trainees (n = 3).All participants described themselves as Asian, Chinese or Hongkongers. More than two thirds (69.1%) had been in the UK for a relatively short time (up to 24 months). Both experience of, and knowledge about, growing food were low amongst participants, although this varied by group. While none of the trainees had previous food growing experience, half of online mentees and more than quarter (26.9%) of workshop attendees had some. All of the online mentees and over half (53.8%) of workshop attendees described themselves as having some knowledge about growing food. The most common reasons given for their involvement were an interest in urban growing/agriculture and practical (rather than theoretical) skills acquisition. Asian vegetables had multiple meanings for participants. Most commonly, they related to aspects of home, demonstrating the importance of culturally specific foods in evoking memories of people, place and time. Asked whether taking part in growing could help them build a sense of belonging within the UK Hong Kong community, responses were almost entirely affirmative for a variety of reasons.This highlights the multiple roles of food in people’s lives, and the potential for food to be used as a bridge between different groups, and as a bridge between their original and current homes. It also emphasises the role that growing food could play in cultural identity and pride, potentially building belonging as well as food resilience.