bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary recommendations for reducing free sugar intakes: A pilot study investigating effects following advice to substitute sweet high-sugar foods with different alternatives
Authors: Appleton K. M. , Bielat A. D. , Guy D. J. , Karami N. , Boxall L. R. 
Published: December 2024

The World Health Organization (WHO) currently recommends reducing free sugar intakes for health benefits(1). Appropriate strategies to achieve these recommendations for the general public, however, remain unclear. While the WHO target is based on nutrients(1), food-based guidelines are currently recommended for public health(2), and practical advice in the form of food substitutions may facilitate dietary change(1,2).Recommendations for reducing free sugar intakes based on nutrients (N, N = 61), nutrients and foods (NF, N = 60), and nutrients, foods, and food substitutions (NFS, N = 63) were recently investigated in a large randomized controlled trial(3). As a percentage of total energy intake (TEI), free sugar intakes reduced over 12 weeks following all three types of dietary advice, resulting in mean (s.e.) reductions of: Group N: 2.5 (0.8) %TEI; Group NF: 3.3 (0.8) %TEI; and Group NFS: 3.1 (0.7) %TEI; compared with no change (1.2 (0.8) %TEI) in the control group (N = 58). Few differences between the three different types of advice however, were found. The pilot study presented here aimed to extend this original study through the additional investigation of three different types of dietary advice based on food substitutions.For this pilot study, a total of 72 UK adults with >5%TEI from free sugars at baseline, were randomized to receive dietary advice to reduce free sugar intakes by: a) replacing sweet high-sugar foods with sweet-tasting low-sugar alternatives, e.g. fruit and low-calorie sweeteners (Group ST, N = 24); b) replacing sweet high-sugar foods with non-sweet-tasting low-sugar alternatives, e.g. herbs, spices and nuts (Group T, N = 24); and c) replacing sweet high-sugar foods with plain lowsugar alternatives, e.g. plain rice-cakes (Group NT, N = 24). The advice was based on current NHS guidance and provided once. Participants were then followed for 4 (and 12) weeks, and betweengroup differences were investigated.Free sugar intakes reduced in all three groups over 4 weeks (F(1,69) = 26.17, p<0.01), with effect sizes comparable to those in the original study (mean (s.e.)): Group ST: 2.4 (1.2) %TEI; Group T: 3.8 (1.3) %TEI; Group NT: 3.3 (1.2) %TEI. No differences were found between groups (F(2,69) = 0.56, p = 0.61). Similar results were also found in a subset of participants who continued in the study for 12 weeks (N = 29) (F(1,26) = 12.38, p<0.01; group x time interaction F(2,26) = 1.07, p = 0.39) (mean (s.e.)): Group ST: 2.3 (0.7) %TEI; Group T: 5.2 (1.3) %TEI; Group NT: 2.3 (1.2) %TEI.Our findings confirm those of the original study – that the provision of dietary advice to reduce free sugar intakes can result in reduced free sugar intakes in willing volunteers, but the exact nature of the advice provided seems less important.
Exploring fruit and vegetable intakes in children in two areas of North Yorkshire - Cooking in Yorkshire Project
Authors: Vidal M. , Vaughan K. , Nykjaer C. , Cade J. 
Published: December 2024

Eating a healthy diet rich in fruits and vegetables (FV) throughout life is crucial for preventing various types of malnutrition, reducing the risk of non-communicable diseases, and promoting overall well-being. Childhood presents a prime opportunity to establish lifelong dietary habits. The World Health Organization advocates promoting healthy diets by integrating culinary skills development, especially in schools. The Cooking in Yorkshire Project (1), a cluster-randomized controlled trial, assessed the impact of the PhunkyFoods programme on dietary behaviour, nutrition knowledge, and cooking skills among primary-aged children (7-9 years) in two-areas of North Yorkshire. We performed a secondary analysis of baseline-data to explore FV intakes of children by deprivation level, provision of free school meals (FSM) and mealtimes at baseline.The Child and Diet Evaluation Tool (CADET) (2) was used to assess the self-reported frequency of consumption of 13 fruits and 18 vegetables on the previous day, categorized by mealtime. Poisson regression was used to evaluate associations between FV consumption (portion/day), deprivation level (categorized based on a median level of 22,642 of the Index of Multiple Deprivation rank 2019 to determine high or low levels) and FSM percentage per mealtime and per day.Twenty-six schools (n = 333 children, 57% girls) completed the dietary assessment. 60% of children reported consuming FV 5 times a day. Significant differences were observed in the proportions of children’s FV intake by mealtimes. During breakfast, 92% of children did not consume any vegetable, and 50% did not eat fruit (p<0.001). At lunchtime, approximately 35% of children reported not consuming any fruits or vegetables. Overall, consumption of FV recorded (7 portions per day) was considerably higher than national average consumption (3 standard portions) (3). The school FSM index was negatively associated with child vegetable intake. For children in schools with high FSM percentage compared to low percentage, the frequency of vegetable intake was 31% lower at lunch (95%CI: 56, 85; p = 0.001) and 15% lower over the whole day (95%CI: 76, 94; p = 0.003), after adjusting for sex and area. No associations were observed in fruit intake by mealtimes or deprivation level.North Yorkshire schools offer free meals to financially supported children, aligning with healthy eating policies. However, negative associations observed between FSM and vegetable intake indicate there may be room for enhanced FV promotion.
Meal patterns and risk of childhood obesity and metabolically unhealthy obesity: a systematic review of the evidence, methodological issues and research gaps
Authors: Saltaouras G. , Kyrkili A. , Bathrellou E. , Georgoulis M. , Yannakoulia MU , Bountziouka V. , Kontogianni M. 
Published: December 2024

Childhood overweight/obesity (Ov/Ob) is a major public health problem, of greater concern when accompanied with comorbidities such as hypertension, insulin resistance leading to metabolically unhealthy obesity (MUO). Current evidence suggests a linkage between meal frequency, diet quality and nutritional status(1–3) in children and adolescents, however data regarding associations between meal patterns, Ov/Ob risk and MUO are limited. The aim was to explore associations between meal patterns and the risk of childhood Ov/Ob and MUO.The PRISMA methodology was used to retrieve prospective studies and randomized controlled trials conducted in children/adolescents 2-19 years old in Europe, USA, Canada or Oceania, from 01/2013 to 06/2023. Exposures that were considered under the umbrella “meal patterns” included consumption of a meal, meal skipping, timing, format and context. The quality of the studies was assessed with the ROBINS-E and RoB-2 tools.Of the 3,020 studies initially retrieved, 27 were included. All studies reported on Ov/Ob risk, whilst no studies on MUO were identified. All but one study had a longitudinal study design. Twenty-two studies (81%) had a high/very high risk of bias, mainly due to the methods measures of exposure were assessed. Consumption of/skipping breakfast was the most common exposure, followed by consumption of lunch (n = 5), dinner (n = 5), meal frequency/eating occasion (EO; n = 5) and consumption of fast foods (n = 4). Some studies reported on meal context (eating while watching TV; n = 4). In most studies, frequent breakfast and evening family dinners (i.e. 7 days/week vs <7days/week) were associated with lower odds of childhood Ov/Ob, BMI and %body fat at followup (FU). Four studies also showed that skipping breakfast was associated with increased obesity markers, while three studies showed no associations. There was limited evidence of a positive association between eating while watching TV and weight trajectories (n = 2). No associations were reported in relation to frequency of lunch and fast food intake. Results regarding meal frequency/EO and Ov/Ob at FU are conflicting, with differences attributed to the definition of an EO.Evidence supports that frequent consumption of breakfast and family dinners may be associated with lower Ov/Ob risk in children and adolescents, while eating in front of TV with increasing weight trajectories. No studies were identified in relation to MUO, highlighting a significant research gap. Nevertheless, clear definition on EOs and improved methodological approach in the assessment of meal patterns emerged as a need, according to current review findings.
Iron bioacessibility from fava bean-fortifed white wheat flour following simulated in vitro gastrointestinal digestion
Authors: Wang R. , Bajka B.H. , Latunde-Dada G.O. , Sharp P.A. 
Published: December 2024

Wheat flour is a major dietary source of iron; however, during milling to produce white wheat flour, the mineral-rich aleurone layer is removed. In the UK elemental iron is added to white flour to replace iron lost during processing(1). Soy flour is also added to bread flour as a flour improver(2). Legumes, including soy, are rich in iron and this raises the possibility that legume flour could be used to increase the iron content of white wheat flour products(3). The aim of this study was to investigate iron bioaccessibility from fava bean-fortified white flour, and to test the hypothesis that fava beans have the potential to be natural iron fortificants for wheat white flour.Dried fava beans were purchased from Hodmedods UK and were ground to a course flour using a coffee grinder. Experiments utilized white flour fortified with different weight percentages of fava bean flour (0%, 25%, 50%). Mineral content of all samples was measured by inductively coupled plasma optical emission spectrometry (ICP-OES). Phytic acid of the samples was measured by using Megazyme kit (Megazyme-K-PHYT). The bioaccessibility of iron was determined by ICPOES following a simulated in vitro peptic (pH 2, 90 min) and pancreatin/bile (pH 7, 90 min) digestion(4). Data are mean ± SEM of 3 independent experiments and were analysed by one-way ANOVA and Tukey’s post-hoc test.The iron content of flours was increased significantly with the inclusion of 25% or 50% fava bean (FB) powder (P<0.0001): 1.07 ± 0.01 (white flour control); 2.12 ± 0.07 (25% FB) and 3.15 ± 0.07 (50% FB) mg/100 g. Furthermore, the fava bean fortified flours had significantly (P<0.0001) higher phytic acid content: 0.19 ± 0.01; 0.40 ± 0.01 and 0.56 ± 0.02 g/100 g, respectively. No significant difference was observed in terms of the molar ratios of phytic acid to iron (15.17 ± 0.36, 15.94 ± 0.26, 15.13 ± 0.38) or in iron bioaccessibility (78.34 ± 2.53%, 77.62 ± 3.01% or 72.56 ± 1.91%) between the white flour (0%) and fava bean-fortified flour samples (25% and 50%).The results from this study show that addition of fava bean flour significantly increased the iron content of the white flour samples; however, the phytic acid content was also increased. The molar ratio of phytic acid to iron is an important determinant of iron bioaccessibility and bioavailability. While this study demonstrates that fava bean flour can be used as a natural iron fortificant, it highlights the need for additional food processing steps to reduce phytic acid levels and enhance iron bioaccessibility from foods produced using fava bean-fortified white wheat flours.
A comparative assessment of specified nutrients and biochemicals in kimchi before and after freeze drying and powdering
Authors: Webster J. , Gordon-Smith K. , Ahmadi KR , Mathur H. , Leech J. , Grassby T. 
Published: December 2024

Our diet and its impact on the human gut microbiota in terms of composition and function are key determinants of human health across the life-course(1). Fermented vegetables can have enhanced functional and nutritional properties through substrate transformation by microbes and production of biochemicals during the fermentation process(2). Kimchi is a traditional Korean vegetable ferment produced via spontaneous lactic acid bacteria fermentation. Plant nutrients and biochemicals, microbial metabolites and microbial cell components are present in kimchi(3). As live products, fermented vegetables present challenges to commercial producers who need shelf/ transport stability to deliver consistent products to consumers. We hypothesise that fermented vegetable health advantages will be preserved by freeze-drying, while enabling product stability, extended shelf and storage life, stable transportation and utility as food ingredients.Utilising existing kimchi physiochemical data, we identified kimchi biochemicals (KBs) (benefit health but not essential to it) and kimchi nutrients (KNs) (essential to health). We quantified these components in 3-day old fresh kimchi (T3) and in 3-day old fresh kimchi that had been freeze-dried and powdered (T3 FDP). We sampled technical triplicates and calculated P values using an unpaired 2 tailed t-test.The hypothesis that KBs and KNs in T3 FDP are preserved at levels not statistically significantly different to those in (T3) (P > 0.005) was disproved. Components of kimchi were affected differently by the FDP process, with decreases in some and increases in others. As a result, the overall profile of KBs and KNs in T3 FDP was different to T3. Based on a daily portion of fresh kimchi being ∼50 g, there was 2.64 g KBs and KNs in 50 g T3 and 2.28 g KBs and KNs in equivalent portion T3 FDP (7.5 g), a reduction of 13.64% after FDP in KBs and KNs combined. Unexpectedly, soluble fibre and iron were significantly lower in equivalent sample T3 FDP compared to T3 (P = 0.003 and P < 0.0001 respectively) and vitamin B9 was significantly higher in T3 FDP compared to T3 (P < 0.0001). For KBs, acetic acid and lactic acid were significantly lower in T3 FDP (P = 0.020 and P = 0.046 respectively), but propionic acid was undetectable in T3 and the equivalent sample T3 FDP contained 1.44 g. Capsaicinoids were not detectable in T3, but were notably present in T3 FDP.This study represents a critical first step in understanding the extent to which the functionality of fresh kimchi is preserved in its freeze dried and powdered form (termed a FermentceuticalTM). Improving health through fermented foods is a critical concept for consumers, food manufacturers and healthcare professionals, alike.
What do consumers want in a local and sustainable plant-based product? Findings from co-creation workshops on the island of Ireland
Authors: Benson T. , Nugent A. , Dean M. 
Published: December 2024

The production and consumption of food has a significant impact on our environment, with 2030% of consumption impact on the environment relating directly to food and drink(1–3). One method of reducing this is to diversify protein intake e.g. reducing meat consumption in favour of more sustainable products. While the use of plant proteins is to be encouraged, on the island of Ireland this still has challenges(4). There is therefore a need to diversify protein intake on the island of Ireland through products which are both sustainable and local.Using co-creation methods, this study aimed to understand what consumers want as sustainable and local plant-based products. Specifically, the study focused on oat, wheat, barley, rye, and pea. Co-creation puts consumers at the heart of product development, ensuring their ideas are understood from the beginning, thus leading to greater acceptance and potential for product success. Four workshops plus a follow-up workshop (n = 38: 21 female, 17 male, age range 22-80 years old) were held across Belfast and Dublin to understand consumers’ wants for a sustainable and local alternative protein product. Workshops discussed factors influencing food purchasing, current sustainability issues, and strategies to shift to a sustainable diet. Key co-creation tasks included drawing a local and sustainable product based on any (or any combination) of the 5 specified ingredients. Discussions were transcribed and initial findings using content analysis are presented.For products made by participants through co-creation, pea was a popular ingredient, with the top 3 highest rating products based on pea. Products containing oats and wheat were also popular. Product types varied and included main meals (plant-based burgers, pastas etc.), snacks (crackers, crisps etc.), and drinks (milks and meal replacements). While popular in the main workshops, consumers in the follow-up workshop who were tasked with reviewing the products created in the other workshops, largely rejected pea-based products due to taste. The highest rated products were a bolognese product made with pea and barley, porridge oats, and wheat and barley pasta.These findings corroborate wider research findings that taste is vital in new product development. Basic products based on similar products already on the market ranked high, in line with findings that familiarity is a key driver of acceptance of alternative proteins. Future research should use these findings to gauge the popularity and acceptance of these products at a wider level.
Associations of pulse-rich diets with risk of cancer incidence and mortality: findings from the UK Biobank prospective cohort study
Authors: Kaimila Y , Olotu O. , Clegg M , Jackson K.G , Lovegrove J.A 
Published: December 2024

Approximately 25% of deaths in the UK are caused by cancer(1). Studies have reported a lower risk of all site cancers, and specifically kidney, stomach, oesophagus, colorectal, oropharyngeal, and upper aerodigestive cancers in higher consumers of pulses compared to low consumers(2). However, findings are inconsistent with others showing no association(3). In view of the limited studies conducted to date, the objective of this data analysis was to assess the association of pulse-rich diets (beans, chickpeas, and lentils) with cancer incidence and mortality in UK adults.This prospective cohort study of the UK Biobank included 115,011 participants (55%, n = 62,977 females) aged 40-70 years at recruitment (2006 and 2010) who had undertaken at least two complete 24-hour dietary recalls and were followed up until 2022. Participants with cancer at baseline, extreme dietary energy intakes, or pregnant were also excluded from the analysis. Pulse consumption was split as non-consumers (NC,0g/day, n = 73,266), and three tertiles (T) according to the level of pulse intake (T1:1-20.4g/day, n = 14,035; T2:20.5-40.4g/day, n = 13,509; and T3:40.5360g/day, n = 14,161). Using Cox proportional hazard models, the hazard ratios (HR) of the effect of pulse consumption on total and multi-site cancer incidence and mortality was conducted with sex, age, dietary energy, region, ethnicity, income, employment, smoking status, education, exercise level, body mass index (BMI), supplement use, alcohol intake, family history of cancer, intake of fruits and vegetables, processed meat, and dietary fibre as covariates in the fully adjusted model as appropriate for the cancer site.The cohort had a mean ± SD age of 55.9 ± 7.0 years, BMI of 26.7 ± 4.6 kg/m2 and pulse intake of 13.3 ± 20.5g/day. White people (n = 110,890, 96.4%) had the lowest mean ± SD pulse intake compared to all other ethnicities (13.2 ± 24.4g/day vs 17.0 ± 27.7g/day, p<0.001 respectively). After a mean follow-up of 12.4 years, there were 3281 cancer deaths and 17,415 incidences of cancer. There were inverse associations of pulse intake with the incidence of liver cancer (HR 0.39: 95% CI:0.17, 0.90) and thyroid cancer (HR 0.40: 95% CI: 0.16, 0.99) in T2 compared to NC for both sexes and in NC compared with T1 for breast cancer in females (HR 0.55: 95% CI: 0.36, 0.86). No associations were observed for other cancer sites or for cancer mortality.Compared with NC, our findings suggest that diets with an intake of pulses up to 40.4g/day are associated with lower incidence of liver, thyroid, and female breast cancer but not other cancers or mortality. The lack of association between diets containing higher pulse intake with cancer incidence and mortality was unexpected and suggestive of effects of other dietary components, studies on the dose dependent effects and types of pulse intake on cancer incidence and mortality are needed.Funding received from BBSRC (BB/W017946).
The nutritional profile of plant-based meat alternatives vs. traditional plant proteins: A product audit
Authors: Lindberg L. , Woodside J.V. , Kelly C. , Robinson M. , Nugent A.P 
Published: December 2024

Plant-based meat alternatives (PBMAs) are products made from manufactured ingredients such as protein isolates, to replicate the organoleptic and functional properties of meat(1). Traditional plant proteins (TPPs) such as tofu, tempeh and legume-based dishes are whole plant foods and have been longstanding components of the protein group of food-based dietary guidelines (FBDGs)(2). PBMAs have been added to some recently revised FBDGs(3,4), however, with considerable differences in ingredient composition, the objective of this study was to evaluate if these products are similar in terms of energy and macronutrients content.An online audit of PBMAs available in Tesco and Sainsbury’s was completed (November 2023January 2024). On-pack information was extracted, and similar products were grouped. Within eligible categories (burgers, beef-style dishes and seafood), products were further grouped according to their classification as a PBMA or TPP. Categories such as tofu and tempeh were combined and compared with PBMA chicken fillets/chunks and beef/pork products separately. Mean energy and nutrient contents were compared using independent sample t-tests, with P values ≤ 0.05 considered statistically significant. A-scores from the UK’s Nutrient Profiling Model(5) were calculated and the EU threshold for protein claims (≥12% energy from protein)(6) was applied to determine the proportion of products within each category considered a protein source.Within the burger category, PBMAs (n = 43) had a significantly higher mean energy (206.8 vs. 197.4 kcal/100g, P = 0.008), total fat (11.2 vs. 8.4 g/100g, P = 0.05), and saturated fat content (2.5 vs. 0.8 g/100g, P = 0.02), and significantly lower carbohydrate content (10.4 vs. 23.5 g/100g, P = 0.002) than TPPs (n = 14). Within the seafood category, PBMAs (n = 11) had a significantly lower total fat content (9.9 vs. 11.4 g/100g, P = 0.001) and significantly higher protein (6.6 vs. 4.5 g/100g, P = 0.04) and salt content (1.0 vs. 0.8 g/100g, P = 0.03) than TPPs (n = 5). PBMAs within the beef-style dishes category (n = 19) were significantly higher in energy (174.2 vs. 111.5 kcal/100g, P = 0.003) than TPPs (n = 20).When PBMA chicken (n = 81) and beef/pork (n = 20) were compared with tofu, tempeh and jackfruit (n = 17 and 20 respectively), PBMA chicken had a significantly higher carbohydrate content (12.2 vs. 2.6 g/100g, P<0.001) and PBMA beef/pork had a significantly higher protein content (17.2 vs. 13.1 g/100g, P = 0.005). PBMAs had higher mean A-scores (6.4 - 8.5) than TPPs (3.2 - 6.6) in 4/5 categories indicating they are ‘less healthy.’ Very few TPPs within the burger and seafood categories met the protein threshold compared to PBMAs.Differences in energy, macronutrient content and A-scores, mean PBMAs and TPPs cannot be considered nutritionally equal.