bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterisation of sedentary lifestyle in patients with Type 2 Diabetes Mellitus in Family Health Centres
Authors: Jiménez S , Fernández-Cao JC , Doepking C , López A , Vega F , Fernández G , Balboa K , Trigo D , Flores J , Bustos M 
Published: December 2024

Diabetes Mellitus (DM) represents a significant public health concern with a global impact(1,2). According to the International Diabetes Federation, in 2021 the global prevalence of this pathology was 10.5% and 12.7% in Chile(3). Of these cases, 90% are cases of type 2 Diabetes Mellitus (DM2). One of the risk factors for its management and prognosis, once diagnosed, is a sedentary lifestyle(3). A sedentary lifestyle rate of 86.7% has been reported in Chile(4). However, to our knowledge, there is no data on sedentary lifestyles in the diabetic population of the commune of Copiapó. Therefore, this study aimed to describe and compare the level of sedentary lifestyle in women and men with DM2 in the Family Health Centres (CESFAM) of Copiapó (Chile).A cross-sectional study was conducted using data obtained from participants in the CODIACO cohort. Twenty-five individuals, comprising both sexes and aged between 30 and 65 years, diagnosed with DM2 and users of the CESFAMs of Copiapó, were included. These individuals also had mobile devices capable of installing the accelerometry application ‘Physics Toolbox Sensor Suite’. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer, and severe inflammatory or infectious diseases were excluded. They were asked to activate and deactivate the application for 7 to 12 days, at waking and bedtime, respectively. Physical activity and sedentarism were determined when the accelerometer was over or below 0.6 mm/sec2 respectively from the total daily activity (%). WhatsApp transmitted the information recorded to estimate each participant’s sedentary lifestyle level. A Student’s t-test for independent samples was employed to compare the percentage of sedentary behaviour between women and men. The results were expressed as the mean and standard deviation. A P-value of less than 0.05 was considered statistically significant. The CODIACO study was approved by the Scientific Research Ethics Committee of the Universidad de Atacama. The project was funded by FONDECYT N° 11180794.The number of women in the sample was 19 (76%) and the number of men was 6 (24%). The values of sedentary lifestyle for women were 85.32 ± 9.5%, which was similar to those found in men, 82.5 ± 10.31%. Although women show a higher tendency to increase sedentary lifestyle behaviour, The T-test did not determine differences between sexes (p>0.05), maybe, due to the high number of women compared with men in the sample.The level of sedentary lifestyle in patients diagnosed with DM2 in the CESFAM of Copiapó is high and is in line with that observed in the general population in Chile. Furthermore, no differences are observed between men and women. Further studies are required to confirm this result and to investigate its cause to generate strategies to help reduce sedentary lifestyles in this population.
Prospective association between ultra-processed food consumption and incidence of type II diabetes: the UK Whitehall II cohort study
Authors: Wang M.E. , Iewellyn C. L , Kastoulis M. , Britton A. 
Published: December 2024

Ultra-processed foods (UPFs) consumption, characterized by high levels of sugars, unhealthy fats, and additives, yet low in nutrients, has increased significantly in recent decades(1). Previous studies have demonstrated the link between UPF consumption and Type 2 diabetes (T2D)(2). Considering the variation in these food categories across studies and the scarcity of large-scale studies focusing on specific UPF subgroups, this study aims to explore the prospective association between UPFs, their subgroups, and the incidence of T2D in a UK based cohort study.A total of 7,774 participants aged 40-69 years without T2D (69% men and 31% women) from the Whitehall II cohort, who had dietary intake data at baseline (1993/1994) and follow-up data on T2D incidence available, were included in the analyses. Food intake was assessed using a validated 127item food frequency questionnaire (FFQ). We applied the NOVA classification to categorize FFQ items into four classes based on the level of processing. The intake of UPFs per day was calculated as a percentage of the total daily food intake in grams to account for UPFs that do not provide energy. The incidence of T2D was evaluated from 1993/1994 to 2007/2009 through self- reports and oral glucose tolerance test results. Multivariate Cox regression models were employed to assess the prospective association between UPFs consumption (in quintiles) and T2D risk, adjusting for socioeconomic factors, family history of T2D, lifestyle characteristics, total energy intake, and indicators of nutritional quality.During the 15-year follow-up, 954 cases of T2D were confirmed. In multivariable models adjusted for family history of T2D, socioeconomic, and lifestyle factors, the highest UPF consumption quintile [mean 33% of total daily intake (grams)] was associated with an increased risk of T2D [HR: 1.35, 95% CI: 1.06-1.71] compared to the lowest quintile [mean 9.6% of total daily intake (grams)]. Adjustment for total energy intake slightly increased the risk of T2D [HR: 1.46, 95% CI: 1.12-1.91].Additional adjustments for sugar, sodium, and fat intake further increased the risk of T2D [HR: 1.51, 95% CI: 1.15-1.98]. Among UPFs subgroups, only the intake of soft drinks was significantly associated with an increased risk of T2D [HR: 1.02, 95% CI: 1.01-1.08], whereas no significant associations were found for other UPFs subgroups. Similar results were found after multiple imputation of missing values.In UK midlife adults, higher UPF consumption tends to be prospectively associates with an increased risk of T2D, with notable variations across UPFs subgroups. These findings suggest that the association between UPFs intake and T2D might be independent of nutritional quality and energy intake, indicating that food processing itself could be a contributing factor. This study provides evidence to support efforts to limit UPF consumption as a strategy to alleviate the population burden of T2D.
Maternal and infant food insecurity: A qualitative investigation into women’s experiences during and after pregnancy in South London
Authors: Flynn A. , Marshall J , Davies L , Lambeth HDRC , Lavelle F. , Harding S. , Bell Z. 
Published: December 2024

A period of the life course where optimal nutrition and food security are crucial for the life-long health and wellbeing of women/birthing parents and infants is preconception, pregnancy, and infancy.(1) It is estimated that nearly one in every four households with pre-school children (0-4 years) experience food insecurity (FI) in the UK.(2) Yet, we lack an evidence-base exploring experiences of FI in this life course stage.(3,4) This study aimed to explore women’s experiences of food insecurity during and after pregnancy, including its influence on infant feeding decisions.This study was ethically approved (Ref No: LRS/DP-23/24-39437) and pre-registered on OSF Registries (https://osf.io/9hn6r). Semi-structured mixed format individual interviews were conducted between November 2023 and February 2024. Pregnant individuals, those who had given birth ≤12 months ago, ≥18 years old, food insecure, residing in South London and with recourse to public funds were recruited through purposive sampling. The topic guide was informed by FI, pregnancy and postpartum related literature and piloted (n = 2). Interviews were audiorecorded and professionally transcribed. Demographic data was summarised using SPSS. Inductive thematic analysis was used to analyse the data and was completed using NVivo.Eleven food insecure participants (2 pregnant, 9 new mothers; 2 White European, 9 Black African/Caribbean/British women) participated in the study. Six women were 0-6 months postpartum, and 3 women were between 6-12 months postpartum. The preliminary findings are represented by three themes: 1) A dichotomy: knowing vs affording, 2) Adaptive food coping strategies, and 3) Infant feeding practices. Participants shared detailed accounts of valuing a healthy diet and adapting food practices, yet they still were unable to meet their dietary needs and desires during and after pregnancy. Participants described worry around breastmilk supply; quality and quantity. Complimentary feeding was also identified as a source of worry. “She is still breastfeeding fully. I don’t want to change to milk, which maybe, sometimes, I might not be able to afford it…I won’t stop until she is 1.”Whilst the cost of formula feeding was a driver of a more severe experience of FI.Policy and practice recommendations include enhancing local breastfeeding support to address FI specific concerns around breastmilk supply and at national level, advocating for greater support for adequate healthy food provision and for a price cap on infant formula. Future interventions must support maternal mental health given the high cognitive stress identified with living with FI during and after pregnancy. Further high-quality research is needed 1) amongst asylum seekers and refugees and non-English speakers who may also experience FI, and 2) exploring cultural influences on breastfeeding and the relationship with FI.
Exploring the impact of cost-of-living-crisis on the dietary practices and health impact among immigrant Nigerians in the UK
Authors: Johnson B. , Sharma M. , Ellahi B. 
Published: December 2024

Morbidity and mortality from preventable diseases among ethnic minority groups are higher when compared with white population group in the UK(1). Diet is a major modifiable disease risk factor and depends on several factors, including the affordability and availability of foods commonly consumed by these communities. With families now bearing the burden of inflation with an increase in the price of food, and with people adapting to this by adjusting their spending, the widening of health inequality is reported(2).Understanding of the impact of the cost-of-living crisis (COLC) on the dietary practice and health of ethnic minority populations is limited(2). This study explored the impact of dietary choices in the immigrant Nigerian community living in the UK, within the context of a COLC.Using hermeneutic phenomenological design and with the aid of purposive sampling, community networks, and snowballing were leveraged to assist in recruiting participants from the Nigerian population in Manchester and London based on age, gender, and socio-economic factors. Utilising an informed consent process, fifteen one-to-one telephone semi-structured interviews were undertaken, and detailed information about culture, dietary choices, and the cost-of-living crisis was collected.The six-step guide Braun & Clark’s Reflexive thematic analysis of verbatim transcribed data from the audio-recorded interviews revealed adaptive and coping strategies have been adopted(3). Participants report what they now eat, and activities adopted to support eating. This includes purchasing cheap, low-quality, and reduced quantities of food, reducing wastage of food through preservation of any excess, bulk cooking, or preparation to minimise energy usage. Other cost savings are being made through, cutting down on social engagements (e.g. eating out and nightlife), A focus on food ‘’needs’’ and not ‘’wants’’, a reliance on social networks for support and assistance, the use of food banks, and skipping meals is also reported. One participant: ‘’This has affected our diet. So, it’s been very challenging. I mean generally, everywhere the cost of things is high’’. (GregM61). Another said, “I just cook enough for two days so that I can save some energy and reduce my energy bills”. (KhadijatF45). Illustrating the impact on health one participant suggested: ‘’When you have a cheap cost of meat and a cheap cost of carbohydrates, then you are eating badly’’. (EkongM51).These findings cause concern since cheap and low-quality diets eaten by ethnic minority communities are known to be unhealthy and are high-risk factors for chronic diseases(4). The need for long-term support for individuals or groups most at risk of the COLC, and an ongoing need to develop culturally appropriate strategies to support healthy eating on a budget for this ethnic group are paramount to prevent poor health outcomes in this group.
Building belonging: the role of community cafés
Authors: Sumpter S. , Nancheva N. , Ranta R. , Bhakta D. , Mulrooney H. 
Published: December 2024

Community cafés are non-profit ventures tackling food insecurity (FI) locally and equitably, primarily using pay-as-you-feel models(1). FI is most prevalent in low-income and other vulnerable groups(2), in whom poor diets and worse health also intersect(3). Despite recognition that FI is largely driven by poverty and inequity(4), FI individuals are often negatively judged(5), risking further marginalisation. Community approaches to tackling both food waste and FI include community cafés, which frequently utilise surplus foods(1) to produce fresh meals and/or donate surplus food to those in need. Beyond a nutritional impact, community cafés have the potential to offer marginalised groups a safe space and a feeling of inclusion, benefitting their mental health and wellbeing. The aim of this study was to explore the social impact of community cafés.Two linked community cafés in a London borough were evaluated to explore their social impact on clients. Both operated using pay-as-you-feel; neither required proof of need. Evaluations were undertaken using mixed methods on 9 site visits (November 2022 - April 2023). Bespoke questionnaires (n = 72) and 4 interviews were completed by clients, and 40 interviews with volunteers. Thematic analysis of qualitative data and Kruskal Wallis analysis (posthoc Dunn’s and Bonferroni correction) of quantitative data were carried out.Both cafés relied on surplus food. Their primary priorities were tackling food waste and the environment followed by addressing FI. Qualitative and quantitative data from interviews and questionnaires revealed that for many clients, social and food provision were equally important. This was especially true for older clients; significantly more of those aged ≥65 compared with those aged 18-24 yr visited for social reasons (p = 0.02). The most highly rated aspects of provision for clients were the friendliness of the people and the helpfulness of the staff (98.7 and 97.1% respectively). Being able to meet and talk was identified as important by 70.1% of clients. Anecdotally, this was especially important to marginalised groups like migrants and refugees. Since referral to the cafés was not needed, clients included individuals utilising them for environmental reasons as well as those affected by FI. This allowed mixing among groups who would not ordinarily meet. Volunteers also highlighted this as key to enable them to hear the stories of those they served. The mixed clientele not only helped build community but helped reduce stigma, since FI was not the sole reason for attending. For volunteers, the open and accepting nature of community provision which did not require referral or proof of need, was valued.The data suggest that community cafés have important value beyond nutrition, enabling formation of community networks and increasing understanding of the lived experience of those with FI.
Associations of eating rate with postprandial glycaemic and insulin responses, gastric emptying, food and energy intake in older adults (aged ≥65 years)
Authors: Zannidi D. , Methven L. , Woodside J.V. , McKenna G. , Forde C. G. , Shafat A. , Clegg M. E. 
Published: December 2024

The population of older individuals worldwide is increasing and achieving a good quality of life in older age is vital(1). However, anorexia of ageing, a phenomenon often associated with delayed gastric emptying and reduced oral processing abilities(2), can negatively affect older adults’ health, quality of life and contribute to undernutrition(2). In younger populations, slower gastric emptying has been associated with greater satiation and satiety(3), and slower eating rates with reduced food intake and postprandial euglycemia(4); however, little is known about these associations in the older adult population. This study investigated individual variations in food oral processing and their influence on postprandial glycaemic and insulin responses, gastric emptying, food and energy intake, in healthy adults, aged ≥65 years.Participants attended a single visit day, after an overnight fast. A fixed-portion breakfast meal was provided and consumption was video-recorded for behavioural-annotation to quantify specific oral processing behaviours. Postprandial glucose and insulin responses were assessed via mixedcapillary fingerprick samples, and gastric emptying was measured with the 13C-octanoic acid breath test(5). Three hours post breakfast, an ad libitum lunch was provided, where eating rate and food intake were measured. Food and drink intake for the rest of the day was assessed using a weighed food diary. Participants were classified as slower and faster eaters using a median of eating rate (g/min) of the breakfast meal, with an even number of males and females in each group. Repeated measures ANOVA and multiple regression analysis were used to explore the relationship between ad libitum intake and the parameters outlined above.Eighty-eight older adults were recruited, 44 males and 44 females, with mean age 73.7 ( ± 5.3) years.For the three hours postprandially, both glucose and insulin changed significantly over time (Fglucose = 150.779, p <0.001 and Finsulin = 111.645, p <0.001), but no differences observed between faster and slower eaters (p >0.05). Similarly, gastric emptying did not differ between faster and slower eaters (p >0.05). At the ad libitum meal, eating rate of the meal was the only significant predictor of energy intake (r = 0.685, p <0.001), after accounting for age, gender and the postprandial (post breakfast) metabolic responses, gastric emptying and subjective satiety.This study found no effect of eating rate on postprandial glycemia or gastric emptying in older adults, but showed significant association of eating rate during the meal on food and energy intake. These findings could provide implications in the design of texture-appropriate foods for this age group for future meal interventions.
Exploration of self-perceived masticatory ability and measured biting force on nutrient intakes in older Thai adults
Authors: Nitsuwat S. , Marshall L. , Sranacharoenpong K. , Sarkar A. , Cade J. 
Published: December 2024

As the global population ages, understanding the factors influencing older adults’ health and wellbeing becomes increasingly important. Aging can lead to various health complications, including reduced muscle strength, affecting daily activities such as food consumption(1). The decline in oromasticatory muscle function can cause chewing difficulties that limit food choices(2). Given that adequate nutrition is essential for maintaining the quality of life, this study aims to examine the relationship between self-perceived chewing ability and objectively measured biting force to understand the extent of their effect on nutrient intake.A total of 148 community-dwelling older adults aged 64 to 90 years old (median age 71 ± 8 years) from urban (Bangkok Metropolitan Region) and rural (Chonburi Province) areas of Thailand participated. Maximum biting force (Newtons, N) of the posterior teeth was instrumentally measured, and participants rated the chewing difficulty of 20 commonly consumed foods as easy, difficult, or cannot be chewed at all. Foods were grouped into five difficulty levels by principal component analysis of the ratings and masticatory ability scores (0 to 10) were calculated. Food intake was obtained from 24-hour dietary recalls through interviews and body mass index (BMI) data was obtained.Participants were grouped into tertiles of low (median = 73 N; IQR = 37–127), moderate (median = 336 N; IQR = 241–387), and high (median = 512 N; IQR = 477–512) biting force. A Kruskal-Wallis test revealed that those with low biting force had significantly (p < 0.01) lower self-assessed masticatory ability scores (median = 7.69) compared to those with high biting force (median = 8.86). Significant differences in the daily intakes of dietary potassium, magnesium, and vitamins B1, B2, B6, and C were observed between the high and low biting force groups (p < 0.01).However, multiple regression analyses adjusted for age, sex, education, and location did not show significant predictive power for any nutrient intake from either biting force or masticatory ability, except for positive associations with vitamins C and B2, and fruit intake. A unit increase in mastication ability was associated with an increase in daily intake of 0.21 milligrams of vitamin C (95% CI = 3.03, 33.64; p = 0.02) and 0.19 milligrams of vitamin B2 (95% CI = −0.01, 0.13; p = 0.03).Additionally, a unit increase in biting force was associated with an increase in daily fruit intake of 0.17 grams (95% CI = −0.02, 0.28; p = 0.08). No relationships with BMI were observed for either biting force or masticatory ability.Higher biting force in older adults improves self-perceived masticatory ability, leading to a higherquality diet with foods rich in vitamins B2 and C, such as meat and fruits. Targeted interventions to enhance biting force could help prevent malnutrition.
Whole Grain Intake in the United Kingdom Remains Unchanged from 2008/9 to 2018/19 and Well Below Recommended Levels
Authors: Kutepova Inga , Rehm Colin D , Joy Friend Samara 
Published: December 2024

Whole grain (WG) consumption has been associated with many health benefits(1–4). However, in the UK, there is a lack of WG intake data with the most recent analysis available spanning the years 2008-2011(5–7). In this study, our aim is to assess the consumption of whole grains among the UK population using data from the National Diet and Nutrition Survey (NDNS) rolling programme covering the years 2008 to 2019.WG intake trends and sociodemographic patterns from the UK NDNS Rolling Programme, 2008/09 to 2018/19, of 15,655 individuals aged ≥1.5 years who completed a four-day food diary were analysed. WG consumption was assessed by examining the WG content of foods in grams based on product ingredient information. Survey-weighted mean consumption of whole grains overall and by socio-demographic group and health status variables. Survey-weighted Wald tests (for categorical variables such as ethnicity) and trend tests (for ordered variables such as age group) will be used to determine whether intakes of whole grains differ within category.No statistically significant trend was observed in total WG intake when comparing the intakes from 2008-2012 to 2016-2019, with mean intakes of 29.2g/day (95% CI: 27.8, 30.5) and 28.2g/day(95% CI: 26.8, 29.6), respectively. In 2016-2019 older adults (65y+) had the highest consumption (33.6 g/day [95% CI: 30.5, 36.8]), followed by 19-64y, with an intake of 29.1 g/day (95% CI: 27.1, 31.2). High-fibre cereals, bread, and other cereals including pasta and rice were the primary sources of WG. Between 2008-2012 and 2016-2019, the mean daily intake of high-fibre cereals and bread significantly declined from 11.1g (10.3, 11.9) to 9.3g (8.5, 10.1) and 12.4g (11.6, 13.1) to 10.0g (9.2, 10.8) respectively. Conversely, consumption of other cereals increased from 4.0g (3.3, 4.7) to 6.9g (6.1, 7.6) per day. Individuals with higher incomes, levels of education and healthy weights showed higher mean WG consumption.Our study showed no statistically significant change in mean whole grain consumption in the UK from 2008/09 and 2018/19. Although, there is absence of dietary WG recommendations in the UK, whole grain intakes are below the recommended levels proposed by many countries.