Pub Date : 2024-09-01Epub Date: 2023-10-06DOI: 10.1017/S0029665123003713
Flora Douglas
Poor dietary patterns leading to poorer health and increased health care use have affected people living in disadvantaged economic circumstances in the UK for decades, which many fear will be exacerbated due to the UK's current so-called 'cost of living crisis'. The voices of experts by experience of those health and social inequalities are not routinely included in health improvement intervention development in relation to obesity prevention policy and programmes. Obesity is highly correlated with food insecurity experience in high-income country contexts (where food insecurity data are routinely collected) and is similarly socially patterned. Using a health equity lens, this review paper highlights qualitative research findings that have revealed the perspectives and direct experiences of people living with food insecurity, or those others supporting food-insecure households, that shed light on the role and influence of the socio-economic contextual factors food-insecure people live with day-to-day. Insights from qualitative research that have focused on the granular detail of day-to-day household resource management can help us understand not only how food insecurity differentially impacts individual household members, but also how behavioural responses/food coping strategies are playing into pathways that lead to avoidable ill health such as obesity, diabetes and other chronic health conditions, including mental health problems. This review paper concludes by discussing research and policy implications in relation to food-insecure households containing people with chronic health conditions, and for pregnant women and families with infants and very young children living in the UK today.
{"title":"What qualitative research can tell us about food and nutrition security in the UK and why we should pay attention to what it is telling us.","authors":"Flora Douglas","doi":"10.1017/S0029665123003713","DOIUrl":"10.1017/S0029665123003713","url":null,"abstract":"<p><p>Poor dietary patterns leading to poorer health and increased health care use have affected people living in disadvantaged economic circumstances in the UK for decades, which many fear will be exacerbated due to the UK's current so-called 'cost of living crisis'. The voices of experts by experience of those health and social inequalities are not routinely included in health improvement intervention development in relation to obesity prevention policy and programmes. Obesity is highly correlated with food insecurity experience in high-income country contexts (where food insecurity data are routinely collected) and is similarly socially patterned. Using a health equity lens, this review paper highlights qualitative research findings that have revealed the perspectives and direct experiences of people living with food insecurity, or those others supporting food-insecure households, that shed light on the role and influence of the socio-economic contextual factors food-insecure people live with day-to-day. Insights from qualitative research that have focused on the granular detail of day-to-day household resource management can help us understand not only how food insecurity differentially impacts individual household members, but also how behavioural responses/food coping strategies are playing into pathways that lead to avoidable ill health such as obesity, diabetes and other chronic health conditions, including mental health problems. This review paper concludes by discussing research and policy implications in relation to food-insecure households containing people with chronic health conditions, and for pregnant women and families with infants and very young children living in the UK today.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":" ","pages":"170-179"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2023-10-12DOI: 10.1017/S0029665123003701
M Wesolowska, A J Yeates, E M McSorley, J J Strain, E van Wijngaarden, G J Myers, M S Mulhern
{"title":"A pilot study investigating the relationship between serum Se concentrations and Selenoprotein P activity at 28wks gestation in a high fish-eating sub-cohort of Seychellois pregnant women - CORRIGENDUM.","authors":"M Wesolowska, A J Yeates, E M McSorley, J J Strain, E van Wijngaarden, G J Myers, M S Mulhern","doi":"10.1017/S0029665123003701","DOIUrl":"10.1017/S0029665123003701","url":null,"abstract":"","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":" ","pages":"217"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this review is to highlight the key issues in relation to food insecurity among children and young people living in Scotland. It provides an overview of the current context of food insecurity more generally within the UK and specifically in Scotland. Food insecurity has risen in Scotland evidenced through responses to national surveys and the dramatic increase in households relying on emergency food provision. Food insecurity is highest among young people, single parent families and single men. The key drivers of food insecurity include insufficient income, welfare reform, food inflation and geo-political events. Evidence suggests that food insecurity is negatively related to sufficient nutritional intake, and the implications for physical and mental health are profound. Policy actions implemented to mitigate the impact of food insecurity on children and young people include the introduction of the Scottish Child Payment, food voucher schemes, free school meals, and holiday food provision. Further evidence is required to evaluate the success of these policies in reducing or mitigating food insecurity. The review concludes by considering the ways in which a rights-based approach to food might benefit children and young people living in Scotland, and argues that wider systemic change is required.
{"title":"Food insecurity in children and young people in Scotland.","authors":"Stephanie Chambers, Kathryn Machray, Gillian Fergie","doi":"10.1017/S0029665124000090","DOIUrl":"10.1017/S0029665124000090","url":null,"abstract":"<p><p>The aim of this review is to highlight the key issues in relation to food insecurity among children and young people living in Scotland. It provides an overview of the current context of food insecurity more generally within the UK and specifically in Scotland. Food insecurity has risen in Scotland evidenced through responses to national surveys and the dramatic increase in households relying on emergency food provision. Food insecurity is highest among young people, single parent families and single men. The key drivers of food insecurity include insufficient income, welfare reform, food inflation and geo-political events. Evidence suggests that food insecurity is negatively related to sufficient nutritional intake, and the implications for physical and mental health are profound. Policy actions implemented to mitigate the impact of food insecurity on children and young people include the introduction of the Scottish Child Payment, food voucher schemes, free school meals, and holiday food provision. Further evidence is required to evaluate the success of these policies in reducing or mitigating food insecurity. The review concludes by considering the ways in which a rights-based approach to food might benefit children and young people living in Scotland, and argues that wider systemic change is required.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":" ","pages":"157-169"},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1017/s0029665124004385
S. Alsanie, K. Ibrahim, S. Lim, S. Wootton
Dehydration during hospital stays is a significant concern, particularly affecting older adults<jats:sup>(1)</jats:sup>. The ageing process associated with pathological changes and conditions such as dementia makes older adults especially vulnerable to both chronic and acute dehydration <jats:sup>(1,2)</jats:sup>. Recent studies indicate that conventional signs and symptoms of low-intake dehydration may not consistently indicate its presence in older inpatients, leading to missed or incorrect assessments. It can result in significant morbidity through falls, constipation, delirium, respiratory and urinary tract disorders, and even death <jats:sup>(2,3)</jats:sup>. Diagnosing low-intake dehydration at the early stage is challenging, leading to treatment delays which further compound the negative consequences of dehydration <jats:sup>(1,3)</jats:sup>. There is a need to determine the scope and practice of detecting and managing low-intake dehydration in ‘Medicine for Older People’ (MOP) wards at University Hospital Southampton (UHS). The primary aim of this study was to explore the current practices and challenges in detecting and managing low-intake dehydration in older inpatients within the MOP wards at UHS.Using a sequential, explanatory mixed-method design, a prospective chart review study (phase 1) was conducted at all the MOP wards at UHS over one month. The study included 50 adults aged 65 and above admitted to the medical wards for various reasons and now deemed ‘Medically Optimised for Discharge’ (MOFD). The quantitative aspect involved reviewing the completion of a local hydration assessment tool and the proper documentation of hydration and fluid balance charts for at-risk patients. The qualitative component (phase 2) consisted of semi-structured interviews with 10 participants—four doctors and six nurses with years of experience ranging from 4 to 12 years—to understand the perceptions of hospital staff on hydration care, its barriers and facilitators.The quantitative phase found that all patients were at risk for dehydration and underwent assessment through the hydration risk assessment, with hydration chart reviews during early, late, and night shifts. 20% did not have hydration assessment within 24h of admission and there were some missing reviews during various shifts. Most 24-hour fluid balance sheets were not completed for patients in the red category (start 24-hour fluid balance chart). Qualitative findings revealed that staff had ‘(1) experiential knowledge of hydration understanding the risks of dehydration in older adults’, ‘(2) difficulty in dehydration assessment and diagnosis due to resources’ and ‘(3) challenges related to staff levels and skills’ as well as (4) patient attributes contributing to difficulty in dehydration assessment.The mixed-methods study underscores the importance of addressing low-intake dehydration in older inpatients on MOP wards and highlights gaps in current practices. The findings emphasise the need
{"title":"Understanding the nature and scale of low-intake dehydration on ‘Medicine for Older People’ wards at University Hospital Southampton: A mixed-methods study","authors":"S. Alsanie, K. Ibrahim, S. Lim, S. Wootton","doi":"10.1017/s0029665124004385","DOIUrl":"https://doi.org/10.1017/s0029665124004385","url":null,"abstract":"Dehydration during hospital stays is a significant concern, particularly affecting older adults<jats:sup>(1)</jats:sup>. The ageing process associated with pathological changes and conditions such as dementia makes older adults especially vulnerable to both chronic and acute dehydration <jats:sup>(1,2)</jats:sup>. Recent studies indicate that conventional signs and symptoms of low-intake dehydration may not consistently indicate its presence in older inpatients, leading to missed or incorrect assessments. It can result in significant morbidity through falls, constipation, delirium, respiratory and urinary tract disorders, and even death <jats:sup>(2,3)</jats:sup>. Diagnosing low-intake dehydration at the early stage is challenging, leading to treatment delays which further compound the negative consequences of dehydration <jats:sup>(1,3)</jats:sup>. There is a need to determine the scope and practice of detecting and managing low-intake dehydration in ‘Medicine for Older People’ (MOP) wards at University Hospital Southampton (UHS). The primary aim of this study was to explore the current practices and challenges in detecting and managing low-intake dehydration in older inpatients within the MOP wards at UHS.Using a sequential, explanatory mixed-method design, a prospective chart review study (phase 1) was conducted at all the MOP wards at UHS over one month. The study included 50 adults aged 65 and above admitted to the medical wards for various reasons and now deemed ‘Medically Optimised for Discharge’ (MOFD). The quantitative aspect involved reviewing the completion of a local hydration assessment tool and the proper documentation of hydration and fluid balance charts for at-risk patients. The qualitative component (phase 2) consisted of semi-structured interviews with 10 participants—four doctors and six nurses with years of experience ranging from 4 to 12 years—to understand the perceptions of hospital staff on hydration care, its barriers and facilitators.The quantitative phase found that all patients were at risk for dehydration and underwent assessment through the hydration risk assessment, with hydration chart reviews during early, late, and night shifts. 20% did not have hydration assessment within 24h of admission and there were some missing reviews during various shifts. Most 24-hour fluid balance sheets were not completed for patients in the red category (start 24-hour fluid balance chart). Qualitative findings revealed that staff had ‘(1) experiential knowledge of hydration understanding the risks of dehydration in older adults’, ‘(2) difficulty in dehydration assessment and diagnosis due to resources’ and ‘(3) challenges related to staff levels and skills’ as well as (4) patient attributes contributing to difficulty in dehydration assessment.The mixed-methods study underscores the importance of addressing low-intake dehydration in older inpatients on MOP wards and highlights gaps in current practices. The findings emphasise the need","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"36 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1017/s0029665124004270
L. Lane, R. Wells, C. Reynolds
Beans, peas and pulses offer significant nutritional, health and environmental benefits <jats:sup>(1,2,3, 4)</jats:sup> and the FAO states that including pulses in agrifood systems is key to achieving the Sustainable Development Goals<jats:sup>(5)</jats:sup>. Recommended intakes vary across national food-based dietary guidelines<jats:sup>(6)</jats:sup>, but higher intakes are associated with benefits including increased satiety, reduced blood pressure, lower risk of cardiovascular disease and improved gut microbiota composition and activity<jats:sup>(7)</jats:sup>. Worldwide, the average consumption of pulses is 21g per person per day<jats:sup>(8)</jats:sup> but published analysis of UK intakes is scarce. The aim of this review was to analyse consumption trends using two UK government datasets.The Family Food module of the Living Costs and Food Survey details food and drink purchases from approximately 5000 households per year<jats:sup>(9)</jats:sup>. The ‘UK – household purchases’ data include the average (mean) quantities purchased per person per week. Categories relating to beans, peas and pulses were identified, and data were presented as graphs of purchasing trends (1974–2021).The National Diet and Nutrition Survey (NDNS)<jats:sup>(10)</jats:sup> assesses the nutritional status of 1000 participants (1.5 years and over) annually. Personal-level dietary data (2008-2019) were evaluated for subgroups ‘baked beans’ and ‘beans and pulses including ready meal and homemade dishes’, including fresh, frozen and canned beans and pulses, and recipes containing them. Peas/ green beans were excluded because of the nature of the data aggregation. Food-level dietary data (2018-19) were assessed for the frequency of consumption of different types of peas, beans and pulses.Our analysis of the Family Food datasets shows that, at 28g per person per day, the current average (mean) consumption of beans, peas and pulses in the UK is suboptimal. Our parallel analysis of NDNS data showed that more than 40% of participants were not eating any beans and pulses (excluding peas).Dietary trends are shifting. The overall consumption of beans, peas and pulses has been falling steadily since the late 1980s. This is mostly due to the drop in consumption of peas and baked beans, though these are still the most frequently consumed legume categories in the UK diet. Canned pea purchases fell from 88g per person per week in 1974 to 14g per person per week in 2020-21. Baked bean purchases peaked at 133g per person per week in 1986, dropping to 78g in 2020-21.Purchases of other canned beans and pulses (excluding baked beans) have increased noticeably in the last decade, from 17g per person per week 2015-16 to 32g in 2020-21. Purchases of dried pulses have remained consistent, averaging 11g per person per week in 2020-21.This analysis indicates significant scope to deliver affordable, accessible health and environmental benefits through increased consumption of beans, peas and pulse
{"title":"Beans, peas and pulses for improved public and planetary health: Changing UK consumption patterns","authors":"L. Lane, R. Wells, C. Reynolds","doi":"10.1017/s0029665124004270","DOIUrl":"https://doi.org/10.1017/s0029665124004270","url":null,"abstract":"Beans, peas and pulses offer significant nutritional, health and environmental benefits <jats:sup>(1,2,3, 4)</jats:sup> and the FAO states that including pulses in agrifood systems is key to achieving the Sustainable Development Goals<jats:sup>(5)</jats:sup>. Recommended intakes vary across national food-based dietary guidelines<jats:sup>(6)</jats:sup>, but higher intakes are associated with benefits including increased satiety, reduced blood pressure, lower risk of cardiovascular disease and improved gut microbiota composition and activity<jats:sup>(7)</jats:sup>. Worldwide, the average consumption of pulses is 21g per person per day<jats:sup>(8)</jats:sup> but published analysis of UK intakes is scarce. The aim of this review was to analyse consumption trends using two UK government datasets.The Family Food module of the Living Costs and Food Survey details food and drink purchases from approximately 5000 households per year<jats:sup>(9)</jats:sup>. The ‘UK – household purchases’ data include the average (mean) quantities purchased per person per week. Categories relating to beans, peas and pulses were identified, and data were presented as graphs of purchasing trends (1974–2021).The National Diet and Nutrition Survey (NDNS)<jats:sup>(10)</jats:sup> assesses the nutritional status of 1000 participants (1.5 years and over) annually. Personal-level dietary data (2008-2019) were evaluated for subgroups ‘baked beans’ and ‘beans and pulses including ready meal and homemade dishes’, including fresh, frozen and canned beans and pulses, and recipes containing them. Peas/ green beans were excluded because of the nature of the data aggregation. Food-level dietary data (2018-19) were assessed for the frequency of consumption of different types of peas, beans and pulses.Our analysis of the Family Food datasets shows that, at 28g per person per day, the current average (mean) consumption of beans, peas and pulses in the UK is suboptimal. Our parallel analysis of NDNS data showed that more than 40% of participants were not eating any beans and pulses (excluding peas).Dietary trends are shifting. The overall consumption of beans, peas and pulses has been falling steadily since the late 1980s. This is mostly due to the drop in consumption of peas and baked beans, though these are still the most frequently consumed legume categories in the UK diet. Canned pea purchases fell from 88g per person per week in 1974 to 14g per person per week in 2020-21. Baked bean purchases peaked at 133g per person per week in 1986, dropping to 78g in 2020-21.Purchases of other canned beans and pulses (excluding baked beans) have increased noticeably in the last decade, from 17g per person per week 2015-16 to 32g in 2020-21. Purchases of dried pulses have remained consistent, averaging 11g per person per week in 2020-21.This analysis indicates significant scope to deliver affordable, accessible health and environmental benefits through increased consumption of beans, peas and pulse","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"151 12 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1017/s0029665124004312
H. Griffin, A.P Nugent, B. A McNulty, D. Wright, L. Brennan
Shifting dietary protein intakes from animal to plant-based sources is suggested as a path to sustain the world’s food consumption and maintain planetary resources <jats:sup>(1)</jats:sup>. However, to facilitate change, it is important to characterise baseline dietary protein patterns. This study aimed to examine dietary protein intakes on the island of Ireland in order to determine population characteristics and food sources influencing protein intake.Analyses were performed on the Northern Ireland sub cohort of the UK National Dietary Nutrition Survey (NDNS 2016-2019) <jats:sup>(2)</jats:sup> and the Irish National Adult Nutrition Survey (2008-2010) <jats:sup>(3)</jats:sup>. Both surveys used a four-day food diary and a final sample of 1484 adults, aged 18-64 years was extracted (NANS; n =1274 and NI NDNS; n=210). Mean daily intakes for protein (MDI; % total energy, TE) for the total population were calculated and the population was divided into three tertile groups based on low, medium and high protein intake (%TE). Differences in population characteristics, energy MDI, key nutrients (%TE or per 10MJ) and contributing food sources were examined across these tertiles, using chi-square and one-way ANOVA with covariates (age and BMI) and correcting for multiple comparisons as appropriate (<jats:italic>P<0.005</jats:italic>).Overall, 17.1% of TE was obtained from protein and 77% of participants met their protein DRV based on EFSA recommendations of 0.83g/kg/body weight <jats:sup>(4).</jats:sup> The difference in protein intakes between the highest and lowest tertiles was 7.8% TE (21.2 % TE vs 13.4% TE) with high protein consumers reporting lower energy intakes (1734 ± 564kcal) compared to low consumers (2185 ± 661 kcal). High protein consumers were older (42.5 ± 12.8 years) and had a higher BMI (27.7 ± 6.0 kg/m<jats:sup>2</jats:sup>). They also had higher MDI of dietary fibre, calcium, zinc, sodium, iron, folate and vitamins A, C, D and B<jats:sub>12</jats:sub> (per 10MJ) (p<0.001) and lower MDI of carbohydrates, fat, saturated fat (%TE) in comparison to low consumers (p<0.001). The % contribution of ‘chicken, turkey and dishes’ (18.3%), ‘beef, veal and dishes’ (12.8%) and ‘fish and fish products (7.0%) to protein intakes were significantly higher in the high versus the low consumption group (10%, 7.4%, 4.4% TE respectively; P<0.001). In contrast, those in the lowest protein intake group had a significantly higher intakes of protein coming from dietary sources including ‘burgers, sausages and meat products (9.9 <jats:italic>vs</jats:italic> 5.9%), ‘white bread and rolls’ (6.9 <jats:italic>vs</jats:italic> 3.9%), ‘potatoes (including chips)’ (4.1 <jats:italic>vs</jats:italic> 2.9 %) and ‘cakes, pastries, buns and fruit pies’ (1.7 <jats:italic>vs</jats:italic> 0.8%) compared to high consumers.In general, animal protein sources contributed more to total daily protein intakes than plant sources, however, the pattern of protein foods diffe
{"title":"Characterising dietary protein intake in Irish adults on the island of Ireland","authors":"H. Griffin, A.P Nugent, B. A McNulty, D. Wright, L. Brennan","doi":"10.1017/s0029665124004312","DOIUrl":"https://doi.org/10.1017/s0029665124004312","url":null,"abstract":"Shifting dietary protein intakes from animal to plant-based sources is suggested as a path to sustain the world’s food consumption and maintain planetary resources <jats:sup>(1)</jats:sup>. However, to facilitate change, it is important to characterise baseline dietary protein patterns. This study aimed to examine dietary protein intakes on the island of Ireland in order to determine population characteristics and food sources influencing protein intake.Analyses were performed on the Northern Ireland sub cohort of the UK National Dietary Nutrition Survey (NDNS 2016-2019) <jats:sup>(2)</jats:sup> and the Irish National Adult Nutrition Survey (2008-2010) <jats:sup>(3)</jats:sup>. Both surveys used a four-day food diary and a final sample of 1484 adults, aged 18-64 years was extracted (NANS; n =1274 and NI NDNS; n=210). Mean daily intakes for protein (MDI; % total energy, TE) for the total population were calculated and the population was divided into three tertile groups based on low, medium and high protein intake (%TE). Differences in population characteristics, energy MDI, key nutrients (%TE or per 10MJ) and contributing food sources were examined across these tertiles, using chi-square and one-way ANOVA with covariates (age and BMI) and correcting for multiple comparisons as appropriate (<jats:italic>P<0.005</jats:italic>).Overall, 17.1% of TE was obtained from protein and 77% of participants met their protein DRV based on EFSA recommendations of 0.83g/kg/body weight <jats:sup>(4).</jats:sup> The difference in protein intakes between the highest and lowest tertiles was 7.8% TE (21.2 % TE vs 13.4% TE) with high protein consumers reporting lower energy intakes (1734 ± 564kcal) compared to low consumers (2185 ± 661 kcal). High protein consumers were older (42.5 ± 12.8 years) and had a higher BMI (27.7 ± 6.0 kg/m<jats:sup>2</jats:sup>). They also had higher MDI of dietary fibre, calcium, zinc, sodium, iron, folate and vitamins A, C, D and B<jats:sub>12</jats:sub> (per 10MJ) (p<0.001) and lower MDI of carbohydrates, fat, saturated fat (%TE) in comparison to low consumers (p<0.001). The % contribution of ‘chicken, turkey and dishes’ (18.3%), ‘beef, veal and dishes’ (12.8%) and ‘fish and fish products (7.0%) to protein intakes were significantly higher in the high versus the low consumption group (10%, 7.4%, 4.4% TE respectively; P<0.001). In contrast, those in the lowest protein intake group had a significantly higher intakes of protein coming from dietary sources including ‘burgers, sausages and meat products (9.9 <jats:italic>vs</jats:italic> 5.9%), ‘white bread and rolls’ (6.9 <jats:italic>vs</jats:italic> 3.9%), ‘potatoes (including chips)’ (4.1 <jats:italic>vs</jats:italic> 2.9 %) and ‘cakes, pastries, buns and fruit pies’ (1.7 <jats:italic>vs</jats:italic> 0.8%) compared to high consumers.In general, animal protein sources contributed more to total daily protein intakes than plant sources, however, the pattern of protein foods diffe","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"86 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1017/s002966512400449x
J. Orliacq, A. Pérez-Cornago, J. Carter
Steatotic liver disease, defined as >5% of hepatic fat content, is a major contributor to global morbidity and mortality, in particular due to its category metabolic associated steatotic liver disease (MASLD)<jats:sup>(1)</jats:sup>. While its prevention focuses on promoting physical activity and maintaining a healthy weight and balanced diet, the associations between dietary fatty acids and liver fat remain unclear<jats:sup>(2,3)</jats:sup>. The aim of this study was to examine the associations between dietary fatty acids and liver fat in the absence of excessive alcohol intake, independently of energy intake.Analyses were conducted on 9,268 non-diabetic participants from the UK Biobank with no pre- existing liver chronic illness or cardiovascular disease at baseline, and without excessive alcohol consumption. Dietary intake of total fat, saturated fatty acids (SFAs), polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs) was measured using the mean of ≥2 Oxford WebQ 24-hr dietary assessments, responded to between 2009 and 2012. Liver proton density fat fraction (LPDFF) was measured by magnetic resonance imaging between 2016 and 2020. Multivariable linear regression models were calculated to assess the associations between fatty acid intakes and LPDFF, adjusting for key demographic and lifestyle confounders. In addition, associations between LPDFF and 10 individual SFAs, 7 PUFAs, and 4 MUFAs were also examined. Sensitivity analyses were carried out including participants who responded ≥4 dietary assessments (N=2,828).After fully adjusting for confounders, no significant associations between LPDFF (%) and MUFAs were found. Inverse associations with LPDFF were observed for PUFAs (−5.8% relative difference [95% confidence interval −0.6, −1.9]), per 5% increase in intake, while SFAs were positively associated with LPDFF (5.8% [3.3, 8.3]). Positive associations were observed per 1 SD increase in intake of individual fatty acids SFA stearic acid (4.20% [2.84, 5.57]) and palmitic acid (3.15% [1.78, 4.54]). Negative associations were observed for PUFAs alpha-linoleic acid (−2.32% [−3.47, −1.17]) and docosahexaenoic acid (−2.14% [−3.23, −1.0.3], and for MUFA erucic acid (−2.52% [−3.61, −1.43]). Sensitivity analyses presented similar results, and the associations between PUFAs and liver fat became slightly stronger (−10.73%, [−17.58, −3.32]).This observational study suggests that SFAs and PUFAs are associated with liver fat in opposite directions, independently of energy intake. While total MUFAs did not present significant associations with LPDFF, erucic acid was inversely associated with liver fat, highlighting the value of studying individual fatty acids. These different associations provide valuable information for the design of dietary trials that compare interventions with different types of fatty acids. These further studies would allow a better understanding of the ideal dietary advice to prevent liver steatosis and its glo
{"title":"Associations between dietary fatty acids and liver fat accumulation in the UK Biobank","authors":"J. Orliacq, A. Pérez-Cornago, J. Carter","doi":"10.1017/s002966512400449x","DOIUrl":"https://doi.org/10.1017/s002966512400449x","url":null,"abstract":"Steatotic liver disease, defined as >5% of hepatic fat content, is a major contributor to global morbidity and mortality, in particular due to its category metabolic associated steatotic liver disease (MASLD)<jats:sup>(1)</jats:sup>. While its prevention focuses on promoting physical activity and maintaining a healthy weight and balanced diet, the associations between dietary fatty acids and liver fat remain unclear<jats:sup>(2,3)</jats:sup>. The aim of this study was to examine the associations between dietary fatty acids and liver fat in the absence of excessive alcohol intake, independently of energy intake.Analyses were conducted on 9,268 non-diabetic participants from the UK Biobank with no pre- existing liver chronic illness or cardiovascular disease at baseline, and without excessive alcohol consumption. Dietary intake of total fat, saturated fatty acids (SFAs), polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs) was measured using the mean of ≥2 Oxford WebQ 24-hr dietary assessments, responded to between 2009 and 2012. Liver proton density fat fraction (LPDFF) was measured by magnetic resonance imaging between 2016 and 2020. Multivariable linear regression models were calculated to assess the associations between fatty acid intakes and LPDFF, adjusting for key demographic and lifestyle confounders. In addition, associations between LPDFF and 10 individual SFAs, 7 PUFAs, and 4 MUFAs were also examined. Sensitivity analyses were carried out including participants who responded ≥4 dietary assessments (N=2,828).After fully adjusting for confounders, no significant associations between LPDFF (%) and MUFAs were found. Inverse associations with LPDFF were observed for PUFAs (−5.8% relative difference [95% confidence interval −0.6, −1.9]), per 5% increase in intake, while SFAs were positively associated with LPDFF (5.8% [3.3, 8.3]). Positive associations were observed per 1 SD increase in intake of individual fatty acids SFA stearic acid (4.20% [2.84, 5.57]) and palmitic acid (3.15% [1.78, 4.54]). Negative associations were observed for PUFAs alpha-linoleic acid (−2.32% [−3.47, −1.17]) and docosahexaenoic acid (−2.14% [−3.23, −1.0.3], and for MUFA erucic acid (−2.52% [−3.61, −1.43]). Sensitivity analyses presented similar results, and the associations between PUFAs and liver fat became slightly stronger (−10.73%, [−17.58, −3.32]).This observational study suggests that SFAs and PUFAs are associated with liver fat in opposite directions, independently of energy intake. While total MUFAs did not present significant associations with LPDFF, erucic acid was inversely associated with liver fat, highlighting the value of studying individual fatty acids. These different associations provide valuable information for the design of dietary trials that compare interventions with different types of fatty acids. These further studies would allow a better understanding of the ideal dietary advice to prevent liver steatosis and its glo","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"103 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141532266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1017/s0029665124004579
E. Coales, A. Hill, S. Heywood-Everett, J. Rabbee, R. West, M. Mansfield, C. Grace, I. Beeton, G. Traviss-Turner
People with type 2 diabetes are more likely to experience binge eating than the general population, which may interfere with their diabetes management. Guided Self-Help (GSH) is the recommended treatment for binge eating disorder <jats:sup>(1)</jats:sup>, but there is currently a lack of evidenced treatment for binge eating in individuals living with type 2 diabetes.The aims of this pilot study were to test the feasibility and acceptability of recruiting and delivering a 12-week, online psychological GSH intervention which has been adapted in an earlier study to the needs of adults with T2 diabetes and binge eating <jats:sup>(2)</jats:sup>.The intervention comprises GSH materials presented online in 7-sections delivered over 12-weeks, supported by a trained Guide. In total 22 participants were recruited in a case series design, through GP practices, NHS specialist weight management and diabetes services and via social media. Outcome measures were collected pre and post-intervention and at 12-week follow-up. The primary outcome was the Gormally Binge Eating Scale and secondary outcomes included eating disorder psychopathology, depression, anxiety, quality of life and HBA1C. Following the intervention, we conducted semi-structured interviews with 6 participants and 4 Guides. Data were analysed using a random intercept multi-level model.Results showed at baseline that 67% of the sample met the criteria for moderate to severe binge eating (cut-off (≤17). At post-intervention there was a statistically significant reduction in self- reported binge eating on the Gormally binge eating scale with a reduction in mean score moving from 26.8 to 14.2, (t= -4.181, p < 0.001) and only 9% meeting criteria for binge eating. There were also notable improvements in anxiety, depression and quality of life scores, but not eating disorder psychopathology.In the interviews both Guides and participants found the adapted online platform easy to use and the sessional support sufficient. They highlighted what a large commitment it was and therefore the importance of the Guide and working in ‘<jats:italic>partnership</jats:italic>’. The intervention appeared particularly suited to ‘<jats:italic>stress eaters</jats:italic>’, those experiencing ‘<jats:italic>severe</jats:italic> binge eating’ episodes and physical symptoms of diabetes. As a result of the intervention, participants reported <jats:italic>‘</jats:italic>making broader lifestyle changes’, <jats:italic>‘</jats:italic>improvements in their diabetes management’ and ‘<jats:italic>confidence</jats:italic>’. Guides found the training and supervision helpful but reflected on some <jats:italic>‘</jats:italic>challenges with engagement’. On ending the intervention, participants requeste<jats:italic>d</jats:italic> ‘ongoing support’, such as an optional follow-up appointment and continued access to the materials.In conclusion, the study shows preliminary evidence for online GSH tailored to the needs of individuals with
{"title":"Can guided self-help improve the management of binge eating in adults type 2 diabetes? Results of the POSE-D study","authors":"E. Coales, A. Hill, S. Heywood-Everett, J. Rabbee, R. West, M. Mansfield, C. Grace, I. Beeton, G. Traviss-Turner","doi":"10.1017/s0029665124004579","DOIUrl":"https://doi.org/10.1017/s0029665124004579","url":null,"abstract":"People with type 2 diabetes are more likely to experience binge eating than the general population, which may interfere with their diabetes management. Guided Self-Help (GSH) is the recommended treatment for binge eating disorder <jats:sup>(1)</jats:sup>, but there is currently a lack of evidenced treatment for binge eating in individuals living with type 2 diabetes.The aims of this pilot study were to test the feasibility and acceptability of recruiting and delivering a 12-week, online psychological GSH intervention which has been adapted in an earlier study to the needs of adults with T2 diabetes and binge eating <jats:sup>(2)</jats:sup>.The intervention comprises GSH materials presented online in 7-sections delivered over 12-weeks, supported by a trained Guide. In total 22 participants were recruited in a case series design, through GP practices, NHS specialist weight management and diabetes services and via social media. Outcome measures were collected pre and post-intervention and at 12-week follow-up. The primary outcome was the Gormally Binge Eating Scale and secondary outcomes included eating disorder psychopathology, depression, anxiety, quality of life and HBA1C. Following the intervention, we conducted semi-structured interviews with 6 participants and 4 Guides. Data were analysed using a random intercept multi-level model.Results showed at baseline that 67% of the sample met the criteria for moderate to severe binge eating (cut-off (≤17). At post-intervention there was a statistically significant reduction in self- reported binge eating on the Gormally binge eating scale with a reduction in mean score moving from 26.8 to 14.2, (t= -4.181, p < 0.001) and only 9% meeting criteria for binge eating. There were also notable improvements in anxiety, depression and quality of life scores, but not eating disorder psychopathology.In the interviews both Guides and participants found the adapted online platform easy to use and the sessional support sufficient. They highlighted what a large commitment it was and therefore the importance of the Guide and working in ‘<jats:italic>partnership</jats:italic>’. The intervention appeared particularly suited to ‘<jats:italic>stress eaters</jats:italic>’, those experiencing ‘<jats:italic>severe</jats:italic> binge eating’ episodes and physical symptoms of diabetes. As a result of the intervention, participants reported <jats:italic>‘</jats:italic>making broader lifestyle changes’, <jats:italic>‘</jats:italic>improvements in their diabetes management’ and ‘<jats:italic>confidence</jats:italic>’. Guides found the training and supervision helpful but reflected on some <jats:italic>‘</jats:italic>challenges with engagement’. On ending the intervention, participants requeste<jats:italic>d</jats:italic> ‘ongoing support’, such as an optional follow-up appointment and continued access to the materials.In conclusion, the study shows preliminary evidence for online GSH tailored to the needs of individuals with ","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"26 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1017/s0029665124004567
C.C Ojobor, G.M O’Brien, M. Siervo, C. Ogbonnaya, K. Brandt
Carrot consumption reduces tumour development in several animal models. The constituent alpha- carotene has not by itself shown anti-cancer properties, however carrots typically provide >85% of alpha-carotene dietary intake(1-3), justifying its use as an indicator of carrot intake(3). We conducted a meta-analysis to investigate inverse associations of carrot/dietary α-carotene intakes and cancer risk, and to quantify potential dose–response relationships.PubMed, Cochrane Library, Web of Science, Scopus, EBSCO, and JSTOR were searched (from database inception to August 2021) for studies reporting risk estimates with 95% CIs for the relationship between carrot intake or α-carotene and cancer risk. Meta-analyses were conducted using a random-effects model comparing highest and lowest intakes to estimate summary risk estimates (RRs).Of 80 prospective studies included, 15 (with 25738 cases) reported data on carrot intake, 35 (26262 cases) on dietary α-carotene intake and 30 (9331 cases) on plasma α-carotene levels. A significantly (P<0.01) decreased risk of overall cancer was associated with carrot intake (RR = 0·90), dietary α- carotene intake (RR = 0·90) and plasma α-carotene (RR = 0·80). In addition, both carrot intake and plasma α-carotene level manifested linear dose-response relationships with cancer risk, with increasing carrot intake reaching 20% risk reduction at 5 servings (400g) per week (p < 0·0001),and successive 50μg/L increments in plasma α-carotene associated with 11% risk reduction (p < 0·0058).Carrot consumption is robustly associated with decreased cancer risk. Carrot consumption should be encouraged, and the causal mechanisms further investigated.
{"title":"Relationship between carrot intake, dietary/circulating α-carotene and cancer risk: A systematic review and meta-analysis of prospective observational studies","authors":"C.C Ojobor, G.M O’Brien, M. Siervo, C. Ogbonnaya, K. Brandt","doi":"10.1017/s0029665124004567","DOIUrl":"https://doi.org/10.1017/s0029665124004567","url":null,"abstract":"Carrot consumption reduces tumour development in several animal models. The constituent alpha- carotene has not by itself shown anti-cancer properties, however carrots typically provide >85% of alpha-carotene dietary intake<jats:sup>(1-3)</jats:sup>, justifying its use as an indicator of carrot intake<jats:sup>(3)</jats:sup>. We conducted a meta-analysis to investigate inverse associations of carrot/dietary α-carotene intakes and cancer risk, and to quantify potential dose–response relationships.PubMed, Cochrane Library, Web of Science, Scopus, EBSCO, and JSTOR were searched (from database inception to August 2021) for studies reporting risk estimates with 95% CIs for the relationship between carrot intake or α-carotene and cancer risk. Meta-analyses were conducted using a random-effects model comparing highest and lowest intakes to estimate summary risk estimates (RRs).Of 80 prospective studies included, 15 (with 25738 cases) reported data on carrot intake, 35 (26262 cases) on dietary α-carotene intake and 30 (9331 cases) on plasma α-carotene levels. A significantly (P<0.01) decreased risk of overall cancer was associated with carrot intake (RR = 0·90), dietary α- carotene intake (RR = 0·90) and plasma α-carotene (RR = 0·80). In addition, both carrot intake and plasma α-carotene level manifested linear dose-response relationships with cancer risk, with increasing carrot intake reaching 20% risk reduction at 5 servings (400g) per week (p < 0·0001),and successive 50μg/L increments in plasma α-carotene associated with 11% risk reduction (p < 0·0058).Carrot consumption is robustly associated with decreased cancer risk. Carrot consumption should be encouraged, and the causal mechanisms further investigated.","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"213 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.1017/s0029665124004294
K. Belogianni, P. Khandige, S. Silverio, S. Windgassen, R. Moss-Morris, M.C.E Lomer
Irritable bowel syndrome (IBS) is a chronic and relapsing gastrointestinal condition which negatively impacts quality of life(1). Dietary triggers are common and dietary management is central to the IBS treatment pathway with dietitians being the main education providers for patients(2). The aim of this study was to explore the perceptions of dietitians towards current practices in IBS services in clinical settings across the UK.Qualitative semi-structured interviews were undertaken to explore current practices, barriers, and facilitators to dietetic practice and expected treatment outcomes. Eligible participants were dietitians specialising in IBS and working in the National Health System (NHS) in the UK. Interviews were held virtually. Audio was recorded and transcribed following intelligent transcription. Data were analysed using template analysis (3).Thirteen dietitians (n=12 female) specialising in gastroenterology consented to participate in the study. Dietitians were working in various NHS Trusts across the country (Southeast England n=3; Southwest England n=3; Northwest England n=2; Northeast England n=1; West Midlands n=1; Southwest Wales n=1 and Southcentral Scotland n=2). Ten out of 13 dietitians had more than five years of experience in IBS management. Three main themes emerged: 1) Dietetic services as part of IBS referral pathways; 2) Practices in relation to dietetic services and 3) Implications of services on patients’ expectations and feelings. Each main theme had subthemes to facilitate the description and interpretation of data. The increasing number of IBS referrals to dietitians and the need for accurate and timely IBS diagnosis and specialist IBS dietitians was reported, alongside the use of digital innovation to facilitate practice and access to dietetic care. The use of Internet as a source of (mis)information by patients and the limited time available for educating patients were identified as potential barriers to dietetic practice. Dietitians follow a patient-centred approach to dietary counselling and recognise the negative implications of perceived IBS-related stigma by patients on their feelings and treatment expectations.The study identified areas and practices which can facilitate access to dietetic services and patient- centred care in IBS management as outlined in guidelines (4).
{"title":"Dietitians’ perspectives on clinical pathways and practice in relation to the dietary management of irritable bowel syndrome in the UK: A qualitative study","authors":"K. Belogianni, P. Khandige, S. Silverio, S. Windgassen, R. Moss-Morris, M.C.E Lomer","doi":"10.1017/s0029665124004294","DOIUrl":"https://doi.org/10.1017/s0029665124004294","url":null,"abstract":"Irritable bowel syndrome (IBS) is a chronic and relapsing gastrointestinal condition which negatively impacts quality of life<jats:sup>(1).</jats:sup> Dietary triggers are common and dietary management is central to the IBS treatment pathway with dietitians being the main education providers for patients<jats:sup>(2)</jats:sup>. The aim of this study was to explore the perceptions of dietitians towards current practices in IBS services in clinical settings across the UK.Qualitative semi-structured interviews were undertaken to explore current practices, barriers, and facilitators to dietetic practice and expected treatment outcomes. Eligible participants were dietitians specialising in IBS and working in the National Health System (NHS) in the UK. Interviews were held virtually. Audio was recorded and transcribed following intelligent transcription. Data were analysed using template analysis <jats:sup>(3)</jats:sup>.Thirteen dietitians (n=12 female) specialising in gastroenterology consented to participate in the study. Dietitians were working in various NHS Trusts across the country (Southeast England n=3; Southwest England n=3; Northwest England n=2; Northeast England n=1; West Midlands n=1; Southwest Wales n=1 and Southcentral Scotland n=2). Ten out of 13 dietitians had more than five years of experience in IBS management. Three main themes emerged: 1) Dietetic services as part of IBS referral pathways; 2) Practices in relation to dietetic services and 3) Implications of services on patients’ expectations and feelings. Each main theme had subthemes to facilitate the description and interpretation of data. The increasing number of IBS referrals to dietitians and the need for accurate and timely IBS diagnosis and specialist IBS dietitians was reported, alongside the use of digital innovation to facilitate practice and access to dietetic care. The use of Internet as a source of (mis)information by patients and the limited time available for educating patients were identified as potential barriers to dietetic practice. Dietitians follow a patient-centred approach to dietary counselling and recognise the negative implications of perceived IBS-related stigma by patients on their feelings and treatment expectations.The study identified areas and practices which can facilitate access to dietetic services and patient- centred care in IBS management as outlined in guidelines <jats:sup>(4)</jats:sup>.","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"45 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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