9994 results in Proceedings of the Nutrition Society
Improved sleep outcomes and next-day cognitive function in adults following clinical testing of a powder-based drink containing Mulberry leaf extract and a natural source of Tryptophan – ADDENDUM
- L. Owen, F. Pierre Martin, K. Mantantzis, S. Chun Siong, L. Tian, A. Cherta-Murillo, R. Thota, J. Jimenez Suarez, C. Ming, M. Boutant Lys, G. Mun Teng Low, M. Chee, C. Darimont
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- Proceedings of the Nutrition Society , First View
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- 13 September 2024, p. 1
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Michael J. Gibney (1948–2024): a man of his time who had the time of his life
- Christine M. Williams
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- Proceedings of the Nutrition Society , First View
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- 11 September 2024, pp. 1-3
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Consumer perceptions of healthy and sustainable eating
- Daniel Hazley, John M. Kearney
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- Proceedings of the Nutrition Society , First View
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- 05 September 2024, pp. 1-9
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The current food system is unsustainable. It encourages unhealthy food choices, increasing the risk of non-communicable diseases, and has a substantial environmental impact, responsible for around a third of all anthropogenic greenhouse gas emissions. Improving both public and planetary health will require dietary change. To promote this transition, it is crucial to understand how consumers conceptualise healthy and sustainable eating. The aim of this review was to examine how adults from high-income countries interpret healthy and sustainable eating, with a specific focus on Ireland and the UK. As healthy eating and sustainable eating are often conceptualised as distinctive constructs, we explored each of these separately before examining how consumers perceive them together. Most consumers have a reasonable understanding of what constitutes a healthy diet, with many echoing aspects consistent with dietary guidelines. However, consumers perceptions of healthy eating often extend beyond these health-centric recommendations, incorporating concepts such as the pleasure of eating and supporting mental well-being. Sustainable eating, on the other hand, is less well understood. Most consumers overemphasise the importance of eating local, organic food and reducing packaging and underestimate or are unaware of the environmental impact of red meat consumption. These findings provide a clear opportunity to improve public awareness of healthy and sustainable diets. Moreover, they emphasise the need to promote the synergies between healthy and sustainable dietary practices. However, knowledge alone will not be enough to change behaviour. Future interventions should also seek to overcome consumers competing dietary priorities and create system-wide changes.
Exploring associations between eating habits, gastrointestinal health and perceived stress and anxiety symptoms in adults
- P. Moitra, A. Balot, K. Panchal, J. Madan
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E218
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Gastrointestinal (GI) disorders are becoming increasingly common in young people in India and globally (1). Diet (eating habits, nutrient intake, and dietary diversity) and mental health (stress and anxiety levels) factors can independently and synergistically regulate gut health through dietary modulation of gut microbiota composition and gut-brain axis-related mechanistic pathways (2-3). However, few studies have investigated the associations between diet, mental health, and GI-related disturbances. Hence, this observational study was conducted to explore the possible effects of eating behaviors and stress and anxiety symptoms on self-reported measures of gastrointestinal health among 18-45-year-old adults in India.
A purposive cluster sampling method guided the recruitment of participants (n=407). Two non- consecutive day 24-hour diet recalls were conducted to estimate nutrient intakes and calculate Individual Diet Diversity (IDD) and Food Variety Scores (FVS). Gastrointestinal health was assessed using a validated instrument comprising 35 items related to gastric, small intestine, and colon function, and GI inflammation. Perceived Stress Scale (PSS-10 scores 0 to 40 with higher scores representing higher levels of stress), and Generalized Anxiety Disorder Scale (GAD-7 scores >5 (mild), >10 (moderate), and >15 (severe)) were used to evaluate perceived stress and anxiety (4-5). Socioeconomic status and eating habits were self-reported and the anthropometry measurements were recorded. Multivariable logistic regression analysis was performed using sociodemographic characteristics, anthropometry measurements, eating habits, and stress and anxiety levels as independent (predictor) variables, and composite gastrointestinal health risk scores as the dependent variables.
Participants reported mild anxiety (mean (M) = 7.09, standard deviation (SD)= 3.25) and moderate stress (M=18.44; SD= 9.89) with preponderance among females, higher age groups (> 35 years), and lower socioeconomic status. Overall, 38.8% and 45.3% were at high-risk score categories for gastric function and GI inflammation respectively. Higher energy and fat consumption, frequent breakfast skipping, and lower IDDS and FVS scores were associated with higher scores for stress and anxiety. Moreover, participants having moderate to severe anxiety reported a higher frequency of GI symptoms such as indigestion (M= 3.23 SD= 2.1-4.6, p= 0.023), excessive belching (M= 2.36 SD =1.21, p=0.043), and post-meal lower abdominal discomfort and cramps (M= 3.07, SD = 2.22, p < 0.001) as compared to those having nominal/mild anxiety. Age-adjusted regression models showed higher waist circumference (OR= 4.69, 95% CI =1.33- 7.28, p= 0.034), and stress scores (OR= 1.66, 95% CI= 1.32-1.90, p = 0.042), lower IDDS (OR= 2.34, 95% CI=1.80- 2.91, p <0.001) and presence of > 2 co-morbid conditions (OR= 8.12, 95% CI = 5.34- 11.21, p < 0.001) as predictors of higher GI disorder risk scores.
The preliminary findings of the study highlight associations between diet, stress, and GI health, presenting opportunities to modulate diet and optimize mental health to prevent and reduce the severity of GI disorders.
Degree of hydrolysis of chicken versus plant-based chicken analogues: An in vitro digestion comparison
- M. Saleh Alotaibi, S. Eldeghaidy, M. Muleya, C. Hoad, A. Salter
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E212
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The adoption of plant-based meat analogues is increasing as an alternative to real meat products among consumers because they offer a more ecologically friendly and sustainable source of protein while also alleviating the ethical concerns related to livestock rearing and slaughter (1). However, there are concerns regarding plant-based meat analogues in terms of its nutritional quality, particularly their protein digestibility. This study aims to compared between chicken and plant-based chicken analogues in terms of nutritional composition and degree of protein hydrolysis.
Proximate analyses were performed for raw and cooked samples to assess protein, fat, and energy concentrations in two chicken samples (breast and thigh) and four commercial plant-based chicken (P-C1[Wheat Protein 37%, Pea Protein 10%], P-C2 [ Soya Protein 63%], P-C3 [ Soya and Wheat Protein 83%], and P-C4 [Soya Protein 30%, Pea Protein 2%]). As a first step, the proximate analyses were assessed for the averaged samples, then the product-cooking interactions was assessed using a one-way ANOVA followed by Tukey test (p <0.05). In vitro digestion was performed following the INFOGEST harmonised static in vitro digestion model (2) for cooked samples. After digestion, o- Phthaldialdehyde (OPA) assay was carried out to measure the degree of protein hydrolysis for each sample, and two-way ANOVA test was performed.
Protein content of chicken was higher compared with the plant-based chicken, whereas fat content and energy concentrations were higher in plant-based chicken. The protein content of chicken was higher for raw and cooked samples (raw: 19.8 ± 0.38 g/100 g; cooked: 30.55 ± 4 g/100g), compared with plant-based chicken (raw: 13.8 ± 5.3 g/100 g; cooked: 23.4 ± 4.5 g/100g). Plant-based chicken have a higher fat content and energy concentrations for raw and cooked samples (raw:6.52 ± 1.5 g/100 g; cooked: 9.6 ± 3.17 g/100g) and (raw:189.4 ± 28.1 g/100 g; cooked: 291.3 ± 48.1 g/100g) respectively; compared to chicken fat content (raw:4.6 ± 2.7 g/100 g; cooked: 6.1 ± 4 g/100g) and energy concentration (raw:150.9 ± 25.4 g/100 g; cooked: 228.3 ± 20.7 g/100g). The product-cooking interactions showed a significant increase (P ≤0.0001) in the protein content (raw: 15.6 ± 2.3g/100g to 19.8 ± 0.74 g/100g; cooked: 21.4 ± 0.55 g/100g to 33.06 ± 0.71 g/100g), and fat content P<0.001 (raw: 2.7 ± 0.06 g/100g to 8.3 ± 0.27 g/100g; cooked: 3.29 ± 0.19 g/100g to 13.22 ± 0.33 g/100g) in both chicken and plant-based chicken samples. No significant product-cooking interactions on energy content was found. The results from a two-way ANOVA test of the OPA and the degree of hydrolysis analyses demonstrated a significant increase in the degree of hydrolysis of chicken samples compared with plant-based chicken (P<0.0001).
The degree of hydrolysis and digestibility of chicken and chicken analogues was influenced by protein type, nutrient composition, and processing. These findings would provide substantial information for the improvement of plant-based chicken products with enhanced nutritional profiles. This work will be extended to investigate the availability and digestibility of individual amino acids.
Association between serum 25-hydroxyvitamin D concentrations and respiratory tract infections requiring hospital admission: analysis of ethnic groups from the UK Biobank cohort
- A. R Bournot, K. H Hart, D. I. Givens, J. A Lovegrove, D. B Bartlett, S. A Lanham-New, A. L Darling
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E237
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Vitamin D status has been found to be inversely associated with risk of respiratory tract infections (RTIs)(1). It varies by ethnicity, with several ethnic minority groups in the United Kingdom (UK) reported to be at a higher risk of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentrations <25 nmol/L) compared to their white counterparts(2, 3). However, the relationship between serum 25(OH)D concentrations and incidence of RTIs by ethnicity in the UK remains unclear. This study aimed to investigate the association between serum 25(OH)D concentrations and likelihood of hospitalisation for RTI in UK ethnic groups.
A nested, case-control study was conducted using data from UK Biobank, which has data for 500k adults for serum 25(OH)D and hospital episodes from linked records. Binary logistic regression models were used to explore the association between serum 25(OH)D concentrations and likelihood of RTIs overall, and by ethnicity.
Of the 36,772 participants included in the analysis, 12,638 (34%) were white Caucasian, 10,311 (28%) Asian, 7,138 (19%) black, 4,034 (11%) other, and 2,651 (7%) of mixed ethnicity. In fully adjusted models, compared to participants with a serum 25(OH)D concentration <15 nmol/L (severe deficiency), those with 25-49 nmol/L, 50-74 nmol/L, and ≥75 nmol/L were found to have statistically significantly lower odds of RTI hospitalisation, with odds ratios (ORs) of 0.53 (95% CI: 0.37, 0.75), 0.61 (95% CI: 0.40, 0.92) and 0.54 (95% CI: 0.30, 0.97), respectively. In the subgroup analysis, ethnic minorities and white individuals with vitamin D deficiency (<25 nmol/L) were more likely to be hospitalised with RTI compared to those that were not deficient, with ORs of 1.36 (95% CI: 1.02, 1.81) and 2.03 (95% CI: 1.30, 3.17), respectively. This association was not statistically significant within ethnic minority subgroups when analysed separately.
Serum 25(OH)D concentrations above 25 nmol/L are associated with lower likelihood of RTI hospitalisation among UK adults. This finding was noted across white and ethnic minority groups, although ethnic minorities with vitamin D deficiency had a lower likelihood of RTIs compared to white individuals. Further studies are warranted to validate these findings and explore the mechanisms underlying the association between vitamin D status and RTIs in different ethnic groups.
Acknowledgements
This project was conducted using the UK Biobank resource under project 15168.
Effect of vitamin D2 supplementation on 25-hydroxyvitamin D3 status: a systematic review and meta-analysis of randomised controlled trials
- E.I.G. Brown, A.L. Darling, T.M. Robertson, K.H. Hart, S.A. Lanham-New, R.M. Elliott, M.J. Warren
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E222
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There are known differences in biological functionality between vitamin D2 and D3. It is suspected from randomised control trial (RCT) data that vitamin D2 supplementation causes a reduction in serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations (1), but the size of the effect has yet to be fully assessed across multiple studies. The aim of this study was to undertake a systematic review and meta-analysis of the effect of vitamin D2 supplementation on serum 25(OH)D3 concentrations.
PUBMED was searched for publications from 1st January 1975 to 1st February 2023. Of the 182 papers retrieved, 29 were included in the systematic review, and of those, 18 were suitable for meta-analysis.
The meta-analysis found significant reductions in serum D3 after vitamin D2 supplementation compared with control, for both end of trial between groups data (weighted mean difference (WMD) (random) = −13.51 nmol/L; 95% CI: −20.14, −6.89; P < 0.0001) and absolute change over the trial (WMD (random) = −9.25 nmol/L; 95% CI: −14.40, −4.10; P = 0.0004). Similar results were found when D2 supplementation was compared to D3 supplementation, although as expected, the magnitude of the difference was larger, with WMD (random) = −46.20 nmol/L (95% CI: −60.80, −31.60; P < 0.00001) for end of trial data, and WMD (random) = −56.23 nmol/L (95% CI: -69.17, −43.28; P < 0.00001) for absolute change.
Overall, we found that vitamin D2 supplementation produces significant reductions in serum 25(OH)D3 concentrations, when compared to either control or vitamin D3 supplementation. An inverse relationship between vitamin D2 and D3 concentrations has been proposed in the literature (2). A regulatory mechanism that disposes of 25(OH)D after an increase in vitamin D concentrations could explain our results (3). Moreover, supplementation with vitamins D2 and D3 has differential effects on gene expression (4). However, longer-term research is needed to establish whether clinical advice should recommend vitamin D3 supplements over vitamin D2 supplements, where appropriate.
Assessment of diet composition of Pakistani ethnic groups in the UK – does dietary pattern change between 1st and 2nd generations?
- M.E.B. Syeda, A.C. Hauge-Evans
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E209
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Dietary acculturation in immigrant groups can impact health and may increase the risk of conditions like diabetes and cardiovascular disease among East Asian immigrants as they adopt host-country eating patterns(1). Pakistani immigration to the UK has resulted in a dynamic cultural exchange, including modifications in culinary preferences and practices among Pakistani ethnic groups. Prior research indicates that second-generation adults exhibit more signs of acculturation in their choice of diets than their first-generation counterparts (2). There is limited understanding of the food habits or the effects of acculturation on this group. The primary purpose of this study was to investigate intergenerational disparities in food preferences among Pakistani immigrants and the impact of dietary acculturation.
This cross-sectional study examined the food habits and acculturation experiences of 51 first (1G) and 51 second-generation (2G) participants of the Pakistani community living in London. Data was collected using survey questionnaires modified from previous studies (3,4). We compared traditional foods like paratha and samosa with Western options like fish and chips through a set of questions, from which a dietary score was calculated (Global scale) (5). We measured food acculturation using a 5-point scale, with higher scores indicating greater Western influence and lower scores indicating less Western acculturation. Scores ranged from 6 to 30 and were categorised as low, moderate, high, or very high. Data was analysed using SPSS (version 28.0). Chi-square and t-tests were applied to identify differences between groups with significance levels set to p<0.05.
Most of the participants were male (67%) with 38.8% aged 36-45 years. Urdu ethnicity predominated in both generations (64.8%). Significant differences in dietary restrictions for health conditions (p =.008), language (p = .001), consumption frequency of traditional Pakistani cuisine (p = .001), desserts/sweets (p = .001), chai/lassi (p = .017), popular UK meals, fizzy drinks, and inclusion of rice/flatbread (p = .003) emerged between first and second generations. Health-related dietary behaviours differed in fruits/vegetables, dairy, and meat consumption (p =.001). ‘Traditional’ and ‘Western’ dietary scores were significantly different between generations (‘Traditional’: 1G: 17.15 ± 3.52 vs 2G: 13.68 ± 4.71, p = .001; ‘Western’: 1G: 16.29± 1.98 vs 2G: 18.21 ± 3.84, p = .001). The results demonstrated a preference for traditional eating patterns by 1G, whereas a nuanced move towards Western food preferences was observed among the 2G participants, falling into the high category of global scale. 1G Participants cited language acquisition, time constraints, and financial issues as factors affecting their dietary changes.
This study found significant differences in dietary habits and preferences between first- and second- generation Pakistani immigrants in the United Kingdom. The second generation displayed a more significant shift towards Western food patterns, possibly because of socio-cultural variables, language fluency, and adaptability to the local environment.
The effectiveness of e-storybook on children’s vegetable acceptance
- N.D Mohd Nor, M. Che Mustafa, J. Bacotang
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E239
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A diet high in fruit and vegetables is beneficial to reduce the risk of many diseases such as cardiovascular diseases, certain cancers and hypertension(1,2). However, reports show that vegetable consumption among children is still low. Intervention must be made to encourage children to eat more vegetables as a dietary pattern in childhood will determine a dietary pattern in adulthood(3). This current study investigated the effects of an e-storybook on children’s vegetable acceptance.
Sixty-five parents and their children aged 4 to 7 years participated in this study and they were divided into 2 groups. Parents in an experimental group read an e-storybook about a target vegetable (asparagus) with their child for 10 days, while the control group did not receive an e-book. Parents in both groups were asked to offer the target vegetable and a match control vegetable (peas) before and after the intervention and record their child’s vegetable intake (measured using a 6-point scale) and liking (measured using a 6-point scale).
In the experimental group, liking of target vegetable increased from 2.5 ± 1.5 to 3.0 ± 1.4 (p = 0.01), but not for control vegetable. There was a tendency that intake of target vegetable increased following exposure to the e-storybook, from 1.6 ± 1.6 to 1.9 ± 1.7 (p=0.052), but there was no significant increase in intake for control vegetable. While in the control group, there were no significant increases in intake and liking for both vegetables post-intervention. When comparing means between groups, there were no significant differences in intake and liking at pre-intervention, however at post-intervention, there was a significant difference in intake (p=0.02), where the intervention group had a higher intake than the control group by 0.9 ± 1.9. There was also a significant difference in liking between these groups at post-intervention (p=0.001), where the intervention group had a higher liking than the control group by 1.1 ± 1.8.
Results suggest that e-storybooks are an effective strategy for parents to use to increase vegetable acceptance in children.
The effect of LCn-3 PUFA supplementation on body weight, body composition, and muscle function during alternate-day fasting (ADF)
- M. Alblaji, S.R Gray, T. Almesbehi, H. Miller, A. Gonzalo, D. Malkova
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E216
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During weight loss the loss of body mass is associated not only with body fat reduction but also with a decrease in fat-free mass (FFM), related to the reduction in muscle mass and function(1). Supplementation with long-chain n-3 fatty acids (LCn-3 PUFA), in the absence of caloric restriction, results in a significant decrease in fat mass and an increase in FFM(2) along with improvements in muscle mass and strength(3). However, the impact of supplementation with LCn-3 PUFA during weight loss) remains unknown. Therefore, the aim of this study was to explore the effects of LCn-3 PUFA supplementation, in the form of Krill oil (KO), during alternate day fasting (ADF) on body weight, fat mass loss, FFM and muscle function changes in healthy overweight and obese adults.
A total of 41 men and women (age: 39.35 ± 10.4 years, BMI: 31.05 ± 4.2 kg/m2) completed the study (NCT06001632), in which they were randomised into either a KO or Placebo (PL) groups. Both groups carried out 8-weeks of ADF combined with intake of 4 g/day of the corresponding supplements. ADF involved consuming no more than 500 calories on the 'fast day’ and consuming food ad libitum on each 'feed day’. Data on body weight and body composition (TBF-300, Tanita, Manchester, UK), handgrip strength (Handheld Hydraulic Dynamometer, Vernier Jamar; England, UK), and time to conduct 5 repetition of chair rising test were obtained pre-and post-intervention. Changes from baseline within groups were assessed using paired samples t-test. Mixed analysis of variance (Mixed-ANOVA) was used to measure 2-way interactions between time and group to identify the differences between groups. All statistical analysis were conducted using IBM Statistical Package for the Social Sciences SPSS 28.0.
In both groups, body mass decreased significantly (KO:-4.7 ± 0.4kg, p<0.001; PL:-4.5 ± 0.4kg, p<0.001), along with a significant reduction in fat mass (KO:-2.4 ± 0.5kg p<0.001; PL:-2.3 ± 0.5kg p<0.001), and FFM (KO:-0.6 ± 0.2kg p<0.001; PL:-0.7 ± 0.2kg, p<0.001), with no differences between groups. In the PL group, there was a reduction in handgrip strength (-0.9 ± 0.7 kg, p<0.001), while there was no change in KO group (-0.2 ± 0.5 kg, p=0.1), with a significant difference between groups (p<0.001). In the KO group there was a significant reduction in time to conduct chair rising test (-1.8 ± 0.9s, p<0.05), with no change in the PL group (-0.3 ± 1.3s, p=0.2), with a significant difference between groups (p<0.001).
Supplementation with LCn-3 PUFA (4 g/day) during 8 weeks of ADF, applied to individuals living with overweigh and obesity, does not facilitate body or fat mass loss and does not diminish the reduction in FFM. However, it attenuated the reduction in muscle function in healthy overweight and obese adults.
Lower intake of plant-derived nitrate is associated with higher odds of frailty: a cross- sectional study in community-dwelling older women
- E. Hayes, E. Dent, O.M Shannon, L.Z Zhong, T. Bozanich, L.C Blekkenhorst, K. Zhu, C.P Bondonno, M. Siervo, J.M Hodgson, R.L Prince, J.R Lewis, M. Sim
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E223
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Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves, and is associated with declines across sensory, neurological, cardiovascular, and musculoskeletal systems(1). Previously, relationships have been identified between high dietary nitrate intake and several components of frailty including muscle strength and cognitive function, as well as vascular disease(2). However, little is known about the relationship between dietary nitrate intake and frailty in older adults. We investigated if higher habitual nitrate intake, derived from plant (e.g., vegetables, grains, beans, and fruits) and animal foods (e.g., meats, cheese, yoghurt) was associated with frailty in older women.
1390 community-dwelling older women (mean age 75.1 ± 2.7 years) from the Perth Longitudinal Study of Ageing Women completed a validated semi-quantitative food frequency questionnaire (FFQ) at baseline (1998). Nitrate concentrations in food were obtained from our recently published international plant and animal nitrate databases and applied to each of the plant and animal foods within the FFQ (described in3). Frailty was operationalised using a standardised frailty index (FI) of cumulative deficits from 33 variables across multiple health domains (physical, mental, comorbidities), with a score ≥0.25 indicating frailty. Cross-sectional associations between dietary nitrate derived from plant and animal foods (separately) with frailty were analysed using multivariable-adjusted logistic regression models as part of restricted cubic splines. Models were adjusted for lifestyle and dietary factors (not used in the FI) that included age, smoking history, protein, alcohol, and energy intake.
Frailty was observed in 276 (19.9 %) women. Median (IQR) daily plant and animal nitrate were 72.1 (55.6-90.0) mg/day and 3.5 (2.2-5.1) mg/day, respectively. A significant non-linear relationship was observed between higher plant nitrate intake and frailty, with a nadir recorded once intakes of ~64 mg/day were achieved (median of quartile [Q]2). Specifically, compared to women with the lowest intake of plant-derived nitrate (Q1, median 45 mg/day), women in Q2 (OR 0.69 95%CI 0.56-0.84), Q3 (OR 0.67 95%CI 0.50-0.90) and Q4 (OR 0.66 95%CI 0.45-0.98) had lower odds for frailty (all p<0.05). Additional adjustment for diet quality (Nutrient Rich Food Index per 1000 kJ) or total plasma 25-hydroxyvitamin D did not alter the findings. Nitrate derived specifically from vegetables and grains were found to drive these results. No relationship was observed between animal-derived nitrate and frailty.
Community-dwelling older women consuming higher amounts of nitrate derived primarily from plants were less likely to present with frailty. Consuming 1-2 servings (75-150 g) per day of nitrate- rich green leafy vegetables, as part of total vegetable intake, will provide adequate nitrate levels (>70 mg/day) that could serve as a novel intervention to limit frailty.
Investigating predictors of protein intake in an adult population utilising the National Health and Nutrition Examination (NHANES) Survey in the United States
- E. O’Bree, I. Soyiri, A. Johnstone
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E227
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It is widely accepted that meeting recommended protein intake is protective of muscle mass(1). Insufficient intake is related to accelerated sarcopenia and impaired physical function, contributing to increased mortality and morbidity. The recommended target set by the American dietary guidelines is 0.8 g of protein per kg of body weight, based on data collated by the National Academies published in 2005(2). Currently approximately 50% of women and 30% of men do not meet these targets(3). It is of public interest to analyse current patterns of intake to allow for improved strategy through awareness of factors that impact protein intake.
To investigate the factors which determine an individual’s protein intake and how they can be used to predict daily intake.
A secondary data analysis of longitudinal data collected in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2020 has been carried out(4). Data was accessed from the public domain on the Centers for Disease Control and Prevention (CDC) website. The study protocol received approval from the research ethics review board of the National Center for Health Statistics (NCHS) of the CDC. Average protein intake has been calculated and participant demographics reported. STATA software has been used to carry out a bivariate regression of factors associated with protein intake, an adjusted multivariate regression analysis and a parsimonious model.
19601 participants (52.4% women) aged 20 and over had valid protein data. Adjusted regression analysis generated three model fits, with the parsimonious model excluding BMI categories and household income had a statistically insignificant impact on protein intake. Men consumed 23.99g more protein per day compared to women (p<0.001: 95% CI 23.09 to 24.89). Individuals over 65 consumed 13.92g less protein per day compared to those aged 20-35 years old (p<0.001: 95% CI − 15.25 to −12.59). Mexican American individuals consumed 7.47g more protein than Non-Hispanic White individuals (p<0.001: 95% CI 5.89 to 9.04) and Non-Hispanic White individuals consumed 2.95g more protein compared to non-Hispanic Black individuals (p<0.001: 95% CI 4.13 to 1.77). Those with the lowest educational attainment consumed 10.77g less protein compared to individuals with a college degree (p<0.001: 95% CI −12.79 to −8.74). From 2011 to 2020, there was a gradual decline in protein intake which is statistically significant when comparing 2011/12 with 2015/16 and 2017/2020.
Protein intake can be predicted by an individual’s gender, age, ethnicity, level of education attainment and time period. This study informs policymakers that individuals aged 65 and above are at risk of insufficient protein intake and there has been a general decrease in protein consumption over time. This provides evidence to support initiatives focused on this age category to maximise change and reduce rates of sarcopenia.
Beans, peas and pulses for improved public and planetary health: Changing UK consumption patterns
- L. Lane, R. Wells, C. Reynolds
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E203
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Beans, peas and pulses offer significant nutritional, health and environmental benefits (1,2,3, 4) and the FAO states that including pulses in agrifood systems is key to achieving the Sustainable Development Goals(5). Recommended intakes vary across national food-based dietary guidelines(6), 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(7). Worldwide, the average consumption of pulses is 21g per person per day(8) 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(9). 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)(10) 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 pulses in the UK.
A systematic scoping review characterising studies investigating workplace nutritional interventions in male employees
- L. Schinnenburg, R. Gibson
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E206
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Non-communicable diseases (NCDs) are the predominant cause of death in the UK(1) and place an economic burden on societies(2). An unhealthy diet is one of the four main behavioural risk factors for NCDs(3) and thus, interventions targeting dietary behaviour are of particular interest in the prevention of NCDs. The workplace may be a valuable setting for these interventions as employees represent a large proportion of the population in the UK(4). In the male population, NCDs and several risk factors typically manifest at a younger age(5) and, additionally, males participate less in health-promoting activities(6).
The aim of this scoping review was to identify and characterise the evidence base to determine if a future full systematic review on nutrition interventions in the workplace to improve health and well- being in males is feasible.
The review was conducted adhering to the PRISMA guideline for Scoping Reviews(7). Three electronic databases (Ovid, PubMed, and The Cochrane Library) were systematically searched for relevant publications responding to the research question from inception. No restrictions were made in the search and all study types were eligible. Articles that were not available in English were excluded from the review. Eligible studies were reviewed using a pre-defined data extraction form and references hand-searched for relevant publications. Data synthesis was focused on describing application-oriented aspects and outcome analyses were reduced to anthropometric outcomes.
Of the 1,224 publications from the initial database search, 46 were included in the review, with an additional 15 studies identified from hand-searching, resulting in 61 included reports on 57 interventions. Four main approaches to nutrition interventions at the workplace were identified; educational, environmental, individual counselling, and meal provision/replacement. Most interventions used multicomponent approaches. One of the 61 included reports followed a qualitative design. Anthropometric outcomes were reported in the majority (83.6%) of studies, followed by bioclinical outcomes (45.9%), other outcomes were food (34.4%) and nutrient intake (22.9%), smoking habits (14.8%) and, one study reported on Quality of Life. Of the studies reporting anthropometric outcomes 69% reported to be effective in improving body weight, 47.8% BMI and 54.5% waist circumference. No determinants of successful interventions such as type, duration, workplace participation were identified.
This review suggests that nutrition interventions at the workplace are effective in improving several anthropometric outcomes. A future full systematic review is feasible but should consider narrowing the research question to account for limitations in the current evidence base as differences in reporting of design, population, intervention, and outcomes severely limited data analyses. Furthermore, to enable high-quality research, the development of a reporting tool, such as the TIDieR checklist (8) is recommended.
A randomised, double-blind, placebo-controlled trial to assess dose-dependent effects of blueberries on blood pressure, glucose and cognition
- L. Ellis, C. Bosch, L. Dye
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E231
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Obesity can increase the risk of diseases such as type 2 diabetes mellitus and cardiovascular disease(1). Glucose control is critical to both preventing and managing diabetes and can be achieved by enhancing secretion of insulin, limiting absorption of glucose from the gut and by upregulating the use of glucose in the muscles(2). Abnormalities in glucose management(3) and blood pressure control(4) are known to impair cognitive function. Epidemiological studies report an inverse risk of type 2 diabetes with increased intake of polyphenols. These data are also supported by in vitro and animal studies reporting positive effects of polyphenols on insulin sensitivity, carbohydrate digestion and glucose regulation(5). Here we aimed to evaluate postprandial glucose metabolism, blood pressure and cognitive function following a high carbohydrate meal accompanied by different doses of anthocyanin containing blueberry drinks.
A double-blind, placebo-controlled, dose-response study was designed and received ethical approval and 22 participants were recruited. Each participant attended four study days in a crossover design, separated by a minimum of 5 days during which, they consumed a high carbohydrate meal consisting of two slices of toast and one of three doses of blueberry beverage or a control beverage. Memory performance was assessed using the visual verbal learning test (VVLT), measured at baseline and 90 minutes post consumption. Glucose was monitored every 15 minutes using a continuous glucose monitor which was worn across 10 days, and blood pressure was assessed every 30 minutes for a period of 4 hours in the laboratory. Glucose area under the curve (AUC) were analysed using linear mixed models. Blood pressure and VVLT data were analysed using repeated measures ANOVA.
The analysis was performed blind to condition. In total, 22 participants completed all four study visits (mean age 28 ± 5.9, mean weight 61kg ± 10.4, mean height, 1.64m ± 0.9, mean BMI 22.7 ± 2.27, N=20 female, N=2 male). There was a significant effect of treatment on total words recalled in the VVLT with best performance following condition B compared to condition C, and condition D compared to condition C (p < 0.05). Condition B also resulted in significant systolic blood pressure lowering compared to condition C (-2.47mmHg, P <0.003). There was no effect of treatment on area under the curve for glucose over 3 hours postprandial (p > 0.05).
Taken together these results suggest that condition B conferred greatest benefit for memory performance and that this was associated with anthocyanin related effects on systolic blood pressure.
This study was funded by the Wild Blueberry Association of North America (WBANA).
Understanding the nature and scale of low-intake dehydration on ‘Medicine for Older People’ wards at University Hospital Southampton: A mixed-methods study
- S. Alsanie, K. Ibrahim, S. Lim, S. Wootton
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E214
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Dehydration during hospital stays is a significant concern, particularly affecting older adults(1). The ageing process associated with pathological changes and conditions such as dementia makes older adults especially vulnerable to both chronic and acute dehydration (1,2). 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 (2,3). Diagnosing low-intake dehydration at the early stage is challenging, leading to treatment delays which further compound the negative consequences of dehydration (1,3). 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 for improved training, awareness, and standardised protocols to prioritise hydration care among healthcare professionals and provide optimal hydration care for older inpatients.
Dietary fibre intake in Kuwaiti older adults assessed by validated food frequency questionnaire
- A. Alajmi, A. Garcia, C.A Edwards
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E236
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Adequate dietary fibre (25-30g/day) is essential in a healthy diet preventing several health problems (1). Age-related changes reduce gut function and increase risk of constipation. A better understanding of fibre in those over 60y is required. This study aimed to measure fibre intake in those over 60y in Kuwait using the Kuwaiti Food Frequency Questionnaire for fibre (KWFFQ-DF) and explore local food sources of fibre and laxative use.
Recruitment was conducted Dec 2022 to April 2023 in Geriatric Health Services in Kuwait and geriatric units across the six main governorates in Kuwait. The study was approved by the University of Glasgow Research Ethics Committee (project No. 200220066) and the Medical Research Ethics Committee of the Ministry of Health in Kuwait (project No 9512018)18). The validated KWFFQ-DF assessed intake of total fibre (TDF), soluble fibre (SF) and insoluble fibre and included seven food groups and 134 food items. The last two questions asked if the participant consumed supplementary fibre and if they took laxatives (type and amount). The associations between fibre intake and gender, age and governorate and between TDF and laxative use were assessed by Chi squared test (P < 0.05 considered significant).
The study recruited 210 people (61 males and 149 females; 61- 96y (median 66y). BMI ranged from 18 to 68 (median 29). Mean TDF intake was 28.7 g/d (SD 6.6; 13 to 46 g/ day). Most participants (n= 186, 89%) did not use laxatives. Several foods high in fibre were frequently consumed by participants including dates, as a snack with coffee eaten 2-6 times/day at 2.2 g TDF per portion and almonds once a day as a snack with 12 g of TDF. Whole grain toast, eaten 1-2 times daily contributed 4g TDF but with eggs or cheese at breakfast so higher in fat. Other key sources were barley bread, (8g TDF), vegetable soup, 2-4 times a week (4 g/d TDF) and Tabouleh Salad, typically eaten with grilled meat or chicken at 2g/d TDF. There was no significant association between fibre intake and gender (χ2= 1.033; P < 0.597) or governorates (χ2= 14.66; P < 0.145). However, the findings identified a significant association between fibre intake and age of participants (χ2= 10.066; P < 0.039). Moreover, there was a highly significant negative association between the TDF intake and laxative use frequency (χ2= 25.63, P<0.001).
In contrast to some populations, fibre intake for people in Kuwait over 60y is within dietary guidelines and laxative use is low. Foods high in fibre in Kuwaiti cuisine can be, however, associated with high calories due to the sugar and fat content and may be associated with high BMI. The consequences of this need to be explored.
Acknowledgements
We would like to express our sincere gratitude to Dr Ali Alqattan and the medical team at the Geriatric Clinic in Mubarak Hospital for their valuable assistance in facilitating the interviews with participants in this research project.
Relationship between carrot intake, dietary/circulating α-carotene and cancer risk: A systematic review and meta-analysis of prospective observational studies
- C.C Ojobor, G.M O’Brien, M. Siervo, C. Ogbonnaya, K. Brandt
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E232
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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.
The association between selenium status and cognitive decline in very old adults: The Newcastle 85+ Study
- G. Perri, J. C Mathers, C. Martin-Ruiz, C. Parker, K. Demircan, T. S. Chillon, L. Schomburg, L. Robinson, E. J Stevenson, G. Terrera, F. F Sniehotta, C. Ritchie, A. Adamson, A. Burns, A.M Minihane, O. Shannon, T.R Hill
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E200
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The trace element selenium is known to protect against oxidative damage which is known to contribute to cognitive impairment with ageing (1,2). The aim of this study was to explore the association between selenium status (serum selenium and selenoprotein P (SELENOP)) and global cognitive performance at baseline and after 5 years in 85-year-olds living in the Northeast of England.
Serum selenium and SELENOP concentrations were measured at baseline by total reflection X-ray fluorescence (TXRF) and enzyme-linked immunosorbent assay (ELISA), respectively, in 757 participants from the Newcastle 85+ study. Global cognitive performance was assessed using the Standardized Mini-Mental State Examination (SMMSE) where scores ≤25 out of 30 indicated cognitive impairment. Logistic regressions explored the associations between selenium status and global cognition at baseline. Linear mixed models explored associations between selenium status and global cognition prospectively after 5 years. Covariates included sex, body mass index, physical activity, high sensitivity C-reactive protein, alcohol intake, self-rated health, medications and smoking status.
At baseline, in fully adjusted models, there was no increase in odds of cognitive impairment with serum selenium (OR 1.004, 95% CI 0.993-1.015, p = 0.512) or between SELENOP (OR 1.006, 95% CI 0.881-1.149, p = 0.930). Likewise, over 5 years, in fully adjusted models there was no association between serum selenium and cognitive impairment (β 7.20E-4 ± 5.57E-4, p = 0.197), or between SELENOP and cognitive impairment (β 3.50E-3 ± 6.85E-3, p = 0.610).
In this UK cohort of very old adults, serum selenium or SELENOP was not associated with cognitive impairment at baseline and 5 years. This was an unexpected finding despite SELENOP’s key role in the brain and the observed associations in other studies. Further research is needed to explore the effect of selenium on global cognition in very old adults.
Empowering pharmacy professionals to enhance public health nutrition: a mixed methods study
- G. Acar, R. Frost, S. Bhamra, M. Heinrich
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE2 / June 2024
- Published online by Cambridge University Press:
- 03 July 2024, E235
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Unhealthy dietary patterns stand as the foremost risk factor for noncommunicable disease- associated morbidity and mortality(1). As widely accessible healthcare providers, pharmacy professionals’ potential to catalyze improvements in public health nutrition is substantial, offering a means to combat the escalating epidemic of obesity and NCDs through tailored interventions, services, and education(2,3).
Our study employed a mixed-methods approach to assess the role of pharmacy professionals in promoting nutrition advice and healthy dietary practices.
An online questionnaire (N=200) was designed and conducted to evaluate pharmacy professionals’ nutrition knowledge, the advice given in various diet-related conditions (e.g. obesity, type 2 diabetes, cardiovascular disease risk factors, malnutrition, sustainable diets), practices in delivering diet- related guidance within their routine practice and perceived roles and future ambitions of pharmacy professionals towards nutrition counselling, yielding both quantitative and qualitative insights.
Subsequently, qualitative interviews and focus group discussions (N=19) were conducted, engaging pharmacists, nutritionists and dietitians to gather insights essential for the development of a comprehensive nutrition toolkit tailored for pharmacy practice.
These interviews delved deeper into the subject, with the goal of designing a nutrition toolkit that empowers pharmacists with the knowledge, tools, and resources needed to play a more active and impactful role in promoting nutrition and healthy lifestyle practices among their patients. Thematic analysis was conducted, and emerging themes and subthemes were identified.
Our findings indicate that a significant portion of participants in our study are involved in providing nutrition and diet advice for various health conditions. The majority of pharmacists considered diabetes programmes having a high level of importance (84%), followed by weight management services (78%), hypertension management (86%), and healthy diet campaigns (63.5%). However, our knowledge and confidence rating questions revealed a significant gap in training and a clear need for educational materials tailored for pharmacists to enhance their ability to provide nutrition advice effectively. Key themes identified in open-text questions were referrals and collaboration, training and education needs, wider needs (changes in the public health system, materials/resources, integration and implementation of nutrition in pharmacy practice) and perceived roles as pharmacists in providing nutrition advice (patient support, feeling responsible, specialised focus areas).
Qualitative findings underscore the pressing demand for nutrition training and education to deliver comprehensive services, as well as the necessity for collaborative efforts with dietitians and nutritionists to ensure effective care and the improvement of referral pathways in pharmacy practice.
This research contributes to the advancement of public health nutrition by recognizing the potential role of pharmacy professionals as key players in the dissemination of nutrition knowledge and fostering healthy behaviours within the community. The results will guide us in the collaborative development of a nutrition toolkit tailored for pharmacy practice, employing a co-design approach.