• Effect of vitamin D3 supplementation on cardiometabolic disease risk among overweight/obese adult males in United Kingdom- A pilot randomised controlled trial

      Mushtaq, Sohail; Agbalalah, Tarimoboere; University of Chester; Baze University (Wiley, 2022-04-22)
      Background Observational studies suggest links between reduced serum 25(OH)D concentration and increased cardiometabolic disease risk. However, these studies provide limited evidence of causation, with few conclusive randomised controlled trials (RCT) having been carried out to date. This RCT investigated the effect of vitamin D3 supplementation on vascular function and cardiometabolic disease risk markers, in fifty-five healthy males aged 18-65 years with plasma 25(OH)D concentration <75nmol/L and BMI ≥24.9kg/m2. Method Participants were assigned to consume 125µg/day (5,000 IU/day) vitamin D3 or placebo for 8-weeks. Blood samples and vascular function measures were obtained at baseline, week 4 and week 8. The primary outcome was arterial stiffness, an indicator of cardiovascular diseases risk (CVD), assessed by pulse wave velocity. Biomarkers of CVD risk, insulin resistance and endothelial function were measured using enzyme linked immunosorbent assay. Results Daily oral intake of 125µg supplemental vitamin D3 led to a significant improvement in plasma 25(OH)D concentrations over the 8-week intervention in the vitamin D group compared to the change in the placebo group (P ˂ 0.001). In the vitamin D group the baseline mean (±SD) 25(OH)D concentration was 38.4 ± 15.9 and this increased to 72.8 ± 16.1 nmol/L after 8 weeks of supplementation. The intervention had no effect on arterial stiffness, as measured by pulse wave velocity (PWV) but vitamin D3 supplementation did lead to a decrease in mean (±SD) brachial pulse pressure from baseline to 8 weeks, by − 2.9 ± 3.4 mmHg, (P = 0.027) in the vitamin D group compared to the same period in the placebo group. The intervention had no effect on the remaining cardiometabolic parameters. Conclusion Overall, treatment significantly improved brachial pulse pressure but no other cardiometabolic disease risk markers. To follow on from this pilot RCT, future large-scale clinical trials over longer durations may offer further insights. Clinical trial registration http://www.clinicaltrials.gov NCT02359214.
    • Assessment of serum total 25-hydroxyvitamin D assays for Vitamin D External Quality Assessment Scheme (DEQAS) materials distributed at ambient and frozen conditions

      Sempos, Christopher T.; Williams, Emma L.; Carter, Graham D.; Jones, Julia; Camara, Johanna E.; Burdette, Carolyn Q.; Hahm, Grace; Nalin, Federica; Duewer, David L.; Kuszak, Adam J.; et al. (Springer, 2021-11-09)
      The Vitamin D External Quality Assessment Scheme (DEQAS) distributes human serum samples four times per year to over 1000 participants worldwide for the determination of total serum 25-hydroxyvitamin D [25(OH)D)]. These samples are stored at −40 °C prior to distribution and the participants are instructed to store the samples frozen at −20 °C or lower after receipt; however, the samples are shipped to participants at ambient conditions (i.e., no temperature control). To address the question of whether shipment at ambient conditions is sufficient for reliable performance of various 25(OH)D assays, the equivalence of DEQAS human serum samples shipped under frozen and ambient conditions was assessed. As part of a Vitamin D Standardization Program (VDSP) commutability study, two sets of the same nine DEQAS samples were shipped to participants at ambient temperature and frozen on dry ice. Twenty-eight laboratories participated in this study and provided 34 sets of results for the measurement of 25(OH)D using 20 ligand binding assays and 14 liquid chromatography–tandem mass spectrometry (LC–MS/MS) methods. Equivalence of the assay response for the frozen versus ambient DEQAS samples for each assay was evaluated using multi-level modeling, paired t-tests including a false discovery rate (FDR) approach, and ordinary least squares linear regression analysis of frozen versus ambient results. Using the paired t-test and confirmed by FDR testing, differences in the results for the ambient and frozen samples were found to be statistically significant at p < 0.05 for four assays (DiaSorin, DIAsource, Siemens, and SNIBE prototype). For all 14 LC–MS/MS assays, the differences in the results for the ambient- and frozen-shipped samples were not found to be significant at p < 0.05 indicating that these analytes were stable during shipment at ambient conditions. Even though assay results have been shown to vary considerably among different 25(OH)D assays in other studies, the results of this study also indicate that sample handling/transport conditions may influence 25(OH)D assay response for several assays.
    • Interlaboratory Comparison of 25-Hydroxyvitamin D Assays: Vitamin D Standardization Program (VDSP) Intercomparison Study 2 – Part 2 Ligand Binding Assays – Impact of 25 Hydroxyvitamin D2 and 24R,25- Dihydroxyvitamin D3 on Assay Performance

      Mushtaq, Sohail; Wise, Stephen A.; Camara, Johanna E.; Burdette, Carolyn Q.; Hahm, Grace; Nalin, Federica; Kuszak, Adam J.; Merkel, Joyce; Durazo-Arvizu, Ramón A.; Williams, Emma L.; et al. (Springer, 2021-08-25)
      An interlaboratory comparison study was conducted by the Vitamin D Standardization Program (VDSP) to assess the performance of ligand binding assays (Part 2) for the determination of serum total 25-hydroxyvitamin D [25(OH)D]. Fifty single-donor samples were assigned target values for concentrations of 25-hydroxyvitamin D2 [25(OH)D2], 25-hydroxyvitamin D3 [25(OH)D3], 3-epi-25-hydroxyvitamin D3 [3-epi-25(OH)D3], and 24R,25-dihydroxyvitamin D3 [24R,25(OH)2D3] using isotope dilution liquid chromatography-tandem mass spectrometry (ID LC-MS/MS). VDSP Intercomparison Study 2 Part 2 includes results from 17 laboratories using 32 ligand binding assays. Assay performance was evaluated using mean % bias compared to the assigned target values and using linear regression analysis of the test assay mean results and the target values. Only 50% of the ligand binding assays achieved the VDSP criterion of mean % bias ≤ |± 5%|. For the 13 unique ligand binding assays evaluated in this study, only 4 assays were consistently within ± 5% mean bias and 4 assays were consistently outside ± 5% mean bias regardless of the laboratory performing the assay. Based on multivariable regression analysis using the concentrations of individual vitamin D metabolites in the 50 single-donor samples, most assays underestimate 25(OH)D2 and several assays (Abbott, bioMérieux, DiaSorin, IDS-EIA, and IDS-iSYS) may have cross-reactivity from 24R,25(OH)2D3. The results of this interlaboratory study represent the most comprehensive comparison of 25(OH)D ligand binding assays published to date and is the only study to assess the impact of 24R,25(OH)2D3 content using results from a reference measurement procedure.
    • Assessment of serum total 25-hydroxyvitamin D assay commutability of Standard Reference Materials and College of American Pathologists Accuracy-Based Vitamin D (ABVD) Scheme and Vitamin D External Quality Assessment Scheme (DEQAS) materials: Vitamin D Standardization Program (VDSP) Commutability Study 2

      Mushtaq, Sohail; Camara, Johanna E.; Wise, Stephen A.; Sempos, Christopher T.; University of Chester; National Institute of Standards and Technology (NIST); National Institutes of Health (NIH); Vitamin D Standardization Program LLC (Springer, 2021-06-28)
      An interlaboratory study was conducted through the Vitamin D Standardization Program (VDSP) to assess commutability of Standard Reference Materials® (SRMs) and proficiency testing/external quality assessment (PT/EQA) samples for determination of serum total 25-hydroxyvitamin D [25(OH)D] using ligand binding assays and liquid chromatography-tandem mass spectrometry (LC-MS/MS). A set of 50 single-donor serum samples were assigned target values for 25-hydroxyvitamin D2 [25(OH)D2] and 25-hydroxyvitamin D3 [25(OH)D3] using reference measurement procedures (RMPs). SRM and PT/EQA samples evaluated included SRM 972a (four levels), SRM 2973, six College of American Pathologists (CAP) Accuracy-Based Vitamin D (ABVD) samples, and nine Vitamin D External Quality Assessment Scheme (DEQAS) samples. Results were received from 28 different laboratories using 20 ligand binding assays and 14 LC-MS/MS methods. Using the test assay results for total serum 25(OH)D (i.e., the sum of 25(OH)D2 and 25(OH)D3) determined for the single-donor samples and the RMP target values, the linear regression and 95% prediction intervals (PIs) were calculated. Using a subset of 42 samples that had concentrations of 25(OH)D2 below 30 nmol/L, one or more of the SRM and PT/EQA samples with high concentrations of 25(OH)D2 were deemed non-commutable using 5 of 11 unique ligand binding assays. SRM 972a (level 4), which has high exogenous concentration of 3-epi-25(OH)D3, was deemed non-commutable for 50% of the LC-MS/MS assays.
    • Nutrition knowledge and dietary intake of hurlers

      Murphy, John; orcid: 0000-0002-8337-722X; O’Reilly, James (SAGE Publications, 2020-11-26)
      The current study investigated the association between sports nutrition knowledge and dietary quality in a sample of adult Irish male hurling players. Nutrition knowledge was measured by the validated Sports Nutrition Knowledge Questionnaire (SNKQ). Diet quality was measured by the Australian Recommended Food Score (ARFS) calculated from food frequency questionnaire data. Analysis of variance and linear modelling were used to assess associations between variables. A total of 265 (129 elite, 136 sub-elite) players were recruited. No significant difference in nutrition knowledge (SNKQ) was found between groups. Results showed a significant difference (p = 0.02; d = 0.39 ± 0.25; small) in food score (ARFS) between groups. A weak, positive association (r = 0.3, p = 0.007) was found between nutrition knowledge and food score. Elite level players, aged 28–32, with college degrees, that have previously received nutritional guidance displayed the highest levels of both nutrition knowledge and food score. Higher levels of nutrition knowledge and food score were expected in elite players, however were only found in food score. Nutrition knowledge does contribute to dietary quality although future interventions should focus on specific gaps in knowledge such as how to meet total energy/carbohydrate requirements.
    • Ecotoxicological and regulatory aspects of environmental sustainability of nanopesticides.

      Grillo, Renato; email: renato.grillo@unesp.br; Fraceto, Leonardo F; Amorim, Mónica J B; Scott-Fordsmand, Janeck James; Schoonjans, Reinhilde; Chaudhry, Qasim (2020-10-02)
      Recent years have seen the development of various colloidal formulations of pesticides and other agrochemicals aimed at use in sustainable agriculture. These formulations include inorganic, organic or hybrid particulates, or nanocarriers composed of biodegradable polymers, that can provide a better control of the release of active ingredients. The very small particle sizes and high surface areas of nanopesticides may however also lead to some unintended (eco)toxicological effects due to the way in which they interact with the target and non-target species and the environment. The current level of knowledge on ecotoxicological effects of nanopesticides is scarce, especially in regard to the fate and behaviour of such formulations in the environment. Nanopesticides will however have to cross a stringent regulatory scrutiny before marketing in most countries for health and environmental risks under a range of regulatory frameworks that require pre-market notification, risk assessment and approval, followed by labelling, post-market monitoring and surveillance. This review provides an overview of the key regulatory and ecotoxicological aspects relating to nanopesticides that will need to be considered for environmentally-sustainable use in agriculture. [Abstract copyright: Copyright © 2020 Elsevier B.V. All rights reserved.]
    • Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss.

      Kirwan, Richard; orcid: 0000-0003-4645-0077; email: r.p.kirwan@2018.ljmu.ac.uk; McCullough, Deaglan; orcid: 0000-0002-9882-9639; Butler, Tom; orcid: 0000-0003-0818-1566; email: t.butler@chester.ac.uk; Perez de Heredia, Fatima; orcid: 0000-0002-2537-3327; Davies, Ian G; orcid: 0000-0003-3722-8466; Stewart, Claire; orcid: 0000-0002-8104-4819 (2020-10-01)
      The COVID-19 pandemic is an extraordinary global emergency that has led to the implementation of unprecedented measures in order to stem the spread of the infection. Internationally, governments are enforcing measures such as travel bans, quarantine, isolation, and social distancing leading to an extended period of time at home. This has resulted in reductions in physical activity and changes in dietary intakes that have the potential to accelerate sarcopenia, a deterioration of muscle mass and function (more likely in older populations), as well as increases in body fat. These changes in body composition are associated with a number of chronic, lifestyle diseases including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. Furthermore, CVD, diabetes, and elevated body fat are associated with greater risk of COVID-19 infection and more severe symptomology, underscoring the importance of avoiding the development of such morbidities. Here we review mechanisms of sarcopenia and their relation to the current data on the effects of COVID-19 confinement on physical activity, dietary habits, sleep, and stress as well as extended bed rest due to COVID-19 hospitalization. The potential of these factors to lead to an increased likelihood of muscle loss and chronic disease will be discussed. By offering a number of home-based strategies including resistance exercise, higher protein intakes and supplementation, we can potentially guide public health authorities to avoid a lifestyle disease and rehabilitation crisis post-COVID-19. Such strategies may also serve as useful preventative measures for reducing the likelihood of sarcopenia in general and in the event of future periods of isolation.
    • Risk Governance of Emerging Technologies Demonstrated in Terms of its Applicability to Nanomaterials.

      Isigonis, Panagiotis; orcid: 0000-0002-8404-7708; Afantitis, Antreas; Antunes, Dalila; Bartonova, Alena; Beitollahi, Ali; Bohmer, Nils; Bouman, Evert; Chaudhry, Qasim; Cimpan, Mihaela Roxana; Cimpan, Emil; et al. (2020-07-23)
      Nanotechnologies have reached maturity and market penetration that require nano-specific changes in legislation and harmonization among legislation domains, such as the amendments to REACH for nanomaterials (NMs) which came into force in 2020. Thus, an assessment of the components and regulatory boundaries of NMs risk governance is timely, alongside related methods and tools, as part of the global efforts to optimise nanosafety and integrate it into product design processes, via Safe(r)-by-Design (SbD) concepts. This paper provides an overview of the state-of-the-art regarding risk governance of NMs and lays out the theoretical basis for the development and implementation of an effective, trustworthy and transparent risk governance framework for NMs. The proposed framework enables continuous integration of the evolving state of the science, leverages best practice from contiguous disciplines and facilitates responsive re-thinking of nanosafety governance to meet future needs. To achieve and operationalise such framework, a science-based Risk Governance Council (RGC) for NMs is being developed. The framework will provide a toolkit for independent NMs' risk governance and integrates needs and views of stakeholders. An extension of this framework to relevant advanced materials and emerging technologies is also envisaged, in view of future foundations of risk research in Europe and globally. [Abstract copyright: © 2020 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.]
    • Ketogenic diets for drug-resistant epilepsy

      Martin-McGill, Kirsty J; Bresnahan, Rebecca; Levy, Robert G; Cooper, Paul N; University of Chester; University of Liverpool; The CroD ShiDa Health Centre, Rochdale; Salford Royal Hospitals NHS Trust (Cochrane Database of Systematic Reviews, 2020-06-26)
      Background Ketogenic diets (KDs) are high in fat and low in carbohydrates and have been suggested to reduce seizure frequency in people with epilepsy. Such diets may be beneficial for children with drug-resistant epilepsy. This is an update of a review first published in 2003, and last updated in 2018. Objectives To assess the effects of ketogenic diets for people with drug-resistant epilepsy. Search methods For this update, we searched the Cochrane Register of Studies (CRS Web) and MEDLINE (Ovid, 1946 to 26 April 2019) on 29 April 2019. The Cochrane Register of Studies includes the Cochrane Epilepsy Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), and randomised controlled trials (RCTs) from Embase, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We imposed no language restrictions. We checked the reference lists of retrieved studies for additional relevant studies. Selection criteria RCTs or quasi-RCTs of KDs for people of any age with drug-resistant epilepsy. Data collection and analysis Two review authors independently applied predefined criteria to extract data and evaluated study quality. We assessed the outcomes: seizure freedom, seizure reduction (50% or greater reduction in seizure frequency), adverse effects, cognition and behaviour, quality of life, and attrition rate. We incorporated a meta-analysis. We utilised an intention-to-treat (ITT) population for all primary analyses. We presented the results as risk ratios (RRs) with 95% confidence intervals (CIs). Main results We identified 13 studies with 932 participants; 711 children (4 months to 18 years) and 221 adults (16 years and over). We assessed all 13 studies to be at high risk of performance and detection bias, due to lack of blinding. Assessments varied from low to high risk of bias for all other domains. We rated the evidence for all outcomes as low to very low certainty. Ketogenic diets versus usual care for children Seizure freedom (RR 3.16, 95% CI 1.20 to 8.35; P = 0.02; 4 studies, 385 participants; very low-certainty evidence) and seizure reduction(RR 5.80, 95% CI 3.48 to 9.65; P < 0.001; 4 studies, 385 participants; low-certainty evidence) favoured KDs (including: classic KD, medium-chain triglyceride (MCT) KD combined, MCT KD only, simplified modified Atkins diet (MAD) compared to usual care for children. We are not confident that these estimated effects are accurate. The most commonly reported adverse effects were vomiting, constipation and diarrhoea for both the intervention and usual care group, but the true effect could be substantially different (low-certainty evidence). Ketogenic diet versus usual care for adults In adults, no participants experienced seizure freedom. Seizure reduction favoured KDs (MAD only) over usual care but, again, we are not confident that the effect estimated is accurate (RR 5.03, 95% CI 0.26 to 97.68; P = 0.29; 2 studies, 141 participants; very low-certainty evidence). Adults receiving MAD most commonly reported vomiting, constipation and diarrhoea (very low-certainty evidence). One study reported a reduction in body mass index (BMI) plus increased cholesterol in the MAD group. The other reported weight loss. The true effect could be substantially different to that reported. Ketogenic diet versus ketogenic diet for children Up to 55% of children achieved seizure freedom with a classical 4:1 KD aDer three months whilst up to 85% of children achieved seizure reduction (very low-certainty evidence). One trial reported a greater incidence of seizure reduction with gradual-onset KD, as opposed to fasting-onset KD. Up to 25% of children were seizure free with MAD and up to 60% achieved seizure reduction.Up to 25% of children became seizure free with MAD and up to 60% experienced seizure reduction. One study used a simplified MAD (sMAD)and reported that 15% of children gained seizure freedom rates and 56% achieved seizure reduction. We judged all the evidence described as very low certainty, thus we are very unsure whether the results are accurate.The most commonly reported adverse effects were vomiting, constipation and diarrhoea (5 studies, very low-certainty evidence). Two studies reported weight loss. One stated that weight loss and gastrointestinal disturbances were more frequent, with 4:1 versus 3:1 KD,whilst one reported no difference in weight loss with 20 mg/d versus 10 mg/d carbohydrates. In one study, there was a higher incidence of hypercalcuria amongst children receiving classic KD compared to MAD. All effects described are unlikely to be accurate. Ketogenic diet versus ketogenic diet for adults One study randomised 80 adults (aged 18 years and over) to either MAD plus KetoCal during the first month with MAD alone for the second month, or MAD alone for the first month followed by MAD plus KetoCal for the second month. No adults achieved seizure freedom. More adults achieved seizure reduction at one month with MAD alone (42.5%) compared to MAD plus KetoCal (32.5%), however, by three months only 10% of adults in both groups maintained seizure reduction. The evidence for both outcomes was of very low certainty; we are very uncertain whether the effects are accurate.Constipation was more frequently reported in the MAD plus KetoCal group (17.5%) compared to the MAD only group (5%) (1 study, very low-certainty evidence). Diarrhoea and increase/change in seizure pattern/semiology were also commonly reported (17.5% to 20% of participants). The true effects of the diets could be substantially different to that reported. Authors' conclusions The evidence suggests that KDs could demonstrate effectiveness in children with drug-resistant epilepsy, however, the evidence for the use of KDs in adults remains uncertain. We identified a limited number of studies which all had small sample sizes. Due to the associatedr isk of bias and imprecision caused by small study populations, the evidence for the use of KDs was of low to very low certainty.More palatable but related diets, such as the MAD, may have a similar effect on seizure control as the classical KD, but could be associated with fewer adverse effects. This assumption requires more investigation. For people who have drug-resistant epilepsy or who are unsuitable for surgical intervention, KDs remain a valid option. Further research is required, particularly for adults with drug-resistant epilepsy.
    • COVID-19 and cardiac rehabilitation: Joint BACPR/BCS/BHF statement on cardiac rehabilitation services

      Dawkes, Susan; Hughes, Sally; Ray, Simon; Nichols, Simon; Hinton, Sally; Roberts, Ceri; Butler, Thomas; Delal, Hayes; Docherty, Patrick; Edinburgh Napier University; British Association for Cardiovascular Prevention and Rehabilitation [BACPR]; British Heart Foundation; British Cardiovascular Society; Sheffield Hallam University; North Bristol NHS Trust; University of Chester; Royal Cornwall Hospitals NHS Trust; University of York; National Audit of Cardiac Rehabilitation (2020-06-15)
      The British Association for Cardiovascular Prevention and Rehabilitation (BACPR), the British Cardiovascular Society (BCS) and the British Heart Foundation (BHF) have issued a joint position statement ‘Retention of cardiac rehabilitation services during the COVID-19 pandemic’.
    • Dietary vitamin D supplementation improves haematological status following consumption of an iron-fortified cereal: an 8-week randomised controlled trial

      Mushtaq, Sohail; Ahmad Fuzi, Salma F.; University of Chester (Cambridge University Press, 2020-06-10)
      Vitamin D, a secosteroid, has recently been implicated in the stimulation of erythroid precursors and ultimately the rate of erythropoiesis. However, there are a paucity of randomised controlled trials (RCT), investigating the effect of vitamin D supplementation iron status, especially in populations at risk of iron deficiency. An eight-week, double-blind RCT was carried out in 50 female (mean age (± SD): 27 ± 9 years), iron-deficient (plasma ferritin concentration < 20 μg/L) participants, randomised to consume an iron-fortified cereal containing 9 mg of iron, with either a vitamin D supplement (1,500 international units (IU)/day, 38 μg/day) or placebo. The effect of dietary vitamin D supplementation on haematological indicators was investigated. Blood samples were collected at baseline, 4-weeks and 8-week timepoints for measurement of iron and vitamin D status biomarkers. The effect of intervention was analysed with a mixed-model repeated measures ANOVA using IBM SPSS statistical software (Version 21, IBM Corporation, New York, USA). Significant increases were observed in two haematological parameters: haemoglobin concentration and haematocrit level from baseline to post-intervention in the vitamin D group, but not in the placebo group. The increase from baseline to post-intervention in haemoglobin concentration in the vitamin D group (135 ± 11 to 138 ± 10 g/L) was significantly higher than in the placebo group (131 ± 15 to 128 ± 13 g/L) (P ≤ 0.05). The increase in haematocrit level from baseline to post-intervention was also significantly higher in the vitamin D group (42.0 ± 3.0 to 43.8 49 ± 3.4%) compared to the placebo group (41.2 ± 4.3 to 40.7 ± 3.6%) (P ≤ 0.05). Despite non-significant changes in plasma ferritin concentration, this study demonstrates that dietary supplementation with 1,500IU vitamin D, consumed daily with an iron-fortified cereal led to improvement in haemoglobin concentration and haematocrit levels in women with low iron stores. Further long-term studies are required, however, these findings suggest a potential role for improvement of vitamin D status as an adjunct therapy for recovery of iron status in iron-deficient populations.
    • Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review.

      Osei-Kwasi, Hibbah; orcid: 0000-0001-5084-6213; Mohindra, Aarti; Booth, Andrew; Laar, Amos; Wanjohi, Milka; Graham, Fiona; Pradeilles, Rebecca; Cohen, Emmanuel; orcid: 0000-0001-5643-1473; Holdsworth, Michelle; orcid: 0000-0001-6028-885X (2020-05-26)
      To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research. We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro. Urban food environments in Africa. Studies involving adolescents and adults (11-70 years, male/female). Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women. The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.
    • An Exploration into the Impact of Social Networking Site (SNS) Use on Body Image and Eating Behavior of Physically Active Men

      Flannery, Orla; orcid: 0000-0002-4348-2156; email: o.flannery@mmu.ac.uk; Harris, Kerrie; Kenny, Ursula Anne (SAGE Publications, 2020-04-02)
      The rapid proliferation of social networking sites (SNSs) has transformed the way people now socialize and communicate. SNSs have been recognized to contribute to body image (BI) dissatisfaction and disordered eating behavior (EB). Few qualitative studies have explored this issue in men. The aim of the current study was to investigate male SNS use and possible impacts on BI and EB. One-to-one semi-structured interviews were conducted with eight men in the United Kingdom. Interviews aimed to examine men’s views on the potential impact of SNSs on BI and EB. Data were thematically analyzed. Findings suggested that SNSs may be a useful nutrition idea tool and motivational platform for men to improve their diet and exercise uptake. However, results also indicated that SNS use may contribute to BI dissatisfaction and increased risk of disorder. Future research may identify risk factors of SNS use, male BI concerns, and eating pathology across the lifespan.
    • Impacts of Reducing UK Beef Consumption Using a Revised Sustainable Diets Framework

      Chalmers, Neil; email: neil.chalmers@abdn.ac.uk; Stetkiewicz, Stacia; email: s.stetkiewicz@lancaster.ac.uk; Sudhakar, Padhmanand; orcid: 0000-0003-1907-4491; email: Padhmanand.Sudhakar@earlham.ac.uk; Osei-Kwasi, Hibbah; orcid: 0000-0001-5084-6213; email: h.oseikwasi@chester.ac.uk; Reynolds, Christian J; orcid: 0000-0002-1073-7394; email: c.reynolds@sheffield.ac.uk (MDPI, 2019-12-02)
      The impact of beef consumption on sustainability is a complex and evolving area, as sustainability covers many areas from human nutrient adequacy to ecosystem stability. Three sustainability assessment frameworks have been created to help policy makers unpack the complexities of sustainable food systems and healthy sustainable dietary change. However, none of these frameworks have yet to be applied to a case study or individual policy issue. This paper uses a hybrid version of the sustainability assessment frameworks to investigate the impact of reducing beef consumption (with a concurrent increase in consumption of plant-based foods, with a focus on legumes) on sustainability at a UK level. The aim of this paper is to understand the applicability of these overarching frameworks at the scale of an individual policy. Such an assessment is important, as this application of previously high-level frameworks to individual policies makes it possible to summarise, at a glance, the various co-benefits and trade-offs associated with a given policy, which may be of particular value in terms of stakeholder decision-making. We find that many of the proposed metrics found within the sustainability assessment frameworks are difficult to implement at an individual issue level; however, overall they show that a reduction in beef consumption and an increase in consumption of general plant-based foods, with a focus around legumes production, would be expected to be strongly beneficial in five of the eight overarching measures which were assessed.
    • Clobazam add-on therapy for drug-resistant epilepsy

      Bresnahan, Rebecca; Williamson, John; Martin-McGill, Kirsty J.; Michael, Benedict D.; Marson, Anthony G. (Wiley, 2019-10-22)
    • Tiagabine add-on therapy for drug-resistant focal epilepsy

      Bresnahan, Rebecca; Martin-McGill, Kirsty J.; Hutton, Jane L.; Marson, Anthony G. (Wiley, 2019-10-14)
    • The composition and oxidative stability of vegetarian omega-3 algal oil nanoemulsions suitable for functional food enrichment

      Li, Weili; Lane, Katie E.; Robinson, Sharon; ZHOU, Qiqian; Liverpool John Moores University, School of Sport and Exercise Sciences, Faculty of Science, University of Chester (Wiley Online Library, 2019-10-10)
      Abstract Background: Long chain omega-3 polyunsaturated fatty acid (LCn3PUFA) nanoemulsion enriched foods offer potential to address habitually low oily fish intakes. Nanoemulsions increase LCn3PUFA bioavailability, but may cause lipid oxidation. This study examined oxidative stability of LCn3PUFA algal oil-in-water nanoemulsions created by ultrasound using natural and synthetic emulsifiers during 5-weeks of storage at 4, 20 and 40°C. Fatty acid composition, droplet size ranges and volatile compounds were analysed. Results: No significant differences were found for fatty acid composition at various temperatures and storage times. Lecithin nanoemulsions had significantly larger droplet size ranges at baseline and during storage regardless of temperatures. While combined Tween 40 and lecithin nanoemulsions had low initial droplet size ranges, there were significant increases at 40°C after 5-weeks storage. Gas chromatograms identified hexanal and propanal as predominant volatile compounds, along with 2-ethylfuran; propan-3-ol; valeraldehyde. The Tween 40 only nanoemulsion sample showed formation of lower concentrations of volatiles compared to lecithin samples. Formation of hexanal and propanal remained stable at lower temperatures although higher concentrations were found in nanoemulsions than bulk oil. The lecithin only sample had formation of higher concentrations of volatiles at increased temperatures despite having significantly larger droplet size ranges than the other samples. Conclusions: Propanal and hexanal were the most prevalent of five volatile compounds detected in bulk oil and lecithin and/or Tween 40 nanoemulsions. Oxidation compounds remained more stable at lower temperatures indicating suitability for enrichment of refrigerated foods. Further research to evaluate the oxidation stability of these systems 35 within food matrices is warranted.
    • A UK consensus on optimising CVD secondary prevention care: perspectives from multidisciplinary team members

      The ICON (Integrating Care Opportunities across the NHS) CVD Secondary Prevention Working Group (2019-10-03)
      Although overall cardiovascular (CV) mortality has declined in recent years, patients with clinically manifest cardiovascular disease (CVD) remain at increased risk of recurrent CV events. To minimise the likelihood of future CV events following an acute myocardial infarction (MI), changes in diet and lifestyle, alongside pharmaceutical interventions, such as dual antiplatelet therapy, a β-blocker, an ACE inhibitor, and a statin, are recommended within current clinical guidelines. The use of cardiac rehabilitation (CR) programmes has been shown to be highly effective in reducing mortality and morbidity following MI, and a cost-benefit analysis suggests that increasing the uptake of CR to 65% among eligible patient would result in potential cost savings of over £30 million annually for the NHS. The involvement of a multidisciplinary team (MDT) of healthcare professionals is central to delivering post-MI care, with initial and/or ongoing input from cardiologists, hospital-based specialist pharmacists, specialist nurses, GPs, dietitians, smoking cessation specialists and practice-based and community pharmacists, among others. This consensus statement was developed based on a meeting of HCPs actively involved in delivering CV secondary prevention care at primary and secondary care centres across the UK. Recognising that HCP team configuration and availability of resources/services vary by location, the authors have focused on three common themes which have broad relevance in CVD secondary prevention, specifically: integration of care, medicines optimisation, and encouraging patient activation. Opportunities for MDT members to improve outcomes in post-MI patients are suggested and examples of best practice models which have been implemented successfully are described.
    • The effects of intake of bread with treated corn bran inclusion on postprandial glycaemic response

      Cui, Zhiming; Li, Weili; Kennedy, Lynne; Department of Clinical Sciences and Nutrition, University of Chester (Informa, 2019-09-30)
      In the current study, corn bran was treated with hydrothermal processing and then incorporated into bread. The consumption of bread with inclusion of treated corn bran (TCB) and control bread (CB) on postprandial glycaemic response was investigated in a randomised crossover intervention trial with eleven healthy participants and one hyperglycaemicparticipant, capillary blood samples were measured at 0, 15, 30, 45, 60, 75, 90, 105 and 120 minutes after consuming the bread. The results showed the baseline-adjusted peak value of postprandial blood glucose with consumption of CB, containing 75 g carbohydrate was 4.27 mmol/L at 60 min after meal, but with consumption of treated corn bran bread (TCBB), containing 75 g carbohydrate was 3.88 mmol/L at 45 min after meal. In addition, the postprandial blood glucose concentration with consumption of CB is consistently higher than that with the consumption of TCBB since the peak time to 120 min. However, there was no significant differences, in turn, the incremental area under the curves (IAUC) with baseline-adjusted for CB consumption is consistently higher than that of TCBB consumption, but not any significant difference either (p>0.05). However, it is interesting to notice that more considerable difference in rise of blood sugar at peak time and thereafter for hyperglycaemicparticipant between the consumptions of TCBB and CB. In conclusion, the consumption of bread with inclusion of TCB is able to reduce the postprandial glycaemic response to a lower level compared with the consumption of CB and the more obvious difference was observed with the hyperglycaemicparticipant and healthy group Key words: Corn bran, hydrothermal treatment, postprandial glycaemic response. Intervention trial.