Proceedings of the Nutrition Society最新文献

{"title":"Understanding the nature and scale of low-intake dehydration on ‘Medicine for Older People’ wards at University Hospital Southampton: A mixed-methods study","authors":"S. Alsanie, K. Ibrahim, S. Lim, S. Wootton","doi":"10.1017/s0029665124004385","DOIUrl":"https://doi.org/10.1017/s0029665124004385","url":null,"abstract":"Dehydration during hospital stays is a significant concern, particularly affecting older adults<jats:sup>(1)</jats:sup>. The ageing process associated with pathological changes and conditions such as dementia makes older adults especially vulnerable to both chronic and acute dehydration <jats:sup>(1,2)</jats:sup>. Recent studies indicate that conventional signs and symptoms of low-intake dehydration may not consistently indicate its presence in older inpatients, leading to missed or incorrect assessments. It can result in significant morbidity through falls, constipation, delirium, respiratory and urinary tract disorders, and even death <jats:sup>(2,3)</jats:sup>. Diagnosing low-intake dehydration at the early stage is challenging, leading to treatment delays which further compound the negative consequences of dehydration <jats:sup>(1,3)</jats:sup>. There is a need to determine the scope and practice of detecting and managing low-intake dehydration in ‘Medicine for Older People’ (MOP) wards at University Hospital Southampton (UHS). The primary aim of this study was to explore the current practices and challenges in detecting and managing low-intake dehydration in older inpatients within the MOP wards at UHS.Using a sequential, explanatory mixed-method design, a prospective chart review study (phase 1) was conducted at all the MOP wards at UHS over one month. The study included 50 adults aged 65 and above admitted to the medical wards for various reasons and now deemed ‘Medically Optimised for Discharge’ (MOFD). The quantitative aspect involved reviewing the completion of a local hydration assessment tool and the proper documentation of hydration and fluid balance charts for at-risk patients. The qualitative component (phase 2) consisted of semi-structured interviews with 10 participants—four doctors and six nurses with years of experience ranging from 4 to 12 years—to understand the perceptions of hospital staff on hydration care, its barriers and facilitators.The quantitative phase found that all patients were at risk for dehydration and underwent assessment through the hydration risk assessment, with hydration chart reviews during early, late, and night shifts. 20% did not have hydration assessment within 24h of admission and there were some missing reviews during various shifts. Most 24-hour fluid balance sheets were not completed for patients in the red category (start 24-hour fluid balance chart). Qualitative findings revealed that staff had ‘(1) experiential knowledge of hydration understanding the risks of dehydration in older adults’, ‘(2) difficulty in dehydration assessment and diagnosis due to resources’ and ‘(3) challenges related to staff levels and skills’ as well as (4) patient attributes contributing to difficulty in dehydration assessment.The mixed-methods study underscores the importance of addressing low-intake dehydration in older inpatients on MOP wards and highlights gaps in current practices. The findings emphasise the need","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"36 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beans, peas and pulses for improved public and planetary health: Changing UK consumption patterns","authors":"L. Lane, R. Wells, C. Reynolds","doi":"10.1017/s0029665124004270","DOIUrl":"https://doi.org/10.1017/s0029665124004270","url":null,"abstract":"Beans, peas and pulses offer significant nutritional, health and environmental benefits <jats:sup>(1,2,3, 4)</jats:sup> and the FAO states that including pulses in agrifood systems is key to achieving the Sustainable Development Goals<jats:sup>(5)</jats:sup>. Recommended intakes vary across national food-based dietary guidelines<jats:sup>(6)</jats:sup>, but higher intakes are associated with benefits including increased satiety, reduced blood pressure, lower risk of cardiovascular disease and improved gut microbiota composition and activity<jats:sup>(7)</jats:sup>. Worldwide, the average consumption of pulses is 21g per person per day<jats:sup>(8)</jats:sup> but published analysis of UK intakes is scarce. The aim of this review was to analyse consumption trends using two UK government datasets.The Family Food module of the Living Costs and Food Survey details food and drink purchases from approximately 5000 households per year<jats:sup>(9)</jats:sup>. The ‘UK – household purchases’ data include the average (mean) quantities purchased per person per week. Categories relating to beans, peas and pulses were identified, and data were presented as graphs of purchasing trends (1974–2021).The National Diet and Nutrition Survey (NDNS)<jats:sup>(10)</jats:sup> assesses the nutritional status of 1000 participants (1.5 years and over) annually. Personal-level dietary data (2008-2019) were evaluated for subgroups ‘baked beans’ and ‘beans and pulses including ready meal and homemade dishes’, including fresh, frozen and canned beans and pulses, and recipes containing them. Peas/ green beans were excluded because of the nature of the data aggregation. Food-level dietary data (2018-19) were assessed for the frequency of consumption of different types of peas, beans and pulses.Our analysis of the Family Food datasets shows that, at 28g per person per day, the current average (mean) consumption of beans, peas and pulses in the UK is suboptimal. Our parallel analysis of NDNS data showed that more than 40% of participants were not eating any beans and pulses (excluding peas).Dietary trends are shifting. The overall consumption of beans, peas and pulses has been falling steadily since the late 1980s. This is mostly due to the drop in consumption of peas and baked beans, though these are still the most frequently consumed legume categories in the UK diet. Canned pea purchases fell from 88g per person per week in 1974 to 14g per person per week in 2020-21. Baked bean purchases peaked at 133g per person per week in 1986, dropping to 78g in 2020-21.Purchases of other canned beans and pulses (excluding baked beans) have increased noticeably in the last decade, from 17g per person per week 2015-16 to 32g in 2020-21. Purchases of dried pulses have remained consistent, averaging 11g per person per week in 2020-21.This analysis indicates significant scope to deliver affordable, accessible health and environmental benefits through increased consumption of beans, peas and pulse","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"151 12 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterising dietary protein intake in Irish adults on the island of Ireland","authors":"H. Griffin, A.P Nugent, B. A McNulty, D. Wright, L. Brennan","doi":"10.1017/s0029665124004312","DOIUrl":"https://doi.org/10.1017/s0029665124004312","url":null,"abstract":"Shifting dietary protein intakes from animal to plant-based sources is suggested as a path to sustain the world’s food consumption and maintain planetary resources <jats:sup>(1)</jats:sup>. However, to facilitate change, it is important to characterise baseline dietary protein patterns. This study aimed to examine dietary protein intakes on the island of Ireland in order to determine population characteristics and food sources influencing protein intake.Analyses were performed on the Northern Ireland sub cohort of the UK National Dietary Nutrition Survey (NDNS 2016-2019) <jats:sup>(2)</jats:sup> and the Irish National Adult Nutrition Survey (2008-2010) <jats:sup>(3)</jats:sup>. Both surveys used a four-day food diary and a final sample of 1484 adults, aged 18-64 years was extracted (NANS; n =1274 and NI NDNS; n=210). Mean daily intakes for protein (MDI; % total energy, TE) for the total population were calculated and the population was divided into three tertile groups based on low, medium and high protein intake (%TE). Differences in population characteristics, energy MDI, key nutrients (%TE or per 10MJ) and contributing food sources were examined across these tertiles, using chi-square and one-way ANOVA with covariates (age and BMI) and correcting for multiple comparisons as appropriate (<jats:italic>P<0.005</jats:italic>).Overall, 17.1% of TE was obtained from protein and 77% of participants met their protein DRV based on EFSA recommendations of 0.83g/kg/body weight <jats:sup>(4).</jats:sup> The difference in protein intakes between the highest and lowest tertiles was 7.8% TE (21.2 % TE vs 13.4% TE) with high protein consumers reporting lower energy intakes (1734 ± 564kcal) compared to low consumers (2185 ± 661 kcal). High protein consumers were older (42.5 ± 12.8 years) and had a higher BMI (27.7 ± 6.0 kg/m<jats:sup>2</jats:sup>). They also had higher MDI of dietary fibre, calcium, zinc, sodium, iron, folate and vitamins A, C, D and B<jats:sub>12</jats:sub> (per 10MJ) (p<0.001) and lower MDI of carbohydrates, fat, saturated fat (%TE) in comparison to low consumers (p<0.001). The % contribution of ‘chicken, turkey and dishes’ (18.3%), ‘beef, veal and dishes’ (12.8%) and ‘fish and fish products (7.0%) to protein intakes were significantly higher in the high versus the low consumption group (10%, 7.4%, 4.4% TE respectively; P<0.001). In contrast, those in the lowest protein intake group had a significantly higher intakes of protein coming from dietary sources including ‘burgers, sausages and meat products (9.9 <jats:italic>vs</jats:italic> 5.9%), ‘white bread and rolls’ (6.9 <jats:italic>vs</jats:italic> 3.9%), ‘potatoes (including chips)’ (4.1 <jats:italic>vs</jats:italic> 2.9 %) and ‘cakes, pastries, buns and fruit pies’ (1.7 <jats:italic>vs</jats:italic> 0.8%) compared to high consumers.In general, animal protein sources contributed more to total daily protein intakes than plant sources, however, the pattern of protein foods diffe","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"86 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between dietary fatty acids and liver fat accumulation in the UK Biobank","authors":"J. Orliacq, A. Pérez-Cornago, J. Carter","doi":"10.1017/s002966512400449x","DOIUrl":"https://doi.org/10.1017/s002966512400449x","url":null,"abstract":"Steatotic liver disease, defined as >5% of hepatic fat content, is a major contributor to global morbidity and mortality, in particular due to its category metabolic associated steatotic liver disease (MASLD)<jats:sup>(1)</jats:sup>. While its prevention focuses on promoting physical activity and maintaining a healthy weight and balanced diet, the associations between dietary fatty acids and liver fat remain unclear<jats:sup>(2,3)</jats:sup>. The aim of this study was to examine the associations between dietary fatty acids and liver fat in the absence of excessive alcohol intake, independently of energy intake.Analyses were conducted on 9,268 non-diabetic participants from the UK Biobank with no pre- existing liver chronic illness or cardiovascular disease at baseline, and without excessive alcohol consumption. Dietary intake of total fat, saturated fatty acids (SFAs), polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs) was measured using the mean of ≥2 Oxford WebQ 24-hr dietary assessments, responded to between 2009 and 2012. Liver proton density fat fraction (LPDFF) was measured by magnetic resonance imaging between 2016 and 2020. Multivariable linear regression models were calculated to assess the associations between fatty acid intakes and LPDFF, adjusting for key demographic and lifestyle confounders. In addition, associations between LPDFF and 10 individual SFAs, 7 PUFAs, and 4 MUFAs were also examined. Sensitivity analyses were carried out including participants who responded ≥4 dietary assessments (N=2,828).After fully adjusting for confounders, no significant associations between LPDFF (%) and MUFAs were found. Inverse associations with LPDFF were observed for PUFAs (−5.8% relative difference [95% confidence interval −0.6, −1.9]), per 5% increase in intake, while SFAs were positively associated with LPDFF (5.8% [3.3, 8.3]). Positive associations were observed per 1 SD increase in intake of individual fatty acids SFA stearic acid (4.20% [2.84, 5.57]) and palmitic acid (3.15% [1.78, 4.54]). Negative associations were observed for PUFAs alpha-linoleic acid (−2.32% [−3.47, −1.17]) and docosahexaenoic acid (−2.14% [−3.23, −1.0.3], and for MUFA erucic acid (−2.52% [−3.61, −1.43]). Sensitivity analyses presented similar results, and the associations between PUFAs and liver fat became slightly stronger (−10.73%, [−17.58, −3.32]).This observational study suggests that SFAs and PUFAs are associated with liver fat in opposite directions, independently of energy intake. While total MUFAs did not present significant associations with LPDFF, erucic acid was inversely associated with liver fat, highlighting the value of studying individual fatty acids. These different associations provide valuable information for the design of dietary trials that compare interventions with different types of fatty acids. These further studies would allow a better understanding of the ideal dietary advice to prevent liver steatosis and its glo","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"103 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141532266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can guided self-help improve the management of binge eating in adults type 2 diabetes? Results of the POSE-D study","authors":"E. Coales, A. Hill, S. Heywood-Everett, J. Rabbee, R. West, M. Mansfield, C. Grace, I. Beeton, G. Traviss-Turner","doi":"10.1017/s0029665124004579","DOIUrl":"https://doi.org/10.1017/s0029665124004579","url":null,"abstract":"People with type 2 diabetes are more likely to experience binge eating than the general population, which may interfere with their diabetes management. Guided Self-Help (GSH) is the recommended treatment for binge eating disorder <jats:sup>(1)</jats:sup>, but there is currently a lack of evidenced treatment for binge eating in individuals living with type 2 diabetes.The aims of this pilot study were to test the feasibility and acceptability of recruiting and delivering a 12-week, online psychological GSH intervention which has been adapted in an earlier study to the needs of adults with T2 diabetes and binge eating <jats:sup>(2)</jats:sup>.The intervention comprises GSH materials presented online in 7-sections delivered over 12-weeks, supported by a trained Guide. In total 22 participants were recruited in a case series design, through GP practices, NHS specialist weight management and diabetes services and via social media. Outcome measures were collected pre and post-intervention and at 12-week follow-up. The primary outcome was the Gormally Binge Eating Scale and secondary outcomes included eating disorder psychopathology, depression, anxiety, quality of life and HBA1C. Following the intervention, we conducted semi-structured interviews with 6 participants and 4 Guides. Data were analysed using a random intercept multi-level model.Results showed at baseline that 67% of the sample met the criteria for moderate to severe binge eating (cut-off (≤17). At post-intervention there was a statistically significant reduction in self- reported binge eating on the Gormally binge eating scale with a reduction in mean score moving from 26.8 to 14.2, (t= -4.181, p < 0.001) and only 9% meeting criteria for binge eating. There were also notable improvements in anxiety, depression and quality of life scores, but not eating disorder psychopathology.In the interviews both Guides and participants found the adapted online platform easy to use and the sessional support sufficient. They highlighted what a large commitment it was and therefore the importance of the Guide and working in ‘<jats:italic>partnership</jats:italic>’. The intervention appeared particularly suited to ‘<jats:italic>stress eaters</jats:italic>’, those experiencing ‘<jats:italic>severe</jats:italic> binge eating’ episodes and physical symptoms of diabetes. As a result of the intervention, participants reported <jats:italic>‘</jats:italic>making broader lifestyle changes’, <jats:italic>‘</jats:italic>improvements in their diabetes management’ and ‘<jats:italic>confidence</jats:italic>’. Guides found the training and supervision helpful but reflected on some <jats:italic>‘</jats:italic>challenges with engagement’. On ending the intervention, participants requeste<jats:italic>d</jats:italic> ‘ongoing support’, such as an optional follow-up appointment and continued access to the materials.In conclusion, the study shows preliminary evidence for online GSH tailored to the needs of individuals with ","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"26 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between carrot intake, dietary/circulating α-carotene and cancer risk: A systematic review and meta-analysis of prospective observational studies","authors":"C.C Ojobor, G.M O’Brien, M. Siervo, C. Ogbonnaya, K. Brandt","doi":"10.1017/s0029665124004567","DOIUrl":"https://doi.org/10.1017/s0029665124004567","url":null,"abstract":"Carrot consumption reduces tumour development in several animal models. The constituent alpha- carotene has not by itself shown anti-cancer properties, however carrots typically provide &gt;85% of alpha-carotene dietary intake<jats:sup>(1-3)</jats:sup>, justifying its use as an indicator of carrot intake<jats:sup>(3)</jats:sup>. We conducted a meta-analysis to investigate inverse associations of carrot/dietary α-carotene intakes and cancer risk, and to quantify potential dose–response relationships.PubMed, Cochrane Library, Web of Science, Scopus, EBSCO, and JSTOR were searched (from database inception to August 2021) for studies reporting risk estimates with 95% CIs for the relationship between carrot intake or α-carotene and cancer risk. Meta-analyses were conducted using a random-effects model comparing highest and lowest intakes to estimate summary risk estimates (RRs).Of 80 prospective studies included, 15 (with 25738 cases) reported data on carrot intake, 35 (26262 cases) on dietary α-carotene intake and 30 (9331 cases) on plasma α-carotene levels. A significantly (P&lt;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 &lt; 0·0001),and successive 50μg/L increments in plasma α-carotene associated with 11% risk reduction (p &lt; 0·0058).Carrot consumption is robustly associated with decreased cancer risk. Carrot consumption should be encouraged, and the causal mechanisms further investigated.","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"213 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietitians’ perspectives on clinical pathways and practice in relation to the dietary management of irritable bowel syndrome in the UK: A qualitative study","authors":"K. Belogianni, P. Khandige, S. Silverio, S. Windgassen, R. Moss-Morris, M.C.E Lomer","doi":"10.1017/s0029665124004294","DOIUrl":"https://doi.org/10.1017/s0029665124004294","url":null,"abstract":"Irritable bowel syndrome (IBS) is a chronic and relapsing gastrointestinal condition which negatively impacts quality of life<jats:sup>(1).</jats:sup> Dietary triggers are common and dietary management is central to the IBS treatment pathway with dietitians being the main education providers for patients<jats:sup>(2)</jats:sup>. The aim of this study was to explore the perceptions of dietitians towards current practices in IBS services in clinical settings across the UK.Qualitative semi-structured interviews were undertaken to explore current practices, barriers, and facilitators to dietetic practice and expected treatment outcomes. Eligible participants were dietitians specialising in IBS and working in the National Health System (NHS) in the UK. Interviews were held virtually. Audio was recorded and transcribed following intelligent transcription. Data were analysed using template analysis <jats:sup>(3)</jats:sup>.Thirteen dietitians (n=12 female) specialising in gastroenterology consented to participate in the study. Dietitians were working in various NHS Trusts across the country (Southeast England n=3; Southwest England n=3; Northwest England n=2; Northeast England n=1; West Midlands n=1; Southwest Wales n=1 and Southcentral Scotland n=2). Ten out of 13 dietitians had more than five years of experience in IBS management. Three main themes emerged: 1) Dietetic services as part of IBS referral pathways; 2) Practices in relation to dietetic services and 3) Implications of services on patients’ expectations and feelings. Each main theme had subthemes to facilitate the description and interpretation of data. The increasing number of IBS referrals to dietitians and the need for accurate and timely IBS diagnosis and specialist IBS dietitians was reported, alongside the use of digital innovation to facilitate practice and access to dietetic care. The use of Internet as a source of (mis)information by patients and the limited time available for educating patients were identified as potential barriers to dietetic practice. Dietitians follow a patient-centred approach to dietary counselling and recognise the negative implications of perceived IBS-related stigma by patients on their feelings and treatment expectations.The study identified areas and practices which can facilitate access to dietetic services and patient- centred care in IBS management as outlined in guidelines <jats:sup>(4)</jats:sup>.","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"45 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of patients’ perceptions of DASH diet apps for dietary self- management of hypertension in Saudi Arabia","authors":"G. Alnooh, E. Williams, M. S Hawley","doi":"10.1017/s0029665124004488","DOIUrl":"https://doi.org/10.1017/s0029665124004488","url":null,"abstract":"Nutrition smartphone apps have become a popular and readily accessible approach to improving dietary behaviour. Hypertension is often associated with a poor diet, and its prevalence is increasing in Saudi Arabia&lt;jats:sup&gt;(1)&lt;/jats:sup&gt;. The Dietary Approaches to Stop Hypertension (DASH) eating plan has been shown to reduce blood pressure in people with hypertension&lt;jats:sup&gt;(2)&lt;/jats:sup&gt;. A previous study identified two high-quality, safe, and potentially effective smartphone apps for managing hypertension: NOOM and DASH To TEN&lt;jats:sup&gt;(3)&lt;/jats:sup&gt;. This study aimed to explore the potential of these two DASH diet self- management apps for controlling blood pressure in the Saudi Arabian context.Fifteen patients were recruited at King Abdullah bin Abdulaziz University Hospital in Riyadh, Saudi Arabia. Ten patients had hypertension, and five had prehypertension (mean age = 45). Patients were given the two apps and asked to try each for one week. Focus groups (n=4) were held at the end of the trial to understand the patient perceptions of the apps. Discussions were recorded, and the transcriptions were analysed using a thematic framework analysis&lt;jats:sup&gt;(4)&lt;/jats:sup&gt;.The following four themes emerged:&lt;jats:list list-type=\"number\"&gt;&lt;jats:list-item&gt;&lt;jats:label&gt;1.&lt;/jats:label&gt;Managing hypertension through diet was perceived as important. Most patients reported thatadhering to the DASH diet was challenging due to a lack of motivation and willpower,inadequate support from household members, and high prices for healthy food.&lt;/jats:list-item&gt;&lt;jats:list-item&gt;&lt;jats:label&gt;2.&lt;/jats:label&gt;The potential and current reach of dietary apps emerged as a main theme, and manycomments related to patients’ belief that dietary apps could increase their motivation and awareness about the DASH diet. Barriers to the use of apps were also identified including their difficulty of use, a preference for dietetic monitoring, and cost.&lt;/jats:list-item&gt;&lt;jats:list-item&gt;&lt;jats:label&gt;3.&lt;/jats:label&gt;Interactive app functionality was identified as a key theme, as evidenced by comments about a straightforward sign-up process, an extensive food database for dietary self-monitoring, feedback, goal setting, and reminders, considered essential for diet adherence.&lt;/jats:list-item&gt;&lt;jats:list-item&gt;&lt;jats:label&gt;4.&lt;/jats:label&gt;A preference for the NOOM app emerged. Patients perceived the NOOM app more suitable in the Saudi context. Noom was deemed to support DASH self-management because it supports weight reduction, which helps lower blood pressure. NOOM was perceived as highly interactive, offering motivational reminders, feedback, realistic dietary plans, and a comprehensive food database. Patients made several recommendations for app improvement; these included Arabic language support, automatic calculation of sodium and potassium consumption, and lower cost. Patients also expressed a desire for training in the use of the app.&lt;/jats:list-item&gt;&lt;/jats:list&gt;This qualitative analysis suggests ","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"42 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low glycaemic index diet in pregnancy and child asthma and eczema: follow-up of the ROLO trial","authors":"S. Callanan, M. Talaei, A. Delahunt, S.O Shaheen, F.M McAuliffe","doi":"10.1017/s0029665124004221","DOIUrl":"https://doi.org/10.1017/s0029665124004221","url":null,"abstract":"Atopic diseases, including asthma and eczema, represent a substantial public health problem in children and adolescents globally; asthma is the commonest chronic disorder of childhood&lt;jats:sup&gt;(1)&lt;/jats:sup&gt;. Research suggests that the origins of childhood asthma lie in utero, and several components of the maternal diet during pregnancy have been investigated in relation to atopic outcomes in children. Epidemiological evidence suggests that a higher intake of sugar during pregnancy is associated with a higher risk of childhood asthma and atopy&lt;jats:sup&gt;(2,3)&lt;/jats:sup&gt;. However, randomised trial evidence supporting such a link is lacking.Aims &lt;jats:list list-type=\"number\"&gt;&lt;jats:list-item&gt;&lt;jats:label&gt;1.&lt;/jats:label&gt;To examine whether a low glycaemic index (GI) dietary intervention during pregnancy decreases the risk of asthma and eczema in childhood.&lt;/jats:list-item&gt;&lt;jats:list-item&gt;&lt;jats:label&gt;2.&lt;/jats:label&gt;To assess observationally whether maternal intake of sugar during pregnancy is positively associated with asthma and eczema in childhood.&lt;/jats:list-item&gt;&lt;/jats:list&gt;This is a secondary analysis of children from the ROLO trial. Healthy women were randomised to receive an intervention of low GI dietary advice or routine antenatal care from early pregnancy. All women completed a 3-day food diary in each trimester of pregnancy. Estimates of maternal intake of sugar in each trimester were averaged to provide mean intakes during pregnancy. Mothers reported current doctor-diagnosed eczema in their children at 2-years of age (n=271), and current doctor-diagnosed asthma and eczema in their children at 5 (n=357) and 9-11 years (n=391) of age. Multivariable logistic regression models were used a) to test the effect of the intervention on child outcomes overall, and stratified by maternal education level (with, versus without, a complete tertiary level education), and b), in observational analyses, to analyse the relation between sugar and carbohydrate intake in pregnancy and child outcomes.There was weak evidence overall for a reduction in asthma at 5-years of age in children whose mothers received the low GI dietary intervention during pregnancy compared to usual care [adjusted odds ratio (OR) 0.43 (95% CI 0.18, 1.03); &lt;jats:italic&gt;P&lt;/jats:italic&gt;=0.06]. However, in stratified analyses the intervention was associated with a marked reduction in risk of asthma at 5-years of age in children born to mothers with lower educational attainment [adjusted OR 0.16 (0.03, 0.85); &lt;jats:italic&gt;P&lt;/jats:italic&gt;=0.032]. Intake of sugar during pregnancy was positively associated with the development of asthma at any time point in childhood [adjusted OR per quartile of mean sugar intake 1.40 (0.99, 1.97), &lt;jats:italic&gt;P&lt;/jats:italic&gt;-trend=0.048] and at 5-years of age [adjusted OR per quartile 1.55 (1.00, 2.40), &lt;jats:italic&gt;P&lt;/jats:italic&gt;-trend=0.046]. No associations with eczema outcomes were found.This novel study provides stronger evidence that higher sugar intake ","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"75 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pro-inflammatory diets are associated with higher C-reactive protein and lower plasma concentrations of vitamins with anti-inflammatory potential, in the EPIC-Norfolk cohort","authors":"A.A Mulligan, M.A.H Lentjes, A.A Welch","doi":"10.1017/s0029665124004257","DOIUrl":"https://doi.org/10.1017/s0029665124004257","url":null,"abstract":"The development of multiple long-term conditions (MLTC) has been shown to be associated with low-grade chronic inflammation&lt;jats:sup&gt;(1)&lt;/jats:sup&gt;. The Dietary Inflammatory Index (DII&lt;jats:sup&gt;®&lt;/jats:sup&gt;) is a literature-based dietary score that was developed to measure the potential impact of diet on the inflammatory status of an individual&lt;jats:sup&gt;(2)&lt;/jats:sup&gt;. In this study, we aimed to validate the DII&lt;jats:sup&gt;®&lt;/jats:sup&gt; score against biomarkers, including high- sensitivity C-reactive protein (hs-CRP), and plasma concentrations of vitamin C, retinol and α- tocopherol in European Prospective Investigation Into Cancer and Nutrition (EPIC)-Norfolk participants, aged 39–79 years at baseline&lt;jats:sup&gt;(3)&lt;/jats:sup&gt;.The DII&lt;jats:sup&gt;®&lt;/jats:sup&gt; score was calculated using a 130-item Food Frequency Questionnaire collected at baseline, between 1993 and 1997. The dietary intakes were adjusted to a 2000 kcal/day diet, to assess diet quality independently of diet quantity. Non-fasting serum cholesterol, hs-CRP, and plasma α- tocopherol, vitamin C and retinol concentrations were also measured at this time-point. Data collected via a self-administered Health and Lifestyle Questionnaire were used to establish classification of a number of variables. Analyses were conducted on sub-samples with a DII&lt;jats:sup&gt;®&lt;/jats:sup&gt; score and measures of hs-CRP (8,034 men and 9,861 women), and concentrations of vitamin C (9,866 men and 11,702 women), retinol (3,673 men and 3,517 women) and cholesterol-adjusted α- tocopherol (3,623 men and 3,476 women). Analysis of covariance and linear regression were used to study associations across sex-specific quintiles of the DII&lt;jats:sup&gt;®&lt;/jats:sup&gt; score (adjusted for age, BMI, smoking status, physical activity, social class and educational level), where a higher score indicates a more pro-inflammatory diet.Mean concentrations in men and women were 2.99 and 3.09 mg/L for hs-crp, 47 and 59 μmol/L for vitamin C, 53 and 50 μg/dL for retinol and 4.34 and 4.42 μmol/mmol for cholesterol-adjusted α- tocopherol, respectively. In both men and women, mean hs-CRP was higher if the diet was more pro-inflammatory (p-trend = 0.02 in men and 0.07 in women), while concentrations of vitamin C, retinol and α-tocopherol were significantly lower (p-trend &lt; 0.001). Positive associations for hs-CRP, but negative associations for plasma concentrations of vitamin C, retinol and α-tocopherol were evident in both men and women, after adjustments for covariates (p-trend &lt; 0.001). The differences between Q1 and Q5 adjusted means for hs-CRP, vitamin C, retinol and α-tocopherol were +9.4%, -22.1%, -3.9% and -8.6% in men and +7.9%, -17.5%, -4.8% and -7.6% in women, respectively.We observed statistically significant positive associations between the DII&lt;jats:sup&gt;®&lt;/jats:sup&gt; score and hs-CRP, a well-known inflammatory biomarker, whilst significant negative associations were found for circulating concentrations of three anti-inflammatory vitamin","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"26 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141527310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}