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  • Journal article
    Garcia Perez I, Posma JM, Gibson R, Chambers ES, Hansen TH, Vestergaard H, Hansen T, Beckmann M, Pedersen O, Elliott P, Stamler J, Nicholson JK, Draper J, Mathers JC, Holmes E, Frost G, Garcia-Perex I, Posma JM, Gibson R, Chambers E, Hansen TH, Vestergaard H, Hansen T, Beckman M, Pedersen O, Elliott P, Stamler J, Nicholson JK, Draper J, Holmes E, Frost Get al., 2017,

    Objective assessment of dietary patterns using metabolic phenotyping: a randomized, controlled, crossover trial

    , The Lancet Diabetes & Endocrinology, Vol: 5, Pages: 184-195, ISSN: 2213-8587

    Background: The burden of non-communicable diseases, such as obesity, diabetes, coronary heart disease and cancer, can be reduced by the consumption of healthy diets. Accurate monitoring of changes in dietary patterns in response to food policy implementation is challenging. Metabolic profiling allows simultaneous measurement of hundreds of metabolites in urine, many of them influenced by food intake. We aim to classify people according to dietary behaviour and enhance dietary reporting using metabolic profiling of urine.Methods: To develop metabolite models from 19 healthy volunteers who attended a clinical research unit for four day periods on four occasions. We used the World Health Organisation’s healthy eating guidelines (increase fruits, vegetables, wholegrains, dietary fibre and decrease fats, sugars, and salt) to develop four dietary interventions lasting for four days each that ranged from a diet associated with a low to high risk of developing non-communicable disease. Urine samples were measured by 1H-NMR spectroscopy. This study is registered as an International Standard Randomized Controlled Trial, number ISRCTN 43087333. INTERMAP U.K. (n=225) and a healthy-eating Danish cohort (n=66) were used as free-living validation datasets.Findings: There was clear separation between the urinary metabolite profiles of the four diets. We also demonstrated significant stepwise differences in metabolite levels between the lowest and highest metabolic risk diets and developed metabolite models for each diet. Application of the derived metabolite models to independent cohorts confirmed the association between urinary metabolic and dietary profiles in INTERMAP (P<0•001) and the Danish cohort (P<0•001).Interpretation: Urinary metabolite models, developed in a highly controlled environment, can classify groups of free-living people into consumers of dietary profiles associated with lower or higher non-communicable disease risk based on multivariate m

  • Journal article
    Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat Tet al., 2016,

    Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies

    , BMC Medicine, Vol: 14, ISSN: 1741-7015

    Background: Although nut consumption has been associated with a reduced risk of cardiovascular disease and all-cause mortality, data on less common causes of death has not been systematically assessed. Previous reviews missed several studies and additional studies have since been published. We therefore conducted a systematic review and meta-analysis of nut consumption and risk of cardiovascular disease, total cancer, and all-cause and cause-specific mortality. Methods: PubMed and Embase were searched for prospective studies of nut consumption and risk of cardiovascular disease, total cancer, and all-cause and cause-specific mortality in adult populations published up to July 19, 2016. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. The burden of mortality attributable to low nut consumption was calculated for selected regions. Results: Twenty studies (29 publications) were included in the meta-analysis. The summary RRs per 28 grams/day increase in nut intake was for coronary heart disease, 0.71 (95% CI: 0.63-0.80, I2=47%, n=11), stroke, 0.93 (95% CI: 0.83-1.05, I2=14%, n=11), cardiovascular disease, 0.79 (95% CI: 0.70-0.88, I2=60%, n=12), total cancer, 0.85 (95% CI: 0.76-0.94, I2=42%, n=8), all-cause mortality, 0.78 (95% CI: 0.72-0.84, I2=66%, n=15), and for mortality from respiratory disease, 0.48 (95% CI: 0.26-0.89, I2=61%, n=3), diabetes, 0.61 (95% CI: 0.43-0.88, I2=0%, n=4), neurodegenerative disease, 0.65 (95% CI: 0.40-1.08, I2=5.9%, n=3), infectious disease, 0.25 (95% CI: 0.07-0.85, I2=54%, n=2), and kidney disease, 0.27 (95% CI: 0.04-1.91, I2=61%, n=2). The results were similar for tree nuts and peanuts. If the associations are causal, an estimated 4.4 million premature deaths in the America, Europe, South-East Asia and Western Pacific would be attributable to a nut intake below 20 grams per day in 2013.Conclusion: Higher nut intake is associated with reduced risk of cardiovascular disease, total c

  • Journal article
    P Mohammed MA, Wanigasooriya L, Chakerabarti-Bell S, Charalambides MNet al., 2016,

    Extrusion of unleavened bread dough: experiments and simulations

    , Journal of Rheology, Vol: 61, ISSN: 0148-6055

    An experimental and numerical study on ram extrusion of bread dough was conducted in order to develop predictive models for the pressures involved, as well as the deformation of the extruded dough. Such studies are needed as high pressures can potentially lead to significant degassing, tearing and shearing of the dough and hence poor bread quality; the latter limits the use of extrusion processes which would otherwise be a cost – effective forming process. A laboratory extrusion rig was designed, with dies of varying angles and exit radii. Rate dependent behaviour was observed from tests conducted at different extrusion speeds, and higher extrusion pressure was reported for dies with smaller exit radius or larger die angle. A simulation of extrusion was performed to predict the extrusion pressure as well as the extrudate swell, as a function of die geometry and extrusion rate. A continuum approach was taken in the constitutive model of dough which is a starch filled system in a protein matrix. A nonlinear viscoelastic model combined for the first time with the Mullins model for filled rubbers is found to capture the continuum behaviour well. A Coulomb friction law combined with a maximum shear stress limit was used to describe the contact definition between the extrusion barrel and the dough. Higher die angles and higher extrusion speeds require higher shear stress limit values for the model and the experiments to agree. A possible reason for this is that the shear stress limit depends on maximum strain as well as strain rate imposed during the extrusion process. Static zones were observed both experimentally and numerically. The onset of the static zones was predicted well but quantifying the geometry of the latter needs further studies.

  • Journal article
    Brooks L, Viardot A, Tsakmaki A, Stolarczyk E, Howard JK, Cani PD, Everard A, Sleeth ML, Psichas A, Anastasovskaj J, Bell JD, Bell-Anderson K, Mackay CR, Ghatei MA, Bloom SR, Frost G, Bewick GAet al., 2016,

    Fermentable carbohydrate stimulates FFAR2-dependent colonic PYY cell expansion to increase satiety

    , Molecular Metabolism, Vol: 6, Pages: 48-60, ISSN: 2212-8778

    ObjectiveDietary supplementation with fermentable carbohydrate protects against body weight gain. Fermentation by the resident gut microbiota produces short-chain fatty acids, which act at free fatty acid receptor 2 (FFAR2). Our aim was to test the hypothesis that FFAR2 is important in regulating the beneficial effects of fermentable carbohydrate on body weight and to understand the role of gut hormones PYY and GLP-1. MethodsWild-type or Ffar2-/-mice were fed an inulin supplemented or control diet. Mice were metabolically characterised and gut hormone concentrations, enteroendocrine cell density measurements were carried out. Intestinal organoids and colonic cultures were utilised to substantiate the in vivo findings.ResultsWe provide new mechanistic insight into how fermentable carbohydrate regulates metabolism. Using mice that lack FFAR2, we demonstrate that the fermentable carbohydrate, inulin, acts via this receptor to drive an 87% increase in the density of cells that produce the appetite-supressing hormone peptide YY (PYY), reduce food intake and prevent diet-induced obesity. Conclusion Our results demonstrate that FFAR2 is predominantly involved in regulating the effects of fermentable carbohydrate on metabolism and does so, in part, by enhancing PYY cell density and release. This highlights the potential for targeting enteroendocrine cell differentiation to treat obesity.

  • Journal article
    Aurino E, 2016,

    Do boys eat better than girls in India? Longitudinal evidence on dietary diversity and food consumption disparities among children and adolescents

    , Economics & Human Biology, Vol: 25, Pages: 99-111, ISSN: 1570-677X

    This paper examines the dynamics of gender-based disparities in the intra-household allocation of food during childhood and adolescence in Andhra Pradesh and Telangana by using three rounds of longitudinal data from two cohorts. While boys are advantaged at all ages (except for the Younger Cohort at 12 years old), the pro-boy gap widens markedly at 15 years old. Specifically, mid-adolescent girls tend to consume fewer protein- and vitamin-rich foods such as eggs, legumes, root vegetables and fruit. This result is robust to gender differences between adolescents in terms of puberty onset, school enrolment, time use and dietary behaviours. Finally, gender disparities in dietary diversity during early and mid-adolescence do not vary by maternal education, poverty or place of residence, whilst they are moderated by levels of caregiver's educational aspirations at 15 years old.

  • Journal article
    Aurino E, Fernandes M, Penny ME, 2016,

    The nutrition transition and adolescents’ diets in low- and middle-income countries: a cross-cohort comparison

    , Public Health Nutrition, Vol: 20, Pages: 72-81, ISSN: 1475-2727

    To investigate changes in dietary diversity and dietary composition among adolescents in four developing countries.We analysed dietary diversity and consumption of seven food groups and foods with added sugars as reported by adolescents from two cohorts growing up 8 years apart, when they were aged about 12 years.Ethiopia, India (Andhra Pradesh), Peru and Vietnam in 2006 and 2013.Adolescents (n 3659) from the older cohort (OC) born in 1995/96 and adolescents (n 7422) from the younger cohort (YC) born in 2001/02 (N 11 081).Controlling for other factors, dietary diversity increased in Peru (OC=4·89, YC=5·34, P<0·001) and Ethiopia (OC=3·52, YC=3·94, P=0·001). Dietary diversity was stable in India (OC=4·28, YC=4·29, P=0·982) and Vietnam (OC=4·71, YC=4·73, P=0·814); however, changes in dietary composition were observed. YC adolescents were more likely to consume eggs (India: +32 %, P=0·038; Vietnam: +50 %, P<0·001) and milk and dairy (India: +12 %, P=0·029; Vietnam: +46 %, P<0·001). Other notable shifts included meat consumption in Peru (+72 %, P<0·001) and consumption of fruit and vegetables in Ethiopia (+36 %, P<0·001). Compared with OC, the prevalence of added sugar consumption was greater among the YC in Ethiopia (+35 %, P=0·001) and Vietnam (+44 % P<0·001). Between 2006 and 2013, disparities in dietary diversity associated with household wealth and place of residence declined, although this varied by country. No marked gender disparities in dietary diversity were evident.We found significant changes over time in dietary diversity among adolescents in four countries consistent with the hypothesis of the nutrition transition.

  • Journal article
    Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat Tet al., 2016,

    Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies

    , BMJ, Vol: 353, ISSN: 0959-8138

    Objective To quantify the dose-response relation between consumption of whole grain and specific types of grains and the risk of cardiovascular disease, total cancer, and all cause and cause specific mortality.Data sources PubMed and Embase searched up to 3 April 2016.Study selection Prospective studies reporting adjusted relative risk estimates for the association between intake of whole grains or specific types of grains and cardiovascular disease, total cancer, all cause or cause specific mortality.Data synthesis Summary relative risks and 95% confidence intervals calculated with a random effects model.Results 45 studies (64 publications) were included. The summary relative risks per 90 g/day increase in whole grain intake (90 g is equivalent to three servings—for example, two slices of bread and one bowl of cereal or one and a half pieces of pita bread made from whole grains) was 0.81 (95% confidence interval 0.75 to 0.87; I2=9%, n=7 studies) for coronary heart disease, 0.88 (0.75 to 1.03; I2=56%, n=6) for stroke, and 0.78 (0.73 to 0.85; I2=40%, n=10) for cardiovascular disease, with similar results when studies were stratified by whether the outcome was incidence or mortality. The relative risks for morality were 0.85 (0.80 to 0.91; I2=37%, n=6) for total cancer, 0.83 (0.77 to 0.90; I2=83%, n=11) for all causes, 0.78 (0.70 to 0.87; I2=0%, n=4) for respiratory disease, 0.49 (0.23 to 1.05; I2=85%, n=4) for diabetes, 0.74 (0.56 to 0.96; I2=0%, n=3) for infectious diseases, 1.15 (0.66 to 2.02; I2=79%, n=2) for diseases of the nervous system disease, and 0.78 (0.75 to 0.82; I2=0%, n=5) for all non-cardiovascular, non-cancer causes. Reductions in risk were observed up to an intake of 210-225 g/day (seven to seven and a half servings per day) for most of the outcomes. Intakes of specific types of whole grains including whole grain bread, whole grain breakfast cereals, and added bran, as well as total bread and total breakfast cereals were also associated with re

  • Journal article
    Skamniotis, Patel Y, Charalambides MN, Elliott Met al., 2016,

    Fracture investigation in starch based foods

    , Interface Focus, Vol: 6, ISSN: 2042-8901

    The study of oral processing and specifically cutting of the food piece during mastication can lead towards optimisation of products for humans or animals. Food materials are complex bio-composites with highly nonlinear constitutive response. Their fracture properties have not been largely investigated as yet while the need for models capable of predicting food breakdown increases. In this study, the blade cutting and the essential work of fracture (EWF) methodologies assessed the fracture behaviour of starch based pet-food. Tensile tests revealed rate dependent stiffness and stress softening effects, attributed to viscoplasticity and micro-cracking, respectively. Cutting data were collected for 5, 10 and 30 mm/s sample feed rates, whereas the EWF tests were conducted at 1.7, 3.3 and 8.3 mm/s crosshead speeds corresponding to average crack speeds of 4, 7 and 15 mm/s respectively. A reasonable agreement was achieved between cutting and EWF, reporting 1.26, 1.78, 1.76 kJ/m² and 1.52, 1.37, 1.45 kJ/m² values, respectively, for the corresponding crack speeds. These toughness data were used in a novel numerical model simulating the ‘first’ bite mastication process. A viscoplastic material model is adopted for the food piece, combined with a damage law which enabled predicting fracture patterns in the product.

  • Journal article
    Chamali B, Finnamore H, Manning R, Laffan MA, Hickson M, Whelan K, Shovlin CLet al., 2016,

    Dietary supplement use and nosebleeds in hereditary haemorrhagic telangiectasia - an observational study.

    , Intractable & rare diseases research, Vol: 5, Pages: 109-113, ISSN: 2186-3644

    Understanding potential provocations of haemorrhage is important in a range of clinical settings, and particularly for people with abnormal vasculature. Patients with hereditary haemorrhagic telangiectasia (HHT) can report haemorrhage from nasal telangiectasia in real time, and suggested dietary factors may precipitate nosebleeds. To examine further, nosebleed severity, dietary supplement use, and blood indices were evaluated in an unselected group of 50 HHT patients recruited from a specialist UK service. Using the validated Epistaxis Severity Score, nosebleed severity ranged from 0 to 9.1 out of 10 (median 3.9). Using a Food Frequency Questionnaire, 24/50 (48%) participants reported use of dietary supplements in the previous year. A third (18/50; 36%) had used self prescribed, non-iron containing dietary supplements, ingesting between 1 and 3 different supplements each day. Eight (16%) used fish oils. Despite having more severe epistaxis (p = 0.012), the 12 iron supplement users had higher serum iron concentrations, and were able to maintain their red blood cell indices. In contrast, there was no evident benefit for the participants using non iron supplements. Furthermore, platelet counts and serum fibrinogen tended to be lower in fish oil/supplement users, and one fish oil user demonstrated reduced in vitro platelet aggregation. In conclusion, in this small study, a third of HHT patients used non-iron dietary supplements, and one in six ingested fish oils, unaware of their known anti-platelet activity. The scale of use, and potential of these "natural health supplements" to exacerbate nosebleeds has not been appreciated previously in HHT.

  • Conference paper
    Baxter W, Aurisicchio M, Childs PRN,

    Tear Here: the Impact of Object Transformations on Proper Disposal

    , IAPRI 20th World Conference on Packaging

    Efforts promoting proper disposal of packaging generally focus on infrastructure and messaging. Significantly less attention has been given to how the attributes of packaging can be used to change disposal behaviour. This research shows how changes in packaging attributes (e.g. alterations in shape, colour, or size) influence two disposal behaviours: recycling and littering. Specifically, we use an implicit association test to measure the subconscious tendency to categorize altered objects as trash rather than recycling. The results indicate that 82% or respondents showed at least a slight effect and 53% showed a strong effect towards associating altered objects with waste. Next, we evaluate object transformations on littering behaviour through an observational field study. Observations (N = 2823) indicated that littering is influenced by deformed, torn, disassembled, and partially full packaging. No significant effect was found with regard to packaging that is wet, sticky, has undergone colour changes or that is has remains (e.g. sauce) on it. These findings suggest that the (re)design of packaging can significantly influence proper disposal. Based on this, packaging can be (re)designed in two ways. First, many types of packaging have scripted alterations such as the iconic ‘tear here’ indicator. These can be changed to preserve properties associated with recyclables and non-littering. Second, packaging can be designed so that there are fewer alterations during use. This work can also help identify inherent attributes that encourage proper disposal.

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