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  • Journal article
    Posma JM, Garcia Perez I, Frost G, Aljuraiban G, Chan Q, Van Horn L, Daviglus M, Stamler J, Holmes E, Elliott P, Nicholson Jet al., 2020,

    Nutriome-metabolome relationships provide insights into dietary intake and metabolism

    , Nature Food, Vol: 1, Pages: 426-436, ISSN: 2662-1355

    Dietary assessment traditionally relies on self-reported data which are often inaccurate and may result in erroneous diet-disease risk associations. We illustrate how urinary metabolic phenotyping can be used as alternative approach for obtaining information on dietary patterns. We used two multi-pass 24-hr dietary recalls, obtained on two occasions on average three weeks apart, paired with two 24-hr urine collections from 1,848 U.S. individuals; 67 nutrients influenced the urinary metabotype measured with ¹H-NMR spectroscopy characterized by 46 structurally identified metabolites. We investigated the stability of each metabolite over time and showed that the urinary metabolic profile is more stable within individuals than reported dietary patterns. The 46 metabolites accurately predicted healthy and unhealthy dietary patterns in a free-living U.S. cohort and replicated in an independent U.K. cohort. We mapped these metabolites into a host-microbial metabolic network to identify key pathways and functions. These data can be used in future studies to evaluate how this set of diet-derived, stable, measurable bioanalytical markers are associated with disease risk. This knowledge may give new insights into biological pathways that characterize the shift from a healthy to unhealthy metabolic phenotype and hence give entry points for prevention and intervention strategies.

  • Journal article
    Garcia Perez I, Posma JM, Chambers E, Mathers J, Draper J, Beckmann M, Nicholson J, Holmes E, Frost Get al., 2020,

    Dietary metabotype modelling predicts individual responses to dietary interventions

    , Nature Food, Vol: 1, Pages: 355-364, ISSN: 2662-1355

    Habitual consumption of poor quality diets is linked directly to risk factors for many non-communicable disease. This has resulted in the vast majority of countries globally and the World Health Organisation developing policies for healthy eating to reduce the prevalence of non communicable disease in the population. However, there is mounting evidence of variability in individual metabolic responses to any dietary intervention. We have developed a method for applying a pipeline for understanding inter-individual differences in response to diet, based on coupling data from highly-controlled dietary studies with deep metabolic phenotyping. In this feasibility study, we create an individual Dietary Metabotype Score (DMS) that embodies inter-individual variability in dietary response and captures consequent dynamic changes in concentrations of urinary metabolites. We find an inverse relationship between the DMS and blood glucose concentration. There is also a relationship between the DMS and urinary metabolic energy loss. Furthermore we employ a metabolic entropy approach to visualize individual and collective responses to dietary. Potentially, the DMS offers a method to target and to enhance dietary response at an individual level therefore reducing burden of non communicable diseases at a population level.

  • Journal article
    Sukkar A, Lett A, Frost G, Chambers Eet al., 2019,

    Regulation of energy expenditure and substrate oxidation by short chain fatty acids

    , Journal of Endocrinology, Vol: 242, Pages: R1-R8, ISSN: 1479-6805

    Short-chain fatty acids (SCFAs) are metabolites produced from the fermentation of dietary fibre by the gut microbiota. High-fibre diets have been associated with lower weight gain and a number of reports have therefore investigated if these positive effects of a dietary fibre on body weight can be replicated through the direct administration of SCFAs. Many of these studies have reported that SCFAs can prevent or attenuate long-term body weight gain by increasing energy expenditure through increased lipid oxidation. The aim of the present review is to therefore evaluate the current evidence for an effect of SCFAs on whole-body energy expenditure and to assess the potential underlying mechanisms. The available data highlights that SCFAs can exert multiple effects at various organ and tissue sites that would cumulatively raise energy expenditure via a promotion of lipid oxidation. In conclusion, the present review proposes that dietary interventions and other therapies that augment gut-derived SCFAs and systemic availability may present an effective strategy to improve long-term energy balance and body weight management.

  • Journal article
    Goiana-da-Silva F, Cruz-E-Silva D, Allen L, Gregório MJ, Severo M, Nogueira PJ, Nunes AM, Graça P, Lopes C, Miraldo M, Breda J, Wickramasinghe K, Darzi A, Araújo F, Mikkelsen Bet al., 2019,

    Modelling impacts of food industry co-regulation on noncommunicable disease mortality, Portugal

    , Bulletin of the World Health Organization, Vol: 97, Pages: 450-459, ISSN: 0042-9686

    Objective: To model the reduction in premature deaths attributed to noncommunicable diseases if targets for reformulation of processed food agreed between the Portuguese health ministry and the food industry were met. Methods: The 2015 co-regulation agreement sets voluntary targets for reducing sugar, salt and trans-fatty acids in a range of products by 2021. We obtained government data on dietary intake in 2015-2016 and on population structure and deaths from four major noncommunicable diseases over 1990-2016. We used the Preventable Risk Integrated ModEl tool to estimate the deaths averted if reformulation targets were met in full. We projected future trends in noncommunicable disease deaths using regression modelling and assessed whether Portugal was on track to reduce baseline premature deaths from noncommunicable diseases in the year 2010 by 25% by 2025, and by 30% before 2030. Findings: If reformulation targets were met, we projected reductions in intake in 2015-2016 for salt from 7.6 g/day to 7.1 g/day; in total energy from 1911 kcal/day to 1897 kcal/day due to reduced sugar intake; and in total fat (% total energy) from 30.4% to 30.3% due to reduced trans-fat intake. This consumption profile would result in 248 fewer premature noncommunicable disease deaths (95% CI: 178 to 318) in 2016. We projected that full implementation of the industry agreement would reduce the risk of premature death from 11.0% in 2016 to 10.7% by 2021. Conclusion: The co-regulation agreement could save lives and reduce the risk of premature death in Portugal. Nevertheless, the projected impact on mortality was insufficient to meet international targets.

  • Journal article
    Tranchant JP, Gelli A, Bliznashka L, Sekou Diallo A, Sacko M, Assima A, Aurino E, Siegel EH, Masset Eet al., 2019,

    The impact of food assistance on food insecure populations during conflict: evidence from a quasi-experiment in Mali

    , World Development, Vol: 119, Pages: 185-202, ISSN: 0305-750X

    Mali, a vast landlocked country at the heart of West Africa in the Sahel region, is one of the least developed and most food insecure countries in the world. Mali suffered from a series of political, constitutional and military crises since January 2012, including the loss of government control of northern territories from April 2012 until January 2013. A range of humanitarian aid interventions were scaled up in response to these complex crises. In this study, we exploit data from a unique pre-crisis baseline to evaluate the impact of humanitarian aid on the food security of rural populations. We design a quasi-experimental study based on two survey rounds, five years apart, in the Mopti region in Northern Mali. Data was collected from 66 communities randomly selected from within food-insecure districts. Study outcomes include household expenditures and food consumption and a proxy for child nutritional status (height measurements). We estimate program impact by combining propensity score matching and difference-in-difference. Food assistance was found to increase household non-food and food expenditures and micro-nutrient availability. Disaggregating by degree of conflict exposure showed that the effects on children’s height and caloric and micro-nutrient consumption were mostly concentrated in areas not in the immediate vicinity of the conflict, unlike the increase in food expenditures that were driven by households located in close proximity to armed groups. The effects were also concentrated on households receiving at least two forms of food assistance. In villages where armed groups were present, food assistance improved household zinc consumption and also appeared to support food expenditures. Food transfers are thus found to exert a protective effect among food insecure population in conflict context.

  • Journal article
    Carpenter G, Bozorgi S, Vladescu S, Forte A, Myant C, Potineni R, Reddyhoff T, Baier Set al., 2019,

    A study of saliva lubrication using a compliant oral mimic

    , Food Hydrocolloids, Vol: 92, Pages: 10-18, ISSN: 0268-005X

    Due to ethical issues and the difficulty in obtaining biological tissues, it is important to find synthetic elastomers that can be used as replacement test media for research purposes. An important example of this is friction testing to understand the mechanisms behind mouthfeel attributes during food consumption (e.g. syrupy, body and clean finish), which requires an oral mimic. In order to assess the suitability of possible materials to mimic oral surfaces, a sliding contact is produced by loading and sliding a hemispherical silica pin against either a polydimethyl siloxane (PDMS), agarose, or porcine tongue sample. Friction is measured and elastohydrodynamic film thickness is calculated based on the elastic modulus of the samples, which is measured using an indentation method. Tests were performed with both saliva and pure water as the lubricating fluid and results compared to unlubricated conditions.PDMS mimics the tongue well in terms of protein adhesion, with both samples showing significant reductions in friction when lubricated with saliva versus water, whereas agarose showed no difference between saliva and water lubricated conditions. This is attributed to PDMS's OSi(CH3)2- group which provides excellent adhesion for the saliva protein molecules, in contrast with the hydrated agarose surface. The measured modulus of the PDMS (2.2 MPa) is however significantly greater than that of tongue (3.5 kPa) and agarose (66–174 kPa). This affects both the surface (boundary) friction, at low sliding speeds, and the entrained elastohydrodynamic film thickness, at high speeds.Utilising the transparent PDMS sample, we also use fluorescence microscopy to monitor the build-up and flow of dyed-tagged saliva proteins within the contact during sliding. Results confirm the lubricous boundary film forming nature of saliva proteins by showing a strong correlation between friction and average protein intensity signals (cross correlation coefficient = 0.87). This demonstrates

  • Journal article
    Aurino E, Fledderjohann J, Vellakkal S, 2019,

    Inequalities in adolescent learning: Does the timing and persistence of food insecurity at home matter?

    , Economics of Education Review, Vol: 70, Pages: 94-108, ISSN: 0272-7757

    We investigated inequalities in learning achievements at 12 years by household food insecurity trajectories at ages 5, 8 and 12 years in a longitudinal sample of 1,911 Indian children. Estimates included extensive child and household controls and lagged cognitive scores to address unobserved individual heterogeneity in ability and early investments. Overall, household food insecurity at any age predicted lower vocabulary, reading, maths and English scores in early adolescence. Adolescents from households that transitioned out from food insecurity at age 5 to later food security, and adolescents from chronically food insecure households had the lowest scores across all outcomes. There was heterogeneity in the relationship between temporal occurrence of food insecurity and cognitive skills, based on developmental and curriculum-specific timing of skill formation. Results were robust to additional explanations of the “household food insecurity gap”, i.e. education and health investments, parental and child education aspirations, and child psychosocial skills.KeywordsCognitive skillsLearningAdolescentFood insecurityIndiaEducation inequalityHuman capitalLongitudinalEducationLifecourseJEL classificationI24, I29, I39, H52

  • Journal article
    Azupogo F, Aurino E, Gelli A, Bosompem KM, Ayi I, Osendarp SJM, Brouwer ID, Folson Get al., 2019,

    Agro-ecological zone and farm diversity are factors associated with haemoglobin and anaemia among rural school-aged children and adolescents in Ghana

    , Maternal and Child Nutrition, Vol: 15, Pages: 1-11, ISSN: 1740-8695

    Understanding contextual risk factors for haemoglobin (Hb) status and anaemia of rural school-aged children (SAC) and adolescents is critical in developing appropriate interventions to prevent anaemia. We analysed secondary data from the baseline of an impact evaluation of the Ghana School Feeding Programme to determine the severity of anaemia and contextual factors associated with anaemia and Hb status among rural SAC (6–9 years; n = 323) and adolescents (10–17 years; n = 319) in Ghana. We used regression models with variable selection based on backward elimination in our analyses. The mean Hb was 113.8 ± 13.1 g/L, and the overall prevalence of anaemia was 52.3%, being 55.1% and 49.5% among SAC and adolescents, respectively. We identified child's age (β = 2.21, P < 0.001); farm diversity score (β = 0.59, P = 0.036); and agro-ecological zone (P trend <0.001) as the main predictors of Hb of SAC. Household asset index (P trend = 0.042) and agro-ecological zone (P trend <0.001) were predictors of Hb in adolescents. Agro-ecological zone and age were predictors of anaemia, but the effect of age was only significant for girls and not boys (prevalence odds ratio [POR] = 1.35, 95% CI [1.04, 1.76] vs. POR = 1.14, 95% CI [0.88, 1.46]). SAC in households with maize stock were less likely to be anaemic (POR = 0.55, 95% CI [0.32, 0.97]). Household dietary diversity score (β = 0.59, P = 0.033) was associated with Hb status for the full sample only. Anaemia is a severe public health problem among SAC and adolescents in rural Ghana irrespective of sex. Farm diversity score, availability of maize stock in the household, household asset index, and agro-ecological zone were the main predictors of Hb and anaemia among the rural SAC and adolescents.

  • Journal article
    Goiana-da-Silva F, Cruz-e-Silva D, Miraldo M, Calhau C, Bento A, Cruz D, Almeida F, Darzi A, Araujo Fet al., 2019,

    Front-of-pack labelling policies and the need for guidance

    , Lancet Public Health, Vol: 4, Pages: E15-E15, ISSN: 2468-2667
  • Journal article
    Sutaria S, Devakumar D, Yasuda SS, Das S, Saxena Set al., 2018,

    Is obesity associated with depression in children? Systematic review and meta-analysis

    , Archives of Disease in Childhood, Vol: 104, Pages: 64-74, ISSN: 1468-2044

    OBJECTIVES: To compare the odds of depression in obese and overweight children with that in normal-weight children in the community. DESIGN: Systematic review and random-effect meta-analysis of observational studies. DATA SOURCES: EMBASE, PubMed and PsychINFO electronic databases, published between January 2000 and January 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Cross-sectional or longitudinal observational studies that recruited children (aged <18 years) drawn from the community who had their weight status classified by body mass index, using age-adjusted and sex-adjusted reference charts or the International Obesity Task Force age-sex specific cut-offs, and concurrent or prospective odds of depression were measured. RESULTS: Twenty-two studies representing 143 603 children were included in the meta-analysis. Prevalence of depression among obese children was 10.4%. Compared with normal-weight children, odds of depression were 1.32 higher (95% CI 1.17 to 1.50) in obese children. Among obese female children, odds of depression were 1.44 (95% CI 1.20 to 1.72) higher compared with that of normal-weight female children. No association was found between overweight children and depression (OR 1.04, 95% CI 0.95 to 1.14) or among obese or overweight male subgroups and depression (OR 1.14, 95% CI 0.93 to 1.41% and 1.08, 95% CI 0.85 to 1.37, respectively). Subgroup analysis of cross-sectional and longitudinal studies separately revealed childhood obesity was associated with both concurrent (OR 1.26, 95% CI 1.09 to 1.45) and prospective odds (OR 1.51, 95% CI 1.21 to 1.88) of depression. CONCLUSION: We found strong evidence that obese female children have a significantly higher odds of depression compared with normal-weight female children, and this risk persists into adulthood. Clinicians should consider screening obese female children for symptoms of depression. BACKGROUND: Childhood mental illness is poorly recognised by

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