Imperial College London

ProfessorGaryFrost

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Chair in Nutrition & Dietetics
 
 
 
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Contact

 

+44 (0)20 7594 0959g.frost Website

 
 
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Location

 

Commonwealth BiuldingHammersmith HospitalHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

484 results found

Valdivia-Garcia MA, Chappell KE, Camuzeaux S, Olmo-Garcia L, van der Sluis VH, Radhakrishnan ST, Stephens H, Bouri S, Braz LMDC, Williams HT, Lewis MR, Frost G, Li Jet al., 2022, Improved quantitation of short-chain carboxylic acids in human biofluids using 3-nitrophenylhydrazine derivatization and liquid chromatography with tandem mass spectrometry (LC-MS/MS), JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL ANALYSIS, Vol: 221, ISSN: 0731-7085

Journal article

O'Donovan SD, Erdos B, Jacobs DM, Wanders AJ, Thomas EL, Bell JD, Rundle M, Frost G, Arts ICW, Afman LA, van Riel NAWet al., 2022, Quantifying the contribution of triglycerides to metabolic resilience through the mixed meal model, ISCIENCE, Vol: 25

Journal article

Brignardello J, Fountana S, Posma JM, Chambers ES, Nicholson JK, Wist J, Frost G, Garcia-Perez I, Holmes Eet al., 2022, Characterization of diet-dependent temporal changes in circulating short-chain fatty acid concentrations: a randomized crossover dietary trial, The American Journal of Clinical Nutrition, Vol: 116, Pages: 1368-1378, ISSN: 0002-9165

Background: Production of Short-chain fatty acids (SCFAs) from food is a complex and dynamic saccharolytic fermentation process mediated by both human and gut microbial factors. SCFA production and knowledge of the relationship between SCFA profiles and dietary patterns is lacking. Objective: Temporal changes in SCFA levels in response to two contrasting diets were investigated using a novel GC-MS method.Design: Samples were obtained from a randomized, controlled, crossover trial designed to characterize the metabolic response to four diets. Participants (n=19) undertook these diets during an inpatient stay (of 72-h). Serum samples were collected 2-h after breakfast (AB), lunch (AL) and dinner (AD) on day 3 and a fasting sample (FA) was obtained on day 4. 24-h urine samples were collected on day 3. In this sub-study, samples from the two extreme diets representing a diet with high adherence to WHO healthy eating recommendations and a typical Western diet were analyzed using a bespoke GC-MS method developed to detect and quantify 10 SCFAs and precursors in serum and urine samples. Results: Considerable inter-individual variation in serum SCFA concentrations was observed across all time points and temporal fluctuations were observed for both diets. Although the sample collection timing exerted a greater magnitude of effect on circulating SCFA concentrations, the unhealthy diet was associated with a lower concentration of acetic acid (FA: coefficient=-17.0; standard error (SE)=5.8; p-trend=0.00615), 2-methylbutyric acid (AL: coefficient=-0.1; SE=0.028; p-trend=4.13x10-4 and AD: coefficient =-0.1; SE:=0.028; p-trend=2.28x10-3) and 2-hydroxybutyric acid (FA: coefficient=-15.8; standard error=5.11; p-trend: 4.09x10-3). In contrast lactic acid was significantly higher in the unhealthy diet (AL: coefficient=750.2; standard error=315.2; p-trend=0.024 and AD: coefficient=1219.3; standard error=322.6; p-trend: 8.28x10-4). Conclusion: The GC-MS method allowed robust mapping of

Journal article

Gardiner B, Wardill H, O'Connor G, Hargrave D, Frost G, Lett Aet al., 2022, THE EFFICACY OF FIBRE AND PREBIOTIC INTERVENTIONS ON CLINICAL OUTCOMES IN CANCER AND HAEMATOPOIETIC STEM CELL THERAPIES: SYSTEMATIC LITERATURE REVIEW, Publisher: WILEY, Pages: S350-S350, ISSN: 1545-5009

Conference paper

Pugh J, Anjum A, Petropoulou K, Thom G, Mccombie L, Tashkova M, Alaraj-Alshehhi S, Babalis D, Prechtl C, Lean MJ, Prevost AT, Vasconcelos JC, Preston T, Morrison D, Frost Get al., 2022, Increase in colonic PRopionate as a method of prEVENTing weight gain in adults aged 20-40 years (iPREVENT): A multi-centre, double-blind, randomised, parallel-group study to investigate the efficacy of inulin-propionate ester versus inulin (control) in the prevention of weight gain over 12 months, F1000Research, Vol: 11, Pages: 1-14, ISSN: 2046-1402

Introduction: Overweight and obesity affects over 70% of the UK population and is a major risk factor for the development of co-morbidities, including type 2 diabetes and cardiovascular disease. There now exists a considerable evidence base for the management of obesity. However, this is not the case for the prevention of obesity. Preventing weight gain in periods of life where there is an elevated risk of fat mass expansion could be beneficial to preventing associated diseases in later life. This protocol investigates the impact of novel food ingredient inulin propionate ester (IPE) in the prevention of weight gain. This trial aims to investigate the primary hypothesis that IPE has a superior effect on preventing body weight gain, compared with inulin, in young (<40 years old) adults over 12 months, whilst also investigating several complementary mechanisms that may explain the prevention of weight gain and improved long-term energy balance from consuming IPE. Methods: In this multi-centre, double-blind, randomised, parallel-group study, eligible participants will be randomly assigned to consume 10g IPE or 10g inulin (control) daily for 12 months. Study visits will be conducted at baseline, two-month, six-month and 12-month time points. The primary outcome is weight gain from baseline to 12 months. Secondary outcomes will examine changes in metabolic and cardiovascular health biomarkers, body composition and appetite. A mechanistic sub-group will explore causal mechanisms around energy balance, body composition, appetite regulation and the gut microbiota. Based on the power calculation, the sample size required is 270 participants or 135 per study group.Ethics and dissemination: The trial protocol and participant-facing documents have been reviewed and approved, by the London Hampstead Ethics Committee (REC Reference 19/LO/0095, 29th January 2019). Upon completion, the trial results will be published in peer-reviewed journals and presented at scientific confer

Journal article

Penney N, Yeung K, Garcia Perez I, Posma J, Kopytek A, Garratt B, Ashrafian H, Frost G, Marchesi J, Purkayastha S, Hoyles L, Darzi A, Holmes Eet al., 2022, Multi-omic phenotyping reveals host-microbe responses to bariatric surgery, glycaemic control and obesity, communications medicine, Vol: 2, Pages: 1-18, ISSN: 2730-664X

Background: Resolution of type 2 diabetes (T2D) is common following bariatric surgery, particularly Roux-en-Y gastric bypass. However, the underlying mechanisms have not been fully elucidated.Methods: To address this we compare the integrated serum, urine and faecal metabolic profiles of participants with obesity +/- T2D (n=80, T2D=42) with participants who underwent Roux-en-Y gastric bypass or sleeve gastrectomy (pre and 3-months post-surgery; n=27), taking diet into account. We co-model these data with shotgun metagenomic profiles of the gut microbiota to provide a comprehensive atlas of host-gut microbe responses to bariatric surgery, weight-loss and glycaemic control at the systems level.Results: Here we show that bariatric surgery reverses several disrupted pathways characteristic of T2D. The differential metabolite set representative of bariatric surgery overlaps with both diabetes (19.3% commonality) and body mass index (18.6% commonality). However, the percentage overlap between diabetes and body mass index is minimal (4.0% commonality), consistent with weight-independent mechanisms of T2D resolution. The gut microbiota is more strongly correlated to body mass index than T2D, although we identify some pathways such as amino acid metabolism that correlate with changes to the gut microbiota and which influence glycaemic control.Conclusion: We identify multi-omic signatures associated with responses to surgery, body mass index, and glycaemic control. Improved understanding of gut microbiota - host co-metabolism may lead to novel therapies for weight-loss or diabetes. However, further experiments are required to provide mechanistic insight into the role of the gut microbiota in host metabolism and establish proof of causality.

Journal article

Muilwijk M, Loh M, Mahmood S, Palaniswamy S, Siddiqui S, Silva W, Frost GS, Gage HM, Jarvelin M-R, Rannan-Eliya RP, Ahmad S, Jha S, Kasturiratne A, Katulanda P, Khawaja K, Kooner JS, Wickremasinghe AR, van Valkengoed IGM, Chambers JCet al., 2022, The iHealth-T2D study: a cluster randomised trial for the prevention of type 2 diabetes amongst South Asians with central obesity and prediabetes-a statistical analysis plan, TRIALS, Vol: 23

Journal article

Habboub N, Manousou P, Forlano R, Mullish BH, Frost G, Challis B, Thursz M, Dumas M-Eet al., 2022, Designing a polymetabolic risk score for non-alcoholic steatohepatitis patients by differentiating their metabolic profiles from healthy controls, JOURNAL OF HEPATOLOGY, Vol: 77, Pages: S179-S179, ISSN: 0168-8278

Journal article

Cherta-Murillo A, Frost GS, 2022, The association of mycoprotein-based foods consumption with diet quality, energy intake and non-communicable diseases' risk in the UK adult population using the National Diet and Nutrition Survey (NDNS) years 2008/09-2016/17: A cross-sectional study., The British Journal of Nutrition: an international journal of nutritional science, Vol: 127, Pages: 1685-1694, ISSN: 0007-1145

Mycoprotein is a fungal-based ingredient rich in fibre and protein used in meat-replacement foods sold under the name of Quorn in 17 countries. Fibre and protein positively regulate glycaemia, lipidaemia, energy intake which are non-communicable diseases' (NCDs) markers. We performed a cross-sectional study to investigate the association of mycoprotein intake with diet quality, nutrient, energy intake and NCDs risk within UK free-living adults from the National Diet and Nutrition Survey (NDNS) from years 2008/09-2016/17. Dietary approaches to stop hypertension (DASH) and healthy diet index (HDI) were calculated to estimate diet quality. Comparison between mycoprotein consumers (>1% kcal) and non-consumers, and associations between consumers and nutrient intakes, NCDs' risk markers and diet quality were investigated using a survey-adjusted general linear model adjusted for sex, age, body mass index (BMI), ethnicity, socio-economic, smoking status, region of residency, total energy, energy density, HDI and non-mycoprotein fibre intake. 5507 adults were included, of which 3.44% were mycoprotein consumers and had a higher intake of dietary fibre (+22.18%,p<0.001), DASH score (+23.33%) and HDI (+8.89%) (p<0.001, both) and lower BMI (-4.77%,p=0.00) vs. non-consumers. There was an association (p=0.00) between mycoprotein consumers and diet quality scores (+0.19 and +0.26), high fibre (+3.17g), total and food energy (+3.09 and +0.22 kcal), but low energy density intakes (-0.08 kcal/g,p=0.04). Consumers were negatively associated with fasting blood glucose (-0.31 mmol/L,p=0.00), and glycated haemoglobin A1c (HbA1c) (-0.15%,p=0.01). In conclusion, mycoprotein intake is associated with lower glycaemic markers and energy density intake, and high fibre, energy intake and diet quality scores.

Journal article

Fiamoncini J, Donado-Pestana CM, Duarte GBS, Rundle M, Thomas EL, Kiselova-Kaneva Y, Gundersen TE, Bunzel D, Trezzi J-P, Kulling SE, Hiller K, Sonntag D, Ivanova D, Brennan L, Wopereis S, van Ommen B, Frost G, Bell J, Drevon CA, Daniel Het al., 2022, Plasma Metabolic Signatures of Healthy Overweight Subjects Challenged With an Oral Glucose Tolerance Test, FRONTIERS IN NUTRITION, Vol: 9, ISSN: 2296-861X

Journal article

Cerminaro C, Sazonov E, McCrory MA, Steiner-Asiedu M, Bhaskar V, Gallo S, Laing E, Jia W, Sun M, Baranowski T, Frost G, Lo B, Anderson AKet al., 2022, Feasibility of the automatic ingestion monitor (AIM-2) for infant feeding assessment: a pilot study among breast-feeding mothers from Ghana, PUBLIC HEALTH NUTRITION, Vol: 25, Pages: 2897-2907, ISSN: 1368-9800

Journal article

Frost G, 2022, How strong is the evidence base for carbohydrate restriction in the management of type 2 diabetes?, AMERICAN JOURNAL OF CLINICAL NUTRITION, Vol: 116, Pages: 7-8, ISSN: 0002-9165

Journal article

Habboub N, Forlano R, Goldin R, Mullish BH, Frost G, Challis B, Thursz MR, Dumas M-E, Manousou Pet al., 2022, EXAMINING THE CORRELATION OF HISTOLOGICAL FEATURES OF NAFLD WITH A POLYMETABOLIC RISK SCORE FOR PREDICTING PATIENTS WITH NAFLD, GASTROENTEROLOGY, Vol: 162, Pages: S1271-S1271, ISSN: 0016-5085

Journal article

Olupot-Olupot P, Connon R, Kiguli S, Opoka RO, Alaroker F, Uyoga S, Nakuya M, Okiror W, Nteziyaremye J, Ssenyondo T, Nabawanuka E, Kayaga J, Williams Mukisa C, Amorut D, Muhindo R, Frost G, Walsh K, Macharia AW, Gibb DM, Walker AS, George EC, Maitland K, Williams TN, Williams Tet al., 2022, A predictive algorithm for identifying children with sickle cell anemia among children admitted to hospital with severe anemia in Africa, American Journal of Hematology, Vol: 97, Pages: 527-536, ISSN: 0361-8609

Sickle cell anemia (SCA) is common in sub-Saharan Africa where approximately 1% of births are affected. Severe anemia is a common cause for hospital admission within the region yet few studies have investigated the contribution made by SCA. The Transfusion and Treatment of severe anemia in African Children Trial (ISRCTN84086586) investigated various treatment strategies in 3983 children admitted with severe anemia (hemoglobin < 6.0 g/dl) based on two severity strata to four hospitals in Africa (three Uganda and one Malawi). Children with known-SCA were excluded from the uncomplicated stratum and capped at 25% in the complicated stratum. All participants were genotyped for SCA at trial completion. SCA was rare in Malawi (six patients overall), so here we focus on the participants recruited in Uganda. We present baseline characteristics by SCA status and propose an algorithm for identifying children with unknown-SCA. Overall, 430 (12%) and 608 (17%) of the 3483 Ugandan participants had known- or unknown-SCA, respectively. Children with SCA were less likely to be malaria-positive and more likely to have an affected sibling, have gross splenomegaly, or to have received a previous blood transfusion. Most outcomes, including mortality and readmission, were better in children with either known or unknown-SCA than non-SCA children. A simple algorithm based on seven admission criteria detected 73% of all children with unknown-SCA with a number needed to test to identify one new SCA case of only two. Our proposed algorithm offers an efficient and cost-effective approach to identifying children with unknown-SCA among all children admitted with severe anemia to African hospitals where screening is not widely available.

Journal article

Kusuma D, Atanasova P, Pineda E, Anjana RM, De Silva L, Hanif AA, Hasan M, Hossain MM, Indrawansa S, Jayamanne D, Jha S, Kasturiratne A, Katulanda P, Khawaja KI, Kumarendran B, Mridha MK, Rajakaruna V, Chambers JC, Frost G, Sassi F, Miraldo Met al., 2022, Food environment and diabetes mellitus in South Asia: A geospatial analysis of health outcome data, PLoS Medicine, Vol: 19, ISSN: 1549-1277

BACKGROUND: The global epidemic of type 2 diabetes mellitus (T2DM) renders its prevention a major public health priority. A key risk factor of diabetes is obesity and poor diets. Food environments have been found to influence people's diets and obesity, positing they may play a role in the prevalence of diabetes. Yet, there is scant evidence on the role they may play in the context of low- and middle-income countries (LMICs). We examined the associations of food environments on T2DM among adults and its heterogeneity by income and sex. METHODS AND FINDINGS: We linked individual health outcome data of 12,167 individuals from a network of health surveillance sites (the South Asia Biobank) to the density and proximity of food outlets geolocated around their homes from environment mapping survey data collected between 2018 and 2020 in Bangladesh and Sri Lanka. Density was defined as share of food outlets within 300 m from study participant's home, and proximity was defined as having at least 1 outlet within 100 m from home. The outcome variables include fasting blood glucose level, high blood glucose, and self-reported diagnosed diabetes. Control variables included demographics, socioeconomic status (SES), health status, healthcare utilization, and physical activities. Data were analyzed in ArcMap 10.3 and STATA 15.1. A higher share of fast-food restaurants (FFR) was associated with a 9.21 mg/dl blood glucose increase (95% CI: 0.17, 18.24; p < 0.05). Having at least 1 FFR in the proximity was associated with 2.14 mg/dl blood glucose increase (CI: 0.55, 3.72; p < 0.01). A 1% increase in the share of FFR near an individual's home was associated with 8% increase in the probability of being clinically diagnosed as a diabetic (average marginal effects (AMEs): 0.08; CI: 0.02, 0.14; p < 0.05). Having at least 1 FFR near home was associated with 16% (odds ratio [OR]: 1.16; CI: 1.01, 1.33; p < 0.05) and 19% (OR: 1.19; CI: 1.03, 1.38; p < 0.05) increases in the odd

Journal article

Cherta-Murillo A, Pugh JE, Alaraj-Alshehhi S, Hajjar D, Frost G, Chambers Eet al., 2022, The effect of short-chain fatty acids on glycemic control in humans: A systematic review and meta-analysis, American Journal of Clinical Nutrition, Vol: 116, ISSN: 0002-9165

Background:Non-communicable disease development is related to impairments in glycaemic and insulinemic response, which can be modulated by fiber intake. Fiber's beneficial effect upon metabolic health can be partially attributed to the production of short-chain fatty acids (SCFAs) via microbial fermentation of fiber in the gastrointestinal tract.Objective:We aimed to determine the effect of the SCFAs, acetate, propionate, and butyrate on glycemic control in humans.Methods:CENTRAL, Embase, PubMed, Scopus and Web of Science databases were searched from inception to the 07/12/2021. Papers were included if they reported a randomized, controlled trial measuring glucose and/or insulin compared to a placebo in adults. Studies were categorized by the type of SCFA and intervention duration. Random effects meta-analyses were performed for glucose and insulin for those subject categories with ≥3 studies, or a narrative review was performed.Results:We identified 43 eligible papers, with 46 studies within those records (n = 913), 44 studies were included in the meta-analysis. Vinegar intake decreased acute glucose response, standard mean difference (SMD) and (95% CI) –0.53 (–0.92, –0.14) (n = 67) in individuals with impaired glucose tolerance or type 2 diabetes and in healthy (SMD) –0.27 (–0.54, 0.00) (n = 186). The meta-analyses for acute acetate as well as acute and chronic propionate studies had no significant effect.Conclusions:Vinegar decreased glucose response acutely in healthy and non-healthy. Acetate, propionate, butyrate, and mixed SCFAs had no effect on blood glucose and insulin in humans. Significant heterogeneity, risk of bias, and publication bias were identified in several study categories, including acute vinegar glucose response. As evidence was very uncertain, caution is urged when interpreting these results. Further high-quality research is required to determine the effect of SCFAs on glycemic control.

Journal article

Miraldo M, Atanasova PETYA, Kusuma DIAN, Pineda E, Frost G, Sassi Fet al., 2022, The impact of the consumer and neighbourhood food environment on dietary intake and obesity-related outcomes: A systematic review of causal impact studies., Social Science and Medicine, Vol: 299, Pages: 1-16, ISSN: 0277-9536

BackgroundThe food environment has been found to impact population dietary behaviour. Our study aimed to systematically review the impact of different elements of the food environment on dietary intake and obesity.MethodsWe searched MEDLINE, Embase, PsychInfo, EconLit databases to identify literature that assessed the relationship between the built food environments (intervention) and dietary intake and obesity (outcomes), published between database inception to March 26, 2020. All human studies were eligible except for those on clinical sub-groups. Only studies with causal inference methods were assessed. Studies focusing on the food environment inside homes, workplaces and schools were excluded. A risk of bias assessment was conducted using the CASP appraisal checklist. Findings were summarized using a narrative synthesis approach.Findings58 papers were included, 55 of which were conducted in high-income countries. 70% of papers focused on the consumer food environments and found that in-kind/financial incentives, healthy food saliency, and health primes, but not calorie menu labelling significantly improved dietary quality of children and adults, while BMI results were null. 30% of the papers focused on the neighbourhood food environments and found that the number of and distance to unhealthy food outlets increased the likelihood of fast-food consumption and higher BMI for children of any SES; among adults only selected groups were impacted - females, black, and Hispanics living in low and medium density areas. The availability and distance to healthy food outlets significantly improved children's dietary intake and BMI but null results were found for adults.InterpretationEvidence suggests certain elements of the consumer and neighbourhood food environments could improve populations dietary intake, while effect on BMI was observed among children and selected adult populations. Underprivileged groups are most likely to experience and impact on BMI. Future research

Journal article

Kusuma D, Atanasova P, Anjana RM, De Silva L, Hanif A, Hasan M, Hossain M, Indrawansa S, Jayamanne D, Jha S, Kasturiratne A, Katulanda P, Khawaja KI, Kumarendran B, Mridha MK, Rajakaruna V, Chambers JC, Frost G, Sassi F, Miraldo Met al., 2022, Food environment and diabetes mellitus in South Asia: a geospatial analysis of health outcome data, PLoS Medicine, ISSN: 1549-1277

Background: The global epidemic of type 2 diabetes mellitus (T2DM) renders its prevention a major public health priority. A key risk factor of diabetes is obesity and poor diets. Food environments have been found to influence people’s diets and obesity positing they may play a role in the prevalence of diabetes. Yet there is scant evidence on the role they may play in the context of low- and middle-income countries. We examined the associations of food environments on T2DM among adults, and its heterogeneity by income and sex. Methods and Findings: We linked individual health outcome data of 12,167 individuals from a network of health surveillance sites (the South Asia Biobank) to the density and proximity of food outlets geolocated around their homes from environment mapping survey data collected between 2018-2020 in Bangladesh and Sri Lanka. Density was defined as share of food outlets within 300m from study participant’s home: proximity was defined as having at least one outlet within 100m from home. The outcome variables include fasting blood glucose level, high blood glucose, and self-reported diagnosed diabetes. Control variables included demographics, socio-economic status, health status, healthcare utilization, and physical activities. Data were analysed in ArcMap 10.3 and STATA 15.1. A higher share of fast food restaurants (FFR) was associated with a 9.21 mg/dl blood glucose increase (95% CI: 0.17, 18.24; p <0.05). Having at least one FFR in the proximity was associated with 2.14 mg/dl blood glucose increase (CI: 0.55, 3.72; p <0.01). A one percent increase in the share of FFR near an individual’s home was associated with 8% increase in the probability of being clinically diagnosed as a diabetic (average marginal effects (AME): 0.08; CI: 0.02, 0.14; p<0.05. Having at least one FFR near home was associated with 16% (OR: 1.16; CI: 1.01, 1.33; p<0.05) and 19% (OR: 1.19; CI: 1.03, 1.38; p<0.05) increases in the odds of higher bl

Journal article

George EC, Uyoga S, M'baya B, Byabazair DK, Kiguli S, Olupot-Olupot P, Opoka RO, Chagaluka G, Alaroker F, Williams TN, Bates I, Mbanya D, Gibb DM, Walker AS, Maitland K, TRACT trail study groupet al., 2022, Whole blood versus red cell concentrates for children with severe anaemia: a secondary analysis of the Transfusion and Treatment of African Children (TRACT) trial, The Lancet Global Health, Vol: 10, Pages: e360-e368, ISSN: 2214-109X

Background:The multicentre Transfusion and Treatment of African Children (TRACT) trial established best evidence on the timing of transfusion in children with uncomplicated anaemia (haemoglobin 4-6g/dl) and optimal volume (20 versus 30ml/kg whole blood (or 10 vs 15ml/kg red cell concentrates) for transfusion in children hospitalised with severe anaemia (Hb <6g/dl) on Day 28 mortality (primary endpoint) and secondary endpoints including safety. As evidence on the safety of blood components is limited we undertook a secondary analysis comparing children receiving whole blood versus red cell concentrates as their initial transfusion on clinical outcomes. Methods :This analysis includes 3188 children with severe anaemia (Hb <6g/dl) who received either whole blood or red cell concentrates. Whole blood or cell concentrates were issued routinely by the blood transfusion services, but not prespecified on the request form. The impact of blood pack type on haematological correction, re-transfusion, and other clinical endpoints was explored using multivariate regression models. Findings:1632/3992 (41%) transfusions in 3188 children were whole blood. Compared with whole blood, children receiving cell concentrates in their first transfusion had less haemoglobin recovery at 8 hours (packed cells mean(95%CI): -1.3(-1.5,-1.0) 20ml/kg arm,-1.4(-1.6,-1.1) 30ml/kg; settled cells mean(95%CI) -1.1g/dl(-1.2,-0.9) 20ml/kg arm, -1.5g/dl(-1.7,-1.3) 30ml/kg arm; p<0.001 for pack type comparisons, p=0.003 heterogeneity by arm), higher odds of receiving a second transfusion [ORs 2.32 (95%CI 1.30,4.12) and 2.97 (2.18,4.05) respectively; p<0.001], and had a longer time to discharge [sub-Hazard Ratios 0.94 (95%CI 0.81,1.10) and 0.86 (95% CI 0.79,0.94) respectively; p=0.002]. No child developed features of cardio-pulmonary overload. Interpretation: Whole blood is safe to use in children, resulting in superior aematologic

Journal article

Atanasova P, Kusuma D, Pineda E, Anjana RM, De Silva L, Hanif AAM, Hasan M, Hossain MM, Indrawansa S, Jayamanne D, Jha S, Kasturiratne A, Katulanda P, Khawaja KI, Kumarendran B, Mrida MK, Rajakaruna V, Chambers JC, Frost G, Sassi F, Miraldo Met al., 2022, Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities., SSM - Population Health, Vol: 17, Pages: 101055-101055, ISSN: 2352-8273

Introduction: In low-middle income countries (LMICs) the role of food environments on obesity has been understudied. We address this gap by 1) examining the effect of food environments on adults' body size (BMI, waist circumference) and obesity; 2) measuring the heterogeneity of such effects by income and sex. Methods: This cross-sectional study analysed South Asia Biobank surveillance and environment mapping data for 12,167 adults collected between 2018 and 2020 from 33 surveillance sites in Bangladesh and Sri Lanka. Individual-level data (demographic, socio-economic, and health characteristics) were combined with exposure to healthy and unhealthy food environments measured with geolocations of food outlets (obtained through ground-truth surveys) within 300 m buffer zones around participants' homes. Multivariate regression models were used to assess association of exposure to healthy and unhealthy food environments on waist circumference, BMI, and probability of obesity for the total sample and stratified by sex and income. Findings: The presence of a higher share of supermarkets in the neighbourhood was associated with a reduction in body size (BMI, β = - 3∙23; p < 0∙0001, and waist circumference, β = -5∙99; p = 0∙0212) and obesity (Average Marginal Effect (AME): -0∙18; p = 0∙0009). High share of fast-food restaurants in the neighbourhood was not significantly associated with body size, but it significantly increased the probability of obesity measured by BMI (AME: 0∙09; p = 0∙0234) and waist circumference (AME: 0∙21; p = 0∙0021). These effects were stronger among females and low-income individuals. Interpretation: The results suggest the availability of fast-food outlets influences obesity, especially among female and lower-income groups. The availability of supermarkets is associated with reduced body size and obesity, but their effects do not outweigh the role of fast-food o

Journal article

Latif J, Weekes CE, Julian A, Frost G, Murphy J, Tronco-Hernandez YA, Hickson Met al., 2022, Strategies to ensure continuity of nutritional care in patients with COVID-19 infection on discharge from hospital: A rapid review, CLINICAL NUTRITION ESPEN, Vol: 47, Pages: 106-116, ISSN: 2405-4577

Journal article

Abbott K, Posma JM, Garcia Perez I, Udeh-Momoh C, Ahmadi-Abhari S, Middleton L, Frost Get al., 2022, Evidence-Based Tools for Dietary Assessments in Nutrition Epidemiology Studies for Dementia Prevention, The journal of prevention of Alzheimer's disease, ISSN: 2274-5807

Increasing evidence proposes diet as a notable modifiable factor and viable target for the reduction of Alzheimer’s Disease risk and age-related cognitive decline. However, assessment of dietary exposures is challenged by dietary capture methods that are prone to misreporting and measurement errors. The utility of -omics technologies for the evaluation of dietary exposures has the potential to improve reliability and offer new insights to pre-disease indicators and preventive targets in cognitive aging and dementia. In this review, we present a focused overview of metabolomics as a validation tool and framework for investigating the immediate or cumulative effects of diet on cognitive health.

Journal article

Wesolowska-Andersen A, Brorsson CA, Bizzotto R, Mari A, Tura A, Koivula R, Mahajan A, Vinuela A, Tajes JF, Sharma S, Haid M, Prehn C, Artati A, Hong M-G, Musholt PB, Kurbasic A, De Masi F, Tsirigos K, Pedersen HK, Gudmundsdottir V, Thomas CE, Banasik K, Jennison C, Jones A, Kennedy G, Bell J, Thomas L, Frost G, Thomsen H, Allin K, Hansen TH, Vestergaard H, Hansen T, Rutters F, Elders P, T'Hart L, Bonnefond A, Canouil M, Brage S, Kokkola T, Heggie A, McEvoy D, Hattersley A, McDonald T, Teare H, Ridderstrale M, Walker M, Forgie I, Giordano GN, Froguel P, Pavo I, Ruetten H, Pedersen O, Dermitzakis E, Franks PW, Schwenk JM, Adamski J, Pearson E, McCarthy M, Brunak Set al., 2022, Four groups of type 2 diabetes contribute to the etiological and clinical heterogeneity in newly diagnosed individuals: An IMI DIRECT study, CELL REPORTS MEDICINE, Vol: 3, ISSN: 2666-3791

Journal article

Penney N, Yeung D, Garcia-Perez I, POSMA J, Kopytek A, Garratt B, Ashrafian H, Frost G, Marchesi J, Purkayastha S, Hoyles L, Darzi A, Holmes Eet al., 2021, Longitudinal Multi-omic Phenotyping Reveals Host-microbe Responses to Bariatric Surgery, Glycaemic Control and Obesity

<jats:title>Abstract</jats:title> <jats:p>Resolution of type-2 diabetes (T2D) is common following bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB). However, the underlying mechanisms have not been fully elucidated. To address this we compared the integrated serum, urine and faecal metabolic profiles of obese participants with and without T2D (n=81, T2D=42) with participants who underwent RYGB or sleeve gastrectomy (pre and 3-months post-surgery; n=27), taking diet into account. We co-modelled these data with shotgun metagenomic profiles of the gut microbiota to provide a comprehensive atlas of host-gut microbe responses to bariatric surgery, weight-loss and glycaemic control at the systems level. Bariatric surgery reversed a number of disrupted pathways characteristic of T2D. The differential metabolite set representative of bariatric surgery overlapped with both diabetes (19.3% commonality) and BMI (18.6% commonality). However, the percentage overlap between diabetes and BMI was minimal (4.0% commonality), consistent with weight-independent mechanisms of T2D resolution. The gut microbiota was more strongly correlated to BMI than T2D, although we identified some pathways such as amino acid metabolism that correlated with changes to the gut microbiota and which influence glycaemic control. Improved understanding of GM-host co-metabolism may lead to novel therapies for weight-loss or diabetes.</jats:p>

Journal article

Kasturiratne A, Khawaja KI, Ahmad S, Siddiqui S, Shahzad K, Athauda LK, Jayawardena R, Mahmood S, Muilwijk M, Batool T, Burney S, Glover M, Palaniswamy S, Bamunuarachchi V, Panda M, Madawanarachchi S, Rai B, Sattar I, Silva W, Waghdhare S, Jarvelin M-R, Rannan-Eliya RP, Gage HM, van Valkengoed IGM, Valabhji J, Frost GS, Loh M, Wickremasinghe AR, Kooner JS, Katulanda P, Jha S, Chambers JCet al., 2021, The iHealth-T2D study, prevention of type 2 diabetes amongst South Asians with central obesity and prediabetes: study protocol for a randomised controlled trial, TRIALS, Vol: 22

Journal article

Frampton J, Murphy K, Frost G, Chambers Eet al., 2021, Higher dietary fibre intake is associated with increased skeletal muscle mass and strength in adults aged 40 years and older, Journal of Cachexia, Sarcopenia and Muscle, Vol: 12, Pages: 2134-2144, ISSN: 2190-6009

BackgroundSkeletal muscle mass begins to decline from 40 years of age. Limited data suggest that dietary fibre may modify lean body mass, of which, skeletal muscle is the largest and most malleable component. We investigated the relationship between dietary fibre intake, skeletal muscle mass, and associated metabolic and functional parameters in adults aged 40 years and older. MethodsWe analysed cross-sectional data from the US National Health and Nutrition Examination Survey between 2011 and 2018 from adults aged 40 years and older. Covariate-adjusted multiple linear regression analyses were used to evaluate the association between dietary fibre intake and body mass components (body mass, BMI, total lean mass, appendicular lean mass, bone mineral content, total fat, trunk fat; n = 6454), glucose homeostasis (fasting glucose, fasting insulin, HOMA2-IR; n = 5032), and skeletal muscle strength (combined grip strength; n = 5326). Body mass components and skeletal muscle strength were expressed relative to body mass (per kg of body mass [BM]). ResultsHigher intakes of dietary fibre were significantly associated with increased relative total lean mass (β: 0.69 g/kg BM; 95% CI, 0.48 to 0.89 g/kg BM; P<0.001), relative appendicular lean mass (β: 0.34 g/kg BM; 95% CI, 0.23 to 0.45 g/kg BM; P<0.001), relative bone mineral content (β: 0.05 g/kg BM; 95% CI, 0.02 to 0.07 g/kg BM; P<0.001), and relative combined grip strength (β: 0.002 kg/kg BM; 95% CI, 0.001 to 0.003 kg/kg BM; P<0.001).Conversely, higher dietary fibre intakes were significantly associated with a lower body mass (β: -0.20; 95% CI, -0.28 to -0.11 kg; P<0.001), BMI (β: -0.08 kg/m2; 95%CI, -0.10 to -0.05 kg/m2), relative total fat (β: -0.68 g/kg BM; 95% CI, -0.89 to -0.47 g/kg BM; P<0.001), relative trunk fat (β: -0.48 g/kg BM; 95%CI, -0.63 to -0.33 g/kg; P<0.001), fasting glucose (β: -0.01 mmol/L; 95% CI, -0.02 to -0.00 mmol/L; P=0.017), fasting ins

Journal article

Muilwijk M, Loh M, Siddiqui S, Mahmood S, Palaniswamy S, Shahzad K, Athauda LK, Jayawardena R, Batool T, Burney S, Glover M, Bamunuarachchi V, Panda M, Madawanarachchi M, Rai B, Sattar I, Silva W, Waghdhare S, Jarvelin M-R, Rannan-Eliya RP, Wijemunige N, Gage HM, Valabhji J, Frost GS, Wickremasinghe R, Kasturiratne A, Khawaja K, Ahmad S, van Valkengoed IGM, Katulanda P, Jha S, Kooner JS, Chambers JCet al., 2021, Effects of a lifestyle intervention programme after 1 year of follow-up among South Asians at high risk of type 2 diabetes: a cluster randomised controlled trial, BMJ GLOBAL HEALTH, Vol: 6, ISSN: 2059-7908

Journal article

Wu Y, Posma JM, Holmes E, Chambers E, Frost G, Garcia Perez Iet al., 2021, Odd chain fatty acids are not robust biomarkers for dietary intake of fiber, Molecular Nutrition and Food Research, Vol: 65, Pages: 1-8, ISSN: 1613-4125

Prior investigation has suggested a positive association between increased colonic propionate production and circulating odd-chain fatty acids [(OCFAs; pentadecanoic acid (C15:0), heptadecanoic acid (C17:0)]. As the major source of propionate in humans is the microbial fermentation of dietary fiber, OCFAs have been proposed as candidate biomarkers of dietary fiber. The objective of this study is to critically assess the plausibility, robustness, reliability, dose-response, time-response aspects of OCFAs as potential biomarkers of fermentable fibers in two independent studies using a validated analytical method. OCFAs were first assessed in a fiber supplementation study, where 21 participants received 10g dietary fiber supplementation for 7 days with blood samples collected on the final day at a 420 minute study visit. OCFAs were then assessed in a highly controlled inpatient setting, which 19 participants consumed a high fiber (45.1g/day) and a low fiber diet (13.6g/day) for 4 days. Collectively in both studies, dietary intakes of fiber as fiber supplementations or having consumed a high fiber diet did not increase circulating levels of OCFAs. The dose and temporal relations were not observed. Current study has generated new insight on the utility of OCFAs as fiber biomarkers and highlighted the importance of critical assessment of candidate dietary biomarkers before application.

Journal article

Othman S, 2021, Innovation adoption and diffusion in nursing: a comparative case study design

Background:Innovation adoption and diffusion(IAD) in healthcare refers to the essential process of integrating novel practices into systems’ critical functions. IAD is often slow and unsuccessful, leading to patients not receiving optimal care in a timely manner. IAD research has been dominated by descriptive or prescriptive theories with limited benefit to practice applications; these theories are often simplistic and assume IAD to follow a linear and predictable pathway despite emerging evidence portraying healthcare organisations as complex adaptive systems. Therefore, contemporary IAD research is increasingly shifting in favour of complexity theory replacing linear theories. Nonetheless, nursing research in the field is still trailing behind other disciplines on this shift.Aim:This study applied complexity theory to evaluate the process of innovation adoption and diffusion in frontline nursing practice.Objectives:The study explored why some nursing units succeed in innovation adoption and diffusion while others, within the same organisation, fail.Methodology: Drawing on constructivism, this study applied a theoretical framework built on complexity theory as the grand theory, complex adaptive system (CAS) as the middle-range theory, and Atun’s framework at the micro level. The theoretical framework requires a systems thinking approach capable of exploring the system as a whole rather than a collection of isolated, separate individual components.Design:A Comparative case study design was adopted, forming a 2x2 matrix incorporating two cases with four units of investigation. The two cases were two innovations selected as representatives for the phenomenon of IAD in frontline nursing: WHO 5 Moments for Hand Hygiene (5MHH) and Intentional Nursing Rounding (INR). Each innovation (case) was evaluated through its adoption and diffusion into two comparable units of investigation (wards); a ward of successful adoption and diffusion and an unsuccessful comparat

Thesis dissertation

Frost G, Domoney C, Wilde P, Rayner T, Petropoulou A, Edwards Cet al., 2021, Foodstuffs having improved digestion properties, WO2022053494A1

The invention relates to methods for determining if a pea variety or a product derived from that pea variety has improved digestion properties. The invention also relates to methods of improving the digestion property of a pea, as well as method of making such plants.

Patent

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