Publications
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Maitland K, 2015, Transfusion and Treatment of severe anaemia in African children (TRACT): a study protocol for a randomized controlled trial, Trials, Vol: 16, ISSN: 1745-6215
BackgroundIn sub-Saharan Africa, where infectious diseases and nutritional deficiencies are common, severe anaemia is a common cause of paediatric hospital admission, yet the evidence to support current treatment recommendations is limited. To avert overuse of blood products, the World Health Organisation advocates a conservative transfusion policy and recommends iron, folate and anti-helminthics at discharge. Outcomes are unsatisfactory with high rates of in-hospital mortality (9–10 %), 6-month mortality and relapse (6 %). A definitive trial to establish best transfusion and treatment strategies to prevent both early and delayed mortality and relapse is warranted.Methods/DesignTRACT is a multicentre randomised controlled trial of 3954 children aged 2 months to 12 years admitted to hospital with severe anaemia (haemoglobin < 6 g/dl). Children will be enrolled over 2 years in 4 centres in Uganda and Malawi and followed for 6 months. The trial will simultaneously evaluate (in a factorial trial with a 3 x 2 x 2 design) 3 ways to reduce short-term and longer-term mortality and morbidity following admission to hospital with severe anaemia in African children.The trial will compare: (i) R1: liberal transfusion (30 ml/kg whole blood) versus conservative transfusion (20 ml/kg) versus no transfusion (control). The control is only for children with uncomplicated severe anaemia (haemoglobin 4–6 g/dl); (ii) R2: post-discharge multi-vitamin multi-mineral supplementation (including folate and iron) versus routine care (folate and iron) for 3 months; (iii) R3: post-discharge cotrimoxazole prophylaxis for 3 months versus no prophylaxis. All randomisations are open. Enrolment to the trial started September 2014 and is currently ongoing. Primary outcome is cumulative mortality to 4 weeks for the transfusion strategy comparisons, and to 6 months for the nutritional support/antibiotic prophylaxis comparisons. Secondary outcomes include mortality, morbidity
Darzi J, Frost GS, Swann JR, et al., 2015, l-rhamnose as a source of colonic propionate inhibits insulin secretion but does not influence measures of appetite or food intake., Appetite, Vol: 98, Pages: 142-149, ISSN: 1095-8304
Activation of free fatty acid receptor (FFAR)2 and FFAR3 via colonic short-chain fatty acids, particularly propionate, are postulated to explain observed inverse associations between dietary fiber intake and body weight. Propionate is reported as the predominant colonic fermentation product from l-rhamnose, a natural monosaccharide that resists digestion and absorption reaching the colon intact, while effects of long-chain inulin on appetite have not been extensively investigated. In this single-blind randomized crossover study, healthy unrestrained eaters (n = 13) ingested 25.5 g/d l-rhamnose, 22.4 g/d inulin or no supplement (control) alongside a standardized breakfast and lunch, following a 6-d run-in to investigate if appetite was inhibited. Postprandial qualitative appetite, breath hydrogen, and plasma glucose, insulin, triglycerides and non-esterified fatty acids were assessed for 420 min, then an ad libitum meal was provided. Significant treatment x time effects were found for postprandial insulin (P = 0.009) and non-esterified fatty acids (P = 0.046) with a significantly lower insulin response for l-rhamnose (P = 0.023) than control. No differences between treatments were found for quantitative and qualitative appetite measures, although significant treatment x time effects for meal desire (P = 0.008) and desire to eat sweet (P = 0.036) were found. Breath hydrogen was significantly higher with inulin (P = 0.001) and l-rhamnose (P = 0.009) than control, indicating colonic fermentation. These findings suggest l-rhamnose may inhibit postprandial insulin secretion, however neither l-rhamnose or inulin influenced appetite.
Guess ND, Caengprasath N, Dornhorst A, et al., 2015, Adherence to NICE guidelines on diabetes prevention in the UK: Effect on patient knowledge and perceived risk, PRIMARY CARE DIABETES, Vol: 9, Pages: 407-411, ISSN: 1751-9918
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- Citations: 14
Guess ND, Dornhorst A, Oliver N, et al., 2015, A Randomised Crossover Trial: The Effect of Inulin on Glucose Homeostasis in Subtypes of Prediabetes, Annals of Nutrition and Metabolism, Vol: 68, Pages: 26-34, ISSN: 1421-9697
Background: Fermentable carbohydrates (FCHO) have beenshown to improve insulin sensitivity in normoglycaemic andinsulin-resistant subjects. However, there are no data onsubjects with prediabetes. We aimed to investigate the effectof the FCHO inulin, on glucose homeostasis in subjectswith prediabetes. Methods: In a double-blind and placebocontrolledcrossover study, 40 volunteers with prediabeteswere randomly allocated to take 30 g/day of inulin or cellulosefor 2 weeks in a crossover trial, following a 4-week doseescalationrun-in. Fasting insulin and glucose were measuredfor all subjects. Fifteen of the 40 subjects also underwenta meal tolerance test to assess insulin sensitivity, freefatty acids and glucagon-like peptide-1 concentrations. Asubanalysis was carried out to examine any differences betweenthe prediabetes subtypes. Results: Inulin was associatedwith a significant increase in (0–30 min) incremental AUC(iAUC) for insulin (treatment: p < 0.04) and (0–60 min) iAUC forinsulin (treatment: p < 0.04) compared to control. There wasa significant reduction in insulin resistance measured by thehomeostatic model assessment in the isolated-impairedfasting glucose (p < 0.05) but not in the isolated-impaired glucose tolerance groups (p = 0.59). Conclusion: The FCHO,inulin, may have unique metabolic effects that are of particularbenefit to people at risk of diabetes, which warrantfurther investigation.
Pettitt C, Liu J, Kwasnicki R, et al., 2015, A pilot study to determine whether using a lightweight, wearable micro-camera improves dietary assessment accuracy and offers information on macronutrients and eating rate., British Journal of Nutrition, Vol: 115, Pages: 160-167, ISSN: 1475-2662
A major limitation in nutritional science is the lack of understanding of the nutritional intake of free living people. There is an inverse relationship between accuracy of reporting of energy intake by all current nutritional methodologies and body weight. In this pilot study we aim to explore whether using a novel lightweight, wearable micro-camera improves accuracy of dietary intake assessment. Doubly-labelled water (DLW) was used to estimate energy expenditure and intake over a 14-day period over which time participants (n = 6) completed a food diary and wore a micro-camera on 2 of the days. Comparisons were made between the estimated energy intake from reported food diary alone and together with the images from the micro-camera recordings. There was an average daily deficit of 3912kJ using food diaries to estimate energy intake compared to estimated energy expenditure from DLW (p=0.0118) representing an under-reporting rate of 34%. Analysis of food diaries alone showed a significant deficit in estimated daily energy intake compared to estimated intake from food diary analysis with images from the micro-camera recordings (405kJ). Use of the micro-camera images in conjunction with food diaries improves the accuracy of dietary assessment and provides valuable information on macronutrient intake and eating rate. There is a need to develop this recording technique to remove user and assessor bias.
Guess ND, Dornhorst A, Oliver N, et al., 2015, A randomized controlled trial: the effect of inulin on weight management and ectopic fat in subjects with prediabetes, Nutrition & Metabolism, Vol: 12, ISSN: 1743-7075
BackgroundFat infiltration of the liver, muscle and pancreas is associated with insulin resistance and risk of diabetes. Weight loss reduces ectopic fat deposition and risk of diabetes, but is difficult to sustain to due to compensatory increases in appetite. Fermentable carbohydrates have been shown to decrease appetite and food intake, and promote weight loss in overweight subjects. In animal studies, fermentable carbohydrate reduces ectopic fat independent of weight loss. We aimed to investigate the effect of the fermentable carbohydrate inulin on weight maintenance, appetite and ectopic fat in subjects with prediabetes.MethodsForty-four subjects with prediabetes were randomized to 18 weeks’ inulin or cellulose supplementation. During weeks 1–9 (weight loss phase) all subjects had four visits with a dietitian to guide them towards a 5 % weight loss. During weeks 10–18 (weight maintenance phase) subjects continued taking their assigned supplementation and were asked to maintain the weight they had lost but were offered no further support. All subjects attended study sessions at baseline, 9 and 18 weeks for measurement of weight; assessment of adipose tissue and ectopic fat content by magnetic resonance imaging and magnetic resonance spectroscopy; glucose, insulin and GLP-1 levels following a meal tolerance test; and appetite by ad libitum meal test and visual analogue scales.ResultsBoth groups lost approximately 5 % of their body weight by week nine (−5.3 ± 0.1 % vs −4.3 ± 0.4 %, p = 0.13, but the inulin group lost significantly more weight between 9 and 18 weeks (−2.3 ± 0.5 % vs −0.6 ± 0.4 %, p = 0.012). Subjects taking inulin had lower hepatic (p = 0.02) and soleus muscle (p < 0.05) fat content at 18 weeks compared to control even after controlling for weight loss and consumed les
Chambers ES, Viardot A, Psichas A, et al., 2015, Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults, Gut, Vol: 64, Pages: 1744-1754, ISSN: 0017-5749
Objective The colonic microbiota ferment dietary fibres, producing short chain fatty acids. Recent evidence suggests that the short chain fatty acid propionate may play an important role in appetite regulation. We hypothesised that colonic delivery of propionate would increase peptide YY (PYY) and glucagon like peptide-1 (GLP-1) secretion in humans, and reduce energy intake and weight gain in overweight adults.Design To investigate whether propionate promotes PYY and GLP-1 secretion, a primary cultured human colonic cell model was developed. To deliver propionate specifically to the colon, we developed a novel inulin-propionate ester. An acute randomised, controlled cross-over study was used to assess the effects of this inulin-propionate ester on energy intake and plasma PYY and GLP-1 concentrations. The long-term effects of inulin-propionate ester on weight gain were subsequently assessed in a randomised, controlled 24-week study involving 60 overweight adults.Results Propionate significantly stimulated the release of PYY and GLP-1 from human colonic cells. Acute ingestion of 10 g inulin-propionate ester significantly increased postprandial plasma PYY and GLP-1 and reduced energy intake. Over 24 weeks, 10 g/day inulin-propionate ester supplementation significantly reduced weight gain, intra-abdominal adipose tissue distribution, intrahepatocellular lipid content and prevented the deterioration in insulin sensitivity observed in the inulin-control group.Conclusions These data demonstrate for the first time that increasing colonic propionate prevents weight gain in overweight adult humans.
Tripkovic L, Muirhead NC, Hart KH, et al., 2015, The effects of a diet rich in inulin or wheat fibre on markers of cardiovascular disease in overweight male subjects, JOURNAL OF HUMAN NUTRITION AND DIETETICS, Vol: 28, Pages: 476-485, ISSN: 0952-3871
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- Citations: 15
Aljuraiban GS, Griep LMO, Chan Q, et al., 2015, Total, insoluble and soluble dietary fibre intake in relation to blood pressure: the INTERMAP Study - CORRIGENDUM, British Journal of Nutrition, Vol: 114, Pages: 1534-1534, ISSN: 1475-2662
Edwards CH, Grundy MML, Grassby T, et al., 2015, Manipulation of starch bioaccessibility in wheat endosperm to regulate starch digestion, postprandial glycemia, insulinemia, and gut hormone responses: a randomized controlled trial in healthy ileostomy participants, American Journal of Clinical Nutrition, Vol: 102, Pages: 791-800, ISSN: 1938-3207
Background: Cereal crops, particularly wheat, are a major dietary source of starch, and the bioaccessibility of starch has implications for postprandial glycemia. The structure and properties of plant foods have been identified as critical factors in influencing nutrient bioaccessibility; however, the physical and biochemical disassembly of cereal food during digestion has not been widely studied.Objectives: The aims of this study were to compare the effects of 2 porridge meals prepared from wheat endosperm with different degrees of starch bioaccessibility on postprandial metabolism (e.g., glycemia) and to gain insight into the structural and biochemical breakdown of the test meals during gastroileal transit.Design: A randomized crossover trial in 9 healthy ileostomy participants was designed to compare the effects of 55 g starch, provided as coarse (2-mm particles) or smooth (<0.2-mm particles) wheat porridge, on postprandial changes in blood glucose, insulin, C-peptide, lipids, and gut hormones and on the resistant starch (RS) content of ileal effluent. Undigested food in the ileal output was examined microscopically to identify cell walls and encapsulated starch.Results: Blood glucose, insulin, C-peptide, and glucose-dependent insulinotropic polypeptide concentrations were significantly lower (i.e., 33%, 43%, 40%, and 50% lower 120-min incremental AUC, respectively) after consumption of the coarse porridge than after the smooth porridge (P < 0.01). In vitro, starch digestion was slower in the coarse porridge than in the smooth porridge (33% less starch digested at 90 min, P < 0.05, paired t test). In vivo, the structural integrity of coarse particles (∼2 mm) of wheat endosperm was retained during gastroileal transit. Microscopic examination revealed a progressive loss of starch from the periphery toward the particle core. The structure of the test meal had no effect on the amount or pattern of RS output.Conclusion: The structural integrity of wheat e
Aljuraiban GS, Oude Griep LM, Chan Q, et al., 2015, Total, insoluble and soluble dietary fibre intake in relation to blood pressure: the INTERMAP Study., British Journal of Nutrition, Vol: 114, Pages: 1480-1486, ISSN: 1475-2662
Prospective cohort studies have shown inverse associations between fibre intake and CVD, possibly mediated by blood pressure (BP). However, little is known about the impact of types of fibre on BP. We examined cross-sectional associations with BP of total, insoluble and soluble fibre intakes. Data were used from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) study, including 2195 men and women aged between 40 and 59 years from the USA. During four visits, eight BP, four 24 h dietary recalls and two 24 h urine samples were collected. Linear regression models adjusted for lifestyle and dietary confounders to estimate BP differences per 2 sd higher intakes of total and individual types of fibre were calculated. After multivariable adjustment, total fibre intake higher by 6·8 g/4184 kJ (6·8 g/1000 kcal) was associated with a 1·69 mmHg lower systolic blood pressure (SBP; 95 % CI -2·97, -0·41) and attenuated to -1·01 mmHg (95 % CI -2·35, 0·34) after adjustment for urinary K. Insoluble fibre intake higher by 4·6 g/4184 kJ (4·6 g/1000 kcal) was associated with a 1·81 mmHg lower SBP (95 % CI -3·65, 0·04), additionally adjusted for soluble fibre and urinary K excretion, whereas soluble fibre was not associated with BP. Raw fruit was the main source of total and insoluble fibre, followed by whole grains and vegetables. In conclusion, higher intakes of fibre, especially insoluble, may contribute to lower BP, independent of nutrients associated with higher intakes of fibre-rich foods.
Byrne CS, Chambers ES, Morrison DJ, et al., 2015, The role of short chain fatty acids in appetite regulation and energy homeostasis, International Journal of Obesity, Vol: 39, Pages: 1331-1338, ISSN: 1476-5497
Over the last 20 years there has been an increasing interest in the influence of the gastrointestinal tract on appetite regulation.Much of the focus has been on the neuronal and hormonal relationship between the gastrointestinal tract and the brain. There isnow mounting evidence that the colonic microbiota and their metabolic activity have a significant role in energy homeostasis. Thesupply of substrate to the colonic microbiota has a major impact on the microbial population and the metabolites they produce,particularly short chain fatty acids (SCFAs). SCFAs are produced when non-digestible carbohydrates, namely dietary fibres andresistant starch, undergo fermentation by the colonic microbiota. Both the consumption of fermentable carbohydrates and theadministration of SCFAs have been reported to result in a wide range of health benefits including improvements in bodycomposition, glucose homeostasis, blood lipid profiles and reduced body weight and colon cancer risk. However, published studiestend to report the effects that fermentable carbohydrates and SCFAs have on specific tissues and metabolic processes, and fail toexplain how these local effects translate into systemic effects and the mitigation of disease risk. Moreover, studies tend toinvestigate SCFAs collectively and neglect to report the effects associated with individual SCFAs. Here, we bring together the recentevidence and suggest an overarching model for the effects of SCFAs on one of their beneficial aspects: appetite regulation andenergy homeostasis.
Chambers ES, Morrison DJ, Tedford MC, et al., 2015, A novel dietary strategy to increase colonic propionate production in humans and improve appetite regulation and bodyweight management, NUTRITION BULLETIN, Vol: 40, Pages: 227-230, ISSN: 1471-9827
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- Citations: 1
Wandrag L, Brett SJ, Frost G, et al., 2015, Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other muscle wasting illness: a systematic review, JOURNAL OF HUMAN NUTRITION AND DIETETICS, Vol: 28, Pages: 313-330, ISSN: 0952-3871
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- Citations: 36
Chambers ES, Morrison DJ, Frost G, 2015, Control of appetite and energy intake by SCFA: what are the potential underlying mechanisms?, PROCEEDINGS OF THE NUTRITION SOCIETY, Vol: 74, Pages: 328-336, ISSN: 0029-6651
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- Citations: 166
Charani E, Gharbi M, Frost G, et al., 2015, Antimicrobial therapy in obesity: a multicentre cross-sectional study., Journal of Antimicrobial Chemotherapy, Vol: 70, Pages: 2906-2912, ISSN: 1460-2091
Objectives Evidence indicates a relationship between obesity and infection. We assessed the prevalence of obesity in hospitalized patients and evaluated its impact on antimicrobial management.Methods Three National Health Service hospitals in London in 2011–12 were included in a cross-sectional study. Data from all adult admissions units and medical and surgical wards were collected. Patient data were collected from the medication charts and nursing and medical notes. Antimicrobial therapy was defined as ‘complicated’ if the patient's therapy met two or more of the following criteria: (i) second- or third-line therapy according to local policy; (ii) intravenous therapy where an alternative oral therapy was appropriate; (iii) longer than the recommended duration of therapy as per local policy recommendations; (iv) repeated courses of therapy to treat the same infection; and (v) specialist advice on antimicrobial therapy provided by the medical microbiology or infectious diseases teams.Results Of the 1014 patients included in this study, 22% (225) were obese, 69% (696) were normal/overweight and 9% (93) were underweight. Obese patients were significantly more likely to have more complicated antimicrobial therapy than normal/overweight and underweight patients (36% versus 19% and 23%, respectively, P = 0.002). After adjustment for hospital, age group, comorbidities and the type of infection, obese patients remained at significantly increased odds of receiving complicated antimicrobial therapy compared with normal/overweight patients (OR = 2.01, 95% CI 1.75–3.45).Conclusions One in five hospitalized patients is obese. Compared with the underweight and normal/overweight, the antimicrobial management in the obese is significantly more complicated.
Correia GDS, Ng KW, Wijeyesekera A, et al., 2015, Metabolic Profiling of Children Undergoing Surgery for Congenital Heart Disease, Critical Care Medicine, Vol: 43, Pages: 1467-1476, ISSN: 1530-0293
Inflammation and metabolism are closely interlinked.Both undergo significant dysregulation following surgery for congenitalheart disease, contributing to organ failure and morbidity.In this study, we combined cytokine and metabolic profilingto examine the effect of postoperative tight glycemic controlcompared with conventional blood glucose management onmetabolic and inflammatory outcomes in children undergoingcongenital heart surgery. The aim was to evaluate changes in keymetabolites following congenital heart surgery and to examinethe potential of metabolic profiling for stratifying patients in termsof expected clinical outcomes.Design: Laboratory and clinical study.Setting: University Hospital and Laboratory.Patients: Of 28 children undergoing surgery for congenital heartdisease, 15 underwent tight glycemic control postoperatively and13 were treated conventionally.Interventions: Metabolic profiling of blood plasma was undertakenusing proton nuclear magnetic resonance spectroscopy. A panel ofmetabolites was measured using a curve-fitting algorithm. Inflammatorycytokines were measured by enzyme-linked immunosorbentassay. The data were assessed with respect to clinical markers ofdisease severity (Risk Adjusted Congenital heart surgery score-1,Pediatric Logistic Organ Dysfunction, inotrope score, duration ofventilation and pediatric ICU-free days).Measurements and Main Results: Changes in metabolic andinflammatory profiles were seen over the time course from surgeryto recovery, compared with the preoperative state. Tight glycemiccontrol did not significantly alter the response profile. We identifiedeight metabolites (3-d-hydroxybutyrate, acetone, acetoacetate,citrate, lactate, creatine, creatinine, and alanine) associated withsurgical and disease severity. The strength of proinflammatoryresponse, particularly interleukin-8 and interleukin-6 concentrations,inversely correlated with PICU-free days at 28 days. The interleukin-6/interleukin-10ratio directly correlated wi
Umpleby M, Shojaee-Moradie F, Fielding B, et al., 2015, A DIET LOW IN SUGAR REDUCES THE PRODUCTION OF ATHEROGENIC LIPOPROTEINS IN MEN WITH HIGH LIVER FAT, 83rd Congress of the European-Atherosclerosis-Society (EAS), Publisher: ELSEVIER IRELAND LTD, Pages: E46-E46, ISSN: 0021-9150
Rahman M, Frost G, Scott JF, et al., 2015, CHARACTERISING HUMAN MONOCYTE SUBSETS AS LIPID VEHICLES FOLLOWING DIETARY STIMULI, 83rd Congress of the European-Atherosclerosis-Society (EAS), Publisher: ELSEVIER IRELAND LTD, Pages: E81-E81, ISSN: 0021-9150
Thangarajah D, Hyde MJ, Konteti VKS, et al., 2015, Systematic review: body composition in children with inflammatory bowel disease, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 42, Pages: 142-157, ISSN: 0269-2813
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- Citations: 41
Johnson LP, Walton GE, Psichas A, et al., 2015, Prebiotics modulate the effects of antibiotics on gut microbial diversity and functioning in vitro, Nutrients, Vol: 7, Pages: 4480-4497, ISSN: 2072-6643
Intestinal bacteria carry out many fundamental roles, such as the fermentation of non-digestible dietary carbohydrates to produce short chain fatty acids (SCFAs), which can affect host energy levels and gut hormone regulation. Understanding how to manage this ecosystem to improve human health is an important but challenging goal. Antibiotics are the front line of defence against pathogens, but in turn they have adverse effects on indigenous microbial diversity and function. Here, we have investigated whether dietary supplementation—another method used to modulate gut composition and function—could be used to ameliorate the side effects of antibiotics. We perturbed gut bacterial communities with gentamicin and ampicillin in anaerobic batch cultures in vitro. Cultures were supplemented with either pectin (a non-fermentable fibre), inulin (a commonly used prebiotic that promotes the growth of beneficial bacteria) or neither. Although antibiotics often negated the beneficial effects of dietary supplementation, in some treatment combinations, notably ampicillin and inulin, dietary supplementation ameliorated the effects of antibiotics. There is therefore potential for using supplements to lessen the adverse effects of antibiotics. Further knowledge of such mechanisms could lead to better therapeutic manipulation of the human gut microbiota.
Robinson SL, Hattersley J, Frost GS, et al., 2015, Maximal fat oxidation during exercise is positively associated with 24-hour fat oxidation and insulin sensitivity in young, healthy men, JOURNAL OF APPLIED PHYSIOLOGY, Vol: 118, Pages: 1415-1422, ISSN: 8750-7587
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- Citations: 60
Carter MC, Albar SA, Morris MA, et al., 2015, Development of a UK Online 24-h Dietary Assessment Tool: myfood24., Nutrients, Vol: 7, Pages: 4016-4032, ISSN: 2072-6643
Assessment of diet in large epidemiological studies can be costly and time consuming. An automated dietary assessment system could potentially reduce researcher burden by automatically coding food records. myfood24 (Measure Your Food on One Day) an online 24-h dietary assessment tool (with the flexibility to be used for multiple 24 h-dietary recalls or as a food diary), has been developed for use in the UK population. Development of myfood24 was a multi-stage process. Focus groups conducted with three age groups, adolescents (11-18 years) (n = 28), adults (19-64 years) (n = 24) and older adults (≥65 years) (n = 5) informed the development of the tool, and usability testing was conducted with beta (adolescents n = 14, adults n = 8, older adults n = 1) and live (adolescents n = 70, adults n = 20, older adults n = 4) versions. Median system usability scale (SUS) scores (measured on a scale of 0-100) in adolescents and adults were marginal for the beta version (adolescents median SUS = 66, interquartile range (IQR) = 20; adults median SUS = 68, IQR = 40) and good for the live version (adolescents median SUS = 73, IQR = 22; adults median SUS = 80, IQR = 25). Myfood24 is the first online 24-h dietary recall tool for use with different age groups in the UK. Usability testing indicates that myfood24 is suitable for use in UK adolescents and adults.
Chambers ES, Viardot A, Psichas A, et al., 2015, Effects of elevating colonic propionate on liver fat content in overweight adults with non-alcoholic fatty liver disease: a pilot study, Proceedings of the Nutrition Society, Vol: 74, Pages: E30-E30, ISSN: 1475-2719
Charani E, Gharbi M, Hickson M, et al., 2015, Lack of weight recording in patients being administered narrow therapeutic index antibiotics: a prospective cross-sectional study, BMJ Open, Vol: 5, ISSN: 2044-6055
Objectives Patient weight is a key measure for safe medication management and monitoring of patients. Here we report the recording of patient's body weight on admission in three hospitals in West London and its relationship with the prescription of antibiotic drugs where it is essential to have the body weight of the patient.Methods A prospective cross-sectional study was conducted in three teaching hospitals in West London. Data were collected during March 2011–September 2011 and July 2012–August 2012, from adult admissions units, medical and surgical wards. Data from each ward were collected on a single day to provide a point prevalence data on weight recording. Patient medication charts, nursing and medical notes were reviewed for evidence of weight and height recording together with all the medication prescribed for the patients. An observational study collecting data on the weight recording process was conducted on two randomly selected wards to add context to the data.Results Data were collected on 1012 patients. Weight was not recorded for 46% (474) of patients. Eighty-nine patients were prescribed a narrow therapeutic antibiotic, in 39% (35/89) of these weight was not recorded for the patient. Intravenous vancomycin was the most commonly prescribed antibiotic requiring therapeutic monitoring. In total 61 patients were receiving intravenous vancomycin and of these 44% (27/61) did not have their weight recorded. In the observational study, the most frequently identified barrier to weight not being recorded was interruptions to the admission process.Conclusions Despite the clinical importance of body weight measurement it is poorly recorded in hospitalised patients, due to interruptions to the workflow and heavy staff workloads. In antibiotics a correct, recent patient weight is required for accurate dosing and to keep drugs within the narrow therapeutic index, to ensure efficacy of prescribing and reduce toxicity.
Aljuraiban GS, Chan Q, Oude Griep L, et al., 2015, The impact of eating frequency and time of intake on nutrient quality and body mass index: The INTERMAP Study, a population-based study, Journal of the Academy of Nutrition and Dietetics, Vol: 115, Pages: 528-536.e1, ISSN: 2212-2672
BackgroundEpidemiologic evidence is sparse on the effect of dietary behaviors and diet quality on body mass index (BMI; calculated as kg/m2), which can be important drivers of the obesity epidemic.ObjectiveThis study investigated the relationships of frequency of eating and time of intake to energy density, nutrient quality, and BMI using data from the International Study on Macro/Micronutrients and Blood Pressure including 2,696 men and women aged 40 to 59 years from the United States and the United Kingdom.DesignThe International Study on Macro/Micronutrients and Blood Pressure is a cross-sectional investigation with four 24-hour dietary recalls and BMI measurements conducted between 1996 and 1999. Consumption of solid foods was aggregated into eating occasion. Nutrient density is expressed using the Nutrient Rich Food Index 9.3. The ratio of evening/morning energy intake was calculated; mean values of four visits were used.Statistical analyses performedCharacteristics across eating occasion categories are presented as adjusted mean with corresponding 95% CI. Multiple linear regression models were used to examine associations of eating occasions, ratio of evening/morning energy intake, dietary energy density, and Nutrient Rich Food Index 9.3 with BMI.ResultsCompared to participants with fewer than four eating occasions in 24 hours, those with six or more eating occasions in 24 hours had lower mean BMI (27.3 vs 29.0), total energy intake (2,129 vs 2,472 kcal/24 hours), dietary energy density (1.5 vs 2.1 kcal/g), and higher Nutrient Rich Food Index 9.3 (34.3 vs 28.1). In multiple regression analyses, higher evening intake relative to morning intake was directly associated with BMI; however, this did not influence the relationship between eating frequency and BMI.ConclusionsOur results suggest that a larger number of small meals may be associated with improved diet quality and lower BMI. This may have implications for behavioral approaches to controlling the obesity
Chambers E, Viardot A, Psichas A, et al., 2015, Effects of Elevating Colonic Propionate on Liver Fat Content in Adults with Non-Alcoholic Fatty Liver Disease, FASEB JOURNAL, Vol: 29, ISSN: 0892-6638
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Byrne C, Chambers E, Alhabeeb H, et al., 2015, Increased Colonic Propionate Reduces Anticipatory Food Reward Responses in the Human Striatum, FASEB JOURNAL, Vol: 29, ISSN: 0892-6638
Fiamoncini J, Frost G, Scheundel R, et al., 2015, Gender Differences in Bile Acid Kinetics After Dietary Challenges, Experimental Biology Meeting, Publisher: FEDERATION AMER SOC EXP BIOL, ISSN: 0892-6638
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Sam AH, Sleeth ML, Thomas EL, et al., 2015, Circulating pancreatic polypeptide concentrations predict visceral and liver fat content, Journal of Clinical Endocrinology and Metabolism, Vol: 100, Pages: 1048-1052, ISSN: 0021-972X
Context and objective:No current biomarker can reliably predict visceral and liver fat content, both of which are risk factors for cardiovascular disease. Vagal tone has been suggested to influence regional fat deposition. Pancreatic polypeptide (PP) is secreted from the endocrine pancreas under vagal control. We investigated the utility of PP in predicting visceral and liver fat.Patients and Methods:Fasting plasma PP concentrations were measured in 104 overweight and obese subjects (46 men and 58 women). In the same subjects, total and regional adipose tissue, including total visceral adipose tissue (VAT) and total subcutaneous adipose tissue (TSAT), were measured using whole-body magnetic resonance imaging. Intrahepatocellular lipid content (IHCL) was quantified by proton magnetic resonance spectroscopy.Results:Fasting plasma PP concentrations positively and significantly correlated with both VAT (r = 0.57, P < .001) and IHCL (r = 0.51, P < .001), but not with TSAT (r = 0.02, P = .88). Fasting PP concentrations independently predicted VAT after controlling for age and sex. Fasting PP concentrations independently predicted IHCL after controlling for age, sex, body mass index (BMI), waist-to-hip ratio, homeostatic model assessment 2-insulin resistance, (HOMA2-IR) and serum concentrations of triglyceride (TG), total cholesterol (TC), and alanine aminotransferase (ALT). Fasting PP concentrations were associated with serum ALT, TG, TC, low- and high-density lipoprotein cholesterol, and blood pressure (P < .05). These associations were mediated by IHCL and/or VAT. Fasting PP and HOMA2-IR were independently significantly associated with hepatic steatosis (P < .01).Conclusions:Pancreatic polypeptide is a novel predictor of visceral and liver fat content, and thus a potential biomarker for cardiovascular risk stratification and targeted treatment of patients with ectopic fat deposition.
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