Anthropometric Indicators of Adiposity related to Body Weight and Body Shape as Cardiometabolic Risk Predictors in British young adults: Superiority of Waist to Height Ratio

Frequently reported poor dietary habits of young adults increases their risk of metabolic syndrome (MetS). Excess adiposity is the most established predictor of MetS and numerous anthropometric measures have been proposed as proxy indicators of adiposity. We aimed to assess prevalence of MetS in young adult population, and to make comparison between weight and shape oriented measures of adiposity to identify the best index in association with measured body fat and as risk predictor for MetS. Healthy males and females aged 18–25 years from the Northwest of England were recruited using convenience sampling (n=550). As part of the assessment of the overall health of young adults, the biochemical variables and adiposity measures BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), new BMI, Body Adiposity Index (BAI), Clinica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and A Body Shape Index (ABSI)) were assessed. Linear regression analysis was used to investigate the association between the proxy indices of adiposity and measured percentage body fat. The odds ratio with 95% confidence interval was used to investigate the relationship between cardiometabolic (CM) risk factors and proxy measures of adiposity. The discriminatory power of these measures for diagnosis of MetS was investigated using area under the receiver operating characteristic curve. Body weight related indicators of adiposity, particularly CUN-BAE, had stronger association with measured body fat compared with body shape related indices. In relation with MetS, body shape related indices, particularly elevated WC and WHtR, had stronger associations with CM risk compared with body weight related measures. Amongst all indices, the best predictor for CM risk was WHtR; while, ABSI had the weakest correlation with body fat, MetS and CM risk. Indices directly associated with WC and specifically WHtR had greater diagnostic power in detection of CM risk in young adults

Estimates of fibre intake and percentage of the population with intake below the dietary reference values (DRVs) in England (1991–2015)

This article has been accepted for publication and will appear in a revised form, subsequent to peer review and/or editorial input by Cambridge University Press, in Proceedings of the Nutrition Society published by Cambridge University Press. Copyright The Authors 2016.In 1991, the Committee on Medical Aspects of Foods (COMA) defined dietary fibre as non-starch polysaccharides (NSP) and set the DRV as the population average intake of 18 g/day 1 , determined using the Englyst method of analysis 2 . The latest publication of the Scientific Advisory Committee on Nutrition (SACN) 3 broadened the definition of dietary fibre beyond NSP to broader definition of Association of Analytical Communities (AOAC) fibre, recommending the DRV to be 30 g/day based on AOAC method. The COMA 1991, DRV of 18 g/day of NSP corresponds to around 24 g/day of AOAC fibre 3 and therefore the new DRV of fibre would represent a higher recommendation (around 22·5 g fibre as per the Englyst method) for the average population. The purpose of this study was to investigate variation in fibre intake of English population by age and gender, in comparison with the COMA and SACN DRVs. Data on the core sample of the National Diet and Nutrition Survey rolling programme from 2008–2012 was reanalysed. Children aged below 16 years were excluded in consideration of their different DRVs. The data on dietary fibre was extracted from fully productive individuals (i.e. participants who completed three/four diary days), as an average daily intake based on the NSP/Englyst fibre. Inferential statistics included the analysis of variance to discover if there were any significant variations in fibre intake of males and females in relation to their age groups. The statistical significance was set at 0·05. For all age groups, the average fibre intake is below the DRVs. The average daily fibre intake slightly increased with age for both genders until 64 years. When differences in energy intake were taken into account, the average daily fibre density (g/1000 kcal) still increased with the age of participants. Overall, less than a third of populations had an intake above the COMA DRV 1 . More than 90 % of the population had intake below the SACN DRV 3 , demonstrating a challenge for future policies to meet the nutritional guidelines, particularly amongst females and younger adults. The findings should be treated with caution considering the definition of AOAC fibre used as the basis for the SACN DRV includes non-digestible oligosaccharides, resistant starch and polydextrose, going beyond NSP/Englyst variables analysed

Reliability, validity, and gender invariance of the exercise benefits/barriers scale: An emerging evidence for a more concise research tool

© 2021 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/ijerph18073516The Exercise Benefits/Barriers Scale (EBBS) research instrument has been extensively used to investigate the perceived benefits and barriers of exercise in a range of settings. In order to examine theoretical contentions and translate the findings, it is imperative to implement measurement tools that operationalize the constructs in an accurate and reliable way. The original validation of the EBBS proposed a nine-factor structure for the research tool, examined the EBBS factor structure, and suggested that various factors are important for the testing of the perception of exercise benefits and barriers, whereas a few items and factors may not be vital. The current study conducted a confirmatory factor analysis (CFA) using hierarchical testing in 565 participants from the northwest region of the United Kingdom, the results of which provided evidence for a four-factor structure of the benefits measure, with the Comparative Fit Index (CFI) = 0.943, Tucker-Lewis Index (TLI) = 0.933, and root means square error of approximation (RMSEA) = 0.051, namely life enhancement, physical performance, psychological outlook, and social interaction, as well as a two-factor structure of the barrier measures, with the CFI = 0.953, TLI = 0.931, and RMSEA = 0.063, including exercise milieu and time expenditure. Our findings showed that for a six-factor correlated model, the CFI = 0.930, TLI = 0.919, and RMSEA = 0.046. The multi-group CFA provided support for gender invariance. The results indicated that after three decades of the original validation of the EBBS, many of the core factors and items are still relevant for the assessment of higher-order factors; however, the 26-item concise tool proposed in the current study displays a better parsimony in comparison with the original 43-item questionnaire. Overall, the current study provides support for a reliable, cross-culturally valid EBBS within the UK adult population, however, it proposes a shorter and more concise version compared with the original tool, and gives direction for future research to focus on the content validity for assessing the perception of the barriers to physical activity.Published versio

Dietetic students' drivers and barriers to healthy eating while studying to be a healthcare professional (a pilot study)

© 2021 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/healthcare9050579For Dietetics students, starting university means developing the knowledge and skills required to be a healthcare practitioner. This pilot study aimed to explore the perceptions and views of the students on their drivers and barriers of healthy eating while studying Dietetics at university. A qualitative study was undertaken with a purposive sample of six final year Dietetic students at a UK university. Semi-structured in-depth interviews were used to elicit students' experiences and perceptions of barriers to healthy eating. Interview data were analysed thematically. Five themes emerged from the interview data including studying Dietetics, placement, influence of significant others, food security, and social and cultural aspects of the university life, with several sub-themes, and perspectives about the future beyond the university life. The findings suggest a potential need for Dietetics course providers to consider the range of barriers to healthy eating that students may encounter whilst studying and how these may undermine their ability to develop healthy eating practices and effective professional skills. Further research is required that explores the extent of barriers to healthy eating and examine whether these impinge upon effective practice.Published versio

Diagnostic power of circulatory metabolic biomarkers as metabolic syndrome risk predictors in community-dwelling older adults in Northwest of England (a feasibility study)

© 2021 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/nu13072275Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06-1.64)), TNF-α (OR: 1.37 (1.02-1.84)), Resistin (OR: 1.27 (1.04-1.54)) and CRP (OR: 1.29 (1.09-1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16-1.53)) and MetS risk (OR: 1.24 (1.12-1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24-2.83) and OR: 1.25 (1.09-1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683-0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653-0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.Published versio

A2 milk enhances dynamic muscle function following repeated sprint exercise, a possible ergogenic aid for a1-protein intolerant athletes?

�� 2019 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher���s website: https://doi.org/10.3390/nu9020094Hyperaminoacidemia following ingestion of cows-milk may stimulate muscle anabolism and attenuate exercise-induced muscle damage (EIMD). However, as dairy-intolerant athletes do not obtain the reported benefits from milk-based products, A2 milk may offer a suitable alternative as it lacks the A1-protein. This study aimed to determine the effect of A2 milk on recovery from a sports-specific muscle damage model. Twenty-one male team sport players were allocated to three independent groups: A2 milk (n = 7), regular milk (n = 7), and placebo (PLA) (n = 7). Immediately following muscle-damaging exercise, participants consumed either A2 milk, regular milk or PLA (500 mL each). Visual analogue scale (muscle soreness), maximal voluntary isometric contraction (MVIC), countermovement jump (CMJ) and 20-m sprint were measured prior to and 24, 48, and 72 h post EIMD. At 48 h post-EIMD, CMJ and 20-m sprint recovered quicker in A2 (33.4 �� 6.6 and 3.3 �� 0.1, respectively) and regular milk (33.1 �� 7.1 and 3.3 �� 0.3, respectively) vs. PLA (29.2 �� 3.6 and 3.6 �� 0.3, respectively) (p < 0.05). Relative to baseline, decrements in 48 h CMJ and 20-m sprint were minimised in A2 (by 7.2 and 5.1%, respectively) and regular milk (by 6.3 and 5.2%, respectively) vs. PLA. There was a trend for milk treatments to attenuate decrements in MVIC, however statistical significance was not reached (p = 0.069). Milk treatments had no apparent effect on muscle soreness (p = 0.152). Following muscle-damaging exercise, ingestion of 500 mL of A2 or regular milk can limit decrements in dynamic muscle function in male athletes, thus hastening recovery and improving subsequent performance. The findings propose A2 milk as an ergogenic aid following EIMD, and may offer an alternative to athletes intolerant to the A1 protein.Published versio

Effects of exercise and whey protein on muscle mass, fat mass, myoelectrical muscle fatigue and health-related quality of life in older adults: a secondary analysis of the Liverpool Hope University-Sarcopenia Ageting Trial (LHU-SAT)

Purpose To investigate the efects of exercise in combination with, or without, a leucine-enriched whey protein supplement on muscle mass, fat mass, myoelectrical muscle fatigue and health-related quality of life (HR-QOL) in older adults. Methods 100 community-dwelling older adults [52% women, age: 69±6years (mean±SD)] were randomised to four [Control (C); Exercise (E); Exercise + Protein (EP); Protein (P)] independent groups. E and EP groups completed 16 weeks of exercise [resistance (2 times/week) and functional (1 time/week]. EP and P groups were also administered a leucine-enriched whey protein supplement (3 times/day) based on body weight (1.5 g/kg/day). Muscle and fat mass (bioelectrical impedance analysis), myoelectrical muscle fatigue (surface electromyography) and HR-QOL (WHOQOL-BREF) were measured pre- and post-intervention. Results At post-intervention, the rectus femoris (E:−4.8%/min, p=0.007, ES=0.86; EP:−3.3%/min, p=0.045,ES=0.58) and bicep femoris (E: − 3.9%/min, p 0.05). Conclusion Physical exercise is a potent method to improve myoelectrical muscle fatigue and HR-QOL in older adults. However, leucine-enriched whey protein did not augment this response in those already consuming suicient quantities of protein at trial enrolment

The Effect of Carbohydrate Restriction on Lipids, Lipoproteins, and Nuclear Magnetic Resonance-Based Metabolites: CALIBER, a Randomised Parallel Trial

Low-carbohydrate high-fat (LCHF) diets can be just as effective as high-carbohydrate, lower-fat (HCLF) diets for improving cardiovascular disease risk markers. Few studies have compared the effects of the UK HCLF dietary guidelines with an LCHF diet on lipids and lipoprotein metabolism using high-throughput NMR spectroscopy. This study aimed to explore the effect of an ad libitum 8-week LCHF diet compared to an HCLF diet on lipids and lipoprotein metabolism and CVD risk factors. For 8 weeks, n = 16 adults were randomly assigned to follow either an LCHF (n = 8, <50 g CHO p/day) or an HCLF diet (n = 8). Fasted blood samples at weeks 0, 4, and 8 were collected and analysed for lipids, lipoprotein subclasses, and energy-related metabolism markers via NMR spectroscopy. The LCHF diet increased (p < 0.05) very small VLDL, IDL, and large HDL cholesterol levels, whereas the HCLF diet increased (p < 0.05) IDL and large LDL cholesterol levels. Following the LCHF diet alone, triglycerides in VLDL and HDL lipoproteins significantly (p < 0.05) decreased, and HDL phospholipids significantly (p < 0.05) increased. Furthermore, the LCHF diet significantly (p < 0.05) increased the large and small HDL particle concentrations compared to the HCLF diet. In conclusion, the LCHF diet may reduce CVD risk factors by reducing triglyceride-rich lipoproteins and improving HDL functionality

The Effect of Dietary Carbohydrate and Fat Manipulation on the Metabolome and Markers of Glucose and Insulin Metabolism: A Randomised Parallel Trial.

From Europe PMC via Jisc Publications RouterHistory: ppub 2022-09-01, epub 2022-09-07Publication status: PublishedHigh carbohydrate, lower fat (HCLF) diets are recommended to reduce cardiometabolic disease (CMD) but low carbohydrate high fat (LCHF) diets can be just as effective. The effect of LCHF on novel insulin resistance biomarkers and the metabolome has not been fully explored. The aim of this study was to investigate the impact of an ad libitum 8-week LCHF diet compared with a HCLF diet on CMD markers, the metabolome, and insulin resistance markers. n = 16 adults were randomly assigned to either LCHF (n = 8, &lt;50 g CHO p/day) or HCLF diet (n = 8) for 8 weeks. At weeks 0, 4 and 8, participants provided fasted blood samples, measures of body composition, blood pressure and dietary intake. Samples were analysed for markers of cardiometabolic disease and underwent non-targeted metabolomic profiling. Both a LCHF and HCLF diet significantly (p &lt; 0.01) improved fasting insulin, HOMA IR, rQUICKI and leptin/adiponectin ratio (p &lt; 0.05) levels. Metabolomic profiling detected 3489 metabolites with 78 metabolites being differentially regulated, for example, an upregulation in lipid metabolites following the LCHF diet may indicate an increase in lipid transport and oxidation, improving insulin sensitivity. In conclusion, both diets may reduce type 2 diabetes risk albeit, a LCHF diet may enhance insulin sensitivity by increasing lipid oxidation

The Effect of Dietary Carbohydrate and Fat Manipulation on the Metabolome and Markers of Glucose and Insulin Metabolism: A Randomised Parallel Trial

From MDPI via Jisc Publications RouterHistory: received 2022-07-22, accepted 2022-08-24, collection 2022-09, epub 2022-09-07Peer reviewed: TrueArticle version: VoRPublication status: PublishedFunder: Liverpool John Moores UniversityHigh carbohydrate, lower fat (HCLF) diets are recommended to reduce cardiometabolic disease (CMD) but low carbohydrate high fat (LCHF) diets can be just as effective. The effect of LCHF on novel insulin resistance biomarkers and the metabolome has not been fully explored. The aim of this study was to investigate the impact of an ad libitum 8-week LCHF diet compared with a HCLF diet on CMD markers, the metabolome, and insulin resistance markers. n = 16 adults were randomly assigned to either LCHF (n = 8, <50 g CHO p/day) or HCLF diet (n = 8) for 8 weeks. At weeks 0, 4 and 8, participants provided fasted blood samples, measures of body composition, blood pressure and dietary intake. Samples were analysed for markers of cardiometabolic disease and underwent non-targeted metabolomic profiling. Both a LCHF and HCLF diet significantly (p < 0.01) improved fasting insulin, HOMA IR, rQUICKI and leptin/adiponectin ratio (p < 0.05) levels. Metabolomic profiling detected 3489 metabolites with 78 metabolites being differentially regulated, for example, an upregulation in lipid metabolites following the LCHF diet may indicate an increase in lipid transport and oxidation, improving insulin sensitivity. In conclusion, both diets may reduce type 2 diabetes risk albeit, a LCHF diet may enhance insulin sensitivity by increasing lipid oxidation