Greater fruit selection following an appearance-based compared with a health-based health promotion poster

Background: This study investigated the impact of an appearance-based compared to a traditional health-based public health message for healthy eating. Methods: 166 British University students (41 male; aged 20.6±1.9 years) were randomized to view either an appearance-based (n=82) or a health-based (n=84) fruit promotion poster. Intentions to consume fruit and immediate fruit selection (laboratory observation) were assessed immediately after poster-viewing and subsequent self-report fruit consumption was assessed 3 days later. Results: Intentions to consume fruit were not predicted by poster type (β=0.03, p=0.74), but were associated with fruit-based liking, past consumption, attitudes, and social norms (smallest β=0.16, p=0.04). Immediate fruit selection was greater following the appearance-based compared to the health-based poster (β=-0.24, p<0.01), and this effect remained when controlling for participant characteristics (β=-0.21, p<0.01). Subsequent fruit consumption was greater following the appearance-based compared to the health-based poster (β=-0.22, p=0.03), but this effect became non-significant on consideration of participant characteristics (β=-0.15, p=0.13), and was instead associated with fruit-based liking and past consumption (smallest β=0.24, p=0.03). Conclusions: These findings demonstrate the clear value of an appearance-based compared to a health-based health promotion poster for increasing fruit selection. A distinction between outcome measures, and the value of a behavioural measure is also demonstrated

Developing and evaluating a model of public involvement and engagement embedded in a national longitudinal study : HealthWise Wales

Acknowledgements: We acknowledge and thank the contribution of all the HWW Champion and Supporters who provided input to the protocol, collaborated with the research team and attended the events. We also thank Ameeta Richardson who helped facilitate the HWW Champion model. Funding HWW is funded by Health and Care Research Wales.Peer reviewedPublisher PD

Do carers care for themselves? A population-based study

Background Informal caregiving has become an integral part of many societies, however there is increasing concern about the well-being of carers and how they manage their care-related responsibilities in conjunction with their health and mental health. Previous studies have reported mixed results with some proposing that carers are intrinsically healthier. Aims To explore the association between different levels of caregiving and health behaviours and mental health status. Methods Data were collected through HealthWise Wales (HWW) and linked to healthcare records (N=27,455). These included self-reported data on level of caring responsibilities (0;1-19;20-49;50+ hours per week), whether or not they left employment due to their caring role, mental health using the short Mental Health Inventory (MHI-5) and health behaviour data on smoking status, physical activity and dietary habits. Data on current diagnosis of Anxiety and Depression were drawn from linked healthcare records. Separate logistic regression models adjusted for age, gender and socio-economic status were fitted to assess the association between intensity of caring responsibility and each mental health and health behaviour outcome. Results Of the 14,451 HWW participants who had complete records, 3,856 (26.7%) reported being an informal carer. Intense carers (20-49 hours per week) were more likely to be physically inactive (OR:1.27, 95%CI:1.04-1.56), smoke cigarettes (OR:1.49, 95%CI:1.11-2.00) and eat unhealthily (OR:1.48, 95%CI:1.13-1.93). They were more also likely to self-report (OR:1.87, 95%CI:1.51-2.32) or have a diagnosis of depression or anxiety (OR:1.57, 95%CI:1.26-1.97). Other levels of caregiving intensity also demonstrated the above associations. Carers who had given up work to care were more likely to be smokers and have common mental disorders. Conclusion Being an informal carer is associated with unhealthy behaviours and common mental disorders, with a gradient effect dependent on the level of caregiving activity. New interventions that can support carers to improve their health and wellbeing are urgently needed

Estimation of the prevalence of cholesteryl ester storage disorder in a cohort of patients with clinical features of familial hypercholesterolaemia

Background and aim Familial hypercholesterolaemia is caused by variants in the low-density lipoprotein cholesterol metabolic pathway involving LDLR, APOB and PCSK9 genes. A national genetic testing service in Wales, UK has observed that no familial hypercholesterolaemia variant is found in almost 80% patients with the familial hypercholesterolaemia phenotype. It has recently been suggested that some adult patients with a familial hypercholesterolaemia phenotype may have cholesteryl ester storage disease which can also present as a mixed hyperlipidaemia. The commonest genetic cause of cholesteryl ester storage disease is an exon 8 splice junction variant in the LIPA gene (rs116928232, c.894G>A; E8SJM) previously found to have an allele frequency of 0.0011 (1 in 450 individuals) in a large European population. This study investigated the prevalence of the E8SJM in patients with a familial hypercholesterolaemia phenotype in Wales, UK. Method A total of 1203 patients with a clinical suspicion of familial hypercholesterolaemia but no familial hypercholesterolaemia variant were invited to participate. Of these, 668 patients provided informed written consent. Stored DNA samples from 663 patients were genotyped for the E8SJM variant. Results Three heterozygotes were identified (allele frequency 0.0023). Whole gene sequencing of the LIPA gene was undertaken in these three individuals, but no other variants were found. Therefore, there were no cholesteryl ester storage disease patients (homozygote or compound heterozygote) identified in this cohort. Conclusion The allele frequency 0.0023 (1 in 221 individuals) for the E8SJM variant was more prevalent in this cohort than in a European population study; however, no cholesteryl ester storage disease homozygotes were identified. We found no evidence to support routine testing for cholesteryl ester storage disease in adult patients with a familial hypercholesterolaemia phenotype

Cohort profile: HealthWise Wales. A research register and population health data platform with linkage to National Health Service data sets in Wales

Peer reviewedPublisher PD

Estimation of the prevalence of cholesteryl ester storage disorder in a cohort of patients with clinical features of familial hypercholesterolaemia

Background and aim Familial hypercholesterolaemia is caused by variants in the low-density lipoprotein cholesterol metabolic pathway involving LDLR, APOB and PCSK9 genes. A national genetic testing service in Wales, UK has observed that no familial hypercholesterolaemia variant is found in almost 80% patients with the familial hypercholesterolaemia phenotype. It has recently been suggested that some adult patients with a familial hypercholesterolaemia phenotype may have cholesteryl ester storage disease which can also present as a mixed hyperlipidaemia. The commonest genetic cause of cholesteryl ester storage disease is an exon 8 splice junction variant in the LIPA gene (rs116928232, c.894G>A; E8SJM) previously found to have an allele frequency of 0.0011 (1 in 450 individuals) in a large European population. This study investigated the prevalence of the E8SJM in patients with a familial hypercholesterolaemia phenotype in Wales, UK. Method A total of 1203 patients with a clinical suspicion of familial hypercholesterolaemia but no familial hypercholesterolaemia variant were invited to participate. Of these, 668 patients provided informed written consent. Stored DNA samples from 663 patients were genotyped for the E8SJM variant. Results Three heterozygotes were identified (allele frequency 0.0023). Whole gene sequencing of the LIPA gene was undertaken in these three individuals, but no other variants were found. Therefore, there were no cholesteryl ester storage disease patients (homozygote or compound heterozygote) identified in this cohort. Conclusion The allele frequency 0.0023 (1 in 221 individuals) for the E8SJM variant was more prevalent in this cohort than in a European population study; however, no cholesteryl ester storage disease homozygotes were identified. We found no evidence to support routine testing for cholesteryl ester storage disease in adult patients with a familial hypercholesterolaemia phenotype