Knowledge gaps that hamper prevention and control of Mycobacterium avium subspecies paratuberculosis infection

In the last decades, many regional and country‐wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were not followed, including the introduction of infected replacement cattle, because tests to identify infected animals were unreliable, and uptake by farmers was not high enough because of a perceived low return on investment. In the absence of a cure or effective commercial vaccines, control of JD is currently primarily based on herd management strategies to avoid infection of cattle and restrict within‐farm and farm‐to‐farm transmission. Although JD control programmes have been implemented in most developed countries, lessons learned from JD prevention and control programmes are underreported. Also, JD control programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps.http://wileyonlinelibrary.com/journal/tbed2019-05-01hj2018Veterinary Tropical Disease

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Parents, portions and potential distortions : Unpicking children's meal size

Parents and caregivers play a powerful role in shaping the food environment in which their children learn about appropriate portion sizes. Parents often report just 'knowing' the amount of food to serve to their children, but evidence indicates that these decisions are driven by the portions parents pick for themselves. This is potentially problematic because, like adults, young children are susceptible to overeating when served large portions, which raises questions about how and when children develop their own portion knowledge. Understanding the social, emotional and cultural factors that shape children's learning about appropriate portion sizes and self-regulation will lead to a better understanding of the calories that end up on children's plates and in their mouths, and the eating behaviours that define them as adults

Sensory influences on food intake control : Moving beyond palatability

The sensory experience of eating is an important determinant of food intake control, often attributed to the positive hedonic response associated with certain sensory cues. However, palatability is just one aspect of the sensory experience. Sensory cues based on a food's sight, smell, taste and texture are operational before, during and after an eating event. The focus of this review is to look beyond palatability and highlight recent advances in our understanding of how certain sensory characteristics can be used to promote better energy intake control. We consider the role of visual and odour cues in identifying food in the near environment, guiding food choice and memory for eating, and highlight the ways in which tastes and textures influence meal size and the development of satiety after consumption. Considering sensory characteristics as a functional feature of the foods and beverages we consume provides the opportunity for research to identify how sensory enhancements might be combined with energy reduction in otherwise palatable foods to optimize short-term energy intake regulation in the current food environment. Moving forward, the challenge for sensory nutritional science will be to assess the longer-term impact of these principles on weight management

Removing energy from a beverage influences later food intake more than the same energy addition

Designing reduced-calorie foods and beverages without compromising their satiating effect could benefit weight management, assuming that consumers do not compensate for the missing calories at other meals. Though research has demonstrated that compensation for overfeeding is relatively limited, the extent to which energy reductions trigger adjustments in later food intake is less clear. The current study tested satiety responses (characterised by changes in appetite and later food intake) to both a covert 200 kcal reduction and an addition of maltodextrin to a soymilk test beverage. Twenty-nine healthy male participants were recruited to consume three sensory-matched soymilk beverages across four non-consecutive study days: a medium energy control (ME: 300 kcal) and a lower energy (LE: 100 kcal) and higher energy (HE: 500 kcal) version. The ME control was consumed twice to assess individual consistency in responses to this beverage. Participants were unaware of the energy differences across the soymilks. Lunch intake 60 min later increased in response to the LE soymilk, but was unchanged after consuming the HE version. These adjustments accounted for 40% of the energy removed from the soymilk and 13% of the energy added in. Rated appetite was relatively unaffected by the soymilk energy content. No further adjustments were noted for the rest of the day. These data suggest that adult men tested were more sensitive to calorie dilution than calorie addition to a familiar beverage

Children's Eating Behaviors and Energy Intake: Overlapping Influences and Opportunities for Intervention

10.1159/000493695Nestle Nutrition Institute Workshop Series9155-67GUSTO (Growing up towards Healthy Outcomes

Combined impact of a faster self-reported eating rate and higher dietary energy intake rate on energy intake and adiposity

10.3390/nu12113264Nutrients12111-No

Ultra-Processing or Oral Processing? A Role for Energy Density and Eating Rate in Moderating Energy Intake from Processed Foods

10.1093/cdn/nzaa019Current Developments in Nutrition43nzaa01

Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake

Background:Substituting sweeteners with non-nutritive sweeteners (NNS) may aid in glycaemic control and body weight management. Limited studies have investigated energy compensation, glycaemic and insulinaemic responses to artificial and natural NNS.Objectives:This study compared the effects of consuming NNS (artificial versus natural) and sucrose (65 g) on energy intake, blood glucose and insulin responses.Methods:Thirty healthy male subjects took part in this randomised, crossover study with four treatments: aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages. On each test day, participants were asked to consume a standardised breakfast in the morning, and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption. Blood glucose and insulin concentrations were measured every 15 min within the first hour of preload consumption and every 30 min for the subsequent 2 h. Participants left the study site 3 h after preload consumption and completed a food diary for the rest of the day.Results:Ad libitum lunch intake was significantly higher for the NNS treatments compared with sucrose (P=0.010). The energy 'saved' from replacing sucrose with NNS was fully compensated for at subsequent meals; hence, no difference in total daily energy intake was found between the treatments (P=0.831). The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour, whereas these responses were higher for all three NNS beverages following the test lunch. Thus, there were no differences in total area under the curve (AUC) for glucose (P=0.960) and insulin (P=0.216) over 3 h between the four test beverages.Conclusions:The consumption of calorie-free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake, postprandial glucose and insulin compared with a sucrose-sweetened beverage

Geochemical evolution of magmatism in an arc - arc collision: the Halmahera and Sangihe arcs, eastern Indonesia.

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