The role of family income and other factors in understanding the food and eating practices of young people in the UK: A mixed methods approach

In the UK there are well recognised socio-economic inequalities in diet and health. However, research about dietary inequalities rarely focuses on young people. Whilst some qualitative research has studied how low-income families manage food and eating, less has examined or compared young people’s food practices in more affluent families. This study takes a mixed methods approach to examine the role of family income and other factors in understanding the food and eating practices of young people (aged 11 – 16 years) in higher-income and lower-income families at home and school. To examine the relationship with young people’s diet quality, secondary analyses of the National Diet and Nutrition Survey (NDNS; 2008/09 - 2013/14) was carried out. To explore the ways in which young people’s diets and food practices are shaped by different contexts, the study employed a case approach using a range of qualitative methods with young people in six higher and 30 lower-income families from one inner London borough. Quantitative analyses of the NDNS show that as household income increases young people’s diet quality also increases. Other factors also appeared to be important: family food purchasing, the young person’s sex, takeaway consumption and mothers’ employment. The qualitative analyses of cases found that lower family income generally constrained the household food budget, limiting young people’s access to quality fresh food. In contrast, higher family income meant families spent more on food and young people had greater access to more nutritious foods. Mothers’ working hours and family food practices related to parental ethnicity were also important. Whilst challenges of bringing together the different data and analyses are noted, it is argued that, in combination, they provide a fuller and more nuanced picture of the ways in which income and other factors influence the diets and food practices of young people

Scottish Food Practices: Household food practices and the use of dietary information

© 2020 The Author(s). This an open access work distributed under the terms of the Creative Commons Attribution Licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.This report presents findings from The Scottish Food Practices study, designed to investigate what and how households across Scotland use dietary information (if at all) when cooking/eating at home, shopping for food and eating outside the home.The study aims to inform the work of Food Standards Scotland (FSS) as they develop new dietary guidance that is accessible and suitable for different population groups in Scotland. The study explores the extent to which dietary information was available, and how it was perceived and taken into account by households when cooking, eating and purchasing food, both in and outside of the home.The study adopted an in-depth qualitative approach with ten households, including those on low incomes, families with younger and older children, single-person households and older adults. Participants were recruited via networks of third sector and food advocacy organisations, as well as via NHS and FSS contacts. Fieldwork with participating households took place between January and March 2020; it ended earlier than planned, due to the social distancing restrictions put in place to control the COVID-19 outbreak.The research design comprised of three visits with each household.1. A semi-structured interview was carried out with the key participant (and other household members if they wished), followed by a photographic ‘kitchen tour’. Participants were asked about their typical patterns of cooking/eating at home, food shopping, and eating outside the home, with particular reference to dietary information.2. A video-recorded food shopping trip was conducted with the household member who was primarily responsible for food shopping in each household.3. An observation took place with one or more household members when ‘eating out of home’.Across households, participants reported having a good general understanding of dietary information. Nonetheless, this knowledge seemed to be inconsistently or rarely applied by households when purchasing food, or when eating in and out of the home. This was a consequence of participants’ apparent misunderstanding of some of the information available to them, contradictions in guidance as perceived by participants, and participants’ reliance on knowledge gained through their own lives or experiences (experiential knowledge). Price was the key deciding factor informing participants’ food purchasing decisions, except in cases where health conditions and/or special dietary requirements made it essential to pay closer attention to dietary information on food packaging.The research provides some pointers for FSS regarding the development of dietary guidance in terms of clarity of information required by consumers. This relates to addressing the interpretation of traffic light labelling and the incorporation of guidance into a healthy diet for those living with/shopping for specific health conditions, allergies, intolerances or preferences. Using price and ‘value for money’ could be a way to leverage healthier food choices in Scotland. Experiential, ‘common sense’ knowledge is important to households therefore an understanding and awareness of this, including among health care professionals, is important when considering the acceptability and efficacy of dietary guidance or information. COVID-19 has impacted on many aspects of food and eating for people in Scotland, perhaps especially so for those whose income, health or vulnerability has been affected in some way. Finding ways to support households to manage their physical and mental health and dietary preferences/needs, despite these ongoing challenges, therefore continues to be important.Final Published versio

Gut-seeded α-synuclein fibrils promote gut dysfunction and brain pathology specifically in aged mice

Parkinson’s disease is a synucleinopathy that is characterized by motor dysfunction, death of midbrain dopaminergic neurons and accumulation of α-synuclein (α-Syn) aggregates. Evidence suggests that α-Syn aggregation can originate in peripheral tissues and progress to the brain via autonomic fibers. We tested this by inoculating the duodenal wall of mice with α-Syn preformed fibrils. Following inoculation, we observed gastrointestinal deficits and physiological changes to the enteric nervous system. Using the AAV-PHP.S capsid to target the lysosomal enzyme glucocerebrosidase for peripheral gene transfer, we found that α-Syn pathology is reduced due to the increased expression of this protein. Lastly, inoculation of α-Syn fibrils in aged mice, but not younger mice, resulted in progression of α-Syn histopathology to the midbrain and subsequent motor defects. Our results characterize peripheral synucleinopathy in prodromal Parkinson’s disease and explore cellular mechanisms for the gut-to-brain progression of α-Syn pathology

Initiation of antidepressant medication and risk of incident stroke: using the Adult Changes in Thought cohort to address time-varying confounding

Purpose Depression strongly predicts stroke incidence, suggesting that treating depression may reduce stroke risk. Antidepressant medications, however, may increase stroke risk via direct pathways. Previous evidence on antidepressant medication and stroke incidence is mixed. We evaluated associations between antidepressant use and incident stroke. Methods For 2302 Adult Changes in Thought cohort participants with no stroke at study entry, we characterized antidepressant use from pharmacy records, biennial depressive symptoms with a 10-item Centers for Epidemiologic Study–Depression scale, and incident strokes from ICD codes. We used discrete-time survival models with inverse probability weighting to compare stroke risk associated with filling antidepressant prescriptions and by medication category: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors, or other. Results Over an average 8.4-year follow-up, 441 incident strokes occurred. Filling antidepressant medications 3+ times versus 0–2 times predicted 35% increased odds of stroke (OR = 1.35; 95% CI: 0.98, 1.66). Use of TCAs was associated with stroke onset (OR per 10 fills = 1.28; CI: 1.04, 1.57), but use of selective serotonin reuptake inhibitors (OR = 0.98; CI: 0.80, 1.20) or other antidepressants (OR = 0.99; CI: 0.67, 1.45) was not. Conclusions Although patients who received antidepressant medication were at higher risk of stroke, this association appeared specific to TCA prescriptions

Aberrant Lipid Metabolism in the Forebrain Niche Suppresses Adult Neural Stem Cell Proliferation in an Animal Model of Alzheimer’s Disease

SummaryLipid metabolism is fundamental for brain development and function, but its roles in normal and pathological neural stem cell (NSC) regulation remain largely unexplored. Here, we uncover a fatty acid-mediated mechanism suppressing endogenous NSC activity in Alzheimer’s disease (AD). We found that postmortem AD brains and triple-transgenic Alzheimer’s disease (3xTg-AD) mice accumulate neutral lipids within ependymal cells, the main support cell of the forebrain NSC niche. Mass spectrometry and microarray analyses identified these lipids as oleic acid-enriched triglycerides that originate from niche-derived rather than peripheral lipid metabolism defects. In wild-type mice, locally increasing oleic acid was sufficient to recapitulate the AD-associated ependymal triglyceride phenotype and inhibit NSC proliferation. Moreover, inhibiting the rate-limiting enzyme of oleic acid synthesis rescued proliferative defects in both adult neurogenic niches of 3xTg-AD mice. These studies support a pathogenic mechanism whereby AD-induced perturbation of niche fatty acid metabolism suppresses the homeostatic and regenerative functions of NSCs

The relationship between left ventricular wall thickness, myocardial shortening and ejection fraction in hypertensive heart disease:insights from cardiac magnetic resonance: LVH independently augments EF in hypertension

Hypertensive heart disease is often associated with a preserved left ventricular ejection fraction despite impaired myocardial shortening. The authors investigated this paradox in 55 hypertensive patients (52±13 years, 58% male) and 32 age‐ and sex‐matched normotensive control patients (49±11 years, 56% male) who underwent cardiac magnetic resonance imaging at 1.5T. Long‐axis shortening (R=0.62), midwall fractional shortening (R=0.68), and radial strain (R=0.48) all decreased (P<.001) as end‐diastolic wall thickness increased. However, absolute wall thickening (defined as end‐systolic minus end‐diastolic wall thickness) was maintained, despite the reduced myocardial shortening. Absolute wall thickening correlated with ejection fraction (R=0.70, P<.0001). In multiple linear regression analysis, increasing wall thickness by 1 mm independently increased ejection fraction by 3.43 percentage points (adjusted β‐coefficient: 3.43 [2.60–4.26], P<.0001). Increasing end‐diastolic wall thickness augments ejection fraction through preservation of absolute wall thickening. Left ventricular ejection fraction should not be used in patients with hypertensive heart disease without correction for degree of hypertrophy