Evaluating the ≤10:1 wholegrain criterion in identifying nutrient quality and health implications of UK breads and breakfast cereals

This article has been published in a revised form in Public Health Nutrition DOI: https://doi.org/10.1017/S1368980017003718. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © 2017 The Authors. Under embargo until 26 June 2018.Objective: To evaluate the nutrient quality of breads and breakfast cereals identified using the wholegrain definition of ≤10:1 carbohydrate:fibre ratio. Design: Following a cross-sectional study design, nutritional information was systematically gathered from food labels of breads and breakfast cereals that met the ≤10:1 carbohydrate:fibre criterion. The median nutrient content was compared with the UK Food Standards Agency nutrient profiling standards and the association between carbohydrate:fibre ratio and other nutrients were analysed. Subgroup analyses were undertaken for products with and without fruit, nuts and/or seeds. Setting: Products from four major supermarket stores in the UK. Subjects: 162 breads and 266 breakfast cereals. Results: Breads which met the ≤10:1 criterion typically contained medium fat, low saturated fat, low sugar and medium sodium. Breakfast cereals typically contained medium fat, low saturated fat, high sugar and low sodium. In both groups, as the carbohydrate:fibre ratio decreased, fat content increased (bread: p=0.029, r=-0.171; breakfast cereal: p=0.033, r=-0.131) and, in breakfast cereals, as the ratio increased, sugar content increased (p<0.0005, r=0.381). Breakfast cereals with fruit, nuts and/or seeds contained, per 100 g, more energy (p=0.002), fat, saturated fat and sugar (all p<0.0005) while seeded breads had more energy, fat and saturated fat (all p<0.0005). Conclusions: Overall, breads and breakfast cereals meeting the ≤10:1 criterion have good nutritional quality, suggesting that the criterion could be useful in public health and/or food labelling. The utility of applying the 10:1 criterion to products containing fruit, nuts and/or seeds is less clear and requires further research.Peer reviewedFinal Accepted Versio

Primary prevention of overweight and obesity in adolescents: An overview of systematic reviews

Summary The aim of this overview of systematic reviews was to summarize evidence from up-to-date reviews of the effectiveness of interventions aimed at preventing overweight and obesity in adolescents aged 10 to 19 years. We searched nine databases for systematic reviews published between January 2008 and November 2019. We used A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 to assess the quality of reviews, excluding those of critically low quality, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool to grade the certainty of included evidence. We included 13 reviews. Three reviews focused on dietary behaviour, six on physical activity, and four on both types of behaviours. Individual-oriented and school-based interventions dominated. Results across reviews showed little or no effect on body mass index, or physical activity levels of adolescents, whereas results from a couple of reviews suggest possibly beneficial effects of public health interventions on dietary behaviours (i.e., consumption of sugar-sweetened beverages). The certainty of evidence was low to very low for all outcomes. Overall, the evidence base for the effect of primary interventions to prevent overweight and obesity in adolescents is weak. In particular, there is a lack of reviews assessing the impact of environmental interventions targeting adolescents, and reviews addressing social inequality are virtually absent from this body of literature

An improved lower bound for (1,<=2)-identifying codes in the king grid

We call a subset $C$ of vertices of a graph $G$ a $(1,\leq \ell)$-identifying code if for all subsets $X$ of vertices with size at most $\ell$, the sets $\{c\in C |\exists u \in X, d(u,c)\leq 1\}$ are distinct. The concept of identifying codes was introduced in 1998 by Karpovsky, Chakrabarty and Levitin. Identifying codes have been studied in various grids. In particular, it has been shown that there exists a $(1,\leq 2)$-identifying code in the king grid with density 3/7 and that there are no such identifying codes with density smaller than 5/12. Using a suitable frame and a discharging procedure, we improve the lower bound by showing that any $(1,\leq 2)$-identifying code of the king grid has density at least 47/111

Monitoring the impacts of trade agreements on food environments

The liberalization of international trade and foreign direct investment through multilateral, regional and bilateral agreements has had profound implications for the structure and nature of food systems, and therefore, for the availability, nutritional quality, accessibility, price and promotion of foods in different locations. Public health attention has only relatively recently turned to the links between trade and investment agreements, diets and health, and there is currently no systematic monitoring of this area. This paper reviews the available evidence on the links between trade agreements, food environments and diets from an obesity and non-communicable disease (NCD) perspective. Based on the key issues identified through the review, the paper outlines an approach for monitoring the potential impact of trade agreements on food environments and obesity/NCD risks. The proposed monitoring approach encompasses a set of guiding principles, recommended procedures for data collection and analysis, and quantifiable ‘minimal’, ‘expanded’ and ‘optimal’ measurement indicators to be tailored to national priorities, capacity and resources. Formal risk assessment processes of existing and evolving trade and investment agreements, which focus on their impacts on food environments will help inform the development of healthy trade policy, strengthen domestic nutrition and health policy space and ultimately protect population nutrition.The following organizations provided funding support for the travel of participants to Italy for this meeting and the preparation of background research papers: The Rockefeller Foundation, International Obesity Taskforce (IOTF), University of Auckland, Deakin University, The George Institute, University of Sydney, Queensland University of Technology, University of Oxford, University of Pennsylvania Perelman School of Medicine, World Cancer Research Fund International, University of Toronto, and The Australian National University. The Faculty of Health at Deakin University kindly supported the costs for open access availability of this paper, and the Australian National Health and Medical Research Council Centre for Research Excellence in Obesity Policy and Food Systems (APP1041020) supported the coordination and finalizing of INFORMAS manuscripts

Uncorking the potential of wine language for young wine tourists

Effective communication with consumers underpins growth in wine knowledge that, in turn, contributes to growth in wine consumption. Indeed, tasting notes may enhance consumers’ experiences of wine. Yet wine language is full of fuzzy concepts. In this chapter, we consider the language used to talk about wine, specifically the humanlike features of wine (e.g., wine is described as honest, sexy, shy, or brooding). We demonstrate that metaphoric language is integral to the experience of wine and influences consumer behaviour. We discuss practical implications for the cellar door experience, and for effective and ethical wine communication. We conclude that metaphoric language is a pedagogical and cultural platform for engaging younger wine tourists in the cellar door experience, which is a significant revenue source for micro, small, and medium wineries

Attenuation of allergic airways inflammation by an extract of Hymenocardia acida

Tracheal hyperresponsiveness, airway mucus production and bronchoalveolar inflammation are the major components of asthma. Here, we aim to investigate the role in the control of asthma of a bioactive plant extracted from Hymenocardia acida in a physiological and pathophysiological model. The effect of H. acida crude extract (HACE) on total cellular components of bronchoalveolar (BAL) fluids was performed on ovalbumin (OVA) and lipopolysaccaride (LPS)-challenged Swiss mice for induction of allergic asthma and airways inflammation, respectively. Mice were pretreated with 0.9% sodium chloride (NaCl), HACE (oral doses at 100 mg/kg/body weight) for a week and then by intranasal instillation with OVA (0.5 mg/ml) + aluminium hydroxyde (20 mg/ml), during three days after intraperitoneally sensitization or with LPS (0.4 mg/ml) for a day (OVA or LPS + HACE). The BAL cells were collected in a mixed solution (0.9% NaCl and 2.6 mm Ethylenediaminetetraacetic acid EDTA) one day after the last challenge and total cells were numbered in a Neubauer chamber. The HACE: (i) significantly inhibited the airways inflammation induced by a single intranasal instillation of LPS or allergic asthma on mice challenged with 3 consecutive days intranasal instillation of OVA in comparison to control mice only instilled with 0.9% sterile. NaCl : (ii) significantly impaired the increased levels of total cells in OVA and LPS-treated mice, without changing the basal cellularity after NaCl or HACE treatment; (iii) and significantly inhibitshydroxyl radicalsandsuperoxideanions production. Taken together, these results suggest that HACE exposure induces a marked reduction of cellular component in the BAL fluid, which is only partially lymphocytes dependent

A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention

Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first (‘minimal’) step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second (‘expanded’) step assesses the nutritional composition of each organization’s products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third (‘optimal’) step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention

Area-level deprivation and adiposity in children: is the relationship linear?

OBJECTIVE: It has been suggested that childhood obesity is inversely associated with deprivation, such that the prevalence is higher in more deprived groups. However, comparatively few studies actually use an area-level measure of deprivation, limiting the scope to assess trends in the association with obesity for this indicator. Furthermore, most assume a linear relationship. Therefore, the aim of this study was to investigate associations between area-level deprivation and three measures of adiposity in children: body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). DESIGN: This is a cross-sectional study in which data were collected on three occasions a year apart (2005-2007). SUBJECTS: Data were available for 13,333 children, typically aged 11-12 years, from 37 schools and 542 lower super-output areas (LSOAs). MEASURES: Stature, mass and WC. Obesity was defined as a BMI and WC exceeding the 95th centile according to British reference data. WHtR exceeding 0.5 defined obesity. The Index of Multiple Deprivation affecting children (IDACI) was used to determine area-level deprivation. RESULTS: Considerable differences in the prevalence of obesity exist between the three different measures. However, for all measures of adiposity the highest probability of being classified as obese is in the middle of the IDACI range. This relationship is more marked in girls, such that the probability of being obese for girls living in areas at the two extremes of deprivation is around half that at the peak, occurring in the middle. CONCLUSION: These data confirm the high prevalence of obesity in children and suggest that the relationship between obesity and residential area-level deprivation is not linear. This is contrary to the 'deprivation theory' and questions the current understanding and interpretation of the relationship between obesity and deprivation in children. These results could help make informed decisions at the local level

Prevalence and Determinants of Obesity among Primary School Children in Dar es Salaam, Tanzania.

Childhood obesity has increased dramatically and has become a public health concern worldwide. Childhood obesity is likely to persist through adulthood and may lead to early onset of NCDs. However, there is paucity of data on obesity among primary school children in Tanzania. This study assessed the prevalence and determinants of obesity among primary school children in Dar es Salaam. A cross sectional study was conducted among school age children in randomly selected schools in Dar es Salaam. Anthropometric and blood pressure measurements were taken using standard procedures. Body Mass Index (BMI) was calculated as weight in kilograms divided by the square of height in meters (kg/m2). Child obesity was defined as BMI at or above 95th percentile for age and sex. Socio-demographic characteristics of children were determined using a structured questionnaire. Logistic regression was used to determine association between independent variables with obesity among primary school children in Dar es Salaam. A total of 446 children were included in the analysis. The mean age of the participants was 11.1±2.0 years and 53.1% were girls. The mean BMI, SBP and DBP were 16.6±4.0 kg/m2, 103.9±10.3mmHg and 65.6±8.2mmHg respectively. The overall prevalence of child obesity was 5.2% and was higher among girls (6.3%) compared to boys (3.8%). Obese children had significantly higher mean values for age (p=0.042), systolic and diastolic blood pressures (all p<0.001). Most obese children were from households with fewer children (p=0.019) and residing in urban areas (p=0.002). Controlling for other variables, age above 10 years (AOR=3.3, 95% CI=1.5-7.2), female sex (AOR=2.6, 95% CI=1.4-4.9), urban residence (AOR=2.5, 95% CI=1.2-5.3) and having money to spend at school (AOR=2.6, 95% CI=1.4-4.8) were significantly associated with child obesity. The prevalence of childhood obesity in this population was found to be low. However, children from urban schools and girls were proportionately more obese compared to their counterparts. Primary preventive measures for childhood obesity should start early in childhood and address socioeconomic factors of parents contributing to childhood obesity