Feeding the food insecure in Britain: learning from the 2020 COVID-19 crisis

The lockdown in Britain has rendered a large proportion of the population economically vulnerable and has at least quadrupled demand for emergency food relief. This paper looks critically at response to the crisis from the government and the voluntary sector with respect to provision of emergency food. In doing so, it has exposed gaps in understanding of the vagaries of the food supply for certain population groups and systemic weaknesses in the current system of emergency food aid. We make recommendations for healthier governmental capacity to react to a food security crisis, better relationships between the government and the voluntary sector, and further research into the dietary constraints of the precariate. Importantly, the social system needs to be responsive to short-term changes in people’s income if people are not to fall into food insecurity

Effect of tart cherry juice on risk of gout attacks: protocol for a randomised controlled trial

Introduction: Gout is a painful form of inflammatory arthritis associated with several comorbidities, particularly cardiovascular disease. Cherries, which are rich in anti-inflammatory and antioxidative bioactive compounds, are proposed to be efficacious in preventing and treating gout, but recommendations to patients are conflicting. Cherry consumption has been demonstrated to lower serum urate levels and inflammation in several small studies. One observational case cross-over study reported that cherry consumption was associated with reduced risk of recurrent gout attacks. This preliminary evidence requires substantiation. The proposed randomised clinical trial aims to test the effect of consumption of tart cherry juice on risk of gout attacks. Methods and analysis: This 12-month, parallel, double-blind, randomised, placebo-controlled trial will recruit 120 individuals (aged 18–80 years) with a clinical diagnosis of gout who have self-reported a gout flare in the previous year. Participants will be randomly assigned to an intervention group, which will receive Montmorency tart cherry juice daily for a 12-month period, or a corresponding placebo group, which will receive a cherry-flavoured placebo drink. The primary study outcome is change in frequency of self-reported gout attacks. Secondary outcome measures include attack intensity, serum urate concentration, fractional excretion of uric acid, biomarkers of inflammation, blood lipids and other markers of cardiovascular risk. Other secondary outcome measures will be changes in physical activity and functional status. Statistical analysis will be conducted on an intention-to-treat basis. Ethics and dissemination: This study has been granted ethical approval by the National Research Ethics Service, Yorkshire and The Humber—Leeds West Research Ethics Committee (ref: 18/SW/0262). Results of the trial will be submitted for publication in a peer-reviewed journal. Trial registration number: NCT03621215

Healthy eating in the early years : a qualitative exploration of food provision in the childminder setting

Purpose – A nutritious diet is critical to the health and development of pre-school children. Children in the UK consume much food outside the home yet day-care food provision is unregulated, and informed by disparate and conflicting dietary guidelines. Factors affecting nursery food provision have been much studied, but less is known about food provision in the child-minder setting. The purpose of this paper is to examine factors influencing child-minders’ food provision. Design/methodology/approach – Qualitative methods were employed, combining participant observation with semi-structured interviews. Participants were selected via purposive and convenience sampling. Eight child-minders from an English borough were interviewed. Findings – The food provided by child-minders was not consistent with dietary guidelines for young children, following menu plans was reported to be difficult, and knowledge about healthy eating guidelines for young children was various. Child-minders reported limited time for food preparation, and problems catering for fussy children. Some child-minders obtained support through an informal peer network group. Only one child-minder reported availing of professional nutritional advice on healthy food provision. Communication with parents about food was considered important, although there was some evidence of discord between providers and parents in dietary objectives. Research limitations/implications – The study was small in size and regionally based. Due to the local nature of the study, it is not possible to make generalisations to the wider national context. Corroboration of the findings is necessary in a larger study. Practical implications – Child-minders have a pivotal role to play in the nutritional health and development of young children, and whilst their interest in provision of nutritious food was great, outside support was lacking. Support should include provision of one clear set of authoritative guidelines, practical guidance that accommodates the realities of providing food in the child-minder setting, investment to strengthen support structures at local level and the development of network groups. Originality/value – Whilst the factors underpinning food provision in nurseries have been examined in various regions of the UK, little attention has been given to child-minder settings. The current study addresses this gap

Exploring the Relationship between Environmental Impact and Nutrient Content of Sandwiches and Beverages Available in Cafés in a UK University

The threat of climate change and population growth has led to calls for the adoption of environmentally sustainable diets; however, concerns have been raised over the nutritional quality of low Greenhouse Gas Emission (GHGE) diets. This study examined the relationship between measures of environmental sustainability and nutrient content of sandwiches and beverages sold in a UK university café. GHGE and Water Footprint Impact Indicator (WFII) values for the ingredients of sandwiches and beverages were used with recipe information to calculate GHGE (gCO2e per portion) and WFIIs (scarcity weighted litres per portion). These estimates were then combined via orthogonal regression to produce a single Environmental Impact Score (EIS); higher scores equate to greater environmental impact. The relationship between EIS and nutrient content was explored using correlation analysis. Sandwiches that contained meat and animal products as well as beverages that contained milk, cocoa, and/or coffee had the highest EIS. EIS was positively associated with the portion size of sandwiches but not the serving size of beverages. EIS was positively correlated with calories, saturated fat, and sodium. However, EIS was also positively correlated with micronutrients: iron, calcium (beverages only), and B12 (beverages only). The choice of smaller or plant-based sandwiches as well as beverages without milk would reduce environmental impact as well as caloric and sodium intake. However, the selection of low impact options may also reduce the intake of nutrients required for good health. This study revealed possible tensions between nutritional quality and environmental sustainability

Food security, nutrition and health of food bank attendees in an English city: A cross-sectional study

Food banks in contemporary Britain are feeding record numbers of people. Little is known about attendees’ level of food insecurity, background diet quality or health. We surveyed 112 food bank attendees. Over 50% had experienced food shortage with hunger on a weekly basis or more often. Obesity and mental health problems were prevalent in women. Diet quality was poor, with energy, protein, fibre, iron and calcium intakes inadequate, while saturated fat and sugars intake were disproportionate. Women had poorer diet quality than men. Such patterns may lead to ill health

Why rational argument fails the genetic modification (GM) debate

AbstractGenetic modification (GM) of crops provides a methodology for the agricultural improvements needed to deliver global food security. However, public opposition to GM-food is great. The debate has tended to risk communication, but here we show through study of a large nationally representative sample of British adults that public acceptance of GM-food has social, cultural and affective contexts. Regression models showed that metaphysical beliefs about the sanctity of food and an emotional dislike of GM-food were primary negative determinants, while belief in the value of science and favourable evaluation of the benefits-to-risks of GM-food were secondary positive determinants. Although institutional trust, general knowledge of the GM-food debate and belief in the eco-friendliness of GM-food were all associated with acceptance, their influence was minor. While a belief in the sanctity of food had a direct inverse effect on GM acceptance, belief in the value of science was largely mediated through favourable perception of benefits-to-risks. Furthermore, segmentation analysis demonstrated that anxiety about GM-food had social and cultural antecedents, with white men being least anxious and older vegetarian women being most anxious. Rational argument alone about the risks and benefits of GM-food is unlikely to change public perceptions of GM-technology

Dietary patterns of university students in the UK: A cross-sectional study

© 2018 The Author(s). Background: University represents a key transition into adulthood for many adolescents but there are associated concerns about health and behaviours. One important aspect relates to diet and there is emerging evidence that university students may consume poor quality diets, with potential implications for body weight and long-term health. This research aimed to characterise dietary patterns of university students in the UK and their sociodemographic and lifestyle antecedents. Methods: An online, cross-sectional survey was undertaken with a convenience sample of 1448 university students from five UK universities (King's College London, Universities of St Andrews, Southampton and Sheffield, and Ulster University). The survey comprised a validated food frequency questionnaire alongside lifestyle and sociodemographic questions. Dietary patterns were generated from food frequency intake data using principal components analysis. Nutrient intakes were estimated to characterise the nutrient profile of each dietary pattern. Associations with sociodemographic variables were assessed through general linear modelling. Results: Dietary analyses revealed four major dietary patterns: 'vegetarian'; 'snacking'; 'health-conscious'; and 'convenience, red meat & alcohol'. The 'health-conscious' pattern had the most favourable micronutrient profile. Students' gender, age, year of study, geographical location and cooking ability were associated with differences in pattern behaviour. Female students favoured the 'vegetarian' pattern, whilst male students preferred the 'convenience, red meat & alcohol' pattern. Less healthful dietary patterns were positively associated with lifestyle risk factors such as smoking, low physical activity and take-away consumption. The health-conscious pattern had greatest nutrient density. The 'convenience, red meat & alcohol' pattern was associated with higher weekly food spending; this pattern was also identified most consistently across universities. Students reporting greater cooking ability tended towards the 'vegetarian' and 'health-conscious' patterns. Conclusions: Food intake varied amongst university students. A substantial proportion of students followed health-promoting diets, which had good nutrient profiles obviating a need for dietary intervention. However, some students consumed poor diets, incurred greater food costs and practised unfavourable lifestyle behaviours, which may have long-term health effects. University policy to improve students' diets should incorporate efforts to promote student engagement in cooking and food preparation, and increased availability of low cost healthier food items

A content analysis of online videos containing dietary recommendations for gout and their alignment with evidence-based dietary guidelines

Abstract Objective: To assess the alignment of YouTube® videos providing dietary recommendations for gout with evidence-based guidelines targeted at the United Kingdom (UK) population and to establish their quality. Design: A content analysis of YouTube® videos providing dietary recommendations for gout was undertaken. Videos were categorised by video source. Each video’s dietary recommendations for gout were compared with three evidence-based guidelines for gout, producing a compliance score. Presence of non-guideline advice was assessed. Understandability and actionability were evaluated using the Patient Education Material Assessment Tool for Audio-Visual Materials. Reliability was assessed using an adapted-DISCERN tool and educational quality using the Global Quality Score Five-Point Scale. Differences between video source and continuous variables were assessed using one-way Kruskal–Wallis H tests. For categorical variables, associations were investigated using Fisher–Freeman–Halton tests. Setting: Online, May–June 2020. Participants: One-hundred thirty-one videos. Results: Alignment of videos with evidence-based guidelines was poor (median compliance score 27 % (interquartile range 17–37 %)). Additionally, 57 % of videos contained non-guideline advice. The health professional source group had the fewest videos containing non-guideline advice, but this was only significantly lower than the naturopath group (31 % v. 81 %, P = 0·009). Almost 70 % of videos were considered poorly actionable and 50 % poorly understandable. Most videos were rated poor for reliability (79 %) and poor to generally poor for educational quality (49 %). Conclusions: YouTube® videos providing dietary recommendations for gout frequently fail to conform to evidence-based guidelines, and their educational quality, reliability, understandability and actionability are often poor. More high-quality, comprehensive, evidence-based YouTube® videos are required for UK gout patients

Meeting school food standards – students’ food choice and free school meals

Objective To examine students’ school food choice in relation to school food standards and entitlement to free school meals (FSM). Design Cross-sectional analysis of students’ school food choices. Setting Two large secondary schools in Yorkshire, England. Subjects Students (n 2660) aged 11–18 years. Results Sandwiches and pizza were the most popular main food items: 40·4 % and 31·2 %, respectively, in School A; 48·3 % and 27·3 %, respectively, in School B. More nutritionally valuable ‘dishes of the day’ accounted for 8·7 % and 8·3 % of main foods for School A and School B, respectively. FSM students were more likely (P < 0·0 0 1) to choose main foods (School A: FSM 87·04 %, non-FSM 70·28 %; School B: FSM 75·43 %, non-FSM 56·13 %). Dishes of the day were chosen on a significantly greater (P < 0·0 0 1) percentage of days by FSM v. non-FSM students (School A: FSM 15·67 %, non-FSM 7·11 %; School B: FSM 19·42 %, non-FSM 5·17 %). Conclusions Despite the availability of nutritionally valuable dishes of the day, the most popular food items were sandwiches, pizza and desserts. FSM students were more likely to choose the more nutritionally valuable dish of the day. School food standards should be reassessed in light of students’ preferences

A content analysis of online videos containing dietary recommendations for gout and their alignment with evidence-based dietary guidelines

Objective: To assess the alignment of YouTube® videos providing dietary recommendations for gout with evidence-based guidelines targeted at the United Kingdom (UK) population and to establish their quality. Design: A content analysis of YouTube® videos providing dietary recommendations for gout was undertaken. Videos were categorised by video source. Each video’s dietary recommendations for gout were compared with three evidence-based guidelines for gout, producing a compliance score. Presence of non-guideline advice was assessed. Understandability and actionability were evaluated using the Patient Education Material Assessment Tool for Audio-Visual Materials. Reliability was assessed using an adapted-DISCERN tool and educational quality using the Global Quality Score Five-Point Scale. Differences between video source and continuous variables were assessed using one-way Kruskal-Wallis H tests. For categorical variables, associations were investigated using Fisher-Freeman-Halton tests. Setting: Online, May-June 2020. Participants: 131 videos. Results: Alignment of videos with evidence-based guidelines was poor (median compliance score 27% (IQR 17-37%)). Additionally, 57% of videos contained non-guideline advice. The health professional source group had the fewest videos containing non-guideline advice, but this was only significantly lower than the naturopath group (31% vs 81%, p = 0.009). Almost 70% of videos were considered poorly actionable and 50% poorly understandable. Most videos were rated poor for reliability (79%) and poor to generally poor for educational quality (49%). Conclusions: YouTube® videos providing dietary recommendations for gout frequently fail to conform to evidence-based guidelines and their educational quality, reliability, understandability, and actionability is often poor. More high-quality, comprehensive, evidence-based YouTube® videos are required for UK gout patients