Public health strategies to reduce sugar intake in the UK: An exploration of public perceptions using digital spaces

Objective: To explore UK public perceptions of children's sugar consumption, Public Health England's Change4Life Sugar Smart app and the Soft Drinks Industry Levy, using solicited and unsolicited digital data. Methods: Data from three digital spaces were used as follows: (1) an online questionnaire advertised on parenting forums; (2) posts to UK online parenting forums; and (3) English language Tweets from Twitter. Quantitative data were analysed using descriptive statistics and qualitative data using content and inductive thematic analysis. Results: Data were (study 1) 184 questionnaire participants; (study 2) 412 forum posts; and (study 3) 618 Tweets. In study 1, 94.0% (n = 173) agreed that children in the UK consumed too much sugar and this had a negative health effect (98.4%, n = 181). Environments (n = 135, 73.4%), media/advertising (n = 112, 60.9%) and parents (n = 107, 58.2%) were all reported as barriers to changing children's sugar intake. In study 2, more posts were negative towards the Soft Drinks Industry Levy (n = 189, 45.9%) than positive (n = 145, 35.2%), and themes about the inability of the Levy to affect sugar consumption in children and childhood obesity emerged. Other themes related to distrust of the government, food industry and retailers. In study 3, the Sugar Smart app was viewed positively (n = 474, 76.7%) with its function associated solely with identification of sugar content. Conclusions: Participants accepted the necessity of sugar reduction in children, but recognised the complexity of behaviour change. Public health activities were not always perceived as effective strategies for health promotion. There was some distrust in government, public health officials and the food industry. A less simplistic approach to sugar reduction and more credible sources of information may, therefore, be welcomed by the public

EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2013. Scientific Opinion on the substantiation of a health claim related to increasing maternal folate status by supplemental folate intake and reduced risk of neural tube defects pursuant to Article 14 of Regulation (EC) No 1924/2006

Following an application from Rank Nutrition Ltd, submitted for authorisation of a health claim pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of the United Kingdom, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to increasing maternal folate status by supplemental folate intake and reduced risk of neural tube defects. The Panel considers that the food constituent, supplemental folate, which is the subject of the claim, is sufficiently characterised. Increasing maternal folate status by supplemental folate intake is a beneficial physiological effect in the context of reducing the risk of neural tube defects. In weighing the evidence, the Panel took into account that the association between low maternal folate intakes and an increased risk of neural tube defects is well established, and that a recent systematic review showed an effect of maternal folic acid intakes on the risk of neural tube defects. The Panel concludes that a cause and effect relationship has been established between increasing maternal folate status by supplemental folate intake and a reduced risk of neural tube defects

The reduction of faecal calprotectin during exclusive enteral nutrition is lost rapidly after food re-introduction

Background: Faecal calprotectin decreases during exclusive enteral nutrition in children with active Crohn's disease. It is unknown how faecal calprotectin changes during food re‐introduction and the influence of maintenance enteral nutrition. Aims: To study changes to faecal calprotectin during exclusive enteral nutrition and at food reintroduction, and explore associations with maintenance enteral nutrition. Methods: Children with Crohn's disease were followed during exclusive enteral nutrition and during food‐reintroduction. Faecal calprotectin was measured before, at 33 and 54 days of exclusive enteral nutrition, and at 17, 52 and 72 days after food‐reintroduction. Maintenance enteral nutrition use was recorded with estimated weight food diaries. Data are presented with medians and Q1:Q3. Results: Sixty‐six patients started exclusive enteral nutrition and 41 (62%) achieved clinical remission (weighted paediatric Crohn's disease activity index <12.5). Baseline faecal calprotectin (mg/kg) decreased after 4 and 8 weeks of exclusive enteral nutrition (Start: 1433 [Q1: 946, Q3: 1820] vs 33 days: 844 [314, 1438] vs 54 days: 453 [165, 1100]; P < .001). Within 17 days of food reintroduction, faecal calprotectin increased to 953 [Q1: 519, Q3: 1611] and by 52 days to 1094 [660, 1625] (both P < .02). Fifteen of 41 (37%) children in remission used maintenance enteral nutrition (333 kcal or 18% of energy intake). At 17 days of food reintroduction, faecal calprotectin was lower in maintenance enteral nutrition users than non‐users (651 [Q1: 271, Q3: 1781] vs 1238 [749, 2102], P = .049) and correlated inversely with maintenance enteral nutrition volume (rho: −0.573, P = .041), kcals (rho: −0.584, P = .036) and % energy intake (rho: −0.649, P = .016). Maintenance enteral nutrition use was not associated with longer periods of remission (P = .7). Faecal calprotectin at the end of exclusive enteral nutrition did not predict length of remission. Conclusions: The effect of exclusive enteral nutrition on faecal calprotectin is diminished early during food reintroduction. Maintenance enteral nutrition at ~18% of energy intake is associated with a lower faecal calprotectin at the early phase of food reintroduction but is ineffective in maintaining longer term remission

Fat and fatty acid composition of cooked meat from UK retail chickens labelled as from organic and non-organic production systems

This study compared fat and fatty acids in cooked retail chicken meat from conventional and organic systems. Fat contents were 1.7, 5.2, 7.1 and 12.9 g/100 g cooked weight in skinless breast, breast with skin, skinless leg and leg with skin respectively, with organic meat containing less fat overall (P < 0.01). Meat was rich in cis-monounsaturated fatty acids, although organic meat contained less than did conventional meat (1850 vs. 2538 mg/100 g; P < 0.001). Organic meat was also lower (P < 0.001) in 18:3 n−3 (115 vs. 180 mg/100 g) and, whilst it contained more (P < 0.001) docosahexaenoic acid (30.9 vs. 13.7 mg/100 g), this was due to the large effect of one supermarket. This system by supermarket interaction suggests that poultry meat labelled as organic is not a guarantee of higher long chain n−3 fatty acids. Overall there were few major differences in fatty acid contents/profiles between organic and conventional meat that were consistent across all supermarkets

Anthocyanins do not influence long-chain n-3 fatty acid status:Studies in cells, rodents and humans

Increased tissue status of the long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) is associated with cardiovascular and cognitive benefits. Limited epidemiological and animal data suggest that flavonoids, and specifically anthocyanins, may increase EPA and DHA levels, potentially by increasing their synthesis from the shorter-chain n-3 PUFA, α-linolenic acid. Using complimentary cell, rodent and human studies we investigated the impact of anthocyanins and anthocyanin-rich foods/extracts on plasma and tissue EPA and DHA levels and on the expression of fatty acid desaturase 2 (FADS2), which represents the rate limiting enzymes in EPA and DHA synthesis. In experiment 1, rats were fed a standard diet containing either palm oil or rapeseed oil supplemented with pure anthocyanins for 8 weeks. Retrospective fatty acid analysis was conducted on plasma samples collected from a human randomized controlled trial where participants consumed an elderberry extract for 12 weeks (experiment 2). HepG2 cells were cultured with α-linolenic acid with or without select anthocyanins and their in vivo metabolites for 24 h and 48 h (experiment 3). The fatty acid composition of the cell membranes, plasma and liver tissues were analyzed by gas chromatography. Anthocyanins and anthocyanin-rich food intake had no significant impact on EPA or DHA status or FADS2 gene expression in any model system. These data indicate little impact of dietary anthocyanins on n-3 PUFA distribution and suggest that the increasingly recognized benefits of anthocyanins are unlikely to be the result of a beneficial impact on tissue fatty acid status

Length of migration and eating habits of Portuguese university students living in London, United Kingdom

Several studies have pointed adverse effects of long term migration on eating habits. Research is needed to understand if this effect occurs also with a short length of migration, as is the case of international students. Our aim was to evaluate the effect of short and long term migration on eating habits of Portuguese university students. Participants were 46 English and 55 Portuguese students from universities in London, United Kingdom. The findings from this study highlight the difficulties that Portuguese students faced in maintaining a traditional Mediterranean diet after moving to a Northern European environment

Contemporary South African Urbanization Dynamics

Abstract The paper provides an overview of urbanization patterns and trends in the current era in South Africa, focusing in particular on the key dynamics and driving forces underlying migration and urbanization. It considers overall demographic trends with regard to migration and urbanization, and points to some of the difficulties with data, and with the analysis of trends and patterns. The paper explores the changing rural context and dynamics, and some of the significant processes in this context: large-scale displacement of black people off farms, the impact of land reform, and conditions in the former homeland areas. Circular migration continues to be an important way in which households in rural areas survive, but some are unable to move, and are falling out of these networks. International migration—the consequence of both conditions in the home country and the draw of the South African economy— is another significant process fuelling mainly urban growth. The paper demonstrates the importance of cities in terms of economic growth and employment, and thus their attractiveness to migrants. Continuing migration to cities is of course a challenge fo

Irregular meal pattern-effects on energy expenditure, metabolism and appetite regulation: a randomized controlled trial in healthy normal-weight women

Background: Obesity is increasing in parallel with greater all-day food availability. The latter may promote meal irregularity, dysregulation of the energy balance, and poor metabolic health. Objective: We investigated the effect of meal irregularity on the thermic effect of food (TEF), lipid concentrations, carbohydrate metabolism, subjective appetite, and gut hormones in healthy women. Design: Eleven normal-weight women (18–40 y of age) were recruited in a randomized crossover trial with two 14-d isoenergetic diet periods (identical foods provided and free living) that were separated by a 14-d habitual diet washout period. In period 1, participants followed a regular meal pattern (6 meals/d) or an irregular meal pattern (3–9 meals/d), and in period 2, the alternative meal pattern was followed. Before and after each period, when participants were fasting and for 3 h after intake of a test drink, measurements were taken of energy expenditure, circulating glucose, lipids (fasting only), insulin, glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and ghrelin. An ad libitum test meal was offered. Subjective appetite ratings were assessed while fasting, after the test drink, after the ad libitum meal, and during the intervention. Continuous interstitial glucose monitoring was undertaken for 3 consecutive days during each intervention, and the ambulatory activity pattern was recorded (ambulatory energy expenditure estimation). Results: Regularity was associated with a greater TEF (P , 0.05) and a lower incremental area under the curve (iAUC) for glucose after intake of the test drink (over 3 h) and, for some identical meals, during the 2 interventions (over 90 min) (day 7: after breakfast; day 9: after lunch and dinner). There was no difference between treatments for the test-drink gut hormone response. A time effect was noted for fasting GLP-1, fasting PYY, PYY responses, and hunger-rating responses to the test drink (P ˂ 0.05). Lower hunger and higher fullness ratings were seen premeal and postmeal during the regular period while subjects were free living. Conclusion: Meal regularity appears to be associated with greater TEF and lower glucose responses, which may favor weight management and metabolic health. This trial was registered at clinical trials.gov as NCT02052076

Effect of dietary vitamin D3 and 25-hydroxyvitamin D3 supplementation on plasma and milk 25-hydroxyvitamin D3 concentration in dairy cows

Milk enriched with vitamin D by supplementing dairy cow diets could provide a valuable dietary source of vitamin D, but information on the feasibility of this approach is limited. In the current study, the effects of supplementing dairy cows with either vitamin D3 or 25(OH) D3 over the transition/early lactation period on plasma and milk vitamin D concentrations were compared. Sixty dairy cows were randomly allocated to one of four dietary treatments from 14 days pre-calving to 56 days post-calving. Treatments were a control diet (Control) for both pre-calving and post-calving periods containing 0.625 mg/day vitamin D3; a pre-calving diet supplemented with 6 mg 25(OH) D3/day, but with a post-calving diet matching that of the control diet (25(OH) D3 pre-calving); the control diet pre-calving but with the post-calving diet supplemented with 2 mg vitamin D3/day (D3max), and the control diet pre-calving but with the post-calving diet supplemented with 1.5 mg 25(OH) D3/day (25(OH) D3 post-calving). No treatment effect on milk yield, composition or 25(OH) D3 concentration was observed. However there was an interaction of treatment and time for plasma 25(OH) D3 concentration; this increased within two weeks of supplementation for the 25(OH) D3 pre-calving treatment (peaking just after calving, 202 ng/ml), whereas that of the 25(OH) D3 post-calving group had a slower response following supplementation, continuing to increase at 56 days. There were correlations between plasma and milk 25(OH) D3 concentrations at days 4 and 14 of lactation, but not at later sampling times. The D3max treatment did not increase 25(OH) D3 concentration in plasma or milk. Overall, results from this study indicate that supplemental 25(OH) D3 is an effective means of enhancing dairy cow plasma 25(OH) D3 concentrations compared with vitamin D3 supplementation, but not necessarily milk concentrations

Effect of a whey protein and rapeseed oil gel feed supplement on milk fatty acid composition of Holstein cows

Isoenergetic replacement of dietary saturated fatty acids (SFA) with cis-monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) can reduce cardiovascular disease (CVD) risk. Supplementing dairy cow diets with plant oils lowers milk fat SFA concentrations. However, this feeding strategy can also increase milk fat trans FA (TFA), and negatively impact rumen fermentation. Protection of oil supplements from the rumen environment is therefore needed. In the present study a whey protein gel (WPG) of rapeseed oil (RO) was produced for feeding to dairy cows, in two experiments. In Experiment 1 four multiparous Holstein-Friesian cows in mid-lactation were used in a change-over experiment, with 8-d treatment periods separated by a 5-day washout period. Total mixed ration diets containing 420 g RO or WPG providing 420 g of RO were fed and the effects on milk production, composition and FA concentration were measured. Experiment 2 involved four multiparous mid-lactation Holstein-Friesian cows in a 4 x 4 Latin square design experiment, with 28-d periods, to investigate the effect of incremental dietary inclusion (0, 271, 617 and 814 g/d supplemental oil) of WPG on milk production, composition and FA concentration in the last week of each period. There were minimal effects of WPG on milk FA profile in experiment 1, but trans-18:1 and total trans-MUFA were higher after 8 days of supplementation with RO than with WPG. Incremental diet inclusion of WPG in experiment 2 resulted in linear increases in milk yield, cis- and trans-MUFA and PUFA, and linear decreases in SFA (from 73 to 58 g/100 g FA), and milk fat concentration. The WPG supplement was effective at decreasing milk SFA concentration by replacement with MUFA and PUFA in experiment 2, but the increase in TFA suggested that protection was incomplete