Dietary patterns of households in Scotland : Differences by level of deprivation and associations with dietary goals

Funding This work was supported by the Scottish Government’s Rural and Environment Science and Analytical Services (RESAS) Division.Peer reviewedPostprin

Weight outcomes audit for 34,271 adults referred to a primary care/commercial weight management partnership scheme

Copyright © 2011 S. Karger AG, Basel.Peer reviewedPublisher PD

Nutrition from a climate change perspective

Peer reviewedPublisher PD

Using food intake records to estimate compliance with the Eatwell plate dietary guidelines

This work was supported by the Scottish Government's Rural and Environment Science and Analytical Services (RESAS) Division. The original studies, from which the current data were taken, were funded by the Food Standards Agency, UK, and the Biscuit, Cake, Chocolate and Confectionery Association, London, UK.Peer reviewedPostprin

Choosing treatment for localised prostate cancer: A patient-conducted-interview study

Objectives: Treatment choice can be particularly difficult in localised prostate cancer because of the uncertainty involved. Indeed, some men prefer maintaining their masculine identity and quality of life to potentially securing longer-term survival through surgery or radiotherapy. UK health services are now obliged to leave the choice of treatment to the patient and the aim of this study is to improve understanding of patients’ experiences of choosing treatment. Methods: A one-day participative workshop where men of six months post-diagnosis design and conduct audio and video interviews on each other about their experiences of choosing treatment. Results: The findings show that treatment choice is a complex process combining emotional and rational elements. Information gathering and delegation to professional expertise were two key themes that emerged. Conclusions: The findings emphasise that treatment choice for localised prostate cancer is little like the traditional notions of consumerism from which it is derived. Importantly, the results illustrate, from a patient perspective, how health professionals can engage in their roles as information providers and as experts

Levothyroxine effects on depressive symptoms and limbic glucose metabolism in bipolar disorder: a randomized, placebo-controlled positron emission tomography study.

Adding supraphysiologic doses of levothyroxine (L-T4) to standard treatment for bipolar depression shows promise, but the mechanisms underlying clinical improvement are unknown. In a previous pilot study, L-T4 treatment reduced depression scores and activity within the anterior limbic network. Here we extended this work in a randomized, double-blind, placebo-controlled study of patients with bipolar depression. Cerebral glucose metabolism was assessed with positron emission tomography and [F-18]fluorodeoxyglucose before and after 6 weeks of treatment with L-T4 (n=15) or placebo (n=10) in 12 volumes of interest (VOIs): the bilateral thalamus, amygdala, hippocampus, dorsal striatum and ventral striatum, and midline cerebellar vermis and subgenual cingulate cortex. Radioactivity in the VOIs, normalized to whole-brain radioactivity was taken as a surrogate index of glucose metabolism, and markers of thyroid function were assayed. Changes in brain activity and their association with clinical response were assessed using statistical parametric mapping. Adjunctive L-T4 treatment produced a significant decline in depression scores during the 6-week treatment. In patients treated with L-T4, we found a significant decrease in regional activity at P<0.05 after Bonferroni correction in the left thalamus, right amygdala, right hippocampus, left ventral striatum and the right dorsal striatum. Decreases in the left thalamus, left dorsal striatum and the subgenual cingulate were correlated with a reduction in depression scores (P<0.05 after Bonferroni correction). Placebo treatment was associated with a significant decrease in activity only in the right amygdala, and no region had a change in activity that was correlated with change in depression scores. The groups differed significantly in the relationship between the changes in depression scores and in activity in the thalamus bilaterally and the left ventral striatum. The findings provide evidence that administration of supraphysiologic thyroid hormone improves depressive symptoms in patients with bipolar disorder by modulating function in components of the anterior limbic network

Subjective response to and tolerability of long-term supraphysiological doses of levothyroxine in refractory mood disorders

NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Affective Disorders, [VOL 64, ISSUE 1, (2001)] DOI:10.1016/S0165-0327(00)00215-9

Healthy and sustainable diets that meet greenhouse gas emission reduction targets and are affordable for different income groups in the UK

Objective: To model dietary changes required to shift the UK population to diets that meet dietary recommendations for health, have lower greenhouse gas emissions (GHGE) and are affordable for different income groups. Design: Linear programming was used to create diets that meet dietary requirements for health and reduced GHGE (57% and 80% targets) by income quintile, taking into account food budgets and foods currently purchased, thereby keeping dietary change to a minimum. Subjects: Nutrient composition, GHGE and price data were mapped to 101 food groups in household food purchase data (UK Living Cost and Food Survey (2013), n=5144 households). Results: Current diets of all income quintiles had similar total GHGE, but the source of GHGE differed by types of meat, and amount of fruit and vegetables. It was possible to create diets with a 57% reduction in GHGE that met dietary and cost restraints in all income groups. In the optimised diets, the food sources of GHGE differed by income group due to the cost and keeping the level of deviation from current diets to a minimum. Broadly, the changes needed were similar across all groups; reducing animal-based products and increasing plant-based foods but varied by specific foods. Conclusions: Healthy and lower GHGE diets could be created in all income quintiles but tailoring changes to income groups to minimise deviation may make dietary changes more achievable. Specific attention must be given to interventions and policies to be appropriate for all income groups

Demographic factors do not predict weight loss maintenance in members of a commercial weight loss organisation

Demographic factors are important correlates of predisposition to obesity but much less is known about how they relate to weight loss and its maintenance. This analysis examined the demographic predictors of weight loss maintenance (WLM) in 1428 participants of a slimming organisation, who had been members for a mean_SD of 16_16 months, had lost 13.8%_9.2% weight and were trying to maintain, or increase, their weight loss during a subsequent 6 month study period. Data were collected as part of the DiOGenes study(1). Ethical approval was given by the University of Surrey Ethics Committee. Adults were recruited between August 2006 and July 2008 from Slimming World at group meetings and by email. Participants’ weights (using calibrated scales) were taken from group records at four time points, measurement 1 (M1) at the start of the study period, nominally six months later (measurement 2 (M2)), six months before M1 and when they initially enrolled with Slimming World. Participants were free to continue following the weight-loss programme as they wished during this study, and there was no intervention other than completing the questionnaires. Participants completed a general screening questionnaire at M1 relating to age, gender, marital status, education level achieved, employment status, number of adults and children in the household, monetary expenditure on food, number of siblings, weight history, weight history of parents and siblings, medical history (whether a doctor had told them they have had obesity, diabetes, cancer, high blood pressure, high cholesterol, heart disease or stroke), medical history of parents and siblings, alcohol intake, smoking status, and birth weight. Linear regression analysis was used to identify the associations between questionnaire responses and weight change (as % M1 weight) over the 6 month study period. Mean age was 46.8 years for women, 50.8 years for men; 95% were women. There was no association between age, sex, marital status or family structure and subsequent WLM. Heavier people lost a greater percentage of their weight during the study period than did lighter people (p<0.001), presumably because they had more to lose. People who were unemployed and “other” lost considerably more weight during the study than those who were employed, or not working for other reasons. However, there were only 37 and 58 people in these first two groups respectively. The percentage of respondents who reported being told by a doctor they had medical conditions was as follows: high blood pressure 30%, high cholesterol 16% and obesity 36%. Fewer than 5% of respondents answered yes for the other conditions. Being told by their GP that they were obese, either currently or in the past, significantly correlated with respondents’ WLM (p = 0.007). All significant associations explained a very small percentage of the variance in WLM. No other demographic variables were associated with WLM. In this study demographic measures were used as baseline indicators of subsequent outcome. They did not change in the time course of the study. While demographic factors are likely to be important in predisposing people to weight gain and in accessing the means to lose weight, it is likely that individual changes in eating and activity behaviour are more important in determining successful weight loss and its maintenance. This work was part of the Diet, Obesity and Genes project (www.diogenes-eu.org) funded by the European Commission (contract #: Food-CT-2005- 513946) in the Food Quality and Safety Priority of the Sixth Framework Program