COMPARISON BETWEEN PRE-PRANDIAL AND POST-PRANDIAL HEART RATE VARIABILITY (HRV)

Abstract : After food ingestion, peptides are released in GIT, which cause local vasodilatation. Therefore, after meals, redistribution of blood occurs b e c a u s e o f s h i f t i n g o f l a r g e a m o u n t s o f b l o o d i n t o G I T . I n n o r m a l individuals, this is well compensated and does not lead to post-prandial hypotension. The mechanism of post-prandial hypotension is well known. We hypothesized that there may be a decrease in parasympathetic activity (tone) after meals to compensate for the change in blood distribution. We carried out the study to find out the changes in the autonomic tone before and after meals (lunch) in normal individuals, using Heart Rate Variability ( H R V ) . F r o m t h e s e r i e s o f R R i n t e r v a l s m a r k e d , t h e t i m e d o m a i n a n d f r e q u e n c y d o m a i n m e a s u r e s o f H R V w e r e o b t a i n e d u s i n g N e v r o k a r d software (version 6.4). Continuous ECG was recorded in 15 healthy adult subjects (mean age 29.06 ± 6.2; 13 males and 2 females). The ECG was r e c o r d e d i n p r e -p r a n d i a l a n d p o s t -p r a n d i a l s t a t e f o r a p e r i o d o f f i v e minutes each as follows: (1) just before the subjects had lunch, (2) 15 minutes after lunch, (3) 1 hour after lunch, and (4) 2 hours after lunch. T i m e d o m a i n a n d f r e q u e n c y d o m a i n m e a s u r e s o f H R V w e r e c o m p a r e d between pre-prandial state and rest of post-prandial states. The autonomic t o n e p a r a m e t e r s d i d n o t s h o w a s i g n i f i c a n t c h a n g e b e t w e e n t h e p r ep r a n d i a l s t a t e a n d t h e i m m e d i a t e p o s t -p r a n d i a l s t a t e . [ R a n g e , i . e . , t h e difference between the maximum and minimum RR intervals (406 ± 161.14 v s . 4 1 6 . 6 6 ± 1 2 5 ) , s t a n d a r d - Synopsis : Ambarish et al studied the changes in autonomic activity (tone) using heart rate variability (HRV) after feeding. Parasympathetic and sympathetic tone was studied in 15 healthy adult subjects before and after lunch. No significant change was seen in both when the autonomic tone parameters were compared. But the authors propose that HRV can be used to detect autonomic neuropathy in diabetics at a very early stage, by c o m p a r i n g p r e -p r a n d i a l a n d p o s t p r a n d i a l H R V

Manchester Intermittent Diet in Gestational Diabetes Acceptability Study (MIDDAS-GDM): a two-arm randomised feasibility protocol trial of an intermittent low-energy diet (ILED) in women with gestational diabetes and obesity in Greater Manchester

Introduction The prevalence of gestational diabetes mellitus (GDM) is rising in the UK and is associated with maternal and neonatal complications. National Institute for Health and Care Excellence guidance advises first-line management with healthy eating and physical activity which is only moderately effective for achieving glycaemic targets. Approximately 30% of women require medication with metformin and/or insulin. There is currently no strong evidence base for any particular dietary regimen to improve outcomes in GDM. Intermittent low-energy diets (ILEDs) are associated with improved glycaemic control and reduced insulin resistance in type 2 diabetes and could be a viable option in the management of GDM. This study aims to test the safety, feasibility and acceptability of an ILED intervention among women with GDM compared with best National Health Service (NHS) care. Method and analysis We aim to recruit 48 women with GDM diagnosed between 24 and 30 weeks gestation from antenatal clinics at Wythenshawe and St Mary’s hospitals, Manchester Foundation Trust, over 13 months starting in November 2022. Participants will be randomised (1:1) to ILED (2 low-energy diet days/week of 1000 kcal and 5 days/week of the best NHS care healthy diet and physical activity advice) or best NHS care 7 days/week until delivery of their baby. Primary outcomes include uptake and retention of participants to the trial and adherence to both dietary interventions. Safety outcomes will include birth weight, gestational age at delivery, neonatal hypoglycaemic episodes requiring intervention, neonatal hyperbilirubinaemia, admission to special care baby unit or neonatal intensive care unit, stillbirths, the percentage of women with hypoglycaemic episodes requiring third-party assistance, and significant maternal ketonaemia (defined as ≥1.0 mmol/L). Secondary outcomes will assess the fidelity of delivery of the interventions, and qualitative analysis of participant and healthcare professionals’ experiences of the diet. Exploratory outcomes include the number of women requiring metformin and/or insulin. Ethics and dissemination Ethical approval has been granted by the Cambridge East Research Ethics Committee (22/EE/0119). Findings will be disseminated via publication in peer-reviewed journals, conference presentations and shared with diabetes charitable bodies and organisations in the UK, such as Diabetes UK and the Association of British Clinical Diabetologists

Mischief, Mermaids, and Mismanagement : A Poetry Hotline

A curated, collaborative poetic happening In the new age of social distancing, poetics and collaboration don’t get much attention, but we would like to use experimental poetic techniques to facilitate collaborating, creating, and connecting through poems and mischief. This happening takes inspiration from the childhood game Telephone, where a message whispered and passed from player to player morphs in meaning through repetition and revision. In our version, Emily Dickinson poems get passed and morph into thirteen new shapes. Our hope is that participants, regardless of their familiarity with poetry, will engage this happening as an opportunity for like-minded creative miscreants to socialize and share with poetry as a focal point. Participants will leave this happening with two collaboratively revised Emily Dickinson poems, a smattering of poetry dates to share with friends and goes, and sparks for original creative work

Estimated portion sizes in a school-aged population

AbstractObjectiveTo produce study-specific portion sizes for 11-year-old children in a population-based birth cohort and to compare these study-specific portion sizes with previously published children's portion sizes, to assess their relevance today.DesignTwo multiple-pass 24 h dietary recalls were taken. The Food Standard Agency's photographic food atlas was used to quantify intakes. Study-specific food portion sizes were calculated for each food group. Portion sizes were calculated for all children and separately for boys and girls. The nutrient intake from the 24 h dietary recalls was analysed using study-specific and published portion sizes for individual participants. Agreement was assessed using Pearson's correlation, intra-class correlation coefficients and the Bland–Altman method.SettingBirth cohort study, UK.SubjectsChildren (mean age 11·3 years, n 264) and parents/guardians.ResultsA total of 124 food portion sizes were calculated. Differences in portion weights between boys and girls were seen only for seven food items. There was a significant positive relationship (P &lt; 0·001) between intakes of each nutrient as determined by the two sets of portion sizes. Correlation coefficients ranged from 0·77 (protein) to 0·98 (β-carotene). The intra-class correlation coefficients showed good agreement between nutrient intakes determined by the study-specific and published portion sizes (P &lt; 0·001).ConclusionsNutrient intakes calculated using portion sizes from our population were similar to those calculated from portion size data collected in a national survey, despite being collected over a decade later. The present study adds to the small amount of evidence regarding portion sizes in UK children and shows agreement with previously published paediatric portion sizes.</jats:sec

Maternal and neonatal influences on, and reproducibility of, neonatal aortic pulse wave velocity

Aortic pulse wave velocity (aPWV), a noninvasive measure of vascular stiffness, is an independent predictor of cardiovascular disease both before and in overt vascular disease. Its characteristics in early life and its relationship to maternal factors have hardly been studied. To test the hypothesis that infant aPWV was positively related to maternal anthropometry and blood pressure (BP) at 28 weeks gestation, after adjusting for neonatal anthropometry and BP, 148 babies born in Manchester were measured 1 to 3 days after birth. A high reproducibility of aPWV, assessed in 30 babies within 3 days of birth, was found with a mean difference between occasions of &ndash;0.04 m/s (95% CI: &ndash;0.08 to 0.16 m/s). Contrary to our hypothesis, a significant inverse relation was found between neonatal aPWV (mean: 4.6 m/s) and maternal systolic BP (mean: 108.9 mm Hg; r=&ndash;0.57; 95% CI: &ndash;0.67 to &ndash;0.45) but not maternal height nor weight. Neonatal aPWV was positively correlated with birth length, birth weight, and systolic BP. In multiple regression, neonatal aPWV remained significantly inversely associated with maternal systolic BP (adjusted &szlig; coefficient: &ndash;0.032; 95% CI: &ndash;0.040 to &ndash;0.024; P&lt;0.001), after adjustment for maternal age, birth weight, length, and neonatal BP (all independently and positively related to aPWV) and for gestational age, maternal weight, and height (unrelated). These results suggest that infant aPWV may be a useful index of infant vascular status, is less disturbing to measure than infant BP, and is sensitive to the gestational environment marked by maternal BP. <br /