Peer assessment of professionalism attributes.

BACKGROUND: Peer assessment can support the development of professionalism by providing feedback that enables learners to reflect on their professional behavioural attributes. APPROACH: We developed and implemented an innovative online peer assessment and feedback tool. Students were encouraged to nominate 12 peer assessors to anonymously conduct their assessment. Assessors were presented with a list of 32 adjectives that described professional behavioural attributes within four domains (integrity, conscientiousness, agreeableness and resilience) and asked to rate the student by selecting a minimum of two adjectives in each domain and to provide free-text comments. The feedback was presented as a collated word cloud and free-text comments. All students had the opportunity to discuss their profiles with a staff member. EVALUATION: Our mixed-methods evaluation found that all students participated, and they valued the peer assessment and feedback process. Although the assessment was formative and confidential, students were reluctant to provide negative comments about their peers. 'Disengaged', 'aloof' and 'argumentative' were the most likely negative adjectives that indicated students with low-level professionalism concerns. IMPLICATIONS: Future development will focus on introducing students who can act as peer champions for the process and repeating the peer assessment over time to identify the change in professionalism development.

Potential innate immunity-related markers of endometrial receptivity and recurrent implantation failure (RIF).

The successful implantation of the embryo into a receptive endometrium is essential for the establishment of a viable pregnancy while recurrent implantation failure (RIF) is a real challenge in assisted reproduction. The maternal innate immune system, specifically the Toll-like receptors (TLRs), are involved in maintaining immunity in the female reproductive tract (FRT) required for fertility. In this study, we aimed to investigate the importance of innate immunity-related gene expression in the regulation of human fertility and as a prediction of potential outcome of in vitro fertilization - embryo transfer (IVF-ET), thus, we assessed the gene expression levels of TLR signalling molecules using quantitative real-time PCR between endometrial biopsies of healthy fertile women, and the patients experiencing RIF. Interestingly, our results showed that, TRIB2 and TLR9 genes were differentially expressed between the endometrial biopsies of healthy women and those with RIF. However, comparing expression levels of same genes between pre-receptive and receptive healthy endometrial biopsies showed different genes (ICAM1, NFKBIA, VCAM1, LIF, VEGFB, TLR5) had significantly altered expression, suggesting their involvement in endometrial receptivity. Thus, further investigations will enable us to better understand the role of these genes in the biology of FRT and as a possible target for the improvement of infertility treatments and/or development of non-hormonal contraception.

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.

Vitamin B12 and folate levels in progression of Alzheimer's disease - a short report.

Background: The status of vitamin B12 and folate has been implicated in the development and progression of Alzheimer's disease.Methods: The study explored this issue through a retrospective case-control study design, with follow up of the case group for 18 months. The case group (n = 136) comprised patients 65 years or older diagnosed with Alzheimer's disease and having a Mini-mental State Examination score (MMSE) of ≤ 27. The control group comprised healthy adults 65 years or older (n = 338) with a MMSE score of >27.Results: Vitamin B12 and folate levels were not found to differ between case and control groups. B12 and folate status at baseline was not predictive of disease progression in the case group.Discussion: This lack of association differs from other studies which have shown a protective effect of vitamin B12 and folate on cognitive decline.KEY POINTSThe findings of this study do not confirm evidence suggesting an effect of vitamin B12 and folate levels on development and progression of Alzheimer's disease.Folate and B12 levels were similar in the Alzheimer's group to those of healthy controls.Folate and B12 levels at initial assessment were not predictive of disease progression.

Studies of salivary pepsin in patients with gastro-oesophageal reflux disease.

BACKGROUND: Gastro-oesophageal reflux disease (GERD) is difficult to diagnose without invasive testing. Peptest (RD Biomed, Hull, UK) is a recently marketed diagnostic tool which aims to quantify salivary pepsin as a marker of reflux, providing a rapid alternative to invasive procedures. AIM: To evaluate optimal timing for sampling, and to evaluate the accuracy of Peptest against an independent measure. METHODS: Thirty diagnosed GERD patients (12 female, mean age 49 [range 20-72]) and 20 asymptomatic subjects (14 female, mean age 56 [range 21-56]) were subject to diurnal saliva sampling, with additional samples for 60 minutes following self-reported reflux symptoms and triggering of a proximal reflux alarm. Saliva samples were split and were analysed by both Peptest and ELISA with operators for each blinded to sample identity. RESULTS: Salivary pepsin was detectable in most patients and most volunteers. Peptest scores were significantly lower for patients than controls (P < 0.005). ELISA scores showed no difference between patients and controls. There was no effect of diurnal sampling time (P = 0.75) or time after symptoms (P = 0.76) on Peptest readout. There was no correlation between Peptest and Pepsin ELISA (P = 0.55); Bland-Altman analysis suggested no agreement between the tests (P = 0.414). Receiver-operator curve suggests that neither Peptest (P = 0.3328) nor pepsin (P = 0.4476) is useful for predicting GERD. CONCLUSION: Salivary pepsin is not a reliable tool for the diagnosis of GERD.

Transformation of the peripheral intravenous catheter placement experience in pediatrics.

BACKGROUND: "Needle pokes" are the most frequent cause of pain encountered by pediatric patients in the hospital setting. Poor control of pain during needle pokes leads to short- and long-term adverse outcomes for both patients and hospitals. J-Tips are a needle-free injection system that use pressurized gas to inject lidocaine in a fine stream of fluid that penetrates the skin. This study undertook an evaluation of their effectiveness at decreasing the pain of the needle poke that takes place with IV insertion. METHODS: Participation was limited to patients between the ages of 3 and 16 who received an IV during a 3-week period at an academic pediatric hospital. Furthermore, patients requiring more than one attempt to place the IV were not included. Participants were recruited within 24 hours after having received their IV. The 10-point, Wong-Baker Faces Pain Rating Scale was the tool used to collect pain scores. Patients were recruited to the study by convenience sampling. RESULTS: Pain scores were collected from 85 patients. There were 41 patients who received needle-free injected lidocaine prior to IV insertion. There were 44 patients who received an IV without previous lidocaine injection. Mean pain scores for the two groups were 2.45 for the patients who received the needle-free injected lidocaine and 5.8 for the patients who did not (p value <0.001). CONCLUSIONS: Results were consistent with the hypothesis that needle-free injection of lidocaine is an effective therapy for the management of pain in children between the ages of 3-16 years who receive an IV.

Fortified breakfast cereal consumed daily for 12 wk leads to a significant improvement in micronutrient intake and micronutrient status in adolescent girls: a randomised controlled trial.

BACKGROUND: Poor micronutrient status is reported among adolescents across Europe and USA. This may be related to the well-documented decline in the regular consumption of breakfast by this group. The regular consumption of a breakfast cereal offers a possible means to improve micronutrient status; fortified cereal is likely to have enhanced benefit. A study was conducted to determine the efficacy of the regular consumption of a fortified cereal with milk, compared with unfortified cereal, consumed either as a breakfast or a supper, in improving micronutrient intake and micronutrient status of adolescent girls. METHODS: A randomised, double-blind, placebo-controlled intervention trial was conducted in girls recruited at ages 16-19 years, from schools and colleges in Sheffield, UK. Girls were randomised to receive 50 g fortified or unfortified cereal, with 150 ml semi-skimmed milk, daily, for 12 weeks, as a breakfast or as a supper. Dietary intake was estimated using a 4-d food diary and blood collected for the assessment of nutritional status. Within-group changes were tested using a paired sample t test; two-way ANOVA was used to analyse effects of the intervention, with cereal type and time of consumption as factors, correcting for baseline values. The analysis was conducted on 71 girls who completed the study. RESULTS: Consumption of unfortified cereal elicited an increase in the intake of vitamins B1, B2 and B6; consumption of fortified cereal elicited increases in vitamins B1, B2, B6, B12, folate and iron (P < 0.001) and of vitamin D (P = 0.007), all increases were significantly greater than for unfortified cereal. Consumption of the fortified cereal also led to a significant improvement in biomarkers of status for vitamins B2, B12, folate and of iron, compared with girls receiving the unfortified cereal, and maintained vitamin D status, in contrast with the girls receiving the unfortified cereal (P < 0.001). CONCLUSIONS: The daily consumption of cereal with milk for 12 weeks by adolescent girls, increased intakes of micronutrients. The consumption of fortified cereal elicited greater increases than for unfortified cereal and improved biomarkers of micronutrient status. The findings justify strategies to encourage the consumption of fortified cereal with milk by adolescents, either as a breakfast or a supper. TRIAL REGISTRATION: Registered with Current Controlled Trials (Registration: ISRCTN55141306 ).

Attitudes and behaviour towards convenience food and food waste in the United Kingdom.

Households in the UK discard much food. A reduction in such waste to mitigate environmental impact is part of UK government policy. This study investigated whether household food waste is linked to a lifestyle reliant on convenience food in younger consumers. A survey of 928 UK residents aged 18-40 years and responsible for the household food shopping (male n = 278; female n = 650) completed an online questionnaire designed to measure attitudes to convenience food and to quantify household food waste. Cluster analysis of 24 food-related lifestyle factors identified 5 consumer groups. General linear modelling techniques were used to test relationships between the purchase frequency of convenience food and household food waste. From the cluster analysis, five distinct convenience profiles emerged comprising: 'epicures' (n = 135), 'traditional consumers' (n = 255), 'casual consumers' (n = 246), 'food detached consumers' (n = 151) and 'kitchen evaders' (n = 141). Casual consumers and kitchen evaders were the most reliant on convenience food and notably were the most wasteful. The demographic profile of kitchen evaders matched the population groups currently targeted by UK food waste policy. Casual consumers represent a new and distinct group characterised by "buy a lot and waste a lot" behaviour. Household size, packaging format, price-awareness and marketing all appear to influence levels of food waste. However, it seems that subtle behavioural and sociocultural factors also have impact. Further research is needed to elucidate the factors that mediate the positive association between the purchase of convenience food and reported food waste in order to inform food waste policy and initiatives.

Perceptions and Attitudes of Egyptian Health Professionals and Policy-Makers towards Pharmaceutical Sales Representatives and Other Promotional Activities.

BACKGROUND: Pharmaceutical promotion activities in low and middle-income countries are often neither regulated nor monitored. While Egypt has the highest population and per capita use of medicines in the Arab world, we know very little about pharmaceutical companies promotional activities in the country. AIM: To explore and analyze the perceptions of physicians towards promotional and marketing activities of pharmaceutical companies among physicians and pharmacists in Egypt. METHODOLOGY: Perspectives of different healthcare system stakeholders were explored through semi-structured, in-depth interviews conducted in 2014 in Cairo, Egypt. Interviewees were chosen via purposive sampling and snowball technique. Each interview was recorded and transcribed. Then qualitative, thematic analysis was conducted with the help of NVIVO software. FINDINGS: The majority of physicians and pharmacists acknowledged exposure to pharmaceutical promotion. It was commonly believed that interaction with the pharmaceutical industry is necessary and both associated risks and benefits were acknowledged. The interviewed physicians considered themselves competent enough to minimize risks and maximize benefits to their prescribing habits. Views diverged on the extent and magnitude of the risks and benefits of pharmaceutical promotion, especially in regard to the influence on patients' health. CONCLUSIONS: Pharmaceutical promotion in Egypt is intensely directed at prescribers and dispensers. Physicians, pharmacists and policymakers expressed little skepticism to the influence of promotion towards their individual prescribing. Raising awareness of the pitfalls of pharmaceutical promotion is necessary, especially among the less experienced physicians.

The influence of academic examinations on energy and nutrient intake in male university students.

BACKGROUND: Taking examinations is central to student experience at University and may cause psychological stress. Although stress is recognised to impact on food intake, the effects of undertaking examinations on students' dietary intake have not been well characterised. The purpose of this study was to assess how students' energy and nutrient intake may alter during examination periods. METHODS: The study design was a within-subject comparison of students' energy and nutrient intake during an examination period contrasted with that outside an examination period (baseline). A total of 20 male students from the University of Sheffield completed an automated photographic 4-d dietary record alongside four 24-h recalls in each time period. Daily energy and nutrient intake was estimated for each student by time period and change in energy and nutrient intake calculated. Intakes at baseline were compared to UK dietary recommendations. Cluster analysis categorised students according to their change in energy intake between baseline and the examination period. Non-parametric statistical tests identified differences by cluster. RESULTS: Baseline intakes did not meet recommendations for energy, non-milk extrinsic sugars, non-starch polysaccharide and sodium. Three defined clusters of students were identified: Cluster D who decreased daily energy intake by 12.06 MJ (n = 5), Cluster S who had similar energy intakes (n = 13) and Cluster I who substantially increased energy intake by 6.37 MJ (n = 2) between baseline and examination period. There were statistically significant differences (all p < 0.05) in change in intake of protein, carbohydrate, calcium and sodium between clusters. Cluster D recorded greater energy, carbohydrate and protein intakes than Cluster I at baseline. CONCLUSIONS: The majority of students were dietary resilient. Students who demonstrated hypophagia in the examination period had a high energy and nutrient intake at baseline, conversely those who showed hyperphagia had a low energy and nutrient intake. These patterns require confirmation in studies including women, but if confirmed, there is need to address some students' poor food choice especially during examinations.

Differing perceptions among ethnic minority and Caucasian medical students which may affect their relative academic performance.

INTRODUCTION: Ethnic minority (EM) medical students in the United Kingdom underperform academically compared to their Caucasian counterparts, but the reasons are unclear and further understanding is required. AIM: To explore self-reported factors that might influence academic underperformance of EM medical students. METHOD: An online semi-structured questionnaire was used to identify associations between several dimensions that had been identified in previous research and obtain free-text comments. RESULTS: Three-hundred and fifty-one medical students (73.3% Caucasian and 26.5% EM) from the Universities of Sheffield, Keele and London responded. EM medical students were less satisfied with their academic performance and less likely to feel they belonged to the medical school community due to their cultural background, including socio-economic factors. CONCLUSION: Differences exist between EM and Caucasian medical students in their learning experiences in medical school. There is a need to increase awareness, for both medical students and teaching staff, of the impact of cultural diversity on academic performance at medical school.

Development of the posterior basic rhythm in children with autism.

OBJECTIVE: Early detection of autism is critical for effective intervention, but currently, no simple screening tests are available. Furthermore, little is known about the development of brain dynamics in young children. We examine the early neurophysiological manifestations of autism by retrospectively analyzing EEG. In particular, we focus on maturation of the posterior basic rhythm (PBR), which is one of the most characteristic features of the normal EEG, and comprises a discrete functional state. METHODS: Subjects with a diagnosis of autism (n=74), as well as normal (n=134) and epileptic (n=108) controls, were extracted retrospectively from our digital EEG database. Segments with clear PBR were extracted, and standard signal analysis methods were used to calculate peak PBR frequency, power, and coherence. RESULTS: In our cohort, a subset of autistic children show accelerated development of the PBR, with early maturation especially in the 2- to 4-year old range. The overall coherence of PBR-specific activity is also lower in autistic children in our cohort. CONCLUSIONS: These findings provide evidence that autism is associated with accelerated development of the PBR. SIGNIFICANCE: These findings generate a clinical hypothesis for future prospective studies on the efficacy of these simple measures as a diagnostic or screening tool.

Tumour suppressor gene methylation and cervical cell folate concentration are determinants of high-risk human papillomavirus persistence: a nested case control study.

BACKGROUND: Persistent infection with one or more high-risk human papillomavirus [HR-HPV] types increases the risk of intraepithelial neoplasia and cervical cancer. A nested case-control study was conducted to investigate the importance of cervical cell folate concentration and tumour suppressor gene methylation as risk factors for HR-HPV persistence. METHODS: Cervical cell samples from 955 women with HR-HPV infection and normal, borderline or mild dyskaryosis were retrieved from the archive of a population-based screening trial. Women were classified as cases or controls, reflecting the presence or absence [respectively] of any HR-HPV infection at a follow-up clinic at least 6 months from baseline. Cervical cell folate concentration and promoter methylation of five tumour suppressor genes were measured in independent samples from cases and controls. RESULTS: A higher cervical cell folate concentration [P = 0.015] was an independent predictor of infection at follow-up, together with infection with HPV-16 or infection with multiple HR-HPV types. Methylation of the tumour suppressor gene DAPK was associated with a 2.64-fold [95% CI, 1.35-5.17] increased likelihood of HPV infection whilst CDH1 methylation was associated with a 0.53-fold [95% CI, 0.331-0.844] likelihood of HR-HPV infection at follow-up. When considering women with normal or abnormal cytology, the predictive effect of higher cervical cell folate was only seen in women with mild cytology [P = 0.021]; similarly the effect of DAPK methylation was seen in women with mild or borderline cytology [P < 0.05]. CONCLUSIONS: Higher cervical cell folate concentration and promoter methylation of the tumour suppressor gene, DAPK, in women with cervical cell dyskaryosis, are associated with increased risk of HR-HPV persistence.

Dietary advice for muscularity, leanness and weight control in Men's Health magazine: a content analysis.

BACKGROUND: The dietary content of advice in men's lifestyle magazines has not been closely scrutinised. METHODS: We carried out an analysis of such content in all 2009 issues (n = 11) of Men's Health (MH) focusing on muscularity, leanness and weight control. RESULTS: Promotion of a mesomorphic body image underpinned advice to affect muscle building and control weight. Diet advice was underpinned by a strong pseudo-scientific discourse, with citation of expert sources widely used to legitimise the information. Frequently multiple dietary components were advocated within one article e.g. fat, omega-3 fatty acids, thiamine, zinc and high-glycaemic index foods. Furthermore advice would cover numerous nutritional effects, e.g. strengthening bones, reducing stress and boosting testosterone, with little contextualisation. The emphasis on attainment of a mesomorphic body image permitted promotion of slimming diets.Advice to increase calorie and protein intake to augment muscle mass was frequent (183 and 262 references, respectively). Such an anabolic diet was advised in various ways, including consumption of traditional protein foods (217 references) and sports foods (107 references), thereby replicating muscle magazines' support for nutritional supplements. Although advice to increase consumption of red meat was common (52 references), fish and non-flesh sources of protein (eggs, nuts & pulses, and soy products) together exceeded red meat in number of recommendations (206 references). Advice widely asserted micronutrients and phytochemicals from plant food (161 references) as being important in muscle building. This emphasis diverges from stereotypical gender-based food consumption patterns.Dietary advice for control of body weight largely replicated that of muscularity, with strong endorsement to consume fruits and vegetables (59 references), diets rich in nuts and pulses and fish (66 references), as well as specific micronutrients and phytochemicals (62 references). Notably there was emphasis on fat-burning, good fats and consumption of single foods, with relatively little mention of dietary restriction. CONCLUSIONS: Despite the widespread use of scientific information to endorse dietary advice, the content, format and scientific basis of dietary content of MH leaves much to be desired. The dietary advice as provided may not be conducive to public health.

Improving the nutritional quality of charitable meals for homeless and vulnerable adults. A case study of food provision by a food aid organisation in the UK.

The prevalence of homelessness in the UK is rising, and demand for food aid through charitable meal services has increased. Charitable services make a substantial contribution to the food and nutrient intake of vulnerable people, and thus offer a platform for dietary improvement. This study examined food provision by a large charitable organisation in a major UK city. It had several objectives: Firstly to quantify nutritional composition of breakfast and lunch meals, secondly to understand factors that influence the composition of menus and meals, and thirdly to determine whether, within the context of these influences, improvements to the menu would be possible and whether these would be acceptable to clients. Mixed methods of ethnography, semi-structured interviews, quantitative nutrient analysis, recipe adaptation and taste tests were employed. The research team worked as volunteers in the organisation for a 3-week period and interviews were held with the kitchen staff. Food choice was recorded for 189 clients at breakfast and 251 clients at lunch over a 5-day period and nutrient content of these meals was estimated. Meals were weighted towards fat and sugar energy. Energy, potassium, calcium, vitamin C, vitamin A, zinc and magnesium content of meals were below Dietary Reference Value (DRV) targets for at least 20% of breakfast and lunch meals. Such inadequacies may be addressed by the addition of simple foods to the breakfast menu and adaptation of lunchtime recipes. Twelve lunchtime dishes were proposed and eight of these were seemingly acceptable to clients in taste testing. Barriers to provision of healthier meals include budget, food donations and acceptability of meals.

Effect of a tart cherry juice supplement on arterial stiffness and inflammation in healthy adults: a randomised controlled trial.

Tart cherries are a particularly rich source of anthocyanins. Evidence indicates that dietary intake of anthocyanins is inversely associated with arterial stiffness. We conducted an open-label randomised placebo controlled study to determine whether a tart cherry juice concentrate (Cherry Active) reduced arterial stiffness, inflammation and risk markers for cardiovascular disease in 47 healthy adults (30-50 years). Participants consumed 30 ml of cherry concentrate diluted to a volume of 250 ml with water or the same volume of an energy matched control drink daily for six weeks. Measurements were taken at baseline and at the end of the intervention. There was no effect of the intervention on arterial stiffness (P = 0.218), c-reactive protein (P = 0.220), systolic blood pressure (P = 0.163), diastolic blood pressure (P = 0.121), total cholesterol (P = 0.342) and high density lipoprotein cholesterol (P = 0.127). At the end of the intervention, plasma antioxidant capacity (measured as the ferric reducing ability of plasma (FRAP)) was significantly higher in the intervention group than the control group (P = 0.012). We conclude that a tart cherry juice concentrate rich in anthocyanins has no effect on arterial stiffness, c-reactive protein and risk markers for cardiovascular disease, but evokes a minor increase in antioxidant status in healthy adults.

Long-chain polyunsaturated fatty acid supplementation had no effect on body weight but reduced energy intake in overweight and obese women.

Longer-chain polyunsaturated fatty acids may have greater appetite-suppressing effects than shorter-chain, monosaturated, and saturated fatty acids. Because fish oils are predominantly composed of n-3 long-chain polyunsaturated fatty acid and may assist in the treatment of obesity comorbidities, their effect on body weight and body mass index is of interest. We hypothesized that daily supplementation with docosahexaenoic acid (DHA)-rich oil would reduce energy intake and body weight in overweight and obese women compared with supplementation with oleic acid (OA) rich oil. A double-blinded, randomized, parallel intervention was conducted. Body mass index (in kilograms per meter squared), body weight (in kilograms), body fat (in percent), and lean tissue (in kilograms) were measured at baseline and 12 weeks after intervention with DHA or OA. Diet diaries were also completed at these time points for estimation of energy and macronutrient intake. Subjects reported significantly lower energy (P = .020), carbohydrate (g) (P = .037), and fat (g) (P = .045) intake after DHA compared with OA. Body mass or composition was not affected by treatment, although a fall in body weight in the DHA group approached statistical significance (P = .089). Daily ingestion of DHA over a 12-week period may reduce energy intake in overweight and obese females, but longer-term and adequately powered studies using subjects of both sexes are needed. Other factors that should be considered include the following: the choice of control, the body mass index category of subjects, and ways of improving the compliancy and accuracy of dietary assessment.

Temporality in British young women's magazines: food, cooking and weight loss.

OBJECTIVE: The present study examines seasonal and temporal patterns in food-related content of two UK magazines for young women focusing on food types, cooking and weight loss. DESIGN: Content analysis of magazines from three time blocks between 1999 and 2011. SETTING: Desk-based study. SUBJECTS: Ninety-seven magazines yielding 590 advertisements and 148 articles. RESULTS: Cluster analysis of type of food advertising produced three clusters of magazines, which reflected recognised food behaviours of young women: vegetarianism, convenience eating and weight control. The first cluster of magazines was associated with Christmas and Millennium time periods, with advertising of alcohol, coffee, cheese, vegetarian meat substitutes and weight-loss pills. Recipes were prominent in article content and tended to be for cakes/desserts, luxury meals and party food. The second cluster was associated with summer months and 2010 issues. There was little advertising for conventional foods in cluster 2, but strong representation of diet plans and foods for weight loss. Weight-loss messages in articles focused on short-term aesthetic goals, emphasising speedy weight loss without giving up nice foods or exercising. Cluster 3 magazines were associated with post-New Year and 2005 periods. Food advertising was for everyday foods and convenience products, with fewer weight-loss products than other clusters; conversely, article content had a greater prevalence of weight-loss messages. CONCLUSIONS: The cyclical nature of magazine content - indulgence and excess encouraged at Christmas, restraint recommended post-New Year and severe dieting advocated in the summer months - endorses yo-yo dieting behaviour and may not be conducive to public health.