Association between adherence to the Mediterranean Diet and the Eatwell Guide and changes in weight and waist circumference in post-menopausal women in the UK Women's Cohort Study.

OBJECTIVE: This study investigated the associations between adherence to the Mediterranean Diet and the Eatwell Guide (EWG) and changes in weight and waist circumference in post-menopausal women. STUDY DESIGN: Post-hoc analysis of post-menopausal women from the UK Women's Cohort Study. MAIN OUTCOME MEASURES: Changes in weight, waist circumference and the risk of abdominal and general obesity. RESULTS: 4162 post-menopausal women were selected. Higher adherence to both the EWG and the Mediterranean Diet was associated with smaller increases in waist circumference over 4 years (EWG: ß -0.47, CI -0.75, -0.20 per 1 tertile increase in score), (Mediterranean Diet: ß -0.29, CI -0.58, -0.01 per 1 tertile increase in score); and lower risk of abdominal obesity (EWG: OR 0.55, CI 0.43, 0.70 third versus the first tertile), (Mediterranean Diet: OR 0.60, CI 0.46, 0.76 third versus the first tertile), but was not associated with weight changes (EWG: ß 0.14, CI -0.07, 0.36 per 1 tertile increase in score), (Mediterranean Diet: ß 0.03, CI -0.19, 0.25 per 1 tertile increase in score) or risk of becoming overweight or obese (EWG: OR 1.09, CI 0.77, 1.52 third versus the first tertile), (Mediterranean Diet: OR 0.91, CI 0.65, 1.27 third versus the first tertile). CONCLUSIONS: The results suggest that adherence to either the Mediterranean Diet or the EWG can help to prevent abdominal obesity in post-menopausal women.

Factors affecting consumer attitudes to fungi-based protein: A pilot study.

Meat substitutes using alternative proteins can facilitate sustainable diets without compromising animal welfare. The fungal protein, also called mycoprotein is the biomass that results from the fermentation of a filamentous fungus. This paper reports the results of a consumer acceptance study of fungal protein-based meat substitutes using a mixed-method design with a web-based survey and a series of semi-structured interviews amongst European participants. Based on the description provided in the survey, 56% of participants were not directly familiar with fungal proteins but they understood its potential societal benefits. The overall Food Technology Neophobia Score (FTNS) of the sample was moderate (M = 40.0, range = 19-62), with more neophilic participants (52.9%) than neophobic (47.1%). FTN was a significant but weak predictor of Perceived Benefits (PB) and Purchase Intentions (PI). Younger participants perceived fungal proteins more positively, and city-dwellers had higher PI than rural dwellers. Reducetarians were more likely to purchase fungal proteins, compared to unrestricted omnivores. Participants with lower acceptance of fungal proteins' association with mould had significantly lower PI than those who were comfortable with it. In turn, familiarity with fungal protein was positively associated with mould acceptance. The qualitative data suggested that the sensory attributes were the most important factor in the acceptance of meat substitutes. The participants also valued clean label products which were perceived as healthier. Familiarity with other products containing mould seemed to assuage concerns and drive acceptance of fungal protein. The findings suggest that the overall acceptance of fungal protein is still rather low. This may be attributed to the perceived low appeal and tastiness of available fungal protein products.

Derivation and Validation of a Total Fruit and Vegetable Intake Prediction Model to Identify Targets for Biomarker Discovery Using the UK National Diet and Nutrition Survey.

BACKGROUND: Dietary assessments in research and clinical settings are largely reliant on self-reported questionnaires. It is acknowledged that these are subject to measurement error and biases and that objective approaches would be beneficial. Dietary biomarkers have been purported as a complementary approach to improve the accuracy of dietary assessments. Tentative biomarkers have been identified for many individual fruits and vegetables (FVs), but an objective total FV intake assessment tool has not been established. OBJECTIVES: To derive and validate a prediction model of total FV intake (TFVpred) to inform future biomarker studies. METHODS: Data from the National Diet and Nutrition Survey (NDNS) were used for this analysis. A modeling group (MG) consisting of participants aged >11 years from the NDNS years 5-6 was created (n = 1746). Intake data for 96 FVs were analyzed by stepwise regression to derive a model that satisfied 3 selection criteria: SEE ≤80, R2 >0.7, and ≤10 predictors. The TFVpred model was validated using comparative data from a validation group (VG) created from the NDNS years 7-8 (n = 1865). Pearson's correlation coefficients were assessed between observed and predicted values in the MG and VG. Bland-Altman plots were used to assess agreement between TFVpred estimates and total FV intake. RESULTS: A TFVpred model, comprised of tomatoes, apples, carrots, bananas, pears, strawberries, and onions, satisfied the selection criteria (R2 = 0.761; SEE = 78.81). Observed and predicted total FV intake values were positively correlated in the MG (r = 0.872; P < 0.001; R2 = 0.761) and the VG (r = 0.838; P < 0.001; R2 = 0.702). In the MG and VG, 95.0% and 94.9%, respectively, of TFVpred model residuals were within the limits of agreement. CONCLUSIONS: Intakes of a concise FV list can be used to predict total FV intakes in a UK population. The individual FVs included in the TFVpred model present targets for biomarker discovery aimed at objectively assessing total FV intake.

Gestational diabetes and progression to type two diabetes mellitus: missed opportunities of follow up and prevention?

BACKGROUND: The incidence of type 2 diabetes (T2DM) is increasing. Having a pregnancy complicated by gestational diabetes mellitus (GDM) is a potent risk factor for the later development of T2DM. AIMS: To explore the characteristics of women diagnosed with GDM in a single centre and their follow up for progression to T2DM. METHODS: A retrospective cohort study using anonymised data of one hundred and fifty four (154) women with GDM receiving maternity care at the Oxford University Hospitals NHS Foundation Trust (OUHFT) in 2010 and their follow up until 2018. RESULTS: The prevalence of GDM in women delivering in Oxfordshire in 2010 was 3.4%. 70% of pregnant women were overweight or obese (with 51% being obese) at booking. Gestational weight gain (GWG) was excessive in 29% of women, when compared to Institute of Medicine (IOM) guidelines. Almost a quarter of women (23.4%) had no follow up after delivery. Over a median follow up of 3.5 years (range 0-8 years) nearly one in six (16.9%) of the total cohort (22% of those tested) went on to develop T2DM. 74% of women with GDM were multiparous, and 65% of nulliparous women were tested compared to 81% of multiparous women. There was a significant difference between multiparous women (53.8%) compared to nulliparous women (46.2%) developing T2DM (p=0.01). There was no significant difference in BMI (p=0.866) or GWG (p=0.83) in women who progressed to T2DM versus those who did not. CONCLUSION: The risk of T2DM after GDM is substantial however, follow up rates of this population is poor. Subsequent screening of women with GDM and their management crosses secondary and primary care with scope for improvement in counselling of women of the importance of annual reviews, in data collection and follow up in both obstetrics and general practice. The implementation of a recall system, an education programme for general practitioners and/or a registry of women diagnosed with GDM could be useful to identify those at high risk of developing T2DM as well as providing a platform for the potential development of interventions to prevent progression to T2DM after GDM.

The Efficacy of Energy-Restricted Diets in Achieving Preoperative Weight Loss for Bariatric Patients: a Systematic Review.

In bariatric practice, a preoperative weight loss of at least 5% is recommended. However, the hypocaloric diets prescribed vary and no consensus exists. This study examined the efficacy of preoperative diets in achieving 5% weight loss. From a systematic literature search, eight randomised controlled trials (n = 862) were identified. Half of the trials used a "very-low-calorie diet" whilst the rest employed a "low-calorie diet". Only five diets achieved ≥ 5% weight loss over varying durations and energy intakes. By inference, compliance with a 700-1050 kcal (2929-4393 kJ) diet, consisting of moderate carbohydrate, high protein and low/moderate fat, for 3 weeks is likely to achieve 5% weight loss. A low-carbohydrate diet (< 20 g/day) may achieve this target within a shorter duration. Additional research is required to validate these conclusions.