Search tips
Search criteria

Results 1-25 (29)

Clipboard (0)

Select a Filter Below

more »
Year of Publication
more »
1.  Obesogenic diet and physical activity behaviors: independent or associated behaviors in adolescents? 
Public health nutrition  2009;13(5):673-681.
Associations between diet and physical activity may identify behaviors that could be changed together to prevent childhood obesity. This study examines associations between physical activity and obesogenic dietary behaviors in a large UK youth cohort.
Cross-sectional analysis of UK cohort.
Subjects and methods
10–11 year old UK youths completed 3, one-day diet diaries. Average daily energy consumption, percent energy from fat, carbohydrate, energy density and grams of fruit and vegetables were estimated. To assess physical activity participants wore an accelerometer for 3 or more days. Regression models were run by sex to examine the extent to which dietary variables predicted physical activity before and after controlling for pubertal status, maternal education and adiposity.
Among boys percent energy from fat was consistently negatively associated with accelerometer determined indicators of physical activity (Std. Beta −.055 to −.101, p<.05) while total energy (Std. Beta = .066 to .091. p<.05) and percent energy from carbohydrate (.054 to .106, p<.05) were positively associated before and after adjustment for confounders. For girls fruit and vegetable intake was consistently positively associated with physical activity (Std. Beta = .056 to .074, p<.005). However all associations were weak. Associations were broadly comparable when participants with non-plausible dietary reports were included or excluded from the analyses.
Obesogenic diet and physical activity behaviors were weakly associated, suggesting that interventions should focus on implementing strategies that are independently successful at changing diet or physical activity behaviors either separately or in combination.
PMCID: PMC2913226  PMID: 19954571
ALSPAC; under-report; physical activity; childhood obesity
2.  Postnatal factors associated with failure to thrive in term infants in the Avon Longitudinal Study of Parents and Children 
Archives of Disease in Childhood  2006;92(2):115-119.
To assess the contribution of postnatal factors to failure to thrive in infancy.
11 900 infants from the Avon Longitudinal Study of Parents and Children (ALSPAC), born at 37–41 weeks' gestation, without major malformations and with a complete set of weight measurements in infancy (83% of the original ALSPAC birth cohort) were studied. Conditional weight gain was calculated for the periods from birth to 8 weeks and 8 weeks to 9 months. Cases of growth faltering were defined as those infants with a conditional weight gain below the 5th centile.
Analysis yielded 528 cases of growth faltering from birth to 8 weeks and 495 cases from 8 weeks to 9 months. In multivariable analysis, maternal factors predicting poor infant growth were height <160 cm and age >32 years. Growth faltering between birth and 8 weeks was associated with infant sucking problems regardless of the type of milk, and with infant illness. After 8 weeks of age, the most important postnatal influences on growth were the efficiency of feeding, the ability to successfully take solids and the duration of breast feeding.
The most important postnatal factors associated with growth faltering are the type and efficiency of feeding: no associations were found with social class or parental education. In the first 8 weeks of life, weak sucking is the most important symptom for both breastfed and bottle‐fed babies. After 8 weeks, the duration of breast feeding, the quantity of milk taken and difficulties in weaning are the most important influences.
PMCID: PMC2083322  PMID: 16905563
3.  Does birth weight predict childhood diet in the Avon longitudinal study of parents and children? 
Study objective: Low birth weight predicts cardiovascular disease in adulthood, and one possible explanation is that children with lower birth weight consume more fat than those born heavier. Therefore, the objective of this study was to investigate associations between birth weight and childhood diet, and in particular, to test the hypothesis that birth weight is inversely related to total and saturated fat intake.
Design: Prospective cohort study.
Setting: South west England.
Participants: A subgroup of children enrolled in the Avon longitudinal study of parents and children, with data on birth weight and also diet at ages 8, 18, 43 months, and 7 years (1152, 998, 848, and 771 children respectively).
Main results: Associations between birth weight and diet increased in strength from age 8 to 43 months, but had diminished by age 7 years. Fat, saturated fat, and protein intakes were inversely, and carbohydrate intake was positively associated with birth weight at 43 months of age, after adjusting for age, sex, and energy intake. After adjustment for other confounders, all associations were weakened, although there was still a suggestion of a relation with saturated fat (–0.48 (95% CI –0.97, 0.02) g/day per 500 g increase in birth weight. Similar patterns were seen in boys and girls separately, and when the sample was restricted to those with complete data at all ages.
Conclusions: A small inverse association was found between birth weight and saturated fat intake in children at 43 months of age but this was not present at 7 years of age. This study therefore provides little evidence that birth weight modifies subsequent childhood diet.
PMCID: PMC1732958  PMID: 16234423
4.  Dietary patterns in pregnancy and associations with socio-demographic and lifestyle factors 
To obtain distinct dietary patterns in the third trimester of pregnancy using principal components analysis (PCA); to determine associations with socio-demographic and lifestyle factors.
Design and methods
A total of 12 053 pregnant women partaking in a population-based cohort study recorded current frequency of food consumption via questionnaire in 1991-1992. Dietary patterns identified using PCA were related to social and demographic characteristics and lifestyle factors.
Five dietary patterns were established and labelled to best describe the types of diet being consumed in pregnancy. The ‘health conscious’ component described a diet based on salad, fruit, rice, pasta, breakfast cereals, fish, eggs, pulses, fruit juices, white meat and non-white bread. The ‘traditional’ component loaded highly on all types of vegetables, red meat and poultry. The ‘processed’ component was associated with high-fat processed foods. The ‘confectionery’ component was characterized by snack foods with high sugar content and the final ‘vegetarian’ component loaded highly on meat substitutes, pulses, nuts and herbal tea and high negative loadings were seen with red meat and poultry. There were strong associations between various socio-demographic variables and all dietary components; in particular, a ‘health conscious’ diet was positively associated with increasing education and age and non-white women. There was a negative association with increased parity, single, non-working women, those who smoked and who were overweight pre-pregnancy. Opposite associations were seen with the ‘processed’ component.
Distinct dietary patterns in pregnancy have been identified. There is clear evidence of social patterning associated with the dietary patterns, these social factors need to be accounted for in future studies using dietary patterns. This study will form the basis for further work investigating pregnancy outcome.
PMCID: PMC2492391  PMID: 17375108
dietary patterns; pregnancy; principal components analysis; ALSPAC
5.  Diet in childhood and adult cardiovascular and all cause mortality: the Boyd Orr cohort 
Heart  2005;91(7):894-898.
Objective: To examine the association between childhood diet and cardiovascular mortality.
Design: Historical cohort study.
Setting: 16 centres in England and Scotland.
Participants: 4028 people (from 1234 families) who took part in Boyd Orr’s survey of family diet and health in Britain between 1937 and 1939 followed up through the National Health Service central register.
Exposures studied: Childhood intake of fruit, vegetables, fish, oily fish, total fat, saturated fat, carotene, vitamin C, and vitamin E estimated from household dietary intake.
Main outcome measures: Deaths from all causes and deaths attributed to coronary heart disease and stroke.
Results: Higher childhood intake of vegetables was associated with lower risk of stroke. After controlling for age, sex, energy intake, and a range of socioeconomic and other confounders the rate ratio between the highest and lowest quartiles of intake was 0.40 (95% confidence interval 0.19 to 0.83, p for trend 0.01). Higher intake of fish was associated with higher risk of stroke. The fully adjusted rate ratio between the highest and lowest quartile of fish intake was 2.01 (95% confidence interval 1.09 to 3.69, p for trend 0.01). Intake of any of the foods and constituents considered was not associated with coronary mortality.
Conclusions: Aspects of childhood diet, but not antioxidant intake, may affect adult cardiovascular risk.
PMCID: PMC1768996  PMID: 15958357
childhood; cardiovascular mortality; fish; fruit; vegetables
6.  Maternal diet in pregnancy and offspring height, sitting height, and leg length 
Study objective: To examine the association between maternal diet in pregnancy and offspring height, sitting height, and leg length.
Design: Cohort study.
Setting: South west England.
Participants: 6663 singletons (51% male) enrolled in the Avon longitudinal study of parents and children, with information on their mother's diet in late pregnancy (obtained by food frequency questionnaire) and their own height recorded at age 7.5 years.
Main results: Before adjustment, maternal magnesium, iron, and vitamin C were the nutrients most consistently associated with offspring height and its components. However, adjusting for potential confounders weakened all relations considerably. For example, a standard deviation (SD) increase in magnesium intake was associated with a 0.10 (–0.07, 0.14) SD unit increase in height before adjustment, which was reduced to 0.05 (0.01, 0.08) SD units after adjustment, and a SD unit increase in iron intake was associated with 0.08 (0.05, 0.12) and 0.04 (0.01, 0.08) SD unit increases in height before and after adjustment respectively. No other dietary variables were associated with height or its components after adjustment.
Conclusions: These findings do not provide evidence that maternal diet in pregnancy has an important influence on offspring height, sitting height, or leg length in well nourished populations, although effects may emerge as offspring become older.
PMCID: PMC1757047  PMID: 15911641
7.  Maternal diet in pregnancy and offspring blood pressure 
Archives of Disease in Childhood  2005;90(5):492-493.
PMCID: PMC1720401  PMID: 15851431
8.  Implications of adopting the WHO 2006 Child Growth Standard in the UK: two prospective cohort studies 
Archives of Disease in Childhood  2007;93(7):566-569.
The WHO 2006 Child Growth Standard is based on data from international optimally nourished breastfed infants from birth to age 5 years.
To assess the potential effect of its use on weight and growth monitoring of UK children.
Full-term members of two population-based UK birth cohorts: the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 1335) and the Gateshead Millennium Baby Study (GMS; n = 923).
Growth data from birth to 5 years were converted into z-scores relative to the WHO 2006 standard.
Compared with the WHO standard, both UK cohorts had higher birth weights (mean z-scores: GMS, 0.17; ALSPAC, 0.34) and ALSPAC had higher birth lengths. After birth, length showed a good fit at all ages. By 2–4 months, both cohorts were similar in weight to the WHO median (mean WHO weight z-score at 4 months: GMS, 0.01; ALSPAC, −0.07), but thereafter the UK cohorts were heavier (mean WHO weight z-score at 12 months: GMS, 0.57; ALSPAC, 0.65). At age 12 months, the risk of being classified as underweight (weight <2nd centile) was considerably lower according to the WHO standard than by the UK 1990 Growth Reference (RR = 0.15, 95% CI = 0.07 to 0.32), and the risk of being classified as obese at 4–5 years (body mass index >98th centile) was slightly increased (RR = 1.35, 95% CI = 1.02 to 1.78).
Adoption of the WHO 2006 Growth Charts would set a markedly lower standard of weight gain beyond the age of 4 months for UK infants and could support efforts to avoid future childhood obesity. However, the WHO standard is not representative of size at birth in the UK.
PMCID: PMC2532956  PMID: 17908712
9.  Maternal fish intake in late pregnancy and the frequency of low birth weight and intrauterine growth retardation in a cohort of British infants 
Objective: To investigate the relation between maternal fish intake in late pregnancy and the frequency of low birth weight and intrauterine growth retardation (IUGR).
Participants: 11 585 pregnant women in south west England.
Methods: Information on fish intake was obtained from a food frequency questionnaire sent to the women at 32 weeks' gestation, and used to calculate n-3 fatty acid (n-3FA) intake from fish. IUGR was defined as a birth weight for gestational age and sex below the 10th centile. Confounding variables considered included maternal age, height, weight, education, parity, smoking and drinking in pregnancy, and whether the mother was living with a partner. Only singleton, liveborn infants were included.
Main results: Mean daily intakes of fish and n-3FAs were 32.8 g and 0.147 g respectively. In unadjusted analyses there were positive associations between mean birth weight and fish intake or n-3FA intake, but these disappeared on adjustment for potential confounders. The frequency of IUGR decreased with increasing fish intake—the OR (95%CI) of IUGR in those eating no fish was 1.85 (1.44 to 2.38) compared with those in the highest fish intake group. On adjustment this relation was attenuated (adjusted OR 1.37 (1.02 to 1.84)), but the decline in the frequency of IUGR with increasing fish intake remained statistically significant. No relation was observed between mean gestation and fish or n-3FA intake.
Conclusions: These results lend some support to the hypothesis that raising fish or n3-FA intake during pregnancy may increase fetal growth rate. However, they provide no evidence that increasing fish consumption is associated with an increase in mean gestation.
PMCID: PMC1732783  PMID: 15143117
10.  Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study 
Archives of Disease in Childhood  2003;88(8):671-675.
Aims: To test for the coexistence of social inequalities in undernutrition and obesity in preschool children.
Methods: Retrospective, cross sectional, study of routinely collected data from 74 500 children aged 39–42 months in 1998/99. Main outcome measures were weight, height, sex, and age routinely recorded by health visitors. Body mass index (BMI) standardised for age and sex, relative to UK 1990 reference data, was used to define undernutrition (BMI <2nd centile) and obesity (BMI >95th centile; BMI >98th centile). Social deprivation was assessed as Carstairs deprivation category (1 = most affluent to 7 = most deprived).
Results: Both undernutrition (3.3%) and obesity (8.5% above 95th centile; 4.3% above 98th centile) significantly exceeded expected frequencies from UK 1990 reference data. Undernutrition and obesity were significantly more common in the more deprived families. Odds ratios in deprivation category 7 relative to category 1 were 1.51 (95% CI 1.22 to 1.87) for undernutrition (BMI <2nd centile) and 1.30 (95% CI 1.05 to 1.60) for obesity (BMI >98th centile). The cumulative prevalence of under and overnutrition (malnutrition) in the most deprived group was 9.5% compared to 6.9% in the least deprived group.
Conclusions: Undernutrition and obesity are significantly more common than expected in young children and strongly associated with social deprivation. Both undernutrition and obesity have adverse short and long term health effects. Public health strategies need to tackle malnutrition (both undernutrition and obesity) in children and take into consideration the association with social deprivation.
PMCID: PMC1719615  PMID: 12876159
11.  Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort 
Study objective: To examine associations between food and nutrient intake, measured in childhood, and adult cancer in a cohort with over 60 years follow up.
Design and setting: The study is based on the Boyd Orr cohort. Intake of fruit and vegetables, energy, vitamins C and E, carotene, and retinol was assessed from seven day household food inventories carried out during a study of family diet and health in 16 rural and urban areas of England and Scotland in 1937–39.
Participants: 4999 men and women, from largely working class backgrounds, who had been children in the households participating in the pre-war survey. Analyses are based on 3878 traced subjects with full data on diet and social circumstances.
Main results: Over the follow up period there were 483 incident malignant neoplasms. Increased childhood fruit intake was associated with reduced risk of incident cancer. In fully adjusted logistic regression models, odds ratios (95% confidence intervals) with increasing quartiles of fruit consumption were 1.0 (reference), 0.66 (0.48 to 0.90), 0.70 (0.51 to 0.97), 0.62 (0.43 to 0.90); p value for linear trend=0.02. The association was weaker for cancer mortality. There was no clear pattern of association between the other dietary factors and total cancer risk.
Conclusions: Childhood fruit consumption may have a long term protective effect on cancer risk in adults. Further prospective studies, with individual measures of diet are required to further elucidate these relations.
PMCID: PMC1732406  PMID: 12594199
12.  Insulin and gall stones 
Gut  2001;48(5):737-738.
PMCID: PMC1728282  PMID: 11336030
13.  Evidence for the ambiguity of the term constipation: the role of irritable bowel syndrome. 
Gut  1994;35(10):1455-1458.
A satisfactory definition of constipation is elusive. An important and measurable element is slow colonic transit. Whole gut transit time, a proxy for colonic transit time, can be estimated from self recorded data on stool form and frequency. Our aim was to compare whole gut transit time with subjective definitions in the context of the general population. In a community based sample of 731 women aged 25-69 years the estimated whole gut transit time was compared with two subjective assessments of constipation-the woman's own perception and a symptom based definition proposed by an international working team (Rome definition). We have defined slow whole gut transit time as > 2 SD above the mean in women who seldom passed lumpy stools (that is, > 92 hours). Slow transit was present in 9.3% of the sample. Similar numbers met the subjective definitions (8.5% and 8.2%). However, the overlap between the three definitions was poor. Of 68 women with estimated slow transit, 28 had self perceived constipation, 20 had Rome defined constipation, and only 11 had both. Of subjects classified as constipated by the subjective definitions only 37% had slow transit; they had a high prevalence of irritable bowel symptoms. In conclusion, this study showed that the term constipation is ambiguous and often misleading and that attempts to base a definition on symptoms are misguided. In epidemiological studies, conclusions about the prevalence of constipation should be based on records of stool type and timing.
PMCID: PMC1375024  PMID: 7959204
14.  Intestinal transit time in the population calculated from self made observations of defecation. 
STUDY OBJECTIVES--To assess the feasibility of estimating intestinal transit time in the general population using self recorded data on stool form, frequency of defecation, and the interdefecatory time interval. DESIGN--Prospective measurement of bowel function. SETTING--Bristol, Avon, UK between 1987 and 1989. SUBJECTS--Subjects were drawn from 1897 people who comprised 72.2% of a stratified random sample of all men aged 40-69 years and women aged 25-69 years on the lists of 19 general medical practitioners. Altogether 1561 subjects (59.4%) recorded bowel function and a subsample of 98 (50 women and 48 men) had intestinal transit time measured. MEASUREMENTS AND MAIN RESULTS--The interdefecatory time interval and stool form (on a validated 1-6 scale sensitive to transit time) were recorded prospectively from three consecutive defecations. In the subsample the mean intestinal transit time was measured simultaneously using a four marker, two stool x ray technique. Multiple regression analysis was used to assess the extent to which intestinal transit time could be predicted from the defecatory data. The formulas obtained were then applied to the whole study population. In women, intestinal transit time was best predicted by the formula 103-1.23 (DF)--4.69 (SFS)+0.638 (IDTI), where DF is the stated defecation frequency per week, IDTI is the interdefecatory time interval, and SFS is the sum of the three stool form scores, for which the correlation coefficient r = 0.736. For men the intestinal transit time = 79-1.33 (DF)--1.88 (SFS)+0.329 (IDTI), for which the correlation coefficient r = 0.541. The predicted intestinal transit time was longer in women than men at equivalent ages. Women of childbearing age had longer transit times than older women. CONCLUSIONS--Observations made by untrained subjects can be used to estimate intestinal transit time in epidemiological studies. A gender related difference in transit time exists.
PMCID: PMC1059804  PMID: 8228773
15.  Final year medical students' knowledge of practical nutrition. 
An entire final-class of medical students was set a 6-part question on dietary advice to patients as commonly seen in general practice. The marks were scored by a formal, agreed system. Eighty-two per cent failed though only 2% failed the whole exam. The teaching of practical nutrition needs to be improved.
PMCID: PMC1293497  PMID: 1625265
16.  Symptomatic and silent gall stones in the community. 
Gut  1991;32(3):316-320.
The prevalence of gall stone disease in a stratified random sample of 1896 British adults (72.2% of those approached) was established using real time ultrasound. The prevalence rose with age, except in women of 40-49 years, so that at 60-69 years, 22.4% of women and 11.5% of men had gall stones or had undergone cholecystectomy. The cholecystectomy rate of people with gall stone disease was higher in women than in men (43.5% v 24%, p less than 0.05). Very few subjects with gall stones had convincing biliary symptoms. In women, 10.4% had symptoms according to a questionnaire definition of biliary pain and 6.3% according to conventional history taking, while no men at all admitted to biliary pain. Nevertheless, cholecystectomy in men had nearly always been preceded by convincing biliary symptoms. The age at cholecystectomy was, on average, nine years less than the age at detection of silent gall stones in both sexes. It is concluded that either gall stones are especially prone to cause symptoms in younger people or that there are two kinds of cholelithiasis - symptomatic and silent. The lack of symptomatic gall stones in cross sectional surveys is probably due to their rapid diagnosis and treatment.
PMCID: PMC1378843  PMID: 2013429
22.  Sugar, fat, and the risk of colorectal cancer. 
The habitual diet of 50 patients with large bowel cancer, as assessed by a dietary history method, was compared with that of 50 closely matched controls. Patients were included only if their symptoms were unlikely to have changed previous eating habits. The mean daily intakes of all major nutrient classes and of dietary fibre were estimated. Patients with large bowel cancer consumed 16% more energy than controls (mean (SEM) daily intake 9.92 (0.41) v 8.56 (0.32) MJ (2370 (98) v 2046 (76) kcal), respectively; p less than 0.0001), mainly in the form of carbohydrate (21% more; 282.6 (13.7) v 233.4 (10.5) g; p less than 0.0001) and fat (14% more; 100.8 (4.3) v 88.4 (3.2) g; p less than 0.001). The extra carbohydrate was largely in the form of sugars depleted in fibre and the extra fat as combinations of fat and such sugars. As the selection criteria used make it unlikely that this eating pattern was caused by the disease the data suggest that a high intake of sugars depleted in fibre and fat predisposes to the development of large bowel cancer.
PMCID: PMC1418069  PMID: 2998541
24.  Effects of dietary sucrose on factors influencing cholesterol gall stone formation. 
Gut  1984;25(3):269-274.
Twelve subjects with radiolucent gall stones and bile supersaturated with cholesterol were studied after six weeks each on diets which contained 112 g and 16 g respectively of refined (fibre depleted) sucrose but which allowed free access to other foods. Energy intake was 24.5% higher on the high sugar diet and body weight ended 1.4 kg higher than on the low sugar diet. Biliary secretion rates of cholesterol, phospholipid and bile acid, measured by a perfusion technique, were similar on the two diets, as were the bile acid pool sizes measured by isotope dilution. Cholesterol saturation index of fasting 'gall bladder' bile was 1.30 +/- 0.11 and 1.37 +/- 0.14 on high and low sugar respectively (NS). Plasma triglycerides were 36% higher and plasma high density lipoprotein cholesterol concentrations were 9% lower on the high sugar diet. These findings indicate that over a six week period refined sugar in normally consumed amounts does not adversely affect the lipid composition of bile.
PMCID: PMC1432282  PMID: 6698443
25.  Diet and gall stones: effects of refined and unrefined carbohydrate diets on bile cholesterol saturation and bile acid metabolism. 
Gut  1983;24(1):2-6.
It has been suggested that consumption of refined carbohydrate foods (notably sugar and white flour) increases bile cholesterol saturation and hence the risk of cholesterol gall stone formation. To test this hypothesis, 13 subjects with probable cholesterol gall stones ate refined and unrefined carbohydrate diets, each for six weeks in random order. On the refined carbohydrate diet, subjects ate more refined sugar (mean = SEM: 106 +/- 7 vs 6 +/- 1 g/day, p less than 0.001), less dietary fibre (13 +/- 1 vs 27 +/- 3 g/day, p less than 0.001), and had a higher energy intake (9.17 +/- 0.66 vs 7.16 +/- 0.64 MJ/day, p less than 0.001). After each diet, the lipid composition of duodenal bile and bile acid kinetics was determined. The cholesterol saturation index of bile was higher on the refined carbohydrate diet in all but one subject, with a mean value of 1.50 +/- 0.10 compared with 1.20 +/- 0.12 on the unrefined diet (p less than 0.005). On the refined carbohydrate diet, bile contained relatively less cholic acid and slightly more deoxycholic acid. There were, however, no significant differences in total or individual bile acid pool sizes. There were also no differences in the rates of primary bile acid synthesis or fractional turnover on the two diets. Consumption of carbohydrate in refined form increases bile cholesterol saturation. The risk of gall stones might be reduced by avoidance of refined carbohydrate foods.
PMCID: PMC1419917  PMID: 6293939

Results 1-25 (29)