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Jebb S.A.,MRC Human Nutrition Research | Aveyard P.N.,University of Oxford | Hawkes C.,World Cancer Research Fund
Obesity Reviews | Year: 2013

Summary: Tackling obesity has been a policy priority in England for more than 20 years. Two formal government strategies on obesity in 2008 and 2011 drew together a range of actions and developed new initiatives to fill perceived gaps. Today, a wide range of policies are in place, including support for breastfeeding and healthy weaning practices, nutritional standards in schools, restrictions on marketing foods high in fat, sugar and salt to children, schemes to boost participation in sport, active travel plans, and weight management services. Data from annual surveys show that the rate of increase in obesity has attenuated in recent years, but has not yet been reversed. This paper considers the actions taken and what is known about the impact of individual policies and the overarching strategy to tackle obesity in England. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.


Pettifor J.M.,University of Witwatersrand | Prentice A.,MRC Human Nutrition Research
Best Practice and Research: Clinical Endocrinology and Metabolism | Year: 2011

Recently there has been renewed interest in the role of vitamin D in paediatric bone health. Its role in the development of rickets and hypocalcaemia in infants and young children, in particular, in many part of the world is well known, and the importance of the prevention of vitamin D deficiency during pregnancy and lactation has been highlighted. Less clear are the possible effects that maintaining maternal vitamin D sufficiency might have on foetal and early infant growth and bone development. There is little evidence to suggest that maintaining childhood vitamin D status well above that necessary to prevent rickets has an effect on intestinal calcium absorption or on peak bone mass. Further studies are needed in these areas prior to definitive conclusions are drawn about the optimal vitamin D requirements and circulating 25(OH)D concentrations for foetal, infant and childhood bone health. © 2010 Elsevier Masson SAS. All rights reserved.


Jebb S.A.,MRC Human Nutrition Research
Nutrition Bulletin | Year: 2012

The UK Department of Health's Responsibility Deal represents a new approach to public private partnerships to improve public health. This paper focuses on the Food Network and actions to improve the nation's diet. It summarises the pledges developed so far and early indicators of progress. It also signposts areas for future work and processes for monitoring and evaluation. © 2012 The Author. Journal compilation © 2012 British Nutrition Foundation.


Ambrosini G.L.,MRC Human Nutrition Research
Proceedings of the Nutrition Society | Year: 2014

A range of individual nutrients and foods have been suggested to increase obesity risk in childhood, but the evidence is inconsistent. Dietary patterns that summarise the whole diet may, however, be more informative. The aim of the present paper was to systematically review the current evidence pertaining to overall dietary patterns in childhood and later obesity risk. Studies eligible for review identified childhood dietary patterns using an empirical method, i.e. principal components analysis, factor analysis or reduced rank regression, and reported their prospective associations with an obesity-related outcome. Literature searches identified 166 studies and of these, seven met the eligibility criteria. Despite differences between studies, a common dietary pattern was identified in all seven studies that was high in energy-dense, high-fat and low-fibre foods. The quality of studies varied, however; the four studies reporting positive associations between this type of dietary pattern and later obesity risk were of consistently higher quality than those reporting null associations. The balance of evidence from this systematic review indicates that dietary patterns that are high in energy-dense, high-fat and low-fibre foods predispose young people to later overweight and obesity. It also highlights that examining multiple dietary factors within a dietary pattern may better explain obesity risk than individual nutrients or foods. However, more prospective studies are needed and dietary pattern research requires greater rigour and focus, to further clarify the role of dietary factors in the aetiology of obesity and inform future interventions. © The Author 2013.


Ni Mhurchu C.,MRC Human Nutrition Research
BMC public health | Year: 2010

Public health strategies place increasing emphasis on opportunities to promote healthy behaviours within the workplace setting. Previous research has suggested worksite health promotion programmes have positive effects on physical activity and weight loss, yet little is known regarding their effects on dietary behaviour. The aim of this review was to assess the effects of worksite interventions on employee diets. Electronic databases (MEDLINE, The Cochrane Library, PsycINFO, EMBASE, LexisNexis) were searched for relevant articles published between 1995 and April 2009. Studies were eligible for inclusion if they were peer-reviewed English language publications describing a worksite-based health promotion intervention with minimum study duration of eight weeks. All study designs were eligible. Studies had to report one or more diet-related outcome (energy, fat, fruit, or vegetable intakes). Methodological quality was assessed using a checklist that included randomisation methods, use of a control group, and study attrition rates. Sixteen studies were included in the review. Eight programmes focussed on employee education, and the remainder targeted change to the worksite environment, either alone or in combination with education. Study methodological quality was moderate. In general, worksite interventions led to positive changes in fruit, vegetable and total fat intake. However, reliance on self-reported methods of dietary assessment means there is a significant risk of bias. No study measured more robust outcomes such as absenteeism, productivity, or healthcare utilisation. The findings of this review suggest that worksite health promotion programmes are associated with moderate improvement in dietary intake. The quality of studies to date has been frequently sub-optimal and further, well designed studies are needed in order to reliably determine effectiveness and cost-effectiveness. Future programmes to improve employee dietary habits should move beyond individual education and aim to intervene at multiple levels of the worksite environment.


Ward K.,MRC Human Nutrition Research
Proceedings of the Nutrition Society | Year: 2012

This review considers the definition of a healthy bone phenotype through the life course and the modulating effects of muscle function and nutrition. In particular, it will emphasise that optimal bone strength (and how that is regulated) is more important than simple measures of bone mass. The forces imposed on bone by muscle loading are the primary determinants of musculoskeletal health. Any factor that changes muscle loading on the bone, or the response of bone to loading results in alterations of bone strength. Advances in technology have enhanced the understanding of a healthy bone phenotype in different skeletal compartments. Multiple components of muscle strength can also be quantified. The critical evaluation of emerging technologies for assessment of bone and muscle phenotype is vital. Populations with low and moderate/high daily Ca intakes and/or different vitamin D status illustrate the importance of nutrition in determining musculoskeletal phenotype. Changes in mass and architecture maintain strength despite low Ca intake or vitamin D status. There is a complex interaction between body fat and bone which, in addition to protein intake, is emerging as a key area of research. Muscle and bone should be considered as an integrative unit; the role of body fat requires definition. There remains a lack of longitudinal evidence to understand how nutrition and lifestyle define musculoskeletal health. In conclusion, a life-course approach is required to understand the definition of healthy skeletal phenotype in different populations and at different stages of life. © 2011 The Author.


Prentice A.,MRC Human Nutrition Research
Nestle Nutrition Workshop Series: Pediatric Program | Year: 2011

Calcium and vitamin D are essential for bone growth and maintenance. Among the bone-forming minerals, dietary calcium supply is close to biological requirements and may be limiting in some parts of the world where there are few rich dietary sources of calcium, particularly for children and women during pregnancy and lactation. Animal milk is a rich source of calcium and, in countries where milk is fortified with vitamin D, a contributor to dietary vitamin D intake. Current evidence indicates that, in the human, there are physiological mechanisms that support the necessary calcium fluxes across the placenta and mammary gland and that are unresponsive to increases in calcium intake. This applies across the range of dietary calcium intakes recorded in healthy individuals. In contrast, although there is unlikely to be an additional requirement for vitamin D during pregnancy and lactation, many women have poor vitamin D status. This places them at risk of osteomalacia and their infants at risk of rickets, osteomalacia, compromised skeletal growth and other outcomes. There needs to be increased awareness among policy makers, health professionals and the public about the importance of safe UVB sunshine exposure and consumption of dietary vitamin D by women of reproductive age at risk of vitamin D deficiency. Copyright © 2011 S. Karger AG, Basel.


Hulston C.J.,Loughborough University | Churnside A.A.,Loughborough University | Venables M.C.,MRC Human Nutrition Research
British Journal of Nutrition | Year: 2015

The purpose of the present study was to determine whether probiotic supplementation (Lactobacillus casei Shirota (LcS)) prevents diet-induced insulin resistance in human subjects. A total of seventeen healthy subjects were randomised to either a probiotic (n 8) or a control (n 9) group. The probiotic group consumed a LcS-fermented milk drink twice daily for 4 weeks, whereas the control group received no supplementation. Subjects maintained their normal diet for the first 3 weeks of the study, after which they consumed a high-fat (65 % of energy), high-energy (50 % increase in energy intake) diet for 7 d. Whole-body insulin sensitivity was assessed by an oral glucose tolerance test conducted before and after overfeeding. Body mass increased by 0·6 (se 0·2) kg in the control group (P< 0·05) and by 0·3 (se 0·2) kg in the probiotic group (P>0·05). Fasting plasma glucose concentrations increased following 7 d of overeating (control group: 5·3 (se 0·1) v. 5·6 (se 0·2) mmol/l before and after overfeeding, respectively, P< 0·05), whereas fasting serum insulin concentrations were maintained in both groups. Glucose AUC values increased by 10 % (from 817 (se 45) to 899 (se 39) mmol/l per 120 min, P< 0·05) and whole-body insulin sensitivity decreased by 27 % (from 5·3 (se 1·4) to 3·9 (se 0·9), P< 0·05) in the control group, whereas normal insulin sensitivity was maintained in the probiotic group (4·4 (se 0·8) and 4·5 (se 0·9) before and after overeating, respectively (P>0·05). These results suggest that probiotic supplementation may be useful in the prevention of diet-induced metabolic diseases such as type 2 diabetes. © The Authors 2015.


Prentice A.,MRC Human Nutrition Research
Journal of Steroid Biochemistry and Molecular Biology | Year: 2013

Nutritional rickets is a major public health problem in many countries of the world. The disease is characterized by deformities of the long bones, enlargement of the wrists and costochondral junctions, hypotonia and, in infants, craniotabes and delayed fontanelle closure. Predominantly caused by severe vitamin D deficiency, rickets can also be associated with hypocalcemic seizures and cardiac failure. First presentation is typically at 6-24 months of age, although hypocalcemia may be evident in younger infants. In many affluent industrialized countries, the prevalence of rickets in the general population diminished after the introduction of clean-air legislation and dietary supplementation. However, in such countries, vitamin-D deficiency rickets has re-emerged in recent years, particularly among groups with limited exposure to UVB-containing sunshine. Infants at risk of rickets tend to be those whose mothers had poor vitamin D status during pregnancy and those exclusively breast-fed for a prolonged period with little skin exposure to UVB. In other countries of the world, the prevalence of rickets can be high, even in regions with abundant year-round UVB-containing sunshine. In general, this is also due to vitamin D deficiency related to limited sun exposure. However, reports from Africa and Asia suggest that there may be other etiological factors involved. Studies in South Africa, Nigeria, The Gambia and Bangladesh have identified rickets in children, typically 3-5 years old at first presentation, in whom plasma 25-hydroxyvitamin D concentrations are higher than those characteristic of primary vitamin D deficiency. Calcium deficiency has been implicated, and in some, but not all, disturbances of phosphate metabolism, renal compromise and iron deficiency may also be involved. Continuing studies of the etiology of nutritional rickets will provide evidence to underpin guidelines for the prevention and treatment of rickets world-wide. This article is part of a Special Issue entitled 'Vitamin D Workshop'. © 2012 Elsevier Ltd. All rights reserved.


Prentice A.,MRC Human Nutrition Research
Nutrition Bulletin | Year: 2013

The quote by Sir Isaac Newton, 'If I have seen further it is by standing on ye sholders of Giants' was the theme of the British Nutrition Foundation (BNF) Annual Lecture 2012. Illustrations of the seminal contributions of six 'giants' of nutrition science, chosen because of their links to the BNF and to vitamin and mineral research in Cambridge, were used to give a historical context to recent studies and controversies on calcium and vitamin D requirements, particularly focusing on rickets and maternal and child nutrition. © 2013 British Nutrition Foundation Nutrition Bulletin.

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