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Jennings A.,London South Bank University | Davies G.J.,London South Bank University | Costarelli V.,Harokopio University | Dettmar P.W.,Technostics Ltd
Journal of Human Nutrition and Dietetics | Year: 2010

Background: The possible influence of diet and body weight on bowel habit in children is unknown. The present study aimed to investigate the inter-relationships between bowel function, excess body weight and dietary intake in a group of preadolescent children. Methods: Eighty-four preadolescent children aged 7-10 years were recruited [mean (SD) age 9.7 (1.0) years]. All children completed a bowel habit diary, examining specific parameters of bowel function and a weighed food inventory concurrently for seven consecutive days. Height and weight measurements were also taken. Children were grouped according to whether they met dietary recommendations and by overweight status; differences in bowel function between the groups were then analysed. Results: Children who exceeded reference values for fat were more likely to report an incidence of straining to start (P = 0.005) and pain during defaecation (P = 0.021). Subjects who met protein recommendations were less likely to report incomplete evacuation (P = 0.000) and those who met zinc recommendations were less likely to report pain during defaecation (P = 0.044). Excess body weight (according to International Obesity Task Force cut-offs) was also associated with poor bowel habit, with overweight and obese children reporting lower defaecation frequency and a higher incidence of straining and feelings of incomplete evacuation, although these findings were not statistically significant. Defaecation frequency in healthy children was 1.4 defaecations per day compared to 1.2 defaecations for overweight and obese children. Conclusion: A poor diet that fails to meet dietary recommendations as well as being overweight and obese appears to be associated with increased defaecation problems in preadolescent children. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd. Source

Brownlee I.A.,Northumbria University | Forster D.J.,Northumbria University | Wilcox M.D.,Northumbria University | Dettmar P.W.,Technostics Ltd | And 2 more authors.
Nutrition Research Reviews | Year: 2010

The most widely used pharmacological therapies for obesity and weight management are based on inhibition of gastrointestinal lipases, resulting in a reduced energy yield of ingested foods by reducing dietary lipid absorption. Colipase-dependent pancreatic lipase is believed to be the major gastrointestinal enzyme involved in catalysis of lipid ester bonds. There is scant literature on the action of pancreatic lipase under the range of physiological conditions that occur within the human small intestine, and the literature that does exist is often contradictory. Due to the importance of pancreatic lipase activity to nutrition and weight management, the present review aims to assess the current body of knowledge with regards to the physiology behind the action of this unique gastrointestinal enzyme system. Existing data would suggest that pancreatic lipase activity is affected by intestinal pH, the presence of colipase and bile salts, but not by the physiological range of Ca ion concentration (as is commonly assumed). The control of secretion of pancreatic lipase and its associated factors appears to be driven by gastrointestinal luminal content, particularly the presence of acid or digested proteins and fats in the duodenal lumen. Secretion of colipase, bile acids and pancreatic lipase is driven by cholecystokinin and secretin release. © 2010 The Authors. Source

Bulmer D.M.,Northumbria University | Ali M.S.,Northumbria University | Brownlee I.A.,Northumbria University | Dettmar P.W.,Technostics Ltd | Pearson J.P.,Northumbria University
Laryngoscope | Year: 2010

Objectives/Hypothesis. Exposure of pig laryngeal mucosa to pepsin and acid will have a differential damaging effect depending on the anatomical site, mirroring the effects seen in the human larynx in laryngopharyngeal reflux (LPR). This study aims to quantitate damage caused to laryngeal tissue by acid alone, and acid and pepsin, and also to determine if the extent of this damage depends on the tissue site. Study Design. Prospective translational research study. Methods. An excised porcine laryngeal damage model in a small Ussing chamber was used to measure the effect of pepsin and acid on five sites (ventricles, vocal folds, posterior commissure, supraglottic, and subglottic mucosa). The tissue samples were incubated on the lumenal side for 1 hour with pH 2 and 4 HCl, pH 2 plus 1 mg/mL pepsin, and pH 4 plus 1 mg/mL pepsin. Damage was assessed by changes in absorbance of the bathing solution at optical density (OD) 260 nm and OD 280 nm and by measurement of released DNA compared to tissues bathed in pH 7.4 buffer. Damage was also assessed histologically. Results. Based on histology, all the tissues were resistant to pH 4.0 except the subglottic mucosa. Only the posterior commissure was not damaged by pH 2.0 plus pepsin. Similar patterns were observed with absorbance changes and DNA release. Conclusions. The subglottic mucosa was the most susceptible to damage and the posterior commissure the least. Laryngeal tissues are essentially resistant to damage at pH 4.0, but are damaged when pepsin is present. This suggests that in LPR, pH 4.0 or above refluxate would only be damaging if it contains pepsin. © 2010 The American Laryngological, Rhinological and Otological Society, Inc. Source

Fahim A.,Castle Hill Hospital | Dettmar P.W.,Technostics Ltd | Morice A.H.,Castle Hill Hospital | Hart S.P.,Castle Hill Hospital
Medicina | Year: 2011

Background and Objective: Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias. There is evidence of the increased prevalence of gastroesophageal reflux disease in patients with IPF. The aim of this prospective study was to evaluate reflux in patients with IPF by analyzing the scores of the reflux cough questionnaire, measurement of pepsin in exhaled breath condensate (EBC) to detect extraesophageal reflux, and Helicobacter pylori serology to evaluate the prevalence of this stomach bacterium in patients with IPF. Material and Methods: The Hull airway reflux questionnaire (HARQ) was completed by 40 patients with IPF and 50 controls in order to evaluate reflux symptoms. EBC was collected from 23 patients (17 patients with IPF and 6 controls) for measurement of pepsin by the lateral flow technique. A prospective study of 57 subjects (34 patients with IPF and 23 controls) for H. pylori antibody detection by ELISA was performed. Results: Significantly higher HARQ scores (maximum score, 70) were recorded in patients with IPF compared with controls (19.6 [SD, 12.4] vs. 3 [SD, 2.9], P<0.001). There was no significant difference in EBC pepsin positivity between patients with IPF and controls (2 of the 17 patients vs. none of the 6 controls, P=0.38). There was no significant difference in H. pylori serology between patients with IPF and controls (17 of the 34 patients vs. 14 of the 23 controls, P=0.42). Conclusion: Patients with IPF had significantly increased scores of airway reflux symptoms. However, no objective evidence of extraesophageal reflux or H. pylori infection in patients with IPF was obtained in this study. The role of gastroesophageal and extraesophageal reflux in pathogenesis of IPF should be evaluated in a larger prospective study. Source

Jennings A.,London South Bank University | Davies G.J.,London South Bank University | Costarelli V.,Harokopio University | Dettmar P.W.,Technostics Ltd
International Journal of Food Sciences and Nutrition | Year: 2010

The aim of the current study was to report on the micronutrient intakes of a sample of pre-adolescent children from a range of socio-economic backgrounds. Eighty-five children aged 7-10 years completed 7-day weighed food diaries, which were used to assess habitual intake of selected micronutrients. Intakes were then compared with the current Department of Health reference values and the findings of the UK National Diet and Nutrition Survey for young people. These children failed to meet the reference values set by the Department of Health for zinc (73% of sample) and potassium (68% of sample), and intakes of calcium, potassium, vitamin B12, vitamin D and folate were lower than the findings of the UK National Diet and Nutrition Survey. Among this sample, dietary changes are required to ensure that children follow a well-balanced diet for optimum health and development. © 2010 Informa UK Ltd. Source

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