Diet, Nutrition and Obesity
http://hdl.handle.net/20.500.12904/4955
2024-03-28T21:26:25Z
2024-03-28T21:26:25Z
Breast feeding in infants diagnosed with phenylketonuria (PKU): a scoping review
Chadborn, Neil
http://hdl.handle.net/20.500.12904/17860
2024-02-16T01:44:26Z
2023-01-01T00:00:00Z
Breast feeding in infants diagnosed with phenylketonuria (PKU): a scoping review
Chadborn, Neil
BACKGROUND: Phenylketonuria (PKU) is the most common inherited disease of amino acid metabolism, characterised by elevated levels of phenylalanine (Phe). There is a lack of infant feeding guidance for those with PKU. From birth to 6 months of age, breast feeding is the optimal nutrition for an infant and continuing breast feeding for infants with PKU is recommended by European guidelines. However, human breast milk contains Phe in varying quantities, and therefore, the effects breast feeding might have on infants with PKU needs careful consideration. AIM: To assess the effects of breast feeding (exclusive or partial) compared with low-Phe formula feeding in infants diagnosed with PKU, on blood Phe levels, growth and neurodevelopmental scores. METHODS: The Cochrane Inborn Errors of Metabolism Trials Register, MEDLINE and Embase were searched (date of latest search: 9 August 2022). Studies were included if they looked at the effects of breast feeding in infants diagnosed with PKU compared with formula feeding. Predetermined outcomes included blood Phe levels, growth in the first 2 years of life and neurodevelopmental scores. RESULTS: Seven observational studies (282 participants) met the inclusion criteria. All studies compared continuation of breast feeding with low-Phe formula versus formula feeding only. While most studies concluded that there was no difference in mean serum Phe levels in their follow-up period, two reported that breastfed infants were more likely to have a normal mean Phe level. Two studies described no difference in mean weight gain after birth, while one found that breastfed infants were more likely to have higher mean weight gain. Two studies commented that breastfed infants achieved higher developmental scores in childhood as compared with formula fed infants. CONCLUSION: Although there are no randomised trials, observational evidence suggests that continuation of breast feeding and supplementation with low-Phe formula is safe and may be beneficial for infants diagnosed with PKU.
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
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2023-01-01T00:00:00Z
Caloric restriction (CR) plus high-nitrate beetroot juice does not amplify CR-induced metabolic adaptation and improves vascular and cognitive functions in overweight adults: A 14-day pilot randomised trial
Stephan, Blossom C. M.
http://hdl.handle.net/20.500.12904/17069
2024-02-22T02:30:41Z
2023-01-01T00:00:00Z
Caloric restriction (CR) plus high-nitrate beetroot juice does not amplify CR-induced metabolic adaptation and improves vascular and cognitive functions in overweight adults: A 14-day pilot randomised trial
Stephan, Blossom C. M.
Caloric restriction (CR) and dietary nitrate supplementation are nutritional interventions with pleiotropic physiological functions. This pilot study investigates the combined effects of CR and nitrate-rich beetroot juice (BRJ) on metabolic, vascular, and cognitive functions in overweight and obese middle-aged and older adults. This was a two-arm, parallel randomized clinical trial including 29 participants allocated to CR + BRJ (n = 15) or CR alone (n = 14) for 14 days. Body composition, resting energy expenditure (REE), and hand-grip strength were measured. Resting blood pressure (BP) and microvascular endothelial function were measured, and Trail-Making Test A and B were used to assess cognitive function. Salivary nitrate and nitrite, and urinary nitrate and 8-isoprostane concentrations were measured. Changes in body composition, REE, and systolic and diastolic BP were similar between the two interventions (p > 0.05). The CR + BRJ intervention produced greater changes in average microvascular flux (p = 0.03), NO-dependent endothelial activity (p = 0.02), and TMT-B cognitive scores (p = 0.012) compared to CR alone. Changes in urinary 8-isoprostane were greater in the CR + BRJ group (p = 0.02), and they were inversely associated with changes in average microvascular flux (r = -0.53, p = 0.003). These preliminary findings suggest that greater effects on vascular and cognitive functions could be achieved by combining CR with dietary nitrate supplementation.
© 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
2023-01-01T00:00:00Z
Impact of a dietitian in general practice: Paediatric food allergy
Freeman-Hughes, Amy
http://hdl.handle.net/20.500.12904/16149
2024-01-26T15:23:31Z
2022-01-01T00:00:00Z
Impact of a dietitian in general practice: Paediatric food allergy
Freeman-Hughes, Amy
BACKGROUND: Food allergy in infants and young children places a significant burden on primary care. This study evaluated a dietetic-led paediatric food allergy service, which attempts to provide more rapid access to the dietitian and reduce the need for general practitioner (GP) and secondary care appointments. METHOD(S): Two community dietetic services for children referred with food allergy were compared. The first was dietetic-led care where dietitians train community children's nurses to recognise potential cases of food allergy, undertake basic diagnostic assessment and subsequently refer to the dietitian. The other is a more traditional dietetic community service where patients are referred predominantly by the GP or secondary care. RESULT(S): In dietetic-led care 86 patients were seen, compared to 96 in dietetic community care. Dietetic-led care received less referrals from the GP; 36% vs 67% (p<0.001), GP appointments for allergy-related conditions prior to dietetic referral were lower; 3 vs 6 visits (p=0.001) and input from secondary care was also lower; 8 vs 25 patients (p=0.002) compared with dietetic community care. Children referred to dietetic-led care were younger; 78% <6 months vs 40% (p<0.001) in dietetic community care. CONCLUSION(S): Dietetic-led care describes a model that has the potential to reduce GP and secondary care appointments, identify patients more quickly and reduce the time to receive dietetic input, thereby resolving symptoms more quickly and reducing prescribed medications. This model demonstrates the importance of integrated care and multidisciplinary working; offering a solution to reducing GP workload whilst maintaining or improving patient care. This article is protected by copyright. All rights reserved.
2022-01-01T00:00:00Z
Dietary nitrate and brain health. Too much ado about nothing or a solution for dementia prevention?
Stephan, Blossom C. M.
http://hdl.handle.net/20.500.12904/15773
2022-09-09T14:49:28Z
2022-01-01T00:00:00Z
Dietary nitrate and brain health. Too much ado about nothing or a solution for dementia prevention?
Stephan, Blossom C. M.
Dementia is a significant public health priority with approximately 55 million cases worldwide, and this number is predicted to quadruple by 2050. Adherence to a healthy diet and achieving optimal nutritional status are vital strategies to improve brain health. The importance of this area of research has been consolidated into the new term ‘nutritional psychiatry’. Dietary nitrate, closely associated with the intake of fruits and vegetables, is a compound that is increased in dietary patterns such as the Mediterranean and MIND diets and has protective effects on cognition and brain health. Nitrate is characterised by a complex metabolism and is the precursor of the nitrate–nitrite–nitric oxide (NO) pathway contributing to systemic NO generation. A higher intake of dietary nitrate has been linked to protective effects on vascular outcomes including blood pressure and endothelial function. However, the current evidence supporting the protective effects of dietary nitrate on brain health is less convincing. This article aims to provide a critical appraisal of the current evidence for dietary nitrate supplementation for improving brain health and provide suggestions for future research.
2022-01-01T00:00:00Z