Search

Studies have shown that Raman spectroscopic analysis of fingernail clippings can help differentiate between post-menopausal women who have and who have not suffered a fracture. However, all studies to date have been retrospective in nature, comparing the proteins in nails sourced from women, post-fracture. The objective of this study was to investigate the potential of a prospective test for hip fracture based on spectroscopic analysis of nail tissue. Archived toenail samples from post-menopausal women aged 50 to 63 years in the Nurses' Health Study were obtained and analysed by Raman spectroscopy. Nails were matched case-controls sourced from 161 women; 82 who underwent a hip fracture up to 20 years after nail collection and 81 age-matched controls. A number of clinical risk factors (CRFs) from the Fracture Risk Assessment (FRAX) tool had been assessed at toenail collection. Using 80% of the spectra, models were developed for increasing time periods between nail collection and fracture. Scores were calculated from these models for the other 20% of the sample and the ability of the score to predict hip fracture was tested in model with and without the CRFs by comparing the odds ratios (ORs) per 1 SD increase in standardised predictive values. The Raman score successfully distinguished between hip fracture cases and controls. With only the score as a predictor, a statistically significant OR of 2.2 (95% confidence interval [CI]: 1.5-3.1) was found for hip fracture for up to 20 years after collection. The OR increased to 3.8 (2.6-5.4) when the CRFs were added to the model. For fractures limited to 13 years after collection, the OR was 6.3 (3.0-13.1) for the score alone. The test based on Raman spectroscopy has potential for identifying individuals who may suffer hip fractures several years in advance. Higher powered studies are required to evaluate the predictive capability of this test. [ABSTRACT FROM AUTHOR]

Patients diagnosed with osteoporosis have reported loss of fingernail resilience as the disease progresses. Keratin is the predominant protein in human nail tissue, and its structure has been postulated to be different in fingernails clipped from subjects who have sustained fragility fractures and those who have not, which may offer a window into the donor's bone health. This study was designed to qualify these differences, which may lead to the development of a novel screening tool for fracture risk. Raman spectroscopy was used to measure the fingernails of 633 postmenopausal women who presented at six fracture clinics located across the UK and Ireland. The Raman signals from donor's fingernails were compared between (1) fracture and nonfracture and (2) osteoporotic versus non-osteoporotic donors The data presented show differences in the protein changes observed for pervasive osteoporosis compared to a general increased risk of fragility fracture. For fracture risk, compositional changes falling into broad classes of amino acid residue (aliphatic, aromatic, acidic, amide and sulphurous) were observed, while a difference in disulphide bonding levels was reaffirmed. For pervasive osteoporosis, the disulphide mode suggested increasing disorder in disulphide bonding orientation. Fractures were associated with a transition from alpha helical secondary structure to random, while the pervasive osteoporosis cases were associated with a transition to beta sheet structure. General fracture risk is associated with a change in the structure and composition of the keratin protein. Osteoporosis is associated with different protein structural changes and an increase in free acid groups. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To evaluate households' diet-quality trends and regional disparities, as well as to identify the influence of its socioeconomic determinants.Methods/subjects: Two dietary indexes were applied: a revised Healthy Diet Indicator version (HDIr) and the Mediterranean Adequacy Index (MAI). The socioeconomic differences between households with low-diet quality (if their scoring in HDIr or MAI was below the national median) and the remaining ones were analysed by means of logistic regression. Representative samples of households among each region were analysed.Results: Adherence to a Mediterranean diet was poor in all Portuguese regions; the proportion of households adhering to it has diminished in the North, Centre, Lisbon and Tejo valley. The proportion of households with high HDIr decreased in the North, Centre, Lisbon and Tejo valley and Algarve. In multivariate analysis, households whose head had secondary or higher education, living in semi-urban or urban areas, from the Azores region, within the higher income or outside home food expenditures groups were more likely to be in low-quality diet.Conclusions: The decreasing adherence to a Mediterranean food pattern and the diminishing compliance with World Health Organization dietary goals show that Portuguese households have reduced their diet quality. The observed influence of urbanization and region on diet quality highlights the importance of considering regional nutrition strategies. [ABSTRACT FROM AUTHOR]

Highlights: [•] SNP rs1143684 results in either a Phe or Leu at position 47 in human NQO2. [•] NQO2-L47 has a slightly lower k cat/K m; it also has a lower K i,app with resveratrol. [•] NQO2-L47 is more unstable to proteolysis and thermal denaturation. [•] NQO2-F47 (but not NQO2-L47) shows negative cooperativity towards resveratrol. [•] NQO2-L47 exists as multiple conformers in solution. [Copyright &y& Elsevier]

The article discusses the International Union of Nutrition Societies' 20th International Congress of Nutrition held in Granada, Spain from September 15-20, 2013. Professor Martin Caraher, of London City University and creative thinker Karl Raats gave presentations on challenges faced by public health nutrition in the era of financial crises. Other topics include food security and global inequality in terms of food distribution.

Purpose – The purpose of this paper is to explore the location of fast-food outlets around secondary schools and the influence of fast-food availability on the food choices of school children in an inner-London borough. Design/methodology/approach – A number of methods including: mapping of outlets relative to schools; sampling food; gathering data on secondary school food policies; observing food behaviour in fast food outlets and focus groups with young people. Findings were fed back to a committee consisting of representatives from nutrition, public health, planning services and local community groups. Findings – There are concentrations of fast-food outlets near schools and students reported use of these, including “stories” of skipping lunch in order to save money and eat after school at these outlets. Food from fast-food outlets was high in fat, saturated fat and salt, but these are not the only source of high such foods, with many of the students reporting buying from shops near the school or on the way to or from school. At lunchtime food outlets were less likely to be used by school students in areas near schools that have a “closed gate” policy. Research limitations/implications – The “snapshot” nature of the research limited what can be said about the food behaviours of the children outside school hours. Practical implications – The local policy context requires action to improve both the food offered in schools and the immediate environment around the school in order to tackle fast-food and other competitive foods on offer outside the school. Originality/value – This is one of the first studies in the UK to systematically map fast food outlets around schools and explore what might be done. This research shows how it is possible to link the findings of local research and develop local responses from both public health and local authority planning perspectives. The research moves away from a mere documenting of problems to devising integrated public health solutions. The findings show how public health and planning services can work together to the mutual benefit of each other. [ABSTRACT FROM AUTHOR]

Objective:To evaluate households’ diet-quality trends and regional disparities, as well as to identify the influence of its socioeconomic determinants.Methods/Subjects:Two dietary indexes were applied: a revised Healthy Diet Indicator version (HDIr) and the Mediterranean Adequacy Index (MAI). The socioeconomic differences between households with low-diet quality (if their scoring in HDIr or MAI was below the national median) and the remaining ones were analysed by means of logistic regression. Representative samples of households among each region were analysed.Results:Adherence to a Mediterranean diet was poor in all Portuguese regions; the proportion of households adhering to it has diminished in the North, Centre, Lisbon and Tejo valley. The proportion of households with high HDIr decreased in the North, Centre, Lisbon and Tejo valley and Algarve. In multivariate analysis, households whose head had secondary or higher education, living in semi-urban or urban areas, from the Azores region, within the higher income or outside home food expenditures groups were more likely to be in low-quality diet.Conclusions:The decreasing adherence to a Mediterranean food pattern and the diminishing compliance with World Health Organization dietary goals show that Portuguese households have reduced their diet quality. The observed influence of urbanization and region on diet quality highlights the importance of considering regional nutrition strategies.European Journal of Clinical Nutrition (2008) 62, 1263–1272; doi:10.1038/sj.ejcn.1602852; published online 1 August 2007 [ABSTRACT FROM AUTHOR]

Background and Objective Successive governments have promoted local action to address food components of public health. This article presents findings from research commissioned by the (then) London NHS Office, scoping the range of food projects in the London area, and the potential challenges to public health practice.Methods Research followed four overlapping phases with a London focus: (1) a systemized review of the literature, (2) analysis of health authority Health Improvement Plans (HImPs) and Coronary Heart Disease (CHD) local implementation plans and Health Action Zone reports, (3) a scoping exercise of'food projects' and community-based participatory projects with a food focus using food databases and directories, and (4) 29 in-depth interviews with individuals responsible for commissioning and running projects.Results There were, in 2001/2, a variety of food projects in the London area, ranging from small-scale social enterprises to those whose turnover marked them out as small businesses. There was a significant human resource cost in maintaining and setting up such projects both from NHS staff and in terms of volunteer and paid labour. The lack of an overall or area-based approach to food policy development in London was apparent, and little thought seemed to have been given to creating a supportive policy environment. Food projects often existed as isolated entities in a borough or health authority area, with short-term funding and little systemic long-term support. The majority employed what might best be called health education approaches. This is now partially addressed by the draft London Food Strategy.Conclusions Food projects run by local professionals and/or volunteers operated within an isolated policy and suffered from a lack of support both from financial and human resources perspectives. The potential for long-term delivery of improved health was unrealized, as was their potential contribution to a London-wide food economy and to London food policy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the feasibility of undertaking a food skills intervention study in areas of social deprivation aimed at altering cooking confidence, food preparation methods and dietary choices.Design: A standardised skills programme was implemented in community-based settings. Pre- (T1) and post-intervention (T2) and 6-month follow-up (T3) measures (7-day diaries and self-administered questionnaires) were undertaken in intervention and comparison groups.Setting: Eight urban communities in Scotland.Subjects: One hundred and thirteen adults living in areas of social deprivation.Results: It was clear that many subjects led fragmented lives and found commitment to intervention classes problematic. Sixty-three subjects completed the final (T3) assessments. The response to each component varied due to inability to attend sessions, illness, study requirements, employment, moving out of the area, change in circumstances, loss of interest and loss of postal questionnaires. At baseline, reported consumption of fruit and vegetables was low (mean frequency 8.1 +/- 4.78 times per week). Fruit intake increased significantly (P < 0.05) between T1 and T2 in the intervention group (1.7 +/- 2.36 to 2.7 +/- 3.28 times per week) only. Between T1 and T3, there was a significant increase (P < 0.05) in intervention subjects who reported confidence in following a recipe (67-90%,).Conclusions: This exploratory trial shows that a food skills intervention is likely to have a small but positive effect on food choice and confidence in food preparation. A full-scale randomised controlled trial in this hard-to-reach group would require a range of flexible approaches rather than a fully defined intervention, and presents challenges for trial design. [ABSTRACT FROM AUTHOR]

Aim: To set out a policy analysis of food taxes as a way of influencing food consumption and behaviour.Design: The study draws on examples of food taxes from the developed world imposed at national and local levels. Studies were identified from a systemised search in six databases with criteria designed to identity articles of policy relevance.Results: The dominant approach identified from the literature was the imposition of food taxes on food to raise general revenue, such as Value Added Tax in the European Union. Food taxes can be applied in various ways, ranging from attempts to directly influence behaviour to those which collect taxes for identified campaigns on healthy eating through to those applied within closed settings such as schools. There is a case for combining taxes of unhealthy foods with subsidies of healthy foods. The evidence from the literature concerning the use and impact of food taxes on food behaviour is not clear and those cases identified are mainly retrospective descriptions of the process. Many food taxes have been withdrawn after short periods of time due to industry lobbying. CONCLUSIONS FOR POLICY: Small taxes with the clear purpose of promoting the health of key groups, e.g. children, are more likely to receive public support. The focus of many tax initiatives is unclear; although they are generally aimed at consumers, another focus could be food manufacturers, using taxes and subsidies to encourage the production of healthier foods, which could have an effect at a population level. Further consideration needs to be given to this aspect of food taxes. Taxing food (and subsidies) can influence food behaviour within closed systems such as schools and the workplace. [ABSTRACT FROM AUTHOR]

Background and Objective: This article sets out the findings from an analysis of food projects, with a particular emphasis on fruit and vegetables, from the 26 Health Action Zones (HAZs) in England and those taking place within the former NHS regional areas in 2001. The objective was to gather information on the existing practice to inform future work.Methods: A series of interviews with key informants in the London area and a review of all the London Health Improvement Programmes and Coronary Heart Disease Local Implementation Plans were used to inform the development of an interview schedule and questionnaire. A second phase consisted of interviews with leads in the NHS Regional Offices. The third phase involved distribution of a questionnaire to the 26 Health Action Zones (HAZs).Results: Comprehensive data on food projects was not routinely available. The large number of initiatives related to food led some respondents to feel unsure as to under which policy to locate their food and fruit and vegetable work. Projects tended to be based on the development of skills (for example, cooking classes) or on a settings approach such as activities in schools or workplaces. A strategic focus was reported as being more common at a local level. Evaluation of food projects was at an early stage in many areas.Conclusions: The future sustainability of food and fruit and vegetable projects was identified as a key issue. Future policy development of food projects need to be clearly guided by a coherent policy focus and an integrated approach which clearly tackles the root causes of food access and poverty. [ABSTRACT FROM AUTHOR]

Food in its many manifestations allows us to explore the global control of health and to examine the ways in which food choice is moulded by many interests. The global food market is controlled by a small number of companies who operate a system that delivers 'cheap' food to the countries of the developed world. This 'cheap' food comes at a price, which externalises costs to the nation state in terms of health consequences (diabetes, coronary heart disease and other food-related diseases) and to the environment in terms of pollution and the associated clean-up strategies. Food policy has not to any great extent dealt with these issues, opting instead for an approach based on nutrition, food choice and biomedical health. Ignoring wider elements of the food system including issues of ecology and sustainability constrains a broader understanding within public health nutrition. Here we argue that public health nutrition, through the medium of health promotion, needs to address these wider issues of who controls the food supply, and thus the influences on the food chain and the food choices of the individual and communities. Such an upstream approach to food policy (one that has been learned from work on tobacco) is necessary if we are seriously to influence food choice. [ABSTRACT FROM AUTHOR]

Assesses the effectiveness of British local food projects designed to address poor households' food needs. Nature and remit of the projects; Policies governing local food projects in the country; Challenge posed by the projects to society in being structured as a main solution to the impact of the food economy on poor households.

The evaluation of a campaign designed to promote mental health among young offenders in all 24 young offender institutions in England is described. The campaign consisted of a postcard for use with young offenders, and two factsheets, one for prison staff and the other for inmates. The development of the materials was not informed by a needs assessment. The campaign lacked clear aims and objectives, thus contributing to confusion at the level of operation. Staff in the institutions saw the campaign materials as relating to World Mental Health Day and not possessing any relevance or use beyond this date. Written materials, while playing an important role in a campaign, are no substitute for clear guidance to members of staff on their role. [ABSTRACT FROM AUTHOR]

Concern is mounting as the retail stranglehold upon access to food grows. Research on the implications of restructuring retailing and health inequality has failed to involve low-income consumers in this debate. This paper reports on an exercise conducted for the UK Government's Social Exclusion Unit's Policy Action Team on Access to Shops. The survey provides a useful baseline of the views of low-income groups in England. The choices that people on low income can make were found to be dominated by certain factors such as income and, most importantly, transport. Consumers reported varying levels of satisfaction with retail provision. The findings suggest gaps between what people have, what they want and what the planning process does and does not offer them. Better policy and processes are needed to include and represent the interests of low-income groups. [ABSTRACT FROM AUTHOR]

This paper examines the issues of access to food and the influences people face when shopping for a healthy food basket. It uses data from the Health Education Authority's 1993 Health and Lifestyles Survey to examine the barriers people face in accessing a healthy diet. The main findings are that access to food is primarily determined by income, and this is in turn closely related to physical resources available to access healthy food. There is an associated class bias over access to sources of healthy food. The poor have less access to a car, find it harder to get to out-of-town shopping centres and thus are less able to carry and transport food in bulk. The majority of people shop in supermarkets as they report that local shops do not provide the services people demand and that food choice and quality are limited. In tackling food poverty and promoting healthy eating, health promotion practice needs to address these structural issues as opposed to relying on psycho-social models of education based on the provision of information and choice. [ABSTRACT FROM AUTHOR]

This paper sets out to examine health promotion practice in hospital settings from a sociological viewpoint. It starts by tracing the development of health promotion among hospital and community nurses. The influences that professional and institutional structures and agendas have in health promotion are explored and a model of operation is proposed. The main emphasis is that health promotion is not an activity relying solely on skills acquisition by the nurse, but one that requires recognition of where power and control are located. A model of working is proposed which takes account of the institutional and professional agendas and the need to balance these with the needs and rights of the patient. [ABSTRACT FROM AUTHOR]

Pharmacological therapy of osteoporosis reduces bone loss and risk of fracture in patients. Modulation of bone mineral density cannot explain all effects. Other aspects of bone quality affecting fragility and ways to monitor them need to be better understood. Keratinous tissue acts as surrogate marker for bone protein deterioration caused by oestrogen deficiency in rats. Ovariectomised rats were treated with alendronate (ALN), parathyroid hormone (PTH) or estrogen (E2). MicroCT assessed macro structural changes. Raman spectroscopy assessed biochemical changes. Micro CT confirmed that all treatments prevented ovariectomy-induced macro structural bone loss in rats. PTH induced macro structural changes unrelated to ovariectomy. Raman analysis revealed ALN and PTH partially protect against molecular level changes to bone collagen (80% protection) and mineral (50% protection) phases. E2 failed to prevent biochemical change. The treatments induced alterations unassociated with the ovariectomy; increased beta sheet with E2, globular alpha helices with PTH and fibrous alpha helices with both ALN and PTH. ALN is closest to maintaining physiological status of the animals, while PTH (comparable protective effect) induces side effects. E2 is unable to prevent molecular level changes associated with ovariectomy. Raman spectroscopy can act as predictive tool for monitoring pharmacological therapy of osteoporosis in rodents. Keratinous tissue is a useful surrogate marker for the protein related impact of these therapies.The results demonstrate utility of surrogates where a clear systemic causation connects the surrogate to the target tissue. It demonstrates the need to assess broader biomolecular impact of interventions to examine side effects. Osteoporotic treatments exhibit substantial differences in biochemical impact.Alendronate preserved the bone tissue in the state closest to the sham group.Parathyroid hormone prevents ovariectomy changes, induces different changes.Estrogen preserves tissue macro structure, but unable to prevent biochemical changes.Systemic conditions affect structural proteins in both bone and claw. [ABSTRACT FROM AUTHOR]