Search

Simple Summary: Vitamin D biology in equids is unique and poorly understood. Naturally managed (grazing) horses rely on dietary vitamin D2 (ergocalciferol) to provide adequate vitamin D, because endogenous ultraviolet radiation-mediated synthesis of vitamin D3 (cholecalciferol) is ineffective in this species. To test the hypothesis that the management of stabled, non-grazing racehorses is a risk factor for low vitamin D status, the vitamin D status of non-grazing Thoroughbred racehorses in Hong Kong (HK) and grazing Thoroughbred racehorses in the United Kingdom (UK) was compared. The HK horses had lower serum concentrations of 25-hydroxyvitamin D2 (25OHD2) and total 25-hydroxyvitamin D (total 25OHD: the index of vitamin D status), reflecting reduced dietary vitamin D2 intake. These data indicate that HK racehorses required dietary vitamin D3 supplementation to maintain adequate vitamin D status. The inverse relationship between the serum concentrations of 25OHD2 and 25OHD3, previously identified in humans, was observed for the first time in horses, indicating that further study is needed to determine the optimal form of dietary vitamin D supplementation for Thoroughbred racehorses. There is a paucity of data relating to the vitamin D status of racehorses. We hypothesised that the management of racehorses in Hong Kong (HK) predisposes to low vitamin D status unless they receive dietary supplementation. Serum concentrations of 25-hydroxyvitamin D2 (25OHD2), 25-hydroxyvitamin D3 (25OHD3) and total 25-hydroxyvitamin D (total 25OHD) for 79 non-grazing HK racehorses were compared with those for 22 racehorses training in the United Kingdom (UK) that grazed for ≥1 h/d, and for which published data exists. A nested group of 41 HK horses was sampled twice to determine the effect of the duration in HK on vitamin D status. The HK horses had significantly lower serum concentrations of total 25OHD and 25OHD2 than the UK horses; 25OHD2 was undetectable in 15/79 HK sera and serum concentrations of 25OHD2 declined with the duration in HK. The main determinants of vitamin D status were assessed using linear regression; the retained variables were the 25OHD3 concentration and the duration in HK. The inverse relationship between the serum concentrations of 25OHD2 and 25OHD3, previously identified in humans, was observed for the first time in horses. In conclusion, HK racehorses have low serum 25OHD2 and total 25OHD concentrations and rely on D3 supplementation to maintain adequate vitamin D status. Further study is required to determine the optimal form of dietary vitamin D supplementation for Thoroughbred racehorses. [ABSTRACT FROM AUTHOR]

Background Inflammatory bowel disease (IBD) may impact the extent to which food, eating, and drinking bring satisfaction and enjoyment to peoples' lives, and this may impact dietary intake. The prevalence of an impaired food-related quality of life (FR-QoL), its associated factors, and its impact on diet have not been explored. Objectives To measure the prevalence and nature of the burden of impaired FR-QoL in people with IBD, the factors associated with these, and their associations with nutrient intake. Methods We recruited 1576 outpatients with IBD (≥16 years old) in person from 7 IBD centers across the United Kingdom. Patients completed validated questionnaires to measure their FR-QoL, quality of life (QoL), distress, fatigue, anxiety, and depression. Dietary intake was recorded using the European Prospective Investigation into Cancer FFQ. A health professional recorded disease activity, Montreal classification, blood results, BMI, and malnutrition risk. FR-QoL was regressed onto explanatory variables using univariable and multivariable analyses. Results Data from 1221 patients were available (77.4% response; Crohn's disease, 65%; ulcerative colitis, 35%). The FR-QoL mean (± SD) score was 80.8 ± 26.9, with wide ranges (minimum, 29; maximum, 145). Following multivariable regression, the strongest associations with FR-QoL were the number of recent disease flares (5 flares β = −12.7; P  < 0.001), the IBD-specific QoL (β = 0.33; P  < 0.001), and IBD-related distress (β = −0.26; P  < 0.001). Patients with poorer FR-QoL had lower intakes of fiber (nonstarch polysaccharide; Q1 to Q5 difference = 2.1 g/d; 95% CI: 0.4–3.8; P  = 0.048), calcium (192.6 mg/d; 95% CI: 112.5–272.6; P  < 0.001), phosphorus (167 mg/d; 95% CI: 58–276; P  = 0.041), and magnesium (34.4 mg/d; 95% CI: 9.3–59.4; P  = 0.041). Conclusions Impaired FR-QoL is prevalent in IBD and is associated with recurrent disease flares, a reduced IBD-specific QoL, and greater IBD-related distress. A poorer FR-QoL was associated with lower intakes of key nutrients of importance to IBD, including those relating to gut health and bone mineralization. [ABSTRACT FROM AUTHOR]

The article presents a study of the type and quality of written information on written nutrition and diet available for patients with inflammatory bowel disease (IBD) and the perceptions of patients and health professionals. Results revealed that majority of patients rated written information as good or very good, with information relating to general diet and IBD rated as the most useful information.

ABSTRACT The inherent complexity of the environment is such that attempts to model it must operate under simplifications and assumptions. Considering predictions from alternative models, with a range of assumptions and data requirements, therefore provides a more robust approach., The intractability and uncertainty resulting from a suite of predictions may hinder the application of science in policy, where a single prediction with little ambiguity or uncertainty would be most desirable. Few studies modelling species' distributions attempt to present multi-model outputs in a format most useful to the non-modelling community, and none of these have done so for the marine environment., The problem of uncertainty is particularly prevalent in predicting the distribution of invasive alien species under climate change. As invasive alien species are one of the main drivers of biodiversity loss and may incur significant economic costs, the benefit of applying predictions to highlight areas of possible establishment and inform policy and management may be large., An ensemble prediction is used to assess the distribution of suitable habitat for the Pacific oyster, Crassostrea gigas, in UK waters both currently and in the future. The ensemble incorporates predictions from three species distribution models, using data from two global climate models. A method is developed highlighting the agreement of the ensemble, further applying threshold values to retain information from constituent predictions in the final map of agreement., Ensemble predictions made here suggest that Pacific oyster will experience an opening of suitable habitat in northern UK waters, reaching the Faroe Islands and the eastern Norwegian Sea by 2050. Habitat suitability will increase with warming temperatures in the English Channel and Central North Sea for this species. The approaches applied here can be incorporated into risk assessment frameworks for invasive species, as stipulated in the Convention on Biological Diversity., Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

ABSTRACT Commercial fishing is an important socio-economic activity in coastal regions of the UK and Ireland. Ocean-atmospheric changes caused by greenhouse gas emissions are likely to affect future fish and shellfish production, and lead to increasing challenges in ensuring long-term sustainable fisheries management., The paper reviews existing knowledge and understanding of the exposure of marine ecosystems to ocean-atmospheric changes, the consequences of these changes for marine fisheries in the UK and Ireland, and the adaptability of the UK and Irish fisheries sector., Ocean warming is resulting in shifts in the distribution of exploited species and is affecting the productivity of fish stocks and underlying marine ecosystems. In addition, some studies suggest that ocean acidification may have large potential impacts on fisheries resources, in particular shell-forming invertebrates., These changes may lead to loss of productivity, but also the opening of new fishing opportunities, depending on the interactions between climate impacts, fishing grounds and fleet types. They will also affect fishing regulations, the price of fish products and operating costs, which in turn will affect the economic performance of the UK and Irish fleets., Key knowledge gaps exist in our understanding of the implications of climate and ocean chemistry changes for marine fisheries in the UK and Ireland, particularly on the social and economic responses of the fishing sectors to climate change. However, these gaps should not delay climate change mitigation and adaptation policy actions, particularly those measures that clearly have other 'co-benefits'. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article discusses the significance of the consultant posts for dietitians in Great Britain. The development of consultant posts for nonmedical health professionals in the country was initiated by the Department of Health to address the need for senior nonmedical staff, and to enhance the strategic level of improving patient outcome. It explores how consultant dietitian post has evolved in gastroenterology clinics who helped improve patient-centered care for inflammatory bowel disease.

The article focuses on the audits in inflammatory bowel disease (IBD) as supported by the national IBD standard in Great Britain. It notes that dieticians are significant in managing patients with gastrointestinal tract disorders and that the provision of dietetic effectiveness can be difficult. It points out that IBD is composed of ulcerative colitis and Crohn's disease which is a chronic modern western relapsing disease of unknown aetiology. Moreover, IBD standards inform healthcare managers and commissioning organisations as part of the country's strategy of improving services for people with IBD.

Background & Aims: There is limited evidence that a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) reduces gut symptoms in quiescent inflammatory bowel disease (IBD). We performed a randomized, controlled trial to investigate the effects of a low FODMAP diet on persistent gut symptoms, the intestinal microbiome, and circulating markers of inflammation in patients with quiescent IBD., Methods: We performed a single-blind trial of 52 patients with quiescent Crohn's disease or ulcerative colitis and persistent gut symptoms at 2 large gastroenterology clinics in the United Kingdom. Patients were randomly assigned to groups that followed a diet low in FODMAPs (n = 27) or a control diet (n = 25), with dietary advice, for 4 weeks. Gut symptoms and health-related quality of life were measured using validated questionnaires. Stool and blood samples were collected at baseline and end of trial. We assessed fecal microbiome composition and function using shotgun metagenomic sequencing and phenotypes of T cells in blood using flow cytometry., Results: A higher proportion of patients reported adequate relief of gut symptoms following the low FODMAP diet (14/27, 52%) than the control diet (4/25, 16%, P=.007). Patients had a greater reduction in irritable bowel syndrome severity scores following the low FODMAP diet (mean reduction of 67; standard error, 78) than the control diet (mean reduction of 34; standard error, 50), although this difference was not statistically significant (P = .075). Following the low FODMAP diet, patients had higher health-related quality of life scores (81.9 ± 1.2) than patients on the control diet (78.3 ± 1.2, P = .042). A targeted analysis revealed that in stool samples collected at the end of the study period, patients on the low FODMAP diet had significantly lower abundance of Bifidobacterium adolescentis, Bifidobacterium longum, and Faecalibacterium prausnitzii than patients on control diet. However, microbiome diversity and markers of inflammation did not differ significantly between groups., Conclusions: In a trial of the low FODMAP diet vs a control diet in patients with quiescent IBD, we found no significant difference after 4 weeks in change in irritable bowel syndrome severity scores, but significant improvements in specific symptom scores and numbers reporting adequate symptom relief. The low FODMAP diet reduced fecal abundance of microbes believed to regulate the immune response, compared with the control diet, but had no significant effect on markers of inflammation. We conclude that a 4-week diet low in FODMAPs is safe and effective for managing persistent gut symptoms in patients with quiescent IBD. www.isrctn.com no.: ISRCTN17061468., (Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Ulcerative colitis and Crohn's disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn's and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn's disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn's disease, including patients, their families and friends., Competing Interests: Competing interests: Conflicts of interest for authors and contributors are presented in online supplementary table 2., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Overnutrition and undernutrition can affect patients with inflammatory bowel disease (IBD). Although all IBD outpatients should be screened for nutrition risk, screening is not routinely performed, potentially leading to reduced identification and treatment. This study aimed to estimate the prevalence of nutrition risk in adult IBD outpatients and the proportion of cases who discussed diet and/or nutrition during their routine clinical appointment., Methods: Adults with IBD attending outpatient clinics at 4 hospitals in Greece and in UK were recruited. Demographic and anthropometric data were collected using face-to-face patient interviews and clinical records. Patients were classified as high (i.e., body mass index [BMI] < 18.5 or 18.5-20 kg/m2 and weight loss > 5%), moderate (i.e., BMI 20-25 kg/m2 and weight loss > 5%) or low risk of undernutrition and high risk of obesity (i.e., BMI 25-30% and weight gain > 5%). The proportion of patients who discussed diet and/or nutrition during their clinical appointment was calculated., Results: In total, 390 IBD patients participated. Sixteen (4%) patients were underweight, 113 (29%) were overweight and 71 (18%) were obese. Twenty-one (5%) patients were at high risk of undernutrition; of these 4 (19%) were under dietetic care. Of those at high risk of undernutrition, 11 (52%) had discussed diet and/or nutrition during their routine clinical appointment. Fifty-six (14%) patients had gained more than 5% weight since their last recorded/reported weight and 19 (5%) were at high risk of obesity., Conclusions: Few patients were identified to be at high risk of undernutrition and less than a fifth of these were under dietetic care. Overnutrition is a growing problem in IBD with almost half of adult patients being overweight or obese. Diet and/or nutrition were not routinely discussed in this group of IBD outpatients., (© 2018 S. Karger AG, Basel.)