Colette Kelly

Chylomicron particle size and number, factor VII activation and dietary monounsaturated fatty acids.

This study evaluated the effects of substituting dietary saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) on postprandial chylomicron (triacylglycerol (TAG), apolipoprotein B-48 (apo B-48) and retinyl ester (RE)), chylomicron particle size and factor VII (FVII) response when subjects were given a standard meal. In a controlled sequential design, 51 healthy young subjects followed an SFA-rich diet (Reference diet) for 8 weeks after which half of the subjects followed a moderate MUFA diet (n=25) and half followed a high MUFA diet (n=26) for 16 weeks. Fasting lipoprotein and lipid measurements were evaluated at baseline and at 8-week intervals during the Reference and MUFA diets. In 25 of the subjects (n=12 moderate MUFA, n=13 high MUFA), postprandial responses to a standard test meal containing RE and 13C-tripalmitin were investigated at the end of the Reference and the MUFA diet periods. Although there were no differences in the postprandial lipid markers (TAG, RE, 13C-TAG) on the two diets, the postprandial apo B-48 response (incremental area under the curve (IAUC)) was reduced by 21% on the moderate MUFA diet (NS) and by 54% on the high MUFA diet (P<0.01). The postprandial peak concentrations of apo B-48 were reduced by 33% on the moderate MUFA diet (P<0.01) and 48% on the high MUFA diet (P<0.001). Fasting values for factor VII activity (FVIIc), activated factor VII (FVIIa) or factor VII antigen (FVIIag) did not differ significantly when subjects were transferred from Reference to MUFA diets. However, the postprandial increases in coagulation FVII activity (FVIIc) were 18% lower and of activated FVII (FVIIa) were 17% lower on the moderate MUFA diet (NS). Postprandial increases in FVIIc and FVIIa were 50% (P<0.05) and 29% (P<0.07) lower on the high MUFA diet and the area under the postprandial FVIIc response curve (AUC) was also lower on the high MUFA diet (P<0.05). Significantly higher ratios of RE:apo B-48 (P<0.001) and 13C-palmitic acid:apo B-48 (P<0.01) during both MUFA diets suggest that the CMs formed carry larger amounts of dietary lipids per particle, reflecting an adaptation to form larger lipid droplets in the enterocyte when increased amounts of dietary MUFAs are fed. Smaller numbers of larger chylomicrons may explain attenuated activation of factor VII during the postprandial state when the background diet is rich in MUFA.

Is School Participation Good for Children? Associations with Health and Wellbeing.

Purpose – There is increasing recognition of childrens abilities to speak for themselves. School democracy, as demonstrated by genuine participation, has the potential to benefit both teachers and students; leading to better relationships and improved learning experiences. The aim of this study is to investigate whether participation in schools in Ireland is linked with perceived academic performance, liking school and positive health perceptions.Design/methodology/approach – Data were collected via self‐completion questionnaires from a stratified random sample of 10,334 students aged 10‐17 years in Irish schools. The questions included encouragement to express their views in class, participation in the organisation of school events; taking part in making school rules; liking school, perceived academic performance, self‐rated health, life satisfaction and self‐reported happiness. Associations between school participation and other measures were expressed by odds ratios from logistic regression models, co...

Trends in overweight prevalence among 11-, 13- and 15-year-olds in 25 countries in Europe, Canada and USA from 2002 to 2010

BACKGROUND The purpose of this study was to assess recent changes in the prevalence of overweight (including obesity) among 11-, 13- and 15-year-olds in 33 countries from 2002 to 2010. METHODS Data from 25 countries from three consecutive survey cycles (2002, 2006 and 2010) that had at least 80% response rate for self-reported height, weight and age were analysed using logistic regression analysis. RESULTS Overweight prevalence increased among boys in 13 countries and among girls in 12 countries; in 10 countries, predominantly in Eastern Europe, an increase was observed for both boys and girls. Stabilization in overweight rates was noted in the remaining countries; none of the countries exhibited a decrease over the 8-year period examined. In the majority of countries (20/25) there were no age differences in trends in overweight prevalence. CONCLUSION In over half of the countries examined overweight prevalence did not change during 2002-2010. However, increasing overweight prevalence was noted in many Eastern European countries over this time period. Overweight prevalence remained high in several countries in Europe and North America. These patterns call for continued research in youth overweight and highlight the need to understand cross-national differences by examining macro-level indicators. Such research should feed into developing sound translations and practices to prevent and reduce overweight in youth.

Fruit and vegetable consumption trends among adolescents from 2002 to 2010 in 33 countries.

BACKGROUND Fruit and vegetable consumption is linked to many positive health outcomes, nevertheless many adolescents do not consume fruit and vegetables on a daily basis. METHODS Data of 488,951 adolescents, aged 11-, 13- and 15- years, from 33 mainly European and North American countries/regions participating in the cross-sectional Health Behaviour in School-aged Children surveys in 2002, 2006 and 2010, were used to investigate trends in daily fruit and vegetable consumption between 2002 and 2010. RESULTS Multilevel logistic regression analyses showed an increase in daily fruit and vegetable consumption between 2002 and 2010 in the majority of countries for both genders and all three age groups. A decrease in consumption was noticed in five countries for fruit and five countries for vegetables. CONCLUSION Overall, a positive trend was noticed, however increases in daily fruit and vegetable consumption are still indicated.

Diet and cardiovascular disease in the UK: are the messages getting across?

Cardiovascular disease (CVD) is a leading cause of premature death in the UK and a major cause of ill health and disability. Whilst death rates from CVD have been falling since the late 1970s in the UK, levels of morbidity (such as angina) do not seem to be falling and may even be rising in some age-groups, especially as the population ages. There is broad consensus that lifestyle factors, including physical activity and diet, are fundamental determinants of heart disease risk. Current recommendations to reduce cardiovascular risk include maintaining a healthy body weight, eating five or more portions of fruit and vegetables each day, reducing intake of fat (particularly saturated fatty acids), reducing salt intake and eating one portion of oily fish per week. Although some improvements have been made in recent years (e.g. a reduction in total fat intake), national studies suggest that more effective campaigns are required to increase awareness of the benefits of these dietary changes. The present paper will discuss how the dietary messages relating to CVD are best communicated to the general public and will identify some of the main barriers to their implementation.

Dietary monounsaturated fatty acids and haemostasis

Diets high in monounsaturated fatty acids (MUFA) are increasingly being recommended as a highly-effective cholesterol-lowering strategy in populations at risk of CHD. However, the need for a re-appraisal of the benefits of diets rich in MUFA became apparent as a result of recent studies showing that meals high in olive oil cause greater postprandial activation of blood coagulation factor VII than meals rich in saturated fatty acids. The present review evaluates the evidence for the effects of MUFA-rich diets on fasting and postprandial measurements of haemostasis, and describes data from a recently-completed long-term controlled dietary intervention study. The data show that a background diet high in MUFA has no adverse effect on fasting haemostatic variables and decreases the postprandial activation of factor VII in response to a standard fat-containing meal. Since the same study also showed a significant reduction in the ex vivo activation of platelets in subjects on the high-MUFA diet, the overall findings suggest that there is no reason for concern regarding adverse haemostatic consequences of high-MUFA diets.

Weight control behaviors among overweight, normal weight and underweight adolescents in Palestine: Findings from the national study of Palestinian schoolchildren (HBSC‐WBG2004)

OBJECTIVE The objective of the study is to examine the relationship between weight-control behaviors and self-reported sociodemographic characteristics, weight status, and perception of body weight in a large, representative sample of adolescents in the West Bank and Gaza Strip territories of Palestine. METHOD Self-report measures of sociodemographic characteristics, body weight perception, height and weight, and weight-control behaviors were completed by 8,885 male and female students aged 12-18 years from 405 randomly selected schools as part of the 2003/2004 Palestinian Health Behavior in School-aged Children Study (HBSC). RESULTS In both genders, dieting to lose weight was common among adolescents and significantly higher among overweight than among underweight or normal weight adolescents. Extreme weight-control behaviors (vomiting, diet pills, or laxatives) and smoking were more common among boys than girls, and extreme weight-control behaviors were particularly common among underweight boys. Older adolescents were less likely than younger adolescents to engage in weight-control behaviors. Perception of body weight as too fat was an influential factor in following an unhealthy diet to lose weight. DISCUSSION Practices to control weight, particularly extreme and unhealthy weight-control behaviors, are common among adolescents in the Palestinian territories. These findings suggest the need to design appropriate prevention and early intervention programs for adolescents in Palestine.

Psychosomatic symptoms among schoolchildren.

UNLABELLED Psychosomatic symptoms are commonly reported among young people. The potential burden of such symptoms on both young people and health services is substantial. Research from several countries indicates that psychosomatic symptoms tend to co-exist rather than occur singularly and could impose limitations on daily living and participation in school life. OBJECTIVES The aim of this paper was to determine the weekly prevalence of somatic (headache, stomach-ache, dizziness, back ache) and psychological (feeling low, irritability/bad temper, difficulty sleeping, and nervousness) symptoms among schoolchildren in Ireland; and to explore, the influence of family material affluence on reported symptoms. STUDY GROUP 11-17 year-old school going children. METHODS Data are presented from the 2006 Irish Health Behaviour in the School-aged Children survey, comprising a nationally representative sample of schoolchildren aged 11-17 years (n = 9969). Sampling units were classes within schools with a response rate of 63% of schools and 83% of students. RESULTS Irritability/bad temper (43.0%) and headache (26.0%) were the most commonly reported psychological and somatic symptoms among both boys and girls. Symptom prevalence was higher among girls (range 17.8% - 43.8%) than boys (range 10.7% - 42.3%) and was higher among older children of both genders, except for stomachache in boys. Girls from less affluent backgrounds were significantly more likely to report frequent symptoms (55.5% vs. 50.7%). CONCLUSIONS Multiple symptoms were inversely related to family material affluence for girls. The factors associated with psychosomatic symptoms and the consequences for schoolchildren require further investigation.

Trends from 2002 to 2010 in Daily Breakfast Consumption and its Socio-Demographic Correlates in Adolescents across 31 Countries Participating in the HBSC Study.

Breakfast is often considered the most important meal of the day and children and adolescents can benefit from breakfast consumption in several ways. The purpose of the present study was to describe trends in daily breakfast consumption (DBC) among adolescents across 31 countries participating in the HBSC survey between 2002 to 2010 and to identify socio-demographic (gender, family affluence and family structure) correlates of DBC. Cross-sectional surveys including nationally representative samples of 11–15 year olds (n = 455,391). Multilevel logistic regression analyses modeled DBC over time after adjusting for family affluence, family structure and year of survey. In all countries, children in two-parent families were more likely to report DBC compared to single parent families. In most countries (n = 19), DBC was associated with family affluence. Six countries showed an increase in DBC (Canada, Netherland, Macedonia, Scotland, Wales, England) from 2002. A significant decrease in DBC from 2002 was found in 11 countries (Belgium Fr, France, Germany, Croatia, Spain, Poland, Russian Federation, Ukraine, Latvia, Lithuania and Norway), while in 5 countries (Portugal, Denmark, Finland, Ireland, Sweden) no significant changes were seen. Frequency of DBC among adolescents in European countries and North America showed a more uniform pattern in 2010 as compared to patterns in 2002. DBC increased significantly in only six out of 19 countries from 2002 to 2010. There is need for continued education and campaigns to motivate adolescents to consume DBC. Comparing patterns across HBSC countries can make an important contribution to understanding regional /global trends and to monitoring strategies and development of health promotion programs.

Achievement of dietary fatty acid intakes in long-term controlled intervention studies: approach and methodology

OBJECTIVE To describe the calculations and approaches used to design experimental diets of differing saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) compositions for use in a long-term dietary intervention study, and to evaluate the degree to which the dietary targets were met. DESIGN, SETTING AND SUBJECTS Fifty-one students living in a university hall of residence consumed a reference (SFA) diet for 8 weeks followed by either a moderate MUFA (MM) diet or a high MUFA (HM) diet for 16 weeks. The three diets were designed to differ only in their proportions of SFA and MUFA, while keeping total fat, polyunsaturated fatty acids (PUFA), trans-fatty acids, and the ratio of palmitic to stearic acid, and n-6 to n-3 PUFA, unchanged. RESULTS Using habitual diet records and a standardised database for food fatty acid compositions, a sequential process of theoretical fat substitutions enabled suitable fat sources for use in the three diets to be identified, and experimental margarines for baking, spreading and the manufacture of snack foods to be designed. The dietary intervention was largely successful in achieving the fatty acid targets of the three diets, although unintended differences between the original target and the analysed fatty acid composition of the experimental margarines resulted in a lower than anticipated MUFA intake on the HM diet, and a lower ratio of palmitic to stearic acid compared with the reference or MM diet. CONCLUSIONS This study has revealed important theoretical considerations that should be taken into account when designing diets of specific fatty acid composition, as well as practical issues of implementation.