Despite advances in therapeutic options for cancers, treatment is often impeded by the presence of cancer attributable malnutrition and metabolic derangements(1). To increase early recognition and intervention of malnutrition and metabolic derangements in cancer, organisations such as the European Society for Clinical Nutrition and Metabolism (ESPEN) have emphasised a greater need for cancer nutritional risk screening and education on cancer nutrition(2). However, prior studies have shown a lack of understanding of fundamental aspects of nutrition screening and treatment by physicians(3) but such data is lacking with regards to physician’s knowledge in cancer malnutrition and metabolic derangements. Therefore, we investigated and compared the attitudes and knowledge towards nutritional support in cancer between physicians and dieticians at a tertiary referral oncology centre.

Physicians (categorised as foundation year 2 (FY2s), core trainees (CTs), specialist registrars (SpRs), clinical research fellows (CRFs) and consultant oncologists (COs)) and oncology dieticians (ODs) were invited to participate in a multiple-choice questionnaire test. Questions assessed the attitudes towards cancer nutrition, assessment and management of common cancer nutritional scenarios. Comparisons in terms of correct and incorrect responses were made between physicians to ODs. Data is presented as the mean ± standard error (SE) and percentage test score with the use of one-way analysis of variance (ANOVA) to determine if any observed differences were statistically significant (p-value <0.05). 

		FY2s (n=15)	CTs (n=8)	SpRs (n=13)	CRFs (n=13)	COs (n=30)	ODs (n=10)	All physicians 
(n=79)
Test Score	Mean	6.6	10.1	7.62	6.38	8.33	18.6	7.73
	SE	1.34	1.77	1.17	1.32	0.929	1.06	0.553
	%	27.5	42.1	31.8	26.6	34.6	77.5	32.2
Maximum test score = 24. Total sample size = 89. All physicians vs. ODs, p<0.0001; FY2s vs. ODs, p<0.0001; CTs vs. ODs, p=0.0036; CRFs vs. ODs, p<0.0001; SpRs vs ODs, p<0.0001; COs vs. ODs, p<0.0001. No statistical significant differences in test scores between individual physician groups.

Physicians collectively and as individual groups achieved a statistically significant lower score compared to ODs, thereby demonstrating a poorer knowledge base in topics centred upon cancer malnutrition and metabolic derangements. No statistically significant differences were observed between test scores when comparing physician groups despite an anecdotal perceived increase in clinical exposure and acumen with increasing seniority. Additionally, only 41.8% (n=33) of physicians collectively felt they had adequate knowledge of nutritional support for cancer patients despite 69.6% (n=55) stating they regularly make decisions regarding nutritional support in cancer patients. Overall, 89.9% (n=71) stated they felt provision of support in cancer nutrition would be valuable to their clinical career demonstrating a need for further cancer malnutrition and metabolic derangements e

Attitudes and knowledge of clinicians and dieticians towards cancer nutrition in a tertiary referral oncology centre

The effect of whole and ground flaxseed on glycaemic and insulinaemic response.

A dietary and lifestyle worksite intervention to reduce high prevalence of overweight and obesity for London firefighters. By G.R. Lessons and D. Bhakta, School of Human Sciences, Health Sciences, London Metropolitan University, London, N7 8DB.
Overweight and obesity in UK firefighters are reaching epidemic proportions exceeding that of the UK general population (1). This compromises physical fitness (2) and concomitant firefighter and public safety (3). Research has identified specific exposures related to firefighting (4-5), which may also contribute to uniquely high rates of coronary heart disease (CHD) and acute myocardial infarctions (MI) seen in this occupational group (6). These exposures include intense heat which could impair vascular function and increase thrombogenicity (4), and fire stations as obesogenic environments which perpetuate a culture of over-nutrition alongside increasing sedentary behaviour (5). Faced with a multitude of exposures, it is imperative that modifiable risk factors for CHD and MI are addressed. This however seems to have been overlooked by UK researchers thus far. We aimed to design, implement and evaluate the efficacy and feasibility of a fire station based dietary and lifestyle weight loss intervention for UK firefighters, factoring in a complex combination of exposures and firefighter specific cultural habits (5). 																	Forty London firefighters were recruited via staff email in February 2017. Thirty-eight firefighters (35 males, 3 females; mean age=44.8, SD=7.2) from 2 London fire stations (Hornchurch: intervention, Harold Hill: control) completed the one-month, cluster-controlled dietary and lifestyle intervention which ran February to March 2017. Hornchurch firefighters received the programme involving a face-to-face personalised information session; general information sheet; midway face-to-face support session; and nutritionist support throughout. Informational components focussed on fire station obesogenic environmental modification alongside nutrition, physical activity and lifestyle education in a low-intensity/low participant burden format. All firefighters were assessed at baseline and post-intervention for Body Mass Index (BMI), Body Fat Percentage (BF%) and Waist Circumference (WC). Dietary assessment was carried out using the EPIC-Norfolk Food Frequency Questionnaire (7). 		At baseline, 70% of the sample were classified overweight or obese by BMI (Harold Hill: 67%; Hornchurch: 74%). Post intervention, Hornchurch displayed significant mean reductions in BMI and BF% of 0.4 kg/m2 (p=0.01) and 0.9% (p=0.04) respectively, and borderline non-significant improvement in WC of 1.4cm (p=0.06). Harold Hill displayed a significant mean reduction of 0.8cm in WC (p = 0.03), but not for BMI or BF%. Hornchurch firefighters reported favourable changes over the one month period for energy intake:              -413kcal/d (p=0.04); saturated fatty acids: -3.5g/d (p=0.01); fats & oils: -3.2g/d (p=0.03); s

A dietary and lifestyle worksite intervention to reduce high prevalence of overweight and obesity for London firefighters.

Objectives: Adoption of healthy lifestyle behaviours has shown promising effectiveness in reducing the high morbidity burden of cancer survivors. Health professionals (HPs) are well suited to provide lifestyle advice but few survivors report receiving guidance from them. The study aimed to explore HPs’ perspective of lifestyle advice (on heathy eating, physical activity, smoking, and alcohol) for cancer survivors.  
Design: In-depth semistructured qualitative interviews were conducted by telephone or face-to-face. Data were analysed using qualitative content analysis.
Setting and participants: Twenty-one UK HPs working in secondary care with breast, prostate, or colorectal cancer survivors were interviewed. 
Results: The over-arching theme was that HPs’ desire to provide lifestyle advice was not necessarily matched by knowledge and action. Three main themes were identified: 1) survivorship-centred barriers to provision, 2) clinician-centred barriers to provision, and 3) optimal delivery of lifestyle advice. Results suggested that survivors’ current status of practising health behaviours, their perceived socio-economic barriers and ability to practise health behaviours, and HPs’ fear for potential loss of connection with the patient influenced provision of lifestyle advice. Further factors included clinicians’ knowledge of healthy lifestyle guidelines, feeling that they were not the ‘right person’ to provide advice, and lack of time and resources. HPs stressed that the optimal delivery of lifestyle advice should (a) be tailored to the individual and delivered throughout the cancer journey, (b) be focused on small and achievable changes framed as part of their treatment regimen, and (c) be cost-effective for wide-scale implementation.
Conclusions: Incorporation of the identified barriers when developing HP training programmes and lifestyle interventions could increase the probability of successful behaviour change and, thus, improved outcomes for cancer survivors.

Lifestyle advice to cancer survivors: a qualitative study on the perspectives of health professionals

Effects of artificial sweeteners on glucagon-like peptide 1 secretion in GLUTag cells, an in vitro model of enteroendocrine cell

Associations between eating style and dietary behaviour in military personnel: preliminary findings from the UK Armed Forces

Disruption of BSCL2 gene, encoding the protein seipin, causes Congenital Generalized Lipodystrophy (CGL), the most severe lipodystrophy. Seipin is an endoplasmic reticulum membrane protein and has a fundamental role in adipose tissue development and maintenance, as demonstrated by cellular and in-vivo models.
We have recently shown that seipin forms highly ordered dodecamers that creates a scaffold for critical pro-adipogenic enzymes (lipin-1 and 1-acylglycerol-3-phosphate-O-acyltransferase 2, AGPAT2) to act in a single functional complex. 
Co-immunoprecipitation and immunofluorescence experiments in overexpressing BOSC293 cells led us to extend these findings to show that seipin also binds 1-acylglycerol-3-phosphate-O-acyltransferase 1 (AGPAT1), glycerol-3-phosphate acyltransferase 3 (GPAT3) and glycerol-3-phosphate acyltransferase 4 (GPAT4), implying an effect in lipid metabolism.  
Sequences annotated in ENSEMBL suggest that several splice variants of seipin may exist. We focused our study on alternative splicing of exon 2 of seipin which generates either the 462 amino acid form of seipin (seipin-L) or the short 398 amino acid form of the protein (seipin-S). 
Gene expression profiles and proteomic analysis revealed that mature adipocytes mainly express seipin-S and that different isoforms have a distinct tissue-specific regulation which is nutritionally controlled by dietary fat intake. We also detected with qPCR analysis the skipping of exon 8 of seipin (seipin-Δx8) in adipocyte cell lines, which would give rise to an isoform of seipin lacking key functional domains. We used this cloned spliced variant to investigate the ability to interact with binding partners and hypothesise the molecular significance of this novel transcripts by performing co-immunoprecipitation experiment in BOSC293 cells (data not shown).
In conclusion, we extended the seipin binding partners to AGPAT1, GPAT3 and GPAT4 further supporting the model in which seipin acts as a molecular scaffold. These interactions may be fundamental in the regulation of lipid handling and the coordinated generation of pro-adipogenic signals. In addition, we have identified alternative seipin splicing events, which give rise to unrelated polypeptide sequences and could alter the ability to bind interacting partners. Overall this work reveals novel insights regarding seipin, a critical regulator of human adipose development and lipid metabolism, including its regulation by dietary lipids.

Defining the expression and metabolic regulation of alternative isoforms of the lipodystrophy protein seipin in adipocytes

Assessment of quality of nutrition information materials for pelvic cancer patients in the UK.

The effect of a slow eating rate protocol on anthropometry in free-living overweight or obese adults. By F.Koidis, S.Hampton, K.Hart; Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford UK.

Obesity rates are increasing worldwide(1) with how we eat as well as what we eat potentially of importance.  Specifically food consumed ‘on the go’ and/ or a lack of mindfulness around eating may be contributing factors in weight gain(2). This study aimed to assess if a previously developed(3) slow eating rate (SER) protocol could facilitate weight loss in free living overweight/obese adults. Fifteen overweight/obese participants were recruited into this 10-week parallel, open label randomised controlled trial. 
     Participants were randomised to either intervention (SER protocol, n=8) or control (Cont, no instructions, n=7) groups at visit 1. Weight, height, body mass index (BMI), % body fat and % visceral fat were measured at each visit. Participants were video-recorded (to assess eating rate via chew counts) while consuming test meals at their own pace at visits 1 (baseline eating rate (ER) and 4. Between these visits, participants returned to their free-living environment in the community for six weeks where the intervention participants were asked to follow the SER protocol daily whilst consuming their lunchtime meal; the control participants were given no instructions. Monitoring of the intervention group was through the study’s dedicated website and phone application, using Mixpanel core analytics (Mixpanel). All data were analysed using GraphPad Prism 7 for Windows. Normality was assessed using the Shapiro-Wilks test and independent and paired t tests were performed to compare measures between groups and within groups over time, respectively. 

At baseline there were no significant differences between the two groups for any anthropometric measures, 
The intervention group significantly reduced their weight, BMI and visceral fat over the intervention period and showed a trend towards a reduction in body fat.  No significant changes were observed for the control group. This is the first study of its kind to successfully use the SER protocol in a free-living population and its results can be used by future studies aiming to target weight loss and maintenance with mindfulness-promoting tools. 

1. World Health Organisation (WHO), (2016). Obesity and overweight. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/ (Accessed: 4/8/2017).
2. Gilbert, D. and Waltz, J., (2010). Mindfulness and Health Behaviors. Mindfulness, 1(4), pp. 227-234.
3. Koidis, F., Brunger, L., Gibbs, M. and Hampton, S., (2014). The effect of eating rate on satiety in healthy and overweight people - A pilot study. e-SPEN Journal, 9(2).

The effect of a slow eating rate protocol on anthropometry in free-living overweight or obese adults

Associations between red and processed meat consumption and cardiometabolic risk markers among British adults. D.A. Hobbs1,2,3*, J.A. Lovegrove1,2,3 and D.I. Givens2,3, 1Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, 2Institute for Food, Nutrition and Health and 3Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AP

The consumption of red and processed meat has been associated with an increased risk of colon cancer(1). The aim of this study was to examine the association between diets with varying levels of red meat (RM), processed red meat (PRM) and total red and processed meat (TRPM) with cardiovascular health markers in adults. 
A secondary analysis was conducted using data from 1068 adults aged 19-64 years old from the National Diet and Nutrition Survey (NDNS) years 1-4 (2008/09-2011/12)(2). Adults (221 men and 517 women) were classified into tertiles according to RM, PRM and TRPM consumption, with tertile 1 (T1: TRPM 0-41; RM 0-12; PRM 0-12 g /day) and tertile 3 (T3: TRPM 87-344; RM 44-225; PRM 42-284 g/day) representing diets with the lowest and highest intake of RPM, respectively. RM food group included beef, lamb, pork, lamb, burgers and other red meat and PRM included processed red meat and sausages. Intakes were obtained from 4-day diet diaries. Anthropometric measures, blood pressure, pulse pressure, plasma glucose, HbA1c, homocysteine, C-reactive protein (CRP), triacylglycerol, total cholesterol, high-and low-density cholesterol from NDNS were used to determine associations between RM, PRM and TRPM with these markers. ANCOVA was used to detect statistically significant differences between tertiles of RM, PRM and TRPM consumption and cardiometabolic risk markers controlling for age, sex, energy intake (kJ), BMI, social class and smoking status (model 1) and dietary vitamin C (biomarker of fruit and vegetable intake), SFA and total fat intakes (model 2). Bonferroni post-hoc tests were used to detect differences between tertiles. Participants with fasted blood glucose above 7 mmol/L or taking medicines known to affect blood analytes were excluded. 
The diets of participants in the highest tertile of TRPM (T3) were associated with significantly higher concentrations of glucose (P-trend=0.004, P-T2/T1=0.020, P-T2/T3=0.01), CRP (P-trend=0.031, P-T1/T3=0.020) and larger waist circumference (P-trend=0.002, P-T1/T3=0.029) and waist to hip ratio (P-trend=0.005, P-T2/T3=0.004) compared to dietary patterns of participants in the lowest tertile of TRPM (T1) (model 1). When additional adjustments were made (model 2) T3 was associated with higher glucose concentration (P-trend=0.001, P-T2/T1=0.012, P-T2/T3=0.004) and larger waist circumference (P-trend=0.007, P-T1/T3=0.075) and waist to hip ratio (P-trend=0.016, P-T2/T3=0.012) compared to T1. Diets of participants in the highest tertile of PRM (T3) were associated with significantly higher homocysteine (model 1: P-trend=0.0

Associations between red and processed meat consumption and cardiometabolic risk markers among British adults

Red and processed meat consumption and nutritional adequacy among British adults. By D.A. Hobbs1,2,3*, J.A. Lovegrove1,2,3 and D.I. Givens2,3, 1Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, 2Institute for Food, Nutrition and Health and 3Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AP

Red meat is a good source of a number of nutrients such as iron, zinc and B vitamins(1). However, consumption of red and processed meat has been associated with unfavourable health outcomes including an increased risk of colon cancer(2). The aim of this study was to examine the association between diets with varying levels of red meat (RM), processed red meat (PRM) and total red and processed meat (TRPM) with nutritional adequacy in adults. 
A secondary analysis was conducted using data from 1068 adults aged 19-64 years from the National Diet and Nutrition Survey (NDNS) years 1-4 (2008/09-2011/12)(3). Adults (221 men and 517 women) were classified into tertiles according to TRPM consumption, with tertile 1 (T1, 0-41 g/day) and tertile 3 (T3, 87-344 g/day) representing diets with the lowest and highest intake of TRPM, respectively. Intakes were obtained from 4-day diet diaries. ANCOVA was used to determine statistically significant differences between tertiles of TRPM, RM and PRM consumption and macro-and micro-nutrient intakes, plasma ferritin and haemoglobin (Hb) concentrations (biomarkers of iron status) controlling for age, sex, total energy intake (kJ), BMI, social class and smoking status. Participants with fasted blood glucose above 7 mmol/L or taking medicines known to affect blood analytes were excluded from the statistical analysis. 
The mean TRPM, PRM and RM consumption was 70.3 (SD 54.0), 36.6 (SD 37.4) and 33.7 (SD 36.3) g/day, respectively. Furthermore, 56% of participants consumed less than SACN recommendations (<70 g/day)(1) for TRPM. Intakes of saturated fat, MUFA, trans-fat, thiamine, haem iron (dietary) and plasma Hb concentration were significantly higher in diets of participants in the high TRPM, RM and PRM tertiles (T3), respectively (all P<0.05). In addition, protein, niacin, iron and zinc intakes were significantly higher for T3 compared with T1 for TRPM and RM, respectively (all P<0.05). Furthermore, total fat and sodium intakes were higher for T3 compared with T1 for TRPM and PRM, respectively (all P-trend=0.0001). Carbohydrate, vitamin E, biotin and manganese intakes were significantly lower for TRPM, RM and PRM, respectively (all P<0.05). Calcium and iodine intakes were significantly lower for TRPM (calcium: P-trend=0.009; iodine: P-trend=0.0001) and RM (calcium: P-trend=0.001; iodine: P-trend=0.0001), respectively. Vitamin B12 (P-trend=0.019), iron (P-trend=0.002), non-haem iron (P-trend=0.0001) and selenium (P-trend=0.006) intakes were significantly lower for T3 compared with T1 for PRM. Moreover, the percentage of participants not meeting the Lower Recomm

Red and processed meat consumption and nutritional adequacy among British adults

The influence of social networks in increasing fruit and vegetables consumption in university students: a randomised controlled

Introduction
It is believed that the time of day of food intake has an effect on health. For example skipping breakfast is associated with an increased risk of obesity whereas regular meal patterns are associated with a reduced risk of obesity. However currently few studies have investigated when people consume food throughout the day. Here we use Latent Class Analysis (LCA) to investigate the hourly eating patterns of UK adults.

Method
Data from four daily food diaries for 1946 men and 2792 women from the 2008-2014 National Diet and Nutrition Survey (NDNS RP) were analyzed. For every hour of the day we calculated whether an Eating Occasion (EO) had occurred.  We defined an EO to have occurred if more than 210kJ had been eaten in a 15 minute period. LCA was used to separate people into three distinct eating classes and also to calculate the probability of an EO occurring for each class for every hour of the day. We then related eating pattern latent class to socio demographics.

Results
We identified three patterns of eating: a standard eating class, a later eating class who ate lunch and dinner slightly later than the standard class, and an irregular eating class who were less likely to eat meals at set times. Figure 1 shows the probability of eating in a particular hour of the day for individuals in each class. The proportion of men and women in each class is provided underneath figure 1.  Table 1 shows daily EO frequency, average time between eating occasion, and daily energy intake by eating pattern class. We found evidence for both men and women (p<0.0001 and p<0.0001) that older people eat earlier. We found evidence (men p=0.0001 and women p=0.0033) that single people are more likely to graze. We found evidence that being from a more advantaged socioeconomic background was associated with eating later (men p=0.0005 and women p=0.0314). And we found evidence that being more highly qualified was associated with eating later (men p=0.0003, women p=0.0001). 

Conclusion
Our results suggest that people fall into distinct eating classes and that later eating is associated with various socioeconomic factors. It would be interesting to next investigate how eating time patterns identified via LCA are associated to health outcomes.

Contact Information
Raoul.Mansukhani@lshtm.ac.uk

Investigating eating time patterns in UK adults from The 2008-2012 National Diet and Nutrition Survey

Vitamin D is the term used to describe two molecules: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). The first of these is derived by ultra-violet irradiation of ergosterol widely distributed in plants and fungi, while cholecalciferol is formed from ultra-violet irradiation on the skin. Serum 25-hydroxvitamin D status (25OHD) is a good clinical indicator of vitamin D health and low 25OHD (<25nmol/l) has been shown to affect markers of musculoskeletal health(1).
The aim of this study was to further analyse the effectiveness of vitamin D food fortification in subjects with a low baseline 25OHD status (<25nmol/l). The D2-D3 Study, participants were randomised to receive placebo, 600IU/d vitamin D2 or 600IU/d vitamin D3 for 12-weeks, delivered via fortified foods. Serum 25OHD was measured by liquid-chromatography-tandem mass spectrometry at baseline (wk0), wk6 and wk12. Two groups were included: white Europeans and South Asians (SA). The study was conducted according to the Helsinki Declaration and received full ethical approval.
In total, 335 women completed the study, of which 90 were SA(2). At baseline, 68 (20%) of women (56 SA: 12 Europeans) presented with low total 25OHD levels (<25nmol/L).  After 12 weeks of supplementation, there was a significant improvement in 25OHD levels from baseline to week 6, and baseline to week 12 in these women randomised to either D2 or D3 supplementation (p<0.0001 for all; Figure 1). Interestingly, 82% of the women randomised to the D2 group (biscuit or juice) demonstrated an increase in total 25OHD levels above 25nmol/L, while 100% of those in the D3 group showed levels over 25nmol/L. Subjects randomised to D3 showed significantly higher 25OHD levels than D2 participants at weeks 6 and 12 (p<0.0001 and p=0.0006 respectively).

Effectiveness of vitamin D fortification in raising serum 25-hydroxyvitamin D (25OHD) status

Sex specific differences in postprandial glycaemic responses to white rice-based meals combined with chicken, fat and vegetable

Liking for and consumption of vegetables in European adolescents: Healthy eating, liking, food neophobia and food choice motives. By KM Appleton1, C Dinnella2, S Spinelli2, D Morizet3, L Saulais4, A Hemingway1, E Monteleone2, L Depezay3, FJA Perez-Cueto5, and H Hartwell1, 1Bournemouth University, Poole, UK; 2University of Firenze, Florence, Italy; 3Bonduelle, Villeneuve D’Ascq, France; 4Institut Paul Bocuse, Ecully, France; 5University of Copenhagen, Copenhagen, Denmark.

A high vegetable consumption is associated with many health benefits, yet vegetable consumption across Europe is lower than recommended for health reasons, particularly in adolescents(1). Low vegetable consumption is often attributed to the bitter taste of many vegetables(2,3), yet not all vegetables are bitter-tasting and not all bitter tastes are disliked. This study investigated the individual characteristics and attitudes associated with the liking for and regular consumption of four bitter and four sweet vegetables in European adolescents. 
	Questionnaire data were collected from 736 adolescents (aged 12-19 years) from Denmark (N=178), France (N=206), Italy (N=197) and the UK (N=155). Data were collected on liking for and regular consumption of eleven frequently consumed vegetables (4 bitter vegetables: broccoli, cauliflower, green salad and spinach(4); 4 sweet vegetables: carrot, peas, sweetcorn and tomato(4); and 3 neither bitter nor sweet vegetables: courgette, green beans, other beans(4)), demographic characteristics: gender, age, family social affluence; and individual healthy eating habits (Adolescent Food Habits Checklist), food neophobia (fear of novel foods) (Food Neophobia Scale), dietary restraint (Dutch Eating Behaviors Questionnaire), and food choice motives (Food Choice Questionnaire). 
	Using regression, the regular consumption of both bitter and sweet vegetables was associated with higher healthy eating habits (smallest β=0.10, p=0.01) and a higher liking for bitter/sweet vegetables respectively (smallest β=0.50, p<0.01). Higher liking for bitter vegetables was associated with a lower food neophobia and higher motivations to consume natural foods (smallest β=0.09, p<0.01). Higher liking for sweet vegetables was associated also with a lower food neophobia, and with higher healthy eating habits and higher motivations to consume foods for sensory reasons (smallest β=0.10, p<0.01). Some effects of gender and country were also found. 
	These findings suggest that strategies to increase vegetable consumption in adolescents should focus on increasing healthy eating, and increasing vegetable liking. Various techniques can be used to change taste preferences(5). From our data, increasing liking for both bitter and sweet vegetables may also benefit from strategies to reduce neophobia. Liking for bitter vegetables may benefit also from increasing motivations to consume natural foods, while liking for sweet vegetables may benefit also from increasing healthy eating and 

01. Liking for and consumption of vegetables in European adolescents: Healthy eating, liking, food neophobia and food choice motives

Evidence linking oral health status and diet quality in older adults is inconsistent and limited by the few prospective studies conducted to date (1-3). This study investigated whether oral health status had an impact on future dietary intake in older Northern Irish (NI) men from the ongoing Prospective Epidemiological Study of Myocardial Infarction (PRIME).
The study involved older men [n=1096, mean=63.5(0.09) years] who underwent a dental examination at baseline (2001-2004). Oral health status was defined in three broad categories: dentate without dentures (n=552), dentate with dentures (n=465) and edentate with dentures (n=79). A food frequency questionnaire administered in 2015 was used to derive intakes of major food groups and diet quality scores were characterised by the Dietary Diversity Score (DDS) (range 0-8) and Mediterranean Diet Score (MDS) (range 0-8). Associations between oral health status, food intakes and diet quality scores were assessed using regression models adjusted for potential confounders (age, socio-economic status, smoking, alcohol, BMI, diabetes and C-reactive protein).
In fully adjusted models, mean fruit intake (portions/day) was significantly higher in men who were dentate without dentures [1.13(95% CI: 1.05, 1.22)] compared to those who were dentate with dentures [1.07(95% CI: 0.98, 1.16)] and edentate with dentures [0.78(95% CI: 0.60, 0.98)] (P=0.008; P trend=0.002). Similarly, mean daily intake of nuts was significantly higher in men who were dentate without dentures [0.17(95% CI: 0.15, 0.19)] compared to those who were dentate with dentures [0.12(95% CI: 0.10, 0.15)] and edentate with dentures [0.10(95% CI: 0.04, 0.17)] (P=0.002; P trend=0.08). Other food groups (olive oil/rapeseed oil, vegetables, oily fish, wine, red meat and wholegrains) were not significantly associated with oral health status. Compared to dentate men without dentures, those who were edentate with dentures were 62% less likely to achieve the UK dietary guideline of 2 portions fruit/day [OR 0.38(95% CI: 0.17, 0.81; P=0.01)]. In fully adjusted models, mean MDS was significantly higher in men who were dentate without dentures [4.42(0.08)] compared to those who were dentate with dentures [4.17(0.09)] and edentate with dentures [3.86(0.25)] (P=0.03; P trend=0.04). Similarly, higher DDS was observed in dentate men without dentures compared to the other dental groups, but the associations were not significant in fully adjusted models. 
In older NI men, oral health status was associated with future dietary intake (>10 years later). Specifically, dentures were associated with lower fruit and nut intake, as well as decreased dietary quality. Therefore, interventions to optimise oral health status could help improve diet quality in older men. 

04. A longitudinal investigation of whether oral health status has an impact on future dietary intake in older adults in Northern Ireland.

There is increasing evidence in studies conducted over recent decades that numerous health benefits are associated with the consumption of long chain omega-3 (ω-3) polyunsaturated fatty acids (LCω3PUFA) throughout the human lifecycle(1). This has created a demand for functional food products enriched with LCω3PUFA. Nanoemulsions, systems with extremely small droplet sizes have been shown to increase LCω3PUFA bioavailability(2). However, nanoemulsion creation and processing methods may impact on the oxidative stability of these systems due to small lipid droplet sizes and large droplet surface areas(3). This study aimed to systematically review published literature that focused on the oxidative stability of LCω3PUFA nanoemulsions suitable for integration into food vehicles. 
The review followed the PRISMA checklist for systematic reviews. Searches were conducted and titles and abstracts screened for relevance by two independent review authors (KEL, LB or LS). Studies were included in the review if they evaluated the oxidative stability of LCω3PUFA nanoemulsions suitable for food enrichment and were published from January 2007 to July 2017.   
The search criteria identified 1880 articles, which were reduced to 1403 upon abstract and title screening. Further application of inclusion/exclusion criteria led to the identification of 17 key studies. Researchers used a range surfactants and antioxidants to create systems which, were evaluated during 7 to 100 days of storage. Nanoemulsions were created using high and low power methods with synthetic and natural emulsifiers. Natural emulsifiers offered equivalent or increased oxidative stability compared to synthetic sources, which is useful as consumers are demanding natural, cleaner label food products(4). LCω3PUFA source oils evaluated included fish (n = 9), flaxseed (n = 2), algae (n = 3), krill (n = 2), walnut (n = 1). Equivalent vegetarian sources of LCω3PUFA to those found in fish oils such as algal oils show potential as they provide direct sources without the need for conversion in the human metabolic pathway. Quillaja saponin is a promising natural emulsifier that can produce nanoemulsion systems with equivalent/increased oxidative stability in comparison to other emulsifiers particularly when additional antioxidants are used. Further studies to evaluate the oxidative stability of quillaja saponin nanoemulsions combined with algal sources of LCω3PUFA are warranted to enable the development of safe, clean label functional food products.



10. Systematic review to evaluate the oxidative stability of omega-3 nanoemulsion systems suitable for functional food enrichment

FoodSMART: A mobile phone application to provide personalised information on the foods available in an eating out situation. By KM Appleton1, J Bray1, I Mavridis2, A Giboreau3, FJA Perez-Cueto4, M Ronge5 and H Hartwell1, 1Bournemouth University, Poole, UK; 2University of Macedonia, Thessalonika, Greece; 3Institut Paul Bocuse, Ecully, France; 4University of Copenhagen, Copenhagen, Denmark; 5Ronge & Partners, Baden, Austria.

Eating out has become an integral part of modern living, but meals consumed out of the home are often high in calories and fat(1). Providing information on foods and dishes (e.g. on nutritional content, allergens, and food provenance) has been associated with improved dietary intakes, but concerns have also been expressed(2,3). Consumers welcome increased information, but only if the information is easily accessible and relevant to them(2,3). This work aimed to develop a mobile phone application (app) to allow consumers easily accessible personalised information on the foods and dishes provided in an eating out situation. 
The app is intended for use in workplace canteens, where a predetermined food menu offers a number of dishes and side-dishes per day. Initial stages of app development gained the information that consumers would like to receive about the foods provided, the information they would like to be able to personalise, and how this information should best be presented(3). An app was then developed consisting of a user interface attached to a secure database. The database stores information per dish, as supplied by food manufacturers and caterers. The user interface allows consumers to input preferences about the information per dish that they receive. The app is activated by scanning a QR code on a menu, to provide information easily, and the consumer then receives the information they desire.
Following initial development, the app was demonstrated to consumers at eight public engagement events (four in the UK (79 respondents), one in France (54 respondents), one in China (48 respondents), one in Malaysia (34 respondents) and one in Denmark (18 respondents); and assessed using the 10-item System Usability Scale (SUS) questionnaire(4), plus an additional question ‘I believe the FoodSmart App will be useful to customers in a canteen setting to help them to get informed about dishes offered’.
A total of 233 respondents provided usable data: 81 (35%) males, 143 (61%) females (9 (4%) preferred not to provide gender); 115 (49%) aged 20-29 years, 39 (17%) aged 30-39 years, 35 (15%) aged 40-49 years and 32 (14%) aged 50 years and over (12 (5%) preferred not to provide age). The mean overall SUS score was 68.3 of a possible 100 (sd.: 15.4, range: 27.50 – 100). All 10 questions, plus the additional question were responded to positively (smallest t(229)=26.40, p<0.05), suggesting the app was positively received. The SUS scores gained are typical of those for other similar IT equipment, such as mobile phones and modems(5). SUS 

11. FoodSMART: A mobile phone application to provide personalised information on the foods available in an eating out situation

Understanding the origin of food can help children make informed food choices (1). Regular breakfast consumption is positively associated with health benefits for children and adolescents (2). The aim of this study was to explore children’s knowledge of the origin of their food with an emphasis on breakfast consumption.  
The frequency of breakfast consumption, attitudes to breakfast and knowledge about the origin of foods commonly eaten at breakfast were investigated in urban-dwelling pupils from primary school (n, 213) and secondary school junior cycle (n, 137) who were participating in a school-organised farm visit using a nine-question, multiple-choice, study-specific questionnaire administered just before the farm visit. Responses were indicated by pupils raising their hands to their answer of choice. To minimise response bias, pupils kept their eyes closed throughout. 
The majority (80%) of school pupils consumed breakfast daily. This was significantly higher in the younger primary school pupils compared with those in junior cycle secondary school (85% vs. 53%, respectively). Breakfast consumption did not differ by gender (73% vs. 81% p > 0.05). Sixty-percent of children correctly identified animal products consumed at breakfast but their knowledge about the animal origin of these foods was poor (average score 45%) with no gender differences observed. As expected, the junior cycle pupils had better knowledge about the origin of foods than the primary school pupils (58% vs. 37%, respectively; p < 0.05).
Food origin knowledge of urban-dwelling school children (n=350)
Urban-dwelling school pupils have a basic understanding about where foods consumed at breakfast originate. In relation to animal products, knowledge of their animal of origin is poor. Breakfast skipping, associated with poor food choices during the day and childhood overweight/obesity (3), is frequent in older school pupils. As farm-based educational programmes enhance children’s knowledge about food (4), they could potentially improve Irish urban-dwelling children’s food choice, their decision-making and improve their diet-related behaviours. 

1.	Vidgen HA, Gallegos D Appetite (2014): 76, 50–59.
2.	Rampersaud GC, Pereira MA, Girard BL et al. J Am Diet Assoc (2005): 105, 743-760.
3.	Abarca-Gómez L, Abdeen ZA, Hamid ZA et al. Lancet. (2017): 390, 2627-2642.
4.	Kos M, Jerman J. Nutr& Food Sci. (2012); 42:324-31.

06. Irish school children’s knowledge of the origins of their breakfast foods

The lack of comprehensive food composition databases for sugar contents in Japanese foods has led to the lack of nutritional epidemiologic studies on sugar intake in Japanese population. This cross-sectional study aimed to investigate the association of free sugar intake estimated using a newly developed food composition database with the characteristics and lifestyles of Japanese children aged 3-6 years.
The food composition database contained information on sugars in 2222 commonly consumed Japanese foods. Total sugar content in each food was determined using a seven-step method including a stepwise strategy in data gathering(1). Free and added sugar contents were assigned using a published stepwise method(2). Using this database, we estimated the sugar (total, added, and free sugars) intakes derived from a 3-day weighed dietary record conducted in 2015 among 166 boys and 166 girls aged 3-6 years living in 24 of 47 prefectures in Japan.
The mean free sugar intake was 26.8 g/d (standard deviation (SD), 12.3 g/d), while the mean % of energy intake from free sugar was 7.8% (SD, 3.2%). The prevalence of excessive free sugar intake (≥10% of energy intake) was 21.7%. Among the characteristics and lifestyles examined, screen time was most strongly associated with the prevalence of excessive free sugar intake: multivariate adjusted odds ratios (95% confidence intervals) for screen time <0.5, ≥0.5 to <1, and ≥1 h/d were 1.0 (reference), 3.81 (1.04, 13.98), and 4.36 (1.16, 16.35), respectively. Additionally, younger age, shorter sleep, and mothers with office work and service and sales jobs (compared with those with professional and managerial jobs) were significantly associated with a higher prevalence of excessive free sugar intake.
In conclusion, this study showed the sugar intakes and the prevalence of excessive free sugar intake of Japanese children aged 3-6 years and identified several lifestyles and characteristics associated with excessive sugar intake. Although the mean free sugar intake and the prevalence of excessive intake in this Japanese population were lower than those in the UK (14.7% of energy and 82%)(3) and Australia (13.2% of energy and 70.8%)(4), the prevalence of excessive free sugar intake was relatively high (21.7%). The next step is to clarify the association of free sugar intake with nutrient intake and health status in Japanese children.

1. Rand WM, Pennington JAT & Murphy SP (1991) Compiling Data for Food Composition Data Bases. Tokyo: United Nation University Press.
2. Louie JCY, Moshtaghian H, Boylan S, et al. (2015) Eur J Clin Nutr 69, 154-161.
3. Gibson S, Francis L, Newens K, et al. (2016) Br J Nutr 116, 1265-1274.
4. Lei L, Rangan A, Flood VM, et al. (2016) Br J Nutr 115, 868-77.

06 / Association of free sugar intake estimated using a newly-developed food composition database with lifestyles and parental charac

Efficacy and comparative uptake rates of sublingual and capsular vitamin D preparations.  By C. E. Williams1, E. A. Williams2 & B.M. Corfe1,3,4 1. Molecular Gastroenterology Research Group, Academic Unit of Surgical Oncology, Department of Oncology & Metabolism, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, 2. Human Nutrition Unit, Department of Oncology & Metabolism, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, 3. Insigneo Institute for In Silico Medicine, The University of Sheffield
 Vitamin D is critical for skeletal health and is increasingly associated with other pathologies encompassing gastrointestinal, immunological, psychological effects (1). A significant proportion of the population exhibit suboptimal levels of vitamin D, particularly in Northern latitudes in winter (2). Supplementation is advocated, but few data are available on relative efficacy of preparations, or rates of uptake, or whether serum status may influence uptake. There has been considerable interest in the potential use of sublingual sprays for delivery of nutrient supplements, but data on efficacy remains sparse.  A randomised, placebo-controlled, 3-arm parallel design study was conducted in healthy volunteers (n=75) to compare uptake rates of vitamin D supplementation in capsule and sublingual spray preparations over a six-week period between January and April 2017.  Serum 25(OH)D concentrations were measured after day 0, 3, 7, 14, 21 and 42 days of supplementation with 3000IU per diem.  Baseline measurements show 25(OH)D deficiency, insufficiency and sufficiency in 14.9%, 44.6% and 40.5% of the participants respectively. There was a significant elevation in serum concentrations of 25(OH)D in the treatment arms (capsule p=0.003, spray p=0.001) (Fig. 1A) compared to control.  The capsule and spray were equally efficacious with average change in serum vitamin D of 2 nmol/ml/day. The data suggest that uptake rates are higher in individuals with lower serum vitamin D (Fig. 1B+C).  71% of the participants preferred the oral spray preparation to the capsule. 



In conclusion, a sublingual vitamin D spray is an effective and preferential mode of delivery for supplementation in a healthy population.  Achievable rates of vitamin D increment are suggested to be around 2 nmol/ml/day.

1.	Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D From the Institute of Medicine: What Clinicians Need to Know. Obstetrical & Gynecological Survey. 2011;66(6):356-7.
2.	Lanham‐New SA, Wilson LR. Vitamin D – has the new dawn for dietary recommendations arrived? Journal of Human Nutrition and Dietetics. 2016;29(1):3-6.

08 / Efficacy and comparative uptake rates of sublingual and capsular vitamin D preparations

Approximately fifty percent of women gain too much weight during pregnancy (1), increasing pregnancy risk (2) and perpetuating the cycle of overweight and obesity (3). With approximately 1.7 million consultations each year (4), shared maternity care led by general practitioners (GPs) is a crucial component of antenatal care in Australia (5). Little is known about the gestational weight gain (GWG) advice women receive in shared maternity care. Therefore, we aimed to explore GPs’ perceptions, barriers and enablers implementing GWG guidelines.
General Practitioners (n = 20) who provide shared maternity care from metropolitan and regional Victoria (Australia) were recruited via postal invitation to participate in a semi-structured interview. Questions were informed by the Theoretical Domains framework (TDF) (6) that explores barriers and enablers of guideline implementation. Interviews were transcribed verbatim and transcripts were analysed by two researchers using deductive thematic analysis (7). NVivo Version 11 (QSR International) was used in the analyses and ethics approval was obtained from Monash University (REF: 7799). 
Key themes regarding GPs’ awareness, knowledge and application of GWG guidelines aligned with the TDF. GPs were aware of the importance of optimal GWG for positive maternal and foetal outcomes however, other pregnancy-related issues were given priority in short consultations. Enablers were practitioner-based and included GPs’ strong sense of their professional role to provide GWG advice, and ongoing and trusting relationships with women through and beyond pregnancy. Barriers were mostly health system-based with limited time, remuneration, and restrictive referral pathways being limiting factors.   
There is an urgent need to support GPs to provide GWG advice in accordance with current national guidelines (8). Solutions lie in changes to policy and funding within the health-system so that longer shared care consultations are remunerated, and referrals to dietitians and other allied health professionals are accessible to women who require additional support to optimise GWG beyond what their GP can offer.

1. Goldstein R, Abell S et al. (2017) JAMA 317, 2207-2225 
2. Cheney K, Farber R et al. (2018) Med J Aust 208, 119-125 
3. Melzer K & Schutz Y. (2010) Int J Obes 34, S44-S52
4. Wong C, Gordon J et al. (2016) Aust Fam Phys 45, 538-541
5. Brodribb W. (2014) MJA 201, 626-267
6. Cane J, O’Connor D et al. (2012) Implement Sci 7, 17 pages
7. Atkins L, Francis J et al. (2017) Implement Sci 12, 18 pages
8. Walker R, Mazza D et al (2018) Aust J Prim Health 24, 4-8

10 / Barriers and enablers of implementing gestational weight gain guidelines in GP-led shared maternity care: a qualitative study

Vitamin D deficiency (25(OH) D ≤30 nmol/L) is a significant global health concern. At far latitudes, non-ethnic population groups from lower latitudes can be at a significantly increased risk of deficiency due to increased skin pigmentation and genetic pre-disposition. Furthermore, some ethnic lifestyle choices or dietary habits can also increase the risk of deficiency (1). This is of particular concern as low vitamin D status can result in impaired bone health and osteoporosis and potentially imbalanced immune function and other chronic conditions (2). The vitamin D status of ethnic minority groups has been examined extensively both in UK and European populations, but to-date, has not been investigated in the Irish context. 
        The aim of this study was to assess the vitamin D status from a selection of the Dublin population of South East Asian descent. The Asian population in Ireland is the 2nd biggest ethnic group making up 1.6% of the population, ahead of Irish Travellers (0.7%) or Black Irish/Black African (1.2%) (3). A search was conducted, using the Biochemistry Department laboratory information system (iSOFT Telepath) of St James’s Hospital Dublin, for vitamin D requests by GPs (known only to take patients self-identified as Asian) for participants of South East Asian descent. From 2010-2101, 115 participants were identified while another 86 were identified from the years 2015-2016. Samples for 25(OH)D analysis  included total serum 25(OH)D (D2 and D3) concentrations which were quantified by using liquid chromatography–tandem mass spectrometry (API 4000; AB SCIEX) and batch analyzed  at St. James’s Hospital (which is accredited to ISO 15189 standard). The quality and accuracy of the method were continuously monitored by the use of internal quality controls, participation in the Vitamin D External Quality Assessment Scheme (DEQAS) and the use of the National Institute of Standards and Technology (NIST) 972 vitamin D standard reference material. The respective inter- and intra-assay coefficients of variation were 5.7 and 4.5 %.
        Overall the median age was 31 years (age range: 2-64 years) with 59.1% male and the mean 25(OH)D concentration ranged from 10 nmo/l to 108 nmol/l. In 2010-2011, 79.1% of the total sample were vitamin D deficient, with 8.7% sufficient. Females had a significantly higher 25(OH)D concentration than males (22.3 vs 16.3 nmol/L; P=0.005) but both groups had a significant proportion with deficient status (88.2% & 66.0% respectively). In males only, no participant reached the level of vitamin D sufficiency (>50 nmol/L). In 2015 -2016, rates of deficiency had halved with 39.5% of the total sample deficient and 33.3% sufficient. Male deficiency rates were still higher compared to females (43.3% vs. 37.5% P<0.05). 
        For the first time in Ireland, a study has investigated the vitamin D status of the 2nd largest ethnic population group. In the sample of adults and children of South Asian descent from 2011-2012

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