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A letter to the editor is presented in response to an article on food banks and how food bank establishment and activities correlates with markers of economic hardship and government austerity policies, and the article "Austerity and the Rise of Food Banks," published in a 2015 issue.

The article discusses a study which examine the quality of evidence that supports proposed actions in the Great Britain's white paper "Healthy Lives, Healthy People." The study utilizes a systematic approach to seek for quality evidence in connection with the white paper. Results show that the equivocal evidence that fastening assessment led in an increased in labour market participation. Moreover, it notes that the evidence was lack of community interventions and has poor quality evidence which affirms the use of community agents.

Objectives To explore similarities and differences in policy content and the political context of the three main English government reports on health inequalities: the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010). Methods Thematic policy and context analysis of the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010) in terms of: (i) underpinningtheoretical principles; (ii) policy recommendations; (iii) the political contexts in which each was released; and (iv) their actual or potential influence on research and policy. Results There were great similarities and very few differences in terms of both the theoretical principles guiding the recommendations of these reports and the focus of the recommendations themselves. However, there were clear differences in terms of the political contexts of each report, as well as their subsequent impacts on research and policy. Conclusion The paper calls into question the progress of health inequalities research, the use of evidence and of the links between research, politics and policy. [ABSTRACT FROM AUTHOR]

Background: Food protein-induced enterocolitis syndrome (FPIES) is a delayed type of food allergy, most often seen in infancy. We aimed to estimate its incidence, to describe common food triggers and the patient journeys of this rare but serious condition.Design: We undertook a prospective epidemiological survey of FPIES using the British Paediatric Surveillance Unit.Setting: UK and Ireland.Participants: A survey of all paediatricians over 13 months between January 2019 and February 2020.Main Outcome Measures: 204 cases were reported, 98 (48%) meeting case definition, giving an incidence of 0.006% for England based on 93 cases.Results: 98 patients reported 135 trigger foods, 27% (26 of 98) had multiple food triggers. Common food triggers included cow's milk (24%, 33 of 135), fruits and vegetables (19%, 26 of 135), hen's egg (16%, 22 of 135) and fish (14%, 19 of 135). In 46% (41 of 90), the initial trigger food had been ingested three or more times before diagnosis, with a median diagnostic delay of 7.9 months (3.0, 17.3). Half (50 of 98) were admitted, yet only 5% (5 of 98) received appropriate acute treatment with ondansetron. Most cases were diagnosed by an allergy specialist (74 of 98, 76%), within a median of 7.5 (3.0, 13.3) miles from home.Conclusion: The incidence of FPIES was significantly lower than expected across the whole of the British Isles. Most reports were of cases local to specialist allergy centres, with delays in diagnosis. This suggests under-recognition of FPIES in frontline clinical setting where education of healthcare professionals is required to improve recognition, earlier diagnosis and treatment. [ABSTRACT FROM AUTHOR]

A letter to the editor and its response regarding an article on the study of the relationship between early childhood adiposity and nearby food environment in an understudied population, published in a previous issue is presented.

Objective: In 1991, the Medical Research Council (MRC) Vitamin Study demonstrated that folic acid taken before pregnancy and in early pregnancy reduced the risk of a neural tube defect (NTD). We aimed to estimate the number of NTD pregnancies that would have been prevented if flour had been fortified with folic acid in the UK from 1998 as it had been in the USA.Design: Estimates of NTD prevalence, the preventive effect of folic acid and the proportion of women taking folic acid supplements before pregnancy were used to predict the number of NTD pregnancies that would have been prevented if folic acid fortification had been implemented.Setting: Eight congenital anomaly registers in England and Wales.Main Outcome Measures: The prevalence of pregnancies with an NTD in the UK and the number of these pregnancies that would have been prevented if folic acid fortification had been implemented.Results: From 1991 to 2012, the prevalence of NTD pregnancies was 1.28 (95% CI 1.24 to 1.31) per 1000 total births (19% live births, 81% terminations and 0.5% stillbirths and fetal deaths ≥20 weeks' gestation). If the USA levels of folic acid fortification from 1998 onwards had been adopted in the UK, an estimated 2014 fewer NTD pregnancies would have occurred.Conclusions: Failure to implement folic acid fortification in the UK has caused, and continues to cause, avoidable terminations of pregnancy, stillbirths, neonatal deaths and permanent serious disability in surviving children. [ABSTRACT FROM AUTHOR]

Objective Spending on cigarettes may deprive households of other items like food. The goal of this study was to examine the prevalence of and factors associated with this smoking-induced deprivation among adult smokers in China. Methods The data came from Waves 1-3 of the International Tobacco Control (ITC) China Survey, conducted from 2006 to 2009 among urban adults aged 18 years or older in China. We focus on the samples of current smokers from six cities (N=7981). Smoking-induced deprivation was measured with the survey question, "In the last six months, have you spent money on cigarettes that you knew would be better spent on household essentials like food?" We examined whether sociodemographic factors, smoking intensity and price paid per pack of cigarettes were associated with smoking-induced deprivation using generalised estimating equations modelling. Findings 7.3% of smokers reported smoking-induced deprivation due to purchasing cigarettes. Low-income and middle-income smokers were more likely to have smoking-induced deprivation compared with high-income smokers (adjusted OR (AOR)=2.06, 95% CI 1.32 to 2.31; AOR=1.44, 95% CI 1.10 to 1.69); smokers living in Shenyang (AOR=1.68, 95% CI 1.25 to 2.24) and Yinchuan (AOR=2.50, 95% CI 1.89 to 3.32) were more likely to have smoking-induced deprivation compared with smokers living in Beijing. Retired smokers were less likely to have smoking-induced deprivation compared with employed smokers (AOR=0.67, 95% CI 0.52 to 0.87). There was no statistically significant relationship between smoking intensity, price paid per pack of cigarettes and smoking-induced deprivation. Conclusions Our findings indicate that certain groups of smokers in China acknowledge spending money on cigarettes that could be better spent on household essentials. Tobacco control policies that reduce smoking in China may improve household living standards by reducing smoking-induced deprivation. [ABSTRACT FROM AUTHOR]

The article reports the move by pro-smoking group Forest as of 2014 to launch a new consumer rights campaign dubbed Action on Consumer Choice (ACC) to convince the alcohol and fast food industries to agree to a collaboration with ACC to advance the rights of their consumers in Great Britain.

The Heimlich manoeuvre is a well-known intervention for the management of choking due to foreign body airway occlusion, but the evidence base for guidance on this topic is limited and guidelines differ. We measured pressures during abdominal thrusts in healthy volunteers. The angle at which thrusts were performed (upthrust vs circumferential) did not affect intrathoracic pressure. Self-administered abdominal thrusts produced similar pressures to those performed by another person. Chair thrusts, where the subject pushed their upper abdomen against a chair back, produced higher pressures than other manoeuvres. Both approaches should be included in basic life support teaching. [ABSTRACT FROM AUTHOR]

During 2007–2010 in the USA, 2214 deaths among people aged ≥65 were attributed to choking on food. The death rate for this cause is higher among the elderly than among any other age group. Using data from the US National Vital Statistics System, we examined the relationship between food suffocation and other causes of death listed on the death certificate. Among decedents aged ≥65, the three most common additional conditions listed on the death certificate were heart disease, dementia and diabetes. However, after estimating the expected joint frequency of other causes based on the overall distribution of all causes of death, we find that three causes—dementia (including Alzheimer’s disease), Parkinson’s disease and pneumonitis—are most strongly associated with deaths from choking on food among older people. [ABSTRACT FROM AUTHOR]

The article summarizes a research study which examined the relation between rising food prices on food demand and consumption worldwide. An overview of the study's selection criteria, primary outcome, and research funding is provided. Study results are highlighted that include the quantity of food changes in response to a one percent increase in food price according to food type, country income level and household income level.

Background Studies evaluating the impact of the neighbourhood food environment on obesity have summarised the density or proximity of individual food outlets. Though informative, there is a need to consider the role of the entire food environment; however, few measures of whole system attributes have been developed. New variables measuring the food environment were derived and used to study the association with body mass index (BMI). Methods Individual data on BMI and sociodemographic characteristics were collected from 48 482 respondents of the 2002–2006 community health survey in New York City and linked to residential zip code-level characteristics. The food environment of each zip code was described in terms of the diversity of outlets (number of types of outlets present in a zip code), the density of outlets (outlets/km2) and the proportion of outlets classified as BMI-unhealthy (eg, fast food, bodegas). Results Results of the cross-sectional, multilevel analyses revealed an inverse association between BMI and food outlet density (−0.32 BMI units across the IQR, 95% CI −0.45 to −0.20), a positive association between BMI and the proportion of BMI-unhealthy food outlets (0.26 BMI units per IQR, 95% CI 0.09 to 0.43) and no association with outlet diversity. The association between BMI and the proportion of BMI-unhealthy food outlets was stronger in lower (

Background Little is known about the effects of overall diet in childhood and intelligence later in life. Methods The current study, based on the Avon Longitudinal Study of Parents and Children, uses data on children's diet reported by parents in food-frequency questionnaires at 3, 4, 7 and 8.5 years of age. Dietary patterns were identified using principal-components analysis and scores computed at each age. IQ was assessed using the Wechsler Intelligence Scale for Children at 8.5 years. Data on a number of confounders were collected, and complete data were available for 3966 children. Results After adjustment, the 'processed' (high fat and sugar content) pattern of diet at 3 years of age was negatively associated with IQ assessed at 8.5 years of age--a 1 SD increase in dietary pattern score was associated with a 1.67 point decrease in IQ (95% CI -2.34 to -1.00; p<0.0001). The 'health-conscious' (salad, rice, pasta, fish, fruit) pattern at 8.5 years was positively associated with IQ: a 1 SD increase in pattern score led to a 1.20 point increase in IQ (95% CI 0.52 to 1.88; p=0.001). Conclusion There is evidence that a poor diet associated with high fat, sugar and processed food content in early childhood may be associated with small reductions in IQ in later childhood, while a healthy diet, associated with high intakes of nutrient rich foods described at about the time of IQ assessment may be associated with small increases in IQ. [ABSTRACT FROM AUTHOR]

Background Government standards are now in place for children's school meals but not for lunches prepared at home. The aim of this trial is to improve the content of children's packed lunches. Methods A cluster randomised controlled trial in 89 primary schools across the UK involving 1291 children, age 8-9 years at baseline. Follow-up was 12 months after baseline. A "SMART" lunch box intervention programme consisted of food boxes, bag and supporting materials. The main outcome measures were weights of foods and proportion of children provided with sandwiches, fruit, vegetables, dairy food, savoury snacks and confectionery in each packed lunch. Levels of nutrients provided including energy, total fat, saturated fat, protein, non-milk extrinsic sugar, sodium, calcium, iron, folate, zinc, vitamin A and vitamin C. Results Moderately higher weights of fruit, vegetables, dairy and starchy food and lower weights of savoury snacks were provided to children in the intervention group. Children in the intervention group were provided with slightly higher levels of vitamin A and folate. 11% more children were provided with vegetables/salad in their packed lunch, and 13% fewer children were provided with savoury snacks (crisps). Children in the intervention group were more likely to be provided with packed lunches meeting the government school meal standards. Conclusions The SMART lunch box intervention, targeting parents and children, led to small improvements in the food and nutrient content of children's packed lunches. Further interventions are required to bring packed lunches in line with the new government standards for school meals. Current controlled trials ISRCTN77710993. [ABSTRACT FROM AUTHOR]

Presents a letter related to suggestion about reading the label of food products for children.

Objectives: To empirically test the impact of dietary intake at several time points in childhood on children's school attainment and to investigate whether any differences in school attainment between children who ate packed lunches or school meals was due to who these children were, their pre-school dietary patterns, or to what they ate at school. Design: Using longitudinal data available in the Avon Longitudinal Study of Parents and Children (ALSPAC), multivariate linear regression was used to assess the relative importance of diet at different ages for school attainment. Main outcome measures: Three indicators of school attainment were used: at ages 4-5 entry assessments to school, at ages 6-7 Key Stage 1 national tests and at ages 10-11 Key Stage 2 national tests. These outcome variables were measured in levels as well as in changes from the previous educational stage. Results: The key finding at age 3 was that "junk food" dietary pattern had a negative association with the level of school attainment. A weak association remained after controlling for the impact of other dietary patterns at age 3, dietary patterns at ages 4 and 7 and other confounding factors. The authors did not find evidence that eating packed lunches or eating school meals affected children's attainment, once the impact of junk food dietary pattern at age 3 was accounted for in the model. Conclusions: Early eating patterns have implications for attainment that appear to persist over time, regardless of subsequent changes in diet. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects on nutrition, health and expenditure of extending value added tax (VAT) to a wider range of foods in the UK. Method: A model based on consumption data and elasticity values was constructed to predict the effects of extending VAT to certain categories of food. The resulting changes in demand, expenditure, nutrition and health were estimated. Three different tax regimens were examined: (1) taxing the principal sources of dietary saturated fat; (2) taxing foods defined as unhealthy by the SSCg3d nutrient scoring system; and (3) taxing foods in order to obtain the best health outcome. Data: Consumption patterns and elasticity data were taken from the National Food Survey of Great Britain. The health effects of changing salt and fat intake were from previous meta-analyses. Results: (1) Taxing only the principal sources of dietary saturated fat is unlikely to reduce the incidence of cardiovascular disease because the reduction in saturated fat is offset by a rise in salt consumption. (2) Taxing unhealthy foods, defined by SSCg3d score, might avert around 2300 deaths per annum, primarily by reducing salt intake. (3) Taxing a wider range of foods could avert up to 3200 cardiovascular deaths in the UK per annum (a 1.7% reduction). Conclusions: Taxing foodstuffs can have unpredictable health effects if cross-elasticities of demand are ignored. A carefully targeted fat tax could produce modest but meaningful changes in food consumption and a reduction in cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background: The recommended age of introduction of solids food to the diet of infants (weaning) has recently been increased in the UK to 6 months, but most babies are still weaned before the age of 4 months. Aims: To examine what predicts the age of weaning and how this relates to weight gain and morbidity using data from a population based cohort. Methods: Parents of 923 term infants born in a defined geographical area and recruited shortly after birth were studied prospectively using postal questionnaires, weaning diaries, and routinely collected weights, of whom 707 (77%) returned data on weaning. Results: The median age of first weaning solids was 3.5 months, with 21% commencing before 3 months and only 6% after 4 months of age. Infants progressed quickly to regular solids with few reported difficulties, even when weaned early. Most parents did not perceive professional advice or written materials to be a major influence. The strongest independent predictors of earlier age at weaning were rapid weight gain to age 6 weeks, lower socioeconomic status, the parents' perception that their baby was hungry, and feeding mode. Weight gain after 6 weeks was unrelated to age of weaning. Babies weaned before 3 months, compared to after 4 months, had an increased risk of diarrhea. Conclusions: Social factors had some influence on when weaning solids were introduced, but the great majority of all infants were established on solids before the previously recommended age of 4 months, without difficulty. Earlier weaning was associated with an increased rate of minor morbidity. [ABSTRACT FROM AUTHOR]

Objectives: To follow up workers in the grain processing and animal feed industry five years after an initial survey, and to monitor exposures to organic dust and endotoxin and changes in prevalence of respiratory symptoms and lung function.Methods: Outcome measures in the present survey were decline in lung function over five years, rapid annual decline in forced expiratory volume in one second (FEV1) above 90 ml.s-1, and loss to follow up.Results: Among 140 workers included in the longitudinal analysis, annual decline in FEV1 and maximal mid-expiratory flow (MMEF) were significantly related to occupational exposure to dust and endotoxin in the grain processing and animal feed industry. Assuming a cumulative exposure over a working life of 40 years with an exposure of 5 mg.m-3, the estimated effect on the FEV1 would be a decline of 157 ml.s-1 (95% CI 13 to 300)--that is, about 4% of the group mean FEV1 and 473 ml.s-1 (95% CI 127 to 800) of the MMEF (about 12%). Workers with a dust exposure > 4 mg.m-3 or endotoxin concentrations > 20 ng.m-3 at the 1986-8 survey had significantly higher risk of rapid decline in FEV1 (odds ratio (OR) 3.3, 95% CI 1.02 to 10.3). The relations between occupational exposure and decline in lung function in this study occurred, despite the selection through the healthy worker effect that occurred as well. Increasing working years was related to decreasing annual decline in FEV1 and fewer people with rapid decline in FEV1 (OR 0.04, 95% CI 0 to 0.61 for over 20 v < 5 working years in the grain processing and animal feed industry). The presence of respiratory symptoms at baseline was a strong predictor of subsequent loss to follow up. Baseline lung function was not found to be predictive of subsequent loss to follow up. However, among workers lost to follow up the number of working years was more strongly negatively related to baseline lung function than among the workers who were studied longitudinally.Conclusions: The existence of the healthy worker effect implies that an exposure-response relation in the grain processing and animal feed industry may well be underestimated. This should be taken into account when health based recommended limit values are to be developed. [ABSTRACT FROM AUTHOR]

The article reports a study compared the energy and macronutrient content of main meals created by television chefs with ready meals sold by supermarkets, and compared both with nutritional guidelines published by the World Health Organization. The results revealed that neither ready meals old at supermarkets nor recipes created by television chefs complied with WHO recommendations. Recipes were less healthy than ready meals, as they contained significantly more fat and less fibre per portion.

The article reports that Public Health England (PHE) has recommended ways of reducing the British public's consumption of sugar. Topics discussed include the agency's recommendation to reduce special offers and discounts on sugary foods in supermarkets and restaurants, controlling the advertising of sugary foods to children and the government imposing a tax on high sugar foods.

This section offers news briefs concerning British medicine during the week of October 24-30, 2015. Topics discussed include detentions under the Mental Health Act in England rising in 2014-2015, a survey showing that more than 50 percent of respondents support a proposed levy on sugary drinks and food and England's health secretary Jeremy Hunt asserting that more than 11,000 deaths per year are associated with poor staffing at hospitals during the weekends.

This article focuses on matters related to Heilcobacter pylori infection. Helkohacter pylori is a major cause of gastrointestinal disease but the precise modes of transmission are unknown. There is no confirmed environmental reservoir other than man, suggesting that transmission is from person to person and faecal-oral, oral-oral, and gastro-oral routes have been implicated. H. pylori infection is common in young children living in poor socioeconomic circumstances. Domestic flies are ubiquitous in these settings and have a close affinity with human faeces and food.

The author reflects on studying the historical role of food in war and in health. He cites the availability of books about the history of food. He also mentions that these books can be found not in the history section of a bookshop or library but in the cookery section, along with sport and leisure. He asserts that food and history are not considered as quite worthy of intellectual analysis.

The article discusses topics relating to childhood diseases. Study shows that low birthweight can increase the risk of later coronary disease. Report reveals that lower respiratory tract infections with respiratory synctial virus will increase the possibility of subsequent problems among infants born before 32 weeks gestation. The pleasure linked with food, alcohol, and recreational drugs will cause pleasure molecules like dopamine and serotonin to be release in brain and peripheral tissues.