Search

Background Increasing protein intake (above the Recommended Dietary Amount) alone or with resistance‐based exercise is suggested to improve cardiometabolic health; however, randomized controlled trials (RCTs) are needed to confirm this. Methods The Liverpool Hope University‐Sarcopenia Aging Trial (LHU‐SAT) was a 16 week RCT (ClinicalTrials.gov Identifier: NCT02912130) of 100 community‐dwelling older adults [mean age: 68.73 ± 5.80 years, body mass index: 27.06 ± 5.18 kg/m2 (52% women)] who were randomized to four independent groups [Control (C), Exercise (E), Exercise + Protein (EP), Protein (P)]. E and EP completed supervised and progressive resistance‐based exercise (resistance exercise: two times per week, functional circuit exercise: once per week), while EP and P were supplemented with a leucine‐enriched whey protein drink (three times per day) based on individual body weight (0.50 g/kg/meal, 1.50 g/kg/day). Outcome measures including arterial stiffness (pulse wave velocity), fasting plasma/serum biomarkers [glucose/glycated haemoglobin, total cholesterol, low‐density lipoprotein (LDL), high‐density lipoprotein, insulin, resistin, leptin, adiponectin, C‐reactive protein, tumour necrosis factor‐alpha, interleukin‐6, cystatin‐C, & ferritin], insulin resistance (HOMA‐IR), and kidney function (eGFR) were measured before and after intervention. Results Total protein intake (habitual diet plus supplementation) increased to 1.55 ± 0.69 g/kg/day in EP and to 1.93 ± 0.72 g/kg/day in P, and remained significantly lower (P 0.05), and kidney function (eGFR) remained unaltered. Conclusions Sixteen weeks of leucine‐enriched whey protein supplementation alone and combined with resistance‐based exercise improved cardiometabolic health markers in older adults.

The current study examined the reliability of a novel Gaelic football match simulation protocol (GFSP) that simulates the match-specific activity demands of elite Gaelic football match-play. After familiarisation, 16 male Gaelic footballers performed the GFSP on two occasions, 7–10 days apart to determine the reliability of a range of team sport performance indicators. The total distance (TD), high-speed running distance (HSRD) and sprint distance were 8479 ± 594 m, 2349 ± 308 m and 651 ± 319 m, respectively. In addition, decrements in TD (− 2.4%), HSRD (− 11.2%) and sprint distance (− 32.6%) from first to second half were observed. There was no significant difference between repeated trials of the GFSP for all running performance and physiological measurements. The GFSP demonstrates good test–retest reliability for the majority of performance and physiological responses. Between trial coefficient of variations (CV) and intraclass correlation coefficients (ICC) were: TD 1.9%, 0.93; HSRD 3.0%, 0.93; sprint distance 17.6%, 0.86; peak speed 4.5%, 0.60; mean heart rate (HR) 1.8%; 0.94; peak HR 2.2%, 0.89. The current investigation shows that the GFSP replicates the average movement demands of elite Gaelic football match play. The current simulation is reliable and may be seen by practitioners as a viable monitoring tool within the Gaelic football research and training process to monitor the effectiveness of various training and nutritional interventions on Gaelic football-related performance.

To investigate the effects of exercise in combination with, or without, a leucine-enriched whey protein supplement on muscle mass, fat mass, myoelectrical muscle fatigue and health-related quality of life (HR-QOL) in older adults. 100 community-dwelling older adults [52% women, age: 69 ± 6 years (mean ± SD)] were randomised to four [Control (C); Exercise (E); Exercise + Protein (EP); Protein (P)] independent groups. E and EP groups completed 16 weeks of exercise [resistance (2 times/week) and functional (1 time/week]. EP and P groups were also administered a leucine-enriched whey protein supplement (3 times/day) based on body weight (1.5 g/kg/day). Muscle and fat mass (bioelectrical impedance analysis), myoelectrical muscle fatigue (surface electromyography) and HR-QOL (WHOQOL-BREF) were measured pre- and post-intervention. At post-intervention, the rectus femoris (E: − 4.8%/min, p = 0.007, ES = 0.86; EP: − 3.3%/min, p = 0.045, ES = 0.58) and bicep femoris (E: − 3.9%/min, p 0.05). Physical exercise is a potent method to improve myoelectrical muscle fatigue and HR-QOL in older adults. However, leucine-enriched whey protein did not augment this response in those already consuming sufficient quantities of protein at trial enrolment.

Background: The prevalence of musculoskeletal (MSK) conditions is increasing, and although current guidelines for physical activity attempt to combat this, many fail to achieve the recommended targets. The present study sought to investigate whether regular tennis participation is more effective at enhancing MSK function than meeting the current international physical activity guidelines. Hypothesis: Tennis players will display significantly enhanced MSK function when compared with age-matched healthy active nonplayers. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Ninety participants (age range, 18-65 years) took part in this study; there were 43 tennis players (18 men, 25 women) and 47 nonplayers (26 men, 21 women). MSK function was assessed by cluster analysis of 3 factors: (1) electromyographic fatigability of prime movers during handgrip, knee extension, and knee flexion; (2) isometric strength in the aforementioned movements; and (3) body composition measured by bioelectrical impedance analysis. Maximal oxygen uptake was also assessed to characterize cardiorespiratory fitness. Results: Tennis players displayed significantly greater upper body MSK function than nonplayers when cluster scores of body fat percentage, handgrip strength, and flexor carpi radialis fatigue were compared by analysis of covariance, using age as a covariate (tennis players, 0.33 ± 1.93 vs nonplayers, −0.26 ± 1.66; P < 0.05). Similarly, tennis players also demonstrated greater lower extremity function in a cluster of body fat percentage, knee extension strength, and rectus femoris fatigue (tennis players, 0.17 ± 1.76 vs nonplayers, −0.16 ± 1.70; P < 0.05). Conclusion: The present study offers support for improved MSK functionality in tennis players when compared with age-matched healthy active nonplayers. This may be due to the hybrid high-intensity interval training nature of tennis. Clinical Relevance: The findings suggest tennis is an excellent activity mode to promote MSK health and should therefore be more frequently recommended as a viable alternative to existing physical activity guidelines.

Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS, however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured, and their fasting capillary and venous blood were collected. The components of the MetS, and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk, however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.

Background: Previous research has reported that elite Gaelic football players’ carbohydrate (CHO) intakes are sub-optimal, especially, in the lead up to competitive matches. Despite clear decrements in running performance across elite Gaelic football matches, there are no studies that have investigated nutrition interventions on match-related Gaelic football performance. The aim of this study was to determine whether a higher-CHO diet in line with sports nutrition guidelines can improve Gaelic football-related performance compared to lower CHO intakes previously observed in Gaelic footballers. Methods: Twelve Gaelic football players completed a Gaelic football simulation protocol (GFSP) on two occasions after consuming a high-CHO diet (7 g·kg−1) (HCHO) or an energy-matched lower-CHO diet (3.5 g·kg−1) (L-CHO) for 48 h. Movement demands and heart rate were measured using portable global positioning systems devices. Countermovement jump height (CMJ) and repeated-sprint ability (RSA) were measured throughout each trial. Expired respiratory gases were collected throughout the trial using a portable gas analyser. Blood samples were taken at rest, half-time, and post-simulation. Results: There was no significant difference in total distance (p = 0.811, η2 = 0.005) or high-speed running distance (HSRD) covered between both trials. However, in the second half of the HCHO trial, HSRD was significantly greater compared to the second half of the LCHO trial (p = 0.015). Sprint distance covered during GFSP was significantly greater in HCHO (8.1 ± 3.5 m·min−1) compared with LCHO (6.4 ± 3.2 m·min−1) (p = 0.011, η2 = 0.445). RSA performance (p &lt, 0.0001, η2 = 0.735) and lower body power (CMJ) (p &lt, η2 = 0.683) were significantly greater during the HCHO trial compared to LCHO. Overall CHO oxidation rates were significantly greater under HCHO conditions compared to LCHO (3.3 ± 0.5 vs. 2.7 ± 0.6 g·min−1) (p &lt, 0.001, η2 = 0.798). Blood lactate concentrations were significantly higher during HCHO trial versus LCHO (p = 0.026, η2 = 0.375). There were no significant differences in plasma glucose, non-esterified fatty acids (NEFAs), and glycerol concentration between trials. In both trials, all blood metabolites were significantly elevated at half-time and post-trial compared to pre-trial. Conclusion: These findings indicate that a higher-CHO diet can reduce declines in physical performance during simulated Gaelic football match play.

Apolipoproteins (apo) regulate lipoprotein characteristics and lipid metabolism. ApoC-III is a regulator of triglyceride-rich lipoprotein (TRL) metabolism and apolipoproteins are important biomarkers for cardiovascular disease (CVD) risk prediction. A low carbohydrate high fat (LCHF) diet improves cardiometabolic risk, especially via reduction of TRL. However, few studies have compared a LCHF vs. a high carbohydrate (HC), lower fat diet under ad libitum conditions on apoC-III levels. The objectives of this investigation were to measure the effect of a LCHF vs. a HC diet on apoC-III, apoA1, apoB and apoB/apoA1 in 16 healthy Caucasian adults aged 19–64. Ethical approval: Liverpool John Moores University Research Ethics Committee (16/ELS/029); registered with ClinicalTrials.gov (Ref. NCT03257085). Participants randomly assigned to a HC diet (UK Eatwell guidelines; ≥ 50% of energy from carbohydrates) (n = 8), or a LCHF diet (consume < 50 g/day of carbohydrates) (n = 8) provided plasma samples at 0, 4 and 8 weeks. ApoA1 and apoB were analysed by an automated chemistry analyser (Daytona, Randox Laboratories Ltd, UK). ApoC-III was analysed via ELISA (Thermo Fisher Ltd, USA). Factorial 2×3 ANOVA and ANCOVA (IBM SPSS 25®) were undertaken to investigate significant differences and to control for variables influenced by baseline measures and visceral adipose tissue (VAT). Results show 0, 4, and 8 weeks respectively: ApoC-III (LCHF: 19.12 ± 9.14, 16.05 ± 7.95, 15.11 ± 3.17 mg/dl; HC: 22.13 ± 8.38, 28.22 ± 13.85, 22.22 ± 7.7 mg/dl) showed no significant (P = 0.319) change. No significant (P = 0.23) change was also observed in ApoB (LCHF: 107.25 ± 20.35, 111.38 ± 24.81, 111.43 ± 19.93 mg/dl; HC: 94.38 ± 20.79, 105.00 ± 20.13, 99.00 ± 29.09 mg/dl). Similarly apoA1 (LCHF: 158.71 ± 14.27, 166.50 ± 23.09, 173.00 ± 29.42 mg/dl; HC: 164.71 ± 30.25, 172.50 ± 29.44, 174.00 ± 32.83 mg/dl) showed no significant change (P = 0.76). This resulted in a relatively unchanged apoB/A1 throughout the study in both diets (P = 0.30). No significant (P > 0.05) differences were found after 4 weeks or between groups also. ANCOVA revealed a trend (P = 0.06) in apoC-III for a difference between groups (LCHF: Δ-6.6 mg/dl vs. HC: Δ1.2 mg/dl) after 8 weeks but no significant (P > 0.05) changes in other apolipoproteins were detected. These preliminary data reveal that a LCHF diet does not improve the apolipoprotein profile; however, when accounting for other metabolic risk factors (i.e. VAT) there was a trend towards lowering apoC-III levels (P = 0.06). Modulation of apoC-III may lead to improved lipid metabolism, but higher-powered studies are warranted before any improvement on CVD risk can be inferred.

It is estimated that 19% of 16–24 year olds suffer from a mental health condition. There has been a fivefold increase in reported mental health problems from first year university students since 2006/07(1). Limited but consistent evidence suggests that nutritional status is linked to mental health. University students may be more vulnerable to the impact of diet on mental health due to increased food insecurity and risk of stress. The aim of this project was to determine the association between nutritional status and stress, anxiety and depression in university students.After obtaining ethical approval, university students (n = 562) aged 18–24 y were recruited. A cross-sectional design was used to measure body mass index (BMI), percent body fat (%BF), capillary blood measures of glucose and lipids and nutrient intake by validated 3-day food diary. Mental health status was determined by DASS21 questionnaire (2) and participants were grouped into 5 categories: normal, mild, moderate, severe and extremely severe for anxiety, depression or stress. Difference in nutritional status between categories was determined by a Kruskal-Wallis test and Dun-Bonferroni post-hoc tests using SPSS version 25 and significance determined as p < 0.05.Results showed that depression was associated with %BF (p = 0.025), blood glucose (p < 0.001), dietary protein (p = 0.003) and dietary sugar (p = 0.041). Anxiety was associated with blood glucose (p < 0.001) and dietary protein (p = 0.007).Stress was associated with total cholesterol (p = 0.007), HDL cholesterol (p = 0.007) and blood glucose (p < 0.001).In light of these findings, further research is required to investigate the effect of student lifestyle habits and university practices on mental health and nutritional status so that strategic interventions can be designed to improve the health of young adults at university.

Worldwide, cardiovascular disease (CVD) is the number 1 cause of mortality and is associated with insulin resistance (IR). Emerging biomarkers such as FGF21 and adiponectin are associated with cardiometabolic risk. Low carbohydrate, high fat (LCHF) diets have been reported to reduce cardiometabolic risk markers; however, few studies have compared a LCHF diet vs. a high carbohydrate (HC), lower fat diet under ad libitum conditions on adiponectin and FGF21. The purpose of this study was to investigate the effects of an ad libitum LCHF vs. HC diet on IR, FGF21 and adiponectin in 16 healthy adults. Ethical approval: Liverpool John Moores University Research Ethics Committee (16/ELS/029); registered with ClinicalTrials.gov (Ref. NCT03257085). Participants were randomly assigned to a HC diet (n = 8, the UK Eatwell guidelines; ≥ 50% of energy from carbohydrates) or a LCHF diet (n = 8, consume < 50 g/day of carbohydrates). All provided plasma samples at 0, 4 and 8 weeks. FGF21 (R&D Systems) was analysed via ELISA and adiponectin, insulin and glucose were analysed via immunoassay technology (Randox Evidence Investigator™ Metabolic Syndrome Arrays I & II). Mann Whitney, Friedmans, Wilcoxon tests and 2×3 ANOVA (IBM SPSS 25®) were undertaken to investigate significant differences between and within groups. The homeostatic model assessment (HOMA) was used to calculate IR. FGF21 significantly (P = 0.04) decreased (Mdn, IQR:148.16, 78.51–282.02 to 99.4, 39.87–132.29 pg/ml) after 4 weeks and significantly (P = 0.02) increased (Mdn, IQR:167.38, 80.82–232.89 pg/ml) by 8 weeks vs. baseline with LCHF. No significant differences (P > 0.05) were observed between groups. Adiponectin was significantly (P = 0.03) different at week 4 only between groups. Adiponectin increased after 4 weeks (Mdn, IQR:13.44, 9.12–25.47 to 16.64, 11.96–21.51 ng/ml) but was only significantly (P = 0.03) different by 8 weeks vs. baseline in the HC group (Mdn, IQR:16, 10.8–27.43 ng/ml). Adiponectin remained unchanged (P = 0.96) in the LCHF group. HOMA significantly decreased with both diets after 8 weeks only (mean ± SD, LCHF: 2.9 ± 1.3 to 1.8 ± 0.8, HC: 2.5 ± 0.6 to 1.9 ± 0.6, P = 0.008) but was not significantly (P = 0.60) different between groups. These preliminary data reveal that while both diets improved insulin sensitivity, they may do so by different mechanisms. Future studies are warranted to investigate further, how a LCHF vs. HC diet affects FGF21 and adiponectin, and the subsequent regulation of IR. Furthermore, studies that extend these findings by determining the impact of LCHF vs. HC on peripheral metabolism to determine potential nutrition-mediated mechanisms of metabolic adaptation are warranted.

Background & aims\ud When body height cannot be measured, it can be predicted from ulna length (UL). However, commonly used published prediction equations may not provide useful estimates in adults from all ethnicities. This study aimed to evaluate the relationship between UL and height in adults from diverse ethnic groups and to consider whether this can be used to provide useful prediction equations for height in practice.\ud Methods\ud Standing height and UL were measured in 542 adults at seven UK locations. Ethnicity was self-defined using UK Census 2011 categories. Data were modelled to give two groups of height prediction equations based on UL, sex and ethnicity and these were tested against an independent dataset (n = 180).\ud Results\ud UL and height were significantly associated overall and in all groups except one with few participants (P = 0.059). The new equations yielded predicted height (H p) that was closer to measured height in the Asian and Black subgroups of the independent population than the Malnutrition Universal Screening Tool (MUST) equations. For Asian men, (H p (cm) = 3.26 UL (cm) + 83.58), mean difference from measured (95% confidence intervals) was −0.6 (−2.4, +1.2); Asian women, (H p = 3.26 UL + 77.62), mean difference +0.5 (−1.4, 2.4) cm. For Black men, H p = 3.14 UL + 85.80, −0.4 (−2.4, 1.7); Black women, H p = 3.14 UL + 79.55, −0.8 (−2.8, 1.2). These differences were not statistically significant while predictions from MUST equations were significantly different from measured height.\ud Conclusions\ud The new prediction equations provide an alternative for estimating height in adults from Asian and Black groups and give mean predicted values that are closer to measured height than MUST equations.

ObjectiveTo investigate the effects of a 16-week concurrent exercise regimen [resistance exercise (RE) + functional exercise (FE)] in combination with, or without, a leucine-enriched whey protein isolate supplement on muscle strength, physical functioning, aerobic capacity, and cardiometabolic health in older adults (≥60 years). Physical activity levels were also evaluated 6 months post-cessation of the intervention.MethodsForty-six, community-dwelling, previously untrained males, and females [age: 68 ± 5 years (mean ± SD); BMI: 27.8 ± 6.2 kg/m2] who completed the trial were initially randomized to one of two independent arms [Exercise n = 24 (E); Exercise+Protein n = 22 (EP)]. Both arms completed 16 weeks of RE (performed to fatigue) (2 times/week) with FE (1 time/week) on non-consecutive days. Additionally, EP were administered a leucine-enriched whey protein supplement (3 times/day) for 16 weeks based on individual body-weight (1.5 g/kg/day).ResultsAs a result of dietary supplementation, protein intake increased in EP (∼1.2 ± 0.4 to 1.5 ± 0.7 g/kg/day) during the intervention. Maximal strength (1RM) values for leg press (E: +39 ± 7 kg, p = 0.006; EP: +63 ± 7 kg, p < 0.001), chest press (E: +22 ± 4 kg, p < 0.001; EP: +21 ± 6 kg, p < 0.001), and bicep curl (E: +7 ± 0 kg, p = 0.002; EP: +6 ± 1 kg, p = 0.008) significantly increased in E and EP respectively, with no differences between arms (p > 0.05). Physical functioning in the obstacle course (E: -5.1 ± 6.8 s, p < 0.001; EP: -2.8 ± 0.8 s, p < 0.001) and short-physical performance battery scores (E: +0.5 ± 0.5, p = 0.05). No significant change was observed for markers of cardiometabolic health (glycaemic control or blood pressure) (p > 0.05). At follow-up, 86% of older adults reported to performing physical activity ≥1 per week. Of those, 61% were still participating in strength- and cardiovascular- based exercise.ConclusionConcurrent exercise (RE + FE) offers a potent method to combat age-related muscle weakness, and our results suggest a high proportion of older adults may continue to exercise unsupervised. However, leucine-enriched whey protein isolate supplementation did not confer any additional benefit in those already consuming ample amounts of dietary protein at trial enrolment. Future trials should utilize a whole-foods approach and investigate the effects in frail and non-frail older adults habitually consuming the RDA of protein, to assess if a higher intake of protein is needed to delay the onset of muscle weakness.Trial RegistrationClinicaltrials.gov Identifier: NCT02912130.

There is currently a lack of research into the energy demands and associated nutritional intakes of elite Gaelic football players during the pre-season period, which is a crucial time of year for physical development. The aim of the current study was to investigate the dietary intake and energy expenditure (EE) of elite Gaelic football players during a typical pre-season week. Over a seven-day period, which included four training days and three rest days, dietary intake (validated self-reported estimated food diary) and EE (Sensewear Pro armband) were recorded in 18 male players from a single elite inter-county Gaelic football team. Average energy intake (EI) (3283 &plusmn, 483 kcal) was significantly (p = 0.002) less than average EE (3743 &plusmn, 335 kcal), with a mean daily energy deficit of &minus, 460 &plusmn, 503 kcal. Training days elicited the greatest deficits between intake and expenditure. The mean carbohydrate (CHO) intake was 3.6 &plusmn, 0.7 g/kg/day, protein intake was 2.1 &plusmn, 0.5 g/kg/day, and fat intake was 1.6 &plusmn, 0.2 g/kg/day. These findings indicate that the dietary practices of the sampled players were inadequate to meet EE and CHO recommendations. Training days are of particular concern, with the players not altering energy and CHO intake to encounter increased energy demands. Education on nutritional strategies for elite Gaelic footballers should be considered in relation to training demands to avoid detriments to performance and health.

The Exercise Benefits/Barriers Scale (EBBS) research instrument has been extensively used to investigate the perceived benefits and barriers of exercise in a range of settings. In order to examine theoretical contentions and translate the findings, it is imperative to implement measurement tools that operationalize the constructs in an accurate and reliable way. The original validation of the EBBS proposed a nine-factor structure for the research tool, examined the EBBS factor structure, and suggested that various factors are important for the testing of the perception of exercise benefits and barriers, whereas a few items and factors may not be vital. The current study conducted a confirmatory factor analysis (CFA) using hierarchical testing in 565 participants from the northwest region of the United Kingdom, the results of which provided evidence for a four-factor structure of the benefits measure, with the Comparative Fit Index (CFI) = 0.943, Tucker–Lewis Index (TLI) = 0.933, and root means square error of approximation (RMSEA) = 0.051, namely life enhancement, physical performance, psychological outlook, and social interaction, as well as a two-factor structure of the barrier measures, with the CFI = 0.953, TLI = 0.931, and RMSEA = 0.063, including exercise milieu and time expenditure. Our findings showed that for a six-factor correlated model, the CFI = 0.930, TLI = 0.919, and RMSEA = 0.046. The multi-group CFA provided support for gender invariance. The results indicated that after three decades of the original validation of the EBBS, many of the core factors and items are still relevant for the assessment of higher-order factors, however, the 26-item concise tool proposed in the current study displays a better parsimony in comparison with the original 43-item questionnaire. Overall, the current study provides support for a reliable, cross-culturally valid EBBS within the UK adult population, however, it proposes a shorter and more concise version compared with the original tool, and gives direction for future research to focus on the content validity for assessing the perception of the barriers to physical activity.

Objectives This study aims to assess adequacy in micronutrient intake in comparison with reference nutrient intakes (RNI) and to identify differences in intakes between normal weight and overweight individuals. Study design A sample of 542 university students (18–25 years), normal weight (N = 369) and overweight (N = 173), were included in a cross-sectional study. Methods A three-day diet diary was used to assess energy and nutrient intake. Body mass index (BMI) and waist circumference were measured. Results Mean dietary vitamin D intake was lower than RNI in both men (4.44 μg) and women (5.04 μg). Mean intakes of calcium (597.44 mg), iron (8.62 mg) and folate (171.29 mg) were also lower than recommendations in women. Weight status (normal weight versus overweight) was significantly associated with micronutrient intake, and a trend towards a decrease in vitamin and mineral intake with increasing weight was noted. Conclusions Results suggest the need to increase the intake of some micronutrients to meet the RNI, to ensure optimal health. This study provides a helpful tool to reinforce recommendations and potential health promotion and intervention strategies in university settings and could influence manufacturers involved in new food product development targeted to this young population.

Increased levels of Fibrogen growth factor 21 (FGF21) is an emerging risk marker for cardiometabolic (CM) disease(1). Little detail is known about the impact of the human diet on FGF21 levels. The aim of this investigation was to assess potential associations between mean daily dietary macronutrient intake and FGF21 levels in a sample of 10 healthy normal-weight and overweight Caucasian adults aged 32–60 (80 % male) at increased CM risk(2). This pilot study received ethical approval from Liverpool John Moores University Research Ethics Committee (16/ELS/029) and was registered with ClinicalTrials.gov (Ref. NCT03257085). Participants were randomly allocated to one of two groups and asked to either consume 50 % energy from CHO for a duration of 8 weeks. Blood plasma samples were col- lected at baseline (BL), interim point (IP) and endpoint (EP) after a 12-hour overnight fast, immediately processed and frozen at −80°C. Thawed plasma samples were analysed via Quantikine® enzyme-linked immunosorbent assay (ELISA) (R&D Systems) for FGF21 levels. Two-way mixed ANOVA and Pearson’s partial correlation adjusted for estimated weekly moderate and vigorous activity was undertaken using IBM SPSS 24®. There were no effects for diet between groups or over time (data not shown). Significant correlations between macronutrient intakes and FGF21 levels were found for both groups at IP, but not at BL or EP. Moderate and significant positive correlations were found in the overall group for intake (g/d) for glucose (rpartial = ·699, p = ·04) and fructose (rpartial = ·686, p = ·04) and strong and significant positive correlations for non-milk extrinsic sugars (rpartial = ·742, p = ·02). Strong and significant positive correlations were also found in the LC group for glucose intake (g/d) (rpartial = ·980, p = ·02) and fructose (rpartial = ·967, p = ·03) and for protein (rpartial =·998, p=·002) after adjusting for physical activity. Mean carbohydrate intake (g/d) was 160·0 (s.d. 124·5) overall and 44·2 (s.d. 14·9) in the LC group at IP. Mean protein intake (g/d) was 113·2 (21·4) 130·0 (s.d. 15·9) overall and in the LC group at IP. Mean FGF21 levels were 179·9 pg/mL (s.d. 144·9) in the overall group and 94.4 pg/ML (s.d. 48.6) in the LC group at IP. %TE Intake (g/d) PROT FAT CHO GLU FRU NMES PROT FAT rrrrrrrrrrr −·214 ·623 ·635 −·326 −·491 ·448 ·699* ·686* ·742* −·606 −·496 ·143 ·637 ·937 ·427 −·059 ·722 ·980* ·967* ·919 ·998** −·080 Total kcal CHO NMES T LC CHO-Total carbohydrates, FAT-Total fat, FRU-Fructose, GLUC-Glucose, LC-low-carbohydrate, high-fat group, NMES-non-milk extrinsic sugars, PROT-protein, T – total, %TE – percentage total energy, *p < ·05 **p < ·005. In conclusion, low-carbohydrate diets provide the opportunity to assess responses to even small amounts of CHO, which are likely to be replaced in part by proteins. Despite low overall intakes of fructose and glucose in the LC group, strong and positive correlations with FGF21 levels were observed. The lower levels of FGF21 in the LC compared to the overall group are in line with findings that FGF21 levels are elevated with high-carbohydrate, low-protein diets with dietary fats having only minor impact(3). However, the majority of studies have still been undertaken using rodent models. The impact of dietary macronutrients on FGF21 levels as novel CMR marker in humans and the mechanism behind this relationship warrant further investigation. 1. Lakhani I, Gong M, Wong W et al. (2018) Metabolism 2018 Feb 1. pii: S0026-0495(18)30023-4. [Epub ahead of print]. 2. Jebb S, Lovegrove J, Griffin B et al. (2010) Am J Clin Nutr 92, 748–58. 3. Solon-Biet S, Cogger V, Pulpitel T et al. (2016) Cell Metab 24, 555–565.

Risk of cardiometabolic (CM) disease is characterised by elevated visceral adipose tissue (VAT) and a number of associated biomar- kers(1). Some dietary carbohydrates (CHO) have been found to contribute to VAT accumulation(2). Little is known about the impact of following a low-carbohydrate diet versus a high-carbohydrate diet on VAT, adiponectin (ADPN), leptin (LEPT) and leptin:adipo- nectin ratio (LAR). The aim of this investigation was to assess the impact of dietary carbohydrates (CHO) on VAT and emerging CM risk markers in a sample of 10 healthy normal-weight and overweight Caucasian adults aged 32–60 (80 % male) at increased CM risk(3). This pilot study received ethical approval from Liverpool John Moores University Research Ethics Committee (16/ELS/ 029) and was registered with ClinicalTrials.gov (Ref. NCT03257085). Participants were randomly allocated to one of two groups and asked to either consume 50 % energy from CHO (high-carb (HC)) for a duration of 8 weeks. VAT was ana- lysed via bioelectrical impedance (SECA mBCA 515). Blood plasma samples were collected at baseline (BL), interim point (IP) and endpoint (EP) after a 12-hour overnight fast, immediately processed and frozen at -80°C. Thawed plasma samples were analysed via immunoassay technology (Randox Evidence InvestigatorTM Metabolic Syndrome Arrays I and II) for ADPN and LEPT levels. Statistical analysis was undertaken using IBM SPSS 24®. Parametric data was analysed via two-way mixed ANOVA; non-parametric data was analysed via Mann-Whitney U test and Friedman test. Average daily carbohydrate intake in the LC group was 44·2 g at IP and 48·9 g at EP. There were no significant differences between groups at any time point for ADPN, LEPT, LAR or VAT and no significant inter- actions for time or group*time for ADPN, LEPT or LAR. However, in the LC group VAT decreased significantly between baseline and endpoint by 15 % (p = ·015) Over the course of the intervention ADPN and LEPT decreased non- significantly (by 4 % and 70 % respectively) in the LC group, whilst increasing non-significantly in the HC group (9 % and 65 % respectively). LAR increased in the HC group throughout the study, whilst LAR in the LC group decreased albeit not significantly. VAT (litre) ADPN (ng/mL) LEPT (ng/mL) LAR BL IP EP Median Median Median M SD M SD M SD BL IP EP BL IP EP BL IP EP LC 4·1a 1·2 3·8 1·3 3·5a 1·2 8·9 8·6 8·5 3·96 1·64 1·20 0·45 0·19 0·14 HC 2·7 0·1 1·6 0·3 2·5 0·1 11·3 13·4 12·3 0·97 1·1 1·60 0·07 0·07 0·46 ADPN = adiponectin, BL = baseline, EP = endpoint, HC = high-carbohydrate, moderate fat diet, IP = interim point, LAR = leptin:adiponectin ratio, LEPT = leptin, LC = low-carbohydrate, high-fat diet, VAT = visceral adipose tissue, ap = ·015. NB: interquartile ranges not provided for median values due to missing data. Higher LAR has been found to be a marker of increased CM risk(4). In conclusion, while the significant reduction in VAT in the LC group corresponds with the reduction of LAR further evidence is required to corroborate these findings. Previous evidence for LC is supportive for improved CM health from various biomarkers(5); LAR should be considered as a useful endocrine addition for future LC studies. 1. Krasimira A, Mozaffarian D & Pischon T (2018) Clin Chem 64, 142–153. 2. Ruttgers D, Fischer K, Koch M et al. (2015) Br J Nutr 114, 1929–1940. 3. Jebb S, Lovegrove J, Griffin B et al. (2010) Am J Clin Nutr 92, 748–58. 4. Lopez-Jaramillo P, Gomez-Arbelaez D, Lopez-Lopez J et al. (2014) Horm Mol Biol Clin Investig 18, 37–45. 5. Bazzano L, Hi T, Reynolds K et al. (2014) Ann Intern Med 161, 309–318.

Background: Frequently reported poor dietary habits of young adults increases their risk of metabolic syndrome (MetS). Excess adiposity is the most established predictor of MetS and numerous anthropometric measures have been proposed as proxy indicators of adiposity. We aimed to make a comparison between traditional and novel indices of adiposity to identify the best index in association with measured body fat and as Cardiometabolic (CM) risk predictor for MetS.Methods: 550 adults aged 18–25 years were recruited in a cross-sectional study. Biochemical variables and adiposity indices including BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), new BMI, Body Adiposity Index (BAI), Clinica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and A Body Shape Index (ABSI)) were measured. Regression analysis, the odds ratio and the area under the receiver operating characteristic curve were used to analyse the findings.Results: Novel indices of adiposity, particularly CUN-BAE, had stronger correlation with measured body fat compared with traditional indices. In relation with MetS, traditional indices, particularly elevated WC and WHtR, had stronger associations with CM risk compared with novel indices. Amongst novel indices, the best predictor for MetS was CUN-BAE, whereas the best predictor for at least one risk factor or at least two risk factors of CM conditions was new BMI. ABSI had the lowest correlation with body fat, MetS and CM risk.Conclusion: Despite higher correlation between CUN-BAE and body fat, WC and particularly WHtR had greater diagnostic power in detection of CM risk and MetS in young adults.

Epidemiological studies investigating the association between fruit and vegetable consumption and cognitive function have produced inconclusive findings. The aim of this review was to systematically investigate if increased fruit and vegetable consumption is linked with decreased risk of cognitive impairment (CI). We conducted a systematic literature search using four databases (PubMed, Embase, Cochrane Library, and Scopus) in October 2016 and identified cohort and cross-sectional studies, which estimated the risk of CI for fruit and vegetable consumption. The pooled odds ratio (OR) and 95% confidence interval (CI) were estimated by using a random effects model. The six studies meeting inclusion criteria offered 10 effect sizes and the total of 17,537 participants in the analysis. Increased fruit and vegetable intake was associated with reduced risk of CI (OR: 0.79; 95% CI: 0.67–0.93; P = 0.006). The subgroup analysis demonstrated that in studies conducted in China (but not in Western countries), the corresponding reduction in risk of CI risk was significant (OR: 0.74; 95% CI: 0.61, 0.89; P = 0.002) and the relationship between fruits, vegetables, and CI did not differ by study design, type of exposure, and gender. Increased fruit and vegetable consumption is associated with the reduced risk of CI; however, such association might be dependent on the geographical region. Further prospective studies specifically designed to compare vegetables and fruit varieties, and also to determine the recommended amounts to prevent CI are warranted.

Dancers undergo huge pressure from the industry to adhere to a specific body shape; therefore, studies have demonstrated a high prevalence of eating disorders and body image dissatisfaction in comparison to non-dancers( 1 , 2 , 3 ). Despite previous studies focusing on dancers, there is limited research in the area of university dance students. Commonly accompanied with disordered eating behaviours and body image dissatisfaction is a failure to meet nutritional requirements; however, except for the examination of calorie intake( 4 ), investigation into the nutritional status of dancers is scarce. The aim of this study was to investigate the differences between dance students and non-dance students in terms of eating attitudes, body image satisfaction and nutritional status. After gaining ethical approval, female dance students (n = 15) and non-dance students (n = 14) were recruited. Anthropometric measures including height, weight and body fat percentage were conducted using standardised procedures and participants completed a three day validated food diary. Eating attitudes and body image satisfaction were assessed using the EAT-26 questionnaire( 5 ) and Stunkard Figure Rating Scale, respectively. The dietary intake data was analysed using Microdiet software (v3) and statistical analysis was conducted using SPSS Statistics (v22). Statistical significance was set at 0·05. Normal distribution was investigated using the Kolmogorov-Smirnov test of normality and because the main variables were not normally distributed (P < 0·05), they were investigated using the nonparametric Mann Whitney U Test. Dance students scored significantly higher than non-dance students on the total EAT-26 and on the EAT-26 subscales of dieting and oral control (Table 1). Five dance students, as opposed to zero non-dance students, scored above the EAT-26 cut-off for being at risk of an eating disorder. There were no significant differences in nutrient intake, anthropometric measures or body image satisfaction between dance and non-dance students (Table 1). Table 1. Median, 25th percentile and 75th percentile of parameters measured in dance students and non-dance students (*p < 0·05, **p < 0·01). Results from the EAT-26 questionnaire support previous studies and show that students studying dance are at higher risk of developing an eating disorder and are more likely to partake in dieting practices than non-dance students. These findings suggest negative eating behaviours are present within Higher Education; therefore, an intervention at this level may be necessary and beneficial.

The amount of carbohydrates recommended for consumption by current dietary guidelines has been challenged in relation to their suitability to prevent or manage cardiometabolic (CM) diseases with suggestions that they should be decreased and replaced by protein or fat( 1 , 2 ). Others have argued that a more personalised approach is required( 3 ). Aim of this investigation was to assess the potential impact of lower versus higher consumption of dietary macronutrients and prevalence of CM risk markers in a representative sample of the UK male white population. Unweighted data from 642 white adult males aged 19 and over in the National Diet and Nutrition Survey Rolling Programme( 4 ) (NDNS RP) 2008–2014 with or without metabolic syndrome (MetS)( 5 ) were analysed for associations of dietary macronutrient intake as percentage food energy (%FE) with CM risk markers. Logistic regression analysis (adjusted for age group and smoking status) was used to compare the odds ratios [OR] of prevalence of individual markers of MetS between the lowest and highest quartiles of dietary macronutrient intake as %FE (⩽44 vs. ≥52 for carbohydrates; ⩽31 vs. ≥39 for fats; ⩽15. vs. ≥19 for protein). There was a significant (p < 0·05) reduction in likelihood of MetS (OR, .55; 95 % confidence interval [CI], .34 to .84), and elevated waist circumference (OR, .50; 95 % CI, .30 to .83) and glucose levels (OR, .51; 95 % CI, .30 to .87) for those in the highest quartile of carbohydrate %FE intake compared to the lowest quartile, whereas those in the highest quartile of protein %FE intake had a significantly (p < 0·05) increased risk of presenting with the same markers of MetS (OR, 1·75; 95 % CI, 1·05 to 2·93; OR, 2·12; 95 % CI, 1·24 to 3·63; and OR, 2·15; 95 % CI, 1·25 to 3·70 respectively). Those with the highest compared to the lowest total dietary fat intake also presented with elevated CM risk markers, albeit these findings were not significant. *Metabolic Syndrome (MetS) definition: 3 out of 5 of the following: triglycerides (TRIG) ≥1·7 mmol/L; High-density lipoprotein cholesterol (HDL-C) ⩽1·03 mmol/L for males; Waist circumference (WC) ≥94 cm for white males; Glucose (GLUC) ≥5·6 mmol/L; Blood pressure (BP) ≥130 mmHg systolic or ≥85 mmHg diastolic respectively; CHO%FE – total carbohydrates percentage food energy; FAT%FE – total fats food energy; PROT%FE– total protein food energy; OR – odds ratio (adjusted for age group and smoking status), 1st vs. 4th quartile of intake; CI – confidence interval; a p < 0·05 Further investigations need to confirm whether the quality of the macronutrients consumed and overall diet quality( 6 ) has had an impact on these results. In the context of a personalised approach to nutrition future cohort studies should also provide data that allow for examining inter-individual variations in responses to dietary macronutrients, especially carbohydrates, to achieve optimum CM health for a larger proportion of the population.

Hyperaminoacidemia following ingestion of cows-milk may stimulate muscle anabolism and attenuate exercise-induced muscle damage (EIMD). However, as dairy-intolerant athletes do not obtain the reported benefits from milk-based products, A2 milk may offer a suitable alternative as it lacks the A1-protein. This study aimed to determine the effect of A2 milk on recovery from a sports-specific muscle damage model. Twenty-one male team sport players were allocated to three independent groups: A2 milk (n = 7), regular milk (n = 7), and placebo (PLA) (n = 7). Immediately following muscle-damaging exercise, participants consumed either A2 milk, regular milk or PLA (500 mL each). Visual analogue scale (muscle soreness), maximal voluntary isometric contraction (MVIC), countermovement jump (CMJ) and 20-m sprint were measured prior to and 24, 48, and 72 h post EIMD. At 48 h post-EIMD, CMJ and 20-m sprint recovered quicker in A2 (33.4 ± 6.6 and 3.3 ± 0.1, respectively) and regular milk (33.1 ± 7.1 and 3.3 ± 0.3, respectively) vs. PLA (29.2 ± 3.6 and 3.6 ± 0.3, respectively) (p < 0.05). Relative to baseline, decrements in 48 h CMJ and 20-m sprint were minimised in A2 (by 7.2 and 5.1%, respectively) and regular milk (by 6.3 and 5.2%, respectively) vs. PLA. There was a trend for milk treatments to attenuate decrements in MVIC, however statistical significance was not reached (p = 0.069). Milk treatments had no apparent effect on muscle soreness (p = 0.152). Following muscle-damaging exercise, ingestion of 500 mL of A2 or regular milk can limit decrements in dynamic muscle function in male athletes, thus hastening recovery and improving subsequent performance. The findings propose A2 milk as an ergogenic aid following EIMD, and may offer an alternative to athletes intolerant to the A1 protein.

Background Accurate estimates of energy expenditure are required in clinical nutrition in order to determine the requirements of individuals and to inform feeding regimes. Calorimetry can provide accurate measurements but is often impractical in clinical or community settings; prediction equations are widely used to estimate resting energy expenditure (REE) but have limited accuracy. A portable, self-calibrating, handheld calorimeter (HHC) may offer an alternative way of determining REE. The aim of the study was to evaluate whether estimates of REE derived using an HHC are closer to accurate measurements than values calculated using selected prediction equations. Methods REE was measured in 36 healthy adults aged 21–58 years using a flow-through indirect calorimeter (FIC) and HHC. Estimated REE was calculated using three predictive equations (Harris & Benedict; Schofield; Henry). Differences in REE between the ‘gold standard’ values derived using the FIC and those derived using the HHC and equations were examined using paired t-tests and Bland Altman plots. Results Mean REEHHC was significantly lower than mean REEFIC [4556 ± 1042 kJ (1089 ± 249 kcal) versus 6230 ± 895 kJ (1489 ± 214 kcal), P = 0.000] and also significantly lower than mean values calculated using all three equations. The mean difference between REEHHC and REEFIC [1674 ± 908 kJ (400 ± 217 kcal)] was significantly greater (P = 0.000) than the mean differences between the values calculated using the three prediction equations [272 ± 490 kJ (65 ± 117 kcal) (Harris-Benedict), 264 ± 510 kJ (63 ± 122 kcal) (Schofield), 84 ± 502 kJ (20 ± 120 kcal) (Henry)]. Conclusions The HHC provides estimates of REE in healthy people that are less accurate than those calculated using the prediction equations and so does not provide a useful alternative.

Previous studies have demonstrated that university students often consume unhealthy snacks and convenience fast foods(1). A swift decline in physical activity is also reported among them(2), overall supporting the notion that university students are susceptible to unhealthy dietary practices and positive energy balance(3). The purpose of this study was to investigate the state of energy balance of university students via comparing their current intake versus the estimate of the energy requirement for each participant. The participants (n = 319) aged 18–30 from two UK universities were interviewed using a validated questionnaire. The anthropometric measures such as weight and height were also collected and used for calculations of energy requirement. The energy requirement was estimated based on calculations of basal metabolic rate (BMR) and physical activity level (PAL) in line with the most recent recommendations of Scientific Advisory Committee on Nutrition(4). Energy intake was measured via a 24-hour diet recall validated by a 4-day weighted record in a subsample of the population (n = 54). Normal distribution was investigated using the Shapiro-Wilk test of normality and because the main variables were not normally distributed (P

ObjectiveTo estimate the phytate intake and molar ratio of phytate to zinc in the diet of the people in the United Kingdom.DesignTables of the phytate content of foods were developed from twenty-eight published and unpublished studies. They were then applied to the nutrient databank of the National Diet and Nutrition Survey (NDNS). The study is a retrospective analysis of data on daily consumption of foods and drinks from the NDNS of children, adolescents, adults and the elderly based on 4–7 d weighed intakes.SubjectsA total of 6786 British participants aged 1·5 years and above, who participated in the NDNS, 1992–2001.SettingEngland, Scotland and Wales.ResultsThe median daily intakes of phytate for children, adolescents, adults and the elderly population were 496, 615, 809 and 629 mg/d, respectively. Although there were differences in phytate intakes between men and women, and for children, adolescents and elderly populations, after adjusting for differences in energy intake, there was no significant variation. The median phytate-to-zinc molar ratios for children, adolescents, adults and the elderly population were 11·8, 10·4, 9·7 and 8·7, respectively. Overall, the main sources of phytate were cereal and cereal products (e.g. breakfast cereals and breads), vegetables, potatoes and savoury snacks (e.g. chips and crisps), hot drinks and miscellaneous foods (e.g. commercial toddler foods and drinks, chocolate and soups), fruits and nuts.ConclusionsThe present study estimated the dietary intake of phytate and the phytate-to-zinc molar ratio of the diet of the UK population, which can be used for estimating the average requirement of zinc. Further research should focus on the completion and validation of the tables of phytate content of UK foods, to assess (and if necessary improve) the accuracy and precision of these findings.