Browsing by Person "McKenzie, Jane"

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25-hydroxyvitamin D concentration in paediatric cancer patients from Scotland: A prospective cohort study
(Cambridge University Press, 2016-12-15) Revuelta-Iniesta, Raquel; Paciarotti, Ilenia; Davidson, Isobel; McKenzie, Jane; Brand, Celia; Chin, Richard; Brougham, Mark FH; Wilson, D. C.
Children with cancer are potentially at high risk of plasma 25-hydroxyvitamin D [25(OH)D] inadequacy and despite UK vitamin D supplementation guidelines their implementation remains inconsistent. Thus, we aimed to investigate 25(OH)D concentration and factors contributing to 25(OH)D inadequacy in paediatric cancer patients. A prospective cohort study of Scottish children aged <18 years, diagnosed with and treated for cancer (patients) between Aug 2010-Jan 2014 was performed, with control data from Scottish healthy children (controls). Clinical and nutritional data were collected at defined periods up to 24 months. 25(OH)D status was defined by the Royal College of Paediatrics and Child Health (2013); inadequacy [<50 nmol/L: deficiency (<25 nmol/L), insufficiency (25-50 nmol/L)], sufficiency (51-75 nmol/L), optimal (>75 nmol/L). Eighty-two patients [median(IQR) age 3.9(1.9-8.8); 56% males)] and 35 controls [median(IQR) age (6.2(4.8-9.1); 49% males] were recruited. 25(OH)D inadequacy was highly prevalent in the controls (63%; 22/35), and in the patients (64%; 42/65) at both baseline and during treatment (33-50%). Non-supplemented children had the highest prevalence of 25(OH)D inadequacy at every stage with 25(OH)D median(IQR) ranging from 32.0 (21.0-46.5) nmol/L to 45.0(28.0-64.5) nmol/L. Older age at baseline [R=-0.46; p<0.001], overnutrition (BMI ≥85th centile) at 3 months [p=0.005; RR=3.1] and not being supplemented at 6 months (p=0.04; RR=4.3) may have contributed to lower plasma 25(OH)D. Paediatric cancer patients are not at higher risk of 25(OH)D inadequacy than healthy children at diagnosis; however prevalence of 25(OH)D inadequacy is still high and non-supplemented children have a higher risk. Appropriate monitoring and therapeutic supplementation should be implemented.
A study to determine if moringa leaf powder is an acceptable supplement to combine with maize meal for Malawian children
(Nutrition Society, 2010) McLellan, L.; McKenzie, Jane; Clapham, Michael
An investigation of the post-prandial effects of a meal rich in long-chain omega-3 fatty acids
(2012) McKenzie, Jane; Paterson, E.; Bell, G.; Gow, Iain F.
Assessment of Plasma Antioxidants, Oxidative Stress and Polyunsaturated Fatty Acids in Paediatric Cancer Patients: A Prospective Cohort Pilot Study
(ECronicon Open Access, 2015-10-07) Revuelta-Iniesta, Raquel; Wilson, David C.; Brougham, Mark FH; Smail, Nacer Foudil; Davidson, Isobel; McKenzie, Jane; Fergus Maclay Leukaemia Trust; Queen Margaret University; Cancer and Leukaemia Trust
Background: Paediatric cancer patients may have a limited dietary intake, particularly nutrients high in antioxidants, docosahexanoic acid (DHA) and eicosapentanoic acid (EPA). Objective: To investigate the antioxidant status (TAS), antioxidant capacity (TAC), oxidative stress, DHA and EPA of paediatric cancer patients during treatment. Methods: A prospective cohort study of Scottish children aged <18 years, diagnosed with and treated for cancer between April-2013 to Jan-2014 was performed. Clinical data and blood samples were collected at baseline and 6 months. Data were stratified by treatment risk (low, medium and high) and nutritional support. We used Oxygen Radical Absorbance Capacity (ORAC) Antioxidant Assay to measure TAC, thiobarbituric acid reactive substances (TBARS) for lipid peroxidation and high performance liquid chromatography and Inductively Coupled Plasma Mass Spectrometry for TAS. The analyses of DHA and EPA were performed by analysing fatty acidmethyl esters (FAME) using gas-liquid chromatography. The reference ranges used were: Yagi 1998 (1.86-3.94) _mol for lipid peroxidation and Damsgaard.,et al. 2014 for EPA (0.45-0.77) % and DHA (2.22-3.76) %. Results: 20 patients (median (IQR) age 4.2 (1.5-8.5) years; 50% males) were recruited. There were no significant changes in plasma TAS, TAC and EPA, but lipid peroxidation significantly decreased from 7.4 (6.2-9.0) at baseline to 5.3 (4.5-6.4) _mol/MDA at 6 months(p = 0.003). The median (IQR) blood percentage of DHA significantly increased from 1.3 (0.9-1.9) to 1.8 (1.3-2.1) (p = 0.001). Lipid peroxidation was high in 95% (19/20) of patients at baseline and 94% (15/16) at 6 months; whilst DHA and EPA were low in 95%(19/20) and 70% (14/20) at baseline and 87.5% (14/16) and 60% (12/16) at 6 months. Children on high-treatment risk exhibited the highest oxidative stress levels. No statitically significant differences were found between non-supplemented and supplemented children in any of the following parameters (TAS, TAC, oxidative stress, EPA and DHA). Conclusion: There was a high prevalence of oxidative stress, especially in children treated with high-risk protocols and during the initial phases of treatment. Nutritional support does not appear to provide enough TAS, EPA and DHA in this cohort; however, larger high-quality population based studies are warranted to confirm these findings. Keywords: Paediatric cancer; Antioxidants; Oxidative stress; Docosahexanoic acid; Eicosapentanoic acid
Complementary and alternative medicine usage in Scottish children and adolescents during cancer treatment
(Churchill Livingstone, 2014-11) Revuelta-Iniesta, Raquel; Wilson, M.; White, K.; Stewart, L.; McKenzie, Jane; Wilson, D. C.
Aim: To determine the prevalence of the use of CAM and spiritual practices in the paediatric oncology population of SE Scotland and to establish both the reasons for their use and the perceived benefits. Methods: A retrospective survey was performed using previously piloted questionnaires. These were distributed to families whose children were <18 years and diagnosed with cancer. Demographic and clinical data were collected, descriptive statistics were used to establish frequencies and univariate associations were established by 2 test. Results: Of 169 families approached, 74 (44%) returned completed questionnaires. 41 (55%) families used CAM and 42 (57%) sought spiritual remedies whilst receiving conventional treatment. Higher socioeconomic status was the only factor associated with CAM usage and the most popular therapies were vitamins and minerals ( n=22; 53%), followed by massage ( n=12; 29%) and fish oils ( n=12; 29%). Most families used CAM to reduce stress and, overall, CAM was perceived to be beneficial. Conclusion: The high prevalence of CAM usage in this population highlights the need for physicians to enquire routinely about CAM use and warrants high-quality interventional studies to assess safety and efficacy. Summary: The use of Complementary and Alternative Medicine (CAM) among paediatric patients during cancer treatment is popular worldwide, yet data from the UK are scarce. This study showed that more than half of this Scottish cohort used CAM and that there was an overall positive perception of the effect that these therapies had on the patients. Also, socio-economically advantaged families might be more likely to use CAM in Scotland. 2014 Elsevier Ltd.
Development and relative validity of an iron specific food frequency questionnaire for women of child bearing age
(Cambridge University Press, 2010-07) Pritchard, S.; Whitton, C.; Bannerman, Elaine; McKenzie, Jane
Effect of Oatmeal on Postprandial Vascular Compliance Following a High Fat Meal
(IMedPub, 2016-02-12) Devlin, N.; McKenzie, Jane; Gow, Iain F.
Background and aim: Postprandial hyperlipidaemia has been associated with acute cardiovascular effects e.g. endothelial dysfunction and peripheral vasodilatation. Oats have known health benefits, and may reduce the transient, post-prandial endothelial dysfunction. The aim of this short study was to investigate if markers of endothelial function pulse wave velocity (PWV) and augmentation index corrected for heart rate (AIx@75) are affected by a meal with varying levels of saturated fat, with or without oatmeal. Methods and results: Fourteen subjects (aged between 22 and 51 years) were recruited. On their first visit, following baseline measurements of anthropometry, blood pressure (BP), heart rate (HR), PWV and AIx@75, they were given one of three meals (low fat, high fat, and high fat with 60g oatmeal) in a randomised order. Subjects returned three hours later for re-assessment of BP, PWV and AIx@75. Visits two and three followed the same protocol, but only BP, HR, PWV and AIx@75 were measured. There was a significant correlation between baseline PWV and systolic pressure (p<0.02), and AIx@75 and diastolic pressure (p<0.005). AIx@75 was positively related to BMI and waist circumference (p<0.01 and p<0.005 respectively). AIx@75 fell following the high fat meal (p<0.05), but not when oats were taken. Heart rate increased following the high fat meal with oats (p<0.05), but no differences were found between fasting and postprandial PWV after any of the meals. Conclusion: AIx@75 was correlated with BMI and waist circumference. The decrease in AIx@75 following the high fat meal requires further investigation, and AIx@75 is possibly a more sensitive marker of arterial compliance than PWV in a young healthy population.
Effects of pediatric cancer and its treatment on nutritional status: A systematic review
(2015-03-28) Revuelta-Iniesta, Raquel; Paciarotti, Ilenia; Brougham, F. H. M.; McKenzie, Jane; Wilson, D. C.
Context: Malnutrition in pediatric cancer is common worldwide, yet its prevalence and effects on clinical outcomes remain unclear. Objective: The aim of this review was to evaluate primary research reporting the prevalence of malnutrition in pediatric cancer patients and to assess the effects of pediatric cancer and its treatment on nutritional status. Data Sources: Electronic databases of MEDLINE, CINHAL, and PubMed were searched (January 1990-February 2013). Study Selection: Studies of patients aged <18 years who were diagnosed with and treated for cancer and for whom measurements of anthropometry were reported were included. The primary outcome was the prevalence of malnutrition (undernutrition and overnutrition), expressed as body mass index (BMI), in children diagnosed with and treated for cancer. Data Extraction: Evidence was appraised critically by employing the Critical Appraisal Skills Program tool, and data was extracted from original articles. Data Synthesis: A total of 46 studies were included, most of which were considered to be of low quality on the basis of heterogeneity in both the criteria and the measurements used to define malnutrition. Undernutrition was identified by measuring BMI, weight loss, mid-upper arm circumference, and triceps skinfold thickness, while overnutrition was assessed using BMI. Overall, the prevalence of undernutrition ranged from 0% to 65% and overnutrition from 8% to 78%. Finally, undernutrition in pediatric cancer at diagnosis was associated with poor clinical outcomes in 6 of 9 studies. Conclusion: The possibility of a high prevalence of malnutrition in childhood cancer, indicated by the studies reviewed, highlights the need for high-quality, populationbased, longitudinal studies using standard criteria to identify malnutrition.
Engaging staff and students in the development and deployment of a departmental website : a review
(Australasian and New Zealand Association for Medical Education, 2004-11) Peacock, Susi; Adamson, S.; McKenzie, Jane; Williams, K.
Introduction: This paper discusses the development, deployment and evaluation of a website for an academic department, built around a customised webtemplate. We draw upon a two-year, co-ordinated initiative between the Dietetics, Nutrition and Biological Sciences Department and the Centre for Academic Practice at Queen Margaret University College. Initially we provide a brief overview of the issues involved in using web-based technologies from the student and staff perspective. We then describe the process of setting up the site and present the results of the evaluation. Results and Conclusions: We address the emergent issues raised by the project. For staff these include ease of use and the provision of a variety of support mechanisms. These are critical for long-term engagement and sustainability since they reduce the risk of distancing staff from their materials and encourage ownership of the website. Students use the website for preparation for lectures, as signposts for further research and reflection. Key barriers relate to access, systems stability and commitment of support departments. To address such concerns an institutional approach is proposed to provide long-term support.
Evaluation of an initiative providing omega-3 rich snacks to preschool children in a deprived area of Edinburgh
(2010) McKenzie, Jane; Drummond, Sandra; Andersson, E. A. D. Scheers
Improving omega-3 fatty acid intakes of preschool children in the United Kingdom
(2010-06) McKenzie, Jane
In vivo regulation of phenylalanine hydroxylation to tyrosine, studied using enrichment in apoB-100
(2008-02) Rafii, M.; McKenzie, Jane; Roberts, S. A.; Steiner, G.; Ball, R. O.; Pencharz, P. B.
Phenylalanine hydroxylation is necessary for the conversion of phenylalanine to tyrosine and disposal of excess phenylalanine. Studies of in vivo regulation of phenylalanine hydroxylation suffer from the lack of a method to determine intrahepatocyte enrichment of phenylalanine and tyrosine. apoB-100, a hepatic export protein, is synthesized from intrahepatocyte amino acids. We designed an in vivo multi-isotope study, [15N]phenylalanine and [2H2]tyrosine to determine rates of phenylalanine hydroxylation from plasma enrichments in free amino acids and apoB-100. For independent verification of apoB-100 as a reflection of enrichment in the intrahepatocyte pool, [1-13C]lysine was used as an indicator amino acid (IAA) to measure in vivo changes in protein synthesis in response to tyrosine supplementation. Adult men (n = 6) were fed an amino acid-based diet with low phenylalanine (9 mgkg-1day-1, 4.54 _molkg-1,h-1) and seven graded intakes of tyrosine from 2.5 (deficient) to 12.5 (excess) mgkg -1day-1. Gas chromatography-quadrupole mass spectrometry did not detect any tracer in apoB-100 tyrosine. A new and more sensitive method to measure label enrichment in proteins using isotope ratio mass spectrometry demonstrated that phenylalanine hydroxylation measured in apoB-100 decreased linearly in response to increasing tyrosine intake and reached a break point at 6.8 mgkg-1day-1. IAA oxidation decreased with increased tyrosine intake and reached a break point at 6.0 mgkg-1day-1. We conclude: apoB-100 is an accurate and useful measure of changes in phenylalanine hydroxylation; the synthesis of tyrosine via phenylalanine hydroxylation is regulated to meet the needs for protein synthesis; and that plasma phenylalanine does not reflect changes in protein synthesis. Copyright 2008 the American Physiological Society.
Low Plasma Vitamin D (25-Hydroxycholecalciferol) in Children and Adolescents Diagnosed with Cancer: A Case-Control Study
(ECronicon, 2015-12) Paciarotti, Ilenia; Revuelta-Iniesta, Raquel; McKenzie, Jane; Brand, Celia; Richard, Chin FM; Brougham, Mark FH; Wilson, David C.; Fergus Maclay Leukaemia Trust; GI-Nutrition Research fund of Child Life and Health; Roald Dahl Marvellous Children's Charity; Burdett Trust for Nursing
Introduction: Children and young people with cancer are less likely to spend time outdoors and they may also have a limited dietary intake. In addition, some cancer treatments can increase vitamin D catabolism. Objectives: This study aimed to investigate if there was an increased risk of poor vitamin D status in newly diagnosed childhood cancer patients compared to healthy controls in Scotland. Methods: Plasma 25 (OH) D was measured in children and adolescents during initial cancer treatment and compared to 33 healthy controls. Vitamin D deficiency was classified as plasma 25 (OH) D <25 nmol/l, with a plasma 25 (OH) D of 25-49 nmol/l classified as insufficient. Results: Forty-one patients (median age 3.8 years, IQR 1.9-8.0) were diagnosed with cancer, 63% were male. Twenty-three (56 %) had solid tumours, 18 (44%) had haematological cancers. Median (IQR) plasma 25 (OH) D at recruitment was 37.0 nmol/l (23.7-58.2). Ten patients (24%) had vitamin D deficiency and 17 (41%) patients were classified as insufficient. The median (IQR) plasma 25 (OH) D in the control group (n = 33) was 37.5 nmol/l (29.0-58.0). Six controls (18%) had vitamin D deficiency and 14 (42%) were classified as having insufficient results. Plasma 25 (OH) D did not differ (p > 0.05) between the patients and the controls. Conclusions: Almost three in four Scottish children treated for cancer had vitamin D deficiency or insufficiency; there was no increased risk of poor vitamin D status compared to healthy controls. Assessment of vitamin D status at diagnosis and in response to the course of treatment appears necessary to optimise nutritional management.
Micronutrient status influences clinical outcomes of paediatric cancer patients during treatment: A prospective cohort study
(2021-03-20) Revuelta-Iniesta, Raquel; Gerasimidis, Konstantinos; Paciarotti, Ilenia; McKenzie, Jane; Brougham, Mark F. H.; Wilson, David C.
Research reporting plasma micronutrient status and its impact on clinical outcomes in paediatric cancer is scarce. Therefore, we investigated the prevalence of plasma micronutrient abnormalities and their impact on clinical outcomes and treatment complications. A multicentre prospective-cohort study of children aged <18 years diagnosed with cancer was performed between Aug 2010-Jan 2014. Clinical and nutritional data were collected at diagnosis, 3, 6, 9, 12 and 18 months. Micronutrient status was established using in-house laboratory references (vitamin B12, vitamin A and Vitamin E/Ch) and aged adjusted Z-scores (Mg, Se, Zn and Cu) generated from a cohort of healthy Scottish children. Clinical outcomes were classified as "event free survival (EFS)" or "event" (relapse, death, new metastasis or becoming palliative) and treatment complications. Descriptive statistics, logistic regression multilevel analysis were performed. Eighty-two patients [median (IQR) 3.9 (1.9-8.8) years, 56% males] were recruited. Of these, 72 (88%) samples were available, 74% (53/72) patients had micronutrient abnormalities at baseline; deficiencies (25%, 18/72), excesses (19%, 14/72) and a combination of both (29%, 21/72), which continued for 18 months. Vitamin A deficiency (15%, 3/20) and excess (50%, 10/20) were most prevalent at 18 months, whilst vitamin E/Cholesterol and vitamin B12 were mostly within the normal range. Prevalence of Zn deficiency at diagnosis was 36% (16/44 adjusted for CRP), which remained at these levels throughout the study. Reduction in each selenium concentration unit increased the odds of an event by 2% (OR 0.02) and lower Se predicted higher complications at diagnosis [β (-1.2); t (-2.1); 95% CI (-2.9 - (-0.04)); p = 0.04], 3 months [β (-3.9); t (-4.2); 95% CI (-5.57 - (-2.02)); p < 0.001] and 12 months [β (-2.3); t (-2.4); 95% CI (-4.10 - (-0.34)); p = 0.02]. Given the prevalence of micronutrient abnormalities and the negative impact of low selenium on clinical outcome, micronutrient status should be assessed and monitored in paediatric cancer patients. Larger multicentre population based studies and clinical trials are now warranted.
Post-prandial effects of a meal rich in long-chain omega-3 fatty acids on indicators of cardiovascular risk
(2012) McKenzie, Jane; Gow, Iain F.; Findlay, S.; Petit, J.; Goua, M.; Wainwright, C.; Davidson, Isobel
Introduction Evidence from epidemiological studies indicates that the regular consumption of oily fish may be protective against the risk of cardiovascular disease. The benefits appear to be related to the content of long-chain omega-3 fatty acids (LC n-3 PUFA), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Current UK dietary guidelines therefore recommend the consumption of two portions of fish per week, one of which should be oily (1), which equates to 0.45g LC n-3 PUFA per day. Although there is limited information about intakes of EPA and DHA in Scotland, recent studies show that they are consistently below recommendations (2). Further review of the dietary intake data indicates that the consumption of oily fish is sporadic and inconsistent (3) despite attempts to promote regular intake. Several of the mechanisms involved in the development of cardiovascular disease (CVD) involve endothelial function. Post-prandial hyperlipidaemia has been linked to an increased risk of CVD (4), which is largely attributed to the transient (2-6 hour) decrease in endothelial function (5). Changes in endothelial function have also been shown to be associated with superoxide production (6), implicating oxidative stress as a possible mechanism for endothelial dysfunction. The long-term effects of LC n-3 PUFA on oxidative stress and inflammation are well established, however little is known about their immediate post-prandial effects. Identifying the possible benefits of consumption of a single meal rich in LC n-3 PUFA may provide a new perspective on which to promote dietary changes. The aim of this pilot project was therefore to identify post-prandial changes in markers of cardiovascular risk, assessed by measurement of arterial compliance, whole blood fatty acid profile, plasma glucose and insulin, markers of endothelial dysfunction, oxidative stress and antioxidant status in response a test meal naturally rich LC n-3 PUFA compared with a control meal.
Re-evaluation of a food frequency questionnaire to estimate total n-3 fatty acid intake in primary school children
(2010) Paciarotti, I.; McKenzie, Jane
Relative validation of a food frequency questionnaire against diet records to estimate n-3 fatty acid intake in adults.
(2010-06) McKenzie, Jane; Muirhead, L.; Shillinglaw, E.; Paciarotti, I.
Systematic review and meta-analysis: Prevalence and possible causes of vitamin D deficiency and insufficiency in pediatric cancer patients
(Elsevier, 2015-01-16) Revuelta-Iniesta, Raquel; Rush, Robert; Paciarotti, Ilenia; Rhatigan, E. B.; Brougham, F. H. M.; McKenzie, Jane; Wilson, D. C.
Background and aims: Vitamin D inadequacy is now an internationally recognized health problem and pediatric cancer patients may be at even higher risk than healthy children. We aimed to evaluate primary research to establish the prevalence of vitamin D inadequacy and to explore its possible causes in pediatric cancer patients. Methods: Electronic databases were searched (no restriction-Aug 2013) with no language restrictions and keywords related to cancer and vitamin D. We included studies of patients aged <18 years, diagnosed with and treated for cancer and reporting plasma vitamin D status. Evidence was critically appraised employing the CASP tool. Meta-analysis was performed when appropriate. Results: We included 19 studies, which were mainly of moderate-quality and heterogeneous in the definitions of vitamin D deficiency and insufficiency. The median (range) prevalence of vitamin D deficiency was 14% (0-61.5%) and insufficiency 23% (0-83%). Finally, a significant effect of younger age with vitamin D inadequacy was shown (effect size:-0.132; 95%CI-0.203,-0.060). Conclusion: There is a possibility of a high prevalence of vitamin D inadequacy in pediatric cancer patients, especially older children, urging the need for high-quality population-based longitudinal studies using standard definitions.
The adequacy of long-chain n-3 fatty acid intakes in primary school children
(2009) McKenzie, Jane; Clapham, Michael; MacGregor, A.
The adequacy of long-chain n-3 fatty acid intakes in primary schoolchildren
(Nutrition Society, 2009) McKenzie, Jane; Clapham, Michael; MacGregor, A.