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Dietetics, Nutrition and Biological Sciences

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/23

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Author: search.filters.author.Davidson, IsobelSubject: search.filters.subject.Obesity

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    Prenatal programming of postnatal obesity: fetal nutrition and the regulation of leptin synthesis and secretion before birth
    (Cambridge University Press, 2004-08) Davidson, Isobel; Smith, Sara
    The introduction of the process of nutritional screening into clinical standards has been driven by the increasing awareness of the prevalence of undernutrition in acute and primary care, along with its associated morbidity and mortality. However, the increasing prevalence of obesity in the general population suggests that an increased number of patients admitted to hospital will be obese. Increased morbidity has also been reported in the injured obese patient and may be associated with poor nutritional support. This situation may occur because the profound metabolic disturbances accompanying trauma in this group are not recognised, and subsequent feeding practices are inappropriate. Screening tools currently classify patients by using simple markers of assessment at the whole-body level, such as BMI. Subsequently, patients are identified as at risk only if they are undernourished. Such comparisons would by definition classify injured obese patients as at minimal or no nutritional risk, and they would therefore be less likely to be re-screened. This approach could result in potential increases in morbidity, length of rehabilitation and consequent length of hospital stay. It is likely that the identification of potential risk in obese injured patients goes beyond the measurement of such indices as BMI and percentage weight loss, which are currently utilised by the majority of screening processes.
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    Intake of polyphenol-rich pomegranate pure juice influences urinary glucocorticoids, blood pressure and homeostasis model assessment of insulin resistance in human volunteers
    (2012-08) Tsang, Catherine; Smail, Nacer Foudil; Almoosawi, Suzana; Davidson, Isobel; Al-Dujaili, Emad A. S.
    Pomegranate juice (PJ; also known as pomegreat pure juice) provides a rich and varied source of polyphenolic compounds that may offer cardioprotective, anti-atherogenic and antihypertensive effects. The aim of this study was to investigate the effect of PJ consumption on glucocorticoids levels, blood pressure (BP) and insulin resistance in volunteers at high CVD risk. Subjects (twelve males and sixteen females) participated in a randomised, placebo-controlled cross-over study (BMI: 2677 (sd 336) kg/m2; mean age: 504 (sd 61) years). Volunteers were assessed at baseline, and at weeks 2 and 4 for anthropometry, BP and pulse wave velocity. Cortisol and cortisone levels in urine and saliva were determined by specific ELISA methods, and the cortisol/cortisone ratio was calculated. Fasting blood samples were obtained to assess plasma lipids, glucose, insulin and insulin resistance (homeostasis model assessment of insulin resistance). Volunteers consumed 500 ml of PJ or 500 ml of a placebo drink containing a similar amount of energy. Cortisol urinary output was reduced but not significant. However, cortisol/cortisone ratios in urine (P = 0009) and saliva (P = 0024) were significantly decreased. Systolic BP decreased from 1364 (sd 63) to 1289 (sd 51) mmHg (P = 0034), and diastolic BP from 803 (sd 429) to 755 (sd 517) mmHg (P = 0031) after 4 weeks of fruit juice consumption. Pulse wave velocity decreased from 75 (sd 086) to 744 (sd 094) m/s (P = 0035). There was also a significant reduction in fasting plasma insulin from 936 (sd 58) to 753 (sd 412) mIU/l (P = 0025) and of homeostasis model assessment of insulin resistance (from 2216 (sd 143) to 182 (sd 112), P = 0028). No significant changes were seen in the placebo arm of the study. These results suggest that PJ consumption can alleviate key cardiovascular risk factors in overweight and obese subjects that might be due to a reduction in both systolic and diastolic BP, possibly through the inhibition of 11_-hydroxysteroid dehydrogenase type 1 enzyme activity as evidenced by the reduction in the cortisol/cortisone ratio. The reduction in insulin resistance might have therapeutic benefits for patients with non-insulin-dependent diabetes, obesity and the metabolic syndrome.