BSc (Hons) Dietetics
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Item An investigation into the short-term consumption of pure green tea on known parameters associated with cardiovascular disease in a healthy population(Queen Margaret University, 2015)Background: Cardiovascular disease is a condition which affects individuals worldwide and its prevalence is continuing to rise; particularly in the Scottish population. A key cause of cardiovascular disease is oxidative stress which leads to the formation of plaque in the arteries. The body produces antioxidants to counteract oxidative stress; green tea is thought to contain high levels of antioxidants and polyphenols which reduce the risk of cardiovascular disease. Previous interventions indicate the antioxidant content of green tea may have protective effects against cardiovascular disease. Objective: The aim of this study is to identify whether short-term consumption of pure green tea which contains an abundance of polyphenols, influences known parameters associated with Cardiovascular Disease in a healthy population. Methods: A non-randomised intervention study was carried out. Twelve healthy participants were requested to consume two cups of pure green tea for three weeks. Weight, height, waist circumference, body fat composition, blood pressure, heart rate, pulse wave velocity, augmentation index and heart rate were measured at baseline (week 0) and post intervention (week 3). Food intake and physical activity were assessed by means of diet and exercise diaries before and during the intervention. Results: After consumption of green tea waist circumference was seen to decrease significantly from 74.9cm ± 2.8 to 71.3cm ± 2.9 (P= 0.005). Yet there was no significant decrease in weight (P=0.140) or BMI (P=0.166) or body fat composition (P=0.120). Cardiovascular parameters showed no significant change from baseline to post intervention (all p values >0.05). Analysis of the tea indicated antioxidants and polyphenols were present. Conclusions: Short term consumption of pure green tea may lead to a decrease in waist circumference; a key indicator of obesity and risk of cardiovascular disease. Cardiovascular parameters, weight, BMI and body fat composition status however showed no significant reduction. Further research should be undertaken with a longer intervention period to validate the results established in this study and also to monitor cardiovascular parameters to obtain further data regarding this relationship. Key Words: Green tea, Cardiovascular disease, waist circumference, polyphenols,Item The impact of a short intervention on adherence to the Mediterranean diet and body composition and lifestyle factors in a Scottish University Population.(Queen Margaret University, 2017)Introduction: The Scottish diet is contributing to obesity rates and subsequently cardiovascular disease. High in sugar and saturated fat and low in fruit and vegetables the diet lacks beneficial components. Current evidence supports the Mediterranean dietary pattern as a way of preventing cardiovascular disease and is supported by NICE 2016. Rich in polyphenols, antioxidants the Mediterranean diet has many components beneficial to heart health. Studies have shown that the diet can have a positive impact on weight, BMI, waist circumference and blood pressure. Many studies have looked at secondary prevention of cardiovascular disease and very few have looked primary prevention in university students. The few studies that have looked at university students are conducted in Mediterranean countries (Gracia-Meseguer et al. 2014; Pationo-Alonso et al. 2014). Aims and Objectives: The study aimed to determine the impact of a short term dietary intervention on adherence to the Mediterranean diet, body composition and other lifestyle factors in the Scottish university population. In addition the study determined if an association exists between the Mediterranean diet and body composition and lifestyle factors. Methodology: This study was a prospective study. The study took place at Queen Margaret University. Anthropometric measurements include weight, height, waist circumference and blood pressure were measured using a standardised procedure (WHO STEPS 2008). Body Mass Index was calculated (WHO 2016a). Participants had their adherence to the Mediterranean diet assessed via the 14-point Mediterranean diet score (Trichopoulou et al. 2003 cited in Martinez-Gonzalez et al. 2012). Physical activity and sedentary behaviour was measured using the long version of the International Physical Activity questionnaire (International Physical Activity Questionnaire Team 2002). A 2 week intervention was given to all participants in the form of a leaflet based on the Mediterranean diet from NICE 2016 and British Heart Foundation 2012 recommendations. Statistical analysis was completed using SPSS version 21. A p value ≤0.05 was considered significant. Descriptive statistics were calculated for parametric (Mean and Standard Deviation) and non parametric (Median and Interquartiles) to describe the data. The paired t-test was used to assess any differences from before and after the intervention. The Wilcoxon Signed Rank test was used for the Mediterranean diet score and physical activity. The Spearman's rho correlation was used to assess association between Mediterranean diet score and body composition and lifestyle factors. Results: Of the 11 total participants to complete the study, 8 were Female (72.7%) and 3 were Male (23.3%). The paired t-test showed a significant difference between before and after intervention weight and body mass index (P value= 0.007, P value= 0.032). The Wilcoxon Signed Rank test demonstrated that Mediterranean diet had significantly (P value= 0.017) improved following the intervention. A Spearman's rho correlation found a significant association between Mediterranean diet score and diastolic blood pressure (R value= -730,P value= 0.011). Discussion: The only significant association was between Mediterranean diet score and Diastolic blood pressure. The study enhances current research that the Mediterranean diet affects body composition and lifestyle factors. In future a longer intervention would be required to see the true effects of the intervention on Mediterranean diet score, body composition and lifestyle factors. Key words: Body Mass Index, Cardiovascular Disease, Mediterranean Diet, International Physical Activity Questionnaire, Scottish Diet, StudentsItem Calcium and Vitamin D intakes of female university students.(Queen Margaret University, 2017)Osteoporosis affects more than 75million people in the western world and causes more than 8.9million fractures a year, a figure expected to increase 3-fold over the next 50years due to an ageing population. High peak bone mass (PBM) can reduce the risk of developing osteoporosis in later life. Diet can influence PBM, in particular, calcium and vitamin D. It is therefore important that DRV's for these are met in order to reduce the risk of developing osteoporosis. A recent publication by SACN has lead to recent implementation of new DRV's for vitamin D based on the high prevalence of low vitamin D status in the UK. The most recent data from the NDNS indicates that a significant proportion of young females have calcium intakes below the lower reference nutrient intake (RNI) and that vitamin D intakes are well below the new RNI. In addition, serum vitamin D levels are below the lower threshold for adequacy. Aim: The aim of this study was to provide quantitative data on the dietary intake of calcium and vitamin D in female university students aged 18-35years. Materials and methods: Participants were required to complete a 4-day diet diary over consecutive days including one weekend day, using household measures to indicate portion sizes. Data collected was analysed using NetWISP to convert food consumed into nutrient intakes. Statistical analyses were then carried out using a sample t-test to indicate significance when comparing mean intakes of vitamin D and calcium to results from the national diet and nutrition survey and to dietary reference values. Results: Mean intakes of vitamin D are 2.5μg/day, significantly lower than the new RNI (P=<0.00) and comparable to the NDNS (P=0.75). Mean calcium intake is 735.65mg/day, meeting the RNI, comparable to the NDNS (P=0.90), however 4% have intakes below the LRNI. Conclusion: It is unlikely that the new RNI for vitamin D can be met through diet alone. In combination with the low calcium intakes observed in a small subset of the population, this has implications for the development of PBM and so the risk of osteoporosis development is increased.Item The 'prebiotic effect' of a lactic acid rich whey fermented product - Molkosan® in modulating glycaemic response and satiation levels in healthy human subjects.(Queen Margaret University, 2017)Background: The global epidemic of obesity and its associated conditions have become economic burdens. Multifactorial factors, including genetic and environmental elements, are recognised as the causes of obesity and its comorbidities, and the altered gut microbiota is one of the environmental elements. Prebiotics are suggested to promote good gut bacteria growth by encouraging colonic fermentation. Microbial metabolites from the gut fermentation, such as organic acids, including short-chain fatty acids (SCFAs), lactate, succinate and formate are identified to have the biogenic effect of inducing satiety effect, reducing energy and improving glucose tolerance. Supplementations of these microbial metabolites have become increasingly popular, further research to verify their effects are therefore, essential. Objective: The aim of the study was to examine the biogenic effects of a lactic acid (microbial metabolite) rich product - Molkosan® on appetite control and glycemic response in healthy human volunteers. Design: This study was a non-randomized, non-blind, within-subject control trial. A total of 12 healthy adults (3 men and 9 women) received 2 teaspoons (10ml) of Molkosan® for 14 days. Oral glucose tolerance tests were performed to measure glucose concentrations at 0, 30, 60 and 90 min time points at day 0 and day 14. Satiation scores were generated to assess hunger, fullness, desire to eat and prospective food consumption levels at 30 min before, 0 min before and 0 min after test meals at day 1 and day 15. Results: Short-term ingestion of lactic acid rich supplement resulted in significant change in initial glycemic response. The mean difference of 1.5 mmol/l ( * p<0.05) blood glucose concentrations between pre and post interventions are shown at 30 min time point following post-ingestion of 410ml of Lucozade Original (equivalent to 75g of anhydrous glucose). Fullness sensations were generally increased after 14 days; significance was detected in 0 min after test meal with a * p-value of 0.018. Conclusion: The short-term ingestion of a lactic acid rich supplement can lead to a significant reduction in the initial rise of plasma glucose in healthy individuals. The satiation test experience could serve as a base for future lactic acid rich supplementation research. Key words: Lactic Acid, Obesity, T2DM, Glycaemic Response, Satiation, Prebiotic EffectItem Evaluation of the short term impact of the Healthier Scotland Cooking Bus.(Queen Margaret University, 2016)Background: The Healthier Scotland Cooking Bus (HSCB) was launched in 2008 following the Scottish Government's plan to improve diet, increase physical activity and tackle obesity. It is a mobile kitchen, in the form of an articulated truck, which visits schools and local communities. It provides cooking sessions for students, healthy eating advice, teaching resources, cooking equipment and continuing professional development (CPD) courses for teachers. Continuous evaluation of nutritional education programmes is essential to allow the impact of the programme to be assessed. Aim: To evaluate the CPD sessions of the HSCB and assess how effective they are. Design: Pre and Post-Surveys currently employed by the HSCB were used to collect a combination of quantitative and qualitative data about the session. Additional questions were developed and added to these surveys to evaluate how effective they were at collecting the relevant data. Results: The CPD session was found to increase confidence in a variety of topics concerning teaching, cooking and nutrition. When the pre and post-surveys were evaluated, the participants' view of the importance of cooking education had significantly increased (p=0.011). Significant increases in confidence in various aspects of teaching cooking were also found (p<0.05). For example, teaching how to use cooking equipment, teaching about food hygiene, food preparation and cooking skills, adapting recipes to make them healthier, coordinating cooking lessons for different age groups/experience levels, coordinating cooking/preparing a variety of healthy recipes, planning, setting up and leading cooking activities, linking cooking education to other areas of the curriculum and developing cooking education. Conclusion: The Healthier Scotland Cooking Bus was successful in increasing confidence in a variety of cooking skills and health education. The surveys were also found to be suitable in collecting the relevant evaluation information about the CPD sessions. Key words: Health, Nutrition, Cooking, Education, Scotland, Evaluation.Item The Impact of a Short-Term Dietary Intervention on Adherence to the Mediterranean Diet, Body Composition and Lifestyle Factors in a Scottish University Population.(Queen Margaret University, 2017)Introduction: The Mediterranean Diet has long been reported to be the ideal diet for preventing Cardiovascular Disease (CVD). This diet is typical of countries surrounding the Mediterranean Sea where rates of CVD are lower than their European counterparts. There is evidence to suggest that increased adherence to this diet can help to improve certain CVD risk factors however there is currently limited research of this within a Scottish population. This study therefore aims to fill this gap in the literature. Aims: (1) To determine the impact of a short-term intervention on adherence to the Mediterranean diet, body composition and lifestyle factors in a Scottish university population (2) To determine the association between Mediterranean diet score and CVD risk-factors. Methods: This study involved 12 participants aged 18-50 years. Mediterranean diet score, levels of physical activity and sedentary behaviour, blood pressure and body composition were measured at baseline. Participants then received an intervention in the form of a leaflet detailing advice on the Mediterranean diet and physical activity in-line with current guidelines. Participants then returned after a two-week period were all measurement were re-taken. Results: Analysis of the results found a significant (p=0.017) increase in Mediterranean diet score and a significant reduction in weight (p=0.007) and BMI (p=0.014) following intervention. The was no significant difference (p >0.05) in any other parameter. Further analysis showed a significant association between Mediterranean diet score and systolic blood pressure at baseline (r=-0.626 (p=0.029)) and between Mediterranean diet score and both systolic blood pressure (r=-0.680 (p=0.021)) and diastolic blood pressure (r=-0.730 (p=0.011)) following intervention. There was no significant (p >0.05) association between MDS and any other CVD risk factor. Conclusion: Overall this study had several positive results including an increase in adherence to the MD and a reduction in weight and BMI following intervention. This study was the first of its kind to be conducted with a Scottish population and highlights that further promotion of the Mediterranean diet in-line with current UK recommendations may have beneficial effects on CVD risk factors. Key Words: Mediterranean Diet, Cardiovascular Disease, Body Composition, Blood Pressure, Physical Activity, Scottish PopulationItem To explore the relationship between adductor pollicis muscle thickness and markers of body composition and function in healthy male and female university students and staff.(Queen Margaret University, 2017)Background: Lean mass is a fundamental determinant of development and growth as well as being a clinical marker of nutritional status, disease and the ageing process (Cruz-Jentoft et al. 2010). The quantification of lean mass allows identification of appropriate outcome measures and effective monitoring of nutritional interventions (Thibault et al. 2011). The adductor pollicis muscle (APM) has recently been suggested as a promising marker of muscle mass and muscle function for some clinical conditions such as chronic renal failure, stroke and haemodialysis patients, however there is limited research within healthy populations. Objective: To explore the relationship between adductor pollicis muscle thickness and markers of body composition and function in healthy male and female university students and staff. Methods: An exploratory, observational, cross-sectional, pilot study was conducted that involved 19 randomly recruited healthy participants. All participants were subjected to measurements of adductor pollicis muscle (APM), body composition (assessed by bioelectrical impedance analysis), body mass index (BMI) and handgrip strength (HGS). Pearson's correlation coefficient was used to identify possible correlations between adductor pollicis muscle thickness and the following variables; body fat (%), body fat (Kg) , lean mass (%), lean mass (Kg) body fat mass index, fat free mass index, phase angle, body mass index and handgrip strength. Results: Adductor pollicis muscle thickness was negatively correlated with body fat (%) (r-0.537 p 0.018) and positively correlated with lean mass (%) (r 0.534 p0.019) lean mass (kg) (r 0.663 p 0.002) fat free mass index (kg/m²) (r 0.568 p 0.011) and handgrip strength (kg) (r 0.468 p 0.043) Conclusion: Adductor pollicis muscle thickness correlated with markers of lean mass and handgrip strength. The results suggest that adductor pollicis muscle thickness may be a determinant of lean mass and handgrip strength within a healthy adult population. Further studies, undertaken with a larger sample are needed to confirm these findings. Keywords: Adductor pollicis muscle thickness, Lean mass, Handgrip strength, Healthy adultsItem Pinch strength as an alternative measurement to handgrip strength in assessing individual's nutritional status.(Queen Margaret University, 2016)Background: Pinch strength is emerging as a simple, inexpensive, easily performed bedside test to assess patients' nutritional status. Handgrip and pinch strengths are important parameters to determine hand function and have been used in clinical settings for decades. There is evidence supporting the corresponding relationship between functional ability of the patient and their nutritional status. There is developing evidence to support the use of pinch strength testing as a suitable comparable method for handgrip strength in assessing nutritional status. Early progress is being made but the data is still limited. It is important that studies are carried out in a healthy population in order to have reference values for use in the clinical setting. Objectives: The aim of this study was to explore the relationship of pinch strength with markers of muscle function; hand grip strength and sit to stand test and with common markers of body composition; BMI, MUAC, calf circumference (CC), fat mass (FM) and fat free mass (FFM) in a healthy non clinical population. Materials and Methods: Twelve healthy students from Queen Margaret University were included in this study. Participants filled in a survey about demographic data and Jamar dynamometer and pinch gauge were used to measure handgrip and pinch strengths. Markers of body composition were measured using a BIA scale. Results: Pinch strength was found to have more significant correlations with the variables than handgrip strength. Pinch strength had significant correlations with the other hand's pinch strength (r=0.89, p=0.001), right handgrip strength (r = 0.90, p = <0.001), FFM (r = 0.73, p = 0.007), MUAC (r = 0.66, p = 0.020), height (r = 0.63, p = 0.029), calf circumference (r = 0.74, p = 0.006) and with 1-minute STS test (r = 0.60, p = 0.037). No statistically significant correlations were found with either of the pinch strengths and weight, BMI or FM. Conclusion: The several correlations found between pinch strength and parameters of muscle function and body compositions are encouraging. However, more studies with bigger study populations in healthy individuals with wider age range are need to be able to gather adequate normative data for pinch strength to be used in practice as a indicator of nutritional status. Keywords: Hand strength, handgrip strength, pinch strength, body composition, nutritional statusItem An Assessment of Calcium and Vitamin D Intakes of Females Aged Between Fifteen and Eighteen Years with an Exploration into Potential Factors behind Low Intakes.(Queen Margaret University, 2016)Introduction: Calcium plays a key role in a number of life sustaining bodily functions and is of great importance for bone health. Vitamin D facilitates absorption of calcium in the body and both nutrients assist in the achievement of peak bone mass (PBM). Adolescence provides window of opportunity for maximising attainment of PBM which can decrease the risk of osteoporosis in later life. The National Diet and Nutrition Survey Rolling Programme (NDNS RP), along with various other studies, have found dietary calcium and vitamin D intakes to be low within adolescent females. Few studies have explored factors which may contribute to poor intakes. Objectives: This study aimed to assess dietary calcium and vitamin D intakes of female Islay High School students aged 15-18 years and thus add to the current body of evidence surrounding intakes of these nutrients within Scottish adolescent females. Intakes were compared to the dietary reference values (DRV) along with results from the NDNS RP. The present study also aimed to give an insight into potential factors which may contribute to poor intakes within this gender and age group. Methods: Four-day diet diaries and a questionnaire were used as a method of data collection for this study. Dietary intakes were assessed using NetWisp. Results: No significant differences were found between participant (n=13) intakes of calcium and vitamin D with those recorded in the NDNS RP. The main sources of nutrients, however, differed to the NDNS RP with milk and milk products providing the largest proportion of dietary calcium (77%) and cereals and cereal products vitamin D (31%). The mean calcium intake, 600±195mg/day, was significantly lower (p<0.05) than the RNI of 800mg/day and 23% of participants had intakes below the LRNI. Vitamin D intakes averaged at 2.9±3.2μ/day and 8% (n=1) achieved an intake of over 10μ/day with the aid of supplementation. Eighty-five percent of participants regarded calcium and vitamin D as important nutrients but only 38% were aware of one or more of their functions. One-hundred percent were aware of calcium rich food sources but only 23% were aware of foods containing vitamin D. Thirty-eight percent reported not drinking milk due to disliking the taste. Sixty-nine percent reported that they would be likely to increase consumption of calcium and vitamin D following an education session with a health care professional. Conclusion: As with previous studies it was found that 15-18 year old females had significantly low calcium and vitamin D intakes when compared to the DRVs. Mean intakes were not significantly different to those observed in the NDNS RP, but the main sources of nutrients differed. Most participants stated that they would improve their intakes of calcium and vitamin D following an education session from a health care professional. Areas identified for education included the role of calcium and vitamin D in bone health, dairy-alternative sources of calcium, sources of vitamin D and ways of achieving RNIs. Future study into calcium and vitamin D intakes of female adolescents prior to and following education from a health care professional may be beneficial in order to assess this as a public health intervention. Key Words: Calcium, Vitamin D, Female Adolescents, Diet Diary, DRV, NDNS RPItem To determine the association between dietary protein intake, distribution and measures of functional status within a female older adult population(Queen Margaret University, 2016)Background: Ageing is associated with a progressive loss of physical function that often leads to a poorer quality of life and an increased risk of mortality in the elderly. The steady decline in skeletal muscle mass and strength, known as sarcopenia, can lead to a 15% reduction in lean body mass by the eighth decade of life. Emerging evidence indicates the protein intake and the distribution of this intake is required to slow the decline in lean body mass and prevent the incidence of sarcopenia. Objective: To determine the association between dietary protein intake, distribution and measures of functional status within a female older adult population Design: Volunteers were recruited to the study and asked to complete 7 day diet diaries. Measures of physical function, hand grip strength test and a sit-to-stand test were performed on all participants to see if there was any associated with their protein intake. Results: No participants managed to achieve an optimal protein intake of 30g per meal (p=<0.05 for all meal times). Only two participants had handgrip strength tests within the reference range and only one participant managed to achieve a sit-to-stand test time within the normal range. Conclusion: Further research is required in this field with a focus on increasing the number of participants recruited. Key words: Protein, sarcopenia, elderly, ageing, muscle strength, muscle mass