BSc (Hons) Nutrition
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Item Adherence to a Mediterranean Diet and Body Weight Status in a Scottish Population(2018)Background: The prevalence of overweight and obesity is at an all-time high in Scotland and strategies are needed to halt this epidemic. The Mediterranean diet is a healthy eating pattern, high in wholegrains, vegetables and fruit and low in processed foods, red meats and confectionary. The eating pattern has been inversely associated with overweight and obesity in Mediterranean countries; however, the relationship has not been investigated in a Scottish context. This healthy dietary strategy could help Scots maintain a healthy body weight status and contribute to the fight against overweight and obesity. The aim of the current study was to examine the relationship between Mediterranean diet adherence and overweight and obesity in a Scottish population. Methods: In this cross-sectional study, 69 adults were recruited by email from three locations around Edinburgh. Mediterranean diet adherence was evaluated using a validated 14-item Mediterranean diet screener with adherence defined as a score ≥9. Physical activity was assessed using a validated 7-item, 7-day, physical activity recall and defined as low, medium or high. The Mediterranean diet adherence screener and 7-day physical activity recall were completed as part of an online questionnaire that included other lifestyle variables. At assessment, following completion of the questionnaire, participant body mass index, waist circumference and weight to height ratio were measured and calculated following standard anthropometric protocols. Body fat percentage was ascertained by bioelectrical impedance analysis. Results: 27.5% of all subjects adhered to a Mediterranean diet and women were 5.6 times more likely to adhere to a Mediterranean diet then men (p=0.004). Overweight and obesity prevalence was 59% and was positively associated with age (p=0.021). Men were 7.9 times more likely to be overweight or obese than women (p<0.01). Participants that adhered to a Mediterranean diet tended to have lower overweight and obesity measurements; however, no significant relationship was found between Mediterranean diet adherence or diet screener score and overweight and obesity. Conclusion: No statistically significant associations were observed between Mediterranean diet and overweight and obesity in this small study; however, the trends observed were consistent with the findings of larger studies in other countries. The present study indicates that a larger, Scottish study with greater statistical power is warranted to further elucidate this relationship. Keywords: Mediterranean diet; diet; lifestyle; overweight; obesity; weight gainItem An investigation into the knowledge of updated vitamin D recommendations in a Scottish population and the availability and affordability of infant vitamin D supplements in Scotland.(2018)Background: Following advice from The Scientific Advisory Committee for Nutrition (SACN) report outlining the updated recommendations (10μg) for vitamin D in the UK, the Scottish Government amended adult and infant vitamin D recommendations in 2017. Previously, no recommendation was set for the general population as they were not thought to be at risk of deficiency. Similarly, infant recommendations have changed from 7μg to 8.5-10μg/day. Healthy Start supplements; free to families on a low income in Scotland, have not yet been updated to meet these new recommendations. Aims: 1. To assess knowledge regarding the sources and role of vitamin D in health and knowledge of updated vitamin D recommendations and supplement use in a Scottish population (18-65 years) 2. To assess the availability and affordability of infant vitamin D supplements in Edinburgh. Methods: For the first part of this study, an online questionnaire was developed using information from NHS choices. The questionnaire consisted of ten open ended and closed questions to assess knowledge of updated vitamin D recommendations as well as sources and health roles of vitamin D and supplement use. A pilot questionnaire was carried out with nine participants for face and validity. A knowledge score (low score=<5, high score= ≥5) was then calculated from the answers. For the second part of the study, a survey was conducted in two areas of high deprivation (SIMD 10% most deprived) and two areas of low deprivation (SIMD 10% least deprived) in Edinburgh, Scotland to assess the availability and affordability of infant vitamin D supplements which meet the new recommendation of 8.5-10μg. Results: 98 participants completed the survey (male = 32% n=31, female= 68%, n=67). Only 18 (18%) participants were currently taking a supplement with just 13 (13%) aware of the new recommendation. Similarly, general vitamin D knowledge was low (low score = 71% n=70, high score = 29% n=28). There was no association between knowledge score and age (X2=2.591, p=0.473), gender (X2 =0.797, p=0.473), education (X2=1.188, p=0.414) and ethnicity (X2=0.152, p=0.738). Similarly, there was no association between supplement use and age (X2= 0.003, p=1.000), gender (X2=0.53, p=1.000), education (X2=0.093, p=0.793) ethnicity (X2=0.203, p=0.751) and knowledge score (X2=2.767, p=0.144). Accessibility to supplements was low in the most deprived areas (SIMD 10% most deprived) with only one supplement available. In contrast, seven supplements were available in the least deprived areas (SIMD 10% least deprived). Conclusion: Vitamin D knowledge scores were low in this Scottish population. There was limited knowledge of updated recommendations and supplement intake was low. Accessibility of infant vitamin D supplements is low in the most deprived areas of Edinburgh (SIMD 10% most deprived) with only one supplement available in comparison to seven available in the least deprived areas (SIMD 10% least deprived). This proves the need for widespread publication and education around vitamin D. There was no association between knowledge score and any demographic variable or supplement use. Further research is required to investigate whether knowledge is associated with vitamin D status, however results indicate the need for improved health literacy around vitamin D in Scotland. Key Words: Vitamin D, SACN, Scotland, Infant supplements, SIMD.Item Short-term evaluation of the Cyrenians six-week parent cooking programme(2018)Background: Cyrenians is a charity which supports people who have been excluded from work, family, home and communities. They offer support by various means including food education programmes. These programmes aim to improve cooking skills, knowledge, confidence, budgeting and reduce social isolation. Classes are accessible to different groups including parents. However, evaluation of classes lack consistent and thorough evaluation. There is limited data on the effectiveness of cooking classes for parents in Scotland. Aim: To identify whether a six-week pilot cooking class for parents in East Lothian improves cooking confidence, skills, food/nutrition-related knowledge and dietary behaviours. To qualitatively explore parents’ experiences of attending a six-week cooking class in East Lothian. Methods: Pre and post questionnaires were developed and distributed by Cyrenians, to collect qualitative and quantitative data on cooking confidence and skills. A post-questionnaire was developed by researchers to collect further data on cooking confidence, diet and knowledge. A semi-structured focus group was conducted to gather views and experiences of the participants attending the cooking class. Results: Data from the Cyrenians pre-evaluation was not valid due to printing errors. All participants rated their cooking skills as ‘excellent’ in the Cyrenians post-evaluations that were valid (n=5). All participants completed the researcher post-evaluation (n=6). The researcher’s post-evaluations identified improvements in cooking confidence, diet and knowledge. The participants expressed that they ate more fruit and vegetables since the beginning of the class. Thematic analysis of the focus group identified six themes; increase in fruit and vegetables, more meal preparation and using leftovers, increase in cooking skills and practices – confidence, more budgeting, cooking with children/stress and positive cooking class experiences. Conclusion: The Cyrenians parent cooking class showed successful changes in the areas of cooking practises, diet, budgeting and knowledge. Overall the participants enjoyed the class and recommended some changes. The focus group broadened the range of qualitative data collection within the study. Further longitudal follow-up evaluation would identify if these results have been sustained by the participants. Keywords: Cooking, Evaluation, Parents, Scotland, HealthItem Is there a relationship between compliance to the Mediterranean Diet and body weight status in Scottish adults.(2018)Introduction: In Scotland there are high levels of overweight and obesity and due to their association with noncommunicable disease such as cardiovascular disease, type II diabetes and cancer along with an increased risk of premature mortality scientifically proven dietary strategies that could help reduce their prevalence in the population are of great importance. The Mediterranean dietary pattern has been associated with various health benefits including a reduced risk of weight gain and central adiposity in other countries however very little work has been carried out in Scotland. The aim of this study was to assess the relationship between Mediterranean diet adherence and body weight status in the adult Scottish population. Objectives included measuring Mediterranean diet adherence and evaluating its relationship with body composition measurements; body mass index, waist circumference and waist height ratio and body fat percentage. Also measuring physical activity levels and various lifestyle factors including alcohol consumption and average sleep patterns, age and gender and assessing their relationships and Mediterranean diet adherence. Method: A cross-sectional study was carried out on 69 adults. Dietary, lifestyle and physical activity assessment data was gathered using a self-reported questionnaire. Adherence to the Mediterranean diet was evaluated using the validated 14-point Mediterranean Diet Screener. Body weight status was assessed by measuring height, weight and waist circumference and by calculating body mass index and waist height ratio. Body composition was measured using bioelectrical impedance analysis for bodyfat percentage. Physical activity levels were assessed using the international physical activity questionnaire short form. Results: The total number of participants was 69 of which 49.3% were male and the mean age was 34.7 years. 4 men and 15 women adhered to the Mediterranean diet whilst 30 men and 20 women were classified as non-adherers. A significant association was found between gender and adherence to the Mediterranean diet (p=0.004) with woman 5.6 times more likely to adhere to the Mediterranean diet than men. Within the male cohort there was a significant association with Mediterranean diet adherence and older age (p=0.048). A moderate positive correlation was found between physical activity levels and Mediterranean diet score in the total population (p=0.007) and in males (0.004) there was also a low inverse correlation between waist circumference and Mediterranean diet score (p=0.026). Conclusion: This study has found that several factors were associated or related to increased Mediterranean diet adherence. Few studies have been conducted in Scotland with regards the Mediterranean diet and although some trends with Mediterranean diet adherence and reduced body weight status were found further studies with much larger and more representative sample sizes giving more reliable results are needed to confirm any beneficial effects of a Mediterranean diet on body weight within the Scottish population. Key words: Mediterranean Diet, Physical Activity, Overweight and Obesity, Body Composition, Scottish Diet, Lifestyle Factors.Item The relationship between compliance to the Mediterranean diet and body weight status in Scottish adults.(2018)Greater adherence to the Mediterranean diet is linked to reduced weight gain and central adiposity in studies of Mediterranean cohorts but no studies have examined the effects of adherence to the Mediterranean diet in Scotland. Therefore, the aim of this study was to observe the relationship between adherence and body weight status in Scottish adults living in Edinburgh. Adherence is defined by the consumption of olive oil, fresh fruits and vegetables, legumes, nuts, moderate-tohigh consumption of fish, whole-grain cereals and wine in addition to a reduced consumption of sugar-sweetened beverages, red and processed meats, butter, margarine, cream, sweets, biscuits and cakes. Cross-sectional assessment of 69 healthy participants aged 19-68 years (51% women) and Mediterranean diet adherence was evaluated using a validated 14- point Mediterranean Diet Adherence Screener, defining adherence as a score of nine or above. Additional lifestyle questions on smoking and alcohol consumption were also assessed. Physical activity was estimated using a validated seven-day assessment questionnaire. Anthropometric measurements of height, weight and waist circumference were taken to calculate body mass index and waist to height ratio. Percentage body fat was measured using bioelectrical impedance analysis. Adherence was higher among women and men aged 38.0 and 48.7 years respectively and adherence was significantly higher for women than men (p<0.004). A trend in moderate to high physical activity, moderate alcohol and nonsmoking was associated with Mediterranean diet adherence in both men and women. Anthropometric measurements revealed a trend in reduced waist circumference, waist to height ratio, body max index and body fat in men but not in women. A significantly moderate inverse correlation (rS = - 0.487, p<0.035) between increasing Mediterranean diet score and lower body mass index was found when both women and men were analysed together. In conclusion, opposing observed trends between Mediterranean diet adherence and body weight status between men and women were found, justifying future intervention studies to fully explore the potential long-term efficacy of a Mediterranean-style diet on body weight status in the adult Scottish population. Keywords: Mediterranean diet adherence; body weight status; body composition; lifestyle; physical activityItem The relationship between Mediterranean diet adherence, perceived Mediterranean diet adherence, body composition and physical activity levels in a Scottish student population.(2018)Introduction: Cardiovascular disease (CVD) is a leading cause of premature mortality in Scotland and is an independent factor for many chronic diseases. Dietary patterns and lifestyle behaviours are recognised as key determinants for adverse health outcomes. Epidemiological studies report that in areas that follow traditional Mediterranean dietary patterns lower rates of chronic disease including CVD have been observed. Recent studies report associations between Mediterranean diet adherence and CVD risk factors such as body composition and physical activity levels, however no such studies have been conducted in a Scottish university population. Aim: The aim of the present study was to investigate the relationship between Mediterranean diet adherence, self-perceived Mediterranean diet adherence, body composition and physical activity levels. Method: A cross-sectional study was conducted in a cohort of 20-52-year-old student participants (n=20) from Queen Margaret University. Mediterranean diet scores (MDS) were obtained using a validated MDS tool questionnaire, self-perceived adherence to a Mediterranean diet was obtained using a Mediterranean diet pyramid and questionnaire. Physical activity levels were self-reported and obtained using the IPAQ long form questionnaire. Participants Anthropometric measurements (height, weight, waist circumference and BMI) were obtained by two researchers following strict protocol. Results: Twenty university student participants with a mean age of 25.50 (±8.55) participated in this study. Among the population, 65% (n=13) were classified as high adherers to a Mediterranean diet, whilst 35% (n=7) were classified as low adherers to a Mediterranean diet. No statistically significant differences were found between Mediterranean diet adherence and body composition, or physical activity as p>0.05 for all parameters. Mediterranean diet adherence was positively associated with perceived adherence to the Mediterranean diet (r=0.564, p=0.01). Conclusion: This study was the first to investigate Mediterranean diet adherence and its relationship with perceived Mediterranean diet adherence, body composition and physical activity level in a Scottish university student population. Results were largely inconsistent with the literature; no significant differences were observed between those who adhere to a Mediterranean diet and those who do not, however a significant difference and association was found between Mediterranean diet adherence and perceived diet adherence. KEY WORDS: Mediterranean diet, Mediterranean diet adherence, Cardiovascular disease, body composition, physical activityItem Comparison of the nutritional knowledge and nutritional adequacy of lacto ovo-vegetarian, vegan and omnivore diets in a student population in Scotland.(2018)Background: Meat-free diets are becoming increasingly popular and although, it is possible for all three diets to provide adequate nutrients, there is still a perception that a vegan and vegetarian diet could be deficient in vital nutrients. Contrastingly, omnivores are believed to consume a number of nutrients in excess. Although no studies have compared nutritional knowledge between the vegan, lacto ovo-vegetarian and omnivore diet, research suggests that a greater nutritional knowledge is associated with a healthier diet. Aim: The aim of this study is to compare the nutritional knowledge and the nutritional adequacy of vegan, lacto ovo-vegetarian and omnivore diets in a Scottish student population. Method: Healthy students (vegans, n=7; lacto ovo-vegetarians, n=5; omnivores, n=12) aged over 18 years were recruited for this study. The validated General Nutrition Knowledge Questionnaire was used to determine whether there was a difference in nutritional knowledge between the three diets. The NDNS 4-day estimated diet diary was used to assess dietary intakes and diets were analysed using Windiets 2015. Statistical analysis was carried out on IBM SPSS Statistics 23 using a one-way ANOVA test to compare the nutritional knowledge of each diet group and to determine the nutritional adequacy of each diet. A one sample t-test was conducted to compare diet group intakes to the Scottish nutritional guidelines. Results: There was found to be no significant difference in nutritional knowledge between the three diets (p>0.05). The results also suggest that there is no difference in macronutrient intakes between the three diets (p>0.05). Vitamin B12 intake was significantly greater in the vegan group due to supplementation (p<0.05). The omnivore group had the greatest iodine intake but did not meet the recommendation, thus all groups were deficient. All group’s nutrient intakes were significantly different from the Scottish nutritional guidelines (p<0.05) except for free sugar intake in the lacto ovo-vegetarians (p>0.05). Conclusion: There is no difference in nutritional knowledge between vegan, lacto ovo-vegetarian and omnivore diets. There are advantages and disadvantages to following each of the diets in a Scottish student population. Further research would provide a better understanding of the nutritional adequacy of each diet as no studies of this kind have been conducted in a Scottish student population. Vegans and lacto ovo-vegetarians need to be aware of their vitamin B12 and iodine intake to prevent deficiency. All diets required improvement to meet the Scottish nutritional guidelines, future research can assess whether this is true for the general population. Keywords: Vegan, Lacto ovo-vegetarian, Omnivore, Student, Dietary intake, Nutritional knowledge.Item An Investigation into the prevalence of Normal-Weight Obesity Syndrome among Caucasian Adults Residing in Scotland(2018)Introduction: Body mass index (BMI) is the most commonly used parameter to measure nutritional status in adults. Recently, it has been discovered individuals can have a BMI within normal range but excess body fat (BF), this is known as Normal-Weight Obesity Syndrome (NWO). These individuals have a healthy BMI, however, are at risk of the same health risks as those with a BMI in the obese range such as cardiovascular disease and insulin resistance. The prevalence is not well established but can range from 5% to 45%. Hypothesis: NWO does exist in Caucasian adults residing in Scotland at an expected prevalence of approximately 10%. Method: A cross sectional study involving a voluntary sample of Caucasian adults aged 18-75 years old with a normal BMI (18.5-24.9 kg/m2). Basic anthropometric measurements such as weight and height were taken. Body fat percentage (BF%) was measured via bioelectrical impedance analyser (BIA). A 3-day diet diary was self-reported and a non-exercise VO2max questionnaire was answered. NWO was defined as normal BMI with a body fat percentage ≥30% for females and ≥23% for males. Results: Forty-two participants, (eleven males and thirty-six females) participated in the study. The mean age was 24.05 years (±7.03) and a mean BMI of 22.67 kg/m2 (±1.55). The prevalence rate of NWO was 14.29% (n=6). Statistical analysis showed there was a significant difference between BF% and BMI (p=0.009). BF% positively correlated with height (r=-0.983, p<0.001) and weight (r=-0.927, p<0.001); VO2max was inversely correlated with BF%; macronutrient intake correlated negatively with body fat percentage in normal-weight obese participants (p<0.001). Conclusion: This is the first study in the UK examining the relationship between BMI and NWO within the Scottish population. It confirms, alongside previous research that NWO occurs moderately within population. A larger-scale prospective cohort study may give a greater insight into the prevalence of NWO in Scotland and how diet and physical activity levels influence this syndrome. Key Words: Normal-Weight Obesity; bioelectrical impedance; body mass index; body fat percentage; obesity.Item The effectiveness of a newly designed diet programme for children with Autism Spectrum Disorder at Park School, Kilmarnock.(2018)Background: Autistic Spectrum Disorder (ASD) is a developmental condition which causes issues with social interaction, communication and cognitive functions. The severity of these issues can vary across a vast spectrum. Food selectivity and refusal is common among children with ASD and can have whole food groups absent from their diet, therefore increasing their risk of a nutritionally inadequate dietary intake. ASD children may refuse certain foods based on their various characteristics such as smell, colour and/or texture. Often food selectivity and refusal is accompanied by poor mood and heightened anxiety for the child, which may lead to undesirable meal time behaviours. Aim: To investigate the effectiveness of a specifically designed dietary intervention programme and how this has an effect on the individual child’s dietary intake. Design: 3 individual case studies were conducted using a specifically designed dietary intervention programme, uniquely designed for each participant. Dependent on the participant 5 or 6 interventions took place in order to introduce a new healthy food previously missing from their diet. This food was chosen by conducting a Food Frequency Questionnaire (FFQ) in order to identify the absent food group as well as a 24-hour dietary recall that was analysed to identify the nutritional adequacy of each diet. This food was introduced using a positive-reinforcement intervention specifically designed for each participant. Results: Participant 1 showed good progress, with highly increased interaction levels with the food stimuli by the end of intervention 6, as well as having reduced anxiety levels and increased positive mood levels by this time also. Participant 2 showed little progress by the end of intervention 5, they were still refusing the food stimuli and had increased anxiety levels as well as poor mood levels. Participant 3 made some progress, showing some increased interaction with the food stimuli by intervention 5 with their mood and anxiety levels being unaffected by the intervention. Conclusion: Overall, the dietary intervention had some success in improving participant’s interaction with the selected food stimuli offered however none of the participants actually ate the food stimuli offered therefore there was no new food introduced into the participant’s everyday diet. Key Words: ASD, Food Selectivity, Intervention, Nutrition, AutismItem Identification of the prevalence of normal weight obesity in a Caucasian population in Scotland.(2018)Background: Normal-weight obesity is a syndrome with increased cardiometabolic risk factors, greater mortality risk and diminished cardiac function compared to normal-weight lean individuals. It is also associated, similarly to obesity, with low-grade proinflammatory status, increased oxidative stress, insulin resistance, and dyslipidaemia. Aims and Objectives: The aim of this study was to identify the prevalence of normal-weight obesity in a normal-weight Caucasian adult population. The objectives were to compare body fat, energy and nutrient intake and physical fitness between normal-weight obese and normal-weight lean participants. Design and Methods: A cross-sectional study of a normal-weight Caucasian population within Scotland (n = 42, 74% female). Body composition was estimated via bioelectrical impedance analysis, maximal oxygen uptake (VO2MAX) was estimated using a physical activity questionnaire and dietary intake was collected via a 3-day diet diary and assessed using Nutritics. Normal-weight Obesity was defined as normal BMI (18.5 ≤ BMI < 25 kg/m2) and body fat >23% in males and >30% in females. Results: Among normal-weight adults, 14.3% were defined as normal-weight obese (n = 6). No difference was observed between normal-weight obese and normal-weight lean individuals in physical fitness, energy and nutrient intake, however, there was a trend for low VO2MAX in Normal-weight obese females (p = 0.051). Body fat was negatively correlated with physical fitness in females but not in the male population. Those with higher body fat % were shorter, weighed less, consumed less energy, less carbohydrate and less protein (p<0.01). Conclusion: A prevalence of 14.3% normal-weight obesity was found within the study group. Normal-weight Obesity was not significantly associated with physical fitness or dietary intake in males or females (p>0.05). There was a significant negative correlation between physical fitness (VO2MAX) and body fat in female subjects but not males (p<0.05) Higher-powered studies are recommended to conclude the prevalence of Normal-weight Obesity and its association with physical fitness and dietary intake in a broader population. Keywords: Normal-weight Obesity, VO2MAX, Body fat percentage, Body composition, Dietary Intake, Obesity