Alyson Hill

Vitamin C (Ascorbic acid) has many important roles in maintaining health and preventing disease. As a water-soluble vitamin, it cannot be synthesized endogenously or stored, therefore must be obtained regularly in sufficient amounts from the diet. The present study examined vitamin C intakes and contributors in a United Kingdom population and used dietary modelling to examine the impact of adding or replacing fruit juice (FJ) on vitamin C intakes in participants within the United Kingdom National Diet and Nutrition survey (NDNS 2016–2019; n = 3,558). Results indicated that 40% of this population consumed FJ which contributed to 25% of vitamin C intakes across all ages. Vitamin C from foods and drinks typically exceeded Reference Nutrient Intakes (RNI) (30–40 mg/day), although <10% of the population fell below the Estimated Average Requirement (EAR) and <2% were below lower RNI (LRNI). Theoretical modelling showed that increasing numbers of FJ consumers would increase mean intakes of vitamin C. However, a greater effect on the proportion meeting Dietary Reference Values (DRVs) for vitamin C was observed by broadening FJ consumption rather than by increasing the amounts consumed by existing consumers. This also had a minimal impact on free sugar intakes. Therefore encouraging more people to include a one daily 150 mL serving of FJ in their diet (as opposed to suggesting increased intake within current consumers), would positively impact on vitamin C intakes within the United Kingdom population, whilst also helping to achieve the national “5-a-day” recommendation via a convenient, accessible dietary choice.

Vitamin C intakes and key contributors in the UK population: preliminary results from the NDNS years 9 -11 Authors: Emily Royle1 , Alyson Hill1 , | POSTER

Background: Gaining excessive weight during pregnancy has been linked with adverse effects including increased risk of caesarean delivery and postpartum weight retention. Despite these recognised risks, currently no UK/Ireland gestational weight gain (GWG) guidelines exist, women are not routinely weighed throughout pregnancy and consequently, women’s understanding of the importance of weight management during, and post-pregnancy remains poor. The present study explored factors influencing weight change during and post-pregnancy and identified potential opportunities that could help women manage weight during these periods. Methods: Women aged 18–45 years-old who had an uncomplicated pregnancy within the last 3 years were invited to complete an online questionnaire (n = 108) regarding their experience of changes in body weight during and post-pregnancy. Follow on focus groups (n = 13 women) were conducted online within the same population to delve deeper into the topic, the sessions were recorded, transcribed verbatim and data subjected to directive content analysis based on the socio-ecological model. Results: Respondents reported in the online questionnaire, they did not receive enough information around weight management during (81.5%) and post-pregnancy (86.1%). Focus group qualitative data identified barriers to managing weight at each level of the ecological model, at the intrapersonal (e.g., changes in diet), interpersonal (e.g., conflicting advice), environment and society (e.g., COVID-19 pandemic), and institutional and policy (e.g., system failing) levels. Potential strategies to help manage weight were also identified, at the intrapersonal (e.g., need for further information), interpersonal (e.g., support groups), environment and society (e.g., messaging), and institutional and policy (e.g., further follow-up care) levels. Conclusions: Mothers report receiving insufficient information around weight management, with barriers identified at each level of the ecological model. Highlighting that support and change is needed on multiple levels both during and post-pregnancy, with potential strategies identified, which could potentially inform future studies.

This review aims to identify and report epidemiological associations between modifiable lifestyle risk factors for overweight or obesity in children and adolescents with type 1 diabetes (T1D). A systematic literature search of medical databases from 1990 to 2023 was undertaken. Inclusion criteria were observational studies reporting on associations between dietary factors, disordered eating, physical activity, sedentary and sleep behaviours and measures of adiposity in children and adolescents (<18 years) with T1D. Thirty-seven studies met inclusion criteria. Studies were mostly cross-sectional (89 %), and 13 studies included adolescents up to 19 years which were included in this analysis. In adolescents with T1D, higher adiposity was positively associated with disordered eating behaviours (DEB) and a higher than recommended total fat and lower carbohydrate intake. A small amount of evidence suggested a positive association with skipping meals, and negative associations with diet quality and sleep stage. There were no published associations between overweight and physical activity, sedentary behaviours and eating disorders. Overall, the findings infer relationships between DEB, fat and carbohydrate intake and adiposity outcomes in people with T1D. Prospective studies are needed to determine causal relationships and to investigate sleep stages. High quality studies objectively measuring physical activity and include body composition outcomes are needed.

This 6-month randomized clinical trial evaluated the effectiveness and safety of time-restricted eating (TRE) compared to daily calorie restriction (CR) in individuals with type 2 diabetes mellitus (T2DM) and obesity. The study involved 75 participants and measured changes in body weight, haemoglobin A1c (HbA1c) levels, and metabolic risk factors. Participants were randomized to 1 of 3 different groups: (1) TRE (eating from 12 to 8pm, without calorie counting), (2) CR (25% energy restriction daily), (3) control. Results showed that the TRE group experienced statistically significant weight loss and reductions in HbA1c levels compared to the control group. However, the CR group did not show significant weight loss. No serious adverse events were reported. The study suggests that TRE could be an effective strategy for weight loss and glycaemic control in individuals with T2D, but further research with larger sample sizes and longer follow-up periods is needed to confirm these findings.

Introduction: Recent studies suggested that sarcopenia may be a significant comorbidity of diabetes mellitus (DM). Nonetheless, studies with nationally representative data are scarce, and the changing trend of sarcopenia prevalence over time is largely unknown. Therefore, we aimed to estimate and compare the prevalence of sarcopenia in diabetic and nondiabetic US older population, and to explore the potential predictors of sarcopenia as well as the trend of sarcopenia prevalent in the past decades. Methods: Data were retrieved from the National Health and Nutrition Examination Survey (NHANES). Sarcopenia and DM were defined according to corresponding diagnosis criteria. Weighted prevalence was calculated and compared between diabetic and nondiabetic participants. The differences among age and ethnicity groups were explored. Results: A total of 6,381 US adults (>50 years) were involved. The overall prevalence of sarcopenia was 17.8% for US elders, and the prevalence was higher (27.9% vs. 15.7%) in those with diabetes ones than those without. Stepwise regression revealed that sarcopenia was significantly associated with DM (adjusted odds ratio = 1.37, 95% CI: 1.08-1.22; p < 0.05) after controlling for potential confounders including gender, age, ethnicity, educational level, BMI, and muscle strengthening activity. A slight fluctuation but overall increasing trend of sarcopenia prevalence was observed among diabetic elders, while no obvious changing trend was observed in their counterparts in recent decades.

Background: Adolescence is recognised as a period of nutritional vulnerability, with evidence indicating that United Kingdom adolescents have suboptimal dietary intakes with many failing to meet dietary recommendations. Additionally, adolescence is a time of transition when they become more independent in their dietary choices and begin to develop their own sense of autonomy and are less reliant on their parent’s guidance, which is reported to lead to less favourable dietary behaviours. Reducing the prevalence of poor dietary intakes and the associated negative health consequences among this population is a public health priority and schools represent an important setting to promote positive dietary behaviours. The aim of this school-based study was to explore the factors and barriers which influence food choices within the school canteen and to identify feasible strategies to promote positive dietary behaviours within this setting.Methods: Thirteen focus groups with 86 pupils in Year 8 (n = 37; aged 11–12 years) and Year 9 (n = 49; aged 12–13 years) in six secondary schools across Northern Ireland, United Kingdom were conducted. Additionally, one-to-one virtual interviews were conducted with 29 school staff [principals/vice-principals (n = 4); teachers (n = 17); and caterers (n = 7)] across 17 secondary schools and an Education Authority (EA) senior staff member (n = 1). Focus groups and interviews were audio-recorded, transcribed, and analysed following an inductive thematic approach.Results: Using the ecological framework, multiple factors were identified which influenced pupils’ selection of food in the school canteen at the individual (e.g., time/convenience), social (e.g., peer influence), physical (e.g., food/beverage placement), and macro environment (e.g., food provision) level. Suggestions for improvement of food choices were also identified at each ecological level: individual (e.g., rewards), social (e.g., pupil-led initiatives), physical (e.g., labelling), and macro environment (e.g., whole-school approaches).Conclusion: Low-cost and non-labour intensive practical strategies could be employed, including menu and labelling strategies, placement of foods, reviewing pricing policies and whole-school initiatives in developing future dietary interventions to positively enhance adolescents’ food choices in secondary schools.

The number of new cases of cancer is increasing each year, and rates of diabetes mellitus are also increasing dramatically over time. It is not an unusual occurrence for an individual to have both cancer and diabetes at the same time, given they are both individually common, and that one condition can increase the risk of the other. In this manuscript, we use national-level diabetes (Virtual Diabetes Register) and cancer (New Zealand Cancer Registry) data on nearly five million individuals over 44 million person-years of follow-up to examine the occurrence of cancer amongst a national prevalent cohort of patients with diabetes. We completed this analysis separately by cancer for the 24 most commonly diagnosed cancers in Aotearoa New Zealand, and then compared the occurrence of cancer among those with diabetes to those without diabetes. We found that the rate of cancer was highest amongst those with diabetes for 21 of the 24 most common cancers diagnosed over our study period, with excess risk among those with diabetes ranging between 11% (non-Hodgkin's lymphoma) and 236% (liver cancer). The cancers with the greatest difference in incidence between those with diabetes and those without diabetes tended to be within the endocrine or gastrointestinal system, and/or had a strong relationship with obesity. However, in an absolute sense, due to the volume of breast, colorectal and lung cancers, prevention of the more modest excess cancer risk among those with diabetes (16%, 22% and 48%, respectively) would lead to a substantial overall reduction in the total burden of cancer in the population. Our findings reinforce the fact that diabetes prevention activities are also cancer prevention activities, and must therefore be prioritised and resourced in tandem.

The number of new cases of cancer is increasing each year, and rates of diabetes mellitus are also increasing dramatically over time. It is not an unusual occurrence for an individual to have both cancer and diabetes at the same time, given they are both individually common, and that one condition can increase the risk of the other. In this manuscript, we use national-level diabetes (Virtual Diabetes Register) and cancer (New Zealand Cancer Registry) data on nearly five million individuals over 44 million person-years of follow-up to examine the occurrence of cancer amongst a national prevalent cohort of patients with diabetes. We completed this analysis separately by cancer for the 24 most commonly diagnosed cancers in Aotearoa New Zealand, and then compared the occurrence of cancer among those with diabetes to those without diabetes. We found that the rate of cancer was highest amongst those with diabetes for 21 of the 24 most common cancers diagnosed over our study period, with excess risk among those with diabetes ranging between 11% (non-Hodgkin's lymphoma) and 236% (liver cancer). The cancers with the greatest difference in incidence between those with diabetes and those without diabetes tended to be within the endocrine or gastrointestinal system, and/or had a strong relationship with obesity. However, in an absolute sense, due to the volume of breast, colorectal and lung cancers, prevention of the more modest excess cancer risk among those with diabetes (16%, 22% and 48%, respectively) would lead to a substantial overall reduction in the total burden of cancer in the population. Our findings reinforce the fact that diabetes prevention activities are also cancer prevention activities, and must therefore be prioritised and resourced in tandem.