1,721,109 research outputs found
Birth size, blood pressure and glucose tolerance in twins : testing the fetal origins hypothesis
No full textThe aim of this study was to explore two main hypotheses. Firstly, that the greater similarity in glucose tolerance and blood pressure in monozygotic twins compared with dizygotic twins is due to their more similar prenatal environment. Secondly, that within pair differences in glucose tolerance and blood pressure would be determined by differences in size at birth. A longitudinal study of births in the city of Birmingham from 1950 onwards provided the sampling frame for the study and allowed a population-based sample of twins to be studied. Twins born between 1950 and 1954 were identified and followed up. They were visited at home where their blood pressure was measured. They were then invited to attend a clinic for an oral glucose tolerance test.Adult levels of glucose tolerance and blood pressure were more highly correlated in the monozygotic than dizygotic twins. These trends were not explained by size at birth. Examination of within pair differences in glucose tolerance revealed significant associations between size at birth and insulin resistance in the monozygotic twins. However, inconsistencies in these trends and the fact that they were based on small numbers of twin pairs weakened these findings. Furthermore, the well documented inverse associations between birth size and adult glucose tolerance and blood pressure in singleton populations were absent in the twins.The findings of this study were not consistent with the fetal origins hypothesis. The association of within pair differences in birth size and insulin resistance in monozygotic twins does, however, suggest an effect of birth size that is independent of genetic factors.</p
Dietary inequalities: what is the evidence for the effect of the neighbourhood food environment?
No full textThis review summarises the evidence for inequalities in community and consumer nutrition environments from ten previous review articles, and also assesses the evidence for the effect of the community and consumer nutrition environments on dietary intake. There is evidence for inequalities in food access in the US but trends are less apparent in other developed countries. There is a trend for greater access and availability to healthy and less healthy foods relating to better and poorer dietary outcomes respectively. Trends for price show that higher prices of healthy foods are associated with better dietary outcomes. More nuanced measures of the food environment, including multidimensional and individualised approaches, would enhance the state of the evidence and help inform future interventions
The challenges of putting systems thinking into practice: In theory, ‘systems thinking’ offers a remarkably attractive solution to the persistent challenges of preventive public health. Haynes and colleagues’ recent analysis of the Prevention Centre in Australia offers reason for optimism that it might be possible to translate this promise into action on the ground. In this commentary, we critically assess the claims from this promising case study and their broader applicability to the cause of preventive health. We argue that, in many other contexts, persistent obstacles remain, such as a lack of buy-in from senior policy actors, and a lack of tangible or concrete action following through on an abstract commitment to systems thinking.
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Engagement with the National Healthy Schools Programme is associated with higher fruit and vegetable consumption in primary school children
No full textBackground:? Improving children’s diets is currently a government focus. However, fruit and vegetable consumption, a key target, is still far below the government guidelines of five portions per day. The present study aimed to assess the impact of engagement with the National Healthy Schools Programme (NHSP) on fruit and vegetable consumption in a sample of primary school children.Methods:? A sample of 511 children, aged 7–9 years, who were attending 10 randomly selected schools in Hampshire, completed the Day in the Life Questionnaire, a validated 24-h recall method of dietary assessment. Fruit and vegetable intake in pupils attending schools engaged with the NHSP was compared with that of pupils attending schools not engaged with the programme.Results:? Children attending schools engaged with the NHSP ate a median of two (interquartile range, 0–8.0) portions of fruit and vegetables, compared to one portion (interquartile range, 0–8.0) consumed by pupils attending a school not engaged with the programme (P = 0.001). Gender was also a significant predictor of fruit and vegetable consumption, with girls being 1.68 times more likely to consume 2.5 or more portions of fruit and vegetables. After adjustment for free school meal eligibility (as a measure of socio-economic status) and gender, pupils attending schools engaged with NHSP were twice as likely to eat 2.5 portions of fruit and vegetables or more per day.Conclusions:? Engagement with the NHSP may be an effective way of increasing fruit and vegetable consumption in primary school children. Further evaluation of the programme is recommended to determine which aspects of the NHSP are successful in achieving this
What quantitative and qualitative methods have been developed to measure the implementation of a life-course approach in public health policies at the national level?
No full textA life-course approach to health and well-being has become a pillar in health policy-making; for example, Member States of the WHO European Region in the 2015 Minsk Declaration resolved to make greater use of a life-course approach in health policies. However, strategies for implementation of a life-course approach, and a plan for monitoring and evaluating this implementation, are lacking. This scoping review identified a lack of literature with a focus on measurement of the implementation of a life-course approach. The report provides suggestions from research on a life-course approach in public health interventions and national-level strategies that could aid policy-makers in developing a measurement framework. For example, Member States using a life-course approach in policy at a population level could report on existing interventions in key stages of the life-course using existing survey platforms and routinely collected quantitative data. Ideally, a monitoring and evaluation framework collecting data longitudinally across different life stages over time should be created for Member States
Early life nutrition and lifelong health
No full textThis report was commissioned after an ARM debate in June 2007 that called on the BMA's Board of Science to recognise and promote the importance of fetal and early life nutrition and its relationship to lifelong health. The Board of Science has previously produced three reports that broadly cover childhood nutrition and exercise. Growing up in Britain: ensuring a healthy future for our children (1999), discusses child health, with a focus on nutrition rather than exercise, from conception to the age of five. Adolescent health (2003) reviews nutrition, exercise and obesity in teenagers (13-19 year olds). It serves in part to develop the 1999 report in order to cover children up to the age of 12 years. It highlights the main aspects of childhood nutrition and exercise, draws attention to the role of the clinician, and provides links to sources of further information. It also makes recommendations for tackling the obesity epidemic in the UK. Preventing childhood obesity (2005) highlights the situation with regard to childhood obesity and the impact this can have on children's current and future health. It highlights the role of healthcare professionals and the environmental barriers to change that need to be overcome or removed.This report concerns early life nutrition, predominantly fetal and infant nutrition, providing useful reference information and 'key messages' for healthcare professionals. It discusses the evidence-base and draws conclusions about the ways in which the patterns of early life nutrition can be improved, and the likely consequences of such improvements. This is now of critical importance in addressing the rapid increase in the incidence of so-called lifestyle diseases such as cardiovascular disease, and type 2 diabetes, which are linked to overweight and obesity. In addition there is now compelling evidence for a role of early life nutrition in setting the risk of other conditions including osteoporosis, asthma, lung disease and some forms of cancer. [1] Evidence is growing that early life nutrition can play a role in behavioural and cognitive problems in children and adolescents, and possibly even in cognitive decline and other aspects of ageing.This report from the BMA Board of Science is intended to be a useful point of reference for a wide audience, including health professionals, policy makers and members of the public. The approach of the BMA Board of Science is to provide a clear synthesis of the available research, and to develop evidence-based conclusions and recommendations for policy.<br/
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