Issue 117 food for thought

NEWS

FOOD FOR THOUGHT

Dr Emma Derbyshire PhD RNutr (Public Health) Nutritional Insight Ltd Emma is a freelance nutritionist and former senior academic. Her interests include pregnancy and public health. www.nutritionalinsight.co.uk hello@nutritionalinsight.co.uk

If you have important news or research updates to share with NHD, or would like to send a letter to the Editor, please email us at info@network healthgroup.co.uk.

We would love to hear from you.

6

Brexit - are RCTs the way to go?

Two new papers have been published questioning whether we need more randomised controlled trials (RCTs) within the field of nutrition. At present the number of epidemiological studies heavily outweighs the number of RCTs. One pool of thought is that RCTs often recruit subjects with a history of disease (or an increased disease risk) and have relatively short periods of follow-up. Cohort studies, on the other hand, typically recruit healthy subjects at baseline and have longer periods of follow-up, usually 10 to 15 years. These differences may account for some of the discrepancies we see between the different types of study.

The other pool of thought is that RCTs play a valuable role in helping to identifying ‘non-significant’ findings. Whilst some may think that the outlook of this is rather grim, it is in fact a good thing. Lack of findings can actually help in refuting epidemiological associations that may have been hampered by confounders.

So, which way to go? Personally, I’d say that we need more RCTs that are adequately designed and fall in line with CONSORT (Consolidated Standards of Reporting Trials) guidelines. That way, outcomes can be compared fairly between studies and firmer conclusions drawn.

Also, given the recent Brexit choice, the question is whether collaborative cohorts with European colleagues will still go ahead. Funding sources were challenging enough and certainly won’t become any easier. So, from that viewpoint, perhaps specific well-designed RCTs may be the way to go for now.

For more information, see: Loannidis JPA et al (2016); American Journal of Clinical Nutrition Vol 103, no 6; pg 1385-86 and Temple NJ (2016); British Journal of Nutrition Vol 116, no3; pg 381-89.

CRANBERRY JUICE FOR UTIs? It is often thought that cranberry juice is great for urinary tract infections (UTIs). That said, the evidence for this has never really been substantiated.

Now, a new randomised controlled trial has tested to see if the science really exists.

Women with a history of UTIs (mean age 41 years) were randomly allocated to drink 240ml cranberry juice (n=185), or a placebo

www.NHDmag.com August / September 2016 - Issue 117

(n=188) over a period of 24-weeks. The number of UTI episodes was reported throughout. Study compliance was good and the number of UTI episodes was significantly reduced from 67 to 39 (by nearly half) in the cranberry juice compared with the placebo group.

Overall, these results show that long-term daily consumption (about one glass per day) of cranberry juice may help to reduce the risk of UTIs in women with a history of this condition.

For more information, see: Maki KC et al (2016);

American Journal of Clinical Nutrition Vol 103, no 6; pg 1434-42.

NEWS THE NEED TO ASSESS WATER INTAKES SEPARATELY Water has long been merged in with ‘fluids’ when looking at data from dietary surveys. That said, given the health benefits of drinking water, this ideally needs to be analysed and categorised separately. New work has looked into how water intakes are currently assessed in Europe.

A survey of 10 European countries looking at methods used to assess water intakes found great variability in methods. These ranged from 24-hour recalls, to estimated food diaries and food frequency questionnaires. None of these methods had been validated to specifically assess water and fluid intakes.

These findings highlight the need to devise uniform and validated methods used to assess water and fluid intakes. This would help to aid comparisons made between countries and support future recommendations.

For more information, see: Gandy J et al (2016); British Journal of Nutrition [Epub ahead of print].

MICRONUTRIENT INTAKES IN THE VERY OLD We are an aging population, but past nutrition research hasn’t tended to go beyond the 60 to 65 year age mark. The good news is that researchers from the University of Newcastle have now done this, providing nutrition intake data for the ‘very old’.

Nutrient intakes of 75-year-olds living in the North-East of England taking part in the Newcastle 85+ Study were measured using 24hour recalls. Median vitamin D intakes were 2.0µg, calcium 731mg, magnesium 215mg, iron 8.7mg and selenium 39µg per day indicating shortfalls. Of most concern was that 95% of the population had vitamin D intakes below the UKs Reference Nutrient Intake of 10µg per day.

These are important and much needed findings, emphasising the need for more research in this age group. Further research of this nature is also needed to support the formulation of agespecific dietary recommendations required for this growing age group.

For more information, see: Mendonca N et al (2016); British Journal of Nutrition [Epub ahead of print].

PRODUCT / INDUSTRY NEWS

GLUTEN-FREE BREADS FROM GENERAL DIETARY

These breads are light, soft and can be eaten straight from the pack. The coeliac’s choice since 1983.

Free from wheat, gluten, milk, eggs, soya, maize and nuts. They also contain vitamins and minerals including calcium and folic acid.

Suitable for vegetarians, vegans and kosher diets. www.generaldietary.com

To book your Company’s product news for the next issue of NHD Magazine call 0845 450 2125 WHAT AGE TO WEAN? While most parents begin weaning their infants at six months, there has been a trend towards early weaning, with the introduction of solids at four months. New research has now looked at how this could affect children’s later eating habits.

Research using data from the Southampton Women’s Survey, looked at what age food was introduced compared with feeding difficulties when the children were three years of age, in 2,389 mother-child pairs. Factors such as breastfeeding, the mother’s BMI, age, education and employment were all accounted for.

Sixty-one percent of mothers/carers had some form of feeding difficulties when their child was aged three years, with children being choosy most common (74%). Children who were given solid foods at six months of age or later were significantly less likely to have feeding problems compared with those given solids at four to six months.

While other studies are needed to reconfirm these results, it seems that holding off from the temptation of early feeding may help children to eat better later on. Next we need to find out why this may be.

For more information: www.mrc.soton.ac.uk/sws/

www.NHDmag.com August / September 2016 - Issue 117

7