New paper on antenatal diet, activity and weight accepted

Our paper entitled ‘Antenatal weight management: Diet, physical activity, and gestational weight gain in early pregnancy’ has been accepted for publication in Midwifery. The study authors are Judy A Swift; Simon Langley-Evans; Jo Pearce; Preeti H Jethwa; Moira A Taylor; Amanda Avery; Sarah Ellis; Sarah McMullen; Kirsty J Elliot-Sale.

The abstract of the study is below.

Objective: to investigate women’s physical activity levels, diet and gestational weight gain, and their experiences and motivations of behavior change.

Design: analysis of cross-sectional data collected during a longitudinal study examining physiological, psychological, sociodemographic, and self-reported behavioural measures relating to bodyweight.

Setting: women recruited from routine antenatal clinics at the Nottingham University Hospitals NHS Trust.

Participants:  193 women £27 weeks gestation and aged 18 years or over.

Measurements & findings: measurements included weight and height, the Dietary Instrument for Nutrition Education (Brief Version), the International Physical Activity Questionnaire (Short Form), and open questions of perceptions of behaviour change. 50.3% (n=97) were overweight/obese and women gained 0.26kg/wk (IQR 0.34 kg/wk) since conception. The majority consumed low levels of fat (n=121; 63.4%), high levels of unsaturated fat (n=103; 53.9%), and used a dietary supplement (n=166; 86.5%). However, 41% (n=76) were inactive, 74.8% (n=143) did not consume high levels of fibre, and 90.0% (n=171) consumed less than 5 portions of fruit and vegetables a day. Body mass index category was not associated with diet, physical activity levels, or gestational weight gain. Themes generated from open-questions were: (1) Risk management, (2) Coping with symptoms, (3) Self-control, (4) Deviation from norm, (5) Nature knows best.

Conclusions: early pregnancy is a period of significant and heterogeneous behaviour change, influenced by perceptions of risk and women’s lived experience. Behaviour was influenced not only by perceptions of immediate risk to the foetus, but also by the women’s lived experience of being pregnant.

Implications for practice: health promotion advice relating to physical activity and diet could be reframed in light of women’s priorities. The need for individualized advice is highlighted and women across all body mass index categories would benefit from improved diet and physical activity levels.

Paper accepted by British Journal of Nutrition

The British Journal of Nutrition has accepted our paper entitled ‘Fetal and neonatal exposure to trans fatty acids impacts on susceptibility to atherosclerosis in apolipoprotein E*3 Leiden mice‘, for publication. The study authors are Louise Gates, Simon Langley-Evans, Jana Kraft, Adam Lock and Andy Salter.  The work was funded by the United States Department of Agriculture as a collaboration between the universities of Michigan, Vermont and Nottingham, and was an element of Louise Gates PhD studies.

The abstract of the paper is below:

Nutrition during pregnancy impacts on the susceptibility of the offspring to a range of chronic diseases, including cardiovascular disease. Postnatal consumption of trans fatty acids (TFA), associated with partially hydrogenated vegetable oil (P-TFA), has been linked to increased risk of atherosclerosis, while evidence for those trans fatty acids associated with ruminant-derived dairy and meat (R-TFA) remain equivocal.  Here, we investigate the impact of maternal consumption of dietary P-TFA and R-TFA on the development of atherosclerosis in their offspring, using the transgenic apoE*3 Leiden mouse.  Dams were fed either chow or one of three high fat diets: a high-fat diet designed to reflect the saturated fatty acid content of a ‘Western’ diet, one enriched with P-TFA or one enriched with R-TFA.  Diets were fed during either pregnancy alone or pregnancy and lactation.  Weaned offspring were then transferred to an atherogenic diet for twelve weeks.  Atherosclerosis was assessed as lipid staining in cross-sections of the aorta.  Compared to those born of chow-fed dams, mice from those fed R-TFA or P-TFA during pregnancy alone were protected from aortic atherosclerosis (p=0.011 and 0.017, respectively). This was not associated with changes in total or lipoprotein cholesterol.  Continuing to feed TFA during lactation increased atherosclerosis compared to that seen in offspring of dams fed TFA only during pregnancy (p= 0.024 and 0.028 for an interaction between diet and section number for P-TFA and R-TFA, respectively).  We conclude that dietary TFA have differing effects on cardiovascular risk at different stages of the lifecycle.

Weight loss paper gets media attention


Our paper on setting weight loss targets and actual achieved weight loss in the Slimming World cohort has had considerable media coverage today, with articles published in the Independent, the Times, Sun, Mirror and Daily Mail.

The message of the paper was that setting targets that were beyond what is normally considered practicable appears to increase the ability of individuals to achieve the clinically desirable 5-10% weight loss.



Getting attention

My review in the Journal of Human Nutrition and Dietetics entitled, Nutrition in early life and the programming of adult disease: a review has been receiving a lot of attention apparently. Not only was it the most downloaded paper in the journal in 2015 and second most downloaded in 2016, it is listed by InCites Essential Science Indicators as a Highly Cited Paper. That’s good news on a slow day.

As of July/August 2016, this highly cited paper received enough citations to place it in the top 1% of the academic field of Clinical Medicine based on a highly cited threshold for the field and publication year.

First MAGIC paper accepted


MAGIC is our longitudinal study of antenatal weight and postpartum weight retention which recruited in Nottingham. A number of outputs are due to come out of the study, but the first has now been accepted for publication in the Journal of Pregnancy.

The paper is entitled ‘Antenatal weight management: women’s experiences, behaviours, and expectations of weighing in early pregnancy’ and the authors were, Judy Swift, Jo Pearce, Preeti Jethwa, Moira Taylor, Amanda Avery, Sarah Ellis, Simon Langley-Evans and Sarah McMullen. The work was part-funded by a donation from the Revere Charitable Trust.

The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative affect associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy) sought to examine women’s self-reported experiences of usual-care antenatal weight management in early pregnancy, and consider these alongside weight monitoring behaviours and future expectations. 193 women (18yrs+) were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10-27 weeks, with 41.5% (n=80) between 12-14 and 43.0% (n=83) between 20-22 weeks. At recruitment 50.3% of participants (n=97) could be classified as overweight or obese. 69.4% of highest weight women (≥30kg/m2) did not report receiving advice about weight, although they were significantly more likely to compared to women with BMI<30kg/m2. The majority of women (regardless of BMI) did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue.

Paper accepted for publication


Our paper entitled ‘Impact of gonadectomy on blood pressure regulation in ageing male and female rats’, has been accepted by Biology of Sex Differences (IF 3.23). The full author list is Wioletta Pijacka, Bethan Clifford, Dawid Walas, Chantal Tilburgs, Jaap A. Joles, Sarah McMullen and Simon C. Langley-Evans

This work was funded by the British Heart Foundation through a grant to Sarah McMullen and myself and is the product of a collaboration with Jaap in the Netherlands. The data give strong support to the hypothesis that testosterone has a major negative impact upon the health of males as they age.

Sexual dimorphism in blood pressure has been associated with differential expression of the angiotensin II (AII) receptors and with activity of the nervous system. It is generally accepted that aging affects kidney function as well as autonomic nervous system and hormonal balance. Given that hypertension is more prevalent in men than women until women reach their seventh decade we hypothesised that females would be relatively protected from adverse effects of ageing compared to males, and that this would be mediated by the protective effect of ovarian steroids. Intact and gonadectomised male and female normotensive Wistar rats aged 6, 12 and 18 months were used to study renal function, blood pressure, heart rate and blood pressure variability. We observed that intact females had lower levels of proteinuria and higher (12.5%) creatinine clearance compared to intact males, and that this difference was abolished by castration but not by ovariectomy. Ovariectomy resulted in a change by 9% in heart rate, resulting in similar cardiovascular parameters to those observed in males or gonadectomised males. Spectral analysis of systolic blood pressure revealed that high frequency power spectra were significantly elevated in the females vs. males and were reduced by ovariectomy. Taken altogether the results show that females are protected from age-related declining renal function and to a lesser extent from rising blood pressure in comparison to males. Whilst ovariectomy had some deleterious effects in females, the strongest effects were associated with gonadectomy in males, suggesting a damaging effect of male hormones.

Elephant nutrition- a new PhD project


Elephants at Knowsley Safari Park

In a few weeks time we will be joined by new PhD student Fiona Sach, who is funded through a NERC Envision Doctoral Training Programme, the Hermes Trust and Royal Society International Exchange scheme. Her project is supervised through Lisa Yon in the Vet School at Nottingham, Martin Broadley and myself in the School of Biosciences and is linked to the British Geological Survey with Michael Watts and Melanie Leng. Fiona will be focusing on mineral nutrition in captive and wild elephants.

Fiona has posted her own blog about the project here.