Nutrition, health and disease: A lifespan approach

Just an update on the state of my book, which was submitted to the publishers at the end of the summer. We are now at the production stage of the process, which means that over the next 2-3 months I will receive proofs of the text and the redrawn figures to approve. Assuming that I can turn those round quickly, we should be seeing the book published in early summer of 2015. I’m pleased that things are moving along smoothly, but there are still a few unknowns in the process. Nobody has told me if there will be any colour in the book (and I have asked a few times). I hope so as some of the new figures were designed with that in mind and even a little blue shading here and there would really enhance the reading experience. And the cover is yet to be discussed. I hope it is more interesting than the strange yellow spirograph affair on the first edition.

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New paper accepted

Our paper entitled, ‘Body composition and behaviour in adult rats are influenced by maternal diet, maternal age and high-fat feeding’ has been accepted for publication in the Journal of Nutritional Sciences. This paper is the first work to be published from the thesis of Samantha Ware, so congratulations to her on getting into print. It is the fifth to arise from our collaboration with Peter Voigt in the Vet School at Nottingham.

The abstract for the paper is below:

Fetal exposure to maternal undernutrition has lifelong consequences for physiological and metabolic function. Maternal low protein diet is associated with an age-related phenotype in rats, characterised by a period of resistance to development of obesity in early adulthood, giving way to an obesity-prone, insulin-resistant state in later adulthood. Offspring of rats fed a control (18% casein; CON) or low protein (9% casein; LP) diet in pregnancy were challenged with a high-fat diet at 9 months of age. To assess whether other maternal factors modulated the programming effects of nutrition, offspring were studied from young (2-4 month old) and older (6-9 month old) mothers. Weight gain with a high-fat diet was attenuated in male offspring of older mothers fed LP (interaction of maternal age and diet P=0.011) and adipose tissue deposition was lower with LP feeding in both males and females (P<0.05). Although the resistance to weight gain and adiposity was partially explained by lower energy intake in offspring of LP mothers (P<0.001 males only), it was apparent that energy expenditure must be influenced by maternal diet and age. Assessment of locomotor activity indicated that energy expenditure associated with physical activity was unlikely to explain resistance to weight gain, but showed that offspring of older mothers were more anxious than those of younger mothers with more rearing observed in a novel environment and on the elevated plus maze. The data showed that in addition to maternal undernutrition, greater maternal age may influence development and long-term body composition in the rat.

Our work in Uganda- maternal and infant nutrition

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Malnutrition in early life severely and irreversibly impacts on the lifetime of its sufferers and their nations alike. It prevents persons from achieving their full potential physically, intellectually and economically, impacting on their productivity and further denying nations the realisation of both human and economic growth and development. There is a growing body of evidence on the importance of investing in tackling and preventing malnutrition as an essential precursor for development. Several developments and initiatives have been made towards meeting food demands and solving hunger and malnutrition in the developing world however, the situation remains dire. Global and regional initiatives like; 1000 Days Partnership, SUN movement and CAADP seek to improve the nutrition status of mothers and children using proven cost effective interventions; and Africa’s economic growth and development through agriculture led development respectively. African countries have designed policies and programs to guide delivery of health, agriculture, food security and nutrition interventions.

Uganda is one of the poorest countries in the world and its people deal with the burdens of poverty, poor health services and a high burden of HIV infection. Maternal mortality is high, with 440 maternal deaths per 100000 live births. Mortality among infants is also high with 135 deaths per 1000 among the under-5s. Malnutrition is a major factor in this high death rate and in spite of government commitments to address food security, the country is off track in terms of meeting Millennium Development Goals.

From WHO http://www.who.int/pmnch/media/membernews/2011/ugandabackgroundpaper.pdf
From WHO http://www.who.int/pmnch/media/membernews/2011/ugandabackgroundpaper.pdf

In Uganda, key policies for improved food security and nutrition status include the Agriculture Development Sector Investment Plan (DSIP) 2010- 2015 and the Uganda Nutrition Action Plan (UNAP) 2011-2016. The UNAP unlike the DSIP explores a multi-sectoral approach bringing together, government departments, local governments, private sector, academia, donors and civil societies to deliver interventions and programs that impact upon nutrition, health, agriculture and development. It is known that policies, programs and interventions should be strategically targeted to incorporate nutrition goals while reducing inequalities, however, little is known about multi-sectoral approaches and their impacts on food and nutrition policy, programming and development.

Objective(s)

Our work in Uganda seeks to explore influences upon delivery and implementation of nutrition, agriculture and health interventions by programs and projects in selected communities in Uganda.

Method 

This work employs qualitative interview methods  to critically assess how food and nutrition policies influence program planning and delivery and further how programs inform policy. Study participants are program implementers, policy actors and community members in Uganda. Study sites are four districts from the Uganda SUN districts where nutrition specific and /or specific interventions are currently being implemented and an additional two districts where none of these interventions are implemented.

This work is driven by PhD student Muniirah Mbabazi, working under by supervision with Judy Swift and Paul Wilson.

From WHO  http://www.who.int/pmnch/media/membernews/2011/ugandabackgroundpaper.pdf

Our work on pregnancy and weight- the MAGIC Study

Managing weight in pregnancy (MAGIC) is a longitudinal study which has been running since 2012 (investigators Judy Swift, Preeti Jethwa, Moira Taylor, Simon Langley-Evans, Jo Pearce, Amanda Avery and Sarah McMullen). The aim of MAGIC was to recruit women from antenatal clinics at Queens Medical Centre in Nottingham, with collection of baseline data at 12 or 20 months gestation. Follow-up data was collected at 32 weeks gestation, 2 weeks postpartum, 6 months postpartum and 12 months postpartum. The overall objective for the project is to examine the determinants of weight retention in the first year postpartum and we are factoring in initial weight, physical activity, dietary pattern, infant feeding choices, behavioural, emotional, socioeconomic and demographic characteristics as elements of a model to address this objective.

MAGIC is now in the analytical phase and we expect to be publishing data in the near future. The work has been supported by the University of Nottingham, National Childbirth Trust (summer studentship) and the Revere Charitable Trust (PhD student stipend for Sarah Ellis).