New paper available online

Our new paper on infant malnutrition in Botswana is now available online. The paper examines levels of stunting, wasting and underweight in infants aged 6-24 months recruited in four regions of the country. Participants were grouped according to HIV status of the mothers, giving a population of infants not exposed to HIV and infants who were not themselves HIV infected, but whose mothers were HIV positive. We found that HIV-exposed infants were more likely to be underweight and stunted and that these children were also predominantly formula fed. Factors relating to the environment before birth also had a clear impact upon risk of malnutrition.

 

Birthweight, HIV exposure and infant feeding as predictors of malnutrition in Botswanan infants

Chalashika et al., JHND Early View

Background

A better understanding of the nutritional status of infants who are HIV-Exposed-Uninfected (HEU) and HIV-Unexposed-Uninfected (HUU) during their first 1000 days is key to improving population health, particularly in sub-Saharan Africa.

Methods

A cross-sectional study compared the nutritional status, feeding practices and determinants of nutritional status of HEU and HUU infants residing in representative selected districts in Botswana during their first 1000 days of life. Four hundred and thirteen infants (37.3% HIV-exposed), aged 6–24 months, attending routine child health clinics, were recruited. Anthropometric, 24-h dietary intake and socio-demographic data was collected. Anthropometric Z-scores were calculated using 2006 World Health Organization growth standards. Modelling of the determinants of malnutrition was undertaken using logistic regression.

Results

Overall, the prevalences of stunting, wasting and being underweight were 10.4%, 11.9% and 10.2%, respectively. HEU infants were more likely to be underweight (15.6% versus 6.9%), (P < 0.01) and stunted (15.6% versus 7.3%), (P < 0.05) but not wasted (P = 0.14) than HUU infants. HEU infants tended to be formula fed (82.5%), whereas HUU infants tended to breastfeed (94%) for the first 6 months (P < 0.001). Significant predictors of nutritional status were HIV exposure, birthweight, birth length, APGAR (appearance, pulse, grimace, activity and respiration) score and mother/caregiver’s education with little influence of socio-economic status.

Conclusions

HEU infants aged 6–24 months had worse nutritional status compared to HUU infants. Low birthweight was the main predictor of undernutrition in this population. Optimisation of infant nutritional status should focus on improving birthweight. In addition, specific interventions should target HEU infants aiming to eliminate growth disparity between HEU and HUU infants.

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Paper accepted for publication

 

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PhD student Paphani Chalashika has had his first paper accepted! His manuscript entitled ‘Birthweight, HIV exposure and infant feeding as predictors of malnutrition in Botswanan infants’ (coauthors Chris Essex, Duane Mellor, Judy Swift and Simon Langley-Evans), will be published in the Journal of Human Nutrition and Dietetics.

 

Double PhD success!

The awful process of being the PhD supervisor left out of the loop during a PhD viva is something that I have blogged about before. The waiting and the tension are unbearable. Well, I have done it twice in one week as both Muniirah Mbabazi and Bashair Al-Riyami have been defending their theses. Both have been successful and have will get their doctorates confirmed, subject to thesis corrections being completed. Congratulations to both of them!

In Bashair’s case, this literally is a double PhD success as she already has a doctorate from her home country. I don’t suppose she will call herself Dr Dr Al-Riyami, but she could well claim that distinction.

Research ethics and integrity- my strange experience

I’ve been involved in research and publishing since 1987 and during that time I have had the usual run of tricky experiences with coauthors. You know the sort of thing, collaborations that break down so that the data never gets properly written up, authors who can’t agree with the direction a paper should take, and authors who never reply to communications about a manuscript while it is being drafted. Luckily though, I have never been in a position where coauthors have engaged in anything that I have felt uncomfortable about from an ethical point of view.

Then this week, out of the blue I received an email from a top international journal asking me to confirm that I was a coauthor on a paper submitted by an investigator who I had never even heard of, let alone collaborated with. Looking at the author list there was a whole group of eminent people from my field, none of whom really looked like they would be associated with the subject matter in the paper. Very strange.

I contacted the journal to deny all knowledge of the submission and raising it as an issue of great concern. I was very grateful to receive their excellent response, showing that they shared my view that this was a serious breach of research ethics.

Thank you for your note regarding …  submission … .   In fact, you
were not alone in being inappropriately added to the authorship list —
6 of the 15 listed authors denied authorship within hours of the
submission.  I want to assure you that the journal shares your point of
view that this is a clear breach of ethics and constitutes unacceptable
authorship practices.  Of course, the journal will not consider this
manuscript in any form further, and I have expressly notified the
submitting author that we considering this an ethical violation.
If this should happen again, you may wish to contact the submittingauthor’s institutional office of research integrity.
This left me with the errant author to deal with. I was curious to discover why he felt it appropriate to take my name in vain.
Please could you explain why you have used my name on a manuscript
submission. I have not participated in the writing of this paper and I am
not aware that you have ever discussed this with me.
I am confused.
No answer was received, so I took things up a notch.
I am yet to hear your explanation of why you have used my name in this
submission. Please respond as soon as possible or I will need to refer
this to your institution.
That did produce a response. A response to bizarre that I decided I needed to put it on the blog, in the hope that someone out there can offer an explanation.
Profesor S. Langley-Evans,
Your last note is out of cordial scientific interaction.
FIRST: THE MANUSCRIPT STATES CLEARLY WE DO NOT HAVE ANY CONFLICTS OF
INTEREST, which means a cordial invitation without any compromize, sort
of a flower for a COLLEAGUE I HAD YOU WITH GREAT ESTIMATION, BECAUSE YUR
WORK PLEASES ME VERY MUCH;
        AND NOTHING ELSE.
I interpret this as he wanted to give me the gift of authorship on his paper as a mark of esteem. I suppose I feel touched by that, but that doesn’t make it ethically acceptable. However, things become more confusing now.
SECOND: I WANTED TO INVITE YOU IN OUR PREVIOUS PUBLICATION WHICH
APPREARED LAST JANUARY 2017 IN BIOCHIM BIOPHYSICS ACTA. YOU DID NOT
ANSWER ME THE INVITATION, YOUR WERE OUT OF TOWN AS FAR AS YOUR AUTOMATIC eMAIL REPLY WROTE TO ME. THUS I DID NOT CONSIDER YOUR NAME FOR THAT PUBLICATION. AGAIN WITHOUR ANY COMPROMISE, JUST FOR THE GOOD SHAKEASPEREAN SPIRITS TO SHARE WITH SOMEONE WHOSE WORK IS ALTOBELLIS’S OUTSTANDING.
Shakeasperean spirits? What is this?
THIRD: I PROMISE TO DISMISS MY AFFECTIVE CCONSIDERATION TOWARD YOUR
NAME; I WILL JUST CITE YOUR WORKS AND THATS IT BETWEEN US. BE ASSURED I
WILL NOT DARE TO THINK OF YOUR NAME, ONCE AGAIN.
Well, that is good news I suppose… Now the email moves to the dark and bizarre side.
FOUR: THERE WAS A STRANGE SMALL GROUP OF ADULT MALES AT THE BELLAS
ARTES PALACE IN MEXICO CITY (DOWNTOWN, LA ALAMEDA) CITING YOUR NAME AS IF GREETNG ME (¡) DURING 2014-2016. I AM NOW CONTACTING THE UNITED
KINGDOM EMBASSY TO NOTICE ALL THESE UNLAWFUL AMBIENTAL CITATIONS FROM THESE INDIVIDUALS. COMMONWEALTH IS HUGE INCLUDING NOT ACCEPTED INVITED ONES. PLEASE BE ASSURED THAT I TURN
DOWN ANY OF THESE INTERACTIVE INDIVIDUALS CONCERNING MY PROFESSION.
I am most thankful for your keen attention to these facts. In fact, I
stop visiting THE BELLAS ARTES PALACE ALL THIS YEAR AND I TRY TO KEEP
UNDER THE BRITISH EMBASSY EYES.
Am I being threatened here? Am I a spy in Mexico? Is he? Who are these strange adult males at the Bellas Artes Palace? Is this some sort of Mexican fan club who chant my name in public places? I am bemused to say the least.

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

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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.