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Iacovou M, Lewis JD. Commentary: When applying dietary therapies for gastrointestinal conditions, family values, culture, and social challenges matter. Nutr Rev 2023; 81:1490-1494. [PMID: 36809548 DOI: 10.1093/nutrit/nuad014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Some gastrointestinal conditions now have diet as a cornerstone to therapy. Three examples include the low-fermentable, oligosaccharide, disaccharide, monosaccharide, and polyol diet for irritable bowel syndrome, a gluten-free diet for celiac disease, and a hypoallergenic diet for eosinophilic esophagitis. All have been shown to be effective in Western or highly industrialized countries. However, these gastrointestinal conditions occur worldwide. Less is known regarding the effectiveness of dietary therapies in cultures and regions of dense religious and traditional practices where food is a central focus. This includes South Asia, the Mediterranean region, Africa, the Middle East, South America, and within Indigenous communities. Hence, there is a need to reproduce dietary intervention studies within cultures of dense traditional dietary practices to understand the applicability and acceptability of dietary therapy to establish generalizability. Furthermore, there is a need for nutrition experts to have a deep understanding of various cultural cuisines, practices, values, and customs. To achieve this, increasing the diversity of students in the sciences and having a diverse workforce of nutrition experts and health professionals that reflects the patient population will allow for more personalized care. In addition, there are social challenges, including a lack of medical insurance coverage, the cost of dietary interventions, and inconsistent nutrition messaging. Although there are many cultural considerations and social challenges to implementing effective dietary interventions around the world, these barriers are addressable through research methodologies that address culture and society challenges, and enhanced training of dietitians.
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Affiliation(s)
- Marina Iacovou
- is with the Centre of Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, and the Department of Molecular and Translational Science, Monash University, Clayton, Victoria, Australia
| | - James D Lewis
- is with the Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Rogers M, Coates A, Huggins CE, Dorrian J, Clark AB, Davis C, Leung GK, Davis R, Phoi YY, Kellow NJ, Iacovou M, Yates CL, Banks S, Sletten TL, Bonham MP. Study protocol for the Shifting Weight using Intermittent Fasting in night shift workers (SWIFt) study: a three-arm randomised controlled trial comparing three weight loss strategies in night shift workers with obesity. BMJ Open 2022; 12:e060520. [PMID: 35473743 PMCID: PMC9045043 DOI: 10.1136/bmjopen-2021-060520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Shift workers are at an increased risk of developing obesity and type 2 diabetes. Eating and sleeping out of synchronisation with endogenous circadian rhythms causes weight gain, hyperglycaemia and insulin resistance. Interventions that promote weight loss and reduce the metabolic consequences of eating at night are needed for night shift workers. The aim of this study is to examine the effects of three weight loss strategies on weight loss and insulin resistance (HOMA-IR) in night shift workers. METHODS AND ANALYSIS A multisite 18-month, three-arm randomised controlled trial comparing three weight loss strategies; continuous energy restriction; and two intermittent fasting strategies whereby participants will fast for 2 days per week (5:2); either during the day (5:2D) or during the night shift (5:2N). Participants will be randomised to a weight loss strategy for 24 weeks (weight loss phase) and followed up 12 months later (maintenance phase). The primary outcomes are weight loss and a change in HOMA-IR. Secondary outcomes include changes in glucose, insulin, blood lipids, body composition, waist circumference, physical activity and quality of life. Assessments will be conducted at baseline, 24 weeks (primary endpoint) and 18 months (12-month follow-up). The intervention will be delivered by research dietitians via a combination of face-to-face and telehealth consultations. Mixed-effect models will be used to identify changes in dependent outcomes (weight and HOMA-IR) with predictor variables of outcomes of group, time and group-time interaction, following an intention-to-treat approach. ETHICS AND DISSEMINATION The study protocol was approved by Monash Health Human Research Ethics Committee (RES 19-0000-462A) and registered with Monash University Human Research Ethics Committee. Ethical approval has also been obtained from the University of South Australia (HREC ID: 202379) and Ambulance Victoria Research Committee (R19-037). Results from this trial will be disseminated via conference presentations, peer-reviewed journals and student theses. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN-12619001035112).
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Affiliation(s)
- Michelle Rogers
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Alison Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Catherine E Huggins
- Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Jillian Dorrian
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Angela B Clark
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Corinne Davis
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Gloria Kw Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Rochelle Davis
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Yan Yin Phoi
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Nicole J Kellow
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Marina Iacovou
- Centre of Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Molecular and Translational Science, Monash University, Clayton, Victoria, Australia
| | - Crystal L Yates
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
- Behaviour-Brain-Body Research Centre, University of South Australia, Adelaide, South Australia, Australia
| | - Siobhan Banks
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
- Behaviour-Brain-Body Research Centre, University of South Australia, Adelaide, South Australia, Australia
| | - Tracey L Sletten
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
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O'Malley J, Iacovou M, Holdsworth-Carson SJ. Evidence for an Association Between Endometriosis and Allergic and Non-allergic Food Hypersensitivity Is Lacking. Front Reprod Health 2021; 3:726598. [PMID: 36304043 PMCID: PMC9580685 DOI: 10.3389/frph.2021.726598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/06/2021] [Indexed: 12/12/2022] Open
Abstract
Endometriosis effects up to 1 in 9 women, and can be a severe and debilitating disease. It is suggested that there is a link between endometriosis and allergic hypersensitivities, including allergic and non-allergic food hypersensitivity. Best practice for managing endometriosis symptoms is holistic and includes broad multi-disciplinary care. Therefore, improving our understanding of common endometriosis comorbidities, including allergic and non-allergic food hypersensitivity, will assist in improving patient quality of life. This mini-review with systematic approach aims to explore the literature for evidence surrounding an association between endometriosis and allergic and/or non-allergic food hypersensitivity from the last 20 years. Of the 849 publications identified, five fulfilled the inclusion criteria. Only one publication reported a statistically significant increased risk for non-allergic food hypersensitivity in patients with endometriosis (P = 0.009), however, the endometriosis group was not uniform in diagnostic criteria and included individuals without laparoscopically visualized disease. No studies elucidated a statistically significant link between allergic food hypersensitivity alone and endometriosis. Therefore, based on a small number of studies with limited research quality, evidence does not support the existence of a link between endometriosis and allergic or non-allergic food hypersensitivity. Sufficiently powered evidence-based research is required, including information which better characterizes the patient's endometriosis symptoms, importantly the gastrointestinal sequalae, as well as specific allergic and non-allergic food hypersensitivities and method of diagnoses. Unequivocally confirming a link between endometriosis and food hypersensitivities is an essential step forward in dispelling the many myths surrounding endometriosis and improving management of disease.
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Affiliation(s)
- Jocelyn O'Malley
- Department of Obstetrics and Gynaecology, The University of Melbourne and Gynaecology Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
| | - Marina Iacovou
- Centre of Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Molecular and Translational Science, Monash University, Clayton, VIC, Australia
| | - Sarah J. Holdsworth-Carson
- Department of Obstetrics and Gynaecology, The University of Melbourne and Gynaecology Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
- *Correspondence: Sarah J. Holdsworth-Carson
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Abstract
BACKGROUND Breastfeeding mothers have been avoiding foods in their diet based on ancient beliefs that it can prevent/reduce unsettled infant crying-fussing behavior. RESEARCH AIMS This study aimed to explore (1) the prevalence of maternal dietary changes during the postpartum period; (2) the demographic and infant feeding differences between women who made dietary changes and those who did not; (3) the reasons for dietary change; and (4) what specific foods were avoided. METHODS A prospective, cross-sectional 2-group comparison using an online survey mixed-methods design was advertised via social media and Australian websites. Anonymous volunteers who were presently breastfeeding or had breastfed for any length of time in the past were eligible. RESULTS Of 1,262 participants, 966 (77%) avoided foods/beverages in their diet. The most commonly avoided beverages were alcohol (79%) and coffee (44%), and the most commonly avoided foods were chili (22%), milk-chocolate (22%), cabbage (20%), onion (20%), and garlic (16%). Reasons for dietary avoidance related to baby being unsettled (31%), baby having wind/gas (29%), colic (11%), and crying (10%). Of 245 participants who removed dairy, 80 (33%) did not substitute with calcium-rich alternatives. Food and beverage avoidance commenced as early as 1 week postpartum and continued until mean (SD) infant age of 9 (5) months. CONCLUSIONS It is commonplace for breastfeeding mothers to avoid foods and beverages for reasons associated with infantile colic. Of major concern is the duration of food avoidance during a time of increased nutritional requirements. This information may assist in improving the nutritional support given to breastfeeding mothers.
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Affiliation(s)
- Marina Iacovou
- 2541 Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, VIC, Australia.,161666 Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - Peter R Gibson
- 2541 Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, VIC, Australia
| | - Jane G Muir
- 2541 Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, VIC, Australia
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Affiliation(s)
- Marina Iacovou
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Vic., Australia
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Skodje GI, Minelle IH, Rolfsen KL, Iacovou M, Lundin KE, Veierød MB, Henriksen C. Dietary and symptom assessment in adults with self-reported non-coeliac gluten sensitivity. Clin Nutr ESPEN 2019; 31:88-94. [DOI: 10.1016/j.clnesp.2019.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 02/20/2019] [Indexed: 01/26/2023]
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Iacovou M, Craig SS, Yelland GW, Barrett JS, Gibson PR, Muir JG. Randomised clinical trial: reducing the intake of dietary FODMAPs of breastfeeding mothers is associated with a greater improvement of the symptoms of infantile colic than for a typical diet. Aliment Pharmacol Ther 2018; 48:1061-1073. [PMID: 30306603 DOI: 10.1111/apt.15007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/10/2018] [Accepted: 09/11/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Therapeutic diets for infantile colic lack evidence. In breastfed infants, avoiding "windy" foods by the breastfeeding mother is common. AIM To examine the effects of a maternal low-FODMAP (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, And Polyols) diet compared to a typical-Australian diet on infant crying-fussing durations of infants with colic in a randomised, double-blind, crossover feeding study. METHODS Between 2014 and 2016 exclusively breastfed infants aged ≤9 weeks meeting Wessel criteria for colic were recruited. Mothers were provided a 10-day low-FODMAP or typical-Australian diet, then alternated without washout. Infants without colic (controls) were observed prospectively and mothers remained on habitual diet. Infant crying-fussing durations were captured using a Barr Diary. Measures of maternal psychological status and samples of breast milk and infant faeces were collected. RESULTS Mean crying-fussing durations were 91 min/d in seven controls compared with 269 min/d in 13 colicky infants (P < 0.0001), which fell by median 32% during the low-FODMAP diet compared with 20% during the typical-Australian diet (P = 0.03), confirmed by a two-way mixed-model analyses-of-variance (ƞp 2 = 0.719; P = 0.049) with no order effect. In breast milk, lactose concentrations remained stable and other known dietary FODMAPs were not detected. Changes in infant faecal calprotectin were similar between diets and groups, and faecal pH did not change. Median maternal anxiety and stress fell with the typical-Australian diet (P < 0.01), but remained stable on the low-FODMAP diet. CONCLUSIONS Maternal low-FODMAP diet was associated with enhanced reduction in crying-fussing durations of infants with colic. This was not related to changes in maternal psychological status, gross changes in breast milk or infant faeces. Mechanisms require elucidation. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR): 12616000512426 - anzctr.org.au.
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Affiliation(s)
- Marina Iacovou
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Victoria, Australia
| | - Simon S Craig
- Emergency Department, Monash Medical Centre, Clayton, Victoria, Australia.,School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Greg W Yelland
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Victoria, Australia
| | - Jacqueline S Barrett
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Victoria, Australia
| | - Peter R Gibson
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Victoria, Australia
| | - Jane G Muir
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Victoria, Australia
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Muir JG, Iacovou M. Editorial: irritable bowel syndrome-in addition to having properly-trained dietitians, is it time to add a yoga teacher to our multidisciplinary team? Aliment Pharmacol Ther 2018; 47:432-433. [PMID: 29314137 DOI: 10.1111/apt.14448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- J G Muir
- Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Victoria, Australia
| | - M Iacovou
- Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Victoria, Australia
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Hewawasam SP, Iacovou M, Muir JG, Gibson PR. Dietary practices and FODMAPs in South Asia: Applicability of the low FODMAP diet to patients with irritable bowel syndrome. J Gastroenterol Hepatol 2018; 33:365-374. [PMID: 28700090 DOI: 10.1111/jgh.13885] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 07/08/2017] [Accepted: 07/11/2017] [Indexed: 12/11/2022]
Abstract
The low Fermentable Oligosaccharides, Disaccharides, and Monosaccharides And Polyols (FODMAP) diet has been described, evaluated, and found efficacious for the treatment of patients with irritable bowel syndrome primarily in Western countries. The aim of this review was to address the applicability of this diet to South Asia. The high prevalence of irritable bowel syndrome in South Asia and its associated effects of quality of life and economics warrant the introduction of efficacious therapies. The considerable heterogeneity of dietary patterns and methods of food preparation across South Asian countries and a paucity of food analysis limit precision in defining foods that are high or low in FODMAPs. Spices and condiments are commonly consumed and mostly have a low FODMAP content. However, major high FODMAP sources are frequently used and include onion, garlic, shallots, legumes/pulses, and wheat-based products, as well as coconut and milk products, offering an opportunity for dietary management to reduce the symptom load. The feasibility of instituting a restrictive diet in which foods with a high FODMAP content are replaced by foods low in FODMAPs must be addressed as a substantial proportion of the nutritional intake including energy, proteins, and micronutrients, is often obtained from FODMAP-rich food. Furthermore, limited knowledge of health professionals together with a paucity of dietitians further challenge the practicality of introducing the diet. Thus, while the use of the low FODMAP diet in South Asia may be more limited than in westernized countries, it does offer potential therapeutic opportunities, the efficacy, and impact of which require further investigation.
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Affiliation(s)
- Samapriya P Hewawasam
- Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
| | - Marina Iacovou
- Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
| | - Jane G Muir
- Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
| | - Peter R Gibson
- Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
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Iacovou M, Lim J, Maningat C, Bogatyrev A, Ly E, Dhital S, Gidley M, Shi YC, Muir J, Seib P. In vivo digestibility of cross-linked phosphorylated (RS4) wheat starch in ileostomy subjects. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.bcdf.2017.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Iacovou M, Mulcahy EC, Truby H, Barrett JS, Gibson PR, Muir JG. Reducing the maternal dietary intake of indigestible and slowly absorbed short-chain carbohydrates is associated with improved infantile colic: a proof-of-concept study. J Hum Nutr Diet 2017. [PMID: 28631347 DOI: 10.1111/jhn.12488] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND To investigate if a low fermentable oligo-, di- and mono-saccharides and polyols (FODMAP) diet consumed by breastfeeding mothers may be associated with reduced symptoms of infantile colic. METHODS Exclusively breastfeeding mothers and their typically-developing healthy infants who met the Wessel Criteria for infantile colic were recruited from the community, to this single-blind, open-label, interventional study. After a 3-day qualifying period, mothers were provided a low FODMAP 7-day diet. On days 5, 6 and 7 mothers completed a Baby Day Diary. At baseline and at the end of the 7-day dietary intervention, breast milk was analysed for FODMAP content and infant faecal samples for pH. RESULTS Eighteen breastfeeding mothers (aged 27-40 years) adhered (100%) to the low FODMAP diet. Infants were of gestational age 37-40.3 weeks and aged 2-17 weeks. At entry, crying durations were a mean [95% CI] of 142 [106-61] min and fell by 52 [178-120] min (P = 0.005; ancova). Combined crying-fussing durations fell by 73 [301-223] min (n = 13; P = 0.007), as did crying episodes (P = 0.01) and fussing durations (P = 0.011). Infant sleeping, feeding, or awake-and-content durations did not change. Infant faecal pH did not change. Breast milk lactose content was stable and other known FODMAPs were not detected. At end of study, mothers reported their baby 'is much more content' and 'can be put down without crying'. CONCLUSIONS Maternal low FODMAP diet may be associated with a reduction in infant colic symptoms. A randomized controlled study is warranted to determine if a maternal low FODMAP diet is effective in reducing symptoms.
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Affiliation(s)
- M Iacovou
- Department of Gastroenterology, Central Clinical School, The Alfred Centre, Monash University, Melbourne, Vic., Australia
| | - E C Mulcahy
- Department of Gastroenterology, Central Clinical School, The Alfred Centre, Monash University, Melbourne, Vic., Australia
| | - H Truby
- Department of Nutrition, Dietetics and Food, Notting Hill, Vic., Australia
| | - J S Barrett
- Department of Gastroenterology, Central Clinical School, The Alfred Centre, Monash University, Melbourne, Vic., Australia
| | - P R Gibson
- Department of Gastroenterology, Central Clinical School, The Alfred Centre, Monash University, Melbourne, Vic., Australia
| | - J G Muir
- Department of Gastroenterology, Central Clinical School, The Alfred Centre, Monash University, Melbourne, Vic., Australia
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Abstract
Management of gut-related symptoms in the pediatric population can be challenging. Many factors need to be taken into consideration including psychological, behavioral, social and family environments, and growth and developmental requirements. This review focuses on two issues: potential dietary therapies that are thought to relieve the symptoms of infantile colic, a condition that is believed to be gastrointestinal in nature; and the evidence and dietary considerations surrounding children with irritable bowel syndrome.
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Affiliation(s)
- Marina Iacovou
- Department of Gastroenterology, Central Clinical School, The Alfred Centre, Monash University, Melbourne, Victoria, Australia
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Michael-Kordatou I, Andreou R, Iacovou M, Frontistis Z, Hapeshi E, Michael C, Fatta-Kassinos D. On the capacity of ozonation to remove antimicrobial compounds, resistant bacteria and toxicity from urban wastewater effluents. J Hazard Mater 2017; 323:414-425. [PMID: 26947803 DOI: 10.1016/j.jhazmat.2016.02.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/06/2016] [Accepted: 02/09/2016] [Indexed: 06/05/2023]
Abstract
The degradation of erythromycin (ERY) and ethylparaben (EtP) in urban wastewater effluents at low concentration level during ozonation was investigated under different experimental conditions. Both substrates were rapidly eliminated within 2min at low ozone dose of 0.3mgL-1 and the experimental data were well fitted in the pseudo-first-order kinetic model. The ratio of HO- and O3-exposure (Rct) at the inherent pH was found to be 1.9×10-8. The degradation of ERY and EtP was pronounced at pH 8 compared to acidic pH conditions, while the degradation rate of both substrates was found to be matrix-depended. It was also shown that both O3- and HO-mediated pathways are involved in the degradation of EtP, whereas the saturated-rich structure of ERY renders it O3-recalcitrant. Under the optimum O3 dose, the BrO3- concentration was found to be lower than 10μgL-1. Five and fifteen transformation products were elucidated during ERY and EtP oxidation, respectively. The root and shoot inhibition can be attributed to the oxidation products formed upon dissolved effluent organic matter transformation. Escherichia coli harbouring resistance to ERY survived ozonation better than EtP-resistant E. coli. However, neither ERY- nor EtP-resistant E. coli were detected after 15min of ozonation.
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Affiliation(s)
- I Michael-Kordatou
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - R Andreou
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - M Iacovou
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Z Frontistis
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus; Department of Chemical Engineering, University of Patras, Caratheodory 1, University Campus, GR-26504 Patras, Greece
| | - E Hapeshi
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - C Michael
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - D Fatta-Kassinos
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus.
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Iacovou M, Yelland G, Gibson P, Muir J. Dietary modifications of the maternal diet among breast-feeding mothers. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Michael-Kordatou I, Iacovou M, Frontistis Z, Hapeshi E, Dionysiou DD, Fatta-Kassinos D. Erythromycin oxidation and ERY-resistant Escherichia coli inactivation in urban wastewater by sulfate radical-based oxidation process under UV-C irradiation. Water Res 2015; 85:346-58. [PMID: 26360228 DOI: 10.1016/j.watres.2015.08.050] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 08/26/2015] [Accepted: 08/27/2015] [Indexed: 05/23/2023]
Abstract
This study evaluates the feasibility of UV-C-driven advanced oxidation process induced by sulfate radicals SO4(.)- in degrading erythromycin (ERY) in secondary treated wastewater. The results revealed that 10 mg L(-1) of sodium persulfate (SPS) can result in rapid and complete antibiotic degradation within 90 min of irradiation, while ERY decay exhibited a pseudo-first-order kinetics pattern under the different experimental conditions applied. ERY degradation rate was strongly affected by the chemical composition of the aqueous matrix and it decreased in the order of: ultrapure water (kapp = 0.55 min(-1)) > bottled water (kapp = 0.26 min(-1)) > humic acid solution (kapp = 0.05 min(-1)) > wastewater effluents (kapp = 0.03 min(-1)). Inherent pH conditions (i.e. pH 8) yielded an increased ERY degradation rate, compared to that observed at pH 3 and 5. The contribution of hydroxyl and sulfate radicals (HO. and SO4(.)-) on ERY degradation was found to be ca. 37% and 63%, respectively. Seven transformation products (TPs) were tentatively elucidated during ERY oxidation, with the 14-membered lactone ring of the ERY molecule being intact in all cases. The observed phytotoxicity against the tested plant species can potentially be attributed to the dissolved effluent organic matter (dEfOM) present in wastewater effluents and its associated-oxidation products and not to the TPs generated from the oxidation of ERY. This study evidences the potential use of the UV-C/SPS process in producing a final treated effluent with lower phytotoxicity (<10%) compared to the untreated wastewater. Finally, under the optimum experimental conditions, the UV-C/SPS process resulted in total inactivation of ERY-resistant Escherichia coli within 90 min.
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Affiliation(s)
- I Michael-Kordatou
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - M Iacovou
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Z Frontistis
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - E Hapeshi
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - D D Dionysiou
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus; Environmental Engineering and Science Program, University of Cincinnati, Cincinnati, OH 45221-0071, USA
| | - D Fatta-Kassinos
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus.
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Iacovou M, Tan V, Muir JG, Gibson PR. The Low FODMAP Diet and Its Application in East and Southeast Asia. J Neurogastroenterol Motil 2015; 21:459-70. [PMID: 26350937 PMCID: PMC4622128 DOI: 10.5056/jnm15111] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 07/29/2015] [Accepted: 08/09/2015] [Indexed: 12/15/2022] Open
Abstract
There is growing interest in using food choice/dietary change to influence clinical outcomes in patients with irritable bowel syndrome (IBS). The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) diet is an evidence-based approach that is gaining popularity in many Western countries. The low FODMAP diet is based on restricting dietary intake of short chain carbohydrates that are slowly absorbed or indigestible and not absorbed during passage through the small intestine. These are collectively described as "FODMAPs" and comprise oligosaccharides (mostly fructans, galacto-oligosaccharides), sugar polyols, fructose in excess of glucose, and lactose in lactose malabsorbers. The general strategy of the diet is to avoid foods high in FODMAPs and replace them with foods low in FODMAPs, with long-term restriction limited to what is required to control symptoms. The likely mechanism of action is minimisation of the stimulation of mechanoreceptors exerted by distension of the intestinal lumen with water from osmotic effects and gases from bacterial fermentation in those with visceral hypersensitivity. The success of this dietary approach greatly depends on detailed knowledge about the FODMAP composition of food com - monly consumed in that country. While the content of foods associated with East and Southeast Asian cuisines has not been fully explored, major high FODMAP sources are frequently used and include onion, garlic, shallots, legumes/pulses, and wheat-based products. Thus, this dietary approach holds great promise in treating IBS patients in East and Southeast Asia. The aim of this review is to highlight how the diet is implemented, its efficacy, and troublesome ingredients frequently used in Asian dishes.
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Affiliation(s)
- Marina Iacovou
- Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Australia
| | - Victoria Tan
- Department of Medicine, University of Hong Kong, Hong Kong
| | - Jane G Muir
- Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Australia
| | - Peter R Gibson
- Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Australia
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Iacovou M, Ralston R, Walker K, Truby H, Gibson P, Muir J. Dietary management for infantile colic: A systematic review. Journal of Nutrition & Intermediary Metabolism 2014. [DOI: 10.1016/j.jnim.2014.10.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kelly Y, Iacovou M, Quigley MA, Gray R, Wolke D, Kelly J, Sacker A. Light drinking versus abstinence in pregnancy - behavioural and cognitive outcomes in 7-year-old children: a longitudinal cohort study. BJOG 2013; 120:1340-7. [PMID: 23590126 PMCID: PMC4296342 DOI: 10.1111/1471-0528.12246] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess whether light drinking in pregnancy is linked to unfavourable developmental outcomes in children. DESIGN Prospective population-based cohort. SETTING UK. POPULATION Ten thousand five hundred and thirty-four 7-year-olds. METHODS Quasi-experimental using propensity score matching (PSM) to compare children born to light (up to 2 units per week) and non-drinkers. MAIN OUTCOME MEASURES Behavioural difficulties rated by parents and teachers; cognitive test scores for reading, maths and spatial skills. RESULTS Ordinary least squares (OLS) regression and PSM analyses are presented. For behavioural difficulties, unadjusted estimates for percentage standard deviation (SD) score differences ranged from 2 to 14%. On adjustment for potential confounders, differences were attenuated, with a loss of statistical significance, except for teacher-rated boys' difficulties. For boys, parent-rated behavioural difficulties: unadjusted, -11.5; OLS, -4.3; PSM, -6.8; teacher-rated behavioural difficulties: unadjusted, -13.9; OLS, -9.6; PSM, -10.8. For girls, parent-rated behavioural difficulties: unadjusted, -9.6; OLS, -2.9; PSM, -4.5; teacher-rated behavioural difficulties: unadjusted, -2.4; OLS, 4.9; PSM, 3.9. For cognitive test scores, unadjusted estimates for differences ranged between 12 and 21% of an SD score for reading, maths and spatial skills. After adjustment for potential confounders, estimates were reduced, but remained statistically significantly different for reading and for spatial skills in boys. For boys, reading: unadjusted, 20.9; OLS, 8.3; PSM, 7.3; maths: unadjusted, 14.7; OLS, 5.0; PSM, 6.5; spatial skills: unadjusted, 16.2; OLS, 7.6; PSM, 8.1. For girls, reading: unadjusted, 11.6; OLS, -0.3; PSM, -0.5; maths: unadjusted, 12.9; OLS, 4.3; PSM, 3.9; spatial skills: unadjusted, 16.2; OLS, 7.7; PSM, 6.4. CONCLUSION The findings suggest that light drinking during pregnancy is not linked to developmental problems in mid-childhood. These findings support current UK Department of Health guidelines on drinking during pregnancy.
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Affiliation(s)
- Y Kelly
- Department of Epidemiology and Public Health, University College LondonLondon, UK
| | - M Iacovou
- Institute for Social and Economic Research (ISER), University of EssexColchester, UK
| | - MA Quigley
- National Perinatal Epidemiology Unit, University of OxfordHeadington, Oxford, UK
| | - R Gray
- National Perinatal Epidemiology Unit, University of OxfordHeadington, Oxford, UK
| | - D Wolke
- Department of Psychology and Health Sciences Research Institute, Warwick Medical School, The University of WarwickCoventry, UK
| | - J Kelly
- Department of Epidemiology and Public Health, University College LondonLondon, UK
| | - A Sacker
- Department of Epidemiology and Public Health, University College LondonLondon, UK
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Abstract
OBJECTIVE To investigate the association between breast feeding and intergenerational social mobility and the possible mediating role of neurological and stress mechanisms. DESIGN Secondary analysis of data from the 1958 and the 1970 British Cohort Studies. SETTING Longitudinal study of individuals born in Britain during 1 week in 1958 and 1970. PARTICIPANTS 17 419 individuals participated in the 1958 cohort and 16 771 in the 1970 cohort. The effect of breast feeding on intergenerational social mobility from age 10/11 to age 33/34 was analysed after multiple imputations to fill in missing data and propensity score matching on a wide range of confounders measured in childhood (1958 cohort N=16 039-16 154; 1970 cohort N=16 255-16 361). MAIN OUTCOME MEASURES Own Registrar General's Social Class (RGSC) at 33/34 years adjusted for father's RGSC at 10/11 years, gender and their interaction. RESULTS Breastfed individuals were more likely to be upwardly mobile (1958 cohort: OR 1.24 95% CI 1.12 to 1.38; 1970 cohort: OR 1.24 95% CI 1.12 to 1.37) and less likely to be downwardly mobile (1958 cohort: OR 0.81 95% CI 0.73 to 0.90; 1970 cohort: OR 0.79 95% CI 0.71 to 0.88). In an ordinal regression model, markers of neurological development (cognitive test scores) and stress (emotional stress scores) accounted for approximately 36% of the relationship between breast feeding and social mobility. CONCLUSIONS Breast feeding increased the odds of upward social mobility and decreased the odds of downward mobility. Consistent with a causal explanation, the findings were robust to matching on a large number of observable variables and effect sizes were alike for two cohorts with different social distributions of breast feeding. The effect was mediated in part through neurological and stress mechanisms.
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Affiliation(s)
- A Sacker
- Research Department of Epidemiology and Public Health, University College London, London, UK.
| | - Y Kelly
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - M Iacovou
- Institute for Social and Economic Research, University of Essex, Colchester, UK
| | - N Cable
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - M Bartley
- Research Department of Epidemiology and Public Health, University College London, London, UK
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Sacker A, Kelly Y, Bartley M, Iacovou M. PL02 Breastfeeding and Social Mobility: Neurological Development or Stress Mechanisms? Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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