Adherence to the Eatwell Guide and cardiometabolic, cognitive and neuroimaging parameters: an analysis from the PREVENT dementia study

BACKGROUND

The Eatwell guide reflects the UK government's recommendations for a healthy and balanced diet. Previous research has identified associations between healthy eating patterns and both cardiovascular and brain health, although there is little evidence specifically focusing on the Eatwell Guide. To date no research has investigated associations between the Eatwell Guide and risk for future dementia.

METHODS

Data from the PREVENT dementia cohort study baseline visit was used in this analysis. Binary and graded Eatwell Guide scores (BEWG, GEWG) were created from a self-reported Food Frequency Questionnaire. The CAIDE score was included as the primary outcome measure to represent risk for future Alzheimer's disease. Secondary outcome measures included cardiometabolic health measures and brain health measures. Generalised additive models were run in R.

RESULTS

A total of 517 participants were included in the analysis, with a mean BEWG score of 4.39 (± 1.66) (out of a possible 12 points) and GEWG score of 39.88 (± 6.19) (out of a possible 60 points). There was no significant association between either Eatwell Guide score and the CAIDE score (BEWG β: 0.07, 95% confidence interval (CI): -0.07, 0.22; GEWG β: 0.02, 95% CI: -0.02, 0.06) or any measures of brain health. There was a significant association between higher GEWG score and lower systolic and diastolic blood pressure and body mass index (BMI) (systolic β: -0.24, 95% CI: -0.45, -0.03; diastolic β: -0.16, 95% CI: -0.29, -0.03; BMI β: -0.09, 95% CI: -0.16, -0.01).

CONCLUSIONS

Although not directly associated with the CAIDE score, the Eatwell Guide dietary pattern may be beneficial for dementia prevention efforts through the modification of hypertension and obesity, which are both known risk factors for dementia. Future work could replicate these findings in other UK-based cohorts as well as further development of Eatwell Guide scoring methodologies.

Effects of PROtein enriched MEDiterranean Diet and EXercise on nutritional status and cognition in adults at risk of undernutrition and cognitive decline: the PROMED-EX Randomised Controlled Trial

INTRODUCTION

Undernutrition leading to unplanned weight loss is common in older age and has been linked to increased dementia risk in later life. Weight loss can precede dementia by a decade or more, providing a unique opportunity for early intervention to correct undernutrition and potentially prevent or delay cognitive impairment. The combined effects of diet and exercise on undernutrition have not yet been evaluated. The objective of this trial is to determine the effect of a protein-enriched Mediterranean diet, with and without exercise, on nutritional status and cognitive performance in older adults at risk of undernutrition and cognitive decline.

METHODS

One hundred and five participants aged 60 years and over at risk of undernutrition and with subjective cognitive decline will be recruited to participate in a 6-month, single-blind, parallel-group randomised controlled trial. Participants will be block randomised into one of three groups: group 1-PROMED-EX (diet+exercise), group 2-PROMED (diet only) and group 3-standard care (control). The primary outcome is nutritional status measured using the Mini Nutritional Assessment. Secondary outcomes include cognitive function, nutritional intake, body composition, physical function and quality of life. Mechanistic pathways for potential diet and exercise-induced change in nutritional status and cognition will be explored by measuring inflammatory, metabolic, nutritional and metabolomic biomarkers.

ETHICS AND DISSEMINATION

The study is approved by the UK Office for Research Ethics Committee (ref: 21/NW/0215). Written informed consent will be obtained from participants prior to recruitment. Research results will be disseminated to the public via meetings and media and the scientific community through conference presentations and publication in academic journals.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Registry (NCT05166564).

Development of a Quantitative Polymerase Chain Reaction Detection Protocol for Cercospora kikuchii in Soybean Leaves and Its Use for Documenting Latent Infection as Affected by Fungicide Applications

Cercospora leaf blight (CLB) of soybean, caused by Cercospora kikuchii, is a serious disease in the southern United States. A sensitive TaqMan probe-based real-time quantitative polymerase chain reaction (qPCR) assay was developed to specifically detect and quantify C. kikuchii in naturally infected soybean plants. The sensitivity was 1 pg of genomic DNA, which was equivalent to about 34 copies of genome of C. kikuchii. Using this qPCR assay, we documented a very long latent infection period for C. kikuchii in soybean leaves beginning at the V3 growth stage (as early as 22 days after planting). The levels of biomass of C. kikuchii remained low until R1, and a rapid increase was detected from the R2/R3 to R4/R5 growth stages shortly before the appearance of symptoms at R6. The efficacy of various fungicide regimens under field conditions also was evaluated over a 3-year period using this qPCR method. Our results showed that multiple fungicide applications beginning at R1 until late reproductive stages suppressed the development of C. kikuchii in leaves and delayed symptom expression. Different fungicide chemistries also had differential effects on the amount of latent infection and symptom expression during late reproductive growth stages.

First Report of Impatiens Downy Mildew Caused by Plasmopara obducens in Kentucky

Impatiens downy mildew (Plasmopara obducens (J. Schröt.) J. Schröt. (syn Peronospora obducens) was first reported in the United States in 2004, but widespread outbreaks were observed throughout North America in 2011 (5). In June 2012, symptoms, including severe defoliation while plants retained upright stems, were observed on approximately 100 landscape impatiens (Impatiens walleriana Hook.f.) in Franklin County in central Kentucky. All plants in the landscape were affected. Plants were primarily defoliated and remaining leaves were stunted, mottled, and chlorotic with edges curled downward; no flowers were present. Under examination with a dissecting microscope, white downy fungal growth was observed. Closer examination confirmed that the growth consisted of colorless sporangiophores that were mainly unbranched, straight, and rigid (1,3). Sporangiophores consisted of apical branches attached at right angles to main axes, ranging from 67.2 to 89.9 μm long (1). Sporangia were ovoid and hyaline, measuring 11.2 to 13.3 μm × 8.2 to 10.7 μm (3). No oospores were observed. Pathogenicity tests were performed by inoculating 20 to 40 leaves on three plants each of the cvs. Dazzler and Super Elfin with suspensions of 1 × 10⁵ sporangiophores per ml in sterile distilled water. Sporangia were obtained by washing infected leaves with sterile distilled water, and inoculations were completed by spraying leaves until runoff. Plants sprayed with sterile water served as controls. Plants were covered with black plastic bags for 48 h and then maintained under fluorescent lights for 10 days at room temperature (22 to 25°C). Sporangiophores were recovered from inoculated plants after 10 days, and morphology matched original inoculum; symptoms included chlorotic, downward curling leaves with sporulation on the undersides. Non-inoculated plants did not develop symptoms after 21 days. Molecular identification of the pathogen was conducted using three leaves from one plant from each cultivar. PCR was conducted by amplifying the large ribosomal subunit DNA using primers NL-1 and NL-4 (2). Amplicons of 762 to 691 bp were produced from diseased plant tissue that contained visible sporangiophores, and the bands were extracted from the gel and purified. Sequence results confirmed 100% similarity to accessions from Florida (GenBank Accession No. JX217746.1) and Ohio (JX142134.1) and 99% similarity to amplicons reported from Serbia (HQ246451.1) and UK (AY587558.1). This is believed to be the first report of downy mildew infecting impatiens in Kentucky. References: (1) O. Constantinescu. Mycologia 83:473, 1991. (2) W. Maier et al. Can. J. Bot 81:12, 2003. (3) P. A. Saccardo. Syllogue Fungorum 7:242, 1888. (4) S. N. Wegulo et al. Plant Dis. 88:909, 2004.

Effects of Simplicillium lanosoniveum on Phakopsora pachyrhizi, the soybean rust pathogen, and its use as a biological control agent

The fungus Simplicillium lanosoniveum was isolated from soybean leaves infected with Phakopsora pachyrhizi, the soybean rust pathogen, in Louisiana and Florida. The fungus did not grow or become established on leaf surfaces until uredinia erupted, but when soybean rust signs and symptoms were evident, S. lanosoniveum colonized leaves within 3 days and sporulated within 4 days. Development of new uredinia was suppressed by about fourfold when S. lanosoniveum colonized uredinia. In the presence of S. lanosoniveum, uredinia became increasingly red-brown, and urediniospores turned brown and germinated at very low rates. Assays using quantitative real time polymerase chain reaction revealed that the fungus colonized leaf surfaces when plants were infected with P. pachyrhizi, either in a latent stage of infection or when symptoms were present. However, when plants were inoculated before infection, there was no increase of DNA of S. lanosoniveum, suggesting that the pathogen must be present in order for the antagonist to become established on soybean leaf surfaces. We documented significantly lower amounts of DNA of P. pachyrhizi and lower disease severity when soybean leaves were colonized with S. lanosoniveum. These studies documented the mycophilic and disease-suppressive nature of S. lanosoniveum.

Paralytic poliomyelitis: seasoned strategies, disappearing disease

With more than 2 years having elapsed since the last case of paralytic poliomyelitis occurred in the Western Hemisphere, significant progress has been made towards the global eradication of wild polioviruses. Poliomyelitis is disappearing from Europe, North Africa, Southern Africa, the Middle East, China, and the Pacific. Reported poliomyelitis cases declined to 15,587 cases in 1992. Current eradication strategies recommended by the World Health Organization include national mass campaigns administering oral poliovaccine to all children under 5 years of age, enhanced surveillance to detect cases of acute flaccid paralysis, creating a network of laboratories for viral diagnosis, and targeted immunisation to areas and populations where poliovirus transmission is likely to persist. The major obstacles to eradication include inadequate political support for eradication and insufficient funding, especially for the purchase of vaccine. With additional support for the international eradication effort, epidemics of poliomyelitis will cease in developing countries, and industrialised countries will be able to save the large sums spent each year on poliovaccine and rehabilitation.

The WHO-EPI initiative for the global eradication of poliomyelitis

Since the development of attenuated oral polio vaccine, Dr Albert Sabin consistently maintained that the global eradication of wild poliovirus was possible, but that to achieve polio eradication in developing countries would require the mass administration of the oral vaccine. Experience in Cuba and Czechoslovakia proved the effectiveness of this technique, but it was only with its deployment in Brazil in 1980 that its role in eradicating the virus from a broad geographical area started to be realized. With the declaration in 1985 of a target of regional polio eradication, extension of this policy, allied with the development of effective surveillance of acute flaccid paralysis in children, with laboratory confirmation of diagnosis rapidly led to apparent interruption of wild poliovirus transmission throughout the Americas. The World Health Assembly in 1988 committed WHO to the global eradication of poliomyelitis. Based on experience in the Americas and building on the solid foundation established by the Expanded Programme on Immunization, WHO has defined the strategies through which the global target could be achieved. Progress is encouraging and where the advocated strategies have been fully implemented, the incidence of poliomyelitis has declined dramatically. Significant geographical areas in Western Europe, the Maghreb, the Arabian peninsula, the Pacific basin and Southern Africa, each incorporating several countries, are now thought to be free of the disease caused by wild poliovirus. The target of a world free of polio by the year 2000 can be achieved.

Fundamental studies in reversed-phase liquid-solid extraction of basic drugs; I: Ionic interactions

Seven basic solutes with known and controlled pKa (7.93-9.5) and log P (0.23-6.63) values have been used as test probes to study the mechanism involved in liquid-solid extraction with C2 and C18 bonded silica phases. A limited comparison has also been made with underivatized silica and CN phases. In addition to the reversed-phase mechanism, cation-exchange was shown to play a very significant role in the retention process. Various cations both organic and inorganic were assessed for their elution strength, and the ordering was similar to that for classical ion-exchange chromatography. Control of selectivity in the elution process can be achieved by varying the concentration of cation or methanol in the eluent. The C2 cartridge in combination with an aqueous ammonium acetate-methanol eluent proved to be the most versatile in that all compounds, irrespective of pKa or log P could be recovered in high yield. The optimal eluent in terms of selectivity with respect to related compounds could be predicted from the solute log P. Blocking of silanols by pre-conditioning the cartridges with cations prior to sample applications was also studied. The order of cation strengths although somewhat variable was similar to that established at the elution stage. To achieve quantitative elution with methanol or aqueous methanol solutions however, high concentrations of inorganic cations, equivalent to 1 ml of a 1 M solution were required to pre-condition a 100 mg cartridge.

Practicalities of a global poliomyelitis control program

Much progress has been achieved in making the world free of poliomyelitis. The countries that have achieved control should be giving practical help to those where the disease is still endemic, while developing their own competence in surveillance, laboratory support, and effective immunization policies. The polio vaccines have been proved effective. The need is now to implement programs by solving their practical difficulties in order to make use of the presently available vaccines.

Smallpox surveillance in Bangladesh: I - Development of surveillance containment strategy

A major epidemic of Variola major with an estimated 90 000 cases and 18 000 deaths occurred in Bangladesh in 1972. During a 3-year period methods of active surveillance (market search, outbreak investigation, and house-to-house search) were developed to supplement the passive reporting system. The percentage of smallpox cases detected increased from 11.8% in 1972 to 83% in 1975. Together with the implementation of improved methods of outbreak control, smallpox transmission was interrupted in October 1975.

Treatment of variola major with adenine arabinoside

A double-blind study of the efficacy of adenine arabinoside in the treatment of patients with variola major was conducted. Adenine arabinoside (20 mg/kg of body weight) was given to patients intravenously every 24 hr for seven days in a 8-hr infusion. Five of the nine patients receiving adinine arabinoside died, and four of 11 patients receiving placebo died. Mortality was related to the severity of illness for both groups of patients. No difference was found between the drug and control groups in number of febrile days after initiation of therapy or in the period during which it was possible to isolate virus from skin lisions, throat swabs, and sources of clotted blood. Formation of scabs on skin lesions was complete 8.3 days after the initiation of therapy for the drug group and after 11.3 days for the control group. The findings suggest that adenine arabinoside is not effective in the chemotherapy of smallpox.