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Ruiz J, Kelly RK, Aplenc R, Laetsch TW, Seif AE. Absolute neutrophil count clinical trial eligibility criteria for pediatric oncology phase I and phase I/II trials by sponsorship. Pediatr Blood Cancer 2024; 71:e30925. [PMID: 38409529 DOI: 10.1002/pbc.30925] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
Normal absolute neutrophil count (ANC) variations, as seen with Duffy-null associated neutrophil count (DANC), are not accounted for in trial eligibility, which may contribute to racial enrollment disparities. We describe ANC eligibility for pediatric oncology phase I/II clinical trials according to primary sponsorship from 2010 to 2023 using ClinicalTrials.gov. Out of 438 trials, 20% were industry-sponsored. Total 17% of trials required ANC ≥1500 cells/μL for enrollment; however, industry-sponsored trials were significantly more likely to require ANC ≥1500 cells/μL than non-industry-sponsored trials (odds ratio 2.53, 95% confidence interval: 1.39-4.62; p < .001). These data suggest laboratory exclusion criteria are one possible mechanism for pediatric clinical trial enrollment disparities.
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Affiliation(s)
- Jenny Ruiz
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rebecca K Kelly
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Richard Aplenc
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Theodore W Laetsch
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alix E Seif
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Stanesby O, Armstrong MK, Otahal P, Goode JP, Fraser BJ, Negishi K, Kidokoro T, Winzenberg T, Juonala M, Wu F, Kelly RK, Xi B, Viikari JSA, Raitakari OT, Daniels SR, Tomkinson GR, Magnussen CG. Tracking of serum lipid levels from childhood to adulthood: Systematic review and meta-analysis. Atherosclerosis 2024; 391:117482. [PMID: 38569384 DOI: 10.1016/j.atherosclerosis.2024.117482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND AIMS The utility of lipid screening in pediatric settings for preventing adult atherosclerotic cardiovascular diseases partly depends on the lifelong tracking of lipid levels. This systematic review aimed to quantify the tracking of lipid levels from childhood and adolescence to adulthood. METHODS We systematically searched MEDLINE, Embase, Web of Science, and Google Scholar in March 2022. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42020208859). We included cohort studies that measured tracking of lipids from childhood or adolescence (<18 years) to adulthood (≥18) with correlation or tracking coefficients. We estimated pooled correlation and tracking coefficients using random-effects meta-analysis. Risk of bias was assessed with a review-specific tool. RESULTS Thirty-three studies of 19 cohorts (11,020 participants) were included. The degree of tracking from childhood and adolescence to adulthood differed among lipids. Tracking was observed for low-density lipoprotein cholesterol (pooled r = 0.55-0.65), total cholesterol (pooled r = 0.51-0.65), high-density lipoprotein cholesterol (pooled r = 0.46-0.57), and triglycerides (pooled r = 0.32-0.40). Only one study included tracking of non-high-density lipoprotein cholesterol (r = 0.42-0.59). Substantial heterogeneity was observed. Study risk of bias was moderate, mostly due to insufficient reporting and singular measurements at baseline and follow-up. CONCLUSIONS Early-life lipid measurements are important for predicting adult levels. However, further research is needed to understand the tracking of non-high-density lipoprotein cholesterol and the stability of risk classification over time, which may further inform pediatric lipid screening and assessment strategies.
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Affiliation(s)
- Oliver Stanesby
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia
| | | | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - James P Goode
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Brooklyn J Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Kazuaki Negishi
- Sydney Medical School Nepean, Faculty of Medicine and Health, Charles Perkins Centre Nepean, The University of Sydney, Sydney, Australia; Nepean Hospital, Sydney, Australia
| | - Tetsuhiro Kidokoro
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Faculty of Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Feitong Wu
- Baker Heart and Diabetes Institute, Melbourne, Australia; Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Rebecca K Kelly
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Bo Xi
- Department of Epidemiology, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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Orliacq J, Pérez-Cornago A, Parry SA, Kelly RK, Koutoukidis DA, Carter JL. Associations between types and sources of dietary carbohydrates and liver fat: a UK Biobank study. BMC Med 2023; 21:444. [PMID: 37968623 PMCID: PMC10652437 DOI: 10.1186/s12916-023-03135-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/26/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND AND AIMS Excess energy intake can lead to metabolic dysfunction-associated steatotic liver disease (MASLD), but the relationship between dietary carbohydrate intake and liver fat content remains unclear. This study aimed to examine the associations between types and sources of dietary carbohydrates and liver fat content. METHODS UK Biobank participants with no pre-existing diabetes, liver disease or cardiovascular disease reported dietary intake of types and sources of carbohydrates (total carbohydrates, free sugars, non-free sugars, starch from whole grains, starch from refined grains, and fibre) on at least two 24-h dietary assessments. In cross-sectional analyses, (n = 22,973), odds ratios (OR) of high liver fat content (defined as a score of ≥ 36 in the hepatic steatosis index) by quintiles of carbohydrate intakes were estimated using multivariable logistic regression models. In prospective analyses, a second sample (n = 9268) had liver proton density fat fraction (PDFF) measured by magnetic resonance imaging (2014-2020). Multivariable linear regression models estimated geometric means of PDFF (%) by quintiles of carbohydrate intakes. Models were adjusted for demographic and lifestyle confounders, including total energy intake. RESULTS In the cross-sectional analyses, 6894 cases of high liver fat content were identified. Inverse associations between intakes of fibre (OR of highest vs. lowest quintile 0.46 [95% CI: 0.41-0.52]), non-free sugars (0.63 [0.57-0.70]) and starch from whole grains (0.52 [0.47-0.57]) with liver fat were observed. There were positive associations between starch from refined grains and liver fat (1.33 [1.21-1.46]), but no association with free sugars (p=0.61). In prospective analyses, inverse associations with PDFF (%) were observed for intakes of fibre (- 0.48 geometric mean difference between highest and lowest quintile of intake [- 0.60 to - 0.35]), non-free sugars (- 0.37 [- 0.49 to - 0.25]) and starch from whole grains (- 0.31 [- 0.42 to - 0.19]). Free sugars, but not starch from refined grains, were positively associated with PDFF (0.17 [0.05 to 0.28]). CONCLUSION This study suggests that different carbohydrate types and sources have varying associations with liver fat, which may be important for MASLD prevention. Non-free sugars, fibre, and starch from whole grains could be protective, while associations with free sugars and starch from refined grains are less clear.
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Affiliation(s)
- Josefina Orliacq
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Cancer Epidemiology Unit (CEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Aurora Pérez-Cornago
- Cancer Epidemiology Unit (CEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Siôn A Parry
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- Aston Medical School, Aston University, Birmingham, B4 7ET, UK
| | - Rebecca K Kelly
- Cancer Epidemiology Unit (CEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- School of Medicine, College of Health and Medicine, The University of Tasmania, Hobart, Australia
| | | | - Jennifer L Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
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Watling CZ, Kelly RK, Dunneram Y, Knuppel A, Piernas C, Schmidt JA, Travis RC, Key TJ, Perez-Cornago A. Associations of intakes of total protein, protein from dairy sources, and dietary calcium with risks of colorectal, breast, and prostate cancer: a prospective analysis in UK Biobank. Br J Cancer 2023; 129:636-647. [PMID: 37407836 PMCID: PMC10421858 DOI: 10.1038/s41416-023-02339-2] [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] [Received: 10/15/2022] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Evidence concerning intakes of protein or sources of dairy protein and risks of colorectal, breast, and prostate cancers is inconclusive. METHODS Using a subsample of UK Biobank participants who completed ≥2 (maximum of 5) 24-h dietary assessments, we estimated intakes of total protein, protein from total dairy products, milk, and cheese, and dietary calcium in 114,217 participants. Hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using multivariable-adjusted Cox regression. RESULTS After a median of 9.4 years of follow-up, 1193 colorectal, 2024 female breast, and 2422 prostate cancer cases were identified. There were inverse associations of total dairy protein, protein from milk, and dietary calcium intakes with colorectal cancer incidence (HRQ4 vs Q1:0.80, 95% CI: 0.67-0.94; 0.79, 0.67-0.94; 0.71, 0.58-0.86, respectively). We also observed positive associations of milk protein and dietary calcium with prostate cancer risk (HRQ4 vs Q1:1.12, 1.00-1.26 and 1.16, 1.01-1.33, respectively). No significant associations were observed between intake of dairy protein and breast cancer risk. When insulin-like growth factor-I concentrations measured at recruitment were added to the multivariable-adjusted models, associations remained largely unchanged. Analyses were also similar when looking at total grams of dairy products, milk, and cheese. CONCLUSION Further research is needed to understand the mechanisms underlying the relationships of dairy products with cancer risk and the potential roles of dietary protein and calcium.
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Affiliation(s)
- Cody Z Watling
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
| | - Rebecca K Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yashvee Dunneram
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Anika Knuppel
- MRC Unit of Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - Julie A Schmidt
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Watling CZ, Kelly RK, Murphy N, Gunter M, Piernas C, Bradbury KE, Schmidt JA, Key TJ, Perez-Cornago A. Prospective Analysis Reveals Associations between Carbohydrate Intakes, Genetic Predictors of Short-Chain Fatty Acid Synthesis, and Colorectal Cancer Risk. Cancer Res 2023; 83:2066-2076. [PMID: 37097623 PMCID: PMC10267681 DOI: 10.1158/0008-5472.can-22-3755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/16/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
Whole grain and fiber intakes may decrease the risk of colorectal cancer. The interplay between host genetic factors, colonization of specific bacteria, production of short-chain fatty acids (SCFA), and intake of whole grains and fiber could alter the protective role of carbohydrates against colorectal cancer. Here, we assessed intakes of types and sources of carbohydrates in 114,217 UK Biobank participants with detailed dietary data (2-5 24-hour dietary assessments), and a host polygenic score (PGS) was applied to categorize participants as high or low for intraluminal microbial SCFA production, namely, butyrate and propionate. Multivariable Cox proportional hazards models were used to determine the associations of carbohydrates and SCFA with colorectal cancer incidence. During a median follow-up of 9.4 years, 1,193 participants were diagnosed with colorectal cancer. Risk was inversely associated with intakes of non-free sugar and whole grain fiber. Evidence of heterogeneity was observed by the butyrate PGS; consuming higher amounts of whole grain starch was only associated with a lower risk of colorectal cancer in those with predicted high SCFA production. Similarly, in additional analyses utilizing the larger UK Biobank cohort (N = 343,621) with less detailed dietary assessment, only individuals with a high genetically predicted butyrate production had a lower risk of colorectal cancer per 5 g/day intake of bread and cereal fiber. This study suggests that colorectal cancer risk varies by intake of carbohydrate types and sources, and the impact of whole grain intake may be modified by SCFA production. SIGNIFICANCE Prospective population-level analyses provide evidence supporting the importance of butyrate production in reduction of colorectal cancer risk by whole grain consumption.
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Affiliation(s)
- Cody Z. Watling
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Rebecca K. Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Neil Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Marc Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Carmen Piernas
- Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom
| | - Kathryn E. Bradbury
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Julie A. Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Kelly RK, Tong TYN, Watling CZ, Reynolds A, Piernas C, Schmidt JA, Papier K, Carter JL, Key TJ, Perez-Cornago A. Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants. BMC Med 2023; 21:34. [PMID: 36782209 PMCID: PMC9926727 DOI: 10.1186/s12916-022-02712-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/14/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Recent studies have reported that the associations between dietary carbohydrates and cardiovascular disease (CVD) may depend on the quality, rather than the quantity, of carbohydrates consumed. This study aimed to assess the associations between types and sources of dietary carbohydrates and CVD incidence. A secondary aim was to examine the associations of carbohydrate intakes with triglycerides within lipoprotein subclasses. METHODS A total of 110,497 UK Biobank participants with ≥ two (maximum five) 24-h dietary assessments who were free from CVD and diabetes at baseline were included. Multivariable-adjusted Cox regressions were used to estimate risks of incident total CVD (4188 cases), ischaemic heart disease (IHD; 3138) and stroke (1124) by carbohydrate intakes over a median follow-up time of 9.4 years, and the effect of modelled dietary substitutions. The associations of carbohydrate intakes with plasma triglycerides within lipoprotein subclasses as measured by nuclear magnetic resonance (NMR) spectroscopy were examined in 26,095 participants with baseline NMR spectroscopy measurements. RESULTS Total carbohydrate intake was not associated with CVD outcomes. Free sugar intake was positively associated with total CVD (HR; 95% CI per 5% of energy, 1.07;1.03-1.10), IHD (1.06;1.02-1.10), and stroke (1.10;1.04-1.17). Fibre intake was inversely associated with total CVD (HR; 95% CI per 5 g/d, 0.96;0.93-0.99). Modelled isoenergetic substitution of 5% of energy from refined grain starch with wholegrain starch was inversely associated with total CVD (0.94;0.91-0.98) and IHD (0.94;0.90-0.98), and substitution of free sugars with non-free sugars was inversely associated with total CVD (0.95;0.92-0.98) and stroke (0.91;0.86-0.97). Free sugar intake was positively associated with triglycerides within all lipoproteins. CONCLUSIONS Higher free sugar intake was associated with higher CVD incidence and higher triglyceride concentrations within all lipoproteins. Higher fibre intake and replacement of refined grain starch and free sugars with wholegrain starch and non-free sugars, respectively, may be protective for incident CVD.
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Affiliation(s)
- Rebecca K. Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Tammy Y. N. Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Cody Z. Watling
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Andrew Reynolds
- Department of Medicine, University of Otago, Dunedin, 9016 New Zealand
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX3 7LF UK
| | - Julie A. Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Jennifer L. Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, OX3 7LF UK
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
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Watling CZ, Kelly RK, Tong TYN, Piernas C, Watts EL, Tin Tin S, Knuppel A, Schmidt JA, Travis RC, Key TJ, Perez-Cornago A. Associations between food group intakes and circulating insulin-like growth factor-I in the UK Biobank: a cross-sectional analysis. Eur J Nutr 2023; 62:115-124. [PMID: 35906357 PMCID: PMC9899744 DOI: 10.1007/s00394-022-02954-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/05/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Circulating insulin-like growth factor-I (IGF-I) concentrations have been positively associated with risk of several common cancers and inversely associated with risk of bone fractures. Intakes of some foods have been associated with increased circulating IGF-I concentrations; however, evidence remains inconclusive. Our aim was to assess cross-sectional associations of food group intakes with circulating IGF-I concentrations in the UK Biobank. METHODS At recruitment, the UK Biobank participants reported their intake of commonly consumed foods. From these questions, intakes of total vegetables, fresh fruit, red meat, processed meat, poultry, oily fish, non-oily fish, and cheese were estimated. Serum IGF-I concentrations were measured in blood samples collected at recruitment. After exclusions, a total of 438,453 participants were included in this study. Multivariable linear regression was used to assess the associations of food group intakes with circulating IGF-I concentrations. RESULTS Compared to never consumers, participants who reported consuming oily fish or non-oily fish ≥ 2 times/week had 1.25 nmol/L (95% confidence interval:1.19-1.31) and 1.16 nmol/L (1.08-1.24) higher IGF-I concentrations, respectively. Participants who reported consuming poultry ≥ 2 times/week had 0.87 nmol/L (0.80-0.94) higher IGF-I concentrations than those who reported never consuming poultry. There were no strong associations between other food groups and IGF-I concentrations. CONCLUSIONS We found positive associations between oily and non-oily fish intake and circulating IGF-I concentrations. A weaker positive association of IGF-I with poultry intake was also observed. Further research is needed to understand the mechanisms which might explain these associations.
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Affiliation(s)
- Cody Z Watling
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK.
| | - Rebecca K Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Biochemistry and Molecular Biology II, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain
| | - Eleanor L Watts
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Sandar Tin Tin
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Anika Knuppel
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
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Kelly RK, Calhoun J, Hanus A, Payne-Foster P, Stout R, Sherman BW. Increased dietary fiber is associated with weight loss among Full Plate Living program participants. Front Nutr 2023; 10:1110748. [PMID: 37139446 PMCID: PMC10150096 DOI: 10.3389/fnut.2023.1110748] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Prior studies have demonstrated that an intake of foods rich in dietary fiber is associated with a favorable impact on health status and body weight. However, the association between fiber intake and weight loss has not been well-studied in employer settings. This research aimed to assess the relationship between dietary fiber and weight loss among individuals participating in the Full Plate Living (FPL) program. Methods The 16-week plant-predominant fiber-rich eating program was delivered to 72 employers, primarily in the Southwest U.S., over 3 years (2017-2019). Participants received weekly video lessons, FPL materials, and additional online resources. A retrospective analysis of repeated measures was conducted using participant data obtained from 4,477 participants, of which 2,792 (62.5%) reduced body weight. Analysis of variance with post hoc analysis was used to assess the statistical significance of the changes between baseline and follow-up measures of dietary fiber intake in each of the food categories, specifically the relationship between changes in individual and combined (composite) daily servings of fruits, vegetables, whole grains, beans, and nuts on body weight measures among three groups at follow-up: those who lost, maintained, or gained weight. Multilevel modeling was used to test the hypothesis that increased intake of fiber was associated with greater weight loss. Results The mean weight loss for the weight loss group was 3.28 kg. As compared to the two other groups, the intake of whole fiber-rich foods at follow-up was significantly higher among the weight loss group with fruits (2.45 servings), vegetables (2.99 servings), beans (1.03 servings), and total fiber composites (9.07 servings; P < 0.001). A significant increase in servings of grains was also noted (P < 0.05). Multilevel modeling demonstrated that a higher total fiber composite (Model 1), as well as higher intakes of either vegetables or fruits (Model 2), resulted in greater weight loss. Discussion Our findings indicate that the FPL program can be a part of a lifestyle medicine approach to healthy eating and weight loss. Delivering the program in clinical, community, and workplace settings can increase its reach as an effective and low-cost offering.
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Affiliation(s)
| | - Janet Calhoun
- Ardmore Institute of Health (AIH), Ardmore, OK, United States
| | - Amy Hanus
- Ardmore Institute of Health (AIH), Ardmore, OK, United States
- *Correspondence: Amy Hanus
| | - Pamela Payne-Foster
- College of Community Health Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Ron Stout
- Ardmore Institute of Health (AIH), Ardmore, OK, United States
| | - Bruce W. Sherman
- School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
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Kelly RK, Peralta L, Nash R. Promoting food literacy in primary school classrooms through the HealthLit4Kids Program in Australia. Health Promot Int 2022; 37:6823569. [DOI: 10.1093/heapro/daac166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lay Summary
Food literacy (FL) refers to the knowledge, skills, and behaviours associated with healthy eating. Schools are recognised as an important setting for FL promotion during childhood. HealthLit4Kids is an Australian primary school intervention that engages students, families, and educators to promote health literacy. This study aimed to assess the promotion of FL, a subtype of health literacy, in primary school classrooms across five schools. Teachers planned and implemented classroom activities over a 12-month period. Researchers examined lesson plans created by teachers and ‘artefacts’ (e.g. drawings, models) created by students during activities. Most classroom activities considered the nutritional knowledge and interpersonal communication skills associated with healthy eating, whereas fewer activities addressed students’ ability to critically analyse and apply information relating to food. The FL themes considered most frequently in classroom activities were ‘food and health choices’, ‘knowledge’, and ‘skills and behaviour’. Whereas the FL themes considered less frequently were ‘food systems’, ‘emotion’, and ‘culture’. The delivery of classroom activities was supported by the integration of other curriculum areas (e.g. The Arts and English). Future studies are required to understand how school-based interventions can promote the areas of FL that were less frequently addressed in this intervention in the classroom and beyond.
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Affiliation(s)
- Rebecca K Kelly
- School of Medicine, College of Health and Medicine, University of Tasmania , Hobart , Australia
- Nuffield Department of Population Health, University of Oxford , Oxford , UK
| | - Louisa Peralta
- School of Education and Social Work, Faculty of Arts and Social Sciences, University of Sydney , Sydney , Australia
| | - Rosie Nash
- School of Medicine, College of Health and Medicine, University of Tasmania , Hobart , Australia
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10
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Kelly RK, Pollard Z, Young H, Piernas C, Lentjes M, Mulligan A, Huybrechts I, Carter JL, Key TJ, Perez-Cornago A. Evaluation of the New Individual Fatty Acid Dataset for UK Biobank: Analysis of Intakes and Sources in 207,997 Participants. Nutrients 2022; 14:3603. [PMID: 36079862 PMCID: PMC9460581 DOI: 10.3390/nu14173603] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
The Oxford WebQ is an online 24 h dietary assessment tool used by several large prospective studies. This study describes the creation of the new individual fatty acid (FA) dataset for the Oxford WebQ and reports intakes and sources of dietary individual FAs in the UK Biobank. Participants who completed ≥1 (maximum of five) 24 h dietary assessments were included (n = 207,997). Nutrient intakes were obtained from the average of all completed 24 h dietary assessments. Nutrient data from the UK McCance and Widdowson's The Composition of Foods and the US Department of Agriculture food composition tables were used to calculate intakes of 21 individual FAs. The individual FA dataset included 10 saturated fatty acids (SFAs), 4 monounsaturated fatty acids (MUFAs), and 7 polyunsaturated fatty acids (PUFAs; including alpha-linolenic (18:3), eicosapentaenoic (20:5), and docosahexaenoic (22:6) acids). Palmitic (16:0; mean ± standard deviation (SD): 13.5 ± 5.7 g/d) and stearic (18:0; 5.2 ± 2.5) acids were the main contributors to SFAs, and the main sources of these were cereals and cereal products (mostly desserts/cakes/pastries), milk and milk products (mostly cheese and milk), and meat and meat products. Oleic acid (18:1; 24.2 ± 9.8) was the main MUFA, derived mainly from cereals and cereal products, and meat and meat products. Linoleic acid (18:2; 9.7 ± 4.3) was the main PUFA, derived mostly from cereals and cereal products, and vegetables (including potatoes) and vegetable dishes. The individual FA dataset for the Oxford WebQ will allow future investigations on individual FAs and disease risk.
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Affiliation(s)
- Rebecca K. Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Zoe Pollard
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Heather Young
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX3 7LF, UK
| | - Marleen Lentjes
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge CB1 8RN, UK
- School of Medical Sciences, Clinical Epidemiology and Biostatistics/Nutrient Gut Brain Interaction, Örebro University, 70182 Örebro, Sweden
| | - Angela Mulligan
- Department of Public Health & Primary Care, Institute of Public Health, University of Cambridge, Cambridge CB1 8RN, UK
- Nutrition Measurement Platform, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, 69372 Lyon, France
| | - Jennifer L. Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford OX3 7LF, UK
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Watling CZ, Schmidt JA, Dunneram Y, Tong TYN, Kelly RK, Knuppel A, Travis RC, Key TJ, Perez-Cornago A. Risk of cancer in regular and low meat-eaters, fish-eaters, and vegetarians: a prospective analysis of UK Biobank participants. BMC Med 2022; 20:73. [PMID: 35197066 PMCID: PMC8867885 DOI: 10.1186/s12916-022-02256-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/13/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Following a vegetarian diet has become increasingly popular and some evidence suggests that being vegetarian may be associated with a lower risk of cancer overall. However, for specific cancer sites, the evidence is limited. Our aim was to assess the associations of vegetarian and non-vegetarian diets with risks of all cancer, colorectal cancer, postmenopausal breast cancer, and prostate cancer and to explore the role of potential mediators between these associations. METHODS We conducted a prospective analysis of 472,377 UK Biobank participants who were free from cancer at recruitment. Participants were categorised into regular meat-eaters (n = 247,571), low meat-eaters (n = 205,385), fish-eaters (n = 10,696), and vegetarians (n = 8685) based on dietary questions completed at recruitment. Multivariable-adjusted Cox regressions were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for all cancer incidence and separate cancer sites across diet groups. RESULTS After an average follow-up of 11.4 years, 54,961 incident cancers were identified, including 5882 colorectal, 7537 postmenopausal breast, and 9501 prostate cancers. Compared with regular meat-eaters, being a low meat-eater, fish-eater, or vegetarian were all associated with a lower risk of all cancer (HR: 0.98, 95% CI: 0.96-1.00; 0.90, 0.84-0.96; 0.86, 0.80-0.93, respectively). Being a low meat-eater was associated with a lower risk of colorectal cancer in comparison to regular meat-eaters (0.91, 0.86-0.96); however, there was heterogeneity in this association by sex (p = 0.007), with an inverse association across diet groups in men, but not in women. Vegetarian postmenopausal women had a lower risk of breast cancer (0.82, 0.68-0.99), which was attenuated and non-significant after adjusting for body mass index (BMI; 0.87, 0.72-1.05); in mediation analyses, BMI was found to possibly mediate the observed association. In men, being a fish-eater or a vegetarian was associated with a lower risk of prostate cancer (0.80, 0.65-0.99 and 0.69, 0.54-0.89, respectively). CONCLUSION The lower risk of colorectal cancer in low meat-eaters is consistent with previous evidence suggesting an adverse impact of meat intake. The lower risk of postmenopausal breast cancer in vegetarian women may be explained by their lower BMI. It is not clear whether the other differences observed for all cancers and for prostate cancer reflect any causal relationships or are due to other factors such as residual confounding or differences in cancer detection.
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Affiliation(s)
- Cody Z Watling
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK.
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Yashvee Dunneram
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Rebecca K Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
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Kelly RK, Tong TYN, Guasch-Ferre M, Papier K, Piernas C, Fensom GK, Carter JL, Key TJ, Perez-Cornago A. Associations between saturated fatty acids from different dietary sources and cardiovascular disease risk in 114,285 UK Biobank study participants. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Previous studies suggest that different foods rich in saturated fatty acids (SFA), particularly meat and dairy, have diverging directions of association with risks of total cardiovascular disease (CVD) and CVD subtypes.(1,2)
Purpose
To investigate the associations between SFA from different dietary sources and risks of total CVD, ischaemic heart disease (IHD), and stroke.
Methods
We analysed data on 114,285 UK Biobank participants who had completed ≥2 24-h dietary assessments and were free of CVD at the date of the latest 24-h dietary assessment. Risks of incident (non-fatal and fatal) total CVD, IHD and stroke by intakes of SFA from different sources were estimated using multivariable Cox regressions. Additional models assessed the role of body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) as potential mediators. We also estimated the associations between modelled isoenergetic substitution of 5% energy from SFA from meat with SFA from dairy, polyunsaturated fatty acids, monounsaturated fatty acids, carbohydrates from whole grains and carbohydrates from fruit and vegetables, and risk of CVD outcomes. A false discovery rate controlling procedure was used to account for multiple testing.
Results
Over a median 8.5 years of follow-up, there were 4,365, 3,394, and 1,041 cases of total CVD, IHD and stroke, respectively. There were no significant associations between total SFA intake and CVD outcomes. SFA from meat was positively associated with total CVD (hazard ratio for each 5% of energy, 1.19; 95% CI, 1.05–1.35) and IHD (1.21; 1.05–1.39) risk independently of lifestyle and cardiovascular risk factors. However, the estimates were attenuated and non-significant for both total CVD (1.11; 0.98–1.26) and IHD (1.12; 0.97–1.29) after adjustment for BMI. SFA from dairy was inversely associated with IHD risk (0.89; 0.82–0.96) in the multivariable model, however this finding was also attenuated after adjustment for BMI and did not pass correction for multiple testing (0.91; 0.84 to 0.98). Modelled replacement of 5% of energy from SFA from meat with carbohydrates from whole grains or carbohydrates from fruit and vegetables were associated with lower risk of stroke in the multivariable model (0.86; 0.78–0.94 & 0.86; 0.78–0.95, respectively) and the model adjusted for BMI and LDL-C (0.87; 0.79–0.96 & 0.86; 0.78–0.95, respectively).
Conclusion(s)
SFA from meat was associated with a higher risk of total CVD and IHD, while SFA from dairy was associated with lower risk of IHD, although BMI seemed to account for a large proportion of these associations. It is possible that diverging associations of SFA from different sources with CVD risk may explain the overall null association with total SFA observed in this study and some previous observational studies. Randomised controlled trials are needed to confirm whether replacing SFA from meat by carbohydrate from wholegrains or fruit and vegetables may be beneficial in reducing stroke risk.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Clarendon Fund and Jesus College Clarendon Old Members' AwardJesus College Graduate Scholarship
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Affiliation(s)
- R K Kelly
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
| | - T Y N Tong
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
| | - M Guasch-Ferre
- Harvard T. H. Chan School of Public Health, Department of Nutrition, Boston, United States of America
| | - K Papier
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
| | - C Piernas
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom
| | - G K Fensom
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
| | - J L Carter
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
| | - T J Key
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
| | - A Perez-Cornago
- University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
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Kelly RK, Nash R. Food Literacy Interventions in Elementary Schools: A Systematic Scoping Review. J Sch Health 2021; 91:660-669. [PMID: 34137459 DOI: 10.1111/josh.13053] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/13/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Childhood is a critical period for developing food-related skills and knowledge, known as food literacy (FL). Schools may be an important setting for interventions aiming to improve FL in children. This systematic scoping review aimed to characterize food literacy interventions in elementary schools. METHODS Databases (PubMed, Web of Science, and EBSCO) were searched for FL interventions in elementary schools (students aged 4-12 years). Studies were assessed according to design, duration, theoretical underpinning, and ascertainment of FL outcome(s). Interventions were assessed according to FL competencies (functional, interactive, and critical). RESULTS After exclusions, 116 studies were eligible for review, including 105 original interventions. Interventions ranged from 45 minutes to 4 years. Social cognitive theory was the most referenced theory and common interventions included; classroom lessons, games, school gardens, food preparation, and cooking classes. Most studies measured FL outcomes quantitatively (96%, N = 111). All studies addressed functional FL (N = 116), while 77% (N = 89) addressed interactive FL and 28% (N = 32) addressed critical FL. CONCLUSIONS This first international review of FL programs in elementary schools found great heterogeneity in school-based FL intervention design and measurement of FL. Few interventions addressed critical FL, which should be a focus for future interventions.
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Affiliation(s)
- Rebecca K Kelly
- Academic associate, Medical officer, DPhil candidate, , Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Rosie Nash
- Lecturer in Public Health, Pharmacist, , Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Kelly RK, Watling CZ, Tong TY, Piernas C, Carter JL, Papier K, Key TJ, Perez-Cornago A. Associations Between Macronutrients From Different Dietary Sources and Serum Lipids in 24 639 UK Biobank Study Participants. Arterioscler Thromb Vasc Biol 2021; 41:2190-2200. [PMID: 34039019 PMCID: PMC8216602 DOI: 10.1161/atvbaha.120.315628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 05/03/2021] [Indexed: 02/04/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Rebecca K. Kelly
- Cancer Epidemiology Unit (R.K.K., C.Z.W., T.Y.N.T., K.P., T.J.K., A.P.-C.), University of Oxford, United Kingdom
| | - Cody Z. Watling
- Cancer Epidemiology Unit (R.K.K., C.Z.W., T.Y.N.T., K.P., T.J.K., A.P.-C.), University of Oxford, United Kingdom
| | - Tammy Y.N. Tong
- Cancer Epidemiology Unit (R.K.K., C.Z.W., T.Y.N.T., K.P., T.J.K., A.P.-C.), University of Oxford, United Kingdom
| | - Carmen Piernas
- Nuffield Department of Population Health and Nuffield Department of Primary Care Health Sciences (C.P.), University of Oxford, United Kingdom
| | - Jennifer L. Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit (J.L.C.), University of Oxford, United Kingdom
| | - Keren Papier
- Cancer Epidemiology Unit (R.K.K., C.Z.W., T.Y.N.T., K.P., T.J.K., A.P.-C.), University of Oxford, United Kingdom
| | - Timothy J. Key
- Cancer Epidemiology Unit (R.K.K., C.Z.W., T.Y.N.T., K.P., T.J.K., A.P.-C.), University of Oxford, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit (R.K.K., C.Z.W., T.Y.N.T., K.P., T.J.K., A.P.-C.), University of Oxford, United Kingdom
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Watling CZ, Kelly RK, Tong TYN, Piernas C, Watts EL, Tin Tin S, Knuppel A, Schmidt JA, Travis RC, Key TJ, Perez-Cornago A. Associations of circulating insulin-like growth factor-I with intake of dietary proteins and other macronutrients. Clin Nutr 2021; 40:4685-4693. [PMID: 34237695 PMCID: PMC8345002 DOI: 10.1016/j.clnu.2021.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/12/2021] [Accepted: 04/10/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIMS Circulating insulin-like growth factor-I (IGF-I) is associated with the risk of several cancers. Dietary protein intake, particularly dairy protein, may increase circulating IGF-I; however, associations with different protein sources, other macronutrients, and fibre are inconclusive. To investigate the associations between intake of protein, macronutrients and their sources, fibre, and alcohol with serum IGF-I concentrations. METHODS A total of 11,815 participants from UK Biobank who completed ≥4 24-h dietary assessments and had serum IGF-I concentrations measured at baseline were included. Multivariable linear regression was used to assess the cross-sectional associations of macronutrient and fibre intake with circulating IGF-I concentrations. RESULTS Circulating IGF-I concentrations were positively associated with intake of total protein (per 2.5% higher energy intake: 0.56 nmol/L (95% confidence interval: 0.47, 0.66)), milk protein: 1.20 nmol/L (0.90, 1.51), and yogurt protein: 1.33 nmol/L (0.79, 1.86), but not with cheese protein: -0.07 nmol/L (-0.40, 0.25). IGF-I concentrations were also positively associated with intake of fibre (per 5 g/day higher intake: 0.46 nmol/L (0.35, 0.57)) and starch from wholegrains (Q5 vs. Q1: 1.08 nmol/L (0.77, 1.39)), and inversely associated with alcohol consumption (>40 g/day vs <1 g/day: -1.36 nmol/L (-1.00, -1.71)). CONCLUSIONS These results show differing associations with IGF-I concentrations depending on the source of dairy protein, with positive associations with milk and yogurt protein intake but no association with cheese protein. The positive association of fibre and starch from wholegrains with IGF-I warrants further investigation.
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Affiliation(s)
- Cody Z Watling
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
| | - Rebecca K Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Eleanor L Watts
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sandar Tin Tin
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Abstract
Our collective experience with COVID-19 and Black Lives Matter has heightened awareness of deeply embedded racial and socioeconomic disparities in American businesses. This time, perhaps, sustained change is within reach. As organizations advance diversity, equity and inclusion (DEI) initiatives, an often overlooked focus of is the health status of employees and their families, where equitable access to high-value health benefits offerings should be available to all. This commentary provides guidance for employers to expand their DEI initiatives to include employee and family health and well-being as a central outcome measure. Employers should ensure that DEI efforts incorporate equitable benefits design, and objectively assess benefit design impact on healthcare utilization and cost. Additionally, employers must appreciate the workplace as a significant determinant of health-for lower income workers, in particular-with review of policies and practices to mitigate any discriminatory negative health or well-being impact. Further, race and ethnicity data should be incorporated in health benefits data analysis to understand more clearly the differential outcomes of health management offerings on these different sub-populations. Finally, social needs data should be incorporated into strategic benefits planning to better understand gaps and opportunities to foster greater benefits equity. The provided recommendations can support employer goals of achieving greater equity and value in workforce health, measurably contributing to business success.
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Affiliation(s)
- Bruce W Sherman
- Department of Public Health Education, University of North Carolina, Greensboro, NC, USA
| | - Rebecca K Kelly
- Division of Health Promotion and Wellness, Element Health, Inc, Birmingham, AL, USA
| | - Pamela Payne-Foster
- Department of Community Medicine/Population Health, College of Community Health Sciences, 8059The University of Alabama, Tuscaloosa, AL, USA
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Kelly RK, Thomson R, Smith KJ, Dwyer T, Venn A, Magnussen CG. Factors Affecting Tracking of Blood Pressure from Childhood to Adulthood: The Childhood Determinants of Adult Health Study. J Pediatr 2015; 167:1422-8.e2. [PMID: 26342719 DOI: 10.1016/j.jpeds.2015.07.055] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/26/2015] [Accepted: 07/28/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the modifiable factors that alter the trajectory of blood pressure (BP) from childhood to adulthood. STUDY DESIGN This study investigated the BP of 798 participants (53% female) from the Childhood Determinants of Adult Health Study who had BP measured when aged 9, 12, or 15 years, and at follow-up 20 years later. BP was classified as normal or elevated (prehypertensive or hypertensive) in childhood and adulthood. BP trajectory groups (persistently normal, resolution, incident elevated, persistently elevated) were established according to these classifications. Potentially modifiable factors measured at both examinations included body mass index, fruit and vegetable intake, physical activity, cardiorespiratory fitness, alcohol consumption, smoking, and socioeconomic status. RESULTS Spearman correlation coefficients for BP tracking from childhood to adulthood were 0.31 (P < .001) for systolic BP and 0.16 (P < .001) for diastolic BP. Children with elevated BP had a 35% increased risk of elevated BP in adulthood compared with those with normal BP (relative risk 1.35, 95% CI 1.18-1.55, P < .001). Relative to those with persistently elevated BP, participants in the resolution group significantly decreased their body mass index z-score, decreased their alcohol consumption z-score, and increased their vegetable consumption z-score between childhood and adulthood. The proportion of participants with upwardly mobile socioeconomic status was significantly higher in the resolution group (41.2%) compared with the persistently elevated group (27.5%). CONCLUSIONS Resolution of elevated BP in the transition from childhood to adulthood appeared to be partially determined by modifiable factors associated with a healthy lifestyle.
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Affiliation(s)
- Rebecca K Kelly
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Russell Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kylie J Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; The George Institute for Global Health/Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
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Abstract
The upward trend in adolescent hypertension is widely attributed to the adolescent obesity epidemic. Secular trends in adolescent prehypertension and hypertension have risen in congruence with increasing trends in the prevalence of overweight and obesity. The correlation between body mass index and blood pressure in adolescence is moderate to strong in most studies and strongest in those classified as overweight or obese. The mechanisms relating to the development of hypertension in overweight adolescents are unclear; however, a number of nonmodifiable and modifiable factors have been implicated. Importantly, certain clinical and biochemical markers in overweight adolescents are indicative of high risk for hypertension, including family history of hypertension and hyperinsulinemia. These characteristics may prove useful in stratifying overweight adolescents as high or low risk of comorbid hypertension. The treatment of overweight and obesity related hypertension in this population focuses on two key modalities: lifestyle change and pharmacotherapy. These approaches focus almost exclusively on weight reduction; however, a number of emerging strategies target hypertension more specifically. Among adolescents with overt hypertension there are also several factors that indicate higher risk of concurrent subclinical disease, persistent adult hypertension, and adult cardiovascular disease. This group may benefit substantially from more aggressive pharmacological treatments. Limitations in the literature relate to the paucity of studies reporting specific effects for the adolescent age group of overweight and obese individuals. Nonetheless, intervention for adiposity-related hypertension in adolescence may partially mitigate some of the cardiovascular risk in adulthood.
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Affiliation(s)
- Rebecca K Kelly
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia ; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Matthew A Sabin
- Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Parkville, Australia
| | - Michael Cheung
- Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Parkville, Australia
| | - Markus Juonala
- Murdoch Childrens Research Institute, Royal Children's Hospital and University of Melbourne, Parkville, Australia ; Department of Medicine, University of Turku, Turku, Finland ; Division of Medicine, Turku University Hospital, Turku, Finland
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Kelly RK, Magnussen CG. Epidemiology of elevated blood pressure in youth and its utility for predicting adulthood outcomes: A review. World J Hypertens 2014; 4:29-36. [DOI: 10.5494/wjh.v4.i4.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 08/29/2014] [Accepted: 10/16/2014] [Indexed: 02/06/2023] Open
Abstract
Elevated blood pressure has been demonstrated to track from youth to adulthood and some have demonstrated an association between early-life blood pressure and subsequent atherosclerosis and cardiovascular disease. In addition, reports regarding the strength of tracking are inconsistent and the modifiable risk factors that affect the trajectory of blood pressure from youth to adulthood remain unclear. This paper comprehensively evaluated the existing classifications of youth hypertension and the current trends of youth hypertension. Further, evidence for the consequences of hypertension in youth has been comprehensively evaluated. Importantly, a review of the studies examining tracking from youth to adulthood has been performed and a number of studies investigating the factors affecting tracking has also been investigated. The overall consideration of this body of literature highlights the vital importance of identifying hypertension in youth to prevent complications in adulthood. Adiposity is regarded to be a factor affecting the progression of hypertension from youth to adulthood yet there is little evidence available for other modifiable factors. It is apparent that further research is necessary within this field in order to create effective preventative strategies to target youth hypertension.
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Flynn J, Monley S, Kelly RK. Expert comments on “The Hopeful Case of Kanban International”. Am J Health Promot 2014; 28:TAHP8-TAHP9. [PMID: 24901113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Carter MR, Kelly RK. Self-reported health status, body mass index, and healthy lifestyle behaviors: differences between Baby Boomer and Generation X employees at a southeastern university. Workplace Health Saf 2013; 61:409-18; quiz 419. [PMID: 23991705 DOI: 10.1177/216507991306100906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 08/01/2013] [Indexed: 11/16/2022]
Abstract
The aim of this study was to assess differences in self-reported health status, body mass index (BMI), and healthy lifestyle behaviors between Baby Boomer and Generation X faculty and staff at a southeastern university. Data were drawn from employee health risk assessment and BMI measures. A total of 730 Baby Boomer and 765 Generation X employees enrolled in a university health promotion and screening program were included in the study. Ordered logistic regressions were calculated separately for BMI, perceived health status, and three healthy lifestyle behaviors. After covariates such as job role, gender, race, education, and income were controlled, Baby Boomers were more likely than Generation X employees to report better health status and dietary habits. Baby Boomers were also more likely to engage in weekly aerobic physical activity (p < .001) yet were also at greater risk of being overweight and obese. The results highlight the need to consider generational differences when developing health promotion programs.
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Carter MR, Kelly RK. Self-Reported Health Status, Body Mass Index, and Healthy Lifestyle Behaviors: Differences Between Baby Boomer and Generation X Employees at a Southeastern University. Workplace Health Saf 2013. [DOI: 10.3928/21650799-20130827-67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Carter MR, Kelly RK, Montgomery M, Cheshire M. An Innovative Approach to Health Promotion Experiences in Community Health Nursing: A University Collaborative Partnership. J Nurs Educ 2013; 52:108-11. [DOI: 10.3928/01484834-20130121-04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 10/03/2012] [Indexed: 11/20/2022]
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Kelly RK, Olson DL, Sun Y, Wen D, Wortham KA, Antognetti G, Cheung AE, Orozco OE, Yang L, Bailly V, Sanicola M. An antibody-cytotoxic conjugate, BIIB015, is a new targeted therapy for Cripto positive tumours. Eur J Cancer 2011; 47:1736-46. [PMID: 21458984 DOI: 10.1016/j.ejca.2011.02.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 02/21/2011] [Accepted: 02/28/2011] [Indexed: 01/03/2023]
Abstract
BIIB015 is an immunoconjugate created for the treatment of solid tumours and is currently in Phase I of clinical evaluation. BIIB015 consists of a humanised monoclonal antibody against the Cripto protein carrying a payload, via a hindered disulphide linker, of the maytansinoid derivative, DM4. Cripto is a GPI-linked protein required for signal transduction of the TGF-beta ligand, Nodal. Cripto has been previously described as an oncogene and fits the classic pattern of an embryonic gene that is re-expressed in a transformed tumour cell. Cripto expression is highly prevalent on a number of solid tumours, including greater than 75% of breast, lung, and colorectal tumours. Our report documents for the first time that targeting the cell surface Cripto protein with an anti-Cripto antibody-cytotoxic conjugate is an effective means of inhibiting or regressing growth of Cripto positive tumours. BIIB015 which utilises a 'cleavable' linker containing a disulphide bond exhibits superior activity when compared to huB3F6 mAb conjugates with different linker systems, including one with a 'non-cleavable' linker. BIIB015 displays specificity for Cripto in both in vitro and in vivo experiments. In human xenograft models originating from lung (Calu-6), colon (CT-3), testicular (NCCIT) and breast (MDA-MB-231) tumour samples, BIIB015 shows robust activity with results ranging from >50% tumour inhibition to complete tumour regression. The efficacy seen in the MDA-MB-231 model, a triple negative (-HER2, -ER, and -PR) tumour, is particularly exciting since there is currently no approved therapy for this indication. In addition, BIIB015 can be combined with standard of care chemotherapeutics for enhanced efficacy.
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Affiliation(s)
- Rebecca K Kelly
- Biogen Idec, Inc, Discovery Oncology, 14 Cambridge Center, Cambridge, MA 02142, USA
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Yamamoto T, Kelly RK, Nielsen O. Epidermal hyperplasias of northern pike (Esox lucius) associated with herpesvirus and C-type particles. Arch Virol 1984; 79:255-72. [PMID: 6320780 DOI: 10.1007/bf01310815] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Northern pike from several locations in central Canada were observed to have two different types of hyperplastic epidermal lesions on the body and fins. One type of epidermal hyperplasia consisted of flat lesions, bluish-white in color with a granular or "gritty" appearance. Histological examination of this granular lesion showed the presence of grossly hypertrophied cells surrounded by normal sized epidermal cells. The enlarged nuclei in thin section contained many typical herpesvirus capsids measuring 100 nm in diameter. A large proportion of the cytoplasmic mass consisted of many dark staining inclusions in which were embedded numerous herpes-like virions. For this herpesvirus of pike the name esocid herpesvirus 1 is proposed in keeping with the herpesvirus nomenclature of Roizman et al. (19). The second type of epidermal hyperplasia was a smooth convex whitish translucent tissue mass consisting largely of a population of randomly oriented normal sized undifferentiated cells. Electron microscopic examination showed them to be associated with clusters of C-type retrovirus measuring 150 nm in diameter. The formation of these virus particles was by budding from the cytoplasmic membrane into the inter-cellular spaces. Neither the herpesvirus nor the C-type particles could be isolated in fish cell cultures.
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Kelly RK, Butel JS. Demonstration of infectious DNA in transformed cells. II. Characterization of uptake of SV40-transformed mouse cell DNA by simian cells. Arch Virol 1975; 48:279-87. [PMID: 173259 DOI: 10.1007/bf01317426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The initial steps in the DNA-transfer, or transfection, method of virus rescue were characterized using primary green monkey (GMK) cells exposed to SV40-transformed mouse (SV-3T3) cell DNA in the presence of 1 mg/ml DEAE-dextran. When large amounts (10-50mug) of high molecular weight DNA (greater than 10(7) daltons) were inoculated onto 10(6) GMK cells, usually less than 1 mug became cell-associated. DNA fragmented to a size of 1-3 X 10(6) daltons was bound more efficiently by the recipient cells, but generally only 5-10 per cent of the inoculum (representing 1-4 mug) was taken up. Approximately 50 per cent of the cell-associated DNA had penetrated to a DNase-resistant state by the end of the 30-minute incubation period. The effect of the size of thr transformed cell DNA molecule on the recovery of SV40 in transfection experiments was investigated. The trend appeared to be that rescue was more efficient with the larger molecular weight samples.
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Abstract
Although IPN virus failed to multiply at 30 degrees, it replicated at 16 degrees and 22 degrees in SWT cells. At 22 degrees the viral eclipse period lasted nearly 6 hr with maximal virion titers attained by 24 hr, whereas replication at 16 degrees was much slower. The replication of the virion was inhibited by 0.05 mug/ml of AD which did not interfere with the production of reovirus. Biochemical studies revealed that cellular DNA synthesis was markedly reduced (greater than 50%) soon after infection whereas total RNA synthesis was enhanced. The period of rapid increase in RNA synthesis paralleled the exponential production of infectious virus. Viral inclusion bodies, revealed by acridine orange-staining of virus-infected cells (SWT and RGG-2) late in the infectious cycle, were found to contain single-stranded RNA on the basis of their staining characteristics and sensitivity to RNase.
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Abstract
An electron microscopical and biochemical examination of the properties of infectious pancreatic necrosis virus (IPN) and of its ribonucleic acid (RNA) was made. The buoyant density of IPN in CsCl was found to be 1.33 g/cm(3). Electron microscopical examination of the banded virus revealed structures similar in size (74 nm) and shape to reoviruses but lacking a characteristic inner capsid structure. Polyacrylamide gel electrophoretic analysis of IPN-RNA revealed a single non-segmented component of molecular weight 3.2 x 10(6). Its susceptibility to ribonuclease, base composition, and resistance to thermal denaturation indicated a single-stranded RNA structure. However, its sedimentation behavior (16S) independent of ionic strength in sucrose gradients, partial solubility in 2 m LiCl, and ribonuclease resistance in the presence of Mg(2+) suggest an unusual secondary structure of unknown nature. The accumulated data indicate that IPN virus does not belong to either the picornavirus or reovirus groups and may represent a new group of viruses.
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