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The main impact of this work has been to provide an evidence base to inform practice and policy in relation to nutrition and diet. Through our contribution to the international EURRECA Network of Excellence, we have developed resources accessible to international expert panels as they review micronutrient recommendations. In addition, this work has had a significant impact on the formation of two major new initiatives; BOND and Zinc-Net, both of which address global issues relating to zinc deficiency and human health. Our pioneering research activities in Pakistan are helping to transform nutrition support and quality of life in marginalised communities.
For over 20 years, conclusive evidence has existed that folic acid in early pregnancy prevents spina bifida and related birth defects (collectively known as neural tube defects; NTD), leading to folic acid recommendations for women of reproductive age worldwide. However, translating these recommendations into practice remains a significant challenge. This case study is focussed on identifying and addressing the challenges in implementing current folic acid policy into practice in healthy populations, and in parallel investigating newer roles for folate in preventing disease. Our international outputs to date have provided a scientific foundation for developing evidence-based, sometimes controversial, policy in this area and its translation to consumers.
Chronic diseases associated with poor nutrition are on the rise; however, people increasingly eat nutritionally-deficient ready meals owing to their convenience. Researchers from the University of Glasgow took an innovative two-fold approach to tackling this worrying trend. First, they created a nutritionally-balanced frozen pizza in collaboration with local start-up company Eat Balanced. Second, they developed content for the Eatwell Everyday website, a government-funded resource that provides user-friendly nutritionally-balanced meal plans. These initiatives have attracted extensive media coverage, with an estimated global audience of about 93 million people. The Eatwell Everyday website has received 9,058 page visits since its launch in April 2013. The Eat Balanced pizza has won 10 business or product awards, has been endorsed by a leading sports nutritionist and is currently stocked by retail giants Sainsbury's, Asda and Ocado. More than 25,000 Eat Balanced pizzas have been sold in the UK since September 2012.
Over the past 15 years, research within the Nutrition and Metabolism in Health and Disease Theme has provided evidence to inform policy and practice in the nutritional care of older and nutritionally-vulnerable adults. This information has been referred to by other bodies when improving guidelines for nutritional management and care in residential or community settings. Theme members have identified key changes in nutritional status and dietary needs which occur with advancing age; these observations have contributed to the development of standards associated with nutritional, food and fluid provision for the care of vulnerable groups in hospitals and care homes in Scotland and beyond.
Although an adequate micronutrient intake and status is necessary for health and deficiency disease prevention, an excess dietary intake may have deleterious effects on health. Our impact has been to inform, stimulate and move forward our understanding of micronutrient requirements across the human lifecycle. Our activities have led to the development of WHO, EU and national nutrient intake recommendations which have had a significant impact on public health policies and initiatives which address food security.
We provided specialist expertise to the WHO Guidance Expert Advisory Group for assessing the effects of potassium and sodium intakes on human health. As a result, WHO has developed its first dietary guideline on intakes of potassium (adults and children) and sodium (children) for cardiovascular health.
Our original research in micronutrients including iron, zinc and fluoride and our systematic review approach have generated the evidence required for deriving nutritional recommendations, exemplified by our contribution to European dietary reference values (DRVs). These are used by member states to produce national health policies, guidelines and nutrient intake recommendations.
Since 1993 researchers from the University of Leeds (UoL) have devised robust and standardised experimental methodologies to study human appetite and food consumption objectively. Companies in the food and pharmaceutical sectors have used these procedures to develop functional foods and anti-obesity drugs. The validated methodologies also allowed global clinical research organisation Covance to establish its Human Appetite Laboratory to provide product evaluation for US and EU pharmaceutical companies. Food regulators have also recommended the Leeds approach for producing evidence to support appetite control claims for functional foodstuffs.
Imperial College research on the gut hormone, oxyntomodulin, showed it caused considerable weight loss in man. A powerful long acting analogue suitable for daily human administration (TKS1225) was developed. This was licensed by Imperial to a spinout, Thiakis Ltd, for successful human toxicity testing and then sold to Wyeth for $30 million initially and $120 million on meeting milestones. Wyeth Pharmaceuticals and the full legal agreement was subsequently acquired and developed by Pfizer in 2009.
One solution proposed to contribute to the resolution of the current UK obesity crisis has been to provide clear, visible and easily understood nutritional information to help consumers make informed decisions when purchasing food. Newcastle research provided two insights: first that consumers found it hard to interpret multiple versions of nutritional labels, and secondly that the label with the highest overall comprehension included traffic light colouring, Guideline Daily Amounts and the words "low", "med" and "high" to aid decision making. This information was used by the Department of Health in their approval of a new, consistent food labelling in June 2013. This system has now been adopted by major manufacturers including MARS, Nestlé UK, PepsiCo UK and Premier Foods, and retailers including Sainsbury's, Tesco, ASDA, Morrisons, The Co-operative Food and Waitrose.
The University has been at the forefront of Vitamin D research over the past decade, with the findings of the work used to change the dietary intake guidelines on the international stage, most notably in the U.S by the Institute of Medicine, the international body responsible for agenda setting of dietary recommendations worldwide. The extensive research has also been crucial in informing UK and Irish Health Service reports on vitamin D assessment and use during pregnancy and in infants and has provided robust scientific evidence to the food industry for fortification strategies. In addition to establishing the vitamin D requirements of population sub-groups, the research at Ulster has also focused on investigating the relationship between vitamin D status and skeletal & cardiovascular health and immune function.
Research by Professor Elliott and colleagues at Imperial College on worldwide salt and potassium intakes, their relationships to blood pressure, and co-authored systematic reviews and meta-analyses of their effects in adults and children on blood pressure and cardiovascular disease — and potential adverse effects — has played an instrumental role in developing international guidelines and public policy on sodium reduction strategies. Furthermore, published primary research has influenced US Centers for Disease Control and Prevention (CDC) strategies for population-wide monitoring of sodium intakes in the USA. This work has thus had impact on policies for sodium reduction and monitoring of sodium intakes worldwide.