Bernadette Egan

Dr Bernadette Egan


Senior Research Fellow
+44 (0)1483 682888
13 AC 04

Biography

Biography

Bernadette Egan graduated with a 1st Class honours degree in Biochemistry from University College Cork (UCC) in 1982, where she subsequently obtained her PhD. She then joined the Microbiology Department at the University of Surrey as a postdoctoral fellow, working on a number of projects in the area food microbiology. After a career break Dr Egan held a Daphne Jackson fellowship in the School of Biomedical and Life Sciences (SBLS) at the University of Surrey (2000-2002), and then worked briefly with Professor Sibel Roller, establishing web based information systems on natural antimicrobials.

Bernadette joined the Food, Consumer Behaviour and Health Research Centre, in the University of Surrey's Department of Psychology in November 2002 where she has worked as a Research Fellow on a range of projects funded by organisations including the Food Standards Agency and the EU. She has also been involved in a number of applied health research projects in conjunction with Professor Heather Gage.

Bernadette is the Academic Lead at Surrey for the NIHR Research Design Service, which is part of the Research Design Service-South East. She was a member of the team that coordinated the University of Surrey's application for an Athena Swan Bronze award and is currently on the self-assessment team in the School of Psychology applying for a Silver Award.

Research interests

Bernadette's research interests are primarily public health-related (food safety, food choice, behavioural nutrition). She works with consumers, professionals (e.g. teachers) and other stakeholders to investigate food-related attitudes, beliefs and behaviour using both qualitative and quantitative methods. Bernadette also has extensive experience in developing study protocols and in the collection, analysis and reporting of data.

Research collaborations

  • Plant Food Supplements: Levels of Intake, Benefit and Risk Assessment - PlantLIBRA (European Union; June 2010 to May 2014)
  • The Effect of Diet on the Mental performance of Children - NutriMENTHE (European Union; March 2008 to February 2013)
  • Early Nutrition programming - long term follow up of efficacy and safety trials and integrated epidemiological, genetic, animal, consumer and economic research - EARNEST (European Union; April 2005 to March 2010)
  • European Food Information Resource Network - EuroFIR (European Union; 5 years from January 2005)
  • Getting food safety and food hygiene messages into schools (Food Standards Agency; March 2004 to November 2005)
  • Evaluation of UK food hygiene and safety training (Food Standards Agency; August 2002 to March 2004)

My publications

Publications

Bielby G, Egan B, Eves A, Lumbers M, Raats M, Adams M (2006) Food hygiene education in UK primary schools: a nation-wide survey of teachers' views, British Food Journal 108 (9) pp. 721-731
Purpose - The purpose of this research is to show how a nation-wide survey of teachers investigated the teaching of food hygiene in primary schools. The survey determined which information sources were known and used by those responsible for teaching food hygiene. Design/methodology/approach - Postal questionnaires were distributed to 3,806 primary schools throughout the UK (response rate 23 per cent). The questionnaire was developed based on the results of in-depth interviews with school teachers and included topics such as where teachers gained up-to-date food hygiene messages, methods used to teach food hygiene, and how key food hygiene messages are reinforced. Teachers cited most preferred resources for teaching food hygiene, influences on the choice of these resources, and limitations on use. Findings - Overall, the results indicated that food hygiene is taught in a number of subject areas, with handwashing and personal hygiene being the principal topics. Teachers use a combination of methods to teach food hygiene and to reinforce food safety messages. The principal limitations of teaching this topic were identified as a lack of suitable space and curriculum time Teachers across the UK also identified new resources that would support the teaching of food hygiene. Originality/value - The study identified how primary school teachers deliver food hygiene messages through the curriculum, daily routines and whole school initiatives. Ways in which primary school teachers could be supported when delivering food hygiene education have been suggested.
Egan MB, Hodgkins C, Fragodt A, Krines C, Raats MM (2009) User-centred food composition data-analysis of user needs through the Use Case approach, FOOD CHEMISTRY 113 (3) pp. 804-807 ELSEVIER SCI LTD
Brands B, Egan B, Györei E, López-Robles JC, Gage H, Campoy C, Decsi T, Koletzko B, Raats MM (2012) A qualitative interview study on effects of diet on children's mental state and performance. Evaluation of perceptions, attitudes and beliefs of parents in four European countries, Appetite 58 (2) pp. 739-746
Nutrition is one of the many factors that influence a child's cognitive development and performance. Understanding the relationship between nutrition and mental performance in children is important in terms of their attainment and productivity both in school and later life. Since parents are seen as nutritional gatekeepers for their children's diets, their views and beliefs are of crucial importance. The present study aims to qualitatively examine parents' perceptions of the relationship between diet and mental performance of children. The study was conducted with a total of 124 parents in four European countries using a semi-structured interview schedule. Parents speak of the effects of diet at two levels; the nature of the effects of diet and the characteristics of the foods responsible for these effects. Mental outcomes are related to diet, with the effects perceived to be associated with attention and concentration, often mediated by effects on children's mood and behaviour. Parents categorise foods as 'good' or 'bad' with positive effects related generally to a healthy balanced diet while negative effects are perceived to be associated with sugary and fatty foods. Understanding parental perceptions is important for many purposes including the targeting of dietary advice and prioritising of public health issues. © 2012 Elsevier Ltd.
Gage H, Von Rosen-Von Hoewel J, Laitinen K, Jakobik V, Martin-Bautista E, Schmid M, Egan B, Morgan J, Williams P, Decsi T, Campoy C, Koletzko B, Raats MM (2013) Health effects of infant feeding: Information for parents in leaflets and magazines in five European countries, Public Understanding of Science 22 (3) pp. 365-379 Sage
Parents? decisions about whether to breastfeed their infant, and when to introduce complementary foods, are important public health issues. Breastfeeding has beneficial health effects and is widely promoted. Leaflets and magazine articles on infant feeding were collected in 2005, in five European countries (England, Finland, Germany, Hungary, Spain), and screened for statements that link feeding behaviours to infant health outcomes. A total of 127 leaflets contained 512 statements (0.38 / published page). Magazines contained approximately 1 article / month. Health outcomes were more intensively covered in England and Germany. Most statements referred to short term health implications. Lack of scientific agreement may underlie lack of cover of longer term health effects. Scope may exist to promote improved infant feeding practices by increasing the quantity and specificity of messages about health effects. Further research is required to evaluate the impact of alternative means of providing information on infant feeding practices.
Egan B, Hodgkins C, Shepherd R, Timotijevic L, Raats MM (2011) An overview of consumer attitudes and beliefs about plant food supplements., Food and Function 2 (12) pp. 747-752 Royal Society of Chemistry
The use of dietary supplements is increasing globally and this includes the use of plant food supplements (PFS). A variety of factors may be influencing this increased consumption including the increasing number of older people in society, mistrust in conventional medicine and the perception that natural is healthy. Consumer studies in this area are limited, with a focus on dietary supplements in general, and complicated by the use of certain plant food supplements as herbal medicines. Research indicates that higher use of dietary supplements has been associated with being female, being more educated, having a higher income, being white and being older, however the drivers for consumption of supplements are complex, being influenced by both demographic and health-related factors. The aim of this paper is to provide an overview of current knowledge about the users and the determinants of usage of plant food supplements. With growing consumption of these products, the need for effective risk-benefit assessment becomes ever more important and an insight into who uses these types of products and why is an important starting point for any future science-based decisions made by policy makers, PFS manufacturers and ultimately by consumers themselves.
Eves A, Bielby G, Egan B, Lumbers M, Raats M, Adams M (2006) Food hygiene knowledge and self-reported behaviours of UK school children (4-14 years), British Food Journal 108 (9) pp. 706-720
Purpose - The purpose of this research is to show the evaluation of food hygiene knowledge and self-reported behaviours of school children, assessment of children's attitudes towards food hygiene and evaluation of barriers to the adoption of appropriate food hygiene behaviours. Design/methodology/approach - The food hygiene knowledge and self-reported behaviours of pupils (4 and 14 years; Key Stages 1-3 in the English system - or Scottish equivalent) were determined using age-appropriate knowledge quizzes completed by 2,259 pupils across England, Scotland, Northern Ireland and Wales. Attitudes towards food hygiene and barriers to performing desirable hygiene-related behaviours were established through semi-structured interviews with 82 pupils who completed knowledge tasks in South East England. Findings - Children generally had good knowledge of food hygiene. However, there were misconceptions about the nature of micro-organisms and how they affect food. In addition, a lack of reminders and practical food activities, especially at Key Stage 2 (7-11 years), coupled with poor hand-washing facilities, meant that children did not always adopt desirable behaviours. Children gave suggestions for ways to help others to remember good practice. Originality/value - The study identified areas of weakness in pupils' hygiene knowledge and understanding and has determined barriers to adoption of desirable behaviours at all times. It has also suggested ways in which food hygiene education could be made more engaging for pupils, and other methods to encourage good practice.
Brands B, Egan B, Gage H, Lopez-Robles JC, Gyoerei E, Raats M, Martin-Bautista E, Decsi T, Campoy C, Koletzko B (2010) THE EFFECT OF DIET ON CHILDREN'S MENTAL PERFORMANCE - A QUALITATIVE STUDY OF PERCEPTIONS, ATTITUDES AND BELIEFS OF PARENTS IN FOUR EUROPEAN COUNTRIES, JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION 50 pp. E189-E189 LIPPINCOTT WILLIAMS & WILKINS
Gage H, Egan B, Williams P, Lopez-Robles JC, Brands B, Gyoerei E, Campoy C, Desci T, Koletzko B, Raats M (2013) ASSOCIATION BETWEEN DIET AND PHYSICAL AND MENTAL DEVELOPMENT OF CHILDREN: VIEWS OF PARENTS AND TEACHERS IN FOUR EUROPEAN COUNTRIES, ANNALS OF NUTRITION AND METABOLISM 63 pp. 1863-1863 KARGER
Lopez-Robles JC, Egan B, Gage H, Gyorei E, Brands B, Raats M, Martin-Bautista E, Tamas D, Koletzko B, Campoy C (2010) QUANTITATIVE STUDY OF SPANISH PARENTS BELIEFS OF WHAT EFFECTS CHILDREN'S MENTAL PERFORMANCE, JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION 50 pp. E191-E191 LIPPINCOTT WILLIAMS & WILKINS
Eves A, Bielby G, Egan B, Lumbers M, Raats M, Adams M (2010) Food safety knowledge and behaviours of children (5-7 years), HEALTH EDUCATION JOURNAL 69 (1) pp. 21-30 SAGE PUBLICATIONS LTD
Gage H, Kaye J, Kimber A, Storey L, Egan M, Qiao Y, Trend P (2011) Correlates of constipation in people with Parkinson's, Parkinsonism and Related Disorders 17 (2) pp. 106-111 Elsevier
Purpose
To investigate clinical, demographic and dietary factors associated with constipation in a sample of community dwelling people with Parkinson?s disease, recruited through a specialist outpatient clinic. Partners/carers provided a convenience control group.

Scope
Participants completed a baseline questionnaire (background information, diet and exercise, activities of daily living: mobility and manual dexterity, health-related quality of life (SF-12), stool frequency and characteristics, extent of concern due to constipation, laxative taking), and a four-week stool diary. The Rome criterion was used to determine constipation status. Multiple regression methods were used to explore the correlates of constipation. Baseline data were provided by 121 people with Parkinson?s, (54 controls), of whom 73% (25%) met the Rome criterion. Prospective diary data from 106 people with Parkinson?s (43 controls) showed lower proportions: 35% (7%) meeting the Rome criterion. Among all study subjects, i.e. Parkinson?s patients and controls taken together, the presence of constipation is predicted by having Parkinson?s disease (p = .003; odds ratio 4.80, 95% CI 1.64?14.04) and mobility score (p = .04; odds ratio 1.15, 95% CI 1.01?1.31), but not by dietary factors. Amongst people with Parkinson?s constipation is predicted by number of medications (p = .027). Laxative taking masks constipation, and is significantly associated with wearing protection against bowel incontinence (p = .009; odds ratio 4.80, 95% CI: 1.48?15.52).

Conclusions
Constipation is disease-related, not a lifestyle factor. More research is needed on optimal management and laxative use.

Egan B, Gage H, Williams P, Brands B, Gyoerei E, Lopez-Robles JC, Koletzko B, Campoy C, Desci T, Raats M (2013) FACTORS AFFECTING FOOD CHOICES OF PARENTS OF CHILDREN AGED 4-10 YEARS IN FOUR EUROPEAN COUNTRIES, ANNALS OF NUTRITION AND METABOLISM 63 pp. 1862-1862 KARGER
Gyoerei E, Egan B, Gage H, Williams P, Raats M, Brands B, Lopez-Robles J, Campoy C, Koletzko B, Decsi T (2011) Effect of food on learning: views of parents in four European countries, ANNALS OF NUTRITION AND METABOLISM 58 pp. 137-138
Gage H, Egan B, Williams P, Gyoerei E, Brands B, Lopez-Robles J-C, Brown KA, Campoy C, Koletzko B, Decsi T, Raats MM (2013) VIEWS OF PARENTS IN FOUR EUROPEAN COUNTRIES ABOUT THE EFFECT OF FOOD ON THE MENTAL PERFORMANCE OF PRIMARY SCHOOL CHILDREN, ANNALS OF NUTRITION AND METABOLISM 63 pp. 1132-1132 KARGER
Klepacz NA, Nash RA, Egan MB, Hodgkins CE, Raats MM (2015) When Is an Image a Health Claim? A False-Recollection Method to Detect Implicit Inferences About Products' Health Benefits, HEALTH PSYCHOLOGY 35 (8) pp. 898-907 AMER PSYCHOLOGICAL ASSOC
Gage H, Von Rosen-Von Hoewel J, Laitinen K, Jakobik V, Martin-Bautista E, Schmid M, Egan B, Morgan J, Williams P, Decsi T, Campoy C, Koletzko B, Raats M (2013) Health effects of infant feeding: Information for parents in leaflets and magazines in five European countries, PUBLIC UNDERSTANDING OF SCIENCE 22 (3) pp. 365-379 SAGE PUBLICATIONS LTD
Gage H, Raats M, Williams P, Egan B, Jakobik V, Laitinen K, Martin-Bautista E, Schmid M, von Rosen-von Hoewel J, Campoy C, Decsi T, Morgan J, Koletzko B (2011) Developmental origins of health and disease: the views of first-time mothers in 5 European countries on the importance of nutritional influences in the first year of life, AMERICAN JOURNAL OF CLINICAL NUTRITION 94 (6) pp. 2018S-2024S AMER SOC NUTRITION-ASN
Egan B, Gage H, Hood J, Poole K, McDowell C, Maguire G, Storey L (2012) Availability of complementary and alternative medicine for people with cancer in the British National Health Service: Results of a national survey, Complementary Therapies in Clinical Practice 18 (2) pp. 75-80 Elsevier
This study assessed access to Complementary and Alternative Medicine (CAM) therapies for people with cancer within the British National Health Service. CAM units were identified through an internet search in 2009. A total of 142 units, providing 62 different therapies, were identified: 105 (74.0%) England; 23 (16.2%) Scotland; 7 (4.9%) each in Wales and Northern Ireland. Most units provide a small number of therapies (median 4, range 1?20), and focus on complementary, rather than alternative approaches. Counselling is the most widely provided therapy (available at 82.4% of identified units), followed by reflexology (62.0%), aromatherapy (59.1%), reiki (43.0%), massage (42.2%). CAM units per million of the population varied between countries (England: 2.2; Wales: 2.3; Scotland: 4.8; Northern Ireland: 5.0), and within countries. Better publicity for CAM units, greater integration of units in conventional cancer treatment centres may help improve access to CAMs.
Anjos T, Altmäe S, Emmett P, Tiemeier H, Closa-Monasterolo R, Luque V, Wiseman S, Pérez-García M, Lattka E, Demmelmair H, Egan B, Straub N, Szajewska H, Evans J, Horton C, Paus T, Isaacs E, Van Klinken JW, Koletzko B, Campoy C (2013) Nutrition and neurodevelopment in children: Focus on NUTRIMENTHE project, European Journal of Nutrition 52 (8) pp. 1825-1842
Abstract: There is growing evidence that early nutrition affects later cognitive performance. The idea that the diet of mothers, infants, and children could affect later mental performance has major implications for public health practice and policy development and for our understanding of human biology as well as for food product development, economic progress, and future wealth creation. To date, however, much of the evidence is from animal, retrospective studies and short-term nutritional intervention studies in humans. The positive effect of micronutrients on health, especially of pregnant women eating well to maximise their child's cognitive and behavioural outcomes, is commonly acknowledged. The current evidence of an association between gestational nutrition and brain development in healthy children is more credible for folate, n-3 fatty acids, and iron. Recent findings highlight the fact that single-nutrient supplementation is less adequate than supplementation with more complex formulae. However, the optimal content of micronutrient supplementation and whether there is a long-term impact on child's neurodevelopment needs to be investigated further. Moreover, it is also evident that future studies should take into account genetic heterogeneity when evaluating nutritional effects and also nutritional recommendations. The objective of the present review is to provide a background and update on the current knowledge linking nutrition to cognition and behaviour in children, and to show how the large collaborative European Project NUTRIMENTHE is working towards this aim. © 2013 Springer-Verlag Berlin Heidelberg.
Gage H, Williams P, Von Rosen-Von Hoewel J, Laitinen K, Jakobik V, Martin-Bautista E, Schmid M, Egan B, Morgan J, Decsi T, Campoy C, Koletzko B, Raats MM (2012) Influences on infant feeding decisions of first-time mothers in five European countries, European Journal of Clinical Nutrition 66 (8) pp. 914-919 Nature Publishing Group
BACKGROUND/OBJECTIVES:

Infant feeding decisions made by new parents have significant health implications. The study aimed to investigate: influences on infant feeding decisions; characteristics of mothers reporting reliance on alternative information sources; associations between reliance on different sources and intentions to exclusively breastfeed and introduce complementary foods later; and subsequent breastfeeding and weaning behaviours.

SUBJECTS/METHODS:

First-time mothers in five European countries (England, Finland, Germany, Hungary, Spain) completed questionnaires about the importance of 17 influences on infant feeding choices at birth and 8 months later, during 2007?2008. Use of individual sources and reliance on four categories (family and friends, health professionals, written materials, audio-visual media) were compared between countries. Associations between information sources used and mother characteristics, feeding intentions and behaviours were investigated using appropriate statistical tests.

RESULTS:

In all, 2071 first-time mothers provided baseline data; 78% at 8 months. Variation exists between countries in the influence of different sources on feeding decisions of first-time mothers. Across all countries, the most important influences at both time points were books, partner and antenatal midwife. Mothers in higher income quintiles and remaining at school beyond age 16 years reported greater reliance on written sources (P

CONCLUSION:

Further research is required about which dissemination strategies are most effective at improving infant feeding behaviours in varied cultural settings, and for different socio-economic groups.

Egan B, Gage H, Williams P, Gyoerei E, Brands B, Lopez-Robles JC, Campoy C, Koletzko B, Desci T, Raats M (2013) ASSOCIATION BETWEEN DIET AND MENTAL PERFORMANCE OF CHILDREN: VIEWS OF PARENTS AND TEACHERS IN FOUR EUROPEAN COUNTRIES, ANNALS OF NUTRITION AND METABOLISM 63 pp. 1862-1862 KARGER
Poole K, Gage H, Storey L, Egan B, Thomas H (2007) Home Chemotherapy: should patients have a choice?, British Journal of Home Healthcare 2 (2) pp. 12-14
Klepacz N, Nash R, Egan MB, Raats MM, Hodgkins CE (2015) When Is an Image a Health Claim? A False-Recollection Method to Detect Implicit Inferences About Products? Health Benefits, Health Psychology 35 (8) pp. 898-907 American Psychological Association
Objective: Images on food and dietary supplement packaging might lead people to infer (appropriately or inappropriately) certain health benefits of those products. Research on this issue largely involves direct questions, which could (a) elicit inferences that would not be made unprompted, and (b) fail to capture inferences made implicitly. Using a novel memory-based method, in the present research, we explored whether packaging imagery elicits health inferences without prompting, and the extent to which these inferences are made implicitly. Method: In 3 experiments, participants saw fictional product packages accompanied by written claims. Some packages contained an image that implied a health-related function (e.g., a brain), and some contained no image. Participants studied these packages and claims, and subsequently their memories for seen and unseen claims were tested. Results: When a health image was featured on a package, participants often subsequently recognized health claims that? despite being implied by the image?were not truly presented. In Experiment 2, these recognition errors persisted despite an explicit warning against treating the images as informative. In Experiment 3, these findings were replicated in a large consumer sample from 5 European countries, and with a cued-recall test. Conclusion: These findings confirm that images can act as health claims, by leading people to infer health benefits without prompting. These inferences appear often to be implicit, and could therefore be highly pervasive. The data underscore the importance of regulating imagery on product packaging; memory-based methods represent innovative ways to measure how leading (or misleading) specific images can be.
Garcia-Alvarez A, Mila-Villarroel R, Ribas-Barba L, Egan B, Badea M, Maggi FM, Salmenhaara M, Restani P, Serra-Majem L (2016) Usage of Plant Food Supplements (PFS) for weight control in six European countries: results from the PlantLIBRA PFS Consumer Survey 2011-2012, BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 16 ARTN 254 BIOMED CENTRAL LTD
Anjos T, Altmäe S, Campoy C, Emmett P, Tiemeier H, Closa-Monasterolo R, Luque V, Wiseman S, van Klinken JW, Pérez-García M, Lattka E, Demmelmair H, Koletzko B, Egan B, Straub N, Szajewska H, Evans J, Horton C, Paus T, Isaacs E (2013) Nutrition and neurodevelopment in children: focus on NUTRIMENTHE project, European Journal of Nutrition pp. 1-18
There is growing evidence that early nutrition affects later cognitive performance. The idea that the diet of mothers, infants, and children could affect later mental performance has major implications for public health practice and policy development and for our understanding of human biology as well as for food product development, economic progress, and future wealth creation. To date, however, much of the evidence is from animal, retrospective studies and short-term nutritional intervention studies in humans. The positive effect of micronutrients on health, especially of pregnant women eating well to maximise their child's cognitive and behavioural outcomes, is commonly acknowledged. The current evidence of an association between gestational nutrition and brain development in healthy children is more credible for folate, n-3 fatty acids, and iron. Recent findings highlight the fact that single-nutrient supplementation is less adequate than supplementation with more complex formulae. However, the optimal content of micronutrient supplementation and whether there is a long-term impact on child's neurodevelopment needs to be investigated further. Moreover, it is also evident that future studies should take into account genetic heterogeneity when evaluating nutritional effects and also nutritional recommendations. The objective of the present review is to provide a background and update on the current knowledge linking nutrition to cognition and behaviour in children, and to show how the large collaborative European Project NUTRIMENTHE is working towards this aim. © 2013 Springer-Verlag Berlin Heidelberg.
Hodgkins C, Raats MM, Egan MB, Fragodt A, Buttriss J, McKevith B (2010) Optimising food composition data flow within the UK food supply chain and to external stakeholders, JOURNAL OF FOOD COMPOSITION AND ANALYSIS 23 (7) pp. 749-752 ACADEMIC PRESS INC ELSEVIER SCIENCE
Egan B, Gage H, Williams P, Brands B, Györei E, López-Robles JC, Campoy C, Decsi T, Koletzko B, Raats M (2016) The effect of diet on the physical and mental development of children: views of parents and teachers in four European countries., The British journal of nutrition pp. 1-9 Cambridge University Press
Although the impact of diet on physical health is an important public health issue, less attention has been devoted to the relationship between nutrition and children's mental development. The views of parents and teachers about the extent to which diet affects physical and mental development of children were compared in four European countries. An online questionnaire (developed in English and translated) was circulated through a market research agency. Participants were parents or teachers of children aged 4-10 years without learning or behavioural issues. Questionnaires were returned by 1606 parents (401 in England, Germany and Hungary; 403 in Spain) and 403 teachers (100 in each country, except for 103 in Hungary). Teachers were older than parents (35·3 % v. 18·3 % over 45 years; P
Lopez Robles J, Egan B, Brands B, Gyoerei E, Gage H, Raats M, Koletzko B, Decsi T, Campoy C (2011) Teachers knowledge of the influence of nutrition on childrens mental performance in four European countries, ANNALS OF NUTRITION AND METABOLISM 58 pp. 409-409
Garcia-Alvarez A, Egan MB, de Klein S, Dima L, Maggi F, Isoniemi M, Ribas-Barba L, Raats MM, Meissner E, Badea M, Bruno F, Salmenhaara M, Mila-Villarroel R, Knaze V, Hodgkins CE, Marculescu A, Uusitalo L, Restani P, Serra-Majem L (2014) Usage of Plant Food Supplements across Six European Countries: Findings from the PlantLIBRA Consumer Survey, PLoS ONE 9 (3) Public Library of Science

Background

The popularity of botanical products is on the rise in Europe, with consumers using them to complement their diets or to maintain health, and products are taken in many different forms (e.g. teas, juices, herbal medicinal products, plant food supplements (PFS)). However there is a scarcity of data on the usage of such products at European level.

Objective

To provide an overview of the characteristics and usage patterns of PFS consumers in six European countries.

Design

Data on PFS usage were collected in a cross-sectional, retrospective survey of PFS consumers using a bespoke frequency of PFS usage questionnaire.

Subjects/setting

A total sample of 2359 adult PFS consumers from Finland, Germany, Italy, Romania, Spain and the United Kingdom.

Data analyses

Descriptive analyses were conducted, with all data stratified by gender, age, and country. Absolute frequencies, percentages and 95% confidence intervals are reported.

Results

Overall, an estimated 18.8% of screened survey respondents used at least one PFS. Characteristics of PFS consumers included being older, well-educated, never having smoked and self-reporting health status as ?good or very good?. Across countries, 491 different botanicals were identified in the PFS products used, with Ginkgo biloba (Ginkgo), Oenothera biennis (Evening primrose) and Cynara scolymus (Artichoke) being most frequently reported; the most popular dose forms were capsules and pills/tablets. Most consumers used one product and half of all users took single-botanical products. Some results varied across countries.

Conclusions

The PlantLIBRA consumer survey is unique in reporting on usage patterns of PFS consumers in six European countries. The survey highlights the complexity of measuring the intake of such products, particularly at pan-European level. Incorporating measures of the intake of botanicals in national dietary surveys would provide much-needed data for comprehensive risk and benefit assessments at the European level.

Egan MB, Fragodt A, Raats M, Hodgkins C, Lumbers M (2007) The importance of harmonizing food composition data across Europe, European Journal of Clinical Nutrition 61 (7) pp. 813-821
Objective: To examine the role of food composition data in Europe in four sectors, namely health, trade regulation and legislation, agriculture and the environment. Results: The need for further harmonization of data across Europe is clearly identified and evidenced from a number of previous successful European collaborations. Conclusions: Data on the nutritional composition of foods are essential for a broad spectrum of activities, including public health nutrition, research, the food industry and government policy development and implementation. With the expansion of the European Union and the concomitant increase in cross border trade and cooperation harmonizing food composition data becomes a more important issue than ever. Harmonization is not solely a technical issue, but also involves creating durable and sustainable structures to maintain the viability of the data. These are some of the issues currently being addressed by the European Food Information Resource Network of Excellence.
Egan MB, Raats MM, Grubb SM, Eves A, Lumbers ML, Dean MS, Adams MR (2007) A review of food safety and food hygiene training studies in the commercial sector, FOOD CONTROL 18 (10) pp. 1180-1190 ELSEVIER SCI LTD
Egan MB, Fragodt A, Raats MM (2006) The importance of harmonising and sustaining food composition data across Europe, Nutrition Bulletin 31 (4) pp. 349-353
Food composition data are essential for a wide variety of activities, including public health nutrition, research, food labelling and government policy. Food composition data play a particularly important role in four sectors in Europe, namely health, trade regulation and legislation, agriculture and the environment. The need to continue the harmonisation of food composition data already achieved through European collaboration can be clearly identified and evidenced. Harmonisation is not exclusively a technical issue, but also entails creating durable and sustainable structures to maintain the viability of food composition data. These and related issues are currently being addressed by the EuroFIR Network of Excellence (project number FP6-513944, http://www.eurofir.net). © 2006 British Nutrition Foundation.
Egan B, Hodgkins C, Fragodt A, Raats MM (2011) Compilation of food composition data sets: an analysis of user needs through the Use Case approach., European Journal of Clinical Nutrition 65 (6) pp. 757-760 Nature Publishing Group
Background/Objectives:The objective of this study was to identify the common requirements of users involved in the compilation of food composition data sets with a view to informing the development of a common access system to food composition data, within the European Food Information Resource (EuroFIR) project.Subjects/Methods:A number of examples of food composition data set compilation have been examined using the Use Case approach, namely the compilation of a data set for a national nutrition survey, for a cross-national nutrition study and for a nutritional software programme.Results:The key user requirement identified from the compilation step analysed by the Use Case approach is the increased availability of and access to more detailed food composition data on a wider range of foods and nutrients.Conclusions:Food composition data serve a variety of purposes, and different user groups will often have both common needs and more individual or specific needs of their data sets. The development of Use Cases for specific processes effectively identifies the needs of users, highlighting any similarities and/or differences in those needs. The application of the Use Case approach to support the software development activities within EuroFIR will ensure that user needs are effectively identified and captured in a systematic and documented way.
Egan MB, Bielby G, Eves A, Lumbers ML, Raats MM, Adams MR (2008) Food hygiene education in UK secondary schools: A nationwide survey of teachers' views, HEALTH EDUCATION JOURNAL 67 (2) pp. 110-120 SAGE PUBLICATIONS LTD
Golding S, Horsfield C, Davies A, Egan M, Jones M, Raleigh M, Schofield P, Squires A, Start K, Quinn T, Cropley M (2017) Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis, PeerJ 5 PeerJ

Background. The study objective was to investigate and synthesize available evidence
relating to the psychological health of Emergency Dispatch Centre (EDC) operatives,
and to identify key stressors experienced by EDC operatives.

Methods. Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo,
PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar)
were searched. All study designs were included, and no date limits were set. Studies
were included if they were published in English, and explored the psychological health
of any EDC operatives, across fire, police, and emergency medical services. Studies were
excluded if they related solely to other emergency workers, such as police officers or
paramedics. Methodological quality of included studies was assessed using checklists
adapted from the Critical Appraisal Skills Programme. A narrative synthesis was
conducted, using thematic analysis.

Results. A total of 16 articles were included in the review. Two overarching themes were
identified during the narrative synthesis: `Organisational and Operational Factors' and
`Interactions with Others'. Stressors identified included being exposed to traumatic
calls, lacking control over high workload, and working in under-resourced and pres-
sured environments. Lack of support from management and providing an emotionally
demanding service were additional sources of stress. Peer support and social support
from friends and family were helpful in managing work-related stress.

Discussion. EDC operatives experience stress as a result of their work, which appears to
be related to negative psychological health outcomes. Future research should explore
the long-term effects of this stress, and the potential for workplace interventions to
alleviate the negative impacts on psychological health.

Banks Adrian P., Egan Bernadette, Hodgkins Charo E., Peacock Matthew, Raats Monique M. (2018) The role of causal models and beliefs in interpreting health claims, British Journal of Health Psychology 23 (4) pp. 933-948 Wiley

Objective: Health claims on food packaging are regulated to inform and protect consumers, however many consumers do not accurately interpret the meaning of the claims. Whilst research has shown different types of misinterpretation, it is not clear how those interpretations are formed. The aim of this study is to elicit the causal beliefs and causal models about food and health held by consumers, i.e. their understanding of the causal relationships between nutrients, health outcomes and the causal pathways connecting them, and investigate how well this knowledge explains the variation in inferences they draw about health benefits from health claims.

Method: 400 participants from Germany, the Netherlands, Spain, Slovenia, and the UK were presented with 7 authorised health claims and drew inferences about the health benefits of consuming nutrients specified in the claim. Then their personal causal models of health were elicited along with their belief in the truth and familiarity with the claims.

Results: The strength of inferences about health benefits that participants drew from the claims were predicted independently by the strength of the relevant causal pathways within the causal model, and belief in the truth of the claim, but not familiarity with the claim. Participants drew inferences about overall health benefits of the nutrients by extrapolating from their causal models of health.

Conclusion: Consumers? interpretation of claims is associated with their belief in the claim and their causal models of health. This prior knowledge is used to interpret the claim and draw inferences about overall health benefits that go beyond the information in the claim. Therefore efforts to improve consumers? understanding and interpretation of health claims must address both their wider causal models of health and their knowledge of specific claims.

Egan M, Gage H, Hood J, Poole K, McDowell C, Maguire G, Storey L (2012) Availability of CAM for people with cancer in the British NHS: the results of a national survey, Complementary Therapies in Clinical Practice 18 (2) pp. 75-80 Elsevier
This study assessed access to Complementary and Alternative Medicine (CAM) therapies for people with cancer within the British National Health Service. CAM units were identified through an internet search in 2009. A total of 142 units, providing 62 different therapies, were identified: 105 (74.0%) England; 23 (16.2%) Scotland; 7 (4.9%) each in Wales and Northern Ireland. Most units provide a small number of therapies (median 4, range 1?20), and focus on complementary, rather than alternative approaches. Counselling is the most widely provided therapy (available at 82.4% of identified units), followed by reflexology (62.0%), aromatherapy (59.1%), reiki (43.0%), massage (42.2%). CAM units per million of the population varied between countries (England: 2.2; Wales: 2.3; Scotland: 4.8; Northern Ireland: 5.0), and within countries. Better publicity for CAM units, greater integration of units in conventional cancer treatment centres may help improve access to CAMs.