Dr Kathryn Hart


Lecturer in Nutrition and Dietetics
PhD (Nutrition), BSc (Hons) Nutrition & Dietetics
+44 (0)1483 686438
40 AY 03
Weds, Thurs, Friday

Biography

Areas of specialism

Nutrition in early life; Dietary assessment

University roles and responsibilities

  • Level 4 co-ordinator
  • Personal tutor across all UG and PGT levels
  • Academic representative on Dietetic Stakeholder Committee

My qualifications

2013
Advanced Nutrition Leadership
European Nutrition Leadership Platform
2008
Diploma in Advanced Dietetic Practice
British Dietetic Association
2007
Postgraduate Certificate in Academic Practice
University of Surrey
2003
PhD (Nutrition)
University of Surrey
1999
BSc (Hons) Nutrition & Dietetics
University of Surrey

Affiliations and memberships

British Dietetic Association
Full member
Member of the Paediatric and Freelance Specialist groups
Health and Care Professions Council
Registered Dietitian
Nutrition Society
Full member
Member of the Training and Education Committee

Academic networks

Research projects

Research collaborations

My teaching

Supervision

Postgraduate research supervision

My publications

Highlights

Tripkovic L, Wilson LR, Hart K, Johnsen S, de Lusignan S, Smith CP, Bucca G, Penson S, Chope G, Elliott R, Hyppönen E, Berry JL, Lanham-New SA (2017) Daily supplementation with 15 μg vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: a 12-wk randomized, placebo-controlled food-fortification trial. Am J Clin Nutr. doi: 10.3945/ajcn.116.138693.

Smith TJ. Tripkovic L, Damsgaard CT, Mølgaard C, Ritz C, Wilson-Barnes SL, Hart KH (2016) Estimation of the dietary requirement for vitamin D in adolescents aged 14-18 years: a dose-response, double-blind, randomized placebo-controlled trial. Am J Clin Nutr, 104(5), 1301-1309.

Tripkovic L, Lambert H, Hart K, Smith CP, Bucca G, Penson S, Chope G, Hyppönen E, Berry J, Vieth R, Lanham-New S (2012) Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis. Am J Clin Nutr;95(6):1357-64.

Publications

Hart K, Cave E, Conroy B, Farina N, Young J, Rusted J, Tabet N (2013) Nutritional status of older adults with and without dementia, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E247-E247 CAMBRIDGE UNIV PRESS
Smith T, Tripkovic L, Hart K, Lanham-New S (2015) Associations between maternal-child dietary vitamin D and calcium intakes in UK male and female adolescents aged 14-18 years, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE5) pp. E329-E329 CAMBRIDGE UNIV PRESS
Whyte M, Johnson R, Cooke D, Hart KH, McCormack M, Shawe J (2016) Diagnosing gestational diabetes mellitus in women following bariatric surgery: A national survey of lead diabetes midwives, British Journal of Midwifery. 24 (6) pp. 434-438 Mark Allen Healthcare
Background: Bariatric surgery is becoming more common among
women of fertile age to manage obesity. The number of pregnancies
following bariatric surgery is, therefore, likely to rise. The standard
oral glucose tolerance test (OGTT) may lead to dizziness, sweating and
collapse in people after some types of bariatric surgery.
Aims: In view of this potential pitfall in the diagnosis of gestational
diabetes mellitus (GDM) after bariatric surgery, the authors surveyed
midwifery units to establish current practice for the screening and
diagnosis of GDM in women who have had bariatric surgery.
Methods: Out of 164 English obstetric units, 120 email surveys were
sent to a network of lead diabetes midwives in units across England.
A reminder email was sent 4 weeks later.
Findings: Twenty-seven (22.5%) responses were received. Five
respondents (26%) had specific policies in place to manage pregnancies
after bariatric surgery. A wide variety of approaches to GDM screening
and diagnosis were used in women with a history of bariatric surgery.
The OGTT was the most widely used test after bariatric surgery.
Conclusions: There is a need for national clinical guidelines to be
developed for the diagnosis of GDM after bariatric surgery.
Darling AL, Hart Kath, Gibbs MA, Gossiel F, Kantermann T, Horton K, Johnsen Sigurd, Berry JL, Skene Debra, Eastell R, Vieth R, Lanham-New Susan (2014) Greater seasonal cycling of 25-hydroxyvitamin D is associated with increased parathyroid hormone and bone resorption, OSTEOPOROSIS INTERNATIONAL 25 (3) pp. 933-941 SPRINGER LONDON LTD
Summary: This analysis assessed whether seasonal change in 25-hydroxyvitamin D concentration was associated with bone resorption, as evidenced by serum parathyroid hormone and C-terminal telopeptide concentrations. The main finding was that increased seasonal fluctuation in 25-hydroxyvitamin D was associated with increased levels of parathyroid hormone and C-terminal telopeptide. Introduction: It is established that adequate 25-hydroxyvitamin D (25(OH)D, vitamin D) concentration is required for healthy bone mineralisation. It is unknown whether seasonal fluctuations in 25(OH)D also impact on bone health. If large seasonal fluctuations in 25(OH)D were associated with increased bone resorption, this would suggest a detriment to bone health. Therefore, this analysis assessed whether there is an association between seasonal variation in 25(OH)D and bone resorption. Methods: The participants were (n = 279) Caucasian and (n = 88) South Asian women (mean (±SD); age 48.2 years (14.4)) who participated in the longitudinal Diet, Food Intake, Nutrition and Exposure to the Sun in Southern England study (2006-2007). The main outcomes were serum 25(OH)D, serum parathyroid hormone (sPTH) and serum C-terminal telopeptide of collagen (sCTX), sampled once per season for each participant. Results: Non-linear mixed modelling showed the (amplitude/mesor) ratio for seasonal change in log 25(OH)D to be predictive of log sPTH (estimate = 0.057, 95 % CI (0.051, 0.063), p
Tripkovic L, Muirhead NC, Hart KH, Frost GS, Lodge JK (2014) The effects of a diet rich in inulin or wheat fibre on markers of cardiovascular disease in overweight male subjects., J Hum Nutr Diet 28 (5) pp. 476-485
BACKGROUND: Previous studies suggest that the beneficial health effects of a diet rich in whole grains could be a result of the individual fibres found in the grain. The present study aimed to investigate the influence of a diet high in either wheat fibre (as an example of an insoluble fibre) or inulin (a nondigestible carbohydrate) on markers of cardiovascular disease. METHODS: Ten male participants classified as at higher risk of cardiovascular disease [mean (SD) body mass index 30.2 (3) kg m(-2) , mean (SD) waist circumference 106.4 (7) cm, mean (SD) age 39.8 (9) years] were recruited to a randomised, controlled, cross-over study comparing the consumption of bespoke bread rolls containing either inulin, wheat germ or refined grain (control) (15 g day(-1) ) for 4 weeks with a 4-week washout period between each regime. At the end of each regime, participants underwent an oral glucose tolerance test (OGTT), measures of pulse wave velocity (PWV), 24-h ambulatory blood pressure (AMBP), plasma lipid status and markers of glucose control. RESULTS: There was no difference in measures of glucose control, lipid status, 24-h AMBP or PWV after the intervention periods and no changes compared to baseline. There was no significant difference between OGTT glucose and insulin time profiles; however, there was a significant difference in area under the curves between the wheat fibre and control interventions when comparing change from baseline (control +10.2%, inulin +4.3%, wheat fibre -2.5%; P = 0.03). CONCLUSIONS: Only limited differences between the interventions were identified, perhaps as a consequence of the amount of fibre used and intervention length. The wheat germ intervention resulted in a significant reduction in glucose area under the curve, suggesting that this fibre may aid glucose control.
Sutton D, Davey T, VenkatRaman G, Hart K (2009) Can a functional food exert a cholesterol lowering effect in renal transplant patients?, Journal of Renal Care 35 (1) pp. 42-47
This study examined whether stanols can exert their cholesterol lowering effect in renal transplant recipients who develop hypercholesterolaemia. The rise in cholesterol is related to the use of cyclosporine. The study was a randomised parallel-group intervention study. The Intervention group (1) was given three months supply of stanol containing food products. Fasting serum lipids were measured monthly. Parameters that might influence serum cholesterol were measured on all subjects at the start of the study period and at three months. These included body weight, blood pressure and drug therapy, dietary intake, exercise, smoking and alcohol intake. 84 patients completed the study. Cholesterol was reduced in both groups. The difference between control (C) and I group reached significance at p = 0.0196. Reduction in cholesterol in subjects also using statins was greater in the I group. Functional foods appear to be effective in reducing cholesterol in this group of patients. Data collection with respect to other factors that influence CV risk suggests that an overall assessment of diet and lifestyle as well as cholesterol lowering should be undertaken. © 2009 European Dialysis and Transplant Nurses Association/European Renal Care Association.
Smith TJ, Tripkovic L, Damsgaard, C, Mølgaard C, Ritz C, Wilson-Barnes SL, Dowling K, Hennessy A, Cashman K, Kiely M, Lanham-New SA, Hart KH (2016) Estimation of the dietary requirement for vitamin D in adolescents aged 14-18 years: a dose-response, double-blind, randomized placebo-controlled trial, The American Journal of Clinical Nutrition 104 (5) 138065 pp. 1301-1309 American Society for Nutrition
Background Adolescents are a population group at high risk of low vitamin D status, yet the evidence base for establishing dietary vitamin D requirements to ensure adequacy remains weak. Objective To establish the distribution of vitamin D intakes required to maintain serum 25- hydroxyvitamin D [25(OH)D] concentrations above proposed cut-offs (25, 30, 40 and 50 nmol/L) during the winter-time in white males and females (14-18 years) in the UK (51o 9 N). Design In a dose-response trial, 110 adolescents (age 15.9 ± 1.4 years; 43% male) were randomizedto receive daily 0, 10 or 20 µg vitamin D3 supplements for 20 weeks during the winter-time. A non-linear regression model was fit to the total vitamin D intake (diet plus supplemental) and post-intervention serum 25(OH)D concentrations, and regression predicted values were used to estimate the vitamin D intakes required to maintain serum 25(OH)D concentrations above specific cut-offs. Results Mean (± SD) serum 25(OH)D concentrations increased from 49.2 ± 12.0 to 56.6 ± 12.4 nmol/L and from 51.7 ± 13.4 to 63.9 ± 10.6 nmol/L in the 10 and 20 µg/day groups respectively, and decreased in the placebo group from 46.8 ± 11.4 to 30.7 ± 8.6 nmol/L (all p d 0.001). Vitamin D intakes required to maintain post-intervention 25(OH)D concentrations > 25 and > 30 nmol/L in 97.5% of adolescents were estimated as 10.1 and 13.1 µg/day respectively, and 6.6 µg/day to maintain 50% of adolescents > 40 nmol/L. As the response of 25(OH)D plateaued at 46 nmol/L, there is uncertainty in estimating the vitamin D intake required to maintain 25(OH)D > 50 nmol/L in 97.5% of adolescents, but it did exceed 30 µg/day Conclusions Vitamin D intakes of between 10 and ~30 µg/day are required by white adolescents during the winter-time in order to maintain serum 25(OH)D concentrations > 25 ? 50 nmol/L, depending on the serum 25(OH)D threshold chosen.
Darling AL, Hart KH, Skene DJ, Arber S, Lanham-New SA (2013) Vitamin D, sunlight exposure, sleep disturbances and musculoskeletal health of older South Asian women in the UK: biological and social influences, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E187-E187 CAMBRIDGE UNIV PRESS
Al-Haddad FA, Rajab MH, Al-Qallaf SM, Musaiger AO, Hart KH (2016) Assessment of vitamin D levels in newly diagnosed children with type 1 diabetes mellitus comparing two methods of measurement: a facility's experience in the Middle Eastern country of Bahrain., Diabetes, metabolic syndrome and obesity : targets and therapy 9 pp. 11-16 Dove Press
The number of children being diagnosed with type 1 diabetes mellitus (T1DM) is on the rise and has more than doubled in the past 10 years in Bahrain. Some studies have linked low vitamin D levels with an increased risk of diabetes. There are concerns regarding the variations in circulating 25(OH)D levels measured by different laboratories and by using different analytical techniques.The aim of this study was to evaluate the vitamin D levels of newly diagnosed children with T1DM using the "gold standard method" with high-pressure liquid chromatography-tandem mass spectrometry methods compared to the chemiluminescence micro-particle immunoassay (CMIA) used in a hospital laboratory.Eighteen children, aged 6-12 years, who received a confirmed diagnosis of T1DM in 2014 were chosen as subjects.Serum vitamin D levels were assessed in a hospital, while an extra aliquot of blood collected during routine blood collection after acquiring informed written consents from the subjects, and sent to Princess Al-Jawhara Center for Molecular Medicine and Inherited Disorders to be analyzed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).The mean age of the study group was 9±2 years. The mean total of 25(OH)D levels (D3 and D2) assessed by UPLC-MS/MS was 49.7±18.8, whereas the mean total of 25(OH)D levels obtained from the CMIA assay was 44.60±13.20. The difference in classification between the two methods was found to be statistically significant (P=0.004). A Bland-Altman plot showed a poor level of agreement between the two assay methods. The CMIA overestimated insufficient values and underestimated deficiency, when compared to UPLC-MS/MS.There was a statistically significant difference between the two assay methods with CMIA overestimating vitamin D insufficiency. Clinicians should be prudent in their assessment of a single vitamin D reading, when the gold standard method is not available or feasible.
Gibson PS, Fitzpatrick E, Kamat D, Dhawan A, Ford-Adams ME, Desai A, Hart K, Moore JB (2015) Assessment of diet and lifestyle factors associated with non-alcoholic fatty liver disease in a UK paediatric population, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE5) pp. E324-E324 CAMBRIDGE UNIV PRESS
Darling AL, Hakim OA, Hart KH, Berry JL, Lanham-New SA (2012) POSTMENOPAUSAL SOUTH ASIAN WOMEN SHOW ADAPTATIONS IN TIBIAL CORTICAL THICKNESS AND VOLUMETRIC BONE MINERAL DENSITY TO COMPENSATE FOR SMALL OVERALL BONE SIZE, OSTEOPOROSIS INTERNATIONAL 23 pp. S584-S584 SPRINGER LONDON LTD
Tripkovic L, Wilson L, Hart K, Elliott R, Smith CP, Bucca G, Penson S, Chope G, Hypponen E, Berry J, Lanham-New S (2015) The D2-D3 Study: a randomised, double-blind, placebo-controlled food-fortification trial in women, comparing the efficacy of 15ug/d vitamin D2 vs vitamin D3 in raising serum 25OHD levels, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE1) pp. E16-E16 CAMBRIDGE UNIV PRESS
Hart KH, Power J (2007) Disorders of the colon, In: Thomas B, Bishop J, Association BD (eds.), Manual of dietetic practice pp. 486-495 Wiley-Blackwell
Hakim O, Lanham-New S, Shojaee-Moradie F, Morgan L, Umpleby A, Griffin B, Berry J, Eastell R, Gossiel F, Hannon R, Hart K (2010) POORER LIPID PROFILE ARE ASSOCIATED WITH INCREASED BONE RESORPTION AND PARATHYROID HORMONE: PRELIMINARY RESULTS OF THE D-FINES STUDY, OSTEOPOROSIS INTERNATIONAL 21 (Suppl 3) pp. S506-S507 SPRINGER LONDON LTD
Omar N, Gibbs M, Hart K (2011) Nutritional status in older adults across care settings, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE6) pp. E390-E390 CAMBRIDGE UNIV PRESS
Tripkovic L, Hart KH, Frost GS, Lodge JK (2014) Interindividual and intraindividual variation in pulse wave velocity measurements in a male population, Blood Pressure Monitoring 19 (4) pp. 233-241
OBJECTIVE: Pulse wave velocity (PWV) is a measure of arterial stiffness and a marker for cardiovascular disease. Although commonly used, there are only a few reports investigating the intersession and intrasession variability in PWV measurements, the determination of which is important in a mixed population when using PWV as a clinical marker. Therefore, the aim of this study was to investigate the variability in PWV measurements and factors that may influence PWV variability. METHODS: A male population (n=8, age 30.9±9.0 years; BMI 25.1±4.0 kg/m) underwent measurements of PWV and blood pressure several times in a single study visit and during six study visits over a 4-6-week period. During these study visits, experiments were performed at rest and following acute exercise and feeding. RESULTS: Intersession coefficients of variation (CVs) were 5.3 and 4.5% for radial-carotid (R-C) and carotid-femoral (C-F) PWVs, respectively, whereas intrasession CVs were 9.3 and 6.9% for R-C and C-F PWVs, respectively. Good reproducibility in PWV measurements was demonstrated by individual responses in the data; two of eight participants had significant differences in C-F PWV over time (P=0.05). There were significant increases in systolic blood pressure following acute exercise (P
Jeanes YM, Hodgson J, Saunders N, Gibson L, Hart K (2012) Eating behaviours in obese and lean women with polycystic ovary syndrome, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E237-E237 CAMBRIDGE UNIV PRESS
Hakim O, Darling A, Hart K, Berry J, Lanham-New S (2011) Differences in volumetric bone mineral density (vBMD) at the radius and tibia in premenopausal Caucasian and Asian women, BONE 48 pp. S269-S270 ELSEVIER SCIENCE INC
Macdonald HM, Mavroeidi A, Fraser WD, Darling AL, Black AJ, Aucott L, O'Neill F, Hart K, Berry JL, Lanham-New SA, Reid DM (2011) Erratum to: Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: a major cause for concern?, Osteoporos Int
Darling AL, Hart KH, Lanham-New SA (2011) Increased dietary protein is strongly associated with reduced bone mineral density and bone mineral content at the femoral neck and lumbar spine in UK dwelling South Asian and Caucasian postmenopausal women, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE4) pp. E123-E123 CAMBRIDGE UNIV PRESS
Hart KH, Hiscutt R, Truby H (2007) A pilot investigation into body composition change and dietary intake during an 8-week low-carbohydrate diet in free-living obese women., International Journal of Body Composition Research 5 (1) pp. 41-44
Hart KH (2007) Dietary Fibre, In: Thomas B, Bishop J, Association BD (eds.), Manual of dietetic practice 2.5 pp. 180-186 Wiley-Blackwell
Tripkovic L, Wilson L, Hart K, Lanham-New S (2012) Reply to HM Macdonald et al, American Journal of Clinical Nutrition 96 (5) pp. 1153-1154
Hakim O, Darling A, Hart K, Berry J, Lanham-New S (2011) VITAMIN D STATUS AND VOLUMETRIC BONE MINERAL DENSITY (VBMD) AT THE RADIUS AND TIBIA IN PREMENOPAUSAL CAUCASIAN AND ASIAN WOMEN, OSTEOPOROSIS INTERNATIONAL 22 pp. S722-S722 SPRINGER LONDON LTD
Barr S, Hart K, Reeves S, Jeanes Y (2007) Dietary composition of UK women with Polycystic Ovary Syndrome, ANNALS OF NUTRITION AND METABOLISM 51 pp. 345-346 KARGER
Tripkovic L, Lambert H, Hart K, Smith CP, Bucca G, Penson S, Chope G, Hyppönen E, Berry J, Vieth R, Lanham-New S (2012) Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis., Am J Clin Nutr 95 (6) pp. 1357-1364 American Society for Nutrition
Currently, there is a lack of clarity in the literature as to whether there is a definitive difference between the effects of vitamins D(2) and D(3) in the raising of serum 25-hydroxyvitamin D [25(OH)D].
Hartwick CA, Moreno L, Fisberg M, Hart K, Fielding B, Lenham-New S, Richards Z (2014) An international study of food behavior and nutritional status of children from 21 countries, FASEB JOURNAL 28 (1) FEDERATION AMER SOC EXP BIOL
Gibson PS, Fitzpatrick E, Kamat D, Dhawan A, Ford-Adams ME, Desai A, Hart K, Moore JB (2015) ASSESSMENT OF DIET AND PHYSICAL ACTIVITY IN PAEDIATRIC NON-ALCOHOLIC FATTY LIVER DISEASE PATIENTS: A UK CASE CONTROL STUDY, JOURNAL OF HEPATOLOGY 62 pp. S821-S822 ELSEVIER SCIENCE BV
Shawe J, Cooke D, Hart K, McGowan BM, Pring C, Subramanian D, Whyte M (2014) Pregnancy after diabetes obesity surgery (PADOS): Qualitative study of pre-pregnancy care., Pregnancy Hypertens 4 (3)
Half of all bariatric surgical procedures are in women of childbearing age. Surgery may improve fertility yet exacerbate nutritional deficiencies, that may be disadvantageous to the fetus. A frequently encountered subgroup of obese women have type 2 diabetes. The health risks, to both mother and child, of diabetes in pregnancy are well described including 4.7× risk of stillbirth and 2× risk of congenital abnormality. What is not clear is whether bariatric surgery mitigates or complicates the health consequences of women with obesity and diabetes in pregnancy. In addition the influence of the type of surgery, the optimal interval between surgery and conception and evidence based preconception recommendations are unknown. This study complements wider research aiming to inform optimal management of this patient population. Obese diabetic women require clear guidance regarding pregnancy planning after surgery. This study will develop an understanding of the barriers and facilitators (psychological, behavioural, attitudinal and nutritional) to achieving effective pre-pregnancy health and care in women with type 2 diabetes who have undergone metabolic surgery. Currently women's perception of fertility issues and risks after bariatric surgery is unknown and thus a qualitative interpretive paradigm was chosen. Interviews with the target population will explore decision-making processes; experience regarding metabolic surgery and perceived pregnancy risk. Interviews with a broad range of health professionals involved in bariatric care will include rationale for selected surgical procedure and post surgery referral processes e.g. contraceptive care. This will advance understanding of how to provide targeted support and monitoring.
Gibson P, Fitzpatrick E, Quaglia A, Dhawan A, Wu H, Hart K, Lanham-New S, Moore JB (2015) Assessment of vitamin D status and genetic variation in vitamin-D related genes: key findings from a UK paediatric non-alcoholic fatty liver disease population, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE1) pp. E12-E12 CAMBRIDGE UNIV PRESS
Gibson PS, Fitzpatrick E, Quaglia A, Dhawan A, Wu H, Hart K, Lanham-New S, Moore JB (2014) Association of NADSYN1, DHCR7, GC and VDR Genotypes With Steatosis And Liver Inflammation in UK Paediatric Non-Alcoholic Fatty Liver Disease Patients, HEPATOLOGY 60 pp. 967A-967A WILEY-BLACKWELL
Tripkovic L, Wilson L, Hart K, Lanham-New S (2013) Associations between dietary intake and volumetric bone mineral density in South Asian and Caucasian women: preliminary analysis of the D2-D3 Study, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E216-E216 CAMBRIDGE UNIV PRESS
Jeanes YM, Barr S, Smith K, Hart KH (2009) Dietary management of women with polycystic ovary syndrome in the United Kingdom: the role of dietitians, JOURNAL OF HUMAN NUTRITION AND DIETETICS 22 (6) pp. 551-558 WILEY-BLACKWELL PUBLISHING, INC
Darling AL, Hart KH, Gossiel F, Eastell R, Berry JL, Lanham-New SA (2015) Bone resorption levels are related to diet in UK dwelling South Asian but not Caucasian women, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE1) pp. E43-E43 CAMBRIDGE UNIV PRESS
Wilson L, Hall E, Hart K, Lanham-New S, Tripkovic L (2012) Association between dietary vitamin D intakes and blood pressure in Caucasian and South Asian females: preliminary analysis of the D2-D3 Study, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E235-E235 CAMBRIDGE UNIV PRESS
Wilson L, Hart K, Elliott R, Smith CP, Bucca G, Penson S, Chope G, Hypponen E, Berry J, Lanham-New S, Tripkovic L (2015) The D2-D3 Study: comparing the efficacy of 15 mu g/d vitamin D2 vs. D3 in raising vitamin D status in both South Asian and Caucasian women, and the ethical implications of placebo treatment, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE1) pp. E116-E116 CAMBRIDGE UNIV PRESS
Al-Haddad FA, Musaiger A, Al-Qallaf M, Hart K (2015) Children with Type 1 Diabetes, Bahrain Medical Bulletin 37 (1)
© 2015, Bahrain Medical Bulletin. All Rights Reserved.Background: The prevalence of diabetes in the Middle East is amongst the highest worldwide; Bahrain ranks amongst the top 10 countries. In particular, increasing number of children are being diagnosed with type 1 diabetes mellitus (T1DM) posing a significant public health concern. Objective: To evaluate the magnitude of type 1 diabetes in Bahrain. Design: A Case-Control Retrospective Study. Setting: Pediatric Diabetes and Endocrine Clinic and Local Health Centers (LHC). Method: Fifty-nine cases and 53 controls were included in the study. Data from the Diabetes Registry were recorded for subjects meeting the inclusion criteria and questionnaire was administered to healthy controls. Chi Square or Student?s t-test was used as appropriate. Logistic regression analysis was used to evaluate independent predictors of T1DM. Result: Fifty-nine children aged 6-12 years diagnosed with T1DM in the years 2009 and 2010 were compared to 53 healthy controls. Children with T1DM were more likely to have suffered from a pre-diabetes illness such as tonsillitis 32 (54.2%) compared to controls 3 (5.7%), and have undergone a surgery prior to diagnosis 14 (23.7%), and to have mothers with T2DM or family history of GDM. No significant difference in infant-feeding practices was observed between children with type 1 diabetes and the healthy controls. Conclusion: Children with T1DM were more likely to have suffered from other infectious illnesses before the diagnosis was established. Whilst unable to fully investigate any potential genetic differences between cases and controls, this study provides support for the theoretical role of infections as a trigger for T1DM.
Gibson PS, Fitzpatrick E, Quaglia A, Dhawan A, Hart K, Lanham-New S, Moore JB (2014) VITAMIN D STATUS, PNPLA3 GENOTYPE AND RISK OF NON-ALCOHOLIC FATTY LIVER DISEASE SEVERITY IN A UK PAEDIATRIC POPULATION, JOURNAL OF HEPATOLOGY 60 (1) pp. S512-S512 ELSEVIER SCIENCE BV
Darling AL, Hakim OA, Horton K, Gibbs MA, Cui L, Berry JL, Lanham-New SA, Hart KH (2012) Associations between vitamin D status and radial bone geometry in older South Asian and Caucasian women, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE3) pp. E230-E230 CAMBRIDGE UNIV PRESS
Koidis F, Makinwa F, Hart K, Gibbs M, Hampton S (2015) Assessment of the use of earplugs effectiveness on a slow eating rate protocol, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE4) pp. E273-E273 CAMBRIDGE UNIV PRESS
Barr S, Hart K, Reeves S, Sharp K, Jeanes YM (2011) Habitual dietary intake, eating pattern and physical activity of women with polycystic ovary syndrome, EUROPEAN JOURNAL OF CLINICAL NUTRITION 65 (10) pp. 1126-1132 NATURE PUBLISHING GROUP
Whyte M, Pring C, Cooke D, Hart K, McGowan BM, Subramanian D, Shawe J (2014) Pregnancy after diabetes obesity surgery (PADOS): Incidence and outcomes., Pregnancy Hypertens 4 (3)
Half of all bariatric surgical procedures are in women of childbearing age but it remains unclear whether surgery is suitable for women who subsequently conceive: specifically the relative risks and benefits of potential nutrient deficiencies versus weight reduction. We will present data collected from Clinical Practice Research Databases on the maternal and fetal outcomes of pregnancies complicated either by obesity or previous bariatric surgery (BS). Two groups, matched to obese controls for BMI pre-BS and post-BS (at the time of ante-natal booking) will be compared. In this way, the effect of BS on pregnancy outcomes may be examined, independent of its effect on weight. A sub-group of women with antecedent Type 2 diabetes (T2DM) will allow for investigation of the additional impact and persistence of this co-morbidity. This builds upon pilot data collected from a retrospective cohort of women (18-45years) undergoing laparoscopic roux-en-Y (RYGB) surgery over a 24-month period (n=218). After exclusions and loss to follow up, data from 111 patients were analysed; 81 (73%) had conceived prior to RYGB, 20 (18%) became pregnant post RYGB and a further 22 patients (20%) were trying to conceive at the time of data collection. Three women had T2DM which resolved post BS. A suggestion of greater miscarriage risk prior to surgery in this sub-group will be confirmed as more women are recruited. Pregnancy is a frequent desire/occurrence after BS. This database study will advance understanding of the maternal and fetal outcomes of such pregnancies and inform antenatal care.
Macdonald HM, Mavroeidi A, Fraser WD, Darling AL, Black AJ, Aucott L, O'Neill F, Hart K, Berry JL, Lanham-New SA, Reid DM (2011) Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: a major cause for concern?, Osteoporos Int 22 (9) pp. 2461-2472
We assessed sunlight and dietary contributions to vitamin D status in British postmenopausal women. Our true longitudinal 25-hydroxyvitamin D (25(OH)D) measurements varied seasonally, being lower in the north compared to the south and lower in Asian women. Sunlight exposure in summer and spring provided 80% total annual intake of vitamin D.
Hart KH (2007) Malabsorption, In: Thomas B, Bishop J, Association BD (eds.), Manual of dietetic practice pp. 455-460 Wiley-Blackwell
Darling AL, Hart KH, Skene DJ, Arber S, Lanham-New SA (2014) Vitamin D status, functional ability and muscle strength in older South Asian and Caucasian women in the UK, PROCEEDINGS OF THE NUTRITION SOCIETY 73 (OCE1) pp. E23-E23 CAMBRIDGE UNIV PRESS
Sibbons C, Boyle L, Burdge GC, Umpleby M, Lilycrop KA, Hartwick CA, Lanham-New S, Hart K, Fielding BA (2015) Evaluation of fatty acid status in children of different nationalities, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE1) pp. E94-E94 CAMBRIDGE UNIV PRESS
Darling AL, Hakim OA, Horton K, Gibbs MA, Cui L, Berry JL, Lanham-New SA, Hart KH (2013) Adaptations in tibial cortical thickness and total volumetric bone density in postmenopausal South Asian women with small bone size., Bone 55 (1) pp. 36-43
There is some evidence that South Asian women may have an increased risk of osteoporosis compared with Caucasian women, although whether South Asians are at increased risk of fracture is not clear. It is unknown whether older South Asian women differ from Caucasian women in bone geometry. This is the first study, to the authors' knowledge, to use peripheral Quantitative Computed Tomography (pQCT) to measure radial and tibial bone geometry in postmenopausal South Asian women. In comparison to Caucasian women, Asian women had smaller bone size at the 4% (-18% p
Omar N, Gibbs M, Hart K (2011) Nutritional status and food-related quality of life in hospitalised older adults, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE4) pp. E130-E130 CAMBRIDGE UNIV PRESS
Tripkovic L, Muirhead NC, Hart KH, Frost GS, Lodge JK (2015) The effects of a diet rich in inulin or wheat fibre on markers of cardiovascular disease in overweight male subjects, Journal of Human Nutrition and Dietetics 28 (5) pp. 476-485
© 2014 The British Dietetic Association Ltd.Background: Previous studies suggest that the beneficial health effects of a diet rich in whole grains could be a result of the individual fibres found in the grain. The present study aimed to investigate the influence of a diet high in either wheat fibre (as an example of an insoluble fibre) or inulin (a nondigestible carbohydrate) on markers of cardiovascular disease. Methods: Ten male participants classified as at higher risk of cardiovascular disease [mean (SD) body mass index 30.2 (3) kg m-2, mean (SD) waist circumference 106.4 (7) cm, mean (SD) age 39.8 (9) years] were recruited to a randomised, controlled, cross-over study comparing the consumption of bespoke bread rolls containing either inulin, wheat germ or refined grain (control) (15 g day-1) for 4 weeks with a 4-week washout period between each regime. At the end of each regime, participants underwent an oral glucose tolerance test (OGTT), measures of pulse wave velocity (PWV), 24-h ambulatory blood pressure (AMBP), plasma lipid status and markers of glucose control. Results: There was no difference in measures of glucose control, lipid status, 24-h AMBP or PWV after the intervention periods and no changes compared to baseline. There was no significant difference between OGTT glucose and insulin time profiles; however, there was a significant difference in area under the curves between the wheat fibre and control interventions when comparing change from baseline (control +10.2%, inulin +4.3%, wheat fibre -2.5%; P = 0.03). Conclusions: Only limited differences between the interventions were identified, perhaps as a consequence of the amount of fibre used and intervention length. The wheat germ intervention resulted in a significant reduction in glucose area under the curve, suggesting that this fibre may aid glucose control.
Hakim OA, Hart Kath, McCabe P, Berry J, Francesca R, Rhodes LE, Spyrou N, Alfuraih A, Lanham-New S (2016) VITAMIN D PRODUCTION IN UK CAUCASIAN AND SOUTH ASIAN WOMEN FOLLOWING UVR EXPOSURE., The Journal of steroid biochemistry and molecular biology 164 pp. 223-229 Elsevier
It is known that skin pigmentation reduces the penetration of ultraviolet radiation (UVR) and thus photosynthesis of 25-hydroxvitamin D (25(OH)D). However ethnic differences in 25(OH)D production remain to be elucidated.The aim of this study was to investigate differences in vitamin D production between UK South Asian and Caucasian postmenopausal women, in response to a defined and controlled exposure to UVR.Seventeen women; 9 white Caucasian (skin phototype II and III), 8 South Asian women (skin phototype IV and V) participated in the study, acting as their own controls. Three blood samples were taken for the measurement of vitamin D status during the run in period (9 days, no sunbed exposure) after which, all subjects underwent an identical UVR exposure protocol irrespective of skin colour (9 days, 3 sun bed sessions, 6, 8 and 8minutes respectively with approximately 80% body surface exposed). Skin tone was measured four times during the study.Despite consistently lower 25(OH)D levels in South Asian women, they were shown to synthesise vitamin D as efficiently as Caucasians when exposed to the same dose of UVR. Interestingly, the baseline level of vitamin D rather than ethnicity and skin tone influenced the amount of vitamin D synthesised.This study have found no ethnic differences in the synthesis of 25(OH)D, possibly due to the baseline differences in 25(OH)D concentration or due to the small population size used in this study. Applying mixed linear model, findings indicated no effect of ethnicity and skin tone on the production of vitamin D; baseline level and length of exposure were the critical factors. To confirm that ethnicity and skin tone has no effect on 25(OH)D production, a larger sample size study is required that considers other ethnic groups with highly pigmented skin. Initial vitamin D status influences the amount of UVB needed to reach equal serum concentrations.
Herriot AM, Thomas DE, Hart KH, Warren J, Truby H (2008) A qualitative investigation of individuals' experiences and expectations before and after completing a trial of commercial weight loss programmes, J HUM NUTR DIET 21 (1) pp. 72-80 BLACKWELL PUBLISHING
Tripkovic L, Wilson LR, Hart K, Elliott R, Smith CP, Bucca G, Penson S, Chope G, Hypponen E, Berry J, Lanham-New S (2014) DAILY SUPPLEMENTATION WITH VITAMIN D3 IS COMPREHENSIVELY MORE EFFECTIVE THAN VITAMIN D2 IN RAISING 25OHD STATUS AND CONCOMITANTLY REDUCING PARATHYROID HORMONE LEVELS: IMPLICATIONS FOR BONE HEALTH, OSTEOPOROSIS INTERNATIONAL 25 pp. S665-S665 SPRINGER LONDON LTD
Wilson LR, Tripkovic L, Hart K, Elliott R, Smith CP, Bucca G, Penson S, Chope G, Hypponen E, Berry J, Lanham-New S (2014) IS VITAMIN D3 MORE EFFECTIVE THAN VITAMIN D2 IN RAISING 25OHD STATUS IN WOMEN WITH OSTEOPOROSIS AND OSTEOPENIA?, OSTEOPOROSIS INTERNATIONAL 25 pp. S687-S687 SPRINGER LONDON LTD
Hakim OA, Darling A, Hart K, Berry JL, Lanham-New S (2012) Volumetric bone mineral density (vbmd) at tibia site and vitamin d status in premenopausal south asian and caucasian women, BONE 50 pp. S143-S143 ELSEVIER SCIENCE INC
Mountford CG, Thompson NP, Hart K (2013) Can a community-based nutritional screening and intervention programme improve clinical outcomes in Newcastle elderly care home residents?, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E250-E250 CAMBRIDGE UNIV PRESS
Tripkovic L, Wilson L, Hart K, Lanham-New S (2012) Comparison of vitamin D-2 and vitamin D-3 supplementation in increasing serum 25-hydroxyvitamin D status: a systematic review and meta-analysis Reply, AMERICAN JOURNAL OF CLINICAL NUTRITION 96 (5) pp. 1153-1154 AMER SOC NUTRITION-ASN
Mountford CG, Okonkwo AC, Hart K, Thompson NP (2016) Managing Malnutrition in Older Persons Residing in Care Homes: Nutritional and Clinical Outcomes Following a Screening and Intervention Program., Journal of nutrition in gerontology and geriatrics 35 (1) pp. 52-66 Taylor & Francis
This study aimed to establish prevalence of malnutrition in older adult care home residents and investigate whether a nutritional screening and intervention program could improve nutritional and clinical outcomes. A community-based cohort study was conducted in five Newcastle care homes. 205 participants entered; 175 were followed up. Residents already taking oral nutritional supplements (ONS) were excluded from interventions. Those with Malnutrition Universal Screening Tool (MUST) score of 1 received dietetic advice and e2 received dietetic advice and were prescribed ONS (220 ml, 1.5 kcal/ml) twice daily for 12 weeks. Body mass index (BMI), MUST, mini nutritional assessment score (MNA)®, mid upper arm muscle circumference (MAMC), and Geriatric Depression Scale (GDS) were recorded at baseline and 12 weeks. Malnutrition prevalence was 36.6% ± 6.6 (95% CI). A higher MUST was associated with greater mortality (p = 0.004). Type of intervention received was significantly associated with change in MUST score (p
Sanders H, Tripkovic L, Wilson L, Hart K, Lanham-New S (2015) Comparison of reported dietary intakes between Caucasian and South Asian women and extent of under-reporting, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE1) pp. E148-E148 CAMBRIDGE UNIV PRESS
Lanham-New SA, Lambert H, Tripkovic L, Smith CP, Bucca G, Hart K, Penson S, Chope G, Hyppoenen E, Berry JL, Vieth R (2011) Vitamin D-2 v. vitamin D-3 supplementation in raising 25OHD status: preliminary findings of a meta-analysis, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE3) pp. E94-E94 CAMBRIDGE UNIV PRESS
Hart KH, Herriot A, Bishop JA, Truby H (2003) Promoting healthy diet and exercise patterns amongst primary school children: a qualitative investigation of parental perspectives, JOURNAL OF HUMAN NUTRITION AND DIETETICS 16 (2) pp. 89-96 BLACKWELL PUBLISHING LTD
Champion M, Hayward M, Hart K (2006) Interprofessional education: Even clinical psychologists can do it, Clinical Psychology Forum (167) pp. 38-41
Clinical psychology trainees and dietetic students came together to learn from and with each other. This article reports some of the experiences of those involved.
Hakim OA, Hart K, Darling AL, Shojaee-Moradie F, Berry JL, Umpleby AM, Griffin BA, Lanham-New SA (2012) Homeostatic model assessment (HOMA) in relation to lipid profiles and vitamin D status in South Asian and Caucasian women: preliminary results from D-FINES, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE2) pp. E70-E70 CAMBRIDGE UNIV PRESS
Darling AL, Hakim OA, Hart KH, Lanham-New SA (2011) Body weight, height and ethnicity are the best predictors of fracture load at the tibia in UK dwelling South Asian and Caucasian postmenopausal women, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE6) pp. E392-E392 CAMBRIDGE UNIV PRESS
Darling A, Hart K, Lanham-New S, MacDonald H, Horton K, Kang'Ombe A, Berry J (2013) Vitamin D deficiency in UK South Asian Women of childbearing age: A comparative longitudinal investigation with UK Caucasian women, Osteoporosis International 24 (2) pp. 477-488 Springer Verlag
This is the first 1-year longitudinal study which assesses vitamin D deficiency in young UK-dwelling South Asian women. The findings are that vitamin D deficiency is extremely common in this group of women and that it persists all year around, representing a significant public health concern. Introduction: There is a lack of longitudinal data assessing seasonal variation in vitamin D status in young South Asian women living in northern latitudes. Studies of postmenopausal South Asian women suggest a lack of seasonal change in 25-hydroxy vitamin D [25(OH)D], although it is unclear whether this is prevalent among premenopausal South Asians. We aimed to evaluate, longitudinally, seasonal changes in 25(OH)D and prevalence of vitamin D deficiency in young UK-dwelling South Asian women as compared with Caucasians. We also aimed to establish the relative contributions of dietary vitamin D and sun exposure in explaining serum 25(OH)D. Methods: This is a 1-year prospective cohort study assessing South Asian (n = 35) and Caucasian (n = 105) premenopausal women living in Surrey, UK (51 N), aged 20-55 years. The main outcome measured was serum 25(OH)D concentration. Secondary outcomes were serum parathyroid hormone, self-reported dietary vitamin D intake and UVB exposure by personal dosimetry. Results: Serum 25(OH)D
Hart K, Nicolaidou Y, Musaiger AO, Alqallaf SM, Al-Haddad F (2013) Type 1 Diabetes in Children: The Bahraini Dilemma, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E298-E298 CAMBRIDGE UNIV PRESS
Darling AL, Gossiel F, Hannon R, Skene DJ, Hart KH, Berry JL, Eastell R, Lanham-New SA (2011) An association between seasonal fluctuation 'cycling' of 25(OH)D and increased bone resorption but not BMD or BMC in UK South Asian and Caucasian women living at 51on, BONE 48 pp. S187-S187 ELSEVIER SCIENCE INC
It has been hypothesised that the U shaped association between 25(OH)D and some health outcomes may be due to large seasonal fluctuations of 25(OH)D1. It is unknown whether such fluctuation of 25(OH)D (?cycling?) influences bone health. This is an important issue, because if ?cycling? is detrimental for bone, then winter only rather than year round vitamin D supplementation may be useful for bone health to ?blunt? the rhythm. In the D-FINES study, n = 373 women (South Asian/Caucasian) had repeated measurements in four seasons for serum 25(OH)D and PTH, as well as a DXA scan in autumn and spring. Serum C-telopeptide (sCTX) was also measured in a random subset (n = 66). Cosinor regression analysis was used to identify individuals showing a significant rhythm (p 0.05) between ?cyclers? and ?non-cyclers? for any of the bone indices in either ethnic group. However, there were trends for a higher CTX and PTH in ?cyclers? versus ?non-cyclers? in both ethnic groups in every season, but no differences for BMD or BMC (Figs. 1?4). This suggests tentatively that ?cycling? could be associated with changes in bone metabolism but may not translate into structural changes. In summary, there is no clear evidence here to suggest that ?cycling? is detrimental to bone health, although there are trends in PTH and CTX that warrant further investigation with a larger sample.
MacDonald HM, Mavroeidi A, Fraser WD, Darling AL, Black AJ, Aucott L, O'Neill F, Hart K, Berry JL, Lanham-New SA, Reid DM (2011) Erratum: Sunlight and dietary contributions to the seasonal vitamin D status of cohorts of healthy postmenopausal women living at northerly latitudes: A major cause for concern? (Osteoporosis International (2011) DOI: 10.1007/s00198-010-1467-x), Osteoporosis International 22 (9) pp. 2473-2474
Hart K, Barr S, Reeves S, Sharp K, Jeanes Y (2015) Suboptimal dietary intake is associated with cardiometabolic risk factors in women with polycystic ovary syndrome, NUTRITION & DIETETICS 73 (2) pp. 177-183 WILEY-BLACKWELL
Hakim OA, Shojaee-Moradie F, Hart K, Berry JL, Eastell R, Gossiel F, Hannon R, Umpleby AM, Griffin BA, Lanham-New SA (2011) Vitamin D deficiency, poor bone health and the risk of CVD in Caucasian and South Asian women: analysis from the D-FINES study, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE3) pp. E100-E100 CAMBRIDGE UNIV PRESS
Boley R, Hart K, Truby H (2005) Influence of different high-protein meals on subsequent food intake, PROCEEDINGS OF THE NUTRITION SOCIETY 64 pp. 51A-51A CAMBRIDGE UNIV PRESS
Wilson L, Lanham-New S, Hart K, Tripkovic L (2012) The influence of habitual dietary intake on bone density in pre-menopausal women, PROCEEDINGS OF THE NUTRITION SOCIETY 71 (OCE2) pp. E127-E127 CAMBRIDGE UNIV PRESS
Darling AL (2014) Vitamin D, light exposure, sleep and musculoskeletal health in South Asian and Caucasian women: biological and social influences,
There is an urgent need to better understand the problem of vitamin D deficiency, and its health effects, in population groups of different ethnicity. The principal aim of this project was to examine vitamin D status, sunlight exposure, and health outcomes in UK dwelling South Asian and Caucasian women. A cohort of 80 postmenopausal and 32 premenopausal South Asian and Caucasian women were assessed for vitamin D status (serum 25-hydroxyvitamin D; 25(OH)D), musculoskeletal health, light exposure and sleep-wake cycles.
In postmenopausal women, South Asians had a significantly lower vitamin D concentration than Caucasians (p=0.002), with 83% of Asians vs. 24% of Caucasians below 50nmol/l for 25(OH)D. Despite adaptations in tibial bone structure of the South Asians to improve bone strength, their bones were weaker by 38% compared with Caucasians (p For both premenopausal and postmenopausal women, Caucasians showed a significantly higher actigraphic sleep efficiency (p The implications of this work are that older South Asian women are in need of intervention to improve vitamin D status. There is also some evidence for poorer musculoskeletal health, lower light exposure and poorer sleep in this group. The qualitative research included in the current study offers future intervention options to improve the health of UK dwelling South Asian women.
Hollingdale R, Sutton D, Hart K (2008) Facilitating dietary change in renal disease: investigating patients' perspectives., J Ren Care 34 (3) pp. 136-142
BACKGROUND: Renal diets are arguably the most restrictive for any patient group, and many of the restrictions contradict current recommendations for healthy eating. OBJECTIVES. This study aims to explore the knowledge and beliefs of chronic kidney disease (CKD) patients about the role of diet in their disease presentation and management. METHODS: Focus groups (FG) with nephrology and dialysis patients informed the development of a questionnaire. Patient experiences and knowledge of diet-disease links and their education needs were explored. RESULTS: Renal diets were not always perceived as compatible with other dietary advice, and often difficult to integrate with family and social occasions. Eighty percent respondents said they would like to receive dietary advice as soon as they know they have renal damage. Renal dietitians were identified as the most reliable and trustworthy source of dietary information, followed by renal specialist doctors. CONCLUSION: Early dietetic intervention would be welcomed by patients, with group work and 'expert patient' assistance offering one means of delivering this service in a patient-centred way.
Hakim OA, Darling A, Hart K, Berry JL, Lanham-New SA (2012) VOLUMETRIC BONE MINERAL DENSITY (VBMD) AT RADIUS SITE AND VITAMIN D STATUS IN PREMENOPAUSAL SOUTH ASIAN AND CAUCASIAN WOMEN, OSTEOPOROSIS INTERNATIONAL 23 pp. S336-S337 SPRINGER LONDON LTD
Long SJ, Hart KH, Morgan LM (2000) The effects of habitual exercise level upon appetite response and food intake following high and low energy preloads., PROCEEDINGS OF THE NUTRITION SOCIETY 59 pp. 123A-123A C A B INTERNATIONAL
Hakim OA, Darling A, Starkey S, Wong M, Shojaee-Moradie F, Hart K, Morgan L, Berry J, Umpleby A, Griffin B, Lanham-New S (2010) POOR BONE HEALTH AND INCREASED CARDIOVASCULAR DISEASE RISK: EVIDENCE OF A LINK IN THE D-FINES STUDY POPULATION, OSTEOPOROSIS INTERNATIONAL 21 pp. 96-97 SPRINGER LONDON LTD
Hart KH, Boyle L, Hartwick CA, Moreno L, Lanham-New SA, Fielding B (2015) Live, eat, sleep football? Body size and composition and beliefs about physical activity in an international cohort of school-aged boys participating in regular team sport, PROCEEDINGS OF THE NUTRITION SOCIETY 74 (OCE1) pp. E97-E97 CAMBRIDGE UNIV PRESS
Gibson PS, Lang S, Gilbert M, Kamat D, Bansal S, Ford-Adams ME, Desai AP, Dhawan A, Fitzpatrick E, Moore JB, Hart KH (2015) Assessment of Diet and Physical Activity in Paediatric Non-Alcoholic Fatty Liver Disease Patients: A United Kingdom Case Control Study, NUTRIENTS 7 (12) pp. 9721-9733 MDPI AG
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver
disease in children, with prevalence rising alongside childhood obesity rates. This study aimed to
characterise the habitual diet and activity behaviours of children with NAFLD compared to obese
children without liver disease in the United Kingdom (UK). Twenty-four biopsy-proven paediatric
NAFLD cases and eight obese controls without biochemical or radiological evidence of NAFLD
completed a 24-h dietary recall, a Physical Activity Questionnaire (PAQ), a Dutch Eating Behavior
Questionnaire (DEBQ) and a 7-day food and activity diary (FAD), in conjunction with wearing
a pedometer. Groups were well matched for age and gender. Obese children had higher BMI
z-scores (p = 0.006) and BMI centiles (p = 0.002) than participants with NAFLD. After adjusting
for multiple hypotheses testing and controlling for differences in BMI, no differences in macro- or
micronutrient intake were observed as assessed using either 24-h recall or 7-day FAD (p > 0.001).
Under-reporting was prevalent (NAFLD 75%, Obese Control 87%: p = 0.15). Restrained eating
behaviours were significantly higher in the NAFLD group (p = 0.005), who also recorded more steps
per day than the obese controls (p = 0.01). In conclusion, this is the first study to assess dietary
and activity patterns in a UK paediatric NAFLD population. Only a minority of cases and controls
were meeting current dietary and physical activity recommendations. Our findings do not support
development of specific dietary/ physical activity guidelines for children with NAFLD; promoting
adherence with current general paediatric recommendations for health should remain the focus of
clinical management.
Hakim O, Shojaee-Moradie F, Hart K, Berry J, Eastell R, Gossiel F, Hannon R, Umpleby M, Griffin B, Lanham-New S (2011) Evidence of a link between poor bone health, low vitamin D status and CVD risk in caucasian and asian women, BONE 48 pp. S197-S198 ELSEVIER SCIENCE INC
Wilson L, Hart K, Lanham-New S, Tripkovic L (2013) Vitamin D intakes and blood pressure in Caucasian and South Asian women aged 20-64 years - baseline analysis of the D2-D3 study, PROCEEDINGS OF THE NUTRITION SOCIETY 72 (OCE4) pp. E189-E189 CAMBRIDGE UNIV PRESS
Sutton D, Hollingdale R, Hart K (2008) Questionnaire to evaluate and elucidate patients' perceptions of renal dietary advice, Journal of Renal Care 34 (3) pp. 143-150
This study aims to explore the knowledge and beliefs of Chronic Kidney Disease (CKD) patients about the role of diet in their disease presentation and management. Focus Groups (FG) with nephrology and dialysis patients informed the development of a questionnaire. A sixty percent response rate was achieved (115/190) with 100 complete questionnaires available for analysis. 80 respondents said they would like to receive dietary advice as soon as they know they have renal damage. In most cases this would have been months or years sooner than they were referred to a dietitian. Group work and 'expert patient' assistance offer the means of delivering this service in a patient-centred way. It is also essential that doctors have access to accurate dietary advice so they can support patients appropriately to change their dietary behaviour. © 2008 European Dialysis and Transplant Nurses Association/European Renal Care Association.
Darling AL, Hakim OA, Hart KH, Lanham-New SA (2011) Vitamin D intakes in UK South Asian and Caucasian postmenopausal women: a novel longitudinal analysis from 2006-2010, PROCEEDINGS OF THE NUTRITION SOCIETY 70 (OCE6) pp. E349-E349 CAMBRIDGE UNIV PRESS
Darling AL, Hart KH, Gibbs MA, Gossiel F, Kantermann T, Horton K, Johnsen S, Berry JL, Skene DJ, Eastell R, Vieth R, Lanham-New SA (2014) Greater seasonal cycling of 25-hydroxyvitamin D is associated with increased parathyroid hormone and bone resorption, Osteoporosis International 25 (3) pp. 933-941
This analysis assessed whether seasonal change in 25-hydroxyvitamin D concentration was associated with bone resorption, as evidenced by serum parathyroid hormone and C-terminal telopeptide concentrations. The main finding was that increased seasonal fluctuation in 25-hydroxyvitamin D was associated with increased levels of parathyroid hormone and C-terminal telopeptide. Introduction: It is established that adequate 25-hydroxyvitamin D (25(OH)D, vitamin D) concentration is required for healthy bone mineralisation. It is unknown whether seasonal fluctuations in 25(OH)D also impact on bone health. If large seasonal fluctuations in 25(OH)D were associated with increased bone resorption, this would suggest a detriment to bone health. Therefore, this analysis assessed whether there is an association between seasonal variation in 25(OH)D and bone resorption. Methods: The participants were (n = 279) Caucasian and (n = 88) South Asian women (mean (±SD); age 48.2 years (14.4)) who participated in the longitudinal Diet, Food Intake, Nutrition and Exposure to the Sun in Southern England study (2006-2007). The main outcomes were serum 25(OH)D, serum parathyroid hormone (sPTH) and serum C-terminal telopeptide of collagen (sCTX), sampled once per season for each participant. Results: Non-linear mixed modelling showed the (amplitude/mesor) ratio for seasonal change in log 25(OH)D to be predictive of log sPTH (estimate = 0.057, 95 % CI (0.051, 0.063), p
Darling AL, Hart KH, Lanham-New SA, Macdonald HM, Horton K, Kang'ombe AR, Berry JL (2012) Vitamin D deficiency in UK South Asian Women of childbearing age: a comparative longitudinal investigation with UK Caucasian women, Osteoporosis International pp. 1-12
Summary: This is the first 1-year longitudinal study which assesses vitamin D deficiency in young UK-dwelling South Asian women. The findings are that vitamin D deficiency is extremely common in this group of women and that it persists all year around, representing a significant public health concern. Introduction: There is a lack of longitudinal data assessing seasonal variation in vitamin D status in young South Asian women living in northern latitudes. Studies of postmenopausal South Asian women suggest a lack of seasonal change in 25-hydroxy vitamin D [25(OH)D], although it is unclear whether this is prevalent among premenopausal South Asians. We aimed to evaluate, longitudinally, seasonal changes in 25(OH)D and prevalence of vitamin D deficiency in young UK-dwelling South Asian women as compared with Caucasians. We also aimed to establish the relative contributions of dietary vitamin D and sun exposure in explaining serum 25(OH)D. Methods: This is a 1-year prospective cohort study assessing South Asian (n = 35) and Caucasian (n = 105) premenopausal women living in Surrey, UK (51° N), aged 20-55 years. The main outcome measured was serum 25(OH)D concentration. Secondary outcomes were serum parathyroid hormone, self-reported dietary vitamin D intake and UVB exposure by personal dosimetry. Results: Serum 25(OH)D
Hakim OA, Hart K, McCabe P, Berry J, Rhodes L, Spyrou N, Alfuraih A, Lanham-New S (2012) VITAMIN D SYNTHESIS IN CAUCASIAN AND SOUTH ASIAN WOMEN FOLLOWING ULTRAVIOLET RADIATION, OSTEOPOROSIS INTERNATIONAL 23 pp. 669-669 SPRINGER LONDON LTD
Hakim O, Darling A, Tripkovic L, Wilson L, Hart K, Berry J, Lanham-New S (2015) DIFFERENCES IN VITAMIN D STATUS AND VOLUMETRIC BONE MINERAL DENSITY (VBMD) AT THE RADIUS AND TIBIA IN PREMENOPAUSAL CAUCASIAN, SOUTH ASIAN, AND ARAB FEMALES LIVING IN UK, OSTEOPOROSIS INTERNATIONAL 26 pp. S474-S474 SPRINGER LONDON LTD
Hakim O, Darling A, Hart K, Berry J, Lanham-New S (2012) 25(OH)D CONCENTRATION AND MUSCLE FUNCTION IN PREMENOPAUSAL SOUTH ASIAN AND CAUCASIAN WOMEN, OSTEOPOROSIS INTERNATIONAL 23 pp. S578-S579 SPRINGER LONDON LTD
Hakim O, Hart K, Morgan L, Griffin B, Lanham-New S, Shojaee-Moradie F, Umpleby A, Berry J (2010) (PREMIER POSTER-AWARD CANDIDATE) EVIDENCE OF A LINK BETWEEN OSTEOPOROSIS RISK AND CVD IN CAUCASIAN BUT NOT ASIAN WOMEN: RESULTS OF THE D-FINES STUDY, OSTEOPOROSIS INTERNATIONAL 21 pp. S466-S467 SPRINGER LONDON LTD
Hart KH, Bishop JA, Truby H (2002) An investigation into school children's knowledge and awareness of food and nutrition, JOURNAL OF HUMAN NUTRITION AND DIETETICS 15 (2) pp. 129-140 BLACKWELL PUBLISHING LTD
Tripkovic L, Hart KH, Frost GS, Lodge JK (2014) Interindividual and intraindividual variation in pulse wave velocity measurements in a male population., Blood Press Monit 19 (4) pp. 233-241
OBJECTIVE: Pulse wave velocity (PWV) is a measure of arterial stiffness and a marker for cardiovascular disease. Although commonly used, there are only a few reports investigating the intersession and intrasession variability in PWV measurements, the determination of which is important in a mixed population when using PWV as a clinical marker. Therefore, the aim of this study was to investigate the variability in PWV measurements and factors that may influence PWV variability. METHODS: A male population (n=8, age 30.9 ± 9.0 years; BMI 25.1 ± 4.0 kg/m(2)) underwent measurements of PWV and blood pressure several times in a single study visit and during six study visits over a 4-6-week period. During these study visits, experiments were performed at rest and following acute exercise and feeding. RESULTS: Intersession coefficients of variation (CVs) were 5.3 and 4.5% for radial-carotid (R-C) and carotid-femoral (C-F) PWVs, respectively, whereas intrasession CVs were 9.3 and 6.9% for R-C and C-F PWVs, respectively. Good reproducibility in PWV measurements was demonstrated by individual responses in the data; two of eight participants had significant differences in C-F PWV over time (P=0.05). There were significant increases in systolic blood pressure following acute exercise (P
Vitamin D deficiency is a major public health concern in the UK. As the natural sources of vitamin D in the UK are limited, supplementation or food fortification are possible strategies for achieving the dietary recommendations of 10 ¼g/d that will be introduced in 2016 for the whole population.
However, there is controversy as to whether vitamin D2 and vitamin D3 are equally effective at raising vitamin D status (25OHD concentration). The primary and secondary aims of this PhD project were: to investigate the effects of both these forms of vitamin D independently on vitamin D status, markers of bone and cardiovascular health, and gene expression; as well as to examine whether common genetic variants affect response to either form of vitamin D.
A cohort of 90 South Asian and 245 Caucasian women were recruited onto a randomised-controlled trial; the D2-D3 Study. Participants were given either 15 µg/d of vitamin D2, 15 µg/d of vitamin D3 or placebo, in fortified foods, for 12 weeks.
At baseline, serum total 25OHD concentrations were significantly lower in the South Asian women (27.6 nmol/L) than the Caucasian women (60.3 nmol/L). In both the South Asian and Caucasian women, 25OHD concentrations significantly decreased in the placebo intervention (-5% and -15% respectively, p Interestingly, whole blood transcriptome analysis indicated that the vitamin D2 and D3 interventions triggered a difference in expression of entirely different genes, and predicted therefore a difference in the activity of the respective metabolic and cellular pathways. The associations between genetic polymorphisms and change in 25OHD concentration in response to vitamin D also appear to differ depending on the form of vitamin D taken, although baseline 25OHD concentration ma
Darling A, Hart K, Gossiel F, Robertson F, Hunt J, Hill T, Johnsen S, Berry J, Eastell R, Vieth R, Lanham-New S (2017) Higher bone resorption excretion in South Asian women vs White Caucasians and increased bone loss with higher seasonal cycling of vitamin D:  results from the D-FINES cohort study, Bone 98 pp. 47-53 Elsevier
Few data exist on bone turnover in South Asian women and it is not well elucidated as to whether Western dwelling South Asian women have different bone resorption levels to that of women from European ethnic backgrounds. This study assessed bone resorption levels in UK dwelling South Asian and Caucasian women as well as evaluating whether seasonal variation in 25-hydroxyvitamin D [25(OH)D] is associated with bone resorption in either ethnic group. Data for seasonal measures of urinary N-telopeptide of collagen (uNTX) and serum 25(OH)D were analysed from n=373 women (four groups; South Asian postmenopausal n=44, South Asian premenopausal n=50, Caucasian postmenopausal n=144, Caucasian premenopausal n =135) (mean (± SD) age 48 (14) years; age range 18-79 years) who participated in the longitudinal D-FINES (Diet, Food Intake, Nutrition and Exposure to the Sun in Southern England) cohort study (2006-2007). A mixed between-within subjects ANOVA (n=192) showed a between subjects effect of the four groups (P
Tripkovic Laura, Wilson LR, Hart Kathryn, Johnsen Sigurd, de Lusignan Simon, Smith CP, Bucca G, Penson S, Chope G, Elliott Ruan, Hypponen E, Berry J L, Lanham-New Susan (2017) Daily supplementation with 15 mg vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: a 12-wk randomized, placebo-controlled food-fortification trial, American Journal of Clinical Nutrition 106 (2) pp. 481-490 American Society for Nutrition
Background: There are conflicting views in the literature as to whether vitamin D2 and vitamin D3 are equally effective in increasing and maintaining serum concentrations of 25-hydroxyvitamin D [25(OH)D], particularly at lower doses of vitamin D.

Objective: We aimed to investigate whether vitamin D2 or vitamin D3 fortified in juice or food, at a relatively low dose of 15 ¼g/d, was effective in increasing serum total 25(OH)D and to compare their respective efficacy in South Asian and white European women over the winter months within the setting of a large randomized controlled trial.

Design: A randomized, double-blind, placebo-controlled food-fortification trial was conducted in healthy South Asian and white European women aged 20?64 y (n = 335; Surrey, United Kingdom) who consumed placebo, juice supplemented with 15 ¼g vitamin D2, biscuit supplemented with 15 ¼g vitamin D2, juice supplemented with 15 ¼g vitamin D3, or biscuit supplemented with 15 ¼g vitamin D3 daily for 12 wk. Serum 25(OH)D was measured by liquid chromatography?tandem mass spectrometry at baseline and at weeks 6 and 12 of the study.

Results: Postintervention in the 2 ethnic groups combined, both the vitamin D3 biscuit and the vitamin D3 juice groups showed a significantly greater absolute incremental change (”) in total 25(OH)D when compared with the vitamin D2 biscuit group [” (95% CI): 15.3 nmol/L (7.4, 23.3 nmol/L) (P

Conclusions: With the use of a daily dose of vitamin D relevant to public health recommendations (15 ¼g) and in vehicles relevant to food-fortification strategies, vitamin D3 was more effective than vitamin D2 in increasing serum 25(OH)D in the wintertime. Vitamin D3 may therefore be a preferential form to optimize vitamin D status within the general population. This trial was registered at www.controlled-trials.com as ISRCTN23421591.

Darling A, Hart K, Macdonald H, Horton K, Kang?ombe A, Berry J, Lanham-New S (2012) Vitamin D deficiency in UK South Asian Women of childbearing age: a comparative longitudinal investigation with UK Caucasian women, Osteoporosis International Springer Verlag
This is the first 1-year longitudinal study which assesses vitamin D deficiency in young UK-dwelling South Asian women. The findings are that vitamin D deficiency is extremely common in this group of women and that it persists all year around, representing a significant public health concern.
Introduction
There is a lack of longitudinal data assessing seasonal variation in vitamin D status in young South Asian women living in northern latitudes. Studies of postmenopausal South Asian women suggest a lack of seasonal change in 25-hydroxy vitamin D [25(OH)D], although it is unclear whether this is prevalent among premenopausal South Asians. We aimed to evaluate, longitudinally, seasonal changes in 25(OH)D and prevalence of vitamin D deficiency in young UK-dwelling South Asian women as compared with Caucasians. We also aimed to establish the relative contributions of dietary vitamin D and sun exposure in explaining serum 25(OH)D.
Methods
This is a 1-year prospective cohort study assessing South Asian (n = 35) and Caucasian (n = 105) premenopausal women living in Surrey, UK (51° N), aged 20?55 years. The main outcome measured was serum 25(OH)D concentration. Secondary outcomes were serum parathyroid hormone, self-reported dietary vitamin D intake and UVB exposure by personal dosimetry.
Results
Serum 25(OH)D Conclusions
Year-round vitamin D deficiency was extremely common in South Asian women. These findings pose great health threats regarding the adverse effects of vitamin D deficiency in pregnancy and warrant urgent vitamin D public health policy and action.
Vitamin D deficiency and inadequacy are worldwide public health concerns and occur across all age, sex and ethnic groups, with significant implications for human health. Adolescents are a population group at high risk of low vitamin D status, yet the evidence base for establishing vitamin D requirements remains weak.
The primary aim of this Thesis was to estimate the dietary vitamin D intakes required to maintain serum 25-hydroxyvitamin D [25(OH)D] concentrations above specific cut-off thresholds (25, 30, 40 and 50 nmol/l) during the winter-time in white Caucasian adolescents residing in the UK (51°N). Secondary aims were to: 1) investigate vitamin D status in relation to musculoskeletal and cardiometabolic health outcomes and; 2) explore familial associations in vitamin D status, dietary intakes and musculoskeletal health in mother-child pairs. This was achieved via a dose-response trial in 110 adolescents (14-18 years), who were randomly allocated to receive 0 (placebo), 10 or 20 ¼g vitamin D3 daily for 20 weeks during the winter-time. A final aim of this Thesis was to assess the vitamin D status and prevalence of vitamin D deficiency in a small study of African Caribbean and South Asian adolescent and young adult females (16-25 years) in comparison to their white Caucasian counterparts.
It was estimated that vitamin D intakes of 10.1, 13.1, 23.3 and ~30 ¼g/day would maintain serum 25(OH)D concentrations > 25, 30, 40 and 50 nmol/l respectively in 97.5% of the adolescents. Adolescents with serum 25(OH)D concentrations below 50 nmol/l had significantly lower radial trabecular volumetric bone mineral density and presented with a poorer cardiometabolic profile, with greater waist circumference and higher triglyceride and glucose concentrations than their more replete counterparts. However cardiometabolic risk was lost after controlling for potential confounders. Positive, sex-specific associations were found for serum 25(OH)D concentrations and radial mass, total area and cortical volumetric bone mineral density in mother-child pairs, but not for dietary vitamin D and calcium intakes. A high prevalence of vitamin D deficiency was found in African Caribbean and South Asian females (serum 25(OH)D In conclusion, dietary vi
Farina Nicolas, Jernerén Fredrik, Turner Cheryl, Hart Kathryn, Tabet Naji (2017) Homocysteine concentrations in the cognitive progression of Alzheimer's disease, Experimental Gerontology 99 pp. 146-150 Elsevier
Objectives: Hyperhomocysteinemia in Alzheimer?s disease (AD) is widely reported and appears to worsen as the disease progresses. While active dietary intervention with vitamins B12 and folate decreases homocysteine blood levels, with promising clinical outcomes in Mild Cognitive Impairment (MCI), this so far has not been replicated in established AD populations. The aim of the study is to explore the relationship between hyperhomocystenemia and relevant vitamins as the disease progresses.
Methods: In this longitudinal cohort study, 38 participants with mild to moderate AD were followed for an average period of 13 months. Plasma folate, vitamin B12 and homocysteine concentrations were measured at baseline and at follow-up. Dietary intake of B vitamins was also measured. Spearman?s correlations were conducted by homocysteine and B vitamin status.
Results: As expected, cognitive status significantly declined over the follow-up period and this was paralleled by a significant increase in homocysteine concentrations (p=0.006). However, during this follow-up period there was no significant decline in neither dietary intake, nor the corresponding blood concentrations of vitamin B12/folate, with both remaining within normal values. Changes in blood concentrations of B vitamins were not associated with changes in homocysteine levels (p>0.05).
Conclusion: In this study, the increase in homocysteine observed in AD patients as the disease progresses cannot be solely explained by dietary and blood levels of folate and vitamin B12. Other dietary and non-dietary factors may contribute to hyperhomocysteinemia and its toxic effect in AD, which needs to be explored to optimise timely intervention strategies.
Jeanes Y, Reeves S, Gibson E, Piggott C, May V, Hart KH (2017) Binge eating behaviours and food cravings in women with Polycystic Ovary Syndrome, Appetite 109 (Feb) pp. 24-32 Elsevier
Polycystic Ovary Syndrome (PCOS), the most common endocrine condition in women, is often anecdotally associated with binge eating behaviours and food cravings; however there is a paucity of research. This study aimed to report the prevalence of binge eating and food cravings and their relation to obesity risk in women with PCOS. Participants completed an online survey including the Bulimia Investigatory Test, Edinburgh, Food Cravings-Trait Questionnaire and the Three Factor Eating Questionnaire revised-18. The study included obese (n = 340), overweight (n = 70) and lean (n = 45) women with PCOS and lean healthy women (n = 40). Sixty percent of obese women with PCOS were categorised with binge-eating behaviour, with 39% presenting with clinically significant behaviour. Obese women with PCOS presented with high mean food cravings-trait scores (131.6 ± 28.9) that were significantly greater compared with lean (114.0 ± 34.9) and overweight women with PCOS (120.1 ± 29.5; p
Smith Taryn, Tripkovic Laura, Lanham-New Susan, Hart Kathryn (2017) Vitamin D in adolescence: evidence-based dietary requirements and implications for public health policy, Proceedings of the Nutrition Society. 77 (3) pp. 292-301 Cambridge University Press
Vitamin D is a unique nutrient. Firstly, it acts as a pro-hormone and secondly, the requirement for
vitamin D can be met by both endogenous synthesis from sunlight and by dietary sources. This
complicates the determination of dietary requirements for vitamin D, which along with the
definition of optimal vitamin D status, have been highly controversial and much debated over recent
years. Adolescents are a population group at high risk of low vitamin D status, which is concerning
given the important role of vitamin D, and calcium, in promoting normal bone mineralisation and
attainment of peak bone mass during this rapid growth phase. Dietary vitamin D recommendations
are important from a public health perspective in helping to avoid deficiency and optimise vitamin
D status for health. However limited experimental data from winter-based dose-response
randomised trials in adolescents has hindered the development of evidence-based dietary
requirements for vitamin D in this population group. This review will highlight how specifically
designed randomised trials and the approach adopted for estimating such requirements can lead to
improved recommendations. Such data indicates that vitamin D intakes of between 10 and ~30
µg/day may be required to avoid deficiency and ensure adequacy in adolescents, considerably
greater than the current recommendations of 10-15 µg/day. Finally this review will consider the
implications of this on public health policy, in terms of future refinements of vitamin D requirement
recommendations and prioritisation of public health strategies to help prevent vitamin D deficiency
Gibson Philippa S., Quaglia Alberto, Dhawan Anil, Wu Huihai, Lanham-New Sue, Hart Kath, Fitzpatrick Emer, Moore J. Bernadette (2018) Vitamin D status and associated genetic polymorphisms in a cohort of UK children with non-alcoholic fatty liver disease, Pediatric Obesity 13 (7) pp. 433-441 Wiley
Background: Vitamin D deficiency has been associated with non-alcoholic fatty liver disease (NAFLD). However, the role of polymorphisms determining vitamin D status remains unknown.

Objectives: To determine in UK children with biopsy-proven NAFLD: (i) vitamin D status throughout a 12-month period; (ii) interactions between key vitamin D-related genetic variants (NADSYN1/DHCR7, VDR, GC, CYP2R1) and disease severity.

Methods: In 103 pediatric patients with NAFLD, serum 25-hydroxyvitamin D (25OHD) levels and genotypes were determined contemporaneously to liver biopsy and examined in relation to NAFLD activity score and fibrosis stage.

Results: Only 19.2% of children had adequate vitamin D status; most had mean 25OHD levels considered deficient (

Conclusions: Children with NAFLD in the UK have particularly low winter vitamin D status; with vitamin D insufficiency prevalent throughout the year. Polymorphisms in the vitamin D metabolic pathway are associated with histological severity of pediatric NAFLD.

Smith Taryn J, Tripkovic Laura, Hauger Hanne, Damsgaard Camilla T, Mølgaard Christian, Lanham-New Susan, Hart Kathryn H (2018) Winter Cholecalciferol Supplementation at 51°N Has No Effect on Markers of Cardiometabolic Risk in Healthy Adolescents Aged 14-18 Years, The Journal of Nutrition 148 (8) pp. 1269-1275 American Society for Nutrition

Background: Epidemiological studies have supported inverse associations between low serum 25-hydroxyvitamin D [25(OH)D] and cardiometabolic risk markers, but few randomized trials have investigated the effect of vitamin D supplementation on these markers in adolescents.

Objective: The objective of this study was to investigate the effect of winter-time cholecalciferol (vitamin D3) supplementation on cardiometabolic risk markers in white, healthy 14-18 year-old adolescents in the UK (51°N) as part of the ODIN Project.

Methods: In a dose-response trial, 110 adolescents (15.9±1.4 years; 43% male; 81% normal weight) were randomly assigned to receive 0, 10 or 20 ¼g/day vitamin D3 for 20 weeks (October-March). Cardiometabolic risk markers including BMI-for-age z-score (BMIz), waist circumference, systolic and diastolic blood pressure, fasting plasma triglycerides, cholesterol (total, HDL, LDL and total:HDL) and glucose were measured at baseline and endpoint as secondary outcomes, together with serum 25(OH)D. Intervention effects were evaluated in linear regression models as between-group differences at endpoint, adjusted for the baseline value of the outcome variable and additionally for age, sex, Tanner stage, BMIz and baseline serum 25(OH)D.

Results: Mean±SD baseline serum 25(OH)D was 49.1±12.3 nmol/L and differed between groups at endpoint with concentrations of 30.7±8.6, 56.6±12.4 and 63.9±10.6 nmol/L in the 0, 10 and 20 ¼g/day groups respectively (Pd0.001). Vitamin D3 supplementation had no effect on any of the cardiometabolic risk markers (all P>0.05), except for lower HDL (-0.12 mmol/L, 95% CI -0.21, 0.04, P=0.003) and total cholesterol (-0.21 mmol/L, 95% CI -0.42, 0.00, P=0.05) in the 20 compared to the 10 ¼g/day group, which disappeared in the fully adjusted analysis (P=0.27 and P=0.30 respectively).

Conclusions: Supplementation with vitamin D3 at 10 and 20 ¼g/25 day, which increased serum 25(OH)D concentrations during the winter-time, had no effect on markers of cardiometabolic risk in healthy 14-18 year-old adolescents. This trial was registered at clinicaltrials.gov as NCT02150122.

Hauger Hanne, Mølgaard Christian, Mortensen Charlotte, Ritz Christian, Frøkiær Hanne, Smith Taryn J, Hart Kath, Lanham-New Susan, Damsgaard Camilla T (2018) Winter Cholecalciferol Supplementation
at 55°N Has No Effect on Markers of
Cardiometabolic Risk in Healthy Children
Aged 4?8 Years,
The Journal of Nutrition 148 (8) pp. 1261-1268 Oxford University Press
Background: Low serum 25-hydroxyvitamin D [25(OH)D] has been associated with unfavorable cardiometabolic risk
profiles in many observational studies in children, but very few randomized controlled trials have investigated this.
Objective: We explored the effect of winter-time cholecalciferol (vitamin D3) supplementation on cardiometabolic risk
markers in young, white, 4- to 8-y-old healthy Danish children (55°N) as part of the pan-European ODIN project.
Methods: In the ODIN Junior double-blind, placebo-controlled, dose-response trial, 119 children (mean ± SD age:
6.7 ± 1.5 y; 36% male; 82% normal weight) were randomly allocated to 0, 10 or 20 ¼g/d of vitamin D3 for 20 wk
(October?March). Cardiometabolic risk markers including BMI-for-age z score (BMIz), waist circumference, systolic and
diastolic blood pressure, serum triglycerides and cholesterol (total, LDL, HDL, and total:HDL), plasma glucose and insulin,
and whole-blood glycated hemoglobin were measured at baseline and endpoint as secondary outcomes together
with serum 25(OH)D. Intervention effects were evaluated in linear regression models as between-group differences at
endpoint adjusted for baseline value of the outcome, and additionally for age, sex, baseline serum 25(OH)D, BMIz, time
since breakfast, and breakfast content.
Results: Mean ± SD serum 25(OH)D was 56.7 ± 12.3 nmol/L at baseline and differed between groups at endpoint
with concentrations of 31.1 ± 7.5, 61.8 ± 10.6, and 75.8 ± 11.5 nmol/L in the 0-, 10-, and 20 ¼g/d groups, respectively
(P for baseline value of the outcome (all P e 0.05), and additional covariate adjustment did not change the results notably.
Conclusions: Preventing the winter decline in serum 25(OH)D with daily vitamin D3 supplementation of 10 or 20 ¼g had
no cardiometabolic effects in healthy 4- to 8-y-old Danish children. This trial was registered at www.clinicaltrials.gov as
NCT02145195.
Wilson Louise, Tripkovic Laura, Hart Kath, Lanham-New Susan (2017) Vitamin D deficiency as a public health issue: using vitamin D2 or vitamin D3 in future fortification strategies, Proceedings of the Nutrition Society 76 (3) pp. 392-399 Cambridge University Press
The role of vitamin D in supporting the growth and maintenance of the skeleton is robust;
with recent research also suggesting a beneficial link between vitamin D and other nonskeletal
health outcomes, including immune function, cardiovascular health and cancer.
Despite this, vitamin D deficiency remains a global public health issue, with a renewed
focus in the UK following the publication of Public Health England?s new Dietary
Vitamin D Requirements. Natural sources of vitamin D (dietary and UVB exposure) are
limited, and thus mechanisms are needed to allow individuals to achieve the new dietary
recommendations. Mandatory or voluntary vitamin D food fortification may be one of
the mechanisms to increase dietary vitamin D intakes and subsequently improve vitamin
D status. However, for the food industry and public to make informed decisions, clarity
is needed as to whether vitamins D2 and D3 are equally effective at raising total 25-hydroxyvitamin
D (25(OH)D) concentrations as the evidence thus far is inconsistent. This review
summarises the evidence to date behind the comparative efficacy of vitamins D2 and D3 at
raising 25(OH)D concentrations, and the potential role of vitamin D food fortification as a
public health policy to support attainment of dietary recommendations in the UK. The comparative
efficacy of vitamins D2 and D3 has been investigated in several intervention trials,
with most indicating that vitamin D3 is more effective at raising 25(OH)D concentrations.
However, flaws in study designs (predominantly under powering) mean there remains a
need for a large, robust randomised-controlled trial to provide conclusive evidence, which
the future publication of the D2?D3 Study should provide (BBSRC DRINC funded: BB/
I006192/1). This review also highlights outstanding questions and gaps in the research
that need to be addressed to ensure the most efficacious and safe vitamin D food fortification
practices are put in place. This further research, alongside cost, availability and ethical considerations
(vitamin D3 is not suitable for vegans), will be instrumental in supporting government,
decision-makers, industry and consumers in making informed choices about
potential future vitamin D policy and practice.
Gibson Philippa, Lang Sarah, Dhawan Anil, Fitzpatrick Emer, Blumfield Michelle L, Truby Helen, Hart Kath, Moore Jennifer (2017) Systematic Review: Nutrition and Physical Activity in the Management of Paediatric Non-alcoholic
Fatty Liver Disease,
Journal of Pediatric Gastroenterology and Nutrition 65 (2) pp. 141-149 Lippincott, Williams & Wilkins [
OBJECTIVES: The aim of the study was to evaluate efficacy of nutrition and physical activity interventions in the clinical management of paediatric nonalcoholic fatty liver disease. The prevalence of paediatric nonalcoholic fatty liver disease continues to rise alongside childhood obesity. Weight loss through lifestyle modification is currently first-line treatment, although supplementation of specific dietary components may be beneficial. METHODS: Medline, CINAHL, EMBASE, Scopus, and Cochrane Libraries were systematically searched to identify randomized controlled trials assessing nutritional and physical activity interventions. Primary outcome measures were changes to liver biomarkers assessed by imaging, histology, or serum liver function tests. Study quality was evaluated using the American Dietetic Association Quality Criteria Checklist. RESULTS: Fifteen articles met eligibility criteria investigating nutritional supplementation (vitamin E [n
=
6], probiotics [n
=
2], omega-3 fatty acids [n
=
5]), dietary modification (low glycaemic load [n
=
1] and reducing fructose intake [n
=
1]). No randomized controlled trials examining physical activity interventions were identified. Vitamin E was ineffective at improving alanine transaminase levels, whereas omega-3 fatty acids decreased hepatic fat content. Probiotics gave mixed results, whereas reduced fructose consumption did not improve primary outcome measures. A low glycaemic load diet and a low-fat diet appeared equally effective in decreasing hepatic fat content and transaminases. Most studies were deemed neutral as assessed by the American Dietetic Association Quality Criteria Checklist. CONCLUSIONS: The limited evidence base inhibits the prescription of specific dietary and/or lifestyle strategies for clinical practice. General healthy eating and physical activity guidelines, promoting weight loss, should remain first-line treatment until high-quality evidence emerges that support specific interventions that offer additional clinical benefit.
Smith Taryn J, Lanham-New Susan, Hart Kath (2017) Vitamin D in adolescents: Are current recommendations enough?, The Journal of Steroid Biochemistry and Molecular Biology 173 pp. 265-272 Elsevier
Vitamin D is essential for bone development during adolescence and low vitamin D status during this critical period of growth may impact bone mineralization, potentially reducing peak bone mass and consequently increasing the risk of osteoporosis in adulthood. Therefore, the high prevalence of vitamin D inadequacy and deficiency in adolescent populations is of great concern. However, there is currently a lack of consensus on the 25-hydroxyvitamin D [25(OH)D] concentration, the widely accepted biomarker of vitamin D status, that defines adequacy, and the vitamin D intake requirements to maintain various 25(OH)D thresholds are not well established. While the current intake recommendations of 10?15 ¼g/day may be sufficient to prevent vitamin D deficiency (25(OH)D 50 nmol/l). This review will address these concerns and consider if the current dietary recommendations for vitamin D in adolescents are sufficient.
Day Kaitlin, Kwok Alastair, Evans Alison, Mata Fernanda, Verdejo-Garcia Antonio, Hart Kath, Ward Leigh, Truby Helen (2018) Comparison of a Bioelectrical Impedance Device against the Reference Method Dual Energy X-Ray Absorptiometry and Anthropometry for the Evaluation of Body Composition in Adults, Nutrients 10 (10) 1469 MDPI
This study aimed to compare the use of the bioelectrical impedance device (BIA) seca®
mBCA 515 using dual X-ray absorptiometry (DXA) as a reference method, for body composition
assessment in adults across the spectrum of body mass indices. It explores the utility of simple
anthropometric measures (the waist height ratio (WHtR) and waist circumference (WC)) for the
assessment of obesity. In the morning after an overnight fast (10 h), 30 participants underwent a
body composition DXA (GE iDXA) scan, BIA (seca 515), and anthropometric measures. Compared to
the DXA reference measure, the BIA underestimated fat mass (FM) by 0.32 kg (limits of agreement
Mendes Marcela M., Darling Andrea L., Hart Kathryn H., Morse Stephen, Murphy Richard, Lanham-New Susan A. (2019) Impact of high latitude, urban living and ethnicity on 25-hydroxyvitamin D status: A need for multidisciplinary action?, The Journal of Steroid Biochemistry and Molecular Biology Elsevier

The effects of urban living on health are becoming increasingly important, due to an increasing global population residing in urban areas. Concomitantly, due to immigration, there is a growing number of ethnic minority individuals (African, Asian or Middle Eastern descent) living in westernised Higher Latitude Countries (HLC) (e.g. Europe, Canada, New Zealand). Of concern is the fact that there is already a clear vitamin D deficiency epidemic in HLC, a problem which is likely to grow as the ethnic minority population in these countries increases. This is because 25-hydroxyvitamin D (25(OH)D) status of ethnic groups is significantly lower compared to native populations.

Environmental factors contribute to a high prevalence of vitamin D deficiency in HLC, particularly during the winter months when there is no sunlight of appropriate wavelength for vitamin D synthesis via the skin. Also, climatic factors such as cloud cover may reduce vitamin D status even in the summer. This may be further worsened by factors related to urban living, including air pollution, which reduces UVB exposure to the skin, and less occupational sun exposure (may vary by individual HLC). Tall building height may reduce sun exposure by making areas more shaded. In addition, there are ethnicity-specific factors which further worsen vitamin D status in HLC urban dwellers, such as low dietary intake of vitamin D from foods, lower production of vitamin D in the skin due to increased melanin and reduced skin exposure to UVB due to cultural dress style and sun avoidance.

A multidisciplinary approach applying knowledge from engineering, skin photobiology, nutrition, town planning and social science is required to prevent vitamin D deficiency in urban areas. Such an approach could include reduction of air pollution, modification of sun exposure advice to emphasise spending time each day in non-shaded urban areas (e.g. parks, away from tall buildings), and advice to ethnic minority groups to increase sun exposure, take vitamin D supplements and/or increase consumption of vitamin D rich foods in a way that is safe and culturally acceptable. This review hopes to stimulate further research to assess the impact of high latitude, urban environment and ethnicity on the risk of vitamin D deficiency.

Darling A.L., Hart K.H., Arber S., Berry J.L., Morgan P.L., Middleton B.A., Lanham-New S., Skene D.J. (2019) 25-Hydroxyvitamin D status, light exposure and sleep quality in UK dwelling South Asian and Caucasian postmenopausal women, The Journal of Steroid Biochemistry and Molecular Biology Elsevier

There is a lack of research into 25-hydroxyvitamin D (25(OH)D) status, light exposure and sleep patterns in South Asian populations. In addition, results of research studies are conflicting as to whether there is an association between 25(OH)D status and sleep quality.

We investigated 25(OH)D status, self-reported and actigraphic sleep quality in n = 35 UK dwelling postmenopausal women (n = 13 South Asians, n = 22 Caucasians), who kept daily sleep diaries and wore wrist-worn actiwatch (AWL-L) devices for 14 days. A subset of n = 27 women (n = 11 South Asian and n = 16 Caucasian) also wore a neck-worn AWL-L device to measure their light exposure.

For 25(OH)D concentration, South Asians had a median ± IQR of 43.8 ± 28.2 nmol/L, which was significantly lower than Caucasians (68.7 ± 37.4 nmol/L)(P = 0.001). Similarly, there was a higher sleep fragmentation in the South Asians (mean ± SD 36.9 ± 8.9) compared with the Caucasians (24.7 ± 7.1)(P = 0.002). Non-parametric circadian rhythm analysis of rest/activity patterns showed a higher night-time activity (L5) (22.6 ± 14.0 vs. 10.5 ± 4.4; P = 0.0008) and lower relative amplitude (0.85 ± 0.07 vs. 0.94 ± 0.02; P Â 0.0001) in the South Asian compared with the Caucasian women. More South Asians (50%) met the criteria for sleep disorders (PSQI score Ã5) than did Caucasians (27%) (P = 0.001, Fishers Exact Test). However, there was no association between 25(OH)D concentration and any sleep parameter measured (P Ã 0.05) in either ethnic group. South Asians spent significantly less time in illuminance levels over 200 lx (P = 0.009) than did Caucasians.

Overall, our results show that postmenopausal South Asian women have lower 25(OH)D concentration than Caucasian women. They also have higher sleep fragmentation, as well as a lower light exposure across the day. This may have detrimental implications for their general health and further research into sleep quality and light exposure in the South Asian ethnic group is warranted.

There is still limited data on the association between 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and bone health in healthy younger adults, particularly in Latin America. This cross-sectional analysis aimed to investigate the associations of 25(OH)D and plasma PTH concentrations with bone parameters, and potential confounders, in women living in a high (England) or low (Brazil) latitude country. Bone was assessed by either peripheral quantitative computed tomography (pQCT) (England) or dual-energy x-ray absorptiometry (DXA) scan (Brazil), serum 25(OH)D concentrations by high performance liquid chromatography tandem mass spectrometry (HPLC-MS) and PTH by the chemiluminescent method. In participants living in England, total volumetric bone mineral density (vBMD) was significantly higher in women

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