The Mediterranean diet and a low-carbohydrate diet are two popular dietary approaches recommended for cardiovascular and metabolic health, respectively. This trial will compare the combined effect of these diets to either approach alone for the treatment of metabolic syndrome (MetS). Males and females (n 222), 30-75 years, with at least three MetS risk factors, will be randomised to one of three diets: (i) traditional Mediterranean (∼55 % of energy carbohydrate:15 % protein:30 % fat), (ii) lower carbohydrate (∼35 % carbohydrate:20 % protein:45 % fat) or (iii) lower carbohydrate Mediterranean (∼35 % carbohydrate:20 % protein:45 % fat) diet for 12 weeks. The primary outcome measure is the MetS severity Z score, a composite score of risk factors, sex and ethnicity. MetS severity Z score will be calculated pre- and post-intervention using fasted blood samples for plasma TAG, HDL-cholesterol and glucose, systolic blood pressure, body weight and waist circumference measures. The findings from this trial will offer new insights into the most effective dietary strategy for managing diabetes and reducing cardiovascular risk in individuals with MetS.

Background/Objectives: A balanced nutritious diet is vital during pregnancy for both the mother and the baby. The aims of this longitudinal study were to (1) determine any differences in macro- and micronutrient intakes in a group of UK women during pregnancy (and in the post-partum period) who were overweight or obese (BMI mean (SD) 31.1 (2.9)) at antenatal booking appointment compared with women who were within the ideal BMI range (BMI mean (SD) 22.1 (1.9)) and (2) determine the proportion of women who met the Harmonized Average Requirements (H-AR) during pregnancy. Methods: Forty-two participants attended four clinic visits: three during pregnancy, one in each trimester (V1, V2, and V3), and one 12 weeks post-partum (V4). Dietary intake was assessed by 24 h diet recall and analysed using DietPlan6. Results: There were no differences in energy and macronutrient intakes between overweight/obese and lean women. During pregnancy, the overweight/obese women consumed a mean (SD) of 3238 (941) sodium (mg per day), which was approximately 10% higher compared to 2934 (732) sodium (mg per day) in the lean group (p = 0.015). Dietary and supplemental intakes of the sodium to potassium ratio was 21% higher in overweight/obese women compared to the lean women, p = 0.0031 (mean (SD) of 1.17 (0.35) versus 0.93 (0.28), respectively). Virtually all women did not meet the H-AR for niacin, folate, and vitamin D through dietary intake alone. Conclusions: The ‘eat better and not more’ message during pregnancy is supported.

Aggressive behavior is commonly measured through institutional records of misconduct (IRM) in prisons, however these records are subject to problems with respect to violence specificity, sensitivity and comparability across jurisdictions. The aim of this study was to validate an alternative tool to assess prisoner aggressive behavior, the Inmate Behavior Observation Scale (IBOS). The IBOS scores were generated by converting the routinely collected prison case notes into numerical values of aggressive behavior. The results showed that the IBOS had good inter-rater reliability (rICC = 0.844, p < .001), and had a higher sensitivity in both frequency (t60 = 2.890, p < .01) and severity (t60 = 2.805, p < .01) compared to the IRM. In conclusion, the IBOS is an alternative measure of aggressive behavior in research conducted in prisons.

Cognitive decline associated with healthy ageing and pathological conditions is driven by multifactorial processes, including oxidative stress, mitochondrial dysfunction and chronic neuroinflammation. Alzheimer’s Disease (AD), a progressive neurodegenerative disorder affecting cognition and behaviour, is the leading cause of dementia worldwide. Current pharmacological interventions provide modest and transient benefits, targeting limited molecular pathways with safety and cost concerns, underscoring the need for safe, accessible and multi-targeted strategies. This review explores new avenues of therapy with a focus on bioactive compounds derived from brown, red and green seaweeds and their potential to modulate key mechanisms underlying AD. Preclinical and emerging clinical studies demonstrate that phlorotannins, fucoidans, fucoxanthin, lutein, zeaxanthin, ulvan, and astaxanthin exert antioxidant, anti-inflammatory, cholinergic-modulating and neuroprotective effects. Supplementation with seaweed-derived bioactive compounds has been shown to exert molecular and cellular effects that lead to reduced amyloid burden, preservation of synaptic integrity, and enhanced cognitive performance. Collectively, seaweed-derived compounds represent promising candidates for multi-target therapeutic strategies in cognitive decline prevention in the context of AD and healthy brain ageing.

Sirtuins (SIRTs), nicotine adenine dinucleotide (+)-dependent histone deacetylases, have emerged as critical regulators in many signalling pathways involved in a wide range of biological processes. Currently, seven mammalian SIRTs have been characterized and are found across a number of cellular compartments. There has been considerable interest in the role of SIRTs in the brain due to their role in a plethora of metabolic- and age-related diseases, including their involvement in learning and memory function in physiological and pathophysiological conditions. Although cognitive function declines over the course of healthy ageing, neurological disorders including Alzheimer’s disease (AD) can be associated with progressive cognitive impairments. This review aimed to report and integrate recent advances in the understanding of the role of SIRTs in cognitive function and dysfunction in the context of AD. We have also reviewed the use of selective and/or natural SIRT activators as potential therapeutic agents and/or adjuvants for AD.

Background: Research suggests a link between deficiencies in omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) and impulsivity among psychiatric populations. However, this association is less evident in non-clinical populations. As omega-3 LCPUFAs are predominantly sourced through fish consumption, non-fish dieters may be more vulnerable to higher impulsivity. Methods: This cross-sectional observational study explored the association between lower intakes of omega-3 LCPUFA food sources and higher self-reported measures of impulsivity among healthy adults consuming non-restricted, vegetarian, and vegan diets. Results: The results from the validated Food Frequency Questionnaire showed significantly lower estimated omega-3 LCPUFA intakes among vegans and vegetarians when compared with people consuming non-restricted diets. Furthermore, although all groups scored within the normal range of impulsivity measures, vegans scored comparatively higher. Vegans also scored significantly higher in impulsivity control relating to attention than those consuming non-restricted diets. Conclusions: The significantly lower omega-3 LCPUFA dietary intakes in the vegan diets were associated with higher scores in the second-order attentional aspect of self-reported impulsiveness.

ABSTRACT Purpose The aim of this study was to determine whether advice to perform postmeal walking could be an effective and feasible alternate to standard care continuous walking for the management of gestational diabetes (GDM). Methods Forty women with GDM were randomized between 28 and 30 wk of gestation into either standard care (CTL; 30-min continuous walking, most days per week) or standard care with advice to PMW (daily 10-min walks after three main meals) for ~7 wk. The primary outcome for this randomized controlled trial was postprandial glucose assessed by continuous glucose monitors. Continuous glucose monitor and ActivPAL inclinometers (physical activity parameters) were each worn for 7 d at ~28 and ~35 wk gestation. Delivery outcomes were also collected. A linear mixed model compared the changes across time between groups. Results Twenty-six women (PMW: n = 12, CTL: n = 14; age 34 ± 5 y) completed the trial. Mean 3 h postprandial glucose at dinner was higher in the PMW versus CTL group at baseline and across the intervention (main effect group, P = 0.04). Twenty-four hours, nocturnal, and fasting glucose were similar between groups. The PMW group spent ~57 min·d −1 more time sedentary and ~11 min·d −1 less time stepping versus CTL (main effect group: P = 0.02 and 0.05). Adherence to the prescribed 30 min·d −1 of physical activity was high, regardless of whether accumulated as 3 × 10-min or one single bout of walking. Conclusions Distributing activity as 10-min bouts after main meals did not improve postprandial glucose outcomes compared with standard-care control. More research on the optimal duration and intensity of postmeal walks to improve postprandial responses are needed. Strategies that mitigate sedentary time and increase the minutes of physical activity accumulated across the day in pregnancy are also warranted.

Sirtuins (SIRTs), nicotine adenine dinucleotide (+)-dependent histone deacetylases, have emerged as critical regulators in many signalling pathways involved in a wide range of biological processes. Currently, seven mammalian SIRTs have been characterized and are found across a number of cellular compartments. There has been considerable interest in the role of SIRTs in the brain due to their role in a plethora of metabolic- and age-related diseases, including their involvement in learning and memory function in physiological and pathophysiological conditions. Although cognitive function declines over the course of healthy ageing, neurological disorders including Alzheimer's disease (AD) can be associated with progressive cognitive impairments. This review aimed to report and integrate recent advances in the understanding of the role of SIRTs in cognitive function and dysfunction in the context of AD. We have also reviewed the use of selective and/or natural SIRT activators as potential therapeutic agents and/or adjuvants for AD.

Pregnant women who develop pre-eclampsia (PE) and/or intra-uterine growth restriction (IUGR) have reduced polyunsaturated fatty acid (PUFA) status compared to healthy pregnancy(1). It is unknown if pregnant women diagnosed with Gestational Diabetes Mellitus (GDM), and their offspring, also have compromised PUFA status. To determine if women with GDM, and their offspring, have altered PUFA status compared to healthy pregnancy. Pregnant women were recruited from Glasgow Scotland, and Brisbane, Australia from antenatal clinics for this cross sectional study. Third trimester maternal blood samples were collected after an overnight fast and cord blood samples were collected at delivery. Plasma fatty acids were analysed using gas chromatography from women with GDM (n = 37) and healthy pregnancies (n = 27) and their respective offspring (n = 31, from women with GDM, and n = 27 from healthy women). T-tests were used to determine significant differences between maternal with GDM and healthy pregnancy, as well as for their offspring and significance was set at p<0.05. Previously, erythrocyte fatty acids were analysed from women with PE (n = 21), IUGR (n = 13) and healthy pregnancies (n = 86)(1). All results were expressed as mol percent of total fatty acids. There were no differences in maternal plasma arachidonic acid (4.51 ± 1.23 vs. 4.72 ± 0.64, p = 0.39) and plasma EPA & DHA (2.33 ± 0.74 vs 2.69 ± 1.04, p = 0.14) in women with GDM and healthy pregnancies, respectively. There were no differences in fetal plasma arachidonic acid (11.58 ± 2.26 vs. 12.63 ± 1.69, p = 0.08) and plasma EPA & DHA (4.44 ± 1.17 vs. 4.44 ± 1.00, p = 0.89) in offspring from women with GDM and healthy pregnancies, respectively. Women with PE and IUGR had approximately 25% lower erythrocyte EPA & DHA and 35% lower erythrocyte arachidonic acid compared to healthy pregnant(1). Offspring from women with PE and IUGR had approximately 25% lower erythrocyte EPA & DHA and 22% lower erythrocyte arachidonic acid compared to healthy pregnancy(1).Women with PE and IUGR had lower PUFA status likely due to reduced PUFA synthesis(1) and offspring from women with PE and IUGR had reduced PUFA status likely due to ectopic fat in placenta tissue(2). Women with GDM do not have compromised PUFA status suggesting there is no reduced synthesis and transport of PUFA. Offspring from women with GDM do not have reduced PUFA status suggesting there is no problem with PUFA transport across the placenta, unlike offspring from women with PE and/or IUGR. Women with GDM, and their offspring, do not have compromised plasma PUFA status compared to healthy pregnancy.

Maintaining blood glucose within the target range is the primary treatment goal for women with gestational diabetes mellitus (GDM). Foods with low glycaemic loads are recommended in clinical practice; however, the relative importance of other key lifestyle variables is unexplored. This pilot study explored the associations of glycaemic load, carbohydrates and physical activity parameters on blood glucose concentrations in free-living women with GDM. Twenty-nine women (28–30 weeks gestation, 34 ± 4 years) with GDM were enrolled. Continuous glucose monitoring, physical activity (ActivPAL inclinometer) and dietary intake and dietary quality were measured concurrently for 3 days. Pearson correlation analyses determined the association between glucose levels and lifestyle variables. Despite all receiving the same nutrition education, only 55% of women were following a low glycaemic load diet with a large range of carbohydrate intakes (97–267 g/day). However, the glycaemic load did not correlate with 3-hr postprandial glucose (r2 = 0.021, p = 0.56) or 24-h glucose iAUC (r2 = 0.021, p = 0.58). A significant relationship between total stepping time and lower 24-h glucose iAUC (r2 = 0.308, p = 0.02) and nocturnal glucose (r2 = 0.224, p = 0.05) was found. In free-living women with diet-controlled GDM, more physical activity, i.e., steps accumulated across the day, may be a simple and effective strategy for improving maternal blood glucose concentrations.

BACKGROUND:The effects of different dietary fatty acids (FA) on cardiovascular risk still needs clarification. Plasma lipids composition may be a biomarker of FA dietary intake. PURPOSE:To evaluate in a composite population the relationships between changes in dietary fat intake and changes in FA levels in serum cholesterol esters. METHODS:In a multinational, parallel-design, dietary intervention (KANWU study), dietary intakes (3-day food record) and FA composition of serum cholesterol esters (gas-liquid chromatography) were evaluated at baseline and after 3 months in 162 healthy individuals, randomly assigned to a diet containing a high proportion of saturated (SFA) or monounsaturated (MUFA) fat, with a second random assignment to fish oil or placebo supplements. RESULTS:Main differences in serum lipid composition after the two diets included saturated (especially myristic, C14:0, and pentadecanoic, C15:0) and monounsaturated (oleic acid, C18:1 n-9) FA. C14:0 and C15:0 were related to SFA intake, while C18:1 n-9 was associated with MUFA intake. Fish oil supplementation induced a marked increase in eicosapentaenoic (C20:5 n-3) and docosahexaenoic (C22:6 n-3) acids. After the 3-month intervention, Δ-9 desaturase activity, calculated as palmitoleic acid/palmitic acid (C16:1/C16:0) ratio, was more reduced after the MUFA (0.31±0.10 vs 0.25±0.09, p<0.0001) than SFA diet (0.31±0.09 vs 0.29±0.08, p=0.006), with a statistically significant difference between the two groups (p<0.0001). CONCLUSIONS:This study shows that serum cholesterol ester FA composition can be used during randomized controlled trials as an objective indicator of adherence to experimental diets based on saturated and monounsaturated fat modifications, as well as fish oil supplementation.

Background: Gestational diabetes mellitus (GDM) affects approximately one in six pregnancies, causing a significant burden on maternal and infant health. Lifestyle interventions are first-line therapies to manage blood glucose levels (BGLs) and prevent future cardiometabolic complications. However, women with GDM experience considerable barriers to lifestyle interventions; thus, the aim of this study was to determine how women with GDM manage their condition and to identify the primary supports and barriers to lifestyle intervention participation. Methods: An online cross-sectional survey of women in Australia with a history of GDM was conducted. Questions included participant demographics, strategies used to manage BGLs, physical activity and dietary habits, and barriers and supports to lifestyle interventions. Results: A total of 665 individuals consented and responded to the advertisement, of which 564 were eligible and provided partial or complete responses to the survey questions. Most respondents were between 35 and 39 years of age (35.5%), not pregnant (75.4%), working part-time (26.7%), university-educated (58.0%), and had only one child (40.1%). Most respondents managed their BGLs through diet (88.3%), with “low-carbohydrate” diets being the most popular (72.3%), and 46.2% of respondents were undertaking insulin therapy. Only 42.2% and 19.8% of respondents reported meeting the aerobic and strengthening exercise recommendations, respectively. Women with one child or currently pregnant expecting their first child were 1.51 times more likely (95% CI, 1.02, 2.25) to meet the aerobic exercise recommendations than those with two or more children. The most common reported barriers to lifestyle intervention participation were “lack of time” (71.4%) and “childcare” commitments (57.7%). Lifestyle interventions delivered between 6 and 12 months postpartum (59.0%), involving an exercise program (82.6%), and delivered one-on-one were the most popular (64.9%). Conclusion: Most women report managing their GDM with lifestyle strategies. The most common strategies reported involve approaches not currently included in the clinical practice guidelines such as reducing carbohydrate consumption. Furthermore, despite being willing to participate in lifestyle interventions, respondents report significant barriers, including lack of time and childcare commitments, whereas mentioned supports included having an online format. Lifestyle interventions for women with a history of GDM should be designed in a manner that is both tailored to the individual and considerate of existing barriers and supports to participation.

Women with gestational diabetes mellitus controlled for their plasma glucose levels, exhibit dyslipidaemia that may contribute to offspring obesity and the risk of future gestational diabetes mellitus - Volume 82 Issue OCE2

A large body of literature has examined the cause and treatment of aggressive behavior in prisons, but heterogeneity in the outcome measures used has led to difficulties comparing outcomes across studies. This systematic review aims to identify a Core Outcome Set for measuring aggression in prisons. Studies were eligible for inclusion if they measured aggressive behavior in adult male prisoners, described original research, and were in English. A systematic search of Medline, PubMed, PsycInfo, CINAHL and Cochrane databases to 7 March 2022 was conducted. Risk of bias was assessed using the QUADAS-2 method. The titles and abstracts of 19,619 records were screened, with 641 reports identified for full-text examination. From these reports, 283 studies with a total of 1,402,931 prisoners were included. These studies were predominantly published from 2000 onwards, published in North America, used a cross-sectional design, and included a single method to measure aggressive behavior. The studies most commonly used self-report and official records of misconduct, with staff report and mixed methods less common. Official records of misconduct and the Buss-Perry Aggression Questionnaire were identified as possible candidates for inclusion into a Core Outcome Set, but caveats exist around the specificity and sensitivity of these measures.

We examined the effect of a dietary seaweed extract-sulfated xylorhamnoglucuronan (SXRG84)-on individuals with inflammatory skin conditions. A subgroup analysis of a larger trial was undertaken, where 44 participants with skin conditions were enrolled in a double-blind placebo-controlled crossover design. Subjects ingested either SXRG84 extract (2 g/day) for six weeks and placebo for six weeks, or vice versa. At baseline, six- and twelve-weeks inflammatory markers and the gut microbiota were assessed, as well as skin assessments using the dermatology quality of life index (DQLI), psoriasis area severity index (PASI) and visual analogue scales (VAS). There were significant differences at weeks six and twelve for pro-inflammatory cytokines IFN-γ (p = 0.041), IL-1β (p = 0.030), TNF-α (p = 0.008) and the anti-inflammatory cytokine IL-10 (p = 0.026), determined by ANCOVA. These cytokines were all significantly higher at six weeks post placebo compared to twelve weeks post placebo followed by SXRG84 treatment. A total of 23% of participants reported skin improvements, as measured by VAS (mean difference 3.1, p = 0.0005) and the DQLI score (mean difference -2.0, p = 0.049), compared to the 'non-responders'. Thus, the ingestion of SXRG84 for 6 weeks reduced inflammatory cytokines, and a subset of participants saw improvements.

AIMS:To compare maternal and fetal cord plasma and lipoprotein triglyceride (TG) concentrations in women with Gestational Diabetes Mellitus (GDM), with hyperglycaemia and hypertriglyceridaemia, and healthy women. METHODS:Fasted maternal blood at 28.6 ± 3.4 (T1) and 36.2 ± 1.0 (T2) [mean ± S.D] weeks of gestation, and cord blood were collected. Plasma lipoprotein fractions underwent compositional analysis. RESULTS:Plasma glucose did not differ between GDM and healthy women. T1 maternal plasma TG (2.60 ± 0.89 mmol/l versus 1.71 ± 0.69 mmol/l) and plasma apolipoprotein B (1.30 ± 0.48 g/l versus 0.75 ± 0.40 g/l) were higher in GDM compared to healthy. Maternal plasma TG increased over gestation in both groups. T1 plasma VLDL total protein (38 ± 15 mg/dl versus 25 ± 11 mg/dl), total cholesterol (TC) (30 ± 14 mg/dl versus 16 ± 13 mg/dl) and phospholipid (PL) (43 ± 17 mg/dl versus 26 ± 16 mg/dl) were higher in GDM than healthy, and similarly for IDL, suggesting increased lipoprotein particle number. T1 VLDL-TG enrichment was higher in healthy and increased over gestation in GDM women but decreased in healthy. IDL-TG enrichment (TG/TC) increased over gestation in women with GDM and decreased in healthy. Cord blood VLDL, IDL and LDL from GDM had a two-fold higher TG enrichment than healthy pregnancy. CONCLUSION:Increased maternal lipoprotein number, but not TG enrichment, in GDM mothers may explain TG enrichment of cord lipoproteins.

Seaweed polysaccharides in the diet may influence both inflammation and the gut microbiome. Here we describe two clinical studies with an Ulva sp. 84-derived sulfated polysaccharide—“xylorhamnoglucuronan” (SXRG84)—on metabolic markers, inflammation, and gut flora composition. The first study was a double-blind, randomized placebo-controlled trial with placebo, and either 2 g/day or 4 g/day of SXRG84 daily for six weeks in 64 overweight or obese participants (median age 55 years, median body mass index (BMI) 29 kg/m2). The second study was a randomized double-blind placebo-controlled crossover trial with 64 participants (median BMI 29 kg/m2, average age 52) on placebo for six weeks and then 2 g/day of SXRG84 treatment for six weeks, or vice versa. In Study 1, the 2 g/day dose exhibited a significant reduction in non-HDL (high-density lipoprotein) cholesterol (−10% or −0.37 mmol/L, p = 0.02) and in the atherogenic index (−50%, p = 0.05), and two-hour insulin (−12% or −4.83 mU/L) showed trends for reduction in overweight participants. CRP (C-reactive protein) was significantly reduced (−27% or −0.78 mg/L, p = 0.03) with the 4 g/day dose in overweight participants. Significant gut flora shifts included increases in Bifidobacteria, Akkermansia, Pseudobutyrivibrio, and Clostridium and a decrease in Bilophila. In Study 2, no significant differences in lipid measures were observed, but inflammatory cytokines were improved. At twelve weeks after the SXRG84 treatment, plasma cytokine concentrations were significantly lower than at six weeks post placebo for IFN-γ (3.4 vs. 7.3 pg/mL), IL-1β (16.2 vs. 23.2 pg/mL), TNF-α (9.3 vs. 12.6 pg/mL), and IL-10 (1.6 vs. 2.1 pg/mL) (p < 0.05). Gut microbiota abundance and composition did not significantly differ between groups (p > 0.05). Together, the studies illustrate improvements in plasma lipids and an anti-inflammatory effect of dietary SXRG84 that is participant specific.

Objective The aim of this study was to determine whether postmeal walking is an effective and feasible alternate to standard-care advice of 30-min continuous walking for the management of gestational diabetes (GDM). Design, Setting Randomised controlled trial conducted in Australia. Sample, Methods Forty women with GDM were randomised between 28-30 weeks’ gestation into either standard-care (CTL; 30-min continuous walking) or standard care with advice for PMW (10-min walking after main meals). ActivPAL inclinometers and continuous glucose monitors (CGM) were worn from 28 weeks to 35 weeks. Birth outcomes were also collected. A linear mixed model analysed the changes from baseline (28 week) through to 35 weeks’ gestation between continuous and postmeal walking. Main Outcome Measure Postprandial glucose. Results Twenty-six women (PMW: n=12, CTL: n=14; 35  5 y) completed the intervention. 3 h postprandial glucose at lunch and dinner, were ~0.25 and ~0.35 mmol/L, respectively higher in PMW vs. CTL (group: p = 0.04). 24 h, nocturnal and fasting glucose were similar. PMW spent ~57 min/d more in sitting time and ~11 min/d less stepping time vs. CTL (group: p= 0.02 and 0.05). Both PMW and CTL had high adherence to exercise prescriptions, physical activity decreased with gestation. No difference in birth outcomes. Conclusions Postmeal walking was less effective than the standard care physical activity guidelines of thirty minutes continuous walking. More research on the optimal duration and intensity of postmeal walks to improve postprandial responses are needed. Strategies that mitigate sedentary time in pregnancy are also warranted.

K. GreenK. NewellS. DownieP. StapleyJ. SteeleT. MitchellJ. SampsonP. ElseH. GroellerB. MeyerM. BrownD. McGheeX.F. Huang