Quantifying Policy Options for Reducing Future Coronary Heart Disease Mortality in England: A Modelling Study

Aims

To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios.

Methods and Results

Using 2007 as baseline, the IMPACT_SEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains.

Conclusions

CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.     

Reducing the Socio-Economic Status Achievement Gap at University by Promoting Mastery-Oriented Assessment

In spite of official intentions to reduce inequalities at University, students’ socio-economic status (SES) is still a major determinant of academic success. The literature on the dual function of University suggests that University serves not only an educational function (i.e., to improve students’ learning), but also a selection function (i.e., to compare people, and orient them towards different positions in society). Because current assessment practices focus on the selection more than on the educational function, their characteristics fit better with norms and values shared by dominant high-status groups and may favour high-SES students over low-SES students in terms of performances. A focus on the educational function (i.e., mastery goals), instead, may support low-SES students’ achievement, but empirical evidence is currently lacking. The present research set out to provide such evidence and tested, in two field studies and a randomised field experiment, the hypothesis that focusing on University’s educational function rather than on its selection function may reduce the SES achievement gap. Results showed that a focus on learning, mastery-oriented goals in the assessment process reduced the SES achievement gap at University. For the first time, empirical data support the idea that low-SES students can perform as well as high-SES students if they are led to understand assessment as part of the learning process, a way to reach mastery goals, rather than as a way to compare students to each other and select the best of them, resulting in performance goals. This research thus provides a theoretical framework to understand the differential effects of assessment on the achievement of high and low-SES students, and paves the way toward the implementation of novel, theory-driven interventions to reduce the SES-based achievement gap at University.     

Analyzing the Environmental Benefits of Industrial Symbiosis

Studies of industrial symbiosis (IS) focus on the physical flows of materials and energy in local industrial systems. In an ideal IS, waste material and energy are shared or exchanged among the actors of the system, thereby reducing the consumption of virgin material and energy inputs, and likewise the generation of waste and emissions. In this study, the environmental impacts of an industrial ecosystem centered around a pulp and paper mill and operating as an IS are analyzed using life cycle assessment (LCA). The system is compared with two hypothetical reference systems in which the actors would operate in isolation. Moreover, the system is analyzed further in order to identify possibilities for additional links between the actors. The results show that of the total life cycle impacts of the system, upstream processes made the greatest overall contribution to the results. Comparison with stand‐alone production shows that in the case studied, the industrial symbiosis results in modest improvements, 5% to 20% in most impact categories, in the overall environmental impacts of the system. Most of the benefits occur upstream through heat and electricity production for the local town. All in all it is recommended that when the environmental impacts of industrial symbiosis are assessed, the impacts occurring upstream should also be studied, not only the impacts within the ecosystem.     

Quantifying the Effect of Polymer Blending through Molecular Modelling of Cyanurate Polymers

Modification of polymer properties by blending is a common practice in the polymer industry. We report here a study of blends of cyanurate polymers by molecular modelling that shows that the final experimentally determined properties can be predicted from first principles modelling to a good degree of accuracy. There is always a compromise between simulation length, accuracy and speed of prediction. A comparison of simulation times shows that 125ps of molecular dynamics simulation at each temperature provides the optimum compromise for models of this size with current technology. This study opens up the possibility of computer aided design of polymer blends with desired physical and mechanical properties.     

Plasma Elaidic Acid Level as Biomarker of Industrial Trans Fatty Acids and Risk of Weight Change: Report from the EPIC Study

BackgroundFew epidemiological studies have examined the association between dietary trans fatty acids and weight gain, and the evidence remains inconsistent. The main objective of the study was to investigate the prospective association between biomarker of industrial trans fatty acids and change in weight within the large study European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.MethodsBaseline plasma fatty acid concentrations were determined in a representative EPIC sample from the 23 participating EPIC centers. A total of 1,945 individuals were followed for a median of 4.9 years to monitor weight change. The association between elaidic acid level and percent change of weight was investigated using a multinomial logistic regression model, adjusted by length of follow-up, age, energy, alcohol, smoking status, physical activity, and region.ResultsIn women, doubling elaidic acid was associated with a decreased risk of weight loss (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.55-0.88, p = 0.002) and a trend was observed with an increased risk of weight gain during the 5-year follow-up (OR = 1.23, 95% CI = 0.97-1.56, p = 0.082) (p-trend<.0001). In men, a trend was observed for doubling elaidic acid level and risk of weight loss (OR = 0.82, 95% CI = 0.66-1.01, p = 0.062) while no significant association was found with risk of weight gain during the 5-year follow-up (OR = 1.08, 95% CI = 0.88-1.33, p = 0.454). No association was found for saturated and cis-monounsaturated fatty acids.ConclusionsThese data suggest that a high intake of industrial trans fatty acids may decrease the risk of weight loss, particularly in women. Prevention of obesity should consider limiting the consumption of highly processed foods, the main source of industrially-produced trans fatty acids.     

Dietary Benefits of Twilight Foraging by the Insectivorous Bat Hipposideros speoris1

Although bats are nocturnal, many species emerge from roosts to forage during twilight, despite a presumed high risk of predation at this time. Here, we describe twilight foraging by a maternity colony of Schneider's leafnosed bat (Hipposideros speoris) in the dry zone of Sri Lanka and determine the dietary benefits of such behavior. Bats usually began foraging during dusk, sometimes before sunset, and also foraged during twilight in the morning. Mean use of available twilight by four radio‐tagged bats was 75 percent. Twilight foraging made up, on average, 47 percent of the total foraging time of these bats (range = 25–96%), although twilight consisted of only 12 percent of the available time between sunset and sunrise the next morning. Eight species of potential predators (7 birds and 1 mammal) were observed within a 1 km radius of the colony, of which 5 species are predicted to regularly capture bats. Bats took a wide diversity of prey (11 insect orders, including at least 27 families, and spiders) that ranged in wing length from 2.0 to 54.0 mm. Major orders in the diet were Coleoptera, Lepidoptera, and Diptera. Prey of secondary importance included Hemiptera, Hymenoptera, Isoptera, and Neuroptera. Bats captured large numbers of insects that were only available or had marked peaks in abundance during twilight. These groups included small, swarming insects (especially flies) that have peaks in flight activity at dusk and dawn, large diurnal species (especially dragonflies) that have crepuscular activity, and winged termites that emerge in swarms at dusk. Access to these insects was a clear benefit of twilight foraging.     

Quantifying the Contribution of Statins to the Decline in Population Mean Cholesterol by Socioeconomic Group in England 1991 - 2012: A Modelling Study

Background

Serum total cholesterol is one of the major targets for cardiovascular disease prevention. Statins are effective for cholesterol control in individual patients. At the population level, however, their contribution to total cholesterol decline remains unclear. The aim of this study was to quantify the contribution of statins to the observed fall in population mean cholesterol levels in England over the past two decades, and explore any differences between socioeconomic groups.

Methods and Findings

This is a modelling study based on data from the Health Survey for England. We analysed changes in observed mean total cholesterol levels in the adult England population between 1991-92 (baseline) and 2011-12. We then compared the observed changes with a counterfactual ‘no statins’ scenario, where the impact of statins on population total cholesterol was estimated and removed. We estimated uncertainty intervals (UI) using Monte Carlo simulation, where confidence intervals (CI) were impractical. In 2011-12, 13.2% (95% CI: 12.5-14.0%) of the English adult population used statins at least once per week, compared with 1991-92 when the proportion was just 0.5% (95% CI: 0.3-1.0%). Between 1991-92 and 2011-12, mean total cholesterol declined from 5.86 mmol/L (95% CI: 5.82-5.90) to 5.17 mmol/L (95% CI: 5.14-5.20). For 2011-12, mean total cholesterol was lower in more deprived groups. In our ‘no statins’ scenario we predicted a mean total cholesterol of 5.36 mmol/L (95% CI: 5.33-5.40) for 2011-12. Statins were responsible for approximately 33.7% (95% UI: 28.9-38.8%) of the total cholesterol reduction since 1991-92. The statin contribution to cholesterol reduction was greater among the more deprived groups of women, while showing little socio-economic gradient among men.

Conclusions

Our model suggests that statins explained around a third of the substantial falls in total cholesterol observed in England since 1991. Approximately two thirds of the cholesterol decrease can reasonably be attributed non-pharmacological determinants.     

Benefits and Risks of the Hormetic Effects of Dietary Isothiocyanates on Cancer Prevention

The isothiocyanate (ITC) sulforaphane (SFN) was shown at low levels (1–5 µM) to promote cell proliferation to 120–143% of the controls in a number of human cell lines, whilst at high levels (10–40 µM) it inhibited such cell proliferation. Similar dose responses were observed for cell migration, i.e. SFN at 2.5 µM increased cell migration in bladder cancer T24 cells to 128% whilst high levels inhibited cell migration. This hormetic action was also found in an angiogenesis assay where SFN at 2.5 µM promoted endothelial tube formation (118% of the control), whereas at 10–20 µM it caused significant inhibition. The precise mechanism by which SFN influences promotion of cell growth and migration is not known, but probably involves activation of autophagy since an autophagy inhibitor, 3-methyladenine, abolished the effect of SFN on cell migration. Moreover, low doses of SFN offered a protective effect against free-radical mediated cell death, an effect that was enhanced by co-treatment with selenium. These results suggest that SFN may either prevent or promote tumour cell growth depending on the dose and the nature of the target cells. In normal cells, the promotion of cell growth may be of benefit, but in transformed or cancer cells it may be an undesirable risk factor. In summary, ITCs have a biphasic effect on cell growth and migration. The benefits and risks of ITCs are not only determined by the doses, but are affected by interactions with Se and the measured endpoint.     

Quantifying the Hydroregime of a Temporary Pool Habitat: A Modelling Approach for Ephemeral Rock Pools in SE Botswana

Ecological and evolutionary processes in temporary rock pools operate within constraints imposed by their hydrologic regimes. These shallow pools flood when seasonal rains accumulate on impermeable substrates. Despite the ecological importance of hydrologic conditions for these ecosystems, we typically lack tools and empirical data required to understand the implications of hydrologic variability and climate change for biotic populations and communities in these habitats. In this study, we developed a hydrologic model to simulate rock pool hydrologic regimes based on rainfall, evapotranspiration, and basin geometry. The model was used to investigate long-term patterns of seasonal and inter-annual variation in hydroregime. In addition, hydrologic conditions associated with potential climate change scenarios were simulated and evaluated with respect to the biological requirements of the anostracan Branchipodopsis wolfi. The model’s output for daily inundation matched with field observations with an overall accuracy of 85% and correctly estimated complete hydroperiods with an overall accuracy of 70%. Simulations indicate large variation in individual hydroperiods (76–115%) as well as in the number of hydroperiods per year (19–23%). Furthermore, this study suggests that climate change may significantly alter the rock pool hydroregime. These findings confirm the hydrologic sensitivity of these ephemeral habitats to precipitation patterns, and their potential sensitivity to future climate change. Modelling indicates that the suitability of average inundation conditions for B. wolfi deteriorates significantly under future climate predictions. High levels of spatial and temporal variation in hydrologic conditions are dominant features of these habitats and an essential consideration for understanding population and community-level ecological processes.     

Vertical Disentrainment of Anabaena circinalis in the Turbid, Freshwater Darling River, Australia: Quantifying Potential Benefits from Buoyancy

The migration patterns of phytoplankton through time and depthwere measure in the Darling River at Revallyn, New South Wales,Australia during a bloom of Anabaena circinalis. Anabaena circinaliswas able to disentrain and maintain position witin surface watersduring the early morning, coinciding with the diel period ofleast wind speeds and a state of no detectable thermocline (0.1°Cdetection limit). Anabaena circinalis concentrations were upto 10 times higher in the surface waters than in the bottomwaters during the morning sampling periods. Afternoon and midnightsampling periods revealed either a small amount of surface accumulationor none. All other phytoplankton were found to have a relativelyeven distribution throughout the water column at all time periodsmeasured (except Aulacoseira on one occasion). These verticaldistribution data were used to determine the potential benefitbuoyant A. circinalis could gain over an evenly distributedpopulation using a quantitative estimate of primary productivity.The buoyant population was found to have a daily integral ofphotosynthetic O₂ production of 3.63 mol m ^–2, five timesgreater than that for the evenly distributed population. Lossesdue to respiration were greater for the evenly distributed population(29.5%) than the buoyant population (4.8%), probably due tothe amount of time cells spent outside the euphotic zone. Itis suggested that buoyancy may offer considerable advantageto A.circinalis in gaining dominance in turbid freshwater rivers.Further, buoyancy may offer some advantage even without strongthermal gradients.     

Thermal Behavior, Microstructure, Polymorphism, and Crystallization Properties of Zero Trans Fats from Soybean Oil and Fully Hydrogenated Soybean Oil

Blends of soybean oil (SO) and fully hydrogenated soybean oil (FHSBO), with 10, 20, 30, 40, and 50% (w/w) FHSBO content were interesterified under the following conditions: 20 min reaction time, 0.4% sodium methoxide catalyst, and 500 rpm stirring speed, at 100 °C. The original and interesterified blends were examined for triacylglycerol composition, thermal behavior, microstructure, crystallization kinetics, and polymorphism. Interesterification produced substantial rearrangement of the triacylglycerol species in all the blends, reduction of trisaturated triacylglycerol content and increase in monounsaturated–disaturated and diunsaturated–monosaturated triacylglycerols. Evaluation of thermal behavior parameters showed linear relations with FHSBO content in the original blends. Blend melting and crystallization thermograms were significantly modified by the randomization. Interesterification caused significant reductions in maximum crystal diameter in all blends, in addition to modifying crystal morphology. Characterization of crystallization kinetics revealed that crystal formation induction period (τ _SFC) and maximum solid fat content (SFC_máx) were altered according to FHSBO content in the original blends and as a result of the random rearrangement. Changes in Avrami constant (k) and exponent (n) indicated, respectively, that—as compared with the original blends—interesterification decreased crystallization velocities and modified crystallization processes, altering crystalline morphology and nucleation mechanism. X-ray diffraction analyses revealed that interesterification altered crystalline polymorphism. The interesterified blends showed a predominance of the β′ polymorph, which is of more interest for food applications.     

Adsorptive Capacity of Charcoals Eaten by Zanzibar Red Colobus Monkeys: Implications for Reducing Dietary Toxins

Colobus monkeys on the African island of Zanzibar eat charcoal from burned trees and lying near kilns, where it is produced for cooking. This behavior may be a learned response for counteracting toxicity due to phenolic and similar compounds that occur in significant concentrations in the Indian almond (Terminalia catappa) leaves and mango (Mangifera indica) leaves which constitute a major part of their diet. Accordingly, we studied the adsorption of organic materials from hot water extracts of Indian almond and mango leaves by five charcoals collected in Zanzibar. For comparison, we also evaluated three commercial powdered activated charcoals. Three African charcoals collected at kilns adsorbed more organic material than two kinds collected from burned tree stumps. The commercial activated charcoals adsorbed the organic material best, as expected, yet the African kiln charcoals adsorbed surprisingly well. Thus, the hypothesized function of charcoal eating is supported.     

Optimisation Modelling to Assess Cost of Dietary Improvement in Remote Aboriginal Australia

Background

The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations.

Objective

We used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods.

Design

A twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet.

Results

Simultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (−90%) and refined cereals (−90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals.

Conclusion

This modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.     

Neuroprotective Benefits of Aerobic Exercise and Organoselenium Dietary Supplementation in Hippocampus of Old Rats

The progressive decline of neurological functions, such as learning and memory, is an unavoidable consequence of aging. Our previous work suggested that the combination of physical exercise and a diet supplemented with diphenyl diselenide improves age-related memory decline in rats. The present study investigated the effects of physical exercise and a diet supplemented with diphenyl diselenide on the levels of proteins involved in the hippocampal neuroprotection to figure out the mechanisms related to the beneficial effects of this intervention in aged rats. Male Wistar rats (27 months old) were fed daily with standard chow supplemented with 1 ppm of diphenyl diselenide and subjected to swimming training with a workload (1% of body weight, 20 min/day) for 4 weeks. The hippocampus was dissected from the brain and used for the western blot and immunohistochemistry analyses. The results of this study demonstrate that the association of diphenyl diselenide-supplemented diet and swimming exercise increased the levels of proteins involved in neuroprotection and decreased the activation of those related to apoptosis and neuroinflammation in the hippocampus of old rats. This study suggests that physical exercise and a diet supplemented with (PhSe)₂ promoted neuroprotection in the hippocampus of aged rats.