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Biomedical subjects

A J Rugg-Gunn

Publications and source records attributed to A J Rugg-Gunn.

At least 19 recordsLinked to original sources
PubMed2004

Changes in water intake of Northumbrian adolescents 1980 to 2000.

OBJECTIVES: To determine: total water intake in young English adolescents; the relative importance of sources of water intake; and changes in water intake and sources of water between 1980 and 2000. DESIGN: A cross-sectional observational study of the diets of 11-12-year-old children attending seven schools in south Northumberland, UK. The information obtained was compared with results from a similar survey carried out 20 years previously. METHODS: All children attending these schools were invited to participate. They completed a three-day diet diary with an interview on the fourth day, on two occasions during the school year. Standard UK food composition tables were used and water intake from various sources calculated. Anthropometric and social class information was obtained. RESULTS: Four hundred and twenty-four children completed all aspects of the study (64% of those eligible). The mean total water intake was 1,130 g d(-1), approximately the same as that recorded 20 years before. Water intake in relation to energy intake: water intake was 139 g MJ(-1) in boys and 143 g MJ(-1) in girls. Sixty-five per cent of water came from drinks and 35% from foods; very similar to proportions 20 years before. The sources of water in drinks had changed considerably, with a marked increase in consumption of soft drinks (especially carbonated drinks) and a decrease in consumption of hot drinks and milk. There were a few differences between sexes but little difference between social groups. CONCLUSIONS: Total water intake was similar to that recorded 20 years previously and lower than intakes reported in other countries. Changes in the sources of water meant that less water consumed was likely to come from the tap in the house and more from drinks made elsewhere, than 20 years previously. These changes have implications for estimating fluoride intake in fluoridated areas.

Adolescent↗
PubMed2004

Changes over 20 years in macronutrient intake and body mass index in 11- to 12-year-old adolescents living in Northumberland.

Monitoring adolescent diets over time enables the assessment of the effectiveness of public health messages which are particularly important in vulnerable groups such as adolescents. In 2000, 424 children aged 11-12 years old completed two 3 d estimated dietary records. On the fourth day one nutritionist interviewed each child to clarify the information in the diary and foods were quantified with the aid of food models. Nutrient intake was calculated using computerised food tables. These children attended the same seven schools in the same Northumberland area as the 11- to 12-year-old children who recorded their diet using the same method in 1980 (n 405) and 1990 (n 379), respectively. Height and weight, and parental occupation were recorded in all three surveys for each child. Height and weight were used to calculate BMI, weight was used to estimate BMR and parental occupation was used to determine social class. Comparing the macronutrient intakes in 2000 with 1980 and 1990, energy intakes (EI) fell in boys (to 8.45 MJ) and girls (to 7.60 MJ). This fall may, at least in part, be due to an increase in low energy reporting. For 1980, 1990 and 2000 the percentage of boys with EI:BMR below 1.1 was 6, 15 and 23 %, respectively; for girls, 3, 14 and 18 %, respectively. Percentage energy from fat was unchanged between 1980 and 1990 but fell to 35 % (about 76 g/d) in 2000, alongside a 3 % increase in percentage energy from starch (30 %). Percentage energy from non-milk extrinsic sugars remained above recommendations (16 %; about 82 g/d). The number of overweight and obese children increased from 11 % to 30 % between 1980 and 2000. Positive changes have occurred in the Northumbrian adolescent diet but social inequalities, reported in previous surveys, remain.

Body Mass Index↗
PubMed2003

Review of methods used to estimate non-milk extrinsic sugars.

BACKGROUND: Those sugars in foods, which are potentially damaging to dental health, were classified by the Committee on Medical Aspects of Food Policy (COMA) as non-milk extrinsic sugars (NMES). The NMES include sugars outside the cellular structure of a food, excluding the sugars naturally present in milk and milk products. The NMES should contribute no more than 10% of energy intake (Department of Health, 1991). A number of studies have been published where NMES content of foods has been estimated. The purpose of this study was to carry out a comprehensive literature review using a methodical search strategy in order to identify the different methods that have been used for NMES estimation. METHODS: Databases searched were MEDLINE, EMBASE, Health-CD and Health Management Information Consortium (HMIC) (as sources of UK government and other official publications). RESULTS: In total, 32 publications were found in which NMES values were reported and five different methods to estimate NMES were identified. No published method provided sufficient information to clearly differentiate between methods and inadequate detail was given to support replication of any of the methods. Of these five methods, The Ministry of Agriculture, Fisheries and Food (MAFF) have published three different descriptions of methods of NMES estimation used in UK national dietary surveys published since 1989. However, one method has been described consistently in the National Diet and Nutrition surveys published since 1994. CONCLUSIONS: A single, uniform approach to the estimation of NMES for application in nutritional surveys is essential for cross-comparison between surveys. The results show that there is a clear need for one standardized approach for the estimation of NMES in foods.

Animals↗
PubMed2002

Acid-etch patterns on the buccal surface of human permanent teeth.

Since the introduction of acid etching to aid adhesion to enamel, there has been much research into dental materials to improve bond strength, but little into the surface topography of etched enamel, particularly regarding possible variations between tooth types. This study was a systematic investigation into the quality and quantity of etch patterns found on the buccal surfaces of different human permanent teeth. Twenty-nine orthodontic patients had high-resolution silicone impressions taken of the buccal surface of incisor, canine, premolar and molar, upper and lower teeth, following etching for 30s with 37% phosphoric acid. Impressions (n=266) were replicated in epoxy resin and examined under high magnification in a scanning electron microscope. A modification of the classification of Galil and Wright was used, with histometric techniques, to quantify the quality of etch patterns on enamel surfaces where orthodontic brackets are typically bonded. There was no difference between right and left or between upper and lower teeth of the same type (P>0.05). There was a general trend toward the increasing occurrence of no etch (type D) from anterior to posterior teeth, and a trend toward fewer good-quality etches (types A and B) in the same direction. Etch types A and B were found to occupy the smallest area on the etched buccal surface enamel. The greatest amount of type A etch 'ideal' was found on the lower incisors, yet it occupied less than 5% of the etched buccal surface enamel. The greatest area of etched enamel surface was occupied by type C (etched, but enamel prisms not evident). It was concluded that there is a significant difference in the acid-etch patterns achieved on different tooth types, which suggests that bond-strength studies should be performed with a single tooth type or that an equal number of different tooth types be included.

Acid Etching, Dental↗
PubMed2001

Dietary intake of folate by adolescents and the potential effect of flour fortification with folic acid.

The UK Department of Health recently recommended that flour be fortified with folic acid, at 2400 microg/kg. The objectives of the present paper were: to determine the consequence of this on folic acid intake of adolescents; to determine the level of fortification necessary to achieve an intake of 400 microg/d in adolescent girls (the amount recommended periconceptionally); to estimate the consequence of fortification on folic acid intake of high flour consumers; and to report on folate intake of adolescents. Dietary intake of folate and flour were determined by analysis of an existing database of the diets of 379 English adolescents. The folic acid intake that would result from white flour fortification with folic acid at 2400 microg/kg was determined and the level of folic acid fortification necessary to achieve an intake of 400 microg/d in girls from this source was also calculated. Without flour fortification, 6.9 % of girls failed to reach the UK lower reference nutrient intake for total folate. Fortification of white flour with folic acid at 2400 microg/kg would result in an additional folic acid intake of 191(sem 6) microg/d in girls. To ensure 97 % of girls received 400 microg/d from white flour, white flour would need to be fortified at a level of 10 430 microg/kg, resulting in intakes of 1260 microg/d from flour in the highest (97.5 centile) female white flour consumers and 1422 microg/d from flour in the highest (97.5 centile) male white flour consumers.

Adolescent↗
PubMed2001

Nutrition, diet and oral health.

Teeth are valued, not least for their contribution to appearance and social acceptability. The cost of treating oral disease, though, is high--about 2.2 billion pounds in the UK in 1999-2000. Nutrition and diet are major determinants of oral health or disease and the purpose of this lecture was to review their impact on the more important oral diseases: defects in the structure and appearance of teeth, dental caries, dental erosion, periodontal disease, noma, and oral cancer. There is growing realisation of the detrimental impact of dental impairment on food choice, nutrient intake and nutritional status. A common feature of many of these diseases is that the causes are well known. However, they are not yet preventable because their aetiology (and prevention) is intimately involved with lifestyle. Nevertheless, there are some hopeful signs of progress being made in several areas.

Diet↗
PubMed2000

Dental fluorosis in permanent incisor teeth in relation to water fluoridation, social deprivation and toothpaste use in infancy.

OBJECTIVES: To determine the prevalence and severity of fluorosis in permanent incisor teeth in young children in a fluoridated and a fluoride-deficient community and to establish what relationship, if any, there was between the occurrence of dental fluorosis and the reported use of fluoride toothpaste in childhood. DESIGN: A prevalence study of children aged 8-9 years who had been continuous residents in fluoridated Newcastle or fluoride-deficient Northumberland. METHOD: The permanent maxillary central incisor teeth were examined clinically and photographically by one examiner using the Thylstrup-Fejerskov index; the photographs were read blind to child identity and clinical score. A closed-response questionnaire enquired into the child's early experiences of toothbrushing and use of fluoride toothpastes. Social deprivation was measured by a Jarman score. The study took place in 1998. OUTCOME MEASURE: Prevalence of dental fluorosis measured by the Thylstrup-Fejerskov index. RESULTS: Complete data were available for 78% (n = 409) and 79% (n = 403) of eligible sampled children in the two areas, respectively. Clinical and photographic results agreed closely and had high reproducibility. The prevalence of fluorosis was 54% in the fluoridated area and 23% in the fluoride-deficient area when all grades (> 0) of fluorosis were included; percentage prevalence of mild to moderate fluorosis (> or = 3) was 3% and 0.5% in the two areas, respectively. Multivariate analysis indicated that area of residence (odds ratio = 4.5), Jarman score (odds ratio = 0.99 per Jarman unit) and type of toothpaste (odds ratio = 1.6) were statistically significantly related to presence or absence of fluorosis: the risk factors were--fluoridated area, affluence, and use of adult toothpaste. CONCLUSIONS AND RECOMMENDATIONS: The prevalence of aesthetically important dental fluorosis was low, although higher in the fluoridated area. Use of a child's toothpaste (with lower fluoride concentration) could decrease risk in a fluoridated area. Adherence to the guidelines published by the British Society of Paediatric Dentistry is recommended.

Child↗
PubMed2000

Adaptation of dental plaque to metabolise maltitol compared with other sweeteners.

UNLABELLED: There is some evidence that plaque can adapt to regular exposure to some bulk sweeteners, leading to increased metabolism and acidogenic potential of the sweetener. This potential for adaptation varies between non-sugar sweeteners and has important implications for manufacturers of food, confectionery and medicines used long-term. Maltitol (99% purity crystalline D-maltitol) is a relatively newly approved non-sugar sweetener and appears to have potentially good dental properties. OBJECTIVES: To compare plaque adaptation to pure sucrose, sorbitol, xylitol or maltitol and the effect of their prolonged use on acid production by plaque from sucrose, in vivo. METHODS: Two series of plaque pH experiments were carried out. Each experiment involved a 14 day adaptive period when four 5 g lozenges of the sweetener were taken between meals each day. Each experiment was separated by a 14 day wash-out period. Acid production was quantified as: (a) minimum pH; and (b) cH area (difference between plaque pH curve and resting value, expressed as cH units). RESULTS: Thirteen adults, of mean age 41 years completed the study. When adaptation of dental plaque to the metabolism of sweeteners was compared, there was a statistically significant difference (p = 0.033) between xylitol and sorbitol, and between xylitol and sucrose but not between xylitol and maltitol. When the effect of prolonged use of sweeteners on acid production after sucrose rinsing was compared, there were no statistically significant differences between the sweeteners. CONCLUSION: Dental plaque does not adapt to metabolise xylitol or maltitol following prolonged exposure over 14 days.

Adaptation, Physiological↗
PubMed2000

Sources of dietary fluoride intake in 4-year-old children residing in low, medium and high fluoride areas in Iran.

Accurate estimation of fluoride dietary intake is desirable for optimising caries prevention. Little is known about the dietary fluoride intake of children aged 4 years, an age when many permanent teeth are forming. This study was undertaken in Fars Province, Iran, in 1995-1996, where there are big differences in temperature between winter and summer. The aims were to determine: (a) the relative contributions of different components of the diet to fluoride intake, (b) the effect of variation in fluoride concentration in drinking water, and (c) the effect of climate temperature. Temperature varied between +40 degrees C in summer to -5 degrees C in winter. The mean fluoride concentrations in drinking water in the three areas were 0.3, 0.6 and 4.0 mgF/L. Dietary information was obtained by two 3-day diet diaries with interview, validated with reference to international standards. The fluoride content of foods was measured using the silicon-facilitated diffusion method. One hundred and three 4-year-old children completed the study. The mean (and 95% confidence interval) dietary fluoride intakes in each of the three areas, respectively, were 413 (+/- 21), 698 (+/- 89) and 3472 (+/- 557) micrograms/day. Drinks provided 72 to 87% of dietary fluoride--this proportion increased with increasing water fluoride concentration and increasing climate temperature. Tea (infusion) was an important source of dietary fluoride, providing 31 to 38% of total dietary intake. Tap water was a more important source of fluoride than soft drinks. Cooked rice and bread were the most important food source of fluoride and the amount of fluoride they contributed increased as water fluoride concentration increased. The results of this first such survey in the Middle East showed (a) that water (as a drink) and tea were by far the most important contributors to dietary fluoride intake, (b) substantial increases in fluoride intake with increasing water fluoride concentrations, and (c) substantially higher fluoride intakes in summer than in the winter.

Beverages↗
PubMed2000

Total fluoride intake and urinary excretion in 4-year-old Iranian children residing in low-fluoride areas.

Knowledge of levels of fluoride ingestion and excretion is important in planning optimum fluoride therapy for young children. In previous literature, it has been assumed that only about one-third of ingested fluoride is excreted in young children. The aims of the present study were (a) to measure total fluoride intake, urinary fluoride excretion and fluoride balance, and (b) to investigate the effect of air temperature on fluoride intake and urinary fluoride excretion, in young children. Children (4 years old) living in a city, a small town and rural areas of Fars province, Iran, where drinking water contained 0.30-0.39 mg F/l, were invited to participate. Selection of subjects was by random sampling of kindergartens or health centres. The children were surveyed twice, once in summer and once in winter. Diet was obtained by 3 d diaries with interview. Samples of most foods and drinks were analysed for fluoride content. Ingestion of fluoride from toothpaste was estimated for each child. Each child's urine was collected over 24 h and analysed for fluoride content. Seventy-eight of the 116 volunteers completed all aspects of the study, which was conducted in 1995-6. For all children, the mean fluoride ingestion from diet was 0.390 (SD 0.122) mg/d or 0.028 (SD 0.008) mg/kg body weight per d. Fluoride ingestion from diet was higher in summer and higher in rural areas. The mean ingestion of fluoride from all sources was 0.426 (SD 0.126) mg/d and the mean fluoride urinary excretion was 0.339 (SD 0.100) mg/d. The difference between ingestion and urinary excretion was +0.087 (SD 0.143) mg, equivalent to 80% excretion. Faecal excretion was not estimated. The results indicate fluoride retention at 4 years to be much lower than previously assumed.

Child, Preschool↗
PubMed1999

Fluoride concentration in foods from Iran.

Knowledge of fluoride intake is important in optimizing the caries-preventive role of fluoride, and the measurement of fluoride intake usually requires information on the fluoride concentration in foods and drinks. Most information comes from developed countries and there are no data on fluoride concentration in foods in Middle Eastern countries including Iran. The aim of the study was to: (a) describe a modification to the silicon-facilitated diffusion method for determining fluoride concentration, (b) provide information on fluoride content of foods in Iran to supplement food tables for the Middle East, and (c) determine the effect of variation in the fluoride concentration of drinking water on the fluoride concentration of prepared foods. Five hundred and ten samples of 84 popular foods and drinks were collected from three areas of Iran where water fluoride concentrations were 0.32, 0.58 and 4.05 mg/L. The mean recovery of fluoride added to food samples before diffusion was 98 +/- 5%. Values for duplicate analysis of 20 food samples were within 0.03 microgram F/g. Most of the samples of foods and drinks came from the area with 0.32 mg F/L in water supplies. For 30 of the 84 items, fluoride concentration was below 0.1 microgram/g. Fluoride concentrations in the cereals group (which constituted much of the diet) were mainly between 0.2 and 0.3 microgram/g, when prepared for consumption. It was concluded that: (a) modification of a published method for determining fluoride concentration of foods appeared to be an advance, (b) values for fluoride concentration of foods commonly consumed in Iran showed variation between groups but were in broad agreement with published data, and (c) concentration of fluoride in water influences positively fluoride concentration in foods cooked in water, but the increase in foods was less than the increase in fluoride concentration in water.

Fluoridation↗
PubMed1999

Development and evaluation of a sugar-free medicines campaign in north east England: analysis of findings from questionnaires.

OBJECTIVE: To develop a strategy for a campaign aimed at general medical practitioners (GPs) and pharmacists and to evaluate the effectiveness of the campaign on (a) awareness of the role of liquid oral medicines containing sugar in dental disease and (b) changing prescribing and dispensing of sugar-containing medicines. DESIGN: Pre- and post-campaign questionnaires were sent to community pharmacists and GPs and following a series of qualitative interviews with them, a campaign was developed. Following post campaign questionnaires, changes due to the effects of the campaign were evaluated. SETTING: The test area was Newcastle and North Tyneside Health Authority area with Sunderland and South Tyneside Health Authority areas as control. INTERVENTIONS: An information pack followed up by a personal contact was the main form of intervention. The pack comprised a Smile for Sugar-Free Medicines leaflet used in the north west campaign, abstracts from professional journals illustrating the benefits of sugar-free medicines, local dental health information and computing information which could be used to adapt computer terminals in surgeries to display sugar-free options more prominently. MAIN OUTCOME MEASURES: Changes in the knowledge and awareness of both pharmacists and GPs to liquid oral medicines containing sugar as assessed by questionnaires. RESULTS: Increased knowledge and awareness of both pharmacists and GPs to the role of liquid oral medicines containing sugar and the use of sugar-free medicines had taken place but these were not statistically significant. CONCLUSION: The campaign created awareness amongst GPs and pharmacists about dental issues and it is hoped that this awareness can be built upon in future oral health promotion campaigns. However, it is likely that facilitation of sugar-free medicines use will occur only if sustained and constant reinforcement is available. The methodology used presented several difficulties in evaluating change.

Carbohydrates↗
PubMed1999

Evaluation of a sugar-free medicines campaign in north east England: quantitative analysis of medicines use.

OBJECTIVE: The aim of the study was to evaluate the effectiveness of a sugar-free medicines campaign using suitable prescribing and purchasing indicators. BASIC RESEARCH DESIGN: Quantitative analysis of sugar-free medicine use, before (1995) and after (1996) the campaign. CLINICAL SETTING: Two test and two control districts in north east England. PARTICIPANTS: General medical practitioners (GPs) and community pharmacists. INTERVENTION: A 12-month campaign involving development and distribution of information packs designed to increase the proportion of prescriptions dispensed sugar-free for paediatric use. MAIN OUTCOME MEASURES: Changes in the proportion of the following which were sugar-free: (a) for target prescribed medicines (i) number of prescriptions dispensed. (ii) number of prescribed daily amounts (PDA); (b) for target over the counter (OTC) medicines, (i) number of bottles sold, (ii) number of standard daily amounts (SDA) sold. RESULTS: Quantitative analysis of prescriptions and OTC sales showed statistically highly significant changes towards sugar-free prescribing and dispensing of prescribed medicines but only small increases in the proportion of some sugar-free OTC sales. CONCLUSIONS: The impact of the campaign was shown to be greatest in changing prescribing habits of GPs with less effect on OTC medicine use. The outcome measures used were suitable for quantitative evaluation of the campaign. POST-CAMPAIGN DEVELOPMENT: Sustainable changes in GPs' prescribing behaviour can be facilitated by software suppliers' modifications to computing software used for prescription writing.

Carbohydrates↗
PubMed1998

Malnutrition and developmental defects of enamel in 2- to 6-year-old Saudi boys.

Three hundred and ninety boys aged 2, 4 or 6 years from Riyadh, Saudi Arabia, took part in a survey in 1993/94. The main aims of the study were first, to identify factors related to malnutrition in young children since a study of older children from the same area 1 year before had shown malnutrition to be strongly related to prevalence of developmental defects of enamel (DDE) of permanent teeth and, second, to identify factors related to the prevalence of developmental defects of primary teeth. Enamel defects were recorded by clinical examination of the buccal surfaces of all primary teeth by 1 examiner using the DDE index. A questionnaire to parents provided information on socio-economic status, illness in the mother and child, infant feeding, trauma to teeth and toothbrushing. A 24-hour dietary record, to estimate water and milk intake, and a 24-hour urine collection were obtained for each child twice. Nutritional status was calculated from height for age using WHO methods. Multiple regression analyses revealed four variables related (p<0.05) to malnourished status: low birth-weight, low volume of water drunk, child stopped breast- and bottle-feeding before 1 year of age, and low class urban or rural area of residence. Birth-weight was itself related to area of residence (p = 0.02), parental education (p = 0.02) and maternal illness during pregnancy (p = 0.06). Malnutrition (p<0.001), low birth-weight (p<0.001), childhood illness (p<0.001), brushing of child's teeth (p = 0.003) and swallowing toothpaste (p<0.001) were related to the prevalence of developmental defects of primary teeth. This study indicated several independent variables which may be related to the prevalence of enamel defects in primary and permanent teeth, but longitudinal studies are required to determine which are causes and which are markers of these developmental defects.

Animals↗