NMC consultations: is the devil in the detail?
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Clinical Competence↗
Biomedical subjects
David Benton
Publications and source records attributed to David Benton.
The delivery rate of dietary carbohydrates affects cognitive performance in both rats and humans.
RATIONALE: Glucose is the main metabolic fuel of the brain. The rate of glucose delivery from food to the bloodstream depends on the nature of carbohydrates in the diet, which can be summarized as the glycaemic index (GI). OBJECTIVES: To assess the benefit of a low versus high GI breakfast on cognitive performances within the following 4 h. METHODS: The influence of the GI of the breakfast on verbal memory of young adults was measured throughout the morning in parallel to the assessment of blood glucose levels. The learning abilities of rats performing an operant-conditioning test 3 h after a breakfast-like meal of various GI was also examined. RESULTS: A low GI rather than high GI diet improved memory in humans, especially in the late morning (150 and 210 min after breakfast). Similarly, rats displayed better learning performance 180 min after they were fed with a low rather than high GI diet. CONCLUSION: Although performances appeared to be only remotely related to blood glucose, our data provide evidence that a low GI breakfast allows better cognitive performances later in the morning.
Adult↗
Carbohydrate ingestion, blood glucose and mood.
A series of studies have reported that a high carbohydrate meal, or diets high in carbohydrate, were associated with feeling less energetic. However, after a drink containing pure sugar most studies report no effect. Meals almost exclusively carbohydrate increase the availability of tryptophan and hence serotonin synthesis in the brain, however, a small amount of protein blocks this mechanism making it an uncommon response. In many individuals, poor mood stimulates the eating of palatable high carbohydrate/high fat foods that stimulate the release of endorphins. There is a tendency for those with lower blood glucose, when performing cognitively demanding tasks, to report poorer mood. In a range of situations an association between a tendency for blood glucose levels to fall rapidly, and irritability, has been found. Differences in the ability to control blood glucose levels influence the association between carbohydrate intake and mood. There is a need in future research to contrast the impact of carbohydrate on mood in those distinguished because of their pre-existing psychological and physiological functioning.
Affect↗
Selenium intake, mood and other aspects of psychological functioning.
Selenium is an essential trace element although the level of selenium in food items reflects the soil in which they were grown and thus varies markedly between different parts of the world. The metabolism of selenium by the brain differs from other organs in that at times of deficiency the brain retains selenium to a greater extent. The preferential retention of selenium in the brain suggests that it plays important functions. To date mood is the clearest example of an aspect of psychological functioning that is modified by selenium intake. Five studies have reported that a low selenium intake was associated with poorer mood. The underlying mechanism is unclear although a response to supplementation was found with doses greater than those needed to produce maximal activity of the selenoprotein glutathione peroxidase. Although the functions of many selenoproteins are unknown some play important roles in anti-oxidant mechanisms. As there are suggestions that oxidative injury plays a role in normal aging, schizophrenia, Parkinson's and Alzheimer's disease, the possible role of selenium is considered. Although there is evidence that supplementation with anti-oxidant vitamins shown some promise with Alzheimer's patients, and in preventing the development of tardive dyskinesia in schizophrenics taking neuroleptics, a role for selenium has been little considered.
Affect↗
The effect of the interaction between glucose tolerance and breakfasts varying in carbohydrate and fibre on mood and cognition.
As a glucose containing drink has been reported to improve memory, and missing breakfast has been reported to adversely influence memory late in the morning, meals designed to differ in their ability to release glucose into the blood stream were contrasted. Using a factorial design, breakfasts containing 15, 30 or 50 g of carbohydrate and 1.5, 6 or 13 g of fibre were compared. The glucose tolerance of participants proved to be an important factor. Those with better tolerance reported better mood. Those eating breakfasts containing greater amounts of carbohydrate reported feeling tired rather than energetic. The amount of carbohydrate did not negatively affect memory in those with better glucose tolerance, however, the consumption of more carbohydrate resulted in more forgetting in those with poorer glucose tolerance. The effect with reactions times differed from memory in that a greater intake of carbohydrate resulted in faster responses later in the morning.
Adolescent↗
Agenda for Change: job evaluation.
Most of the popular press and professional journal coverage associated with Agenda for Change (DoH 1999a) has tended to focus on the terms and conditions of service. While this is clearly important, this article focuses on the possible longer term, cultural, career, service, education and regulatory impact of this initiative.
Career Mobility↗
Deconstructing nursing from practice to theory.
People often talk about 'basic' nursing care as if it is the simplest thing in the world: it looks so easy that anyone could do it. But there is more to it than meets the eye. We asked three prominent nurses to spend time watching individual nurses going about their business in an attempt to get to the bottom of this thing called nursing care. And when you look beyond the surface it is obvious delivering nursing care is neither simple nor basic.
Attitude of Health Personnel↗
Sharing best practice across the Atlantic.
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Benchmarking↗