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Biomedical subjects

M J Whichelow

Publications and source records attributed to M J Whichelow.

At least 19 recordsLinked to original sources
PubMed2000

A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome.

Previous epidemiological studies have demonstrated relationships between individual nutrients and glucose intolerance and type 2 diabetes, but the association with the overall pattern of dietary intake has not previously been described. In order to characterize this association, 802 subjects aged 40-65 years were randomly selected from a population-based sampling frame and underwent a 75 g oral glucose-tolerance test. Principal component analysis was used to identify four dietary patterns explaining 31.7% of the dietary variation in the study cohort. These dietary patterns were associated with other lifestyle factors including socio-economic group, smoking, alcohol intake and physical activity. Component 1 was characterized by a healthy balanced diet with a frequent intake of raw and salad vegetables, fruits in both summer and winter, fish, pasta and rice and low intake of fried foods, sausages, fried fish, and potatoes. This component was negatively correlated with central obesity, fasting plasma glucose, 120 min non-esterified fatty acid and triacylglycerol, and positively correlated with HDL-cholesterol. It therefore appears to be protective for the metabolic syndrome. Component 1 was negatively associated with the risk of having undiagnosed diabetes, and this association was independent of age, sex, smoking and obesity. The findings support the hypothesis that dietary patterns are associated with other lifestyle factors and with glucose intolerance and other features of the metabolic syndrome. The results provide further evidence for the recommendation of a healthy balanced diet as one of the main components of chronic disease prevention.

Adult↗
PubMed2000

Seasonal consumption of salad vegetables and fresh fruit in relation to the development of cardiovascular disease and cancer.

OBJECTIVE: To investigate the protective association between seasonality of consumption of fresh fruit or salad vegetables and cancer and cardiovascular disease (CVD) development. DESIGN AND SETTING: Face-to-face interviews, including a food frequency questionnaire, were conducted on 1489 men and 1900 women, aged 35-75 years, who were respondents in the British Health and Lifestyle Survey 1984/85 (HALS1). CVD and cancer morbidity and mortality were determined from the 1991/92 British Health and Lifestyle Survey (HALS2) and by NHS Register 'flagging'. RESULTS: Risk was assessed by odds ratio (OR) for trend per frequency category. In men, frequent winter salad vegetable consumption was more closely protective than that in summer for cancer (winter OR=0.79 [0.62-0.99], P=0.045, summer OR=0.83 [0.69-1.01], NS) and CVD (winter OR=0.85 [0.72-1.00], P=0.049, summer OR=0.95 [0.82-1.10], NS). Fresh fruit consumption showed no significant protection. In women, frequent salad vegetable consumption at any season was significantly protective of CVD (winter OR=0.76 [0.65-0.89], P<0.001, summer OR=0.76 [0.65-0.89], P<0.001), although not of cancer. Frequent fresh fruit consumption in women was significantly protective of CVD (winter OR=0.84 [0.74-0.94], P=0.004, summer OR=0.85 [0.74-0.97], P=0.014) but not quite significant, and only in winter, for cancer (winter OR=0.87 [0.76-1.00], P=0.052, summer OR=0.88 [0.75-1.02], P=0.097). Maintenance of salad vegetable consumption from summer to winter, to within one frequency category, was associated with further protection for cancer in men (P=0.050) and CVD in women (P=0.024). CONCLUSIONS: Diets high in fresh fruit and salad vegetables appear protective against cancer and CVD. It is important to take into account the seasonality of consumption in estimating and establishing significance of risk.

Adult↗
PubMed1998

The development of cardiovascular disease in relation to anthropometric indices and hypertension in British adults.

OBJECTIVE: To examine the predictive ability of simple anthropometric indices for the development of cardiovascular disease (CVD) over seven years in British adults, and the influence of hypertension on these associations. DESIGN: Longitudinal study of the development of CVD (morbidity or mortality) over a seven year period in a random stratified sample of British adults who were respondents in the 1984-1985 Health and Lifestyle Survey (HALS1) and who were seen again in 1991-1992 (HALS2) or who had died by then. METHODS: Face-to-face interviews at HALS1 and HALS2 recorded socio-demographic, health and lifestyle details followed by measurements of height, weight, waist circumference and blood pressure (BP). The quintiles of body mass index (BMI), waist circumference, waist: height ratio (WHTR) and height were calculated for those aged between 35 and 75 y, at HALS1. Dates and causes of death were recorded. Logistic regression was used to estimate the odds ratios (OR) of developing CVD in 1284 men and 1570 women, aged 35-75 y who were free of known CVD, cancer and diabetes at HALS1. RESULTS: By HALS2, 316 respondents in the qualifying population had developed CVD, 114 of whom were dead. There were linear trends in the development of CVD (adjusted for age and smoking) for all the men from the lowest to the highest quintile of WHTR (P = 0.034), but not for waist circumference (P = 0.095), or BMI (P > 0.2). Excluding the hypertensive men increased the significance of the trend for WHTR (P = 0.005) and waist circumference (P = 0.027). The significant interactions with hypertension for WHTR (P < 0.001), waist circumference (P = 0.006) and BMI (P = 0.044) showed that there was an increasing incidence of CVD with increasing adiposity in non-hypertensive men but, in men with treated hypertension, although the overall incidence of CVD was higher, the relationship with adiposity was inverse. In the women, there were no significant linear trends for waist circumference, WHTR or BMI. Quintile estimates were more consistent with J-shaped curves with the lowest risk in the second quintile. Excluding the hypertensive women, increased the significance of these trends. In normotensive women, there was a significant quadratic trend (P = 0.039) for the association between the incidence of CVD and the quintiles of waist circumference, but no associations for WHTR or BMI. For waist circumference there was weak evidence of an interaction with hypertension (P = 0.053). CONCLUSIONS: For the men, indices involving waist circumference, particularly WHTR, had stronger linear associations with the log odds of CVD development than BMI. The interactions with hypertension were significant for WHTR, waist circumference and also BMI. In women, none of the indices was linearly associated with the log odds of CVD development, but there was a significant J-shaped curve for waist circumference and evidence of an interaction with hypertension. These results suggest that studies in which hypertensives are included, but in which possible hypertension interactions are overlooked, important hypertensive-specific associations between anthropometric indices and CVD development may be masked. Men on anti-hypertensive medication with the lowest central adiposity, experienced higher short-term CVD risk than those with greater central adiposity.

Adipose Tissue↗
PubMed1997

Association of anthropometric indices with elevated blood pressure in British adults.

OBJECTIVE: To investigate which of six anthropometric indices was most strongly associated with elevated blood pressure and frank hypertension in a representative population sample of young and middle-aged British adults. SUBJECTS: A representative random sample of British adults (2712 men and 3279 women) aged between 18 and 64y, who were resident in England, Scotland and Wales, were studied in the 1984-85 Health and Lifestyle Survey. MEASUREMENTS: Following an interview where demographic, health and lifestyle details were recorded, measurements of height, weight and waist and hip circumference were made by a nurse at a home visit, where blood pressure and medication to control blood pressure were also recorded. BMI and the ratios of waist circumference to height (WHTR) and waist circumference to hip (WHR) were calculated. Respondents with a blood pressure above 140 mm Hg (systolic) and/or 90 mm Hg (diastolic) or who were being treated for hypertension were classified as having elevated blood pressure. RESULTS: For men and women aged 18-39 and 40-64 y the prevalence of elevated blood pressure increased across the quintiles of BMI, weight, waist, WHTR and WHR was P < 0.001 for each, with waist and WHTR having the highest odds ratios. Waist and height adjusted for each other were independently related to the prevalence of elevated blood pressure in 40-64 y old men and women. Height, on its own, was inversely related (P < 0.05) only in the 40-64 y old men. The age adjusted partial correlations between systolic and diastolic blood pressure measurements and the measurements of BMI, weight, waist, WHTR and WHR were close and significant, P < 0.001 for each. The ranking and significance of the correlations were hardly affected by excluding the treated hypertensives. CONCLUSIONS: The prevalence of elevated blood pressure was associated with quintiles of BMI, waist, WHTR, WHR and weight, with WHTR and WHR having the highest odds ratios. Waist and height were independently related to the prevalence of elevated blood pressure.

Adolescent↗
PubMed1997

Longitudinal dietary changes between 1984-5 and 1991-2 in British adults: association with socio-demographic, lifestyle and health factors.

The study aimed to examine dietary changes and their associations with demographic, lifestyle and health variables in a random sample of British adults. The Health and Lifestyle Survey of 1984-5 (HALS1) identified four main dietary components by principal component analysis from food frequency data. Comparison of the HALS1 dietary component scores with those of the follow-up survey of 1991-2 (HALS2) for the same individuals revealed increases on component 1 (high weightings for fresh fruit, salads, 'brown' bread, fruit juice and green vegetables but low weightings for chips, fried food and processed meat). There were substantial decreases on component 2 (high weightings for puddings/pies, cake, potatoes, biscuits, preserves, pulses and meat), small increase on component 3 (high weightings for crisps, soft drinks and chips) and increases on component 4 (high weightings for confectionery, biscuits and cake and low weightings for vegetables of all kinds). Except for women on component 3 the changes were all significant, P < 0.001. Unadjusted score changes were smallest in elderly respondents for all components. Differences in score changes between groups were based on an analysis of covariance adjusting for the HALS1 score. On component 1 the largest score increases were associated with non-manual groups, improvements in lifestyle and good health. For component 2 the greatest changes in score were associated with changes in household size, smoking habit and heavy drinking. Score increases on component 3 were also associated with heavy drinking, whilst the largest rises on component 4 were amongst the non-manual, the non-drinkers and the non-smokers and, for women only, those who had few malaise symptoms or who lived in Scotland. The results show that there have been overall dietary changes and that changes have been associated with longitudinal alterations in socio-demographic, lifestyle and health circumstances.

Adult↗
PubMed1996

Dietary patterns and their associations with demographic, lifestyle and health variables in a random sample of British adults.

The present study aimed to identify dietary patterns, from the frequency of consumption of food items and some semi-quantitative data, in a random sample of 9003 British adults, and to examine the associations of the main dietary patterns with demographic factors, lifestyle habits, measures of self-reported health and mortality. Principal component analysis was used to identify four main dietary patterns, and analysis of variance employed to examine the characteristics associated with them. The four components explained, respectively, 10.2, 7.3, 5.1 and 4.9% of the total dietary variation. Component 1, frequent fruit, salad and vegetable consumption with infrequent consumption of high-fat foods, was associated with middle age, non-manual socio-economic groups, non- and ex-smokers, 'sensible' drinkers, small households, the south of the country, and self-assessed 'excellent' or 'good' health. Component 2, frequent consumption of high-starch foods, most vegetables and meat, was popular with young men, older men and women, large households, non-smokers, non-drinkers and those who viewed themselves as healthy. Component 3, frequent consumption of high-fat foods, was predominantly consumed by young people, smoking women, 'high-risk' drinkers, and men reporting many illness and/or malaise symptoms. Component 4, high positive loadings for sweets, biscuits and cakes, with negative weightings for vegetables, was most favoured by students, the elderly, those living alone, residents in Scotland, but not those in central England, and those who did not smoke. For women only the first component was associated with low all-cause mortality, and the third component with excess mortality.

Adult↗
PubMed1991

A comparison of the diets of non-smokers and smokers.

Dietary data, mostly in the form of the frequency of consumption of foods, from the 9003 respondents in the Health and Lifestyle Survey were used to compare lifetime non-smokers with light, heavy and ex-smokers, taking account of age and social class. Non-smokers, of both sexes, were significantly more likely than smokers to consume, frequently, fresh fruit in summer and winter, fruit juice, cooked and canned fruit, salads in summer and winter, breakfast cereals, cakes, biscuits, puddings, pasta, poultry, light desserts and preserves. They were also more likely to choose 'brown' bread, semi- or skimmed milk, low fat or polyunsaturated spread and to eat breakfast. Smokers were likely to consume chips and processed meats frequently, to drink more alcohol, more cups of tea and coffee and take sugar in these beverages. The differences from the non-smokers were more marked in the heavy smokers. Ex-smokers only differed from non-smokers in consuming more alcohol, tea and coffee, and nuts, in consuming cakes and soft drinks less frequently and in being more likely to choose skimmed or semi-skimmed milk. The results extend previous findings, and suggest that the eating patterns of non-smokers are more in line with current dietary recommendations than those of light smokers or, more particularly, heavy smokers.

Adolescent↗
PubMed1991

Ventilatory function and winter fresh fruit consumption in a random sample of British adults.

The relation between ventilatory function and the reported frequency of consumption of fresh fruit and fruit juice was studied among 1502 lifelong non-smokers and 1357 current smokers aged 18-69 with no history of chronic respiratory disease. Forced expiratory volume in one second (FEV1) was assessed by turbine spirometry. As winter fruit consumption was more widely dispersed than summer consumption and few subjects ate fruit more frequently in the winter, winter fruit consumption was taken as an indicator of habitual (year round) consumption. After adjustment for sex, age, height, cigarette consumption, region of residence, and household socioeconomic group, FEV1 was associated with winter fruit consumption. The mean adjusted FEV1 among those who never drank fresh fruit juice and ate fresh fruit less than once a week during the winter was 78 ml lower (95% confidence interval 24-132 ml) than the mean for the other subjects. A similar difference was found in all age-sex groups and among both current smokers and lifelong non-smokers. Antioxidant and other actions of vitamin C may protect against pulmonary emphysema, or reduce bronchoconstrictor responses to environmental pollutants.

Adolescent↗
PubMed1991

Some regional variations in dietary patterns in a random sample of British adults.

Comparison was made of the reported frequency of consumption or choice of 30 food items by 8860 adults in the 11 standard regions of Great Britain, with the use of log-linear analysis to allow for the age, sex, social class and smoking habit variations between the regions. The South-East was taken as the base region against which the others were compared. The number of food items for which there were significant differences from the South-East were Scotland 23, North 25, North-West and Yorkshire/Humberside 20, Wales 19, West Midlands 15, East Midlands 10, East Anglia 8, South-West 7 and Greater London 9. Overall the findings confirm a North/South trend in relation to eating habits, even when demographic and smoking-habit variations are taken into account, with the frequent consumption of many fruit and vegetable products being much less common and of several high-fat foods (chips, processed meats and fried food) more common in Scotland, Wales and the northern part of England. In most regions there was a significantly lower frequency of consumption of fresh fruit, fruit juice, 'brown' bread, pasta/rice, poultry, skimmed/semi-skimmed milk, light desserts and nuts, and a higher consumption of red meat, fish and fried food than in the South-East.

Adolescent↗
PubMed1989

Choice of spread by a random sample of the British population. Association with socio-economic status and risk factors for cardiovascular disease.

The usual choice of spread used on bread, and the calculated total amount of fat spread on bread per day, were related to socio-economic and coronary artery disease risk factors in 9003 respondents in the Health and Lifestyle Survey. Butter was the most popular spread, regardless of social group or income. Polyunsaturated margarine and low fat spread were chosen significantly more frequently by those in the higher socio-economic groups and by non-smokers in each group. A past history of heart disease was associated with the choice of polyunsaturated margarine, low fat spread, or no spread at all; this was most apparent in men. No such relationship was found between choice of spread and family history of heart disease or hypertension. Overweight and obese respondents were a little more likely than lean respondents to choose low fat spread or no spread. Men over 60 years consumed less fat, as spread, than younger men, but in women there was a tendency for consumption to increase with age. In both sexes, the non-manual groups consumed less spread than the manual at comparable ages. Smokers in each group consumed significantly more than non-smokers. The amount of spread consumed was not associated with body mass index, a past history or family history of heart disease or previously diagnosed hypertension. These findings suggest that current recommendations to reduce total fat intake and to reduce the proportion of saturated fats used are not being followed, at least in respect of spread, by those at greatest risk of coronary heart disease.

Adolescent↗
PubMed1988

Which foods contain dietary fibre? The beliefs of a random sample of the British population.

Over 7000 participants in the Health and Lifestyle Survey were asked whether they thought each of ten common foods contained fibre. Five of these foods were fibre-free and five contained fibre. The overall proportions of respondents giving correct answers for each food were (as percentages): Weetabix 93.4, digestive biscuits 80.0, eggs 78.7, cheese 74.5, orange juice 66.2, grilled fish 57.2, roast meat 50.7, apples 49.8, potatoes 46.4 and white bread 41.7. Less than 30 per cent of the respondents gave eight or more correct answers. Those in the middle years (aged 30-59) gave the highest number of correct answers, and those aged over 70 the fewest. Amongst the 18-29 year old group, those with low educational achievement scored particularly badly. The likelihood of giving correct responses to potatoes, apples, eggs, cheese, orange juice and grilled fish was positively associated with the level of education for most age groups in both sexes. Women were better informed than men about the foods containing fibre except for white bread (Chi-squared, P less than 0.01 in each case). The mean scores (+/- s.e.m.) of correct answers given by medical practitioners and nurses were 8.00 (+/- 0.39) and 7.50 (+/- 0.12) respectively compared to 7.43 (+/- 0.07) by the other respondents with similar educational achievements. There were close associations between correct answers for certain groups of foods.

Adolescent↗
PubMed1985

Carbon monoxide levels in the breath of smokers and nonsmokers: effect of domestic heating systems.

Breath and ambient (room) carbon monoxide (CO) levels were measured in a random sample of 168 adults in their own homes. The levels of breath CO in the 69 smokers ranged from 3 ppm to over 100 ppm, 74% being above 10 ppm; mean levels in the 99 nonsmokers were lower than in the smokers, 79% being below 6 ppm. In the remaining 21% of nonsmokers with higher breath levels than expected, the ambient CO was also found to be elevated, ranging up to 38 ppm. A close correlation in the nonsmokers was found between the breath and ambient CO levels (r = 0.952, p less than 0.001). The rooms with the elevated ambient CO levels (above 5 ppm) were those which, at the time of testing, were being heated by gas radiant heaters, open fires or stoves. The maximum ambient CO in the rooms of smokers with non CO generating heating was 16 ppm. The results suggest that many people, both smokers and nonsmokers, may be at risk from CO generated by certain domestic heating systems and that nonsmokers are far more likely to be exposed to high levels of CO from these sources than from being in a room with a heavy smoker. Poor ventilation associated with the current trend towards excluding all draughts is likely to exacerbate the situation for both smokers and nonsmokers.

Adolescent↗
PubMed1985

Constipation during pregnancy: dietary fibre intake and the effect of fibre supplementation.

Forty women who complained of constipation during the third trimester of pregnancy completed 14-day weighed diet records and bowel function charts over a 4-week period. After 2 weeks of baseline observation the women were randomly allocated into three groups which were asked to take 10 g dietary fibre supplements per day in the form of either a corn-based biscuit (Group A), or as wheat bran (Gp B), or to continue without intervention (Gp C). Mean (+/- s.e.m.) daily dietary fibre intake in the first 2 weeks was similar to that in the general population, at 20.4 +/- 1.2 g, for the whole group, and 21.1 +/- 1.6 g for the 26 women who said they had already increased their dietary fibre intakes in attempts to relieve their symptoms. In the final 2 weeks changes in fibre intakes were: Gp A, mean increase 7.2 +/- 1.0 g per day (P less than 0.001); Gp B, mean increase 9.1 +/- 1.6 g per day (P less than 0.001); Gp C mean decrease 3.50 +/- 1.6 g per day (P less than 0.005). These changes were accompanied by an increase in the number of bowel movements and a change to a softer stool consistency in Gps A and B, with no changes in number of bowel movements or stool consistency in Gp C.

Adult↗