@article{Firth2018c,
title = {Diet as a hot topic in psychiatry: a population‐scale study of nutritional intake and inflammatory potential in severe mental illness},
author = {Joseph Firth and Brendon Stubbs and Scott B. Teasdale and Philip B. Ward and Nicola Veronese and Nitin Shivappa and James R. Hebert and Michael Berk and Alison R. Yung and Jerome Sarris },
url = {https://onlinelibrary.wiley.com/doi/10.1002/wps.20571},
year = {2018},
date = {2018-09-07},
journal = {World Psychiatary },
abstract = {People with severe mental illnesses (SMIs) – including schizophrenia, major depressive disorder (MDD) and bipolar disorder – have excessive caloric intake, a low‐quality diet, and poor nutritional status compared to the general population1, 2. Poor diet increases the risk of diabetes and cardiovascular mortality in this population3. Furthermore, excessive consumption of high‐fat and high‐sugar foods can increase systemic inflammation4. Indeed, all classes of SMI show heightened levels of peripheral inflammatory markers, which is linked to worse prognosis in these conditions. However, there currently is an absence of large‐scale studies comparing the nutritional intake and inflammatory profile of the diets of individuals with SMIs.

To address this, we used detailed dietary intake data from the baseline phase (2007‐2010) of the UK Biobank study5 to examine differences in nutritional intake and diet‐associated inflammation between people with SMIs and the general population. Full details on the UK Biobank, including approval from the National Health Service (NHS) Research Ethics Committee, are available elsewhere5. We used patient hospital records to identify individuals with a ICD‐10 diagnostic history of recurrent depressive disorder, bipolar disorder (type I or II) or schizophrenia. Additionally, participants' answers to questions from the Structured Clinical Interview for DSM‐IV Axis I Disorders (SCID‐I) and Patient Health Questionnaire (PHQ), administered at the UK Biobank baseline, were used to identify additional individuals with MDD or bipolar disorder6. Participants who fell into multiple psychiatric categories were assigned hierarchically to only one, in this order: schizophrenia, bipolar disorder, MDD. Healthy controls were derived from all UK Biobank participants who had no indication of any previous or present psychotic or mood disorder. Individuals with neurological conditions known to affect memory recall were excluded from all groups.

Diet was assessed using a validated computerized questionnaire, the Oxford WebQ7. This brief, self‐administered 24‐hour recall measure queries previous day intake for >200 food items. To capture intra‐individual (day‐to‐day) variation in food intake, the WebQ was administered on up to five separate occasions over a 16‐month period. Missing individual data points were imputed as the mean average across all available time points from that individual. The first assessment was administered on‐site at the UK Biobank assessment centre; all subsequent administrations were completed online.

A total of 69,843 eligible UK Biobank subjects (mean age 56.5 years, 46.4% male) provided sufficient data for analyses. Of these, 14,619 individuals had MDD, 952 had bipolar disorder, 262 had schizophrenia, and 54,010 were SMI‐free. Multivariable linear regression was used to examine differences in total daily energy intake and each macronutrient between the SMI and control samples. Analyses were adjusted for gender and age.

The greatest differences in diet were observed for the schizophrenia sample. Age‐ and gender‐adjusted comparisons to control subjects showed highly elevated intakes in that sample (all p<0.001) for total energy (+553.4 kilojoules (kj)/day, SE=143.8), carbohydrates (+25.4 g/day, SE=4.86), sugar (+16.0 g/day, SE=2.98), total fat (+6.04 g/day, SE=1.77), saturated fat (+3.76 g/day, SE=0.76) and protein (+5.24 g/day, SE=1.51), with no difference in dietary fibre (p=0.78).

Individuals with bipolar disorder similarly showed significantly (all p≤0.01) higher intake of total energy (+298.5 kj/day, SE=75.9), carbohydrates (+11.4 g/day, SE=2.57), protein (+1.97 g/day, SE=0.80), sugar (+9.63 g/day, SE=1.57), total fat (+2.40 g/day SE=0.93) and saturated fat (+1.29 g/day, SE=0.40) compared to controls, with no difference in fibre (p=0.32).

The MDD sample also showed significantly greater (all p<0.001) age‐ and gender‐adjusted intake in comparison to controls, for total energy (+189.4 kj/day, SE=21.88), carbohydrates (+5.15 g/day, SE=0.74), sugar (+3.11 g/day, SE=0.45), total fat (+2.19 g/day, SE=0.27), saturated fat (+0.96 g/day, SE=0.12) and protein (+1.12 g/day, SE=0.23), along with a small difference in dietary fibre intake (+0.15 g/day, SE=0.06, p=0.01).

Sensitivity analyses were conducted to adjust for ethnicity, body mass index (BMI), education and social deprivation. This did not substantially alter the overall findings.

Beyond examining raw macronutrient intakes, we also explored the inflammatory potential of the diet using the dietary inflammatory index (DII®)4, which has produced consistent positive associations in over ten studies using inflammatory markers including C‐reactive protein, interleukin‐6 and tumor necrosis factor‐α as construct validators8.

A total of 68,879 participants had provided sufficient dietary intake data across the 18 macro/micronutrient intake parameters relevant for DII® calculation. Multiple linear regression was used to examine if SMI was positively associated with DII scores, adjusting for age, gender, ethnicity, BMI, social deprivation, education and total energy intake. DII scores were significantly elevated in subjects with schizophrenia (B=0.220, SE=0.084, p=0.009) and MDD (B=0.031, SE=0.013, p=0.014), but not with bipolar disorder (p=0.27), compared to controls.

Overall, this population‐scale analysis of nutritional intake confirms that people with SMIs have higher intakes of obesogenic nutrients and more inflammatory diets than the general population. Whereas dietary interventions for SMIs often focus exclusively on over‐consumption of obesogenic, pro‐inflammatory foods, this study shows that further consideration should be given to increasing consumption of nutrient‐dense foods that are known to reduce systemic inflammation4, 8.

In terms of both total caloric intake and excess obesogenic nutrients, the worst dietary patterns were observed among people with schizophrenia. This is a notable finding, as these individuals also have significantly higher rates of metabolic disorders and greater premature mortality than individuals with other classes of SMI3, 9, indicating that diet could be a key factor influencing these outcomes.

Indeed, dynamic weight change algorithms predict that each 100 kj of excess energy intake per day will eventually lead to at least 1 kg increase in body weight10. Thus, the 553 kj (132 calories) per day excess observed in the schizophrenia sample suggests that dietary differences alone can account for 5‐6 kg of the increased body weight observed in this population. Not only does excess caloric, carbohydrate and fat intake increase inflammation, but the concomitant increase in adipose tissue also enhances chronic, systemic inflammation.

The degree to which the heightened systemic inflammation observed in SMIs is attributable to dietary factors needs to be clarified. Sufficiently sized cohort studies, using detailed dietary and psychiatric data alongside biomarkers of inflammation, can provide new insights into of the role of diet in SMIs. Future work should also aim to establish the extent to which heightened dietary inflammation in SMIs independently contributes to the poor physical, psychological and neurocognitive outcomes observed in these populations, which represent a significant public health challenge.

This research was conducted using the UK Biobank Resource (application no. 22125). J. Firth is supported by a Blackmores Institute fellowship and Medical Research Council (MRC) doctoral training grant (P117413F07). B. Stubbs is in part funded by the UK National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. J. Sarris is supported by a research fellowship from the National Health and Medical Research Council (NHMRC), Australia (APP1125000). M. Berk is supported by an NHMRC senior principal research fellowship (1059660). The views expressed are those of the authors and not necessarily those of the above entities.
},
keywords = {22125, diet, featured, mental illness},
pubstate = {published},
tppubtype = {article}
}

@article{Celis-Morales2018c,
title = {Associations of dietary protein intake with fat free mass and grip strength: cross-sectional study in 146,816 UK Biobank participants },
author = {Carlos A Celis-Morales and Fanny Petermann and Lewis Steell and Jana Anderson and Paul Welsh and Daniel F Mackay and Stamatina Iliodromiti and Donald M Lyall Mike E Lean Jill P Pell Naveed Sattar Jason M R Gill Stuart R Gray },
url = {https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwy134/5046854#.Wzn76llzUOM.twitter},
year = {2018},
date = {2018-06-29},
journal = {American Journal of Epidemiology},
abstract = {Adequate dietary protein intake is important for the maintenance of fat-free mass (FFM) and muscle strength: optimal requirements remain unknown. The aim of the current study was to explore the associations of protein intake with FFM and grip strength. We used baseline data from the UK Biobank (146,816 participants aged 40-69 years with data collected 2007-2010 across the UK) to examine the associations of protein intake with FFM and grip strength. Protein intake was positively associated with FFM (men 5.1% [95% CI: 5.0; 5.2] and women 7.7% [95% CI: 7.7; 7.8]) and grip strength (men 0.076 kg/kg [95% CI: 0.074; 0.078] and women 0.074 kg/kg [95% CI: 0.073; 0.076]) per 0.5 grams per kg body mass per day (g/kg/day) increment in protein intake. FFM and grip strength were higher with higher intakes across the full range of intakes, i.e. highest in those reporting consuming > 2.0 g/grams per kg/day independently of socio-demographics, other dietary measures, physical activity and comorbidities. FFM and grip strength were lower with age, but this association did not differ by protein intake categories (P > 0.05). Current recommendation for all adults (40-69 years) for protein intake (0.8 grams per kg body mass per day) may need to be increased to optimise FFM and grip strength.},
keywords = {diet, fat free mass, featured, grip strength},
pubstate = {published},
tppubtype = {article}
}

@article{Tong2018,
title = {Anthropometric and physiologic characteristics in white and British Indian vegetarians and nonvegetarians in the UK Biobank},
author = {TY Tong and TK Key and JG Sobiecki and KE Bradbury },
url = {https://www.ncbi.nlm.nih.gov/pubmed/29868910},
year = {2018},
date = {2018-06-01},
journal = {American Journal of Clinical Nutrition},
abstract = {Background:

A detailed description of anthropometric and physiologic characteristics of persons in different diet groups is lacking.

Objective:

We aimed to perform cross-sectional analyses of diet group with anthropometric and physiologic characteristics in a large cohort in the United Kingdom.

Design:

The UK Biobank recruited ∼500,000 middle-aged participants throughout the United Kingdom in 2006-2010. Anthropometric indexes (height, weight, waist and hip circumference, body composition) and other physiologic characteristics (heel bone mineral density, grip strength, blood pressure, pulse rate) were measured following standardized protocols. We estimated the age-adjusted means of each characteristic in 6 diet groups (198,166 regular meat eaters, 199,784 low meat eaters, 4381 poultry eaters, 9674 fish eaters, 6366 vegetarians, and 378 vegans) in white women and men, and in 2 diet groups (3322 meat eaters and 1186 vegetarians) in British Indian women and men.

Results:

In white women, after adjustment for age and compared with regular meat eaters, non-red meat eaters had lower adiposity (e.g., 4.5% lower body fat in vegan women) and lower systolic and diastolic blood pressure (-4.2 and -3.3 mm Hg, respectively), and generally lower heel bone mineral density t-score (-0.26). Patterns of differences by diet group were similar in white men. In the Indian population, compared with meat eaters, vegetarian women were shorter (-1.1 cm) and had lower lean mass (-0.5 kg), and both vegetarian women and men had lower grip strength (-1.3 and -1.4 kg, respectively). No significant differences in the other characteristics were observed.

Conclusions:

Differences in anthropometric and physiologic characteristics were observed across diet groups in white participants, but fewer differences were observed in British Indian participants. The observed differences may be important as intermediate markers of long-term health in different diet groups. This observational study was registered at http://www.isrctn.com/ as ISRCTN10125697.},
keywords = {3037, diet, vegetarian},
pubstate = {published},
tppubtype = {article}
}

@article{Bennett2018,
title = {Sex differences in macronutrient intake and adherence to dietary recommendations: findings from the UK Biobank},
author = {Elizabeth Bennett and Sanne A E Peters and Mark Woodward},
url = {https://bmjopen.bmj.com/content/8/4/e020017},
year = {2018},
date = {2018-04-28},
journal = {BMJ Open},
abstract = {Objectives To characterise sex differences in macronutrient intakes and adherence to dietary recommendations in the UK Biobank population.

Design Cross-sectional population-based study.

Setting UK Biobank Resource.

Participants 210 106 (52.5% women) individuals with data on dietary behaviour.

Main outcome measures Women-to-men mean differences in nutrient intake in grams and as a percentage of energy and women-to-men ORs in non-adherence, adjusting for age, socioeconomic status and ethnicity.

Results There were sex differences in energy intake and distribution. Men had greater intakes of energy and were less likely to have energy intakes above the estimated average requirement compared with women. Small, but significant, sex differences were found in the intakes of all macronutrients. For all macronutrients, men had greater absolute intakes while women had greater intakes as a percentage of energy. Women were more likely to have intakes that exceeded recommendations for total fat, saturated fat and total sugar. Men were less likely to achieve the minimum recommended intakes for protein, polyunsaturated fat and total carbohydrate. Over 95% of men and women were non-adherent to fibre recommendations. Sex differences in dietary intakes were moderated by age and to some extent by socioeconomic status.

Conclusions There are significant sex differences in adherence to dietary recommendations, particularly for sugar. However, given the increased focus on food groups and dietary patterns for nutritional policy, these differences alone may not be sufficient for policy and health promotion. Future studies that are able to explore the sex differences in intakes of different food groups that are risk factors for diet-related diseases are warranted to improve the current understanding of the differential impact of diet on health in women and men.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ },
keywords = {2495, diet, sex difference},
pubstate = {published},
tppubtype = {article}
}

@article{Bradbury2018,
title = {Dietary assessment in UK Biobank: an evaluation of the performance of the touchscreen dietary questionnaire},
author = {Kathryn E. Bradbury and Heather J. Young and Wenji Guo and Timothy J. Key},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799609/},
year = {2018},
date = {2018-02-01},
journal = {Journal of Nutritional Science},
abstract = {UK Biobank is an open access prospective cohort of 500 000 men and women. Information on the frequency of consumption of main foods was collected at recruitment with a touchscreen questionnaire; prior to examining the associations between diet and disease, it is essential to evaluate the performance of the dietary touchscreen questionnaire. The objectives of the present paper are to: describe the repeatability of the touchscreen questionnaire in participants (n 20 348) who repeated the assessment centre visit approximately 4 years after recruitment, and compare the dietary touchscreen variables with mean intakes from participants (n 140 080) who completed at least one of the four web-based 24-h dietary assessments post-recruitment. For fish and meat items, 90 % or more of participants reported the same or adjacent category of intake at the repeat assessment visit; for vegetables and fruit, and for a derived partial fibre score (in fifths), 70 % or more of participants were classified into the same or adjacent category of intake (κweighted > 0·50 for all). Participants were also categorised based on their responses to the dietary touchscreen questionnaire at recruitment, and within each category the group mean intake of the same food group or nutrient from participants who had completed at least one web-based 24-h dietary assessment was calculated. The comparison showed that the dietary touchscreen variables, available on the full cohort, reliably rank participants according to intakes of the main food groups.},
keywords = {3037, diet, questionnaire},
pubstate = {published},
tppubtype = {article}
}

@article{Shafique2017,
title = {Dietary intake in people consuming a low-carbohydrate diet in the UK Biobank},
author = {M Shafique and S Russell and S Murdoch and JD Bell and N Guess},
url = {https://www.ncbi.nlm.nih.gov/pubmed/29235157},
year = {2017},
date = {2017-12-13},
journal = {Journal of Human Nutrition and Dietics },
abstract = {BACKGROUND:

Low-carbohydrate diets are becoming increasingly popular, although their dietary quality outside of clinical studies is unknown. A previous study analysed the dietary intake in people consuming a reduced-carbohydrate diet (<40% calories). However, it is not clear what foods people consume when carbohydrate is reduced to below 26% of total calories.
METHODS:

In the present cross-sectional study, the dietary and nutrient intake collected via up to five consecutive 24-h dietary recalls and a food frequency questionnaire of 444 individuals (aged 46-79 years) consuming <26% of calories from carbohydrate (LCHO) was compared with that of 131 897 individuals consuming ≥45% calories from carbohydrate (NCHO) using the UK Biobank Dataset. Absolute cut-offs to define the low-carbohydrate group (<130 g day-1 ; n = 1953 versus ≥225 g day-1 , n = 113 036) were also used.
RESULTS:

Both NCHO (>45% calories and ≥225 g) groups consumed significantly more high-sugar, high-fat snacks [median 6.0, interquartile range (IQR) = 2.0-11.0 and median 6.0, IQR = 3.0-11.8, respectively) compared to the LCHO (<26% calories and <130 g) groups (median 0, IQR = 0-2.8 and median 1, IQR = 0-3.8, respectively) (P < 0.0001). Both LCHO groups reported consuming significantly more red meat, oily fish, nuts and seeds but fewer fruits, vegetables and pulses compared to the NCHO groups. In general, the consumption of oily fish, nuts, seeds and pulses was low across the whole cohort and differences in intake between the LCHO and NCHO groups were small. After adjusting for socio-economic status, most differences remained.
CONCLUSIONS:

Carbohydrate restriction is associated with both beneficial and potentially deleterious dietary changes compared to a normal carbohydrate intake.},
keywords = {9914, carbohydrate, diet},
pubstate = {published},
tppubtype = {article}
}

@article{Bradbury2017b,
title = {Dietary Intake of High-Protein Foods and Other Major Foods in Meat-Eaters, Poultry-Eaters, Fish-Eaters, Vegetarians, and Vegans in UK Biobank.},
author = {KE Bradbury and TYN Tong and TJ Key},
url = {https://www.ncbi.nlm.nih.gov/pubmed/29207491},
year = {2017},
date = {2017-12-02},
journal = {Nutrients },
abstract = {Vegetarian diets are defined by the absence of meat and fish, but differences in the intake of other foods between meat-eaters and low or non-meat eaters are also important to document. We examined intakes of high-protein foods (meat, poultry, fish, legumes, nuts, vegetarian protein alternatives, dairy products, and eggs) and other major food groups (fruit, vegetables, bread, pasta, rice, snack foods, and beverages) in regular meat-eaters, low meat-eaters, poultry-eaters, fish-eaters, vegetarians, and vegans of white ethnicity participating in UK Biobank who had completed at least one web-based 24-h dietary assessment (n = 199,944). In regular meat-eaters, around 25% of total energy came from meat, fish, dairy and plant milk, cheese, yogurt, and eggs. In vegetarians, around 20% of energy came from dairy and plant milk, cheese, yoghurt, eggs, legumes, nuts, and vegetarian protein alternatives, and in vegans around 15% came from plant milk, legumes, vegetarian alternatives, and nuts. Low and non-meat eaters had higher intakes of fruit and vegetables and lower intakes of roast or fried potatoes compared to regular meat-eaters. The differences in the intakes of meat, plant-based high-protein foods, and other foods between meat-eaters and low and non-meat eaters in UK Biobank may contribute to differences in health outcomes.},
keywords = {3037, diet},
pubstate = {published},
tppubtype = {article}
}

@article{Welch2017,
title = {Dietary Magnesium May Be Protective for Aging of Bone and Skeletal Muscle in Middle and Younger Older Age Men and Women: Cross-Sectional Findings from the UK Biobank Cohort.},
author = {AA Welch and J Skinner and M Hickson},
url = {https://www.ncbi.nlm.nih.gov/pubmed/29084183},
year = {2017},
date = {2017-10-30},
journal = {Nutrients},
abstract = {Although fragility fractures, osteoporosis, sarcopenia, and frailty are becoming more prevalent in our aging society the treatment options are limited and preventative strategies are needed. Despite magnesium being integral to bone and muscle physiology, the relationship between dietary magnesium and skeletal muscle and bone health has not been investigated concurrently to date. We analysed cross-sectional associations between dietary magnesium and skeletal muscle mass (as fat free mass-FFM), grip strength, and bone density (BMD) in 156,575 men and women aged 39-72 years from the UK Biobank cohort. FFM was measured with bioelectrical impedance and was expressed as the percentage of body weight (FFM%) or as divided by body mass index (FFMBMI). Adjusted mean grip strength, FFM%, FFMBMI, and BMD were calculated according to quintiles of dietary magnesium, while correcting for covariates. Significant inter-quintile differences across intakes of magnesium existed in men and women, respectively, of 1.1% and 2.4% for grip strength, 3.0% and 3.6% for FFM%, 5.1% and 5.5% for FFMBMI, and 2.9% and 0.9% for BMD. These associations are as great or greater than annual measured losses of these musculoskeletal outcomes, indicating potential clinical significance. Our study suggests that dietary magnesium may play a role in musculoskeletal health and has relevance for population prevention strategies for sarcopenia, osteoporosis, and fractures.},
keywords = {11058, diet, osteoporosis},
pubstate = {published},
tppubtype = {article}
}

@conference{Burgoine2016,
title = {Interplay of takeaway food outlet exposure and income on diet and obesity: a cross-sectional study in UK Biobank},
author = {T Burgoine, C Sarkar, C Webster, P Monsivais, },
url = {thelancet.com/journals/lancet/article/PIIS0140-6736(16)32264-4/abstract},
year = {2016},
date = {2016-11-01},
journal = {Lancet},
abstract = {Background

The proliferation of takeaway food outlets has been called a public health problem by Public Health England and the Chief Medical Officer for England. Evidence indicates that the density of takeaway outlets in neighbourhoods can promote unhealthy eating and obesity. But takeaway outlets tend to cluster in deprived areas, and vulnerability to unhealthy food environments might vary across social groups. This study examined the interplay between exposure to takeaway outlets and individual-level socioeconomic position in relation to diet and obesity.
Methods

This cross-sectional study included UK Biobank participants based in Greater London (n=51 361) aged 38–72 years with valid height and weight data, food frequency data, and food environment exposures. Food environment exposures were estimated using geographic information systems and food outlet data from UKMap, as counts of outlets by type, within one-mile radius Euclidean (circular) buffers centred on each participant's home address. Our primary exposure was the number of takeaway outlets as a proportion of all food outlets. Participants were jointly classified on the basis of household income (four groups) and quartile of neighbourhood takeaway outlet proportion to create 16 exposure groups. Regression models estimated the odds of frequent processed meat consumption and obesity. We calculated relative excess risk due to interaction (RERI), relative to a single reference group. Participant data were collected during 2005–13 and analysed in 2016.
Findings

Both income and takeaway exposure were systematically associated with frequent consumption of processed meat and obesity. In mutually adjusted models, lowest-income participants were more likely than highest-income participants to be obese (odds ratio 1·53, 95% CI 1·38–1·69); and relative to those least exposed, highest takeaway exposure was also associated with obesity (1·76, 1·61–1·91). In additive models, the combination of lowest income and highest takeaway exposure was associated with substantially increased odds of obesity (2·75, 2·33–3·24), with the RERI indicating significant interaction. Results were similar in diet analyses.
Interpretation

We have confirmed the findings of earlier work showing independent associations between income, neighbourhood takeaway outlet exposure, and diet and adiposity. Moreover, we provide evidence of the double burden of low income and an unhealthy neighbourhood food environment, resulting in higher rates of unhealthy diet and obesity.
},
keywords = {10570, diet, obesity, takeaway food},
pubstate = {published},
tppubtype = {conference}
}

@article{Galante2016,
title = {The acceptability of repeat Internet-based hybrid diet assessment of previous 24-h dietary intake: administration of the Oxford WebQ in UK Biobank},
author = {J Galante and A damska and A Young and H Young and T.J. Littlejohns and J Gallacher and N Allen},
url = {https://www.ncbi.nlm.nih.gov/pubmed/26652593},
year = {2015},
date = {2015-12-15},
journal = {British Journal of Nutrition},
abstract = {Although dietary intake over a single 24-h period may be atypical of an individual's habitual pattern, multiple 24-h dietary assessments can be representative of habitual intake and help in assessing seasonal variation. Web-based questionnaires are convenient for the participant and result in automatic data capture for study investigators. This study reports on the acceptability of repeated web-based administration of the Oxford WebQ--a 24-h recall of frequency from a set food list suitable for self-completion from which energy and nutrient values can be automatically generated. As part of the UK Biobank study, four invitations to complete the Oxford WebQ were sent by email over a 16-month period. Overall, 176 012 (53% of those invited) participants completed the online version of the Oxford WebQ at least once and 66% completed it more than once, although only 16% completed it on all four occasions. The response rate for any one round of invitations varied between 34 and 26%. On most occasions, the Oxford WebQ was completed on the same day that they received the invitation, although this was less likely if sent on a weekend. Participants who completed the Oxford WebQ tended to be white, female, slightly older, less deprived and more educated, which is typical of health-conscious volunteer-based studies. These findings provide preliminary evidence to suggest that repeated 24-h dietary assessment via the Internet is acceptable to the public and a feasible strategy for large population-based studies.},
keywords = {24-hour dietary intake, diet, Internet-based, methodology},
pubstate = {published},
tppubtype = {article}
}

@article{McCormack2014b,
title = {Association of Dietary Factors with Presence and Severity of Tinnitus in a Middle-Aged UK Population},
author = {Abby McCormack and Mark Edmondson-Jones and Duane Mellor and Piers Dawes and Kevin J. Munro and David R. Moore and Heather Fortnum},
url = {http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0114711},
year = {2014},
date = {2014-12-12},
journal = {PLOS One},
volume = {9},
number = {12},
abstract = {Objective

The impact of dietary factors on tinnitus has received limited research attention, despite being a considerable concern among people with tinnitus and clinicians. The objective was to examine the link between dietary factors and presence and severity of tinnitus.

Design

This study used the UK Biobank resource, a large cross-sectional study of adults aged 40–69. 171,722 eligible participants were asked questions specific to tinnitus (defined as noises such as ringing or buzzing in the head or ears). Dietary factors included portions of fruit and vegetables per day, weekly fish consumption (oily and non-oily), bread type, cups of caffeinated coffee per day, and avoidance of dairy, eggs, wheat and sugar. We controlled for lifestyle, noise exposure, hearing, personality and comorbidity factors.

Results

Persistent tinnitus, defined as present at least a lot of the time, was elevated with increased: (i) fruit/vegetable intake (OR = 1.01 per portion/day), (ii) bread (wholemeal/wholegrain, OR = 1.07; other bread, 1.20) and (iii) dairy avoidance (OR = 1.27). Persistent tinnitus was reduced with: (i) fish consumption (non-oily, OR = 0.91; oily, 0.95), (ii) egg avoidance (OR = 0.87) and (iii) caffeinated coffee consumption (OR = 0.99 per cup/day). Reports of “bothersome” tinnitus (moderate-severe handicap) increased with wholemeal/wholegrain bread intake (OR = 0.86). Reports of less frequent transient tinnitus increased with dairy avoidance (OR = 1.18) and decreased with caffeinated coffee (OR = 0.98 per cup/day) and brown bread (OR = 0.94).

Conclusions

This is the first population study to report the association between dietary factors and tinnitus. Although individually dietary associations are mostly modest, particular changes in diet, such as switching between foodstuffs, may result in stronger associations. These findings offer insights into possible dietary associations with tinnitus, and this may be useful when discussing management options in combination with other lifestyle changes and therapies.},
keywords = {13489, diet, tinnitus},
pubstate = {published},
tppubtype = {article}
}