Journal articles
Holsgrove‐West RK, Revuelta Iniesta R, Abdelrahman DR, Murton AJ, Wall BT, Stephens FB (2023). Maximal sustainable energy intake during transatlantic ocean rowing is insufficient for total energy expenditure and skeletal muscle mass maintenance.
Experimental PhysiologyAbstract:
Maximal sustainable energy intake during transatlantic ocean rowing is insufficient for total energy expenditure and skeletal muscle mass maintenance
AbstractStudies of extreme endurance have suggested that there is an alimentary limit to energy intake (EI) of ∼2.5 × resting metabolic rate (RMR). To gain further insight, this study aimed to simultaneously measure EI, total energy expenditure (TEE) body mass and muscle mass in a large cohort of males and females of varying ages during a transatlantic rowing race. Forty‐nine competitors (m = 32, f = 17; age 24–67 years; time at sea 46 ± 7 days) in the 2020 and 2021 Talisker Whisky Atlantic Challenge rowed 12–18 hday−1 for ∼3000 miles. TEE was assessed in the final week of the row using 2H218O doubly labelled water, and EI was analysed from daily ration packs over this period. Thickness of relatively active (vastus lateralis, intermedius, biceps brachaii and rectus abdominus) and inactive (gastrocnemius, soleus and triceps) muscles was measured pre (<7 days) and post (<24 h) row using ultrasound. Body mass was measured and used to calculate RMR from standard equations. There were no sex differences in males and females in EI (2.5 ± 0.5 and 2.3 ± 0.4 × RMR, respectively, P = 0.3050), TEE (2.5 ± 1.0 and 2.3 ± 0.4 × RMR, respectively, P = 0.5170), or body mass loss (10.2 ± 3.1% and 10.0 ± 3.0%, respectively, P = 0.8520), and no effect of age on EI (P = 0.5450) or TEE (P = 0.9344). Muscle loss occurred exclusively in the calf (15.7% ± 11.4% P < 0.0001), whilst other muscles remained unchanged. After 46 days of prolonged ultra‐endurance ocean rowing incurring 10% body mass loss, maximal sustainable EI of ∼2.5 × RMR was unable to meet total TEE suggesting that there is indeed a physiological capacity to EI.New Findings
What is the central question of this study?During a prolonged endurance transatlantic ocean rowing race over ∼46 days, what changes occur in energy intake (EI), total energy expenditure (TEE) and body mass and are there differences between males and females or an effect of age?
What is the main finding and its importance?During a ∼46 days, there appeared to be a maximal sustainable EI of ∼2.5 × resting metabolic rate (RMR), matching TEE of 2.5 × RMR, incurring a 10% body mass loss There were no sex differences, and minimal influence of age.
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Iniesta RR, Cook S, Oversby G, Koufaki P, Van der Linden ML, Vlachopoulos D, Williams CA, Urquhart DS (2023). Systematic review and meta-analysis: Associations of vitamin D with pulmonary function in children and young people with cystic fibrosis. Clinical Nutrition ESPEN, 54, 349-373.
Glatt DU, McSorley E, Pourshahidi LK, Revuelta Iniesta R, McCluskey J, Beggan L, Slevin M, Gleeson N, Cobice DF, Dobbin S, et al (2022). Vitamin D Status and Health Outcomes in School Children in Northern Ireland: Year One Results from the D-VinCHI Study.
Nutrients,
14(4), 804-804.
Abstract:
Vitamin D Status and Health Outcomes in School Children in Northern Ireland: Year One Results from the D-VinCHI Study
(1) Background: Vitamin D status has never been investigated in children in Northern Ireland (UK). (2) Methods: Children (4–11 years) (n = 47) were recruited from November 2019 to March 2020 onto the cross-sectional study. Anthropometry was assessed. Plasma 25-hydroxyvitamin D (25(OH)D) was analysed. Vitamin D intake, parental knowledge and perceptions, participant habits, physical activity and sedentary behaviour were established via questionnaire. Muscle strength was assessed via isometric grip strength dynamometry and balance via dominant single-leg and tandem stance. Parathyroid hormone, bone turnover markers (OC, CTX and P1NP), glycated haemoglobin and inflammatory markers (CRP, IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8 and TNF-α) were analysed. (3) Results: Mean (SD) 25(OH)D was 49.17 (17.04) nmol/L (n = 47); 44.7% of the children were vitamin D sufficient (25(OH)D >50 nmol/L), 48.9% were insufficient (25–50 nmol/L) and 6.4% were deficient (<25 nmol/L). 25(OH)D was positively correlated with vitamin D intake (µg/day) (p = 0.012, r = 0.374), spring/summer outdoor hours (p = 0.006, r = 0.402) and dominant grip strength (kg) (p = 0.044, r = 0.317). Vitamin D sufficient participants had higher dietary vitamin D intake (µg/day) (p = 0.021), supplement intake (µg/day) (p = 0.028) and spring/summer outdoor hours (p = 0.015). (4) Conclusion: over half of the children were vitamin D deficient or insufficient. Wintertime supplementation, the consumption of vitamin D rich foods and spring/summer outdoor activities should be encouraged to minimise the risk of vitamin D inadequacy.
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Revuelta Iniesta R, Gerasimidis K, Paciarotti I, McKenzie JM, Brougham MFH, Wilson DC (2021). Micronutrient status influences clinical outcomes of paediatric cancer patients during treatment: a prospective cohort study. Clinical Nutrition, 40(5), 2923-2935.
Revuelta Iniesta R, Causer A, Arregui-Fresneda I, Connett G, Allenby M, Daniels T, Carroll M, Urquhart D, Saynor Z (2021). The impact of plasma 25-hydroxyvitamin D on pulmonary function and exercise physiology in cystic fibrosis: a multicentre retrospective study. Journal of Human Nutrition and Dietetics
Glatt DU, Slevin MM, Beggan L, Pourshahidi LK, McSorley E, Revuelta Iniesta R, McCluskey J, Gleeson N, Cobice DF, Dobbin S, et al (2021). Vitamin D status in school children in Northern Ireland. Proceedings of the Nutrition Society, 80(OCE3).
Revuelta Iniesta R, Paciarotti I, McKenzie MJ, Brand C, Chin FMR, Brougham FHM, Wilson DC (2020). Low Plasma Vitamin D (25-Hydroxycholecalciferol) in Children and Adolescents Diagnosed with Cancer: a Case-Control Study. EC Nutrition, 3, 513-520.
Glatt D, Hughes C, McCarthy O, O'Shea F, Brougham MFH, Wilson DC, Revuelta Iniesta R (2020). Nutritional screening and assessment of paediatric cancer patients: a quality improvement project (baseline results).
Clinical Nutrition ESPEN,
38, 242-252.
Abstract:
Nutritional screening and assessment of paediatric cancer patients: a quality improvement project (baseline results)
Background: the department of Haematology and Oncology at the Royal Hospital for Sick Children (RHSC) in Edinburgh have developed their own nutritional standards specific to paediatric cancer. We aimed to audit the current nutritional practice in anthropometry, nutritional biochemistry and malnutrition screening for paediatric cancer patients against nutritional standards to identify areas for nutritional-practice improvement and progress nutrition-related clinical outcomes. Methods: a Clinical audit was conducted >20 weeks between 2015 and 2017 in three data collection locations (inpatient (IP), day-care (DC), or outpatient (OP)) at RHSC. We included patients aged 0–18 years and undergoing treatment for diagnosed malignant childhood cancer (ICCC-3 or Langerhans Cell Histiocytosis). Data were collected by analysing documentation and observing clinical practice for frequency and mode of administration of anthropometry, malnutrition screening, nutritional biochemistry and resulting documentation completion. Results were presented as descriptive statistics and stratified by percentage of standard met (100%, 99-70%,
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Revuelta Iniesta R, Wyness L, Wilson DC (2019). A systematic review of n-3 and n-6 polyunsaturated fatty acid concentration in childhood cancer patients and associated clinical outcomes. EC Nutrition, 14.9, 709-722.
Revuelta Iniesta R, Paciarotti I, Davidson I, McKenzie JM, Brougham MFH, Wilson DC (2019). Nutritional status of children and adolescents with cancer in Scotland: a prospective cohort study. Clinical Nutrition ESPEN, 32, 96-106.
O’Connor C, Glatt D, White L, Revuelta Iniesta R (2018). Knowledge, Attitudes and Perceptions towards Vitamin D in a UK Adult Population: a Cross-Sectional Study.
International Journal of Environmental Research and Public Health,
15(11), 2387-2387.
Abstract:
Knowledge, Attitudes and Perceptions towards Vitamin D in a UK Adult Population: a Cross-Sectional Study
The prevalence of vitamin D deficiency in the United Kingdom is high, despite updated Scientific Advisory Committee on Nutrition (SACN) guidelines. Therefore, our aims were to identify population knowledge, attitudes and perceptions of vitamin D supplementation and factors contributing to supplement use in a UK adult population. A cross-sectional study was performed between April–June 2018 using a newly designed piloted questionnaire. Scores for knowledge were calculated as a percentage (Boland et al. 2015). Logistic regression analysis was used to predict supplement use. 209 participants (82% female), mean (±SD) age 34.9 (±12.3) completed the questionnaire. The mean (±SD) vitamin D knowledge score was 56.6% (±19.9%); only 48% were concerned about their vitamin D concentration and 57% did not take vitamin D. Most participants (86%) wished to learn more about vitamin D. Knowledge score (OR 2.5; p = 0.01; 95% CI 1.2–5.3), concern (OR 2.1; p = 0.03; 95% CI 1.0–4.2) and location (OR 0.3; p = 0.006; 95% CI 0.1–0.7) predicted supplemented use. Individuals living in England had 2.9 (95% CI 1.4–6.3) lower odds of taking vitamin D than those living in Scotland. As a result of these findings, this study suggests that vitamin D supplementation and fortification, alongside education strategies, may be an effective method for improving UK vitamin D health; however, more research is warranted.
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Brierley CK, Revuelta Iniesta R, Storrar N, Thomas AE (2017). Hyperferritinemia in Pediatric Acute Lymphoblastic Leukemia: What Does it Mean?. Journal of Pediatric Hematology/Oncology, 39(3), 238-238.
Iniesta RR, Paciarotti I, Davidson I, McKenzie JM, Brand C, Chin RFM, Brougham MFH, Wilson DC (2016). 5-Hydroxyvitamin D concentration in paediatric cancer patients from Scotland: a prospective cohort study.
British Journal of Nutrition,
116(11), 1926-1934.
Abstract:
5-Hydroxyvitamin D concentration in paediatric cancer patients from Scotland: a prospective cohort study
AbstractChildren with cancer are potentially at a high risk of plasma 25-hydroxyvitamin D (25(OH)D) inadequacy, and despite UK vitamin D supplementation guidelines their implementation remains inconsistent. Thus, we aimed to investigate 25(OH)D concentration and factors contributing to 25(OH)D inadequacy in paediatric cancer patients. A prospective cohort study of Scottish children aged <18 years diagnosed with, and treated for, cancer (patients) between August 2010 and January 2014 was performed, with control data from Scottish healthy children (controls). Clinical and nutritional data were collected at defined periods up to 24 months. 25(OH)D status was defined by the Royal College of Paediatrics and Child Health as inadequacy (<50 nmol/l: deficiency (<25 nmol/l), insufficiency (25–50 nmol/l)), sufficiency (51–75 nmol/l) and optimal (>75 nmol/l). In all, eighty-two patients (median age 3·9, interquartile ranges (IQR) 1·9–8·8; 56 % males) and thirty-five controls (median age 6·2, IQR 4·8–9·1; 49 % males) were recruited. 25(OH)D inadequacy was highly prevalent in the controls (63 %; 22/35) and in the patients (64 %; 42/65) at both baseline and during treatment (33–50 %). Non-supplemented children had the highest prevalence of 25(OH)D inadequacy at every stage with 25(OH)D median ranging from 32·0 (IQR 21·0–46·5) to 45·0 (28·0–64·5) nmol/l. Older age at baseline (R −0·46; P<0·001), overnutrition (BMI≥85th centile) at 3 months (P=0·005; relative risk=3·1) and not being supplemented at 6 months (P=0·04; relative risk=4·3) may have contributed to lower plasma 25(OH)D. Paediatric cancer patients are not at a higher risk of 25(OH)D inadequacy than healthy children at diagnosis; however, prevalence of 25(OH)D inadequacy is still high and non-supplemented children have a higher risk. Appropriate monitoring and therapeutic supplementation should be implemented.
Abstract.
Al-Dujaili EAS, Munir N, Iniesta RR (2016). Effect of vitamin D supplementation on cardiovascular disease risk factors and exercise performance in healthy participants: a randomized placebo-controlled preliminary study.
Therapeutic Advances in Endocrinology and Metabolism,
7(4), 153-165.
Abstract:
Effect of vitamin D supplementation on cardiovascular disease risk factors and exercise performance in healthy participants: a randomized placebo-controlled preliminary study
Background and objectives: Evidence suggests associations between vitamin D deficiency and cardiovascular disease (CVD) risk factors, including hypertension and excessive cortisol levels. Also, vitamin D levels may impact exercise performance. Thus, we aimed to investigate the effects of vitamin D intake on cardiovascular risk factors, free urinary cortisol and exercise performance. Methods: a randomized placebo-controlled single-blinded parallel trial was conducted in healthy participants ( n = 15). They received 2000 IU (50 µg) vitamin D3 per day ( n = 9) or placebo (lactose) ( n = 6) for 14 days. Body composition, systolic blood pressure (SBP), diastolic blood pressure (DBP) and arterial elasticity (as measured by pulse wave velocity, PWV) were recorded at baseline, day 7 and day 14 of intervention. A total of two 24-hour urine samples were collected to estimate free cortisol and cortisone levels. Exercise performance was assessed at the baseline and day 14 of the intervention using a bike ergometer in which BP and PWV were measured before and after exercise. The distance cycled in 20 minutes and the Borg Scale rate of perceived exertion (RPE) were recorded. Results: in the intervention arm, at day 14, vitamin D supplementation significantly reduced SBP and DBP from 115.8 ± 17.1 and 75.4 ± 10.3 at baseline to 106.3 ± 10.9 ( p = 0.022) and 68.5 ± 10.1 mmHg ( p = 0.012) respectively. Also arterial stiffness was markedly reduced in the vitamin D group (from 7.45 ± 1.55 to 6.11 ± 1.89, p = 0.049). Urinary free cortisol levels and cortisol/cortisone ratio were significantly reduced from 162.65 ± 58.9 nmol/day and 2.22 ± 0.7 to 96.4 ± 37.2 ( p = 0.029) and 1.04 ± 0.4 ( p = 0.017) respectively. Exercise-induced SBP and DBP were significantly reduced post vitamin D intake from 130.7 ± 12.2 to 116.1 ± 8.1 ( p = 0.012) and from 76.2 ± 8.4 to 70.5 ± 7.7 mmHg ( p = 0.042) respectively. The distance cycled in 20 minutes significantly increased from 4.98 ± 2.65 to 6.51 ± 2.28km ( p = 0.020), while the Borg Scale RPE reduced from 5.13 ± 1.36 to 4.25 ± 0.71 RPE ( p = 0.021). In the placebo arm, no significant effects on CVD risk factors and exercise performance were observed. Conclusion: These results suggest that daily vitamin D supplementation may ameliorate CVD risk factors including a decrease in 11β-HSD1 activity, as evidenced by the decrease in the cortisol/cortisone ratio, and improve exercise performance in healthy individuals. However, large scale studies are required to verify our findings.
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Revuelta Iniesta R, Rush R, Paciarotti I, Rhatigan EB, Brougham FHM, McKenzie JM, Wilson DC (2016). Systematic review and meta-analysis: Prevalence and possible causes of vitamin D deficiency and insufficiency in pediatric cancer patients. Clinical Nutrition, 35(1), 95-108.
Revuelta Iniesta R, Wilson DC, Brougham MFH, Smail NF, Davidson I, McKenzie JM (2015). Assessment of Plasma Antioxidants, Oxidative Stress and Polyunsaturated Fatty Acids in Paediatric Cancer Patients: a Prospective Cohort Pilot Study. EC Nutrition, 2.4, 412-425.
Iniesta RR, Paciarotti I, Brougham MFH, McKenzie JM, Wilson DC (2015). Effects of pediatric cancer and its treatment on nutritional status: a systematic review. Nutrition Reviews, 73(5), 276-295.
Revuelta-Iniesta R, Wilson ML, White K, Stewart L, McKenzie JM, Wilson DC (2014). Complementary and alternative medicine usage in Scottish children and adolescents during cancer treatment. Complementary Therapies in Clinical Practice, 20(4), 197-202.
Revuelta-Iniesta R, Al-Dujaili EAS (2014). Consumption of Green Coffee Reduces Blood Pressure and Body Composition by Influencing 11<i>β</i>-HSD1 Enzyme Activity in Healthy Individuals: a Pilot Crossover Study Using Green and Black Coffee.
BioMed Research International,
2014, 1-9.
Abstract:
Consumption of Green Coffee Reduces Blood Pressure and Body Composition by Influencing 11β-HSD1 Enzyme Activity in Healthy Individuals: a Pilot Crossover Study Using Green and Black Coffee
Dietary polyphenols may have a protective role against the development of CVD. Thus, we aimed to investigate the effects of green coffee (GC), rich in chlorogenic acid, and black coffee (BC) on cardiovascular markers. A randomised pilot crossover study was performed on healthy subjects who consumed both coffees for 2 weeks. We measured anthropometry, blood pressure, and arterial elasticity after each intervention and collected urine samples to monitor antioxidant capacity. Free cortisol and cortisone levels were obtained from urine and analysed by specific ELISA methods. Systolic blood pressure (P=0.018) and arterial elasticity (P=0.001) were significantly reduced after GC. BMI (P=0.04for BC;P=0.01for GC) and abdominal fat (P=0.01for BC;P=0.009for GC) were also significantly reduced with no changes in energy intake. Urinary free cortisol was significantly reduced from125.6±85.9 nmol/day to76.0±54.9 nmol/day following GC and increased to132.1±89.1 nmol/day after BC. Urinary free cortisone increased by 18% following BC and 9% following GC (nonsignificant). Cortisol/cortisone ratio (indicating 11β-HSD1 activity) was reduced after GC (from3.5±1.9to1.7±1.04,P=0.002). This suggests that GC can play a role in reducing cardiovascular risk factors. Further research including hypertensive and overweight individuals will now be justified to clarify whether GC could have a therapeutic role in CVD.
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