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Papers by H. McNulty

Journal of Human Nutrition and Dietetics, 2018

Background: Although lifespan is increasing there is no evidence to suggest that older people are... more Background: Although lifespan is increasing there is no evidence to suggest that older people are experiencing better health in their later years than previous generations. Nutrition, at all stages of life, plays an important role in determining health and wellbeing. Method: A roundtable meeting of United Kingdom (UK) experts on nutrition and ageing considered key aspects of the diet-ageing relationship and developed a consensus position on the main priorities for research and public health actions that are required to help people live healthier lives as they age. Results: The group consensus highlighted the requirement for a life course approach, recognising the multifactorial nature of the impact of ageing. Environmental and lifestyle influences at any life stage are modified by genetic factors and early development. The response to the environment at each stage of life can determine the impact of lifestyle later on. There are no key factors that act in isolation to determine patterns of ageing and that combinations of environmental and social factors drive healthy or unhealthy ageing. Too little is known about how contemporary dietary patterns and sedentary lifestyles will impact upon healthy ageing in future generations and this is a priority for future research. Conclusions: There is good evidence to support change to lifestyle (i.e. diet, nutrition and physical) activity in relation to maintaining or improving body composition, cognitive health and emotional intelligence, immune function and vascular health. Lifestyle change at any stage of life may extend healthy lifespan, but the impact of early changes appears to be greatest.

Clinical therapeutics, 2018

Evidence supporting the use of dietary supplements, in particular, multivitamin/multimineral supp... more Evidence supporting the use of dietary supplements, in particular, multivitamin/multimineral supplements (MVMS), has been mixed, complicating the ability of health care professionals to recommend their use. To clarify the role that MVMS can play in supporting human health, a series of consensus statements was developed based on expert opinion. A panel of 14 international experts in nutritional science and health care was convened to develop consensus statements related to using MVMS in supporting optimal human health. The modified Delphi process included 2 rounds of remote voting and a final round of voting at a roundtable meeting where evidence summaries were presented and discussed. The level of agreement with each of 9 statements was rated on a 5-point Likert scale: agree strongly; agree with reservation; undecided; disagree; or disagree strongly. Consensus was predefined as ≥80% of the panel agreeing strongly or agreeing with reservation to a given statement. Consensus was reach...

Background: Dietary reference values for... more Background: Dietary reference values for folate intake vary widely across Europe. Methods: MEDLINE and Embase through November 2016 were searched for data on the association between folate intake and biomarkers (serum/plasma folate, red blood cell [RBC] folate, plasma homocysteine) from observational studies in healthy adults and elderly. The regression coefficient of biomarkers on intake (β) was extracted from each study, and the overall and stratified pooled β and SE (β) were obtained by random effects meta-analysis on a double log scale. These dose-response estimates may be used to derive folate intake reference values. Results: For every doubling in folate intake, the changes in serum/plasma folate, RBC folate and plasma homocysteine were +22, +21, and –16% respectively. The overall pooled regression coefficients were β = 0.29 (95% CI 0.21–0.37) for serum/plasma folate (26 estimates from 17 studies), β = 0.28 (95% CI 0.21–0.36) for RBC (13 estimates from 11 studies), and β = –0.21 (95% CI –0.31 to –0.11) for plasma homocysteine (10 estimates from 6 studies). Conclusion: These estimates along with those from randomized controlled trials can be used for underpinning dietary recommendations for folate in adults and elderly.

Biochemical Society Transactions, 2000

Proceedings of the Nutrition Society, 2012

Clinical Nutrition ESPEN, 2015

Hypertension is a key risk factor for stroke, cardiovascular disease and dementia. Although the l... more Hypertension is a key risk factor for stroke, cardiovascular disease and dementia. Although the link between weight, sodium and hypertension is established in younger people, little is known about their inter-relationship in people beyond 80 years of age. Associations between blood pressure, anthropometric indices and sodium were investigated in 495 apparently healthy, community-living participants (age 90, SD 4.8; range 80–106), from the crosssectional Belfast Elderly Longitudinal Free-living Aging STudy (BELFAST) study. In age-sex-adjusted logistic regression models, blood pressure ≥140/ 90 mmHg significantly associated with body mass index (BMI) [odds ratio (OR)=1.28 / kg/m 2], with weight (OR=1.22/kg) approaching significance (P= 0.07). In further age-sex-adjusted models, blood pressure above the 120/80 mmHg normotensive reference value significantly associated with BMI (OR=1.44/kg/m 2), weight (OR=1.36/kg), skin-foldthickness (OR=1.33/mm) and serum sodium (OR= 1.37 mmol/l). In ...

Proceedings of the Nutrition Society, 2021

Advances in Experimental Medicine and Biology, 1993

Folate plays a crucial and indispensible role in cell division so it is not surprising that it is... more Folate plays a crucial and indispensible role in cell division so it is not surprising that it is important in pregnancy. This importance was first highlighted by the historical observation made by Lucy Wills in India1 that the latter stages of pregnancy are frequently associated with a megaloblastic anaemia that is folate responsive, i.e. in pregnancy not only is extra folate needed but it is frequently lacking. Subsequent studies over the years have found that folate deficiency in the second and particularly the third trimester is common in some countries and quite rare in others. The determining feature was found to be adequate folate nutrition for the mother not only during pregnancy but before the pregnancy began2. The most often suggested mechanism for folate deficiency in pregnancy is increased requirement for the rapidly growing fetus and placenta. However the mechanism is unclear and certainly cannot be accounted for by transfer of the vitamin to the fetus. One possible explanation is that the events of fetal/placental growth cause an increase in the rate of catabolism of the vitamin. Early studies in our laboratory demonstrated that the mechanism of folate catabolism in the rat was cleavage of the C9-N10 bond with excretion of a mixture of pteridines and p-aminobenzoylglutamate (pABGlu) with the latter being largely acetylated to acetamidobenzoylglutamate (apABGlu)3. Subsequent studies by us in the rat4 and by Krumdieck5 in man confirmed this mechanism. These studies used radioactive tracers. They had the disadvantage that they assumed that the exogenous tracer would equilibrate with the endogenous pool given sufficient time. In addition while they could be used to compare rates of catabolism in specific circumstances between animals, say treated with convulsant drugs and controls6, they did not measure true endogenous rates of catabolism. Furthermore, since they used radioactive tracers they were unsuitable for routine studies on humans.

Human nutrition. Applied nutrition, 1987

All official recommendations for folate tend to be far in excess of current estimated intakes. Se... more All official recommendations for folate tend to be far in excess of current estimated intakes. Several recent studies have highlighted this, showing satisfactory folate status in healthy populations consuming considerably less than official RDAs. This study takes a critical look at current RDAs for folate. We have recently developed an assay to quantify the end product of folate catabolism in human urine, thus affording the possibility of a more rational and scientific approach to setting the RDA for folate. Results of this study (now confirmed by further work) suggest that, under normal dietary conditions, the body appears to catabolize only about 100 micrograms total folate per day. Furthermore, this rate of catabolism remained relatively unchanged in response to saturating doses of a 5 mg folic acid supplement over several days. It is therefore most unlikely that our diet is as seriously deficient in folate as current official RDAs seem to imply.

Proceedings of the Nutrition Society, 2012

Proceedings of the Nutrition Society, 2016

The number of adults aged 60 years and over is predicted to reach up to 2 billion by 2050 and hen... more The number of adults aged 60 years and over is predicted to reach up to 2 billion by 2050 and hence the associated health and socioeconomic costs will continue to increase. Cognitive dysfunction, depression and anxiety are significant problems of ageing. Preventing or delaying the onset of these disorders should therefore be a public health priority. Accumulating evidence suggests that low status of folate and the related B-vitamins (B12, B6 and riboflavin) are linked to an increased risk of these conditions 1,2,3. The aim of this study is to investigate whether these B-vitamins are determinants of neuropsychiatric health in ageing. Participants for this investigation were recruited to the Trinity Ulster Department of Agriculture (TUDA) Ageing cohort study and health, clinical, medication, lifestyle and nutritional details were collected (n 5186). A non-fasting blood sample was taken for the analysis of B-vitamin biomarkers. Cognitive function was assessed using the Mini Mental State Examination (MMSE), and depression and anxiety were assessed by the Centre for Epidemiologic Studies Depression scale (CES-D) (a score ⩾16•0 suggestive of depression) and the Hospital Anxiety and Depression (HADS) scale (a score ⩾11•0 suggestive of anxiety).

Proceedings of the Nutrition Society, 2012

Proceedings of the Nutrition Society, 2021

M. Clements, L. Hoey, M. Ward, C.F. Hughes, K.M. Porter, C. Cunningham, M.C. Casey, F. Tracey, M.... more M. Clements, L. Hoey, M. Ward, C.F. Hughes, K.M. Porter, C. Cunningham, M.C. Casey, F. Tracey, M. O’Kane, J.J. Strain, A.M. Molloy and H. McNulty Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Coleraine, Northern Ireland, United Kingdom, Mercers Institute for Research on Aging, St James’s Hospital, Dublin, Ireland, Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, United Kingdom, Clinical Chemistry Laboratory, Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom and School of Medicine, Trinity College Dublin, Dublin, Ireland

Proceedings of the Nutrition Society

The common C677T polymorphism in the MTHFR gene encoding the folate-metabolising enzyme methylene... more The common C677T polymorphism in the MTHFR gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase is implicated in hypertension and hypertension in pregnancy. Hypertension affects up to 15% of all pregnancies and has been identified as a leading cause of maternal and neonatal morbidity and mortality worldwide. We previously reported higher systolic and diastolic blood pressure (BP) in non-pregnant women with the variant MTHFR 677TT genotype compared to CT/CC genotypes. In addition, randomised controlled trials (RCTs) in non-pregnant hypertensive adults from our Centre demonstrated that supplemental riboflavin (co-factor for MTHFR) lowers BP specifically in those with the TT genotype. However, the role of this common folate polymorphism and its interaction with riboflavin during pregnancy remains unclear. The aim of this study was to investigate the impact of MTHFR genotype and riboflavin status on BP in pregnancy. Data were generated from the ongoing Optima...

Proceedings of the Nutrition Society

Diets rich in (poly)phenols are recognised as having potentially beneficial roles in health and t... more Diets rich in (poly)phenols are recognised as having potentially beneficial roles in health and the prevention of chronic diseases (1). However, linking (poly)phenols with health outcomes is problematic because of their transient appearance in plasma (2) , which limits the development of robust biomarkers of dietary exposure. Measures of phenyl-γ-valerolactones, products of colonic bacterial metabolism of the (poly)phenols (epi)catechin and procyanidin, offer the advantage of being more stable in plasma (3) , and may represent novel biomarkers of dietary intake of (epi)catechin and procyanidin-rich foods such as tea, cocoa, grapes, nuts, red wine and berries. The aim of this analysis was to develop and validate plasma phenyl-γ-valerolactones as biomarkers of (epi)catechin and procyanidinrich diets in a subsample of older adults from the island of Ireland. This preliminary investigation was conducted as part of the multi-centred VALID project (www.jpi-valid.com) on 346 participants who provided a blood sample and completed an interviewer led (poly)phenol focused food frequency questionnaire. Plasma phenyl-γ-valerolactones were quantified using UHPLC-ESI-MS (3) at the University of Parma, while Phenol-Explorer ® was used to estimate dietary intakes of (epi)catechin and procyanidin at Ulster University. Analysis showed that 3 of a total of 11 phenyl-γ-valerolactones metabolites investigated, namely 5-(3′,4′-dihydroxyphenyl)γ-valerolactone-3′-O-sulfate (3′4'-DiOH-VL-3′-O-Sulph), 5-(3′,4′-dihydroxyphenyl)-γ-valerolactone-3′-O-glucuronide (3′4'-DiOH-VL-3′-O-Gluc) and 5-(3′,5′-dihydroxyphenyl)-γ-valerolactone-3′-O-glucuronide (3′5'-DiOH-VL-3′-O-Gluc), were detectable in ≥52% of plasma samples and these were examined in relation to corresponding dietary (poly)phenol intake. Participants were classified into tertiles of low, medium and high (poly)phenol intake and the two most predominant phenyl-γ-valerolactones metabolites (3′4'-DiOH-VL-3′-O-Sulph and 3′4'-DiOH-VL-3′-O-Gluc, detected in 95% and 77% of samples, respectively) showed markedly higher concentrations in participants reporting the highest dietary (poly)phenol intakes (Table 1).

Journal of Human Nutrition and Dietetics, 2018

Clinical therapeutics, 2018

Biochemical Society Transactions, 2000

Proceedings of the Nutrition Society, 2012

Clinical Nutrition ESPEN, 2015

Proceedings of the Nutrition Society, 2021

Advances in Experimental Medicine and Biology, 1993

Human nutrition. Applied nutrition, 1987

Proceedings of the Nutrition Society, 2012

Proceedings of the Nutrition Society, 2016

Proceedings of the Nutrition Society, 2012

Proceedings of the Nutrition Society, 2021

Proceedings of the Nutrition Society