Nerys Astbury - Academia.edu (original) (raw)

Papers by Nerys Astbury

NeuroImage, Oct 1, 2014

Sexually-dimorphic behavioral and biological aspects of human eating have been described. Using p... more Sexually-dimorphic behavioral and biological aspects of human eating have been described. Using psychophysiological interactions (PPI) analysis, we investigated sex-based differences in functional connectivity with a key emotion-processing region (amygdala, AMG) and a key reward-processing area (ventral striatum, VS) in response to high vs. low energy-dense (ED) food images using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) in obese persons in fasted and fed states. When fed, in response to high vs. lowED food cues, obese men (vs. women) had greater functional connectivity with AMG in right subgenual anterior cingulate, whereas obese women had greater functional connectivity with AMG in left angular gyrus and right primary motor areas. In addition, when fed, AMG functional connectivity with pre/post-central gyrus was more associated with BMI in women (vs. men). When fasted,

Children, 2022

An economic perspective is crucial to understand the broad consequences of childhood excess weigh... more An economic perspective is crucial to understand the broad consequences of childhood excess weight (CEW). These can manifest in the form of elevated health care and societal costs, impaired health status, or inefficiencies in the allocation of resources targeted at its prevention, management, or treatment. Although existing systematic reviews provide summaries of distinct economic research strands covering CEW, they have a restricted focus that overlooks relevant evidence. The overarching aim of this structured review was to update and enhance recent key reviews of four strands of economic evidence in this area, namely, (1) economic costs associated with CEW, (2) health utilities associated with CEW, (3) economic evaluations of interventions targeting CEW, and (4) economic determinants and broader consequences of CEW. Our de novo searches identified six additional studies for the first research strand, five studies for the second, thirty-one for the third, and two for the fourth. Mo...

This study aims to investigate the associations between occurrence of Gestational Diabetes Mellit... more This study aims to investigate the associations between occurrence of Gestational Diabetes Mellitus and future health risks, with a focus on cardiovascular disease, in the UK Biobank.

Skipping breakfast leads to weight loss but also elevated cholesterol compared with consuming dai... more Skipping breakfast leads to weight loss but also elevated cholesterol compared with consuming daily breakfasts of oat porridge or frosted cornflakes in overweight individuals: a randomised controlled trial

There is considerable interest in whether non-nutritive sweeteners are sensed in the gastrointest... more There is considerable interest in whether non-nutritive sweeteners are sensed in the gastrointestinal tract to modulate appetitive or absorptive responses to ingested carbohydrate. We determined the effect of a panel of non-nutritive sweeteners, aspartame, saccharin and acesulfame-K, delivered in doses that would be consumed in normal usage. Each was given in combination with glucose, assessing their effect on glycemic responses and appetite in ten healthy human subjects. There was no additional effect of aspartame or saccharin on the blood glucose response to oral glucose at any time point, although acesulfame-K exerted a small effect. However, none had an effect on perceptions of hunger or fullness. We conclude that there is no consistent evidence that non-nutrient sweeteners, when acutely consumed with glucose in dietetically relevant doses, have a class effect in modulating blood glucose in healthy human subjects. However, acesulfame-K may require further exploration.

BMJ Open, 2019

Introduction A diet high in saturated fat (SFA) increases the risk of cardiovascular disease (CVD... more Introduction A diet high in saturated fat (SFA) increases the risk of cardiovascular disease (CVD) and intakes in the UK exceed dietary recommendations. The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study aims to test the effect of an intervention for people with raised low-density lipoprotein (LDL) cholesterol involving health professional (HP) advice alone, or in combination with personalised feedback based on nutritional analysis of grocery store loyalty card data, on SFA intake and blood lipids in comparison with no intervention. Methods and analysis PC-SHOP is a three-arm parallel randomised controlled trial with an allocation ratio of 1:3:3 (‘no intervention’: n=16, ‘brief support’: n=48, ‘brief support plus shopping feedback’: n=48, respectively). Participants with raised LDL will be recruited from general practitioner (GP) practices for a 3-month intervention period. In brief support, an HP will deliver a behaviourally informed 10 min...

В работе представлены результаты анализа эффективности использования метода обучения действием на... more В работе представлены результаты анализа эффективности использования метода обучения действием на «Фабрике процессов» Кубанского государственного медицинского университета. Проведена оценка комплексного навыка применения бережливых технологий сотрудниками медицинских организаций, участвующих в реализации приоритетного федерального проекта «Создание новой модели медицинской организации, оказывающей первичную медико-санитарную помощь» после обучения на «Фабрике процессов». В статье описан алгоритм работы «Фабрики процессов» Кубанского государственного медицинского университета. Представлены результаты оценки эффективности обучения по методике Д. Киркпатрика на базе трех контрольных срезов знаний и умений обучающихся: после теоретического курса, после первогои второго этапов обучения на «Фабрике процессов». Приведены данные сравнительной оценки эффективности использования метода обучения действием и иных интерактивных методов обучения, используемых в теоретическом цикле «Философия, принципы и инструменты бережливого производства». Эмпирически подтверждена высокая эффективность применения новой технологии образования «Фабрика процессов» и лежащего в ее основе метода обучения действием для подготовки сотрудников медицинских организаций к осуществлению проектной деятельности с применением бережливых технологий. Описан комплексный результат обучениябережливому производству с использованием анализируемых образовательных технологий. Ключевые слова: бережливое производство, здравоохранение, фабрика процессов, обучение действием

In 2014, almost 2 billion adults had overweight or obesity, and prevalence continues to increase.... more In 2014, almost 2 billion adults had overweight or obesity, and prevalence continues to increase. The fundamental cause of obesity is an imbalance between energy expenditure and intake, but determinants of these behaviours are complex. Obesity is one of the most important preventable causes of morbidity and mortality, and its control is one of the most pressing issues facing modern health care systems. Primary prevention is vital, but many of the health risks can be mitigated by weight loss. There has been considerable progress in weight management interventions for adults, including behavioural programmes, pharmacotherapy, and surgeries, but management in children and adolescents remains more challenging. Weight regain post-intervention is common, and obesity needs to be managed as a chronic, relapsing condition with individual-level interventions offered on repeated occasions. Population-level interventions to curb the environmental drivers of obesity are important for primary pre...

International Journal of Obesity, 2021

Objectives To test the long-term effectiveness of a total diet replacement programme (TDR) for ro... more Objectives To test the long-term effectiveness of a total diet replacement programme (TDR) for routine treatment of obesity in a primary care setting. Methods This study was a pragmatic, two-arm, parallel-group, open-label, individually randomised controlled trial in adults with obesity. The outcomes were change in weight and biomarkers of diabetes and cardiovascular disease risk from baseline to 3 years, analysed as intention-to-treat with mixed effects models. Interventions The intervention was TDR for 8 weeks, followed by food-reintroduction over 4 weeks. Behavioural support was provided weekly for 8 weeks, bi-weekly for the next 4 weeks, then monthly for 3 months after which no further support was provided. The usual care (UC) group received dietary advice and behavioural support from a practice nurse for up to 3 months. Results Outcome measures were collected from 179 (66%) participants. Compared with baseline, at 3 years the TDR group lost −6.2 kg (SD 9.1) and usual care −2.7 ...

Clinical Obesity, 2021

Guidelines ask health professionals to offer brief advice to encourage weight loss for people liv... more Guidelines ask health professionals to offer brief advice to encourage weight loss for people living with obesity. We tested whether referral to one of three online programmes could lead to successful weight loss. A total of 528 participants aged ≥18 years with a body mass index of ≥30 kg/m2 were invited via a letter from their GP. Participants were randomised to one of three online weight loss programmes (NHS Weight Loss Plan, Rosemary Online or Slimming World Online) or to a control group receiving no intervention. Participants self-reported weight at baseline and 8 weeks. The primary outcome was weight change in each of the active intervention groups compared with control. We also compared the proportion of participants losing ≥5% or ≥10% of body weight. For Rosemary, Online mean weight loss was modestly greater than control (-1.5 kg [95% confidence interval (CI) -2.3 to -0.6]) and more than three times as many participants in this group lost ≥5% (relative risk [RR] = 3.64, 95% CI: 1.63-8.1). For Slimming World, mean weight loss was not significantly different from control (-0.8 kg [95%CI -1.7 to 0.1]), twice as many participants lost ≥5% (RR = 2.70, 1.17-6.23). There was no significant difference in weight loss for participants using the NHS Weight Loss Plan (-0.4 kg, [95% CI -1.3 to 0.5]), or the proportion losing ≥5% (RR = 2.09, 0.87-5.01). Only one of three online weight loss programmes was superior to no intervention and the effect size modest among participants living with obesity.

PLOS ONE, 2020

Introduction The participants' experience of low-energy total diet replacement (TDR) programmes d... more Introduction The participants' experience of low-energy total diet replacement (TDR) programmes delivered by lay counsellors in the community for the routine treatment of obesity is currently unclear. We interviewed a sample of twelve participants who took part in the Doctor Referral of Overweight People to Low-Energy total diet replacement Treatment (DROPLET) trial and were randomised to the TDR programme. Methods We purposively sampled twelve patients who took part in the DROPLET trial, and conducted in-depth telephone interviews, which were audio-recorded and transcribed verbatim. Interview questions focused on participants' experiences and perceptions of the TDR programme. We conducted a thematic analysis, actively developing themes from the data, and used the one sheet of paper (OSOP) technique to develop higher-level concepts. Results Nine key themes were identified; Reasons for taking part, Expectations, Support and guidance from the counsellor, Time to build a personal relationship, Following the TDR Programme, Adverse events, Outcomes from the TDR, Weight Loss Maintenance, Recommending TDR to others. The relationship between participants and the counsellor was central to many of the themes. Close relationships with counsellors facilitated TDR adherence through providing one-to-one support (including during difficult times), sharing expert knowledge, and building a close relationship. Adherence was also supported by the rapid weight loss that patients reported experiencing. Overall participants reported positive experiences of the TDR, and emphasised the positive impact on their wellbeing.

Journal of Hypertension, 2021

Where a licence is displayed above, please note the terms and conditions of the licence govern yo... more Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

BMC Pregnancy and Childbirth, 2021

Background Excess gestational weight gain is common and an important risk factor for adverse preg... more Background Excess gestational weight gain is common and an important risk factor for adverse pregnancy outcomes. Regular weighing can be used to assess and manage weight gain, but NICE guidelines do not recommend routine weighing during antenatal care. Trials that have tested the effectiveness of self-weighing to manage GWG have been unsuccesful in engaging women in regular self-weighing, although the reasons for lack of engagement are not fully understood. This study aimed to understand why this lack of engagement occurred by exploring the naturally occurring thoughts and feelings of pregnant women (9 to 15 weeks gestational age) who were asked to weigh themselves at home. Methods Twenty-five women were recruited to take part. Participants completed short questionnaires at their first-trimester and 20-week scans. After recruitment, participants were asked to weigh themselves at roughly the same time each week for 8 weeks. Whilst they weighed themselves they were asked to audio-reco...

Proceedings of the Nutrition Society, 2020

Reducing saturated fat (SFA) intake can lower low-density lipoprotein (LDL)-cholesterol and there... more Reducing saturated fat (SFA) intake can lower low-density lipoprotein (LDL)-cholesterol and thereby cardiovascular disease (CVD) but there are no brief interventions sufficiently scalable to achieve this. The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study developed and tested a behavioural intervention to provide health professional (HP) advice alone or in combination with personalised feedback on food shopping, which was delivered using a bespoke tool that created a nutritional profile of the grocery shopping based on loyalty card data from the UK largest supermarket.Participants with raised LDL-cholesterol were randomly allocated to one of three groups: ‘No Intervention’ (n = 17), ‘Brief Support’ (BS, n = 48), ‘Brief Support plus Shopping Feedback’ (BSSF, n = 48). BS consisted of a 10-minute consultation with a nurse to inform and motivate participants to reduce their SFA intake. The BSSF group received brief support as well as personalise...