ORCID Profile
0000-0003-3541-8960
Current Organisation
University of Newcastle Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Cambridge University Press (CUP)
Date: 27-07-2020
DOI: 10.1017/S0007114520002925
Abstract: There is increasing evidence linking the gut microbiota to various aspects of human health. Nuts are a food rich in prebiotic fibre and polyphenols, food components which have been shown to have beneficial effects on the gut microbiota. This systematic review aimed to synthesise the evidence regarding the effect of nut consumption on the human gut microbiota. A systematic search of the databases MEDLINE, PubMed, Cochrane CENTRAL and CINAHL was performed until 28 November 2019. Eligible studies were those that investigated the effects of nut consumption in humans (aged over 3 years old), utilising next-generation sequencing technology. Primary outcome measures were between-group differences in α - and β - ersity metrics and gut microbial composition. A total of eight studies were included in the review. Included studies assessed the effects of either almonds, walnuts, hazelnuts or pistachios on the gut microbiota. Overall, nut consumption had a modest impact on gut microbiota ersity, with two studies reporting a significant shift in α - ersity and four reporting a significant shift in β - ersity. Walnuts, in particular, appeared to more frequently explain shifts in β - ersity, which may be a result of their unique nutritional composition. Some shifts in bacterial composition (including an increase in genera capable of producing SCFA: Clostridium, Roseburia , Lachnospira and Dialister ) were reported following the consumption of nuts. Nut intake may yield a modulatory effect on the gut microbiota however, results were inconsistent across studies, which may be explained by variations in trial design, methodological limitations and inter-in idual microbiota.
Publisher: MDPI AG
Date: 20-07-2021
DOI: 10.3390/NU13072472
Abstract: Food manufacturers are increasingly substituting potassium chloride (KCl) in food products so as to reduce the sodium chloride content. Bread and bread products are common staple foods in many Western households and are a target for recipe reformulation using KCl. Given that chronic kidney disease (CKD) is a medical condition of global importance that requires dietary potassium restriction in the later stages, we sought to evaluate the impact and safety of varying levels of KCl substitution in bread products. We undertook a secondary analysis of dietary data from the National Nutrition and Physical Activity Survey 2011–2012 for 12,152 participants (154 participants with CKD). The sodium chloride content in bread and bread-based products was substituted with 20%, 30%, and 40% of KCl. The contribution of these alterations in the dietary potassium intake to the total daily potassium intake were then examined. The replacement of sodium in bread with varying amounts of KCl (20%, 30%, and 40%) resulted in one third of people with CKD exceeding the safe limits for dietary potassium consumption (31.8%, 32.6%, and 33%, respectively). KCl substitution in staple foods such as bread and bread products have serious and potentially fatal consequences for people who need to restrict dietary potassium. Improved food labelling is required for consumers to avoid excessive consumption.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Elsevier BV
Date: 03-2021
DOI: 10.1053/J.JRN.2020.07.008
Abstract: The objective of the study was to evaluate associations among diet quality, serum uremic toxin concentrations, and the gut microbiota profile in adults undergoing hemodialysis therapy. This is a cross-sectional analysis of baseline data from a clinical trial involving adults receiving hemodialysis therapy. Usual dietary intake was determined using a diet history method administered by Accredited Practising Dietitians. Two approaches were used for diet quality assessment: (1) using three a priori defined plant-based diet indices-an overall plant-based diet index (PDI), a healthy PDI, and an unhealthy PDI and (2) classification of food group intake. Serum uremic toxins (p-cresyl sulfate and indoxyl sulfate (IS) free and total) were determined by ultra-performance liquid chromatography. Gut microbiota composition was established through sequencing the 16S rRNA gene in stool s les. Twenty-two adults (median age 70.5 [interquartile range: 59-76], 64% male) were included in the final analysis. Higher adherence to the PDI was associated with lower total IS levels (P = .028), independent of dialysis adequacy, urinary output, and blood albumin levels. In contrast, higher adherence to the unhealthy PDI was associated with increases in both free and total IS. Several other direct and inverse associations between diet quality with uremic toxins, microbial relative abundances, and ersity metrics were also highlighted. Diet-associated taxa showed significantly different trends of association with serum uremic toxin concentrations (P < .05). Higher adherence to the PDI was negatively associated with relative abundances of Haemophilus and Haemophilus parainfluenzae that were related to elevated total IS levels. In contrast, increased intake of food items considered unhealthy, such as animal fats, sweets and desserts, were associated with bacteria linked to higher IS and p-cresyl sulfate (total and free) concentrations. The quality of diet and food selections may influence uremic toxin production by the gut microbiota in adults receiving hemodialysis. Well-designed dietary intervention trials that adopt multi-omic technologies appropriate for the functional annotation of the gut microbiome are needed to validate our findings and establish causality.
Publisher: Elsevier BV
Date: 09-2020
DOI: 10.1053/J.JRN.2019.10.002
Abstract: Constipation is common in patients with end-stage kidney disease. Nondrug strategies to manage constipation are challenging because of dietary potassium, phosphate, and fluid restrictions. Nuts are a high-fiber food but are excluded from the diet because of the high potassium and phosphate content. The aim of this study was to examine the safety and efficacy of using nuts to improve constipation in adults undertaking hemodialysis (HD). Adult patients undertaking HD were recruited to this nonrandomized, 10-week repeated measures, within-subject, pragmatic clinical trial, conducted in two HD units. The intervention consisted of consumption of 40g of raw almonds daily for four weeks, followed by a two-week washout and four-week control period. The primary safety outcome measures were change in predialysis serum potassium and phosphate levels. The primary efficacy outcome was reduction in constipation, measured using the Bristol Stool Form Scale and Palliative Care Outcome Scale (POS-S) renal symptom score. Secondary outcomes included quality of life, selected uremic toxins, cognition, gut microbiota profile, and symptom burden. Twenty patients completed the trial (median age: 67 [interquartile range: 57.5-77.8] years, 51% male). After controlling for dialysis adequacy, anuria, dietary intake, bicarbonate, and parathyroid hormone, there were no statistically significant changes in serum potassium (P = 0.21) or phosphate (P = 0.16) associated with daily consumption of almonds. However, statistically significant improvements in constipation were seen at weeks 2, 3, 4, and 10. There were statistically significant improvements in quality of life (P = 0.030), overall symptom burden (P = 0.002), vomiting (P = 0.020), itching (P = 0.006), and skin changes (P = 0.002). Daily consumption of almonds for four weeks was safe, effective, and well tolerated. Improvements in quality of life and symptom burden warrant further research to elucidate potential mechanisms. The findings support the potential reinclusion of foods such as nuts into the diet of patients who underwent HD.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Research Square Platform LLC
Date: 04-11-2019
Abstract: The authors have withdrawn this preprint from Research Square
Publisher: Research Square Platform LLC
Date: 02-10-2019
Abstract: Background There is mounting evidence that in iduals with kidney disease have an abnormal gut microbiota composition. No studies to date have summarised the evidence to categorise how the gut microbiota profile of in iduals with kidney disease may differ from healthy controls. Synthesis of this evidence is important to inform future clinical trials. This systematic review aims to characterise differences of the gut microbiota composition in adults with kidney disease, as well as to describe the functional capacity of the gut microbiota and reporting of diet as a confounder in these studies. Methods Included studies were those that investigated the gut microbial community in adults with any type of kidney disease and compared this to the profile of healthy controls. Six scientific databases (CINHAL, Medline, PubMed, Scopus, Web of Science, Cochrane Library) as well as selected grey literature sources were searched up until August 2018. Quality assessment was undertaken independently by three authors. The system of evidence level criteria was employed to quantitatively evaluate the alteration of microbiota by strictly considering the number, methodological quality and consistency of the findings. Additional findings relating to altered functions of the gut microbiota, dietary intakes and dietary methodologies used were qualitatively summarised. Results Sixteen articles, reporting 15 studies met the eligibility criteria and included a total of 540 adults with kidney disease and 1117 healthy controls. Compared to healthy controls, in iduals with kidney disease had increased abundances of Enterobacteriaceae, and decreased abundances of Coprococcus and Prevotella. Adults with kidney stones also had an altered microbial composition with variations to Bacteroides, Lachnospiraceae NK4A136 group, Ruminiclostridium 5 group, Dorea, Enterobacter, Christensenellaceae and its genus Christensenellaceae R7 group. Altered microbial functions in adults with kidney disease were reported, particularly in the context of metabolic pathways relating to urea and uremic toxin generation. Only three of the 16 articles accounted for diet, and of these studies only two used a valid dietary assessment method. Conclusions The gut microbiota profile of adults with kidney disease differs from healthy controls. Future study designs should include adequate reporting of important confounders such as dietary intakes to assist with interpretation of findings.
Publisher: BMJ
Date: 07-2023
DOI: 10.1136/BMJOPEN-2023-073658
Abstract: Traditional dietary assessment methods such as 24-hour recalls and food frequency questionnaires rely on self-reported data and are prone to error, bias and inaccuracy. Identification of dietary metabolites associated with different dietary patterns can provide objective markers of whole diet patterns that account for metabolism and in idual responses to dietary interventions. Additionally, few studies have investigated country-specific healthy and unhealthy dietary patterns using metabolomics. Therefore, the current study aims to identify urinary and plasma metabolites that characterise a ‘healthy’ (aligned with current national dietary guidelines) and an ‘unhealthy’ dietary pattern (Typical Australian Diet) in Australian adults. The Diet Quality Feeding Study (DQFS) is an 8-week cross-over feeding study that will recruit 40 healthy adults from the Hunter region (NSW, Australia). Data collected includes biospecimens (whole blood, urine, stool) for quantification of dietary metabolite biomarkers questionnaires (medical history/demographic, physical activity, quality of life) physical measures (anthropometry, body composition, waist circumference, blood pressure, arterial pressure) skin carotenoids and dietary intake (24-hour recalls, food frequency questionnaire). Participants will attend the research facility every 2 weeks (end of the run-in, each diet intervention and washout period) for collection of physical measures. All food will be provided to participants for each dietary intervention period, and participants will return to their usual diet during the run-in and washout periods. Targeted and untargeted metabolomics using liquid chromatography-mass spectrometry and/or proton nuclear magnetic resonance (1H-NMR) spectroscopy will be used to identify metabolites in biospecimens associated with dietary intake. This study is approved by the Hunter New England Human Research Ethics Committee (HNEHREC 2022/ETH01649) and the University of Newcastle’s Human Research Ethics Committee (HREC H-2022-0330). Findings will be disseminated to study participants, funding bodies supporting the DQFS, peer-review publications and presented at scientific conferences within the field of research. Australian New Zealand Clinical Trials Registry (ACTRN12622001321730).
Publisher: MDPI AG
Date: 21-05-2023
DOI: 10.3390/NU15102405
Abstract: Evidence suggests that diet can play a role in modulating systemic inflammation. This study aims to examine the relationship between fatty acids (FAs) (self-reported dietary intake and red blood cell (RBC) membrane fatty acid concentrations), three diet quality scores, and the plasma concentrations of inflammatory markers (interleukin-6, IL-6 tumour necrosis factor alpha, TNF-α and C-reactive protein, CRP) in a group of Australian adults (n = 92). Data were collected on their demographic characteristics, health status, supplement intake, dietary intake, RBC-FAs and plasma inflammatory markers over a nine-month period. Mixed-effects models were used to determine the relationship between RBC-FAs, dietary intake of FAs, diet quality scores and inflammatory markers to determine which variable most strongly predicted systemic inflammation. A significant association was identified between dietary saturated fat intake and TNF-α (β = 0.01, p 0.05). An association was also identified between RBC membrane saturated fatty acids (SFA) and CRP (β = 0.55, p 0.05). Inverse associations were identified between RBC membrane monounsaturated fatty acids (MUFAs) (β = −0.88, p 0.01), dietary polyunsaturated fatty acids (PUFAs) (β = −0.21, p 0.05) and CRP, and the Australian Eating Survey Modified Mediterranean Diet (AES-MED) score and IL-6 (β = −0.21, p 0.05). In summary, using both objective and subjective measures of fat intake and diet quality, our study has confirmed a positive association between saturated fat and inflammation, while inverse associations were observed between MUFAs, PUFAs, the Mediterranean diet, and inflammation. Our results provide further evidence that manipulating diet quality, in particular fatty acid intake, may be useful for reducing chronic systemic inflammation.
Publisher: Wiley
Date: 10-07-2023
DOI: 10.1111/JHN.13204
Abstract: Immediate action is needed to stabilise the climate. Dietitians require knowledge of how the therapeutic diets they prescribe may contribute to climate change. No previous research has quantified the climate footprint of therapeutic diets. This study sought to quantify and compare the climate footprint of two types of therapeutic diets for people with chronic kidney disease (CKD) with two reference diets. A usual diet for an in idual with CKD and a novel plant‐based diet for CKD were compared with the current Australian diet and the Australian‐adapted EAT Lancet Planetary Health Diet (PHD). The climate footprint of these diets was measured using the Global Warming Potential (GWP*) metric for a reference 71‐year‐old male. No diets analysed were climate neutral, and therefore, all contribute to climate change. The novel plant‐based diet for CKD (1.20 kg carbon dioxide equivalents [CO 2 e] per day) produced 35% less CO 2 e than the usual renal diet for an in idual with CKD (1.83 kg CO 2 e per day) and 50% less than the current Australian diet (2.38 kg CO 2 e per day). The Australian‐adapted EAT Lancet PHD (1.04 kg CO 2 e per day) produced the least amount of CO 2 e and 56% less than the current Australian diet. The largest contributors to the climate footprint of all four diets were foods from the meats and alternatives, dairy and alternatives and discretionary food groups. Dietetic advice to reduce the climate footprint of therapeutic diets for CKD should focus on discretionary foods and some animal‐based products. Future research is needed on other therapeutic diets.
Publisher: Springer Science and Business Media LLC
Date: 07-02-2019
Publisher: MDPI AG
Date: 04-01-2022
DOI: 10.3390/NU14010216
Abstract: The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the acceptability of a hypothetical plant-based dietary prescription aiming for the consumption of 30 unique plant foods per week. This study used an exploratory mixed methods design. Forty-six renal dietitians participated in either an online survey (n = 35) or an in-depth interview (n = 11). Dietitians perceived that plant-based diets could address multiple clinical concerns relevant to CKD. Forty percent of survey respondents reported the hypothetical dietary prescription was realistic for people with CKD, 34.3% were unsure, and 25.7% perceived it as unrealistic. Strengths of the hypothetical prescription included shifting the focus to whole foods and using practical resources like recipes. Limited staffing, time, and follow-up opportunities with patients, as well as differing nutrition philosophies were the most commonly reported challenges to implementation while a supportive multidisciplinary team was identified as an important enabler. To increase patient acceptance of plant-based dietary approaches, education about plant food benefits was recommended, as was implementing small, incremental dietary changes. Successful implementation of plant-based diets is perceived to require frequent patient contact and ongoing education and support by a dietitian. Buy-in from the multidisciplinary team was also considered imperative.
Publisher: Springer Science and Business Media LLC
Date: 05-06-2020
DOI: 10.1186/S12882-020-01805-W
Abstract: There is mounting evidence that in iduals with kidney disease and kidney stones have an abnormal gut microbiota composition. No studies to date have summarised the evidence to categorise how the gut microbiota profile of these in iduals may differ from controls. Synthesis of this evidence is essential to inform future clinical trials. This systematic review aims to characterise differences of the gut microbial community in adults with kidney disease and kidney stones, as well as to describe the functional capacity of the gut microbiota and reporting of diet as a confounder in these studies. Included studies were those that investigated the gut microbial community in adults with kidney disease or kidney stones and compared this to the profile of controls. Six scientific databases (CINHAL, Medline, PubMed, Scopus, Web of Science and Cochrane Library), as well as selected grey literature sources, were searched. Quality assessment was undertaken independently by three authors. The system of evidence level criteria was employed to quantitatively evaluate the alteration of microbiota by strictly considering the number, methodological quality and consistency of the findings. Additional findings relating to altered functions of the gut microbiota, dietary intakes and dietary methodologies used were qualitatively summarised. Twenty-five articles met the eligibility criteria and included data from a total of 892 adults with kidney disease or kidney stones and 1400 controls. Compared to controls, adults with kidney disease had increased abundances of several microbes including Enterobacteriaceae, Streptococcaceae, Streptococcus and decreased abundances of Prevotellaceae, Prevotella, Prevotella 9 and Roseburia among other taxa. Adults with kidney stones also had an altered microbial composition with variations to Bacteroides, Lachnospiraceae NK4A136 group, Ruminiclostridium 5 group , Dorea, Enterobacter, Christensenellaceae and its genus Christensenellaceae R7 group . Differences in the functional potential of the microbial community between controls and adults with kidney disease or kidney stones were also identified. Only three of the 25 articles presented dietary data, and of these studies, only two used a valid dietary assessment method. The gut microbiota profile of adults with kidney disease and kidney stones differs from controls. Future study designs should include adequate reporting of important confounders such as dietary intake to assist with interpretation of findings.
Publisher: Cambridge University Press (CUP)
Date: 09-05-2023
DOI: 10.1017/S0007114523001101
Abstract: Despite evidence for favourable health outcomes associated with plant-based diets, a database containing the plant and animal content of all foods eaten is required to undertake a reliable assessment of plant-based diets within a population. This study aimed to expand an existing Australian food database to include the plant and animal content of all whole foods, beverages, multi-ingredient products and mixed dishes. Twenty-three plant- and animal-based food group classifications were first defined. The food servings per 100 g of each product were then systematically calculated using either a recipe-based approach, a food label-based approach, estimates based on similar products or online recipes. Overall, 4687 (83·5 %) foods and beverages were identified as plant or plant-containing products, and 3701 (65·9 %) were animal or animal-containing products. Results highlighted the versatility of plant and animal ingredients as they were found in various foods across many food categories, including savoury and sweet foods, as well as discretionary and core foods. For ex le, over 97 % of animal fat-containing foods were found in major food groups outside the AUSNUT 2011–2013 ‘fats and oils’ group. Surprisingly, fruits, nuts and seeds were present in a greater percentage of discretionary products than in core foods and beverages. This article describes a systematic approach that is suitable for the development of other novel food databases. This database allows more accurate quantitative estimates of plant and animal intakes, which is significant for future epidemiological and clinical research aiming to investigate plant-based diets and their related health outcomes.
No related grants have been discovered for Jordan Stanford.