Modelling the public health benefits of fibre fortification in the Chinese population through food reformulation.

OBJECTIVES: Various studies have highlighted how consuming adequate dietary fibre (DF) foods could confer multiple potential health benefits to humans, though data suggested that the average intake of the population is below the recommendations. The aim of this study, which involved probabilistic, mathematical and statistical modelling, was to understand, for the first time, how fibre fortification in a broad array of food categories could impact the diet and health status of Chinese consumers. DESIGN: A simulation-based approach was used to examine the potential impact of fibre fortification. The China Health and Nutrition Survey dataset was used to evaluate intakes of DF together with a dietary intake mathematical model. Commercially manufactured foods and beverages eligible for fibre fortification were identified and a total of 296 food and beverages were selected for fibre fortification calculation. Foods and beverages eligible for fibre fortification and the concentration of fibre used at intervention were identified based on Chinese legislations and regulations of nutrition label claims. Populations who meet the dietary reference values of fibre fortification have their health outcomes such as weight, cardiovascular disease (CVD) and type 2 diabetes risk quantified prefibre and postfibre reformulation as per published studies. RESULTS: The simulated fibre fortification intervention model has shown that the mean DF intake increased by 13.28%, from 12.8 g/day of baseline to 14.5 g/day, leading to an increase of 48% (from 6.85% to 10.13%) and 54% (from 14.22% to 21.84%) of the adult and children population, respectively, achieving the recommended fibre guidelines. Additionally, 234 diabetes cases per day (85 340 cases per year) as well as 73 065 deaths secondary to CVD could also potentially be averted or delayed with the increase of DF intake via fibre fortification. CONCLUSIONS: This study provides a practical application implicating the potential public health benefits that could be achieved with food product reformulation.

Reliability and concurrent validity of knee angle measurement: smart phone app versus universal goniometer used by experienced and novice clinicians.

The use of goniometers to measure joint angles is a key part of musculoskeletal practice. Recently smartphone goniometry applications have become available to clinicians. This study examined the intra- and inter-measurer reliability of novice and experienced clinicians and the concurrent validity of assessing knee range of motion using a smartphone application (the Knee Goniometer App (Ockendon(©))) (KGA) and a standard universal goniometer (UG). Three clinicians, each with over seven years' experience as musculoskeletal physiotherapists and three final year physiotherapy students, measured 18 different knee joint angles three times, using both the universal goniometer and the smartphone goniometric application. The universal goniometer and the smartphone goniometric application were reliable in repeated measures of knee flexion angles (average Concordance Correlation Coefficient (CCC) > 0.98) with both experienced clinicians and final year physiotherapy students (average CCCs > 0.96). There were no significant differences in reliability between the experienced and the novice practitioners for either device. Agreement between the universal goniometer and smartphone goniometric application measurements was also high for all examiners with average CCCs all above 0.96. The Standard Error of Measurement ranged between 1.56° (0.52-2.66) for the UG and 0.62° (0.29-1.27) for the KGA. The universal goniometer and the smartphone goniometric application were reliable in repeated measures of knee flexion angles. Smaller error of measurement values for the smartphone goniometric application might indicate superiority for assessment where clinical situations demand greater precision of knee range of motion.

Functional expression of the gene encoding cytidine triphosphate synthetase from Plasmodium falciparum which contains two novel sequences that are potential antimalarial targets.

CTP synthetase (E C 6.3.4.2 UTP: ammonia ligase (ADP-forming)) catalyses the formation of CTP from UTP and, in the human parasite Plasmodium falciparum, is the sole source of cytidine nucleotides. It is thus a potential chemotherapeutic target, especially as the gene sequence indicated that the encoded GAT-domain of the enzyme contains two extended peptide segments (42aa and 223aa as compared to the host enzyme). Here, we circumvent the codon usage problems associated with the high A/T content of the P. falciparum sequence, especially evident in sequences encoding the extra peptides, to successfully express active recombinant P. falciparum CTP synthetase using preferred E. coli codons. This partially synthetic gene produced recombinant enzyme, containing the additional segments, which was functionally assayed for activity in vitro. We also show the native enzyme contains the additional peptides using immunoblots with antibodies derived from the recombinant protein. Confocal microscopy, using antibodies to the recombinant protein, provided evidence that the enzyme is expressed in vivo. This establishes for the first time that P. falciparum contain active CTP synthetase and that this enzyme contains two novel insert sequences in the functional enzyme.