Charlotte Atkinson's research while affiliated with University of Bristol and other places
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Publications (92)
Background:
Diet is a common concern amongst people with an ileostomy as it can be associated with serious and burdensome complications, e.g., dehydration and obstruction, and dietary advice is often unsatisfactory. In this study, we explored healthcare professionals' (HCPs) perspectives on dietary advice for ileostomy management.
Methods:
Semi-...
Background:
People with ileostomy are frequently advised to avoid specific foods and food groups, making it plausible that they are at risk of a range of nutrition-related adverse health consequences. Despite this there has been no recent study in the UK describing dietary intake, symptoms, and food avoidance in people with ileostomy or post-rever...
Background
Current guidance on pre-operative fasting for clear fluids to reduce aspiration risk may result in unnecessary dehydration and more liberal fluid regimes are being advocated.
Methods
This randomised single blinded crossover study used an established ultrasound protocol to measure the gastric volume of 15 healthy volunteers following the...
Background:
Debate remains regarding whether to recommend a low iodine diet (LID) prior to radioactive-iodine treatment and its duration and stringency. This mixed-methods review aimed to determine if iodine status affects treatment success, the most effective diet to reduce iodine status, and how LID impacts wellbeing.
Methods:
Five electronic...
Background and Aims
Patients with differentiated thyroid cancer are often advised to follow a low iodine diet (LID) one to two weeks before radioiodine remnant ablation (RRA). We describe treatment practices and ablation success rates in centres (C1, C2, C3) in the UK with different approaches to LID advice.
Methods
Historic cohort of patients wit...
Objective
To determine the benefits and harms of pre-admission interventions (prehabilitation) on postoperative outcomes in patients undergoing major elective surgery.
Design
Systematic review and meta-analysis of randomised controlled trials (RCTs) (published or unpublished). We searched Medline, Embase, CENTRAL, DARE, HTA and NHS EED, The Cochra...
Objective:
To identify and map the evidence for oral dietary management of ileostomies.
Introduction:
Dietary advice is commonly provided for ileostomy management but can be inconsistent, conflicting, and inadequate. There is a lack of high-quality research investigating dietary management of ileostomies. This scoping review highlights gaps in t...
Background and aims
The home parenteral nutrition (HPN) population face many challenges, especially with respect to fluid balance management. A low urinary sodium concentration of <20 mmol/L is commonly used as an indicator of dehydration that requires clinical assessment in these patients. The Quantab titrator dipstick measures chloride concentrat...
Background International guidelines on the treatment of differentiated thyroid cancers promote low iodine diets (LID) before radioiodine remnant ablation. Evidence that the LID ultimately improves treatment success is inconsistent. This study aimed to determine if there is a difference in ablation success rates according to provision of advice to f...
Background and aims
International guidelines on the treatment of differentiated thyroid cancers (DTC) promote the use of low iodine diets (LID) prior to radioactive iodine remnant ablation (RIA), as high iodine status may interfere with radioiodine uptake. Most UK treatment centres adhere to these guidelines and advise people to consume a LID. Ther...
Aim
To explore whether people with an ileostomy in the UK and Ireland receive the dietary advice they require.
Method
An online survey with multiple choice questions asked people with an ileostomy about the dietary advice they received and would have preferred to receive. Participants were recruited via websites of the Ileostomy and Internal Pouch...
Objectives:
The objective of this study was to explore potential relationships between neonatal line (NNL) width and early life history variables such as maternal health, gestation, the birth process, and perinatal health.
Materials and methods:
Histological thin sections of deciduous canines were studied from 71 children from the Avon Longitudi...
Background and aims
Early post-operative feeding is recommended within enhanced recovery after surgery programmes. This study aimed to describe post-operative feeding patterns and associated factors among patients following colorectal surgery, using a post-hoc analysis of observational data from a previous RCT on chewing gum after surgery.
Methods...
Background:
Guidelines suggest that a low iodine diet (LID) is advised prior to radioiodine ablation (RIA) for thyroid cancer. We aim to describe current practice regarding LID advice in the UK, determine uptake of the 2016 UK LID Working Group diet sheet and discover whether there are differences in practice.
Methods:
We used an online survey d...
Background:
Capecitabine and oxaliplatin (CAPOX) chemotherapy is a standard treatment for stage 2/3 colorectal cancer. Treatment is associated with dose-limiting toxicities such as neutropenia, vomiting, diarrhoea, and stomatitis. Short-term fasting prior to chemotherapy may help protect normal cells from the toxic effects of chemotherapy by allow...
Background:
Diets that restrict energy or macronutrient intake (e.g. fasting/ketogenic diets (KDs)) may selectively protect non-tumour cells during cancer treatment. Previous reviews have focused on a subset of dietary restrictions (DR) or have not performed systematic searches. We conducted a systematic scoping review of DR at the time of cancer...
Background:
This is an update of the review last published in 2011. It focuses on early postoperative enteral nutrition after lower gastrointestinal surgery. Traditional management consisted of 'nil by mouth', where patients receive fluids followed by solids after bowel function has returned. Although several trials have reported lower incidence o...
Background:
This is an update of the review last published in 2011. It focuses on early postoperative enteral nutrition after lower gastrointestinal surgery. Traditional management consisted of 'nil by mouth', where patients receive fluids followed by solids after bowel function has returned. Although several trials have reported lower incidence o...
Review question/objective:
The objective of this scoping review is to identify and map the evidence for oral dietary management of ileostomies.The primary review question is: what oral dietary strategies for managing ileostomies in humans have been reported?Secondary review questions are: i) what types of evidence have considered oral dietary stra...
Background:
Patients with head and neck cancer are often malnourished. Surgery for such cancers is complex and may be undertaken after a course of radiotherapy. As a result, patients may have postoperative complications such as fistulae and wound infections, as well as more generalised infections such as pneumonia. One possible way to enhance reco...
[This corrects the article DOI: 10.1371/journal.pone.0195890.].
Introduction:
The Enhanced Recovery After Surgery programme (ERAS) is an approach to the perioperative care of patients encompassing multiple interventions and involving a wide range of different actors. It can thus be defined as a complex intervention. Despite the strength of the evidence-base in its support, the implementation of ERAS has been s...
ERAS key components and actors.
(PDF)
Background:
It has been proposed that maternal folic-acid supplement use may alter the DNA-methylation patterns of the offspring during the in-utero period, which could influence development and later-life health outcomes. Evidence from human studies suggests a role for prenatal folate levels in influencing DNA methylation in early life, but this...
The mechanisms by which obesity increases cancer risk are unclear, but some lines of evidence suggest that gut microbial communities (GMC) may contribute to chronic inflammation in obese individuals through raised systemic levels of lipopolysaccharides (LPS). We evaluated associations of the GMC in stool with plasma LPS-binding protein (LBP, a meas...
Background & aims
Urinary sodium concentration is a commonly used marker for extracellular fluid depletion which is often associated with dehydration. A point of care test for urinary sodium may reduce delays in clinical decision making by offering more timely guidance leading to improved salt and fluid management. We compared laboratory assessed u...
Background
The Enhanced Recovery After Surgery (ERAS) programme is an approach to the perioperative care of patients which aims to improve outcomes and speed up recovery after surgery. Although the evidence base appears strong for this programme, the implementation of ERAS has been slow. This study aimed to gain an understanding of the facilitating...
Background
Poor physical health and fitness increases the risk of death and complications after major elective surgery. Pre-admission interventions to improve patients’ health and fitness (referred to as prehabilitation) may reduce postoperative complications, decrease the length of hospital stay and facilitate the patient’s recovery. We will condu...
Background:
Chewing gum may stimulate gastrointestinal motility, with beneficial effects on postoperative ileus suggested in small studies. The primary aim of this trial was to determine whether chewing gum reduces length of hospital stay (LOS) after colorectal resection. Secondary aims included examining bowel habit symptoms, complications and he...
Equol (a bacterial metabolite of the soy isoflavone daidzein) is produced by 30-50% of humans and may be associated with health outcomes. We hypothesized that plasma equol would be inversely associated with risks of fibrocystic breast conditions (FBC) and breast cancer (BC). Plasma from women in a breast self-examination trial in Shanghai with BC (...
Appendix S1. Topic guide.
Aim:
Nutrition is an important element of the Enhanced Recovery After Surgery (ERAS) programme. Patients have previously indicated that nutrition is a key ERAS component requiring improvement. Our aim was to explore perioperative nutrition experiences of colorectal surgical patients, to identify barriers and facilitators to the integration of nutr...
Supplemental periconceptional folic acid is recommended to reduce the risk of fetal neural tube defects. A previous report indicated an elevated risk of breast cancer and all cancer deaths in later life among women randomised by alternate allocation to high-dose (5 mg/day) folic acid in pregnancy compared with placebo; however, findings were based...
Background:
Ileus commonly occurs after abdominal surgery, and is associated with complications and increased length of hospital stay (LOHS). Onset of ileus is considered to be multifactorial, and a variety of preventative methods have been investigated. Chewing gum (CG) is hypothesised to reduce postoperative ileus by stimulating early recovery o...
Background: Lignans in plant foods are metabolized by gut bacteria to the enterolignans, enterodiol (END) and enterolactone (ENL). Enterolignans have biologic activities important to the prevention of cancer and chronic diseases. We examined the composition of the gut microbial community (GMC) as a contributor to human enterolignan exposure. Method...
Estrogen exposure plays a role in breast cancer (BC) development. A novel estrogen biomarker, the estrogen DNA adduct (EDA) ratio, was shown to be elevated in women at high-risk of BC and among BC cases. Modifiable factors may impact the EDA ratio, with studies demonstrating that resveratrol reduces EDA ratio in vitro. We sought to examine the hypo...
This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review is to examine whether chewing gum after surgery hastens the return of gastrointestinal function. The review will consider the impact of chewing gum on indicators of bowel function (time to first passage of flatus, bowel movement a...
Background/objectives:
Studies have observed associations between the gut microbiome and obesity. O-desmethylangolensin (ODMA) and equol are gut bacterial metabolites of daidzein, a compound found in high amounts in soy foods. Approximately 80-95% and 25-60% of individuals harbor gut microbial communities capable of producing ODMA or equol, respec...
Background: An expansive body of evidence implicates estrogen in the development of breast cancer (BC). Recently, a novel estrogen biomarker, the genotoxoic estrogen ratio (GER), was shown to be associated with BC. In addition, an elevated GER was observed in women at high-risk of BC, and furthermore, high GER has been shown to be reversible. Becau...
Background:
Bone density has been suggested as a marker of cumulative hormone exposure. Small studies also suggest that patterns of daidzein metabolism may be related to hormone concentrations. To our knowledge, no studies in premenopausal women have compared bone density by daidzein-metabolizing phenotypes in the absence of a soy intervention.
O...
Urinary concentrations of 2:16-hydroxyestrone (2:16-OHE1) approximate concentrations of 2-OHE1 and 16α -OHE1 in breast tissue. As estrogens are purported to be involved in breast cancer development, the 2:16-OHE1 ratio can provide an indication of estrogen metabolite exposure in the breast. With prior studies observing associations between urinary...
Few population-based longitudinal studies on diet and stroke have been conducted, and associations between dietary fat and fish intake and risk of stroke are unclear.
To prospectively examine relationships between intakes of total fat, saturated fat, unsaturated fat, white fish and oily fish and risk of stroke in a well-defined population of 2710 m...
Cadmium, a persistent and widespread environmental pollutant, has been associated with kidney function impairment and several diseases. Cigarettes are the dominant source of cadmium exposure among smokers; the primary source of cadmium in non-smokers is food. We investigated sources of cadmium exposure in a sample of healthy women.
In a cross-secti...
Mammographic density (MD), a strong marker of breast cancer risk, is influenced by genetic, environmental, and hormonal factors. Cadmium, a persistent and widespread environmental pollutant, has been associated with risk of breast cancer, and laboratory evidence suggests cadmium is a carcinogen in the breast. We investigated the hypothesis that cad...
s: AACR International Conference on Frontiers in Cancer Prevention Research‐‐ Nov 7-10, 2010; Philadelphia, PA
Background: Mammographic density (MD), a strong marker of breast cancer risk, is influenced by genetic, environmental, and hormonal factors. Cadmium, a persistent and widespread environmental pollutant, has been associated with risk of br...
Glucuronidation, catalyzed by UDP-glucuronosyltransferases (UGT) and sulfation, catalyzed by sulfotransferases (SULT), are pathways through which sex steroids are metabolized to less active compounds. These enzymes are highly polymorphic and genetic variants frequently result in higher or lower activity. The phenotypic effects of these polymorphism...
Sex hormones are metabolized to less active compounds via (a) glucuronidation catalyzed by UDP-glucuronosyltransferases (UGT) and (b) sulfation catalyzed by sulfotransferases (SULT). Functional UGT and SULT polymorphisms can affect clearance of sex hormones, thereby influencing exposure in hormone-sensitive tissues, such as the breast. We assessed...
Providing an evidence base for the rational delivery of medicines and treatments is the cornerstone of modern health care
delivery. Much of this evidence base is gained through conducting clinical trials. Superficially, designing a clinical trial
seems straightforward. However, in practice many unforeseen difficulties arise with long setting up tim...
Mammographic breast and bone mineral densities (BMD) have been associated with luteal phase hormone concentrations in premenopausal women. We assessed the associations of breast and bone densities with follicular phase hormones and sex hormone binding globulin (SHBG) in premenopausal women, given that follicular phase hormones have been shown to be...
Mammographic breast density is an established marker of breast cancer risk, and is hormonally sensitive. Studies suggest that production of the daidzein metabolites equol and O-Desmethylangolensin (ODMA) may be associated with hormones and hormonally mediated factors, but few studies have assessed relationships between the capacity to produce these...
Steven J Thomas and colleagues think that recent changes in dental care provision have led to increased numbers of hospital admissions for dental abscess, and they suggest that access to routine and emergency dental care needs to be reviewed
Blood and urine concentrations of hormones are implicated in the etiology of some cancers. Small studies have assessed relationships between production of the daidzein metabolites equol and O-desmethylangolensin (ODMA) and hormones, but findings are unclear. We evaluated relationships between daidzein-metabolizing phenotypes and follicular phase co...
The soy isoflavone daidzein is metabolized to equol and O-desmethylangolensin (ODMA) by intestinal bacteria in approximately 30-50% and 80-90% of persons, respectively. Studies suggest beneficial health effects associated with daidzein-metabolizing phenotypes; thus, assessing their determinants is an important goal.
We evaluated relations between d...
Naturopathic physicians commonly make dietary and/or dietary supplement recommendations for breast cancer prevention. This placebo-controlled, parallel-arm, pilot study tested the effects of two naturopathic interventions over five menstrual cycles on sex steroid hormones and metabolic markers in 40 healthy premenopausal women. The intervention arm...
Uterine fibroids are hormonally responsive; estradiol and progesterone stimulate their growth, and gonadotrophin-releasing hormone agonists shrink them. Phytoestrogens, including isoflavones and lignans, can act as weak estrogens or antiestrogens.
The objective of this case-control study was to evaluate the relation between uterine fibroid risk and...
Phytoestrogens occur naturally in plants and are structurally similar to mammalian estrogens. The lignans are a class of phytoestrogen and can be metabolized to the biologically active enterolignans, enterodiol, and enterolactone by a consortium of intestinal bacteria. Secoisolariciresinol diglucoside (SDG), a plant lignan, is metabolized to entero...
Interindividual differences in metabolism of the soy isoflavone, daidzein, to equol and O-desmethylangolensin (ODMA) by human gut bacteria, have been associated with altered risk of cancer and other chronic diseases, according to some studies. Differences have been reported in the prevalence of the equol-producer phenotype among populations, with a...
Particular intestinal bacteria are capable of metabolizing the soya isoflavone daidzein to equol and/or O-desmethylangolensin (O-DMA), and the presence of these metabolites in urine after soya consumption are markers of particular intestinal bacteria profiles. Prevalences of equol producers and O-DMA producers are approximately 30-50 % and 80-90 %,...
The indigenous intestinal microflora are involved in a variety of processes within the human body, and are important for maintaining host health. As such, interindividual differences in the ability to harbor certain intestinal bacteria might be associated with interindividual differences in health and/or disease susceptibility. In the last decade t...
Particular intestinal bacteria metabolize the soy isoflavone daidzein to equol and O-desmethylangolensin (O-DMA), metabolites that can be identified in urine. Individuals that harbor bacteria capable of producing equol or O-DMA are known as equol producers (approximately 30%-50% of the population) and O-DMA producers (approximately 80%-90% of the p...
Physical activity has been associated with reduced breast cancer risk, potentially via hormonal pathways, and high urinary excretion of 2-hydroxyestrone (2-OH E(1)) relative to 16alpha-hydroxyestrone (16alpha-OH E(1)) also has been associated with reduced breast cancer risk. Studies suggest that body composition and exercise can influence estrogen...
Equol and O-desmethylangolensin (O-DMA) are products of bacterial metabolism of daidzein, an isoflavone in soybeans; thus, the presence or absence of equol and/or O-DMA in urine is a marker of particular intestinal bacteria profiles. Plasma hormone concentrations may be lower in pre-menopausal women who harbor the bacteria capable of producing equo...
Daidzein can be metabolized to equol, dihydrodaidzein (DHD), and O-desmethylangolensin (ODMA) by intestinal bacteria. Only one third to one half of individuals produce equol, and evidence exists to support potential cancer-protective effects of equol production. We investigated the in vitro metabolism of daidzein by fecal bacteria and assessed the...
Women with high circulating estrogen concentrations have an increased risk of breast cancer; thus, it is important to understand factors, including genetic variability, that influence estrogen concentrations. Several genetic polymorphisms that may influence sex hormone concentrations have been identified, including CYP17 (5'-untranslated region T--...
Approximately one-third to one-half of individuals harbor the colonic bacteria that are capable of metabolizing the soy isoflavone daidzein to equol. Results of prior studies suggest beneficial effects of producing equol in relation to breast cancer risk, potentially through effects on endogenous hormones. High urinary excretion of 2-hydroxyestrone...
Dietary isoflavones are biologically active in humans, but few observational data exist on the relationship between isoflavone intake and excretion in Western populations. We examined associations between self-reported soy intakes and overnight urinary isoflavone excretion in a population-based sample of western Washington State women, and we inves...
Citations
... Some professionals may also lack clarity on the recommended duration, opting for longer durations to ensure effective low-iodine preparation. However, prolonged low-iodine diets pose challenges to patient compliance [7]. Conducting studies tailored to the Chinese diet and typical iodine levels will facilitate determination of the optimal duration of low-iodine diets, offering a reliable foundation for clinical practice relevant to the Chinese population. ...
... There is evidence in the literature that patients with reduced muscle mass or density are associated with worse surgical outcomes [11,21]. Targeted prehabilitation of patients with physiotherapy, exercise training and dietary optimisation has been shown to improve both short-term complications, including infection risk as well as long-term patient survival [22]. ...
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... Due to the fact that the major part of macro-and micronutrients are absorbed in the small intestine, ileostomy patients do not often develop any further nutrient deficiencies and should be encouraged postoperatively to follow a regular diet without any restrictions. Foods that are high in fiber and/or harder to digest such as dried fruit, wholegrains, popcorn, nuts, and raw cabbage may get stuck in the intestine causing a blockage or obstruction so it is important to chew food thoroughly [32,33]. If food blockage does occur, it is usually temporary, causing abdominal pain, and the ostomy output will either cease or contain excessive amounts of watery fluid. ...
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... It is found in the specific literature some reviews on the accuracy of these tests. 25,[33][34][35] According to Roberts, 36 emergency physicians order these analyses routinely when they can fully interpret the results. James et al. 35 comment that patients themselves can easily perform the test, which we believe it can be very useful for an instant assessment of a chemical panel. ...
... Moreover, the popularity of iodized salt raises concerns about the practicality of completely prohibiting its intake, which could potentially disrupt patients' lives. Herbert G et al. reported that poorly managed salt intake during a lowiodine diet led to signi cant reductions in food intake by patients [20]. Therefore, further empirical studies to inform evidence-based recommendations are required before completely prohibiting the use of iodized salt. ...
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... 12 Consequently, there are concerns regarding the perceived clarity and helpfulness of dietary advice being provided to people with an ileostomy from various sources, including healthcare professionals (HCP) and institutions, charities and support groups and stoma care companies, which can be a significant source of anxiety and confusion and prevent optimal stoma management. 11,13 Understanding current practice, knowledge and beliefs is important to identify where further research is needed and how provision of dietary advice may be improved. The aim of this study was to explore HCPs' perspectives on dietary advice for management of an ileostomy. ...
... Primary teeth (also known as deciduous, baby or milk teeth) are naturally exfoliated during childhood and are distinct in holding an extensive record of life experiences that occur during tooth formation, including maternal and perinatal health, gestation and birth conditions, health-related stress, [1][2][3][4] and toxin exposures from prenatal to postnatal periods. [5][6][7][8] Indeed, primary teeth may record both health risks 9 and positive life events. ...
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... 19 Simply put, they were not aware of the data supporting oral intake on day one post colon resection. [20][21] This led to an obstinate adherence to the traditional approach of initiating diet based on passage of flatus or a bowel movement. 19 Occasionally the nursing staff delayed discharge until the patient had their first bowel movement after surgery. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/278487349907460-1443407966299_Q64/Chris-Penfold.jpg)
... signi cant disparities in dietary recommendations among hospitals. This was consistent with previous ndings[15]. Clinicians' recommendations for thyroid cancer patients undergoing 131 I treatment differed depending on the time points in a "biological metabolism model". ...
... The analyses of relevant epidemiological surveys, meta-analysis results, and animal experimental data in recent years indicate that different dietary patterns have significant effects on the incidence of CRC. The Mediterranean diet, ketogenic diet, vegetarian diet, and restrictive diet may reduce the risk of CRC by improving and regulating gut microbiome homeostasis (Castejón et al., 2020;Dai et al., 2016;Farinetti et al., 2017;Godos et al., 2017;Shingler et al., 2019). Contrarily, diets usually involving a high intake of red and processed meats, high-fructose corn syrup, and unhealthy cooking methods tend to increase CRC risk (Hofseth et al., 2020). ...
