RRD 29: Programme N02 - Diet and cardiovascular health
Wednesday 8 October 2008
Deadline for receipt of applications: 19 December 2008 (3 requirements)
The Agency aims to provide the best possible advice to consumers on a healthy, balanced diet. This research programme aims to provide evidence to develop dietary recommendations and help reduce diet-related disease.
The Scientific Advisory Committee on Nutrition informs the Agency by evaluating the evidence to provide up-to-date and targeted advice for consumers. The Agency gathers evidence, by commissioning research, to support this e.g. for the determination of dietary recommendations.
The aim of the Diet and Cardiovascular Health Programme is to provide sound scientific evidence on the biological effects of diet on cardiovascular health, which can be used in the formulation of healthy eating recommendations for consumers. The scientific and technical objectives of the programme focus on long-term, human in vivo intervention studies examining the effects of dietary modifications on cardiovascular health.
The Impact of Cardiovascular Disease in the United Kingdom
According to the latest available figures from the British Heart Foundation, diseases of the heart and circulation (cardiovascular disease or CVD) remain the main cause of death in the United Kingdom. CVD accounted for 197,767 deaths or 35% of all deaths in 2006.
The main forms of CVD are coronary heart disease (CHD) and stroke. In 2006, CHD accounted for 94,381 deaths (1 in 5 deaths in men and 1 in 7 deaths in women) and stroke for 55,098 deaths. CHD was responsible for 19% of premature (under the age of 75) deaths in men and 10% of premature deaths in women. CHD death rates have been falling since the late 1970s and for adults under 65 years they have fallen by 46% in the last 10 years. However, while CHD death rates are falling rapidly, morbidity from CHD and other heart disease is rising. About 851,000 people in the United Kingdom have had a heart attack and over 1.1million of those aged 35-75 are suffering from angina. In addition, about 707,000 people have definite heart failure.
Deaths from CHD vary geographically, between socio-economic groups and between different ethnic groups. Death rates are highest in Scotland, and the North of England, lowest in the South of England and intermediate in Wales and Northern Ireland. Premature death rates are falling faster in non-manual than manual workers. Death rates are also higher in South Asians living in the United Kingdom. Although death rates from CHD in the United Kingdom are much lower than those in the countries of Eastern and Central Europe they are not falling as fast as they are in some other countries e.g. Australia and Norway.
Risk factors for CHD include smoking, physical activity, overweight and obesity, alcohol, psychosocial wellbeing, blood pressure, blood cholesterol, diabetes and diet. It has been estimated that 58% of the fall in CHD death rates can be attributed to reductions in the major risk factors.
Diet
Dietary constituents such as lipids, carbohydrates, minerals, vitamins and other bioactive compounds (e.g. polyphenols, carotenoids), have been associated with a possible reduced risk of developing different diseases including CVD, as have certain foods such as fish, fruits, vegetables, pulses, nuts and wholegrain cereals. Work undertaken as part of this programme aims to examine the effects of the relative quantities of different foods and dietary constituents on cardiovascular health. Current dietary recommendations are incomplete and more evidence is required.
Numerous observational studies present consistent evidence that diets rich in plant foods (e.g. fruits, vegetables, pulses, nuts and wholegrain cereals) protect against CVD. These observations have led to the recommendation (e.g. the government white paper on ‘Choosing Health’) that populations with high rates of CVD, such as the UK, should substantially increase their consumption of fruit and vegetables. Despite dietary intakes and plasma levels of antioxidants being inversely associated with CVD risk, intervention trials supplementing with antioxidant nutrients have failed to show any consistent benefit on CVD risk, and some trials have even suggested possible harmful effects e.g. the effects of vitamin E supplements on total mortality and mortality from heart failure. There are limited experimental data exploring the relationship between plant food consumption and CVD risk.
There is, therefore, a need for adequately powered randomised controlled trials to further assess and quantify the dose-response effects that different foods and their constituents have on cardiovascular health.
Research Requirements guidance
Proposals will be judged using the following criteria: relevance to the research requirements; scientific quality; and value for money. The full list of selection criteria can be found on page 4 of the Research Requirements background and instructions document.
Proposals should have public health relevance. It is anticipated that this objective will be achieved by randomised controlled trials. Potential contractors should be able to demonstrate a track record of carrying out human feeding trials.
One page summaries should be submitted to the Programme Advisor in the first instance. Full proposals can only be accepted if a one page summary has been first approved by the Programme Advisor.
Proposals should have the following characteristics:
- Method development should be avoided
- Free living populations should be studied and effective recruitment strategies and tests of compliance should be in place
- Intakes of nutrients studied should be those achievable through diet. Proposals which study intakes of nutrients outside this range will not be funded
- Single meal studies and short-term dietary interventions should be avoided
- Studies incorporating a dose response element of the effects of foods and/or nutrients on CVD risk rather than mechanisms of effects will be viewed favourably
- Intervention trials should be powered to 90%
The reporting of nutrition intervention trials will be expected to conform to the CONSORT (Consolidated Standards of Reporting Trials) statement (http://www.consort-statement.org). Successful applicants will be expected to register trials, e.g. with Current Controlled Trials (www.controlled-trials.com) or the Cochrane Central Register of Controlled Trials.
Research / Survey Requirements (3 requirements)
The effects of implementing current United Kingdom dietary recommendations on cardiovascular disease risk factors and vascular function
Cardiovascular disease is the major cause of death and ill-health in the United Kingdom. One task for the Agency is to improve the evidence base for dietary recommendations aimed at reducing the risk of this disease. Existing dietary recommendations in the United Kingdom are based on the scientific evidence on the effects of foods and nutrients on the risk of cardiovascular disease. The four current dietary recommendations are i) a quantitative recommendation to reduce saturated fat intakes, ii) a quantitative recommendation to increase fruit and vegetable consumption, iii) a quantitative recommendation to increase the consumption of fish and fatty fish and iv) a qualitative recommendation to increase the consumption of foods containing whole grain. The combined effect of implementing all four dietary recommendations on the risk of cardiovascular disease is unknown. Accordingly there is a strong case for testing the effects of all these dietary recommendations on cardiovascular disease risk factors and vascular function.
This research requirement will involve an intervention trial investigating the effects of the habitual UK diet compared to a diet that encompasses the current UK Government dietary recommendations on cardiovascular disease risk factors.
Applicants may wish to view the Agency’s practical guidance, including weekly example menus to help caterers across the UK provide food that meets the nutritional needs of adults.
Proposals are therefore invited to:
| Requirement Reference: N02R0009 - Study the effects of implementing current United Kingdom dietary recommendations on cardiovascular disease risk factors and vascular function |
Consumption of different types of fruit or vegetables on cardiovascular disease risk factors and vascular function
Current dietary recommendations include advice to increase the consumption of fruit and vegetables to five portions a day. The scientific evidence for this recommendation is derived almost entirely from epidemiological studies rather than the more desirable intervention trials. In order to improve the evidence base, the Agency funded two of the first intervention trials in the world on the effects of fruit and vegetable consumption on cardiovascular disease risk, both of which have now been completed. One trial demonstrated beneficial effects of fruit and vegetables on the vascular system while the other found no effect. Fruit and vegetables are a large food group and there are many possible interventions some of which will be effective and others which will not be. There is a strong case for moving on to the next stage of this research by identifying which types of fruit and vegetable are effective.
Proposals on the effect of tomatoes or flavonoid rich fruit and vegetables are not invited, as the agency is currently funding a project in this area.
Proposals are therefore invited to:
| Requirement Reference: N02R0010 - Study the effects of consumption of different types of fruit or vegetables on cardiovascular disease risk factors and vascular function |
Additional and novel policy relevant information using biological samples from completed and ongoing dietary intervention trials funded by the Food Standards Agency under the diet and cardiovascular health research programme
A major objective of the Diet and Cardiovascular Health research programme is to carry out dietary intervention trials, on the relationship between foods and nutrients and the risk of developing cardiovascular disease. Such studies provide the best possible scientific evidence for dietary recommendations aimed at reducing the risk of this disease. Over recent years, FSA have funded some of the biggest intervention trials in the world. In many cases, samples of blood and other body fluids have been stored at low temperature for subsequent but as yet undecided analyses. The more useful analyses that are carried out on intervention trial samples the greater the value for money. In the light of advances in the science it is now easier to see what these additional analyses should be. Accordingly there is a strong case for inviting scientists in charge of completed or ongoing FSA funded intervention trials to apply for funding to support additional and novel analyses.
Proposals are therefore invited to:
| Requirement Reference: N02R0011 - Obtain additional and novel policy relevant information using biological samples from completed and ongoing dietary intervention trials funded by the FSA under the diet and cardiovascular health research programme |
Further Information
Applicants must discuss their proposals with the programme advisor and submit an outline application (one side of A4) to the programme advisor prior to submitting a full application.
FULL PROPOSALS WILL BE REJECTED, WHERE THE PROGRAMME ADVISOR HAS NOT APPROVED A ONE PAGE OUTLINE.
Programme advisor: Dr John Stanley
Tel. 07837940615
E-mail: john.stanley@trinity.ox.ac.uk
Full proposals should be sent, to be received by 17:00 hrs on Friday 19 December 2008 to:
E-mail: FSA_Remind@foodstandards.gsi.gov.uk
Post:
Joanne Tongue
Nutrition Division
Food Standards Agency
Aviation House
125 Kingsway
London WC2B 6NH
See also
(pdf 63KB)