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Active ageing is presented as a potential panacea for the challenges faced due to population ageing. Work presented in this Thesis improves the integration and evaluation of sensor technology, embedded within a clothing system, designed specifically for the active ageing. A review of wearable sensors highlighted issues involving sensor integration, placement, validation and the effects of body shape and size as key challenges. These issues guided the focus of four studies within the Thesis. A study assessing the effect placing an accelerometer within clothing had on step count accuracy has been undertaken. Results demonstrated that a reliable step-count can be achieved from accelerometers placed within clothing at the sternum, waist or lower back. Subsequently, an investigation into the optimal location of an accelerometer to classify a range of everyday activities was perfonned. Results demonstrated data from the hip as the best single location to perfonn activity recognition. Following on from this, 3D body scanning was used to assess the effect of adiposity on the accuracy of step count obtained from an accelerometer. This study established that neither BMI, waist circumference nor ABVol had an effect on step count accuracy obtained from an accelerometer placed at the chest, waist or lower back. This adds clarity to the current inconsistencies within the literature. Considering a different fonn of sensor technology, the perfonnance of textile electrodes, integrated within custom fitted garments was investigated. Performance tests indicated that the custom garments did not perform accurately during tasks which included movement of the arms and torso. The performance during these tasks, did, however, vary considerably between subjects. The incorporation of these findings within the design of smart garments will help to ensure that wearable sensors and systems meet their potential, particularly in the role of supporting the health and wellbeing of an active ageing society.

Progress has been made in research identifying relationships between the food we eat, the lifestyles we lead, and the prevention of illness. We should each consume a minimum level of fruit and vegetables, 400g daily, to reduce incidence of ‘chronic lifestyle diseases’, with vast aggregate social and financial implications. Despite political intervention, however, and a focus upon ‘5 A Day: Just Eat More’, there persists a general under consumption, with the concept of ‘Food Choice’ at the explanatory forefront. Most research on fruit and vegetable consumers has focussed on those who do not meet the daily recommended levels, identifying ‘barriers’ that restrict choice. This research however places the investigative emphasis on those who do attain the 5 A Day target, described in this study as ‘High’ fruit and vegetable consumers, exploring the reasons for this success and the management of high levels of fruit and vegetables within the diet. A mixed method approach to investigate consumers in South East Northumberland was employed, using purposeful sampling and integrating research stages. Empirical and policy sources were investigated, and life course model implied as useful. Following discussions with health professionals and clinicians, in-depth exploratory interviews were conducted with mainly High (17/19) fruit and vegetable consumers. Results identified themes: general health, specific ill-health, spousal relationship with food, children, food history, seasonality, shopping, taste and flavour, time, and personal relationship with fruits and vegetables. These affected both quantity and type of vegetables and fruit consumed, and ‘how’ consumption was managed. A series of conceptual ‘reasons’ for high consumption were indicated though not all reasons experienced by all consumers to the same extent at the same time. The main constructs are; ‘Environment(s)’, ‘Information(s)’, ‘Motivation(s)’, ‘Aims & Goals’, ‘Triggers / Trigger Point(s)’, and ‘Strategies and Management’. A typology was also proposed to categorise consumers based on enthusiasm, and consciousness towards High consumption. A consumer survey, based on the identified themes, was completed by 239 respondents (148 High). It included a seven day food frequency questionnaire of nutritionally linked fruit and vegetable items. Factor Analysis was applied to both sections of the questionnaire, and subsequently Cluster Analysis. 34 factors were identified for attitude and behaviour. Of these, 16 exhibited significant mean difference between High and Low consumers. Six clusters were derived, with defining features between clusters being reasons for consumption, general enthusiasm and mood. 12 factors were derived as underlying the fruit and vegetable consumption itself. Both the qualitative and quantitative stages of the research identified distinct types of fruit and vegetable consumer, implying an importance, not only of specific drivers to fruit and vegetable consumption, but also fruit and vegetable “consciousness”, and levels of specific and general enthusiasm. Hence policy needs to recognise and target those influences and benefits specific to groups. It also needs to support both irregular and regular levels of High consumption, as well as the opportunity to target specific fruit and vegetable dietary patterns in relation to, for example, seasonality social consumption. Understanding how high levels of fruit and vegetable consumption is achieved and negotiated amidst other influences has been indicated as of real value to further research.

Short term food choices can affect not only hunger, but can also affect mood and cognitive function, yet few studies have measured all three factors in a single study. The macronutrient composition of breakfast and diet influences mood, appetite and cognitive function. This thesis describes a series of studies in healthy female subjects investigating the effects of breakfast, and manipulations of breakfast and diet composition on mood, appetite and cognitive function. In these studies subjects were provided with high fat, low carbohydrate (HFLC) and low fat, high carbohydrate (LFHC) breakfasts and diets. Study 1 found that breakfast provision (LFHC breakfast), in comparison to breakfast omission resulted in significant improvements in subjects' self reported ratings of mood and appetite, which were closely correlated with each other. Breakfast provision did not cause any significant changes in cognitive function, but this may be as a result of insufficiently demanding tests. The macronutrient composition of the breakfasts was modified in study 2 which found that the HFLC breakfast reduced subjective feelings of anger, reduced target reaction times and prevented a deterioration in the letter x accuracy task in comparison the LFHC breakfast. The HFLC and LFHC breakfast differed from subjects habitual breakfast composition. Study 3 and study 4 found that habitual breakfast consumption (in comparison to the HFLC and LFHC breakfasts) resulted in a much greater increase (relative to baseline) in subjective ratings of energy and placidity, a greater reduction in ratings of tiredness and a reduction in reaction times. Study 4 also found that consumption of a HFLC diet for 2 weeks resulted in an increase in subjective ratings of energy, whilst consumption of a LFHC diet resulted in a reduction. Consumption of both diets resulted in a reduction in ratings of tense and an increase in ratings of placidity at the second study visits.

The use of low-calorie sweeteners (LCSs) has increased considerably over recent decades and can now commonly be found in a wide range of both dietary and non-dietary products. Information on exposure to LCSs is a legislative requirement in the European Union (EU). Furthermore the health effects of LCS consumption remain an area of great scientific interest and therefore a method which assesses intakes more reliably than current methods would be highly desirable. A review of the literature revealed that several LCSs, namely acesulfame-K, saccharin, cyclamate, sucralose and steviol glycosides, may lend themselves well to the application of a urinary biomarker approach for assessing exposure as they are excreted relatively unchanged via the urine. Given that no analytical method has been published for the simultaneous determination of the compounds of interest in urine, a novel liquid chromatography tandem-mass spectrometry method of simultaneously determining acesulfame-K, saccharin, cyclamate, sucralose and the excretory product of steviol glycosides, steviol glucuronide, was developed and validated and shown to be accurate and precise. The analytical method was then used to validate a novel urinary biomarker approach for assessing short-term intakes of the five LCSs of interest. Two studies were conducted with the aims of investigating variation in 24-hour and spot urinary excretion in healthy subjects following a single oral dose containing all of the compounds of interest. A subsequent investigation into the relationship between the candidate biomarkers and the respective LCSs was carried out in a dose-response study where apparently healthy individuals were administered low, medium and high LCS doses relevant to a free-living population. It was shown that both fasting spot and 24-hour urine excretions were capable of distinguishing between low, medium and high intakes of acesulfame-K, saccharin, cyclamate and steviol glycosides while for sucralose, 24-hour urine excretion of sucralose was shown to be sensitive to high and low intakes. These results suggest that using a urinary biomarker approach may be useful for assessing exposure to these commonly consumed LCSs. The final study was carried out in collaboration with the National Institute for Public Health and the Environment, the Netherlands and involved the application of the analytical method to 24-hour urine samples for assessing intakes of the five LCSs of interest within a free-living A biomarker approach for the investigation of the intakes of low-calorie sweeteners Dutch population. Samples were previously collected in 2010 as part of a salt and iodine excretion study and LCS analysis revealed a high prevalence of exposure to multiple LCSs. Interestingly it also revealed that approximately 6% of the study population were exposed to steviol glycosides 12 months before it was approved in the EU, illustrating the usefulness of a biomarker approach for identifying exposure which may not have otherwise been detected. Based on the urinary excretion, intakes within this population were likely to be well within acceptable daily intakes, which is in agreement with previous exposure studies. However the ability to discern intakes of individual LCSs represents a significant advantage over some current research approaches. This thesis presents a novel urinary biomarker approach for the investigation of short-term exposure to five commonly consumed LCSs. The application of such an approach has a number of potential advantages over more traditional methods of monitoring exposure to LCSs which in turn, will enhance research into the health effects of these commonly used food additives.

Iron and zinc deficiency during pregnancy is common among women in low-income nations. In such settings, prenatal nutritional intervention is encouraged to improve pregnancy outcome. The impact of the intervention on transporter proteins involved in fetal nutrient supply is unexplored. This study investigated gene expression of some transporter proteins involved in fetal nutrient supply in the placenta. In a trial in rural Gambia, pregnant women at <20weeks of gestation were randomised to 4 nutritional intervention arms: i) Iron and folic acid (FeFol), representing the usual care ii) Multiple micronutrients (MMN) iii) Protein energy (PE) iv) MMN and PE (PE+MMN). All the intervention arms contained 60mg iron and 400μg of folic acid. FeFol and MMN interventions were given in tablet format, whereas PE and PE+MMN were in food format (lipid-based nutrient supplement- LNS). Maternal blood samples collected at booking, 20 and 30 weeks of gestation were assessed for iron levels, and zinc levels measured only the later samples. Gene expression of proteins involved in fetal iron, zinc, amino acid and glucose transport were measured on placental samples collected at birth. LNS (PE and PE+MMN) intervention was associated with low maternal iron status in late pregnancy and increased placental mRNA expression of the primary iron-uptake protein, transferrin receptor 1(TfR1). Intervention arms with no supplementary zinc (FeFol and PE) had lower maternal plasma zinc levels and increased placental mRNA expression of intracellular zinc-uptake proteins, ZIP1, ZIP4 and ZIP8. Different nutritional intervention strategies are associated with changes in maternal iron and zinc status during pregnancy and corresponding changes in the gene expression of placental iron and zinc uptake proteins. This might suggest differential fetal intrauterine response to the interventions. Understanding the role of the placenta in the delivery of nutrients to the fetus is important when considering intervention strategies.