Staff Profiles

Teaching

I am teaching on a number of modules on the Nutrition BSc and MSc courses. I am currently supervising BSc dissertation students, MSc students during their summer research projects and multiple PhD students.

Research Interests

I am interested in how the diet quality of people with neurological conditions can influence the severity of disease associated symptoms. I have been involved in many clinical trials to date and have worked with large cohorts including collaboration with the MRC and Multiple Sclerosis Register UK. One of my current interests includes the role of flavonoid rich sources for fatigue management in people with Multiple Sclerosis and Cancer. I am currently working on projects looking at diet quality and/ or metabolic parameters in vulnerable groups such as those with Parkinson's, Cerebral Palsy, UK Prisoners, and paediatric patients with neurological and autoimmune conditions. 

Research group membership

I belong to the Oxford Brookes Centre for Nutrition and Health (OxBCNH) and the Centre for Movement Occupational and Rehabilitation Sciences (MOReS; UoA3).

Research grants and awards

Central Research Grant, Oxford Brookes, April ‘15 - £ 19,885; PI

Title: The assessment of diet intake in relation to symptoms in people with Multiple Sclerosis using the MS Register cohort.

Multiple Sclerosis Society Project Grant, March ’15 – £ 75,000; CI

Title: The effect of flavonoid rich cocoa on fatigue in people with Multiple Sclerosis – a feasibility trial.

Supervisor for a Nutrition Society studentship, May ’17 - £2500; CI

Title: The effect of ketone supplementation on fatigue in people with Chronic Fatigue Syndrome.

Action Medical Research, March ’17 - £232,367; CI

Title: Standing up for Cerebral Palsy

Parkinson’s UK, Jan ‘16 - £29,973; CI

Title: First Steps for people with Parkinson’s’

Faculty Collaborative Learning/Teaching Proposal, December ’17 - £1382; PI

Title: OBU Centre for Movement, Occupational and Rehabilitation Sciences (MOReS) and Centre for Nutrition and Health (OxCNH): Student input into PPI (Patient and Public Involvement) initiatives and novel development of an important student skill set.

Alzheimer’s Research UK, Pilot Grant, Feb ’18 - £4,000; PI

Title: Does mitochondrial and bioenergetic functioning relate to physical and cognitive fatigue and fatigability in Parkinson’s: a model for the Dementias.

Oxford Brookes: Research Excellence Award Sept ’18 - £10,000; CI

To increase research impact

The National Institute for Health and Care Excellence (NICE) ’19 - £24,094; CI

Title: Involving children and young people in developing a NICE guideline on Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) diagnosis and management.

Oxford Brookes: Research Excellence Award Jan '21 - £19,400; PI

Title: Assessment of malnutrition in overweight and obese patients with cancer. 

Research impact

https://www.mssociety.org.uk/research/latest-research/latest-research-news-and-blogs/research-shows-hot-chocolate-could-help-reduce-fatigue?utm_source=Twitter&utm_medium=organic_post&utm_content=chocolate_flavonoid_research_tw&utm_campaign=2019M7202_0992

Further information

/shssw/research/centres-and-groups/mores/can/

/shssw/nutrition/research/oxbcnh/

Journal articles

• Grace Bennett, Elysia Young, Isabel Butler, Shelly Coe, 'The impact of lockdown during the COVID-19 outbreak on dietary habits in various population groups: a scoping review'
  Frontiers in Nutrition 8 (2021)
  eISSN: 2296-861X
  Abstract

  Background: Since the beginning of the COVID-19 pandemic, access to fresh food has been restricted, and people are spending more time inside and have limited their physical activity. However, more time at home may have resulted in some positive habits including an increase in cooking. The aim of this review was to assess dietary changes during the first lockdown. Themes and patterns were considered and associations with other lifestyle factors were assessed.

  Methods: Between June and July 2020, the PubMed, Google Scholar, and Science Direct databases were searched, and results were screened for eligibility based on title, abstract, and full text. The inclusion criteria of this search included: papers published (or in pre-print) in the year 2020; studies that investigated the impact of COVID-19 lockdown on diet; papers published in English. Exclusion criteria were as follows: papers examining dietary changes in those following a structured diet based on diagnosed conditions or dietetic advice; literature, systematic, or narrative studies reviewing previous research. Researchers agreed on the study characteristics for extraction from final papers.

  Results: Four thousand three hundred and twenty-two studies were originally considered with 23 final full-text papers included. Four themes were identified: dietary patterns, dietary habits (favorable), dietary habits (unfavorable), and other (includes physical activity levels, weight gain). A total of 10 studies reported an increase in the number of snacks consumed, while six studies found that participants increased their meal number and frequency during quarantine. Eleven studies reported favorable changes in dietary habits with an increase in fresh produce and home cooking and reductions in comfort food and alcohol consumption. However, nine studies found a reduction in fresh produce, with a further six reporting an increase in comfort foods including sweets, fried food, snack foods, and processed foods. Two studies reported an increase in alcohol consumption. In eight studies participants reported weight gain with seven studies reporting a reduction in physical exercise.

  Conclusion: The effect of COVID-19 lockdown both negatively and positively impacted dietary practices throughout Europe and globally, and negative diet habits were associated with other poor lifestyle outcomes including weight gain, mental health issues, and limited physical activity. Both in the short term and if sustained in the long term, these changes may have significant impacts on the health of the population.

  Website 
• Coe S, Tektonidis TG, Coverdale C, Penny , Collett J, Chu BTY, Izadi H, Middleton R, and Dawes H, 'A cross sectional assessment of nutrient intake and the association of the inflammatory properties of nutrients and foods with symptom severity, in a large cohort from the UK Multiple Sclerosis Registry.'
  Nutrition Research 85 (2020) pp.31-39
  ISSN: 0271-5317
  Abstract

  To assess the intake of nutrients in people with multiple sclerosis (pwMS) compared to a control population, and to assess the pro/ anti-inflammatory properties of nutrients/ foods and their relationships with fatigue and quality of life. This was a cross sectional study in which 2410 pwMS (686 men; 1721 women, 3 n/a, mean age 53 (11 years)) provided dietary data using a food frequency questionnaire that was hosted on the MS Register for a period of 3 months and this was compared to a cohort of 24,852 controls (11,250 male, 13,602 female, mean age 59 years). Consent was implied by anonymously filling out the questionnaire. A Wilcoxon test was used to compare intake between pwMS and controls, and a bivariate analyses followed by chi2 test were undertaken to identify significance and the strength of the relationship between pro/anti-inflammatory dietary factors and fatigue and EQ-5D. Compared to controls, all nutrients were significantly lower in the MS group (P < .05). Bivariate associations showed a significant correlation between consuming fish and lower clinical fatigue (χ2(1) = 4.221, P< .05), with a very low association (φ (phi) = −0.051, P = .04. Positive health outcomes on the EQ-5D measures were associated with higher carotene, magnesium oily fish and fruits and vegetable and sodium consumption (P < .05). Fiber, red meat, and saturated fat (women only) consumption was associated with worse outcomes on the EQ-5D measures (P < .05). pwMS have different dietary intakes compared to controls, and this may be associated with worse symptoms.
  

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• Saltaouras G, Coe S, Lightowler H, Watson E, 'Diet and nutrition information and support needs in pelvic radiotherapy: a systematic, mixed-methods review.'
  European Journal of Cancer Care x (2020)
  ISSN: 0961-5423 eISSN: 1365-2354
  Abstract

  Introduction: This study aimed to review diet and nutrition information and support needs of cancer patients who receive pelvic radiotherapy to inform the development of interventions to improve this area of care.
  Methods: The systematic review followed the PRISMA guidelines. Six electronic databases were searched for peer-reviewed studies of any design that assessed diet and nutrition needs after a pelvic cancer diagnosis. Narrative synthesis was used to integrate findings. Results: Thirty studies (12 quantitative, 15 qualitative, 3 mixed-methods) were included. Four themes, “content of dietary information”; “sources of information”. “sustaining dietary change”; and “views on the role of diet post-treatment”, summarised evidence about provision of nutritional guidance following diagnosis, but also contrasting views about the role of diet post diagnosis. Qualitative studies contributed considerably more to the synthesis, compared to quantitative studies. Included studies were of moderate to good quality; selection bias in quantitative studies and poor evidence of credibility and dependability in qualitative studies were highlighted. Conclusion: There is some evidence of lack of nutrition support in pelvic cancer survivors, but methodological limitations of included studies may have had an impact on the findings. Future, prospective studies that focus on diet and nutrition needs post-diagnosis are warranted to improve care.
  

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• Cossington J, Coe S, Liu Y, Dawes H, 'Potential benefits of a ketogenic diet to improve response and recovery from physical exertion in people with Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A feasibility study'
  International Journal of Sport, Exercise and Health Research 3 (2) (2019) pp.33-39
  ISSN: 2581-4923
  Abstract

  Background. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) affects approximately 250,000 people in the UK. The condition varies in severity causing long-term physical and cognitive fatigue which is not alleviated by rest. Whilst the pathology is not understood, recent evidence suggests metabolic abnormalities may be associated with the manifestation of symptoms, particularly involving the metabolism of glucose and energy production. The use of ketone bodies as an alternative energy substrate may be beneficial to people with ME/CFS, in order to by-pass the glycolytic pathway, enhance energy production and reduce fatiguing outcomes.

  Study Design and Methods. Using a pragmatic collective case study with repeated measures methodology we investigated the feasibility of following a ketogenic diet and potential effects of the high fat, low carbohydrate diet on response to physical activity in people with ME/CFS (n=3) and healthy controls (n=3) using a submaximal exercise stress test both with and without dietary intervention. Exercise tolerance (mins), rate of oxygen consumption (VO2) to workload (75W), respiratory exchange ratio (RER), rate of perceived effort (RPE) and lactate response were measured throughout and descriptive statistics performed.  

  Results. We found that the ketogenic diet was followed, with compliance higher in the pwME/CFS. Variations in response following the ketogenic diet was observed across individuals in minutes performed, VO2, HR, RER, and RPE post diet but the KD only limited exercise capacity in the control individuals. Individuals responded differently to the KD but group trends have been reported as means and standard deviation. The KD resulted in a decrease in RER at submax in the controls with a mean change of 0.07 from baseline (0.86 ± 0.1) to post intervention (0.79 ± 0.1) compared to a mean change of 0.02 in the ME/CFS from baseline (1.03 ± 0.1) to post intervention (1.01 ± 0.1). A decrease in VO2 (L/min) at submax showed a mean change of 0.06 (L/min) in the pwME/CFS at baseline (1.34 ± 0.1) to post intervention (1.27 ± 0.2) compared to a mean change of 0.07 (L/min) in the controls at baseline (1.40 ± 0.3) to post intervention (1.33 ± 0.2). HR (bpm) at submax decreased in all individuals, with a mean change of 4 (bpm), with pwME/CFS at baseline (139 ± 8.2) to post intervention (135 ± 14) and control individuals at baseline (107 ± 7.8) to intervention (103 ± 3.2). RPE at submax decreased in the pwME/CFS from baseline (6 ± 1.0) to post intervention (5 ± 2.1) whereas the controls increased from baseline (2 ± 1.0) to post intervention (3 ± 1.5). 

  Conclusion. Our observations suggest individualised but metabolic flexibility in healthy individuals is achievable via dietary manipulation showing the ability to switch from glucose to fats under controlled conditions. The different response in substrate utilisation in individuals with ME/CFS suggests that potential metabolic abnormalities may be present in ME/CFS.  Further investigation is now warranted in order to assess whether the KD is beneficial for people with ME/CFS.

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• Tektonidis TG, Coe S, Esser P, Maddock J, Buchanan S, Mavrommati F, Schott JM, Izadi H, Richards M, Dawes H, 'Diet quality in late midlife is associated with faster walking speed in later life in women, but not men: findings from a prospective British birth cohort'
  British Journal of Nutrition 123 (8) (2019) pp.913-921
  ISSN: 0007-1145
  Abstract

  Healthy diet has been linked to better age-related physical functioning, but evidence on the relationship of overall diet quality in late midlife and clinically relevant measures of physical functioning in later life is limited. Research on potential sex differences in this relationship is scarce. The aim was to investigate the prospective association between overall diet quality, as assessed by the Healthy Eating Index-2015 at age 60-64y and measures of walking speed seven years later, among men and women from the Insight46, a neuroscience sub-study of the Medical Research Council National Survey of Health and Development. Diet was assessed at age 60-64y using five-day food diaries, from which total HEI-2015 was calculated. At age 69-71y, walking speed was estimated during four 10-meter walks at self-selected pace, using inertial measurement units. Multivariable linear regression models with sex as modifier, controlling for age, follow-up, lifestyle, health, social variables and physical performance were used. The final sample was 164 women and 167 men (n=331). Women had higher HEI-2015 scores and slower walking speed than men. A 10 point increase in HEI-2015 was associated with faster walking speed seven years later among women (B: 0.024, 95% CI: 0.006, 0.043), but not men. The association remained significant in the multivariable model (B: 0.021, 95% CI: 0.003, 0.040). In women in late midlife higher diet quality is associated with faster walking speed. A healthy diet in late midlife is likely to contribute towards better age-related physical capability and sex differences are likely to affect this relationship.

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• Dias da Silva T, Cardoso Ribeiro-Papa D, Coe S, Regina Pinheiro Malheiros S, Massetti T, de Miranda Meira Junior C, Hervaldo Nicolai Ré A, Collett J, Bandeira de Mello Monteiro C, Dawes H, 'Evaluation of speed-accuracy trade-off in a computer task to identify motor difficulties in individuals with Duchenne Muscular Dystrophy - a cross-sectional study'
  Research in Developmental Disabilities 96 (2019)
  ISSN: 0891-4222 eISSN: 1873-3379
  Abstract

  Introduction: Individuals with Duchenne Muscular Dystrophy (DMD) present with progressive loss of motor function which can impair both control of speed and accuracy of movement. Aim: to evaluate movement time during a task at various levels of difficulty and to verify whether the level of difficulty affects the speed and/ or accuracy during the task. Methods: the DMD group comprised of 17 individuals age matched with 17 individuals with typical development (TD group). The task evaluates the relationship between speed and accuracy, consisting of the execution of manual movements (using the mouse of the computer) aimed at a target at three different levels of difficulty (ID). Results: A MANOVA demonstrated statistically significant differences in dispersion data and intercept values between the groups with greater movement time in the DMD group. An ANOVA indicated differences between groups for ID, except for when there was a higher accuracy demand (higher ID). In the other IDs that required lower accuracy demand, individuals in the DMD group had significantly longer movement time when compared to the TD group. Conclusion: These results show that the TD and DMD did not differ in the higher ID, therefore it can be concluded that for those with DMD, motor performance is more affected by speed than accuracy of movement. 

  What this paper adds?
  It is known that individuals with DMD have considerable motor deficits, however this paper shows that when the task involves higher accuracy compared with speed, people with DMD have performance similar to typically developed peers. This insight is a novel finding and can inform the rehabilitation team, to focus on training of speed, whilst maintaining accuracy for better execution of daily life tasks. 

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• Soundy A, Collett J, Lawrie S, Coe S, Roberts HC, Hu MT, Bromley S, Harling P, Reed A, Coebergh J, Carroll C, Dawes H, 'A qualitative study on the impact of First Steps: A peer-led, educational intervention for people newly diagnosed with Parkinson’s Disease.'
  Behavioral Sciences 9 (10) (2019)
  ISSN: 2076-328X
  Abstract

  Aim. The dual aim of this research is to consider the impact of providing the First Steps program on the stories of people with Parkinson’s Disease (PD)  and investigate the psychosocial and emotional mechanisms which may explain this impact. 
  Methods. A qualitative study using a subtle realist paradigm and hermeneutic phenomenological methodology was undertaken. A single semi-structured interview was used to consider the impact and experiences of people with PD who completed either the intervention (2-day peer-led behavior intervention using storytelling 6-8 weeks apart) or received telephone support calls as part of the active control group. Descriptive statistics and narrative analysis were undertaken on the results. 
  Results. Forty-two participants were invited to participate of whom forty completed the interview. This included 18 from the intervention group and 22 from the active control group. The intervention group identified the value of the program as worth-while, demonstrating improved exercise behavior and coping mechanisms following the intervention. Three major stories (the affirmed, the validated and the transformed story) identified the impact of the intervention. Three internal mechanisms (perceived control, hope and action, and the individual’s mind set) alongside three social mechanisms (social comparison, social control and the first opportunity to share with peers) appeared to explain the impact. 
  Conclusion. This study provides exciting and novel evidence for the impact of a peer led psycho-educational intervention for people newly diagnosed with PD. Further research is needed to consider the impact of stories-based approaches on participants and consider a critical evaluation of the mechanisms which may explain changes in stories and self-reported behaviour.
  

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• Peña de Moraes IA, Bandeira de Mello Monteiro C, Dias da Silva T, Massetti T, Brusque Crocetta T, Del Ciello de Menezes L, Pena de Rezende Andrade G, Hervaldo Nicolai Ré A, Dawes H, Coe S, Henrique Magalhães F, 'Motor learning and transfer between real and virtual environments in young people with autism spectrum disorder: a prospective randomized cross over controlled trial'
  Autism Research 13 (2) (2019) pp.307-319
  ISSN: 1939-3792
  Abstract

  Autism spectrum disorder (ASD) is associated with persistent deficits in social communication and social interaction, including impaired multisensory integration which might negatively impact cognitive and motor skill performance, and hence negatively affect learning of tasks. Considering that tasks in virtual environment may provide an engaging tool as adjuncts to conventional therapies, we set out to compare motor performance between young people with ASD and a typically developing (TD) control group that underwent coincident timing tasks based on Kinect (no physical contact) and on Keyboard (with physical contact) environments. Using a randomized repeated cross-over controlled trial design, fifty young people with ASD and fifty with TD, matched by age and sex were divided into subgroups of 25 people that performed the two first phases of the study (acquisition and retention) on the same device – real or virtual – and then switched to the other device to repeat acquisition and retention phases and finally switched on to a touch screen (transfer phase). Results showed that practice in the virtual task was more difficult (producing more errors), but led to a better performance in the subsequent practice in the real task, with more pronounced improvement in the ASD as compared to the TD group. It can be concluded that the ASD group managed to transfer the practice from a virtual to a real environment, indicating that virtual methods may enhance learning of motor and cognitive skills. A need for further exploration of its effect across a number of tasks and activities is warranted. 
  

  Website 
• Almaski A, Coe S, Lightowler H, Thondre S, 'Millet Intake and Risk Factors of Type 2 Diabetes: A Systematic Review'
  Journal of Food and Nutritional Disorders 8 (3) (2019)
  ISSN: 2573-3664
  Abstract

  Daily consumption of millet-based foods is associated with a reduced risk of type-2 diabetes. The aim of the present study was to systematically review the literature describing intervention studies that have investigated the effects of consuming different types and forms of millet on the risk factors for type-2 diabetes. A literature search was conducted, using five databases, from May 2016 to January 2017, which identified 57 articles. Search terms included ‘millet’ AND healthy, pre-diabetic or type-2 diabetes AND fasting blood glucose or glycaemic or glycemic response or insulin response or glucose tolerance or insulin sensitivity. Nineteen
  studies met the inclusion criteria. Although glycemic and insulin responses differ depending on the millet type and cooking method used, overall, millet has a beneficial effect on fasting and postprandial blood glucose and the plasma-insulin response in healthy individuals and those with type-2 diabetes. It can be concluded that millets do have the potential to play a protective role in the management of type-2 diabetes.
  

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• Kenyon J, Coe S, Izadi H, 'A retrospective outcomes study 42 patients with chronic fatigue syndrome, 30 of whom who had irritable bowel syndrome. Half were treated with oral approaches, and half were treated with Faecal Microbiome Transplantation'
  Human Microbiome Journal 13 (2019)
  ISSN: 2452-2317
  Abstract

  The gut microbiome comprises the community of microorganisms in the intestinal tract. Research suggests that an altered microbiome may play a role in a wide range of disorders including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

  Methods. 42 participants with ME/CFS with Irritable Bowel Syndrome (IBS) were allocated into one of two groups, 21 were treated with standard oral approaches, which centred around various nutritional remedies, probiotics, prebiotics, dietary advice and lifestyle advice. The second group who had mostly failed using oral approaches, were treated with Faecal Microbiome Transplantation (FMT). Each patient received 10 Implants, each from a different screened donor, and the Implants were processed under anaerobic conditions. The transplant is delivered via a paediatric rectal catheter, which is inserted through the anus to reach the lower part of the sigmoid colon.

  The results were assessed on a percentage basis before and after treatment, 0% being no improvement, 100% being maximum improvement. An exact non-parametric Mann-Whitney (one-tailed) test was used to compare medians from those on FMT compared with those receiving oral approaches only. On clinical experience over many years, the only way to judge improvement in Chronic Fatigue Syndrome as there is no test for Chronic Fatigue Syndrome, is my clinical assessment.

  Results. The median for the FMT group was found to be significantly higher compared to the oral treatment group (Mann-Whitney U = 111.5, p = .003). Therefore, the FMT group improved to a greater extent (z = −2.761).

  Conclusion. This study shows that FMT is a safe and a promising treatment for CFS associated with IBS. Adequately powered randomised controlled trials should be carried out to assess the effectiveness of FMT in patients with CFS and IBS.

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• Coe S, Spruzen SL, Sanchez C, Izadi H, Dawes H, 'A cross-sectional feasibility study of nutrient intake patterns in people with Parkinson’s compared to government nutrition guidelines'
  Journal of the American College of Nutrition 30 (3) (2019) pp.187-191
  ISSN: 0731-5724 eISSN: 1541-1087
  Abstract

  Background: Diet could have implications for disease progression and management in people with Parkinson’s disease (PwP). However, the knowledge of diet intake patterns in PwP is limited.
  Objectives: We set out to assess the feasibility of collecting diet data in PwP to determine food and nutrient intake, in order to compare to national nutrition guidelines and thus understand the habits in this population. Methods: In this cross-sectional feasibility study, PwP were approached through local support groups throughout the Thames Valley and were asked to complete a Food Frequency Questionnaire. Eligibility criteria included a self-reported neurologist confirmed diagnosis of Parkinson’s disease. Completeness of questionnaires was reported and 80% was considered appropriate for each measure including demographic information. Results: Response rate was 61% and missing data rate for the 121 returned questionnaires was 74%; however, of the 90 used for analysis there was 100% completion of the questionnaires. Compared to the UK government guidelines, protein was significantly higher for both males and females and fluid intake was lower for both genders (p < 0.001). There were several other differences in nutrient intake compared to guidelines. Conclusion: We observed high levels of engagement from PwP and found that assessing food and nutrient patterns in PwP was feasible. Importantly, the diet was generally healthy overall, yet there were specific nutrients that may affect medication metabolism in PwP that were found to be high. Therefore further research into this emerging and important area is warranted.
  

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• Saltaouras G, Lightowler H, Coe S, Brett J, Watson E, 'Availability and quality assessment of online nutrition information materials for pelvic cancer patients in the UK'
  European Journal of Cancer Care 28 (4) (2019)
  ISSN: 0961-5423 eISSN: 1365-2354
  Abstract

  Written information can be an essential source of support in the promotion of lifestyle changes after a cancer diagnosis. This study aimed to identify and assess the quality of available online Patient Information Materials (PIMs) in relation to diet and nutrition for pelvic cancer patients. The online sources of the National Health Service, cancer centres and charitable organisations throughout the UK were searched. Content was assessed using an evidence-based checklist, and readability with two validated formulas. Consumer feedback was sought through Patient and Public Involvement (PPI) groups. Forty PIMs were identified; four were designed specifically for pelvic cancers (bladder, bowel, prostate) and 36 were generic (relevant for all cancers). Most PIMs had a good content score, with PIMs from charities scoring higher overall than PIMs from cancer centres [32 (4) Vs 23 (11), P<0.001]. Seventy-three percent of PIMs had a readability score within acceptable levels (6th-8th grade; reading ability of 11-14 year-olds). PPI contributors found most PIMs useful and comprehensive but lacking specific information needed to meet individual needs. There is limited availability of online PIMs for cancer survivors and even fewer tailored to pelvic cancers. Most materials have comprehensive content and acceptable readability. Some PIMs may require improvement
  

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• Berezowska M, Coe S, Dawes H, 'Effectiveness of Vitamin D Supplementation in the Management of Multiple Sclerosis: A Systematic Review'
  International Journal of Molecular Sciences 20 (6) (2019)
  ISSN: 1661-6596 eISSN: 1422-0067
  Abstract

  Objective: to examine the extent of effect vitamin D in MS on pathology and symptoms. Methods: A literature search was performed in November 2017 (CRD42018103615). Eligibility criteria: randomised control trials  in English from 2012 to 2018; a clinical diagnosis of MS; interventions containing vitamin D supplementation (vitamin D3 or calcitriol) in disease activity compared to a control/ placebo; improvement in: serum 25(OH)D, relapse rates, disability status by EDSS scores, cytokine profile, quality of life, mobility, T2 lesion load and new T2 or T1 Gd enhancing lesions, safety and adverse effects. Risk of bias was evaluated. Results: Ten studies were selected. The study size ranged from 40 to 94 people. All studies evaluated the use of vitamin D supplementation (ranging from 10 IU to 98,000 IU), comparing to a placebo or low dose vitamin D. The duration of the intervention ranged from 12 to 96 weeks.  One trial found a significant effect on EDSS score, three demonstrated a significant change in serum cytokines level, one found benefits to current enhancing lesions and three studies evaluating the safety and tolerability of vitamin D reported no serious adverse events. Disease measures improved to a great extent overall in those with higher serum 25(OH)D levels. Conclusions: Improvement in disease measures may be more apparent in those with lower baseline vitamin D levels.

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• Coe S, Cossington J, Collett J, Soundy A, Izadi H, Ovington M, Durkin L, Kirsten M, Clegg M, Cavey A, Wade DT, Palace J, DeLuca G, Chapman K, Harrison JM, Buckingham E, Dawes H, 'A randomised double blind placebo-controlled feasibility trial of flavonoid-rich cocoa for fatigue in people with Relapsing and Remitting Multiple Sclerosis'
  Journal of Neurology, Neurosurgery and Psychiatry 90 (5) (2019) pp.507-513
  ISSN: 0022-3050 eISSN: 1468-330X
  Abstract

  The impact of flavonoids on fatigue has not been investigated in Relapsing and Remitting Multiple Sclerosis (RRMS). Objective. To determine the feasibility and estimate the potential effect of flavonoid-rich cocoa on fatigue and fatigability in RRMS.  Methods. A randomised double-blind placebo-controlled feasibility study in people recently diagnosed with RRMS and fatigue, throughout the Thames Valley (ISRCTN: 69897291). During a six week intervention participants consumed a high or low flavonoid cocoa beverage daily. Fatigue and fatigability were measured at three visits (weeks 0, 3 and 6). Feasibility and fidelity were assessed through recruitment and retention, adherence and a process evaluation. Results. 40 pwMS (10 men, 30 women, age 44 ± 10 yrs) were randomised and allocated to high (n=19) or low (n=21) flavonoid groups and included in analysis. Missing data was <20% and adherence to intervention of allocated individuals was >75%. There was a small effect on fatigue (Neuro-QoL: effect size {ES} 0.04; confidence interval {CI} -0.40-0.48) and a moderate effect on fatigability (six-minute walk test: ES 0.45; CI -0.18 - 1.07). There were seven adverse events (four control, three intervention), only one of which was possibly related and it was resolved.   Conclusion. A flavonoid beverage demonstrates the potential to improve fatigue and fatigability in RRMS. 

  
  
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• Bruna Leal Freitas, Talita Dias Silva, Tânia Brusque Crocetta, Thais Massetti, Luciano Vieira Araújo, Shelly Coe, Helen Dawes, Fatima Aparecida Caromano, Carlos Bandeira de Mello Monteiro, 'Analysis of different device interactions in a virtual reality task in individuals with Duchenne Muscular Dystrophy – a randomized controlled trial'
  Frontiers in Neurology 10 (2019)
  ISSN: 1664-2295
  Abstract

  There is a need to support individuals with Duchenne Muscular Dystrophy (DMD) to achieve optimal functionality in everyday life and with meaningful tasks and activities, throughout stages of the disease progression. Thus, technological developments have created an exciting opportunity for the use of affordable virtual reality (VR) systems with different kinds of interaction devices, providing an efficient and fun tool for enabling improvement in motor performance. Objective. To compare performance on a virtual task using interfaces with and without physical contact in order to identify functionality by using different devices in individuals with DMD. Methods. One hundred and twenty male individuals took part on this study: 60 with DMD with a mean age of 16 ± 5 (range 9–34 years old) and 60 without DMD in the control group (CG) matched by age. Participants were divided into three groups of 20 individuals each which performed a virtual task in three different interfaces: Kinect®, computer Touch Screen and Leap Motion®, in a cross over design in which all participants used all devices. Motor impairment in the DMD group was measured by using the Motor Function Measurement and Vignos scales. Results. All participants improved performance through practice, regardless of the interface used, although the DMD group had a continuous lower performance compared to the CG. In addition, the DMD group obtained a significant better performance with Leap Motion interface compared to the other interfaces, while the CG presented better performance on Touch Screen interface. Conclusion. Leap Motion provided better performance for individuals with DMD due to enablement of distal muscle function and ease of instrument adjustment using the virtual interface. Therefore, this type of interface should be encouraged for promoting functionality on general tasks using computer systems. Clinical Trial register number: NCT02891434.

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• Dawes H, Coe S, 'Efficacy of different interaction devices using non-immersive virtual tasks in individuals with Amyotrophic Lateral Sclerosis: a cross-sectional randomized trial'
  BMC Neurology 18 (2018)
  ISSN: 1471-2377
  Abstract

  Background. Amyotrophic Lateral Sclerosis (ALS) is a rapid progressive neurodegenerative disease, characterized by a selective loss of motor neurons, brain stem and spinal cord which leads to deterioration of motor abilities. Devices that promote interaction with tasks on computers can enhance performance and lead to greater independence and utilization of technology. Objective. To evaluate performance on a computer task in individuals with ALS using three different commonly used non-immersive devices. Method. Thirty individuals with ALS (18 men and 12 women, mean age 59 years, range 44–74 years) with a mean score of 26, (minimum score of 14 and maximum 41) on the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and 30 healthy controls matched for age and gender, participated. All participants were randomly divided into three groups, each using a different device system (motion tracking, finger motion control or touchscreen) to perform three task phases (acquisition, retention and transfer). Results. Both the ALS and control group (CG) showed better performance on the computer task when using the touchscreen device, but there was limited transfer of performance onto the task performed on the Finger Motion control or motion tracking. However, we found that using the motion tracking device led to transfer of performance to the touchscreen. Conclusion. This study presents novel and important findings when selecting interaction devices for individuals with ALS to access technology by demonstrating immediate performance benefits of using a touchscreen device, such as improvement of motor skills. There were possible transferable skills obtained when using virtual systems which may allow flexibility and enable individuals to maintain performance overtime.
  

  Website 
• Soundy A, Dawes H, Collett J, Coe S, Rosewilliam S, 'Understanding the importance of illness narratives in people with Multiple Sclerosis who participated in an exercise rehabilitation trial; a qualitative study'
  Archives of Physical Medicine and Rehabilitation 1 (1) (2018) pp.1-20
  ISSN: 0003-9993 eISSN: 1532-821X
  Website 
• Coe S, Franssen M, Collett J, Boyle D, Meaney A, Chantry R, Esser P, Izadi H, Dawes H, 'Physical activity, fatigue and sleep in people with Parkinson’s: a secondary per protocol analysis from an intervention trial.'
  Parkinson's Disease 2018 (2018)
  ISSN: 2090-8083 eISSN: 2090-8083
  Abstract

  Symptoms of Parkinson’s can result in low physical activity and poor sleep patterns which can have a detrimental effect on a person’s quality of life. To date, studies looking into exercise interventions for people with Parkinson’s (PwP) for symptom management are promising but inconclusive. The aim of this study is to estimate the effect of a clearly defined exercise prescription on general physical activity levels, fatigue, sleep, and quality of life in PwP. Method. PwP randomised into either an exercise group (29; 16 males, 13 females; mean age 67 years (7.12)) or a control handwriting group (36; 19 males; 17 females; mean age 67 years (5.88)) as part of a larger trial were included in this substudy if they had completed a 6-month weekly exercise programme (intervention group) and had complete objective physical activity data (intervention and control group). Sleep and fatigue were recorded from self-reported measures, and physical activity levels measured through the use of accelerometers worn 24 hours/day over a seven-day testing period at baseline and following the 24-week intervention. A Wilcoxon’s test followed by a Mann–Whitney post hoc analysis was used, and effect sizes were calculated. Results. Participants showed a significant increase in time spent in sedentary and light activities during the overnight period postintervention in both exercise and handwriting groups (p < 0.05) with a moderate effect found for the change in sedentary and light activities in the overnight hours for both groups, over time (0.32 and 0.37-0.38, resp.). There was no impact on self-reported fatigue or sleep. Conclusion. The observed moderate effect on sedentary and light activities overnight could suggest an objective improvement in sleep patterns for individuals participating in both exercise and handwriting interventions. This supports the need for further studies to investigate the role of behavioural interventions for nonmotor symptoms.
  

  Website 
• Coe S, Philip O, Cossington J, Collett J, Izadi H, Dawes H, 'A Cross-Sectional Pilot Study Assessing Dietary Intake in People with Multiple Sclerosis and the Relationships with National Diet Guidelines'
  Enliven: Journal of Dietetics Research and Nutrition 5 (1) (2018)
  ISSN: 2378-5438
  Abstract People with the Multiple Sclerosis (PwMS) modify their diet, however their knowledge of diet is unknown and dietary modifications may have long term health implications. We set out to assess the feasibility of a study to determine diet patterns compared to national nutritional guidelines in PwMS, and in those with and without fatigue. Methods: In this cross sectional study four MS support groups were attended throughout the Thames Valley area, with approximately 20 to 25 people attending each group at any one point in time. Measures of feasibility were sought. Descriptive statistics were used to determine inconsistencies in nutrient intake in PwMS with and without fatigue compared to the Scientific Advisory Committee on Nutrition guidelines. Results: 31 PwMS provided dietary data using a Food Frequency Questionnaire, alongside the Fatigue Severity Scale, Barthel Index activities of daily living and demographic data. One third of participants were on a modified diet. Compared to the UK nutrition guidelines, several nutrients were ±1 standard deviation in PwMS, and PwMS tended to miss targets for diet guidelines. Those who were fatigued showed further differences in nutrient intake compared to those who were non-fatigued, and women tended to have healthier diets than men. Missing data was low and response rate was high Conclusion: For the first time data is provided that shows PwMS may have altered dietary intake compared to national guidelines. Furthermore, those who were fatigued show further differences compared to non-fatigued PwMS. Considering the high incidence of modified diets in this group, more substantial investigation of diet is required.Website 
• Coe S, Collett J, Izadi H, Wade D, Clegg M, Harrison JM, Buckingham E, Cavey A, De Luca G, Palace J, Dawes H, 'A protocol for a randomised double blind placebo-controlled feasibility study to determine whether the daily consumption of flavonoid-rich pure cocoa has the potential to reduce fatigue in people with relapsing and remitting multiple sclerosis (RRMS)'
  Pilot and Feasibility Studies 4 (2018)
  ISSN: 2055-5784
  Abstract Background. Dietary interventions including consumption of flavonoids, plant compounds found in certain foods, may have the ability to improve fatigue. However, to date, no well-designed intervention studies assessing the role of flavonoid consumption for fatigue management in people with MS (pwMS) have been performed. The hypothesis is that the consumption of a flavonoid-rich pure cocoa beverage will reduce fatigue in pwMS. The aim of this study is to determine the feasibility and potential outcome of running a trial to evaluate this hypothesis.
  Methods. Using a randomised (1:1) double-blind placebo-controlled feasibility study, 40 men and women (20 in each trial arm) with a recent diagnosis (< 10 years) of relapsing and remitting MS (RRMS) and who are over 18 years of age will be recruited from neurology clinics and throughout the Thames Valley community. During a 6-week nutrition intervention period, participants will consume the cocoa beverage, high flavonoid or low flavonoid content, at breakfast daily. At baseline, demographic factors and disease-related factors will be assessed. Fatigue, activity and quality of life, in addition to other measures, will be taken at three visits (baseline, week 3 and week 6) in a university setting by a researcher blinded to group membership. Feasibility and fidelity will be assessed through recruitment and retention, adherence and a quantitative process evaluation at the end of the trial. We will describe demographic factors (age, gender, level of education) as well as disease-related factors (disease burden scores, length of time diagnosed with MS) and cognitive assessment, depression and quality of life and general physical activity in order to characterise participants and determine possible mediators to identify the processes by which the intervention may bring about change. Feasibility (recruitment, safety, feasibility of implementation of the intervention and evaluation, protocol adherence and data completion) and potential for benefit (estimates of effect size and variability) will be determined to inform future planned studies. Results will be presented using point estimates, 95% confidence intervals and p values. Primary statistical analysis will be on an intention-to-treat basis and will use the complete case data set. Discussion. We propose that a flavonoid-enriched cocoa beverage for the management of fatigue will be well received by participants. Further, if it is implemented early in the disease course of people diagnosed with RRMS, it will improve mobility and functioning by modifying fatigue. Trial registration: Registered with ISRCTN Registry. Trial registration No: ISRCTN69897291; Date April 2016.Website 
• Godsiff DT, Coe S, Elsworth-Edelsten C, Collett J, Howells K, Morris M, Dawes H, 'Exploring the metabolic and perceptual correlates of self-selected walking speed under constrained and un-constrained conditions'
  Journal of Sports Science and Medicine 17 (2018) pp.1-6
  ISSN: 1303-2968
  Abstract Mechanisms underpinning self-selected walking speed (SSWS) are poorly understood. The present study investigated the extent to which SSWS is related to metabolism, energy cost, and/or perceptual parameters during both normal and artificially constrained walking. Fourteen participants with no pathology affecting gait were tested under standard conditions. Subjects walked on a motorized treadmill at speeds derived from their SSWS as a continuous protocol. RPE scores (CR10) and expired air to calculate energy cost (J.kg-1.m-1) and carbohydrate (CHO) oxidation rate (J.kg-1.min-1) were collected during minutes 3-4 at each speed. Eight individuals were re-tested under the same conditions within one week with a hip and knee-brace to immobilize their right leg. Deflection in RPE scores (CR10) and CHO oxidation rate (J.kg-1.min-1) were not related to SSWS (five and three people had deflections in the defined range of SSWS in constrained and unconstrained conditions, respectively) (p > 0.05). Constrained walking elicited a higher energy cost (J.kg-1.m-1) and slower SSWS (p < 0.05) versus normal walking. RPE (CR10) was not significantly different between walking conditions or at SSWS (p > 0.05). SSWS did not occur at a minimum energy cost (J.kg-1.m-1) in either condition, however, the size of the minimum energy cost to SSWS disparity was the same (Froude {Fr} = 0.09) in both conditions (p = 0.36). Perceptions of exertion can modify walking patterns and therefore SSWS and metabolism/ energy cost are not directly related. Strategies which minimize perceived exertion may enable faster walking in people with altered gait as our findings indicate they should self-optimize to the same extent under different conditions.
• Coe S.*, Axelsson E., Murphy V., Santos M., Collett J., Clegg M., Izadi H., Harrison JM., Buckingham, E. & Dawes H., 'Flavonoid rich dark cocoa may improve fatigue in people with Multiple Sclerosis, yet has no effect on glycaemic response: an exploratory trial'
  Clinical Nutrition ESPEN 21 (2017) pp.20-25
  ISSN: 2405-4577 eISSN: 2405-4577
  Abstract
  Context. Current research suggests that dark cocoa may reduce fatigue; however, the effect on fatigue in people with MS (pwMS) has never been established. The objective of this feasibility study was to explore the acute effect of high flavonoid cocoa on measures of fatigue and glycaemic response. Methods. This was a randomised crossover participant blind exploratory study in 12 participants (2 male and 10 female) with MS-related fatigue (>4 on the Fatigue Severity Scale; FSS). After fasting overnight, participants consumed the high flavonoid cocoa drink (350 mg gallic acid equivalents {GAE}/g) or a low flavonoid cocoa control (120 mg GAE/g), consuming the alternative drink on the next visit. Fatigue was self-reported on a 100 mm visual analogue scale at 30-min time intervals for 2 h post cocoa consumption and every 2 h for the rest of the day. Fatigability was monitored using a 6 min walk test (6MWT) at the end of the visit (2 h), and activity monitors worn for 24 h commencing at 12 noon on the day of testing. The feasibility of performing the trial including outcome measures was documented. Results. A moderate effect was found in self-reported fatigue throughout the day in favour of the high flavonoid group (Cohen's d 0.32, 95% non-central t CI −0.57 to 1.20). Fatigability measures did not change. Participants consumed and enjoyed the cocoa, all participants completed the study and outcome measures were accepted. Conclusion. The results of this study support further trials to investigate the feasibility and efficacy of pure cocoa as a dietary supplement for fatigue in pwMS.
  Website 
• Garvey R, Clegg M, Coe S, 'The acute effects of baobab fruit (Adansonia digitata) on satiety in healthy adults.'
  Nutrition and Health 23 (2) (2017) pp.83-86
  ISSN: 0260-1060
  Abstract Background: The baobab fruit is high in both dietary fibre and polyphenols and therefore may increase satiety. The aim of the study was to measure the effects of baobab fruit extract on satiety.
   
  Methods: The study was conducted on 20 healthy participants. The study was a one day single blind crossover design. Participants were randomised to either a test smoothie consisting of 15g of baobab extract or a control smoothie without the addition of baobab. Subjective ratings of satiety were taken on visual analogue scales immediately pre consumption and then post consumption, and energy intake at a post ad libitum meal was recorded. 
   
  Results: Subjective measures of hunger were reduced following the test smoothie compared to the control (p<0.05). There was no significant difference in calorie intake at an ad libitum meal. 
   
  Conclusions: This research has positive implications for the use of baobab for reducing hunger, possibly having a positive effect on weight maintenance.
   
  Website 
• Bycroft A, Coe S, 'The acute effect of a baobab fruit (Adansonia digitata) smoothie on cognitive function in healthy adults.'
  Proceedings of the Nutrition Society 76 (OCE1) (2017) pp.E16-
  ISSN: 0029-6651
  Abstract Meeting abstractWebsite 
• Almaski A, Thondre S, Lightowler H, Coe S, 'Determination of the polyphenol and antioxidant activity of different types and forms of millet'
  Proceedings of the Nutrition Society 76 (OCE1) (2017)
  ISSN: 0029-6651
  Abstract Meeting abstractWebsite 
• Coe S, Ryan L, 'Impact of polyphenol-rich sources on acute postprandial glycaemia: a systematic review'
  Journal of Nutritional Science 5 (2016)
  ISSN: 2048-6790 eISSN: 2048-6790
  Abstract Increasingly, evidence suggests a role for polyphenols in blood glucose control. The objective of this systematic review was to evaluate the effect of polyphenol-rich sources in combination with carbohydrate sources on resulting postprandial glycaemic and insulin responses. A literature search was conducted using Medline, CINHAL and Web of Science databases. Selected studies included randomised controlled trials in which the association of polyphenol-containing food or beverage consumption with a carbohydrate source and effect on acute postprandial glycaemia and/or insulin was reported. A total of thirteen full articles were included in the review. Polyphenol sources included coffee, black tea, fruit juice, plant extracts, berries and different rye breads, and carbohydrate sources included bread, pancakes and simple sugars such as sucrose, glucose and fructose. Although glycaemic and insulin responses differed depending on the polyphenol-carbohydrate combination, overall, polyphenol sources were shown to reduce the peak and early-phase glycaemic response and maintain the glycaemic response in the later stages of digestion. To a lesser extent, polyphenol sources were also shown to reduce peak insulin response and sustain the insulin response, especially when consumed with bread. This review supports epidemiological data suggesting that polyphenols in foods and beverages may have a beneficial effect on reducing the risk of type 2 diabetes. However, the extent of this effect is variable depending on the polyphenol and carbohydrate source.Website 
• Santos M, Coe S, 'The total polyphenol content of various commercial cocoa beverages, with and without the addition of cow’s milk'
  Proceedings of the Nutrition Society 75 (OCE1) (2016) pp.E22-
  ISSN: 0029-6651
  Website 
• Coe S, Oni BT, Collett J, Clegg M, Dawes H, 'Increased carbohydrate and energy consumption in people with Multiple Sclerosis compared to healthy controls'
  Proceedings of the Nutrition Society 74 (OCE1) (2015)
  ISSN: 0029-6651
  Website 
• Coe S, Ryan L, 'White bread enriched with polyphenol extracts shows no effect on glycemic response or satiety, yet may increase postprandial insulin economy in healthy participants'
  Nutrition Research 36 (2) (2015) pp.193-200
  ISSN: 0271-5317
  Abstract

  Extracts from different plant sources have been shown to modify starch digestion from carbohydrate-rich foods and lower resulting glycemia. It was hypothesized that extracts rich in polyphenols, added to white bread, would improve the glycemic response and insulin response and increase satiety in healthy participants. An in vitro dose-response analysis was performed to determine the optimal dose of a variety of extracts (baobab fruit extract, green tea extract, grape seed extract, and resveratrol) for reducing rapidly digestible starch in white bread. The 2 extracts with the greatest sugar reducing potential were then used for the human study in which 13 volunteers (9 female and 4 male) were recruited for a crossover trial of 3 different meals. On separate days, participants consumed a control white bread, white bread with green tea extract (0.4%), and white bread with baobab fruit extract (1.88%). Glycemic response, insulin response, and satiety were measured 3 hours postprandially. Although enriched breads did not reduce glycemic response or hunger, white bread with added baobab fruit extract significantly (P < .05) reduced the total (0-180 minutes) and segmental insulin area under the curve at 0 to 90, 0 to 120, and 0 to 150 minutes, and therefore reduced the amount of insulin needed for a given blood glucose response. This preliminary research suggests that there is potential for baobab fruit extract added into white bread to improve insulin economy in healthy adults.

  Website 
• Coe S, Ryan L, 'Investigation of polyphenol synergism for reducing sugar release from white bread'
  Proceedings of the Nutrition Society 74 (OCE1) (2015)
  ISSN: 0029-6651
  Website 
• Coe S, Fraser A, Ryan L, 'Polyphenol Bioaccessibility and Sugar Reducing Capacity of Black, Green, and White Teas'
  International Journal of Food Science 2013 (2013) pp.1-6
  ISSN: 2356-7015
  Abstract Tea (Camellia sinensis) is a widely consumed beverage and recognised for its potential enhancing effect on human health due to its rich polyphenol content. While a number of studies have investigated the quantity and type of polyphenols present in different tea samples, no study has reported the potential effect of digestive enzymes on the availability of tea polyphenols for human absorption or the subsequent impact on glycaemic response. The objectives of the present study were to assess the total polyphenol content of different teas, to assess the bioaccessibility of polyphenols in whole and bagged teas, and to determine the effect of black, white, and green tea infusions on sugar release. All of the teas were a significant source of polyphenols (10–116 mg Gallic acid equivalents/g). There was an overall increase in the release of polyphenols from both the bagged and the whole teas following in vitro digestion. Bagged green tea significantly (P<0.05) reduced rapidly digestible starch from white bread samples compared to control and black and white bagged teas. The present study confirms that tea is a rich source of polyphenols and highlights the potential benefits it may have on modulating glycaemic response in humans.Website 
• Coe SA, Clegg M, Armengol M, Ryan L, 'The polyphenol-rich baobab fruit (Adansonia digitata L.) reduces starch digestion and glycemic response in humans'
  Nutrition Research 33 (11) (2013) pp.888-896
  ISSN: 0271-5317
  Abstract The baobab fruit (Adansonia digitata L.) is found throughout regions of Africa and is becoming increasingly recognized for its high nutrient and polyphenol content. Polyphenols have been beneficial for their effects on reducing the glycemic response (GR) and for improving various other metabolic parameters. Based on previous research, it was hypothesized that the baobab fruit extract would reduce starch digestion in vitro and would show potential for reducing the GR and for increasing satiety and diet-induced thermogenesis in humans. Six extracts of baobab from 6 different locations in Africa were measured for their antioxidant and polyphenol content using the ferric ion–reducing antioxidant power and the Folin-Ciocalteu methods, respectively. Baobab extract was baked into white bread at different doses to determine the optimal dose for reducing starch breakdown and sugar release from white bread after an in vitro digestion procedure. In vivo, baobab extract was consumed in solution at both a low-dose (18.5 g) and a high-dose (37 g) aqueous drink in 250 mL of water along with white bread, and resulting GR, satiety, and postprandial energy expenditure were measured. All extracts in this study were shown to be good sources of polyphenols. Baobab fruit extract added to white bread at 1.88 % significantly (P < .05) reduced rapidly digestible starch from white bread samples. In vivo, the baobab fruit extract at both low and high doses significantly (P < .05) reduced GR, although there was no significant effect on satiety or on energy expenditure.Website 
• Coe S, Ryan L, 'Sugar release from various starch rich foods with added polyphenol extracts'
  Proceedings of the Nutrition Society 72 (OCE4) (2013)
  ISSN: 0029-6651 eISSN: 1475-2719
  Website 
• Coe S, Ryan L, 'Polyphenol content and in vitro bioaccessibility of six baobab fruit extracts'
  Proceedings of the Nutrition Society 71 (OCE2) (2012) pp.E26-
  ISSN: 0029-6651
  Website 

Conference papers

• Tektonidis TG, Esser P, Coe S, Maddock J, Buchanan S, Mavrommati F, Schott JM, Izadi H, Richards M, Dawes H, 'DIET QUALITY IN LATE MIDLIFE IS ASSOCIATED WITH FASTER WALKING SPEED IN LATER LIFE IN WOMEN, BUT NOT MEN: FINDINGS FROM A BRITISH BIRTH COHORT'
  38 (S1) (2019) pp.S316-S317
  Website 
• Almaski A, Coe S, Lightowler H, Thondre S, 'Sensory evaluation of polyphenol-rich millet-based muffins and their effect on in vitro starch digestion'
  76 (OCE4) (2017) pp.E227-
  ISSN: 0029-6651 eISSN: 1475-2719
  Website 
• Soleymani Majd N, Coe S, Thondre S and Lightowler H, 'Determination of the antioxidant activity and polyphenol content of different types of Rhus coriaria Linn (sumac) from different regions'
  76 (OCE4) (2017) pp.E137-
  ISSN: 0029-6651 eISSN: 1475-2719
  Website 

Areas of expertise

Nutrition in vulnerable groups, including neurological and autoimmune conditions, flavonoids, polyphenols, cognitive function, nutrition in children and young people, large nutrition cohorts.

Membership of professional bodies

Memberships of Professional Bodies

• Registered Nutritionist of the Association for Nutrition
• Member of the Nutrition Society

Further information

Twitter: @Dr_ShellyC