Rich and slim, but relatively short Explaining the halt in the secular trend in Japan

An almost complete halt in the secular trend in stature at a relatively low level is observed in Japan since the late 1980s with average height of around 171 cm for males and 158 cm for females at age 18. Unidentified characteristics in the Japanese genetic pool or in the nutritional intake do not provide a convincing explanation. Japan is unique among OECD countries in combining contrasted health outcomes: a stagnation of height suggests a decline in biological well-being, but this picture is not consistent with high life expectancy and extremely low prevalence of infant mortality, overweight/obesity, and other pathologies. Individual data that could allow investigating the influence of socio-economic and other environmental conditions are unavailable. As a second best, we take advantage of the regional variance in average height and other indicators across the 47 Japanese prefectures and use data covering the period 1950-2005. A positive and significant influence of income and housing conditions on height is identified but the effect is fading. Caloric restraint of pregnant women, and the decrease in sleeping time observed since the 1980s appear as possible explanatory variables of the halt in the secular trend and a symptom of a decline in well-being. Public health policy implications are considered.height, income, housing, sleep, sexual dimorphism, Japan

Sleep, Health, and Aging

As people grow older, getting a good night's sleep remains essential to maintaining good health. Insomnia is a common complaint in older adults, and although occasional sleep complaints may not be associated with age, chronic sleep difficulties are experienced more often by older adults than by younger adults

Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes

Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes.BackgroundQuality of life (QoL) is increasingly well recognized as an important measure of treatment outcome. The aim of this study was to determine which key factors affect QoL, which aspects of QoL change over time, and if measurements of QoL were associated with clinical outcome in our peritoneal dialysis (PD) population.MethodsThe results of 88 patients (70% of our PD population) enrolled in longitudinal studies of dialysis adequacy, nutrition, and quality of life were reviewed. The sample comprised Indo-Asian [N = 35 (diabetic N = 18)], and white Europeans [N = 53 (diabetic N = 18)] heritage. At enrollment (>3 months on PD) demographic data was recorded. At enrollment, and six-month intervals, the dialysis adequacy, nutritional status, QoL (using the KDQOL-SF™ instrument), hospital admissions, PD infections, and changes in treatment modality were recorded.ResultsMale gender, Asian ethnicity, and poor nutritional status as measured by Subjective Global Assessment were the most significant characteristics independently associated with worse overall QoL dimension scores (physical health, mental health, kidney disease issues, patient satisfaction). Comorbidity, months of renal replacement, social deprivation and serum albumin were related to some of the 19 health domains measured. QoL declined steadily during the two-year study period. The most significant changes were for the items general health symptoms/problems, burden of kidney disease, emotional well-being, and patient satisfaction. Increased hospital admissions were associated with a worse QoL.ConclusionsQuality of life declines in patients on PD over time. Certain aspects of QoL are especially poor in Asian and male patients. This study suggests that further research is necessary to determine the effects of interventions directed at enhancing emotional and social support

Resourcefulness, Desperation, Shame, Gratitude and Powerlessness : Common Themes Emerging from A Study of Food Bank Use in Northeast Scotland

Acknowledgements This study received funding support from the Scottish Government’s Rural and Environment Science and Analytical Services (RESAS), Theme 7 ‘Healthy Safe Diets’ Research Programmed. The authors would also like to thank and acknowledge the invaluable support and time given by Fiona Rae and Dave Simmers, the Community Food Initiative North East food bank volunteers and study participants. The authors would also like to thank Professor Elizabeth Dowler and Dr Lucia d’Ambruoso, and the anonymous peer reviewers for their helpful comments during the preparation of the manuscript.Peer reviewedPublisher PD

Can clinicians and scientists explain and prevent unexplained underperformance syndrome in elite athletes: an interdisciplinary perspective and 2016 update

The coach and interdisciplinary sports science and medicine team strive to continually progress the athlete's performance year on year. In structuring training programmes, coaches and scientists plan distinct periods of progressive overload coupled with recovery for anticipated performances to be delivered on fixed dates of competition in the calendar year. Peaking at major championships is a challenge, and training capacity highly individualised, with fine margins between the training dose necessary for adaptation and that which elicits maladaptation at the elite level. As such, optimising adaptation is key to effective preparation. Notably, however, many factors (eg, health, nutrition, sleep, training experience, psychosocial factors) play an essential part in moderating the processes of adaptation to exercise and environmental stressors, for example, heat, altitude; processes which can often fail or be limited. In the UK, the term unexplained underperformance syndrome (UUPS) has been adopted, in contrast to the more commonly referenced term overtraining syndrome, to describe a significant episode of underperformance with persistent fatigue, that is, maladaptation. This construct, UUPS, reflects the complexity of the syndrome, the multifactorial aetiology, and that ‘overtraining’ or an imbalance between training load and recovery may not be the primary cause for underperformance. UUPS draws on the distinction that a decline in performance represents the universal feature. In our review, we provide a practitioner-focused perspective, proposing that causative factors can be identified and UUPS explained, through an interdisciplinary approach (ie, medicine, nutrition, physiology, psychology) to sports science and medicine delivery, monitoring, and data interpretation and analysis

Position statement part two: maintaining immune health

The physical training undertaken by athletes is one of a set of lifestyle or behavioural factors that can influence immune function, health and ultimately exercise performance. Others factors including potential exposure to pathogens, health status, lifestyle behaviours, sleep and recovery, nutrition and psychosocial issues, need to be considered alongside the physical demands of an athlete’s training programme. The general consensus on managing training to maintain immune health is to start with a programme of low to moderate volume and intensity; employ a gradual and periodised increase in training volumes and loads; add variety to limit training monotony and stress; avoid excessively heavy training loads that could lead to exhaustion, illness or injury; include non-specific cross-training to offset staleness; ensure sufficient rest and recovery; and instigate a testing programme for identifying signs of performance deterioration and manifestations of physical stress. Inter-individual variability in immunocompetence, recovery, exercise capacity, non-training stress factors, and stress tolerance likely explains the different vulnerability of athletes to illness. Most athletes should be able to train with high loads provided their programme includes strategies devised to control the overall strain and stress. Athletes, coaches and medical personnel should be alert to periods of increased risk of illness (e.g. intensive training weeks, the taper period prior to competition, and during competition) and pay particular attention to recovery and nutritional strategies. [...continues]

Sleep in elite athletes and nutritional interventions to enhance sleep

Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Recent evidence, as well as anecdotal information, suggests that athletes may experience a reduced quality and/or quantity of sleep. Sleep deprivation can have significant effects on athletic performance, especially submaximal, prolonged exercise. Compromised sleep may also influence learning, memory, cognition, pain perception, immunity and inflammation. Furthermore, changes in glucose metabolism and neuroendocrine function as a result of chronic, partial sleep deprivation may result in alterations in carbohydrate metabolism, appetite, food intake and protein synthesis. These factors can ultimately have a negative influence on an athlete’s nutritional, metabolic and endocrine status and hence potentially reduce athletic performance. Research has identified a number of neurotransmitters associated with the sleep–wake cycle. These include serotonin, gamma-aminobutyric acid, orexin, melanin-concentrating hormone, cholinergic, galanin, noradrenaline, and histamine. Therefore, nutritional interventions that may act on these neurotransmitters in the brain may also influence sleep. Carbohydrate, tryptophan, valerian, melatonin and other nutritional interventions have been investigated as possible sleep inducers and represent promising potential interventions. In this review, the factors influencing sleep quality and quantity in athletic populations are examined and the potential impact of nutritional interventions is considered. While there is some research investigating the effects of nutritional interventions on sleep, future research may highlight the importance of nutritional and dietary interventions to enhance sleep