A vitamin D, calcium and leucine-enriched whey protein nutritional supplement improves measures of bone health in sarcopenic non-malnourished older adults: The PROVIDE study

Alterations in musculoskeletal health with advanced age contribute to sarcopenia and decline in bone mineral density (BMD) and bone strength. This decline may be modifiable via dietary supplementation. To test the hypothesis that a specific oral nutritional supplement can result in improvements in measures of bone health. Participants (n 380) were participants of the PROVIDE study, a 13-week, multicenter, randomized, controlled, double-blind, 2 parallel-group study among non-malnourished older participants (≥ 65 years) with sarcopenia [determined by Short Physical Performance Battery (SPPB; 0-12) scores between 4 and 9, and a low skeletal muscle mass index (SMI; skeletal muscle mass/BW × 100) ≤ 37% in men and ≤ 28% in women using bioelectric impedance analysis] Supplementation of a vitamin D, calcium and leucine-enriched whey protein drink that comprises a full range of micronutrients (active; 2/day) was compared with an iso-caloric control. Serum 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), biochemical markers of bone formation (osteocalcin; OC, procollagen type 1 amino-terminal propeptide; P1NP) and resorption (carboxy-terminal collagen crosslinks; CTX), insulin like growth factor 1 (IGF-1) and total-body BMD were analysed pre- and post-intervention. Serum 25(OH)D concentrations increased from 51.1 ± 22.9 nmol/L (mean ± SD) to 78.9 ± 21.1 nmol/L in the active group (p < 0.001 vs. control). Serum PTH showed a significant treatment difference (p < 0.001) with a decline in the active group, and increase in the control group. Serum IGF-1 increased in the active group (p < 0.001 vs. control). Serum CTX showed a greater decline in the active group (p = 0.001 vs. control). There were no significant differences in serum OC or P1NP between groups during the intervention. Total body BMD showed a small (0.02 g/cm2; ~ 2%) but significant increase in the active group after supplementation (p = 0.033 vs. control). Consuming a vitamin D, calcium and leucine-enriched whey protein supplement for 13 weeks improved 25(OH)D, suppressed PTH and had small but positive effects on BMD, indicative of improved bone health, in sarcopenic non-malnourished older adults

Size-selective mortality during freshwater and marine life stages of steelhead related to freshwater growth in the Skagit River, Washington

Wild steelhead trout, Oncorhynchus mykiss, in the Puget Sound are currently in decline, and very little is known about the early life history of these threatened fish. This study evaluated consequences of early growth and survival to smolt or adult stages in different precipitation zones of the Skagit River Basin, Washington. The objectives of this study were to determine whether significant size-selective mortality (SSM) in wild steelhead could be detected between freshwater stages and returning adults; and if so, how the magnitude of SSM varied among juveniles rearing in different precipitation zones (snow and mixed rain-snow). Wild steelhead were sampled as juveniles, smolts, and adults, and scales were measured to compare back-calculated size distributions and growth rates of rearing juveniles with individuals that survived from an earlier life stage to the smolt and adult stages. Back-calculated size-at-annulus comparisons indicated that steelhead in the snow zone were significantly larger at annulus-1 than those in the mixed zone. Steelhead sampled as adults were significantly larger than those sampled as juveniles at annuli-1, -2, and -3, and larger than those sampled as smolts at annuli-2 and -3, Steelhead sampled as smolts were larger than those sampled as juveniles at annuli-1 and -2, but smolts and juveniles were the same size at annulus-3. The disparity in size-at-age-2 and -3 between steelhead sampled at earlier and later life stages suggested that fast growth during the second or third freshwater growing seasons was vitally important for survival to adulthood, and that both freshwater and marine survival could be attributed, in part, to size attained at earlier life stages in freshwater. Efforts for recovery of threatened Puget Sound steelhead could benefit by considering SSM in freshwater environments, and identifying factors that limit growth during early life stages

Target blood pressure in diabetes patients with hypertension—What is the accumulated evidence in 2011?*

There is overwhelming evidence that hypertension is an important risk factor for both macrovascular and microvascular complications in patients with diabetes, but the problem remains to identify appropriate goals for preventive therapies. A number of guidelines (the European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) 2007, the Joint National Committee (JNC)-VII 2003, the American Diabetes Association (ADA) 2011) have for example advocated a blood pressure goal of less than 130/80 mmHg, but this suggestion has been challenged by findings in recent trials and meta-analyses (2011). The European Society of Hypertension (ESH) therefore recommends a systolic blood pressure goal of “well below” 140 mmHg. Based on evidence from both randomized controlled trials (hypertension optimal treatment (HOT), action in diabetes and vascular disease: preterax and diamicron MR controlled evaluation (ADVANCE), action to control cardiovascular risk in diabetes (ACCORD)) and observational studies (ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET), international verapamil-trandolapril study (INVEST), treat to new targets (TNT), and the National Diabetes Register (NDR)), it has been shown that the benefit for stroke reduction remains even at lower achieved blood pressure levels, but the risk of coronary events may be uninfluenced or even increased at lower systolic blood pressure levels. In a recent meta-analysis, it was therefore concluded that the new recommended goal should be 130–135 mmHg systolic blood pressure for most patients with type 2 diabetes. Other risk factors should also be controlled with a more ambitious strategy applied in the younger patients with shorter diabetes duration, but a more cautious approach in the elderly and frail patients with a number of vascular or non-vascular co-morbidities. In patients from East Asia, such as China, the stroke risk is relatively higher than the risk of coronary events. This must also be taken into consideration for individualized goal setting in relation to total risk, for example in patients from stroke-prone families. In conclusion, the current strategy is to have a more individualized approach to risk factor control in patients with type 2 diabetes, also relevant for blood pressure control

Modification of marine habitats by trawling activities: prognosis and solutions

Fishing affects the seabed habitat worldwide on the continental shelf. These impacts are patchily distributed according to the spatial and temporal variation in fishing effort that results from fishers' behaviour. As a consequence, the frequency and intensity of fishing disturbance varies among different habitat types. Different fishing methodologies vary in the degree to which they affect the seabed. Structurally complex habitats (e.g. seagrass meadows, biogenic reefs) and those that are relatively undisturbed by natural perturbations (e.g. deep-water mud substrata) are more adversely affected by fishing than unconsolidated sediment habitats that occur in shallow coastal waters. These habitats also have the longest recovery trajectories in terms of the recolonization of the habitat by the associated fauna. Comparative studies of areas of the seabed that have experienced different levels of fishing activity demonstrate that chronic fishing disturbance leads to the removal of high-biomass species that are composed mostly of emergent seabed organisms. Contrary to the belief of fishers that fishing enhances seabed production and generates food for target fish species, productivity is actually lowered as fishing intensity increases and high-biomass species are removed from the benthic habitat. These organisms also increase the topographic complexity of the seabed which has been shown to provide shelter for juvenile fishes, reducing their vulnerability to predation. Conversely, scavengers and small-bodied organisms, such as polychaete worms, dominate heavily fished areas. Major changes in habitat can lead to changes in the composition of the resident fish fauna. Fishing has indirect effects on habitat through the removal of predators that control bio-engineering organisms such as algal-grazing urchins. Fishing gear resuspend the upper layers of sedimentary seabed habitats and hence remobilize contaminants and fine particulate matter into the water column. The ecological significance of these fishing effects has not yet been determined but could have implications for eutrophication and biogeochemical cycling. Simulation results suggest that the effects of low levels of trawling disturbance will be similar to those of natural bioturbators. In contrast, high levels of trawling disturbance cause sediment systems to become unstable due to large carbon fluxes between oxic and anoxic carbon compartments. In low energy habitats, intensive trawling disturbance may destabilize benthic system chemical fluxes, which has the potential to propagate more widely through the marine ecosystem. Management regimes that aim to incorporate both fisheries and habitat conservation objectives can be achieved through the appropriate use of a number of approaches, including total and partial exclusion of towed bottom fishing gears, and seasonal and rotational closure techniques. However, the inappropriate use of closed areas may displace fishing activities into habitats that are more vulnerable to disturbance than those currently trawled by fishers. In many cases, the behaviour of fishers constrains the extent of the impact of their fishing activities. Management actions that force them to redistribute their effort may be more damaging in the longer term