Vitamin D Status and Bone Mineral Density in Female Collegiate Dancers and Cheerleaders

Introduction: An athlete’s bone mineral density reflects their cumulative history of energy availability, physical activity, genetic predisposition for bone health, and menstrual status, as well as nutritional, behavioral, and environmental factors. Purpose: To determine if bone mineral density (BMD) and nutritional factors in bone health are different in two groups of female athletes who have comparable body size/weight requirements, but who engage in qualitatively different training regimens. Methods: Participants were female collegiate athletes who were members of the UNLV Dance team (n=10) or Cheer team (n=9), ages 18-22. Participants vitamin D status was assessed by obtaining a finger prick sample of blood (\u3c 1 ml). BMD for full body, spine and dual femur was assessed by dual energy X-ray absorptiometry (DXA). A calcium and vitamin D intake questionnaire was also completed. Results: There was no significant difference between the groups for total body BMD (1.23 g/cm2 dance vs 1.22 g/cm2 cheer, p=0.70), spine BMD (1.39 g/cm2 dance vs 1.36 g/cm2 cheer, p=0.72) or dual femur BMD (1.20 g/cm2 dance vs 1.11 g/cm2, p=0.23). Age matched z- scores for total body BMD were also not significantly different (1.46±1.23 dance vs 0.83±0.52 cheer, p=0.19). However there was a significant difference between age-matched z-scores of the dance team vs. non-athlete female controls (1.46±1.23 dance vs 0.19±1.22 control, p=0.033). Serum vitamin D status was found to be insufficient (10-29 ng/mL) in 74% of the athletes (27 ± 4 ng/mL dance and 25 ± 8 ng/mL cheer). Daily calcium intake was 504 ± 723 mg for dance and 531 ± 236 mg for cheer versus the RDA of 1,000mg/day. Daily vitamin D intake was 256 ± 335 IU for dance and 228 ± 145 IU for cheer versus the RDA of 600 IU/day. Conclusion: BMD was not significantly different between the low impact dance team and high impact cheer team. These results suggest that the type of activity (low impact dance vs. high impact cheerleading) was not as important for BMD as participating in 20+ hours a week of physical activity. Although the low levels of calcium and serum vitamin D are of concern, the amount of physical activity in these athletes could have counteracted the negative effects of these nutrient insufficiencies on their bone health

A retrospective public health analysis of the Republic of Ireland's Food Harvest 2020 strategy: absence, avoidance and business as usual

The concept of an Ecological Approach to health and including Health in All Policies warrants inter-sectoral and transdisciplinary collaboration to improve health determinants and reduce health inequities. Agriculture policies, which greatly influence food production and its environmental impacts as well as food availability and dietary consumption, are therefore of interest to public health. Increasing rates of non-communicable diseases linked to diets containing high levels of processed foods, increasing numbers of households unable to access nutritious food and the environmental consequences of the food system are amongst the major health challenges of today, both globally and in Ireland. In 2010, Ireland’s Department of Agriculture, Food and Fisheries published Food Harvest 2020 a roadmap for Irish agriculture for the subsequent decade prepared against a backdrop of rising diet-related ill-health and increasing environmental concerns. This article critically analyses the process of consultation and stakeholder involvement in the development of Food Harvest 2020 from a public health perspective. Publically available documents including submissions to the Food Harvest 2020 consultation process were the primary source of data. This study highlights a distinct absence of public health representation in the process, an avoidance of some key public health challenges and the dominance of a ‘business as usual’ approach

Vitamin D Status and Bone Mineral Density in Female Collegiate Dancers and Cheerleaders

Bone mineral density reflects an athlete’s cumulative history of energy availability, physical activity, and menstrual status, as well as nutritional and environmental factors. Although sports with high-impact loading are associated with higher bone mineral density than low-impact or non-impact sports, confounding variables are differences in the athletes’ body size and sport-specific training. The purpose of this study was to determine if bone mineral density (BMD) and vitamin D status are different between two groups of female collegiate athletes who have comparable body size/weight requirements, but who engage in qualitatively different training regimens. Full body, spine and dual femur BMD was assessed by dual energy X-ray absorptiometry (DXA) in members of a university pep-dance team (n = 10) or cheer team (n = 9), ages 18-22. Plasma vitamin D status was assessed by ELIZA. There was no significant difference between the groups for total body BMD (1.23 g/cm2 dance vs 1.22 g/cm2 cheer, P = 0.70), spine BMD (1.39 g/cm2 dance vs 1.36 g/cm2 cheer, P = 0.72) or dual femur BMD (1.20 g/cm2 dance vs 1.11 g/cm2, P = 0.23). Insufficient serum vitamin D status (20-32 ng/mL) was found in 74% of the athletes (27 ± 4 ng/mL, dance and 25 ± 8 ng/mL, cheer). In addition, estimated daily vitamin D and calcium intakes were less than the RDA for both dancers and cheerleaders. Despite nutritional insufficiencies, BMD was not significantly different between the low-impact activity pep dance team and high-impact activity cheer team, suggesting that the type of physical activity was not as important for BMD in these athletes as participating in 20+ hours a week of physical activity, which could have counteracted the negative effects of the nutrient insufficiencies on their bone health

Surplus food redistribution and healthy, sustainable diets: Exploring the contradictions of charitable food provisioning

A substantial body of literature points to the necessity of a ‘Great Food Transformation’ requiring an urgent shift towards sustainable food systems across multiple levels. A key part of this transition is the need to reduce food waste and food loss by 50 percent and where charitable surplus food redistribution is regarded as making an important contribution to this target. Surplus driven charitable food provisioning is now part of the food environment in many countries and is influencing the diets of a significant number of people. Its proponents argue that such work contributes to a more sustainable food system by reducing food waste and food insecurity. However, few studies have examined the factors influencing the governance of food within the charitable food system. This paper seeks to fill this gap in the literature through an examination of recent developments in charitable food provisioning in the Republic of Ireland. Using Cork city as a case study we explore Ireland’s charitable food system by examining the motivations, ideas, and practices of key organisations. The paper highlights the growing role of surplus-driven charitable food systems and argues that the redistribution of surplus products for the purpose of reducing food waste and improving economic efficiency requires re-evaluation within a wider appreciation of sustainable diets, and, ultimately, with regard to strengthening the right to food for all

Individual common variants exert weak effects on the risk for autism spectrum disorders.

While it is apparent that rare variation can play an important role in the genetic architecture of autism spectrum disorders (ASDs), the contribution of common variation to the risk of developing ASD is less clear. To produce a more comprehensive picture, we report Stage 2 of the Autism Genome Project genome-wide association study, adding 1301 ASD families and bringing the total to 2705 families analysed (Stages 1 and 2). In addition to evaluating the association of individual single nucleotide polymorphisms (SNPs), we also sought evidence that common variants, en masse, might affect the risk. Despite genotyping over a million SNPs covering the genome, no single SNP shows significant association with ASD or selected phenotypes at a genome-wide level. The SNP that achieves the smallest P-value from secondary analyses is rs1718101. It falls in CNTNAP2, a gene previously implicated in susceptibility for ASD. This SNP also shows modest association with age of word/phrase acquisition in ASD subjects, of interest because features of language development are also associated with other variation in CNTNAP2. In contrast, allele scores derived from the transmission of common alleles to Stage 1 cases significantly predict case status in the independent Stage 2 sample. Despite being significant, the variance explained by these allele scores was small (Vm< 1%). Based on results from individual SNPs and their en masse effect on risk, as inferred from the allele score results, it is reasonable to conclude that common variants affect the risk for ASD but their individual effects are modest

Maternal sildenafil for severe fetal growth restriction (STRIDER): a multicentre, randomised, placebo-controlled, double-blind trial

Background Severe early-onset fetal growth restriction can lead to a range of adverse outcomes including fetal or neonatal death, neurodisability, and lifelong risks to the health of the affected child. Sildenafil, a phosphodiesterase type 5 inhibitor, potentiates the actions of nitric oxide, which leads to vasodilatation of the uterine vessels and might improve fetal growth in utero. Methods We did this superiority, placebo-controlled randomised trial in 19 fetal medicine units in the UK. We used random computer allocation (1:1) to assign women with singleton pregnancies between 22 weeks and 0 days' gestation and 29 weeks and 6 days' gestation and severe early-onset fetal growth restriction to receive either sildenafil 25 mg three times daily or placebo until 32 weeks and 0 days' gestation or delivery. We stratified women by site and by their gestational age at randomisation (before week 26 and 0 days or at week 26 and 0 days or later). We defined fetal growth restriction as a combination of estimated fetal weight or abdominal circumference below tenth percentile and absent or reversed end-diastolic blood flow in the umbilical artery on Doppler velocimetry. The primary outcome was the time from randomisation to delivery, measured in days. This study is registered with BioMed Central, number ISRCTN 39133303. Findings Between Nov 21, 2014, and July 6, 2016, we recruited 135 women and randomly assigned 70 women to sildenafil and 65 women to placebo. We found no difference in the median randomisation to delivery interval between women assigned to sildenafil (17 days [IQR 7–24]) and women assigned to placebo (18 days [8–28]; p=0·23). Livebirths (relative risk [RR] 1·06, 95% CI 0·84 to 1·33; p=0·62), fetal deaths (0·89, 0·54 to 1·45; p=0·64), neonatal deaths (1·33, 0·54 to 3·28; p=0·53), and birthweight (−14 g,–100 to 126; p=0·81) did not differ between groups. No differences were found for any other secondary outcomes. Eight serious adverse events were reported during the course of the study (six in the placebo group and two in the sildenafil group); none of these were attributed to sildenafil. Interpretation Sildenafil did not prolong pregnancy or improve pregnancy outcomes in severe early-onset fetal growth restriction and therefore it should not be prescribed for this indication outside of research studies with explicit participants' consent. Funding National Institute for Health Research and Medical Research Council

A Multicomponent Animal Virus Isolated from Mosquitoes

RNA viruses exhibit a variety of genome organization strategies, including multicomponent genomes in which each segment is packaged separately. Although multicomponent genomes are common among viruses infecting plants and fungi, their prevalence among those infecting animals remains unclear. We characterize a multicomponent RNA virus isolated from mosquitoes, designated Guaico Culex virus (GCXV). GCXV belongs to a diverse clade of segmented viruses (Jingmenvirus) related to the prototypically unsegmented Flaviviridae. The GCXV genome comprises five segments, each of which appears to be separately packaged. The smallest segment is not required for replication, and its presence is variable in natural infections. We also describe a variant of Jingmen tick virus, another Jingmenvirus, sequenced from a Ugandan red colobus monkey, thus expanding the host range of this segmented and likely multicomponent virus group. Collectively, this study provides evidence for the existence of multicomponent animal viruses and their potential relevance for animal and human health.RNA viruses exhibit a variety of genome organization strategies, including multicomponent genomes in which each segment is packaged separately. Although multicomponent genomes are common among viruses infecting plants and fungi, their prevalence among those infecting animals remains unclear. We characterize a multicomponent RNA virus isolated from mosquitoes, designated Guaico Culex virus (GCXV). GCXV belongs to a diverse clade of segmented viruses (Jingmenvirus) related to the prototypically unsegmented Flaviviridae. The GCXV genome comprises five segments, each of which appears to be separately packaged. The smallest segment is not required for replication, and its presence is variable in natural infections. We also describe a variant of Jingmen tick virus, another Jingmenvirus, sequenced from a Ugandan red colobus monkey, thus expanding the host range of this segmented and likely multicomponent virus group. Collectively, this study provides evidence for the existence of multicomponent animal viruses and their potential relevance for animal and human health

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London