Building Resilience in Social-Ecological Food Systems in Vermont

There is an expanding interest in Local Food Systems (LFSs) in Vermont, along with a growing effort to create adaptive governance to facilitate action. In this case study, we investigate how adaptive governance of LFS can provide ideas and act as a catalyst for creating resilience in other social-ecological systems (SESs). By participating in meetings and interviewing stakeholders inside and outside the Vermont LFS network, we found that consumers were highly motivated to participate by supporting environmental issues, the local economy, and interactive communities, as well as building social relationships. Farmers experienced better income and increased respect in the local community. All participants found adequate “safe space” to share new ideas and explore partnerships. Their identities and values were also place-specific, reflecting the working landscape of Vermont. Adaptive governance was built on equal partnerships, where problems were discussed and responsibilities were shared among many stakeholders across geographic areas and multiple sectors. Some skepticism was expressed towards mainstreaming local food production and sales. Challenges remain to more fully include farmers, for-profit players, and low-income consumers in the network. This might limit the resilience and sustainability of the LFS. Because SESs are held together by common culture and identities, the risk of non-adaptive social patterns exemplifies one key challenge for future adaptive management towards resilient and sustainable outcomes. There is a critical need for developing relevant theory and conducting further research on LFSs and their potential roles in local SESs

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Building Resilience in Social-Ecological Food Systems in Vermont

There is an expanding interest in Local Food Systems (LFSs) in Vermont, along with a growing effort to create adaptive governance to facilitate action. In this case study, we investigate how adaptive governance of LFS can provide ideas and act as a catalyst for creating resilience in other social-ecological systems (SESs). By participating in meetings and interviewing stakeholders inside and outside the Vermont LFS network, we found that consumers were highly motivated to participate by supporting environmental issues, the local economy, and interactive communities, as well as building social relationships. Farmers experienced better income and increased respect in the local community. All participants found adequate “safe space” to share new ideas and explore partnerships. Their identities and values were also place-specific, reflecting the working landscape of Vermont. Adaptive governance was built on equal partnerships, where problems were discussed and responsibilities were shared among many stakeholders across geographic areas and multiple sectors. Some skepticism was expressed towards mainstreaming local food production and sales. Challenges remain to more fully include farmers, for-profit players, and low-income consumers in the network. This might limit the resilience and sustainability of the LFS. Because SESs are held together by common culture and identities, the risk of non-adaptive social patterns exemplifies one key challenge for future adaptive management towards resilient and sustainable outcomes. There is a critical need for developing relevant theory and conducting further research on LFSs and their potential roles in local SESs

Building Resilience in Social-Ecological Food Systems in Vermont

There is an expanding interest in Local Food Systems (LFSs) in Vermont, along with a growing effort to create adaptive governance to facilitate action. In this case study, we investigate how adaptive governance of LFS can provide ideas and act as a catalyst for creating resilience in other social-ecological systems (SESs). By participating in meetings and interviewing stakeholders inside and outside the Vermont LFS network, we found that consumers were highly motivated to participate by supporting environmental issues, the local economy, and interactive communities, as well as building social relationships. Farmers experienced better income and increased respect in the local community. All participants found adequate “safe space” to share new ideas and explore partnerships. Their identities and values were also place-specific, reflecting the working landscape of Vermont. Adaptive governance was built on equal partnerships, where problems were discussed and responsibilities were shared among many stakeholders across geographic areas and multiple sectors. Some skepticism was expressed towards mainstreaming local food production and sales. Challenges remain to more fully include farmers, for-profit players, and low-income consumers in the network. This might limit the resilience and sustainability of the LFS. Because SESs are held together by common culture and identities, the risk of non-adaptive social patterns exemplifies one key challenge for future adaptive management towards resilient and sustainable outcomes. There is a critical need for developing relevant theory and conducting further research on LFSs and their potential roles in local SESs

Bone Turnover and Metabolism in Patients with Early Multiple Sclerosis and Prevalent Bone Mass Deficit: A Population-Based Case-Control Study

Low bone mass is prevalent in ambulatory multiple sclerosis (MS) patients even shortly after clinical onset. The mechanism is not known, but could involve shared etiological risk factors between MS and low bone mass such as hypovitaminosis D operating before disease onset, or increased bone loss after disease onset. The aim of this study was to explore the mechanism of the low bone mass in early-stage MS patients. We performed a population-based case-control study comparing bone turnover (cross-linked N-terminal telopeptide of type 1 collagen; NTX, bone alkaline phosphatase; bALP), metabolism (25-hydroxy- and 1, 25-dihydroxyvitamin D, calcium, phosphate, and parathyroid hormone), and relevant lifestyle factors in 99 patients newly diagnosed with clinically isolated syndrome (CIS) or MS, and in 159 age, sex, and ethnicity matched controls. After adjustment for possible confounders, there were no significant differences in NTX (mean 3.3; 95% CI −6.9, 13.5; p = 0.519), bALP (mean 1.6; 95% CI −0.2, 3.5; p = 0.081), or in any of the parameters related to bone metabolism in patients compared to controls. The markers of bone turnover and metabolism were not significantly correlated with bone mass density, or associated with the presence of osteoporosis or osteopenia within or between the patient and control groups. Intake of vitamin D and calcium, reported UV exposure, and physical activity did not differ significantly. Bone turnover and metabolism did not differ significantly in CIS and MS patients with prevalent low bone mass compared to controls. These findings indicate that the bone deficit in patients newly diagnosed with MS and CIS is not caused by recent acceleration of bone loss, and are compatible with shared etiological factors between MS and low bone mass

Bone mineral density in patients with multiple sclerosis, hereditary ataxia or hereditary spastic paraplegia after at least 10 years of disease - a case control study

Background Although disability is considered the main cause of low bone mineral density (BMD) in multiple sclerosis (MS), other factors related to the disease process or treatment could also be involved. The aim of this study was to assess whether patients with MS are more likely to develop low BMD (osteopenia or osteoporosis) than patients with the non-inflammatory neurological diseases Hereditary Spastic Paraplegia (HSP) and Hereditary Ataxia (HA). Methods We performed a case control study comparing BMD (spine, hip and total body) and biochemical measures of bone metabolism in 91 MS patients and 77 patients with HSP or HA, matched for age, gender and disability. Both patient groups had lived with the disease for at least 10 years. Results In total 74.7% of the patients with MS and 75.3% of the patients with HSP or HA had osteopenia (−2.5 < T- score < −1.0) or osteoporosis (T- score ≤ −2.5) in one or more sites. Osteoporosis was more common in patients with MS than with HSP/HA (44.0 vs 20.8%, p =0.001). This difference was not significant after correction for confounders (p = 0.07), nor were any of the biochemical markers. Conclusion Most patients with disabling neurological diseases like MS and HSP/HA develop osteopenia or osteoporosis. MS patients had osteoporosis more frequently than HA/HSP patients, though the difference was not significant after adjusting for confounders. Osteoporosis and bone health should be considered in all patients with both inflammatory and degenerative chronic neurological diseases

Additional file 1: of Bone mineral density in patients with multiple sclerosis, hereditary ataxia or hereditary spastic paraplegia after at least 10Â years of disease - a case control study

Supplementary Table 1: an overview of possible bone influential factors in both groups. (DOCX 14 kb

Differences in urine NTX between patients and controls, without and with adjustment for possible confounders.

<p>β: unstandardized β coefficient, CI: β confidence interval. NTX (cross-linked N-terminal telopeptide of type 1 collagen) was analyzed as dependent and the following as independent variables (separately and simultaneously): recent childbirth, breastfeeding, systemic glucocorticoids, current smoking, alcohol use, began menopausal transition, sun tanning in northern latitudes, and phosphate. Recent childbirth and breastfeeding were not included simultaneously in the regression analysis due to their high correlation (r = 0.921; p<0.001).</p

Distribution of factors that may influence current bone metabolism.

<p>iv: intravenous, po: per oral.</p>a<p>Mediterranean or other destinations nearer equator than Norway.</p>b<p>percentages of female participants (female patients, n = 71; female controls, n = 117). Comparison of groups was calculated using Chi-square test and independent-samples two-tailed t test.</p