The BASES expert statement on exercise, immunity, and infection

An individual's level of physical activity influences their risk of infection, most likely by affecting immune function. Regular moderate exercise reduces the risk of infection compared with a sedentary lifestyle, but very prolonged bouts of exercise and periods of intensified training are associated with an increased risk of infection. There are several lifestyle, nutritional, and training strategies that can be adopted to limit the extent of exercise-induced immunodepression and minimize the risk of infection. This expert statement provides a background summarizing the evidence together with extensive conclusions and practical guidelines

Is there an optimal vitamin D status for immunity in athletes and military personnel?

Vitamin D is mainly obtained through sunlight ultraviolet-B (UVB) exposure of the skin, with a small amount typically coming from the diet. It is now clear that Vitamin D has important roles beyond its well-known effects on calcium and bone homeostasis. Immune cells express the Vitamin D receptor, including antigen presenting cells, T cells and B cells, and these cells are all capable of synthesizing the biologically active Vitamin D metabolite, 1, 25 dihydroxy Vitamin D. There has been growing interest in the benefits of supplementing Vitamin D as studies report Vitamin D insufficiency (circulating 25(OH)D 75 nmol/L

Long-Term PIT and T-Bar Anchor Tag Retention Rates in Adult Muskellunge

Mark-recapture studies require knowledge of tag retention rates specific to tag types, fish species and size, and study duration. We determined the probability of tag loss for passive integrated transponder (PIT) tags implanted into dorsal musculature, T-bar anchor tags attached to dorsal pterygiophores, and loss of both tags in relation to years post-tagging for double-marked adult muskellunge Esox masquinongy over a 10 year period. We also used PIT tags as a benchmark to assess the interactive effects of fish length at tagging, sex, and years post-tagging on T-bar anchor tag loss rates. Only five instances of PIT tag loss were identified; the calculated probability of a fish losing its PIT tag was consistently \u3c 1.0% for up to 10 years post-tagging. The probability of T-bar anchor tag loss by muskellunge was related to the number of years post-tagging and total length of fish at tagging. T-bar anchor tag loss rate one year after tagging was 6.5%. Individuals \u3c 750 mm total length at tagging had anchor tag loss rates \u3c 10% for up to 6 years after tagging. However, the proportion of fish losing T-bar anchor tags steadily increased with increasing years post-tagging (~30% after 6 years) for larger muskellunge. Fish gender did not influence probability of T-bar anchor tag loss. Our results indicate that T-bar anchor tags are best suited for short-term applications (≤ 1 year duration) involving adult muskellunge. We recommend use of PIT tags for longer-term tagging studies, particularly for muskellunge \u3e 750 mm total length

Vitamin D metabolites are associated with musculoskeletal injury in young adults: a prospective cohort study.

The relationship between vitamin D metabolites and lower body (pelvis and lower limb) overuse injury is unclear. In a prospective cohort study, we investigated the association between vitamin D metabolites and incidence of lower body overuse musculoskeletal and bone stress injury in young adults undergoing initial military training during all seasons. In 1637 men and 530 women (age, 22.6 ± 7.5 years; BMI, 24.0 ± 2.6 kg∙m−2; 94.3% white ethnicity), we measured serum 25-hydroxyvitamin D (25(OH)D) and 24,25-dihydroxyvitamin D (24,25(OH)2D) by high-performance liquid chromatography tandem mass spectrometry, and 1,25-dihydroxyvitamin D (1,25(OH)2D) by immunoassay during week 1 of training. We examined whether the relationship between 25(OH)D and 1,25(OH)2D:24,25(OH)2D ratio was associated with overuse injury. During 12 weeks training, 21.0% sustained ≥1 overuse musculoskeletal injury, and 5.6% sustained ≥1 bone stress injury. After controlling for sex, BMI, 2.4 km run time, smoking, bone injury history, and Army training course (Officer, standard, or Infantry), lower body overuse musculoskeletal injury incidence was higher for participants within the second lowest versus highest quartile of 24,25(OH)2D (OR: 1.62 [95%CI 1.13–2.32; P = 0.009]) and lowest versus highest cluster of 25(OH)D and 1,25(OH)2D:24,25(OH)2D (OR: 6.30 [95%CI 1.89–21.2; P = 0.003]). Lower body bone stress injury incidence was higher for participants within the lowest versus highest quartile of 24,25(OH)2D (OR: 4.02 [95%CI 1.82–8.87; P < 0.001]) and lowest versus highest cluster of 25(OH)D and 1,25(OH)2D:24,25(OH)2D (OR: 22.08 [95%CI 3.26–149.4; P = 0.001]), after controlling for the same covariates. Greater conversion of 25(OH)D to 24,25(OH)2D, relative to 1,25(OH)2D (i.e., low 1,25(OH)2D:24,25(OH)2D), and higher serum 24,25(OH)2D were associated with a lower incidence of lower body overuse musculoskeletal and bone stress injury. Serum 24,25(OH)2D may have a role in preventing overuse injury in young adults undertaking arduous physical training

Portable prehospital methods to treat near-hypothermic shivering cold casualties

Objectives To compare the effectiveness of a single-layered polyethylene survival bag (P), a single-layered polyethylene survival bag with a hot drink (P+HD), a multi-layered metalized plastic sheeting survival bag (MPS: Blizzard Survival), and a multi-layered MPS survival bag with four large chemical-heat pads (MPS+HP: Blizzard Heat) to treat cold casualties. Methods Portable cold casualty treatment methods were compared by examining core and skin temperature, metabolic heat production and thermal comfort during a 3-h, 0°C cold-air exposure in seven shivering, near-hypothermic men (35.4°C). The hot drink (70°C, ~400ml, ~28kJ) was consumed at 0, 1 and 2 h during the cold-air exposure. Results During the cold-air exposure, core-rewarming and thermal comfort were similar on all trials (P = 0.45 and P = 0.36, respectively). However, skin temperature was higher (10-13%, P 2.7) and metabolic heat production lower (15-39%, P 0.9) on MPS and MPS+HP than P and P+HD. The addition of heat pads further lowered metabolic heat production by 15% (MPS+HP vs. MPS, P = 0.05, large effect size d = 0.9). The addition of the hot drink to polyethylene survival bag did not increase skin temperature or lower metabolic heat production. Conclusions Near-hypothermic cold casualties are rewarmed with less peripheral cold stress and shivering thermogenesis using a multi-layered MPS survival bag compared with a polyethylene survival bag. Prehospital rewarming is further aided by large chemical heat pads but not by hot drinks

Influence of vitamin D supplementation by sunlight or oral D3 on exercise performance

Purpose: To determine the relationship between vitamin D status and exercise performance in a large, prospective cohort study of young men and women across seasons (Study-1). Then, in a randomized, placebo-controlled trial, to investigate the effects on exercise performance of achieving vitamin D sufficiency (serum 25(OH)D ≥ 50 nmol·L-1) by a unique comparison of safe, simulated-sunlight and oral vitamin D3 supplementation in wintertime (Study-2).  Methods: In Study-1, we determined 25(OH)D relationship with exercise performance in 967 military recruits. In Study-2, 137 men received either placebo, simulated-sunlight (1.3x standard erythemal dose in T-shirt and shorts, three-times-per-week for 4-weeks and then once-per-week for 8-weeks) or oral vitamin D3 (1,000 IU[BULLET OPERATOR]day-1 for 4-weeks and then 400 IU[BULLET OPERATOR]day-1 for 8-weeks). We measured serum 25(OH)D by LC-MS/MS and endurance, strength and power by 1.5-mile run, maximum-dynamic-lift and vertical jump, respectively.  Results: In Study-1, only 9% of men and 36% of women were vitamin D sufficient during wintertime. After controlling for body composition, smoking and season, 25(OH)D was positively associated with endurance performance (P ≤ 0.01, [INCREMENT]R2 = 0.03–0.06, small f2 effect sizes): 1.5-mile run time was ~half-a-second faster for every 1 nmol·L-1 increase in 25(OH)D. No significant effects on strength or power emerged (P > 0.05). In Study-2, safe simulated-sunlight and oral vitamin D3 supplementation were similarly effective in achieving vitamin D sufficiency in almost all (97%); however, this did not improve exercise performance (P > 0.05).  Conclusion: Vitamin D status was associated with endurance performance but not strength or power in a prospective cohort study. Achieving vitamin D sufficiency via safe, simulated summer sunlight or oral vitamin D3 supplementation did not improve exercise performance in a randomized-controlled trial