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INTRODUCTION: Diabetes mellitus is common in primary care, yet little has been reported of its primary care prevalence or the clinical characteristics of patients with Type 2 diabetes mellitus (T2DM). AIM: To determine the prevalence of diabetes mellitus and clinical characteristics of diabetes patients in primary care in the Waikato region. METHODS: Primary care data were extracted from the electronic records of 15 general practices for patients aged >20 years with current diabetes mellitus at 20 June 2017. Diabetes mellitus was defined as having a glycated haemoglobin (HbA1c) of ≥50 mmol/mol (6.7%) or having being dispensed two or more anti-diabetic medications in the previous 12 months. Additional data collected included patients' ethnicity, age, sex and years since diagnosis. RESULTS: The overall prevalence of diabetes mellitus was 5.7% and was higher for Māori (8.6%), Asian (7.0%) and Pacific peoples (9.1%) than Europeans (5.0%; all P < 0.001). For patients with T2DM for whom current diabetes annual review data were available (n = 2227) the mean body mass index (BMI) was 32.8 ± 0.2 kg/m2, but BMI was higher in Māori, younger patients, females and patients diagnosed <2 years previously (all P < 0.001). Similarly, HbA1c levels were highest in Māori and younger patients (both P < 0.001), with 40% of patients overall having a HbA1c of ≤53 mmol/mol (7.0%). Approximately 70% of all patients had at least one measure of hypertension (systolic ≥130 or diastolic ≥80 mmHg), or dyslipidaemia. More than 85% of patients had completed a recent retinal screen and foot check. DISCUSSION: We found that management of T2DM was suboptimal, with measures for many patients not meeting clinical targets. Support should be provided to improve weight and glycaemic management, particularly for Māori, females and younger patients. [ABSTRACT FROM AUTHOR]

Purpose: To measure the iodine status and iodine intake of New Zealand adults 18-64 years of age following mandatory fortification of bread with iodine. Methods: A cross-sectional survey of NZ adults living in Dunedin and Wellington during February-November 2012. Three hundred and one men and women aged 18-64 years randomly selected from the New Zealand Electoral Roll completed a 24-h urine collection, a demographic and iodine-specific food frequency questionnaire (FFQ), and had height and weight measured. Urine collections were analysed for iodine and reported as median urinary iodine concentration (UIC) µg/L and median urinary iodine excretion (UIE) µg/day. The FFQ was used to estimate iodine intake with and without discretionary iodised salt use. Results: The median UIC for all adults was 73 µg/L, indicative of mild iodine deficiency. The mean urinary volume was 2.0 L. As an estimate of iodine intake, the median UIE was 127 µg/day. Estimated iodine intake, using the FFQ which included discretionary iodised salt use, was 132 µg/day. Iodine intakes were associated with UIC ( P = 0.040) and UIE ( P = 0.003), but not with bread iodine intake and iodised salt use. Conclusion: Using the WHO/UNICEF/ICCIDD target for iodine sufficiency (a UIC of >100 µg/L) based on school-aged children with a mean urinary volume of 1.0 L, the iodine status of NZ adults does not reach adequate levels (73 µg/L). A more realistic parameter in a population with a higher urinary volume excretion (2.0 L) is the UIE. A median UIE of 127 µg/day suggests that the iodine status of NZ adults is now likely to be adequate. [ABSTRACT FROM AUTHOR]

Background: Human milk is typically low in vitamin D activity (VDA). Whether the vitamin D content of breast milk at birth can be increased by supplementing the mother during pregnancy has not been reported to the best of our knowledge. Objective: We examined the effect of vitamin D supplementation during pregnancy on breast-milk VDA in the first 2 mo of lactation. Design: Breast-milk samples were obtained from women who were enrolled in a randomized, double-blinded, placebo-controlled trial of vitamin D supplementation during pregnancy. Pregnant women were enrolled at 27 wk of gestation and randomly assigned to the following 3 groups: a placebo group, a group who received one dosage of daily oral vitamin D3 (1000 IU), or a group who received 2 dosages of daily oral vitamin D3 (2000 IU). Serum 25-hydroxy-vitamin D [25(OH)D] was measured at enrollment, at 36 wk of gestation, and in cord blood at birth. Study participants who were breastfeeding were invited to provide breast-milk samples for VDA measurement [concentration of vitamin D2, vitamin D3, 25(OH)D2, and 25(OH)D3] at 2 wk and 2 mo postpartum. A linear mixed model was used to compare breast-milk VDA between the 3 study groups. Results: A total of 75 women provided breast-milk samples (44 women provided breast-milk samples at both 2 wk and 2 mo postpartum). The mean (95% CI) VDA at age 2 wk was 52 IU/L (12, 217 IU/L) in the placebo group, 51 IU/L (17, 151 IU/L) in the 1000-IU group, and 74 IU/L (25, 221 IU/L) in the 2000-IU group; and at age 2 mo, the mean (95% CI) VDA was 45 IU/L (16, 124 IU/L), 43 IU/L (18, 103 IU/L), and 58 IU/L (15, 224 IU/L), respectively. There was no significant interaction in VDA between the sample-collection time and treatment (P = 0.61), but there was a difference between lower- and higher-dosage treatment groups (P = 0.04). Conclusion: Maternal vitamin D supplementation during pregnancy of 2000 IU/d (compared with 1000 IU/d and with a placebo) results in a higher VDA of breast milk ≥2 mo postpartum. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12610000483055. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aim of this study was to determine the association between the school nutrition climate and students' eating behaviors and body mass index (BMI). METHODS Data were collected as part of Youth'07, a nationally representative health survey of high school students in New Zealand. Overall, 9107 randomly selected students from 96 randomly selected schools participated. School-level measures were created by aggregating students' reports within schools. Analyses were conducted using multilevel modeling, accounting for student-level characteristics. RESULTS There was a positive association between the school nutrition climate and students' consumption of fruits and vegetables. This relationship was statistically significant after controlling for the background characteristics of students. There were no associations between the school nutrition climate and students' junk food consumption or BMI. CONCLUSIONS The school nutrition climate appears to have a positive influence on adolescents' healthy eating behaviors (fruit and vegetable intake), but a limited effect on unhealthy eating behaviors and ultimately body weight. This may reflect the pervasiveness of junk food in the environments of adolescents outside of school and the difficulty in limiting its consumption. [ABSTRACT FROM AUTHOR]

The article presents research which examined the occurrence of childhood trauma in children with bipolar disorder. Topics covered include the impact of stress on the treatment course for the children and the rate of childhood trauma in patients with the condition. Also mentioned is the use of the Childhood Trauma Questionnaire in the study.

The aim of the study was to validate the self-report Multimedia Activity Recall for Children and Adolescents (MARCA) against accelerometry for the assessment of physical activity in New Zealand children. Participants (n = 716, 10–18 years) recalled 3–4 days of activity using the MARCA and underwent a partially overlapping 7-day accelerometry protocol during a national survey. Spearman correlation coefficients (ρ) assessed the association between accelerometer-derived counts per minute and MARCA-derived physical activity level and time in locomotion. Both data sources estimated time spent in light and moderate–vigorous physical activity. Association and agreement between methods for light physical activity and moderate–vigorous physical activity was assessed using correlations and Bland–Altman plots respectively, and pairedt-tests conducted. Accelerometer-derived activity counts were moderately correlated with both MARCA-derived physical activity level and locomotion (ρ = 0.38,P < 0.0001). The correlation between methods was –0.14 for light physical activity and 0.28 for moderate–vigorous physical activity (P < 0.0001). The MARCA overestimated moderate–vigorous physical activity compared with accelerometry (120 min,P < 0.0001), which increased as moderate–vigorous physical activity time increased. Some sex and ethnicity (Māori [indigenous] versus non-Māori) differences were observed. Overall, the MARCA indicated moderate validity for assessment of physical activity level, locomotion and moderate–vigorous physical activity and poor validity for assessment of light physical activity. This was comparable to other self-report tools. The MARCA has utility for future large-scale research. [ABSTRACT FROM PUBLISHER]

Aim To examine the relationships between cardiovascular risk factors, cardiovascular health at baseline, and cardiovascular disease ( CVD) events 28 months later, in advanced age. Methods 108 adults in advanced age were recruited. Data were collected through a standardised questionnaire including a measure of physical activity, comprehensive physical assessment and fasting blood samples. CVD events at follow-up were ascertained from hospital records. Results Sixty-seven per cent of participants had CVD at baseline. Physical activity ( OR (95% CI): 0.99 (0.98-1.0); P = 0.04) and high-density lipoprotein ( HDL) ( OR (95% CI): 0.3 (0.09-1.0); P = 0.046) were independently associated with CVD. The 28-month incidence rate of CVD was 6 cases/100 person-years. Baseline diastolic BP ( OR (95% CI): 0.9 (0.9-1.0); P = 0.03) and waist circumference ( OR (95% CI): 1.06 (1.01-1.1); P = 0.01) were independently associated with subsequent CVD events at follow-up. Conclusion Physical activity and HDL levels were inversely associated with CVD at baseline but did not predict future CVD events. CVD in advanced age warrants further investigation. [ABSTRACT FROM AUTHOR]

Background: Vitamin C (ascorbate) is likely to be essential for skeletal muscle structure and function via its role as an enzyme cofactor for collagen and carnitine biosynthesis. Vitamin C may also protect these metabolically active cells from oxidative stress. Objective: We investigated the bioavailability of vitamin C to human skeletal muscle in relation to dietary intake and plasma concentrations and compared this relation with ascorbate uptake by leukocytes. Design: Thirty-six nonsmoking men were randomly assigned to receive 6 wk of 0.5 or 2 kiwifruit/d, an outstanding dietary source of vitamin C. Fasting blood samples were drawn weekly, and 24-h urine and leukocyte samples were collected before intervention, after intervention, and after washout. Needle biopsies of skeletal muscle (vastus lateralis) were carried out before and after intervention. Results: Baseline vastus lateralis ascorbate concentrations were ~16 nmol/g tissue. After intervention with 0.5 or 2 kiwifruit/d, these concentrations increased 3.5-fold to 53 and 61 nmol/g, respectively. There was no significant difference between the responses of the 2 groups. Mononuclear cell and neutrophil ascorbate concentrations increased only ~1.5- and ~2-fold, respectively. Muscle ascorbate concentrations were highly correlated (P < 0.001) with dietary intake (R = 0.61) and plasma concentrations (R = 0.75) in the range from 5 to 80 μmol/L. Conclusions: Human skeletal muscle is highly responsive to vitamin C intake and plasma concentrations and exhibits a greater relative uptake of ascorbate than leukocytes. Thus, muscle appears to comprise a relatively labile pool of ascorbate and is likely to be prone to ascorbate depletion with inadequate dietary intake. [ABSTRACT FROM AUTHOR]

The prevalence of overweight and obesity is increasing worldwide at an alarming rate. An Internet-based weight-loss programme has the potential to reach larger numbers of people than traditional face-to-face programmes. A growing body of evidence supports the use of low glycaemic load (GL) diets for weight loss. The present study aimed to investigate the efficacy of an Internet-based weight-loss programme that included foods with a low GL. One hundred and three volunteers, with a body mass index (BMI) ≥28 kg m, enrolled into an Internet weight-loss programme. A dietitian counselled participants over the Internet via weekly interactive chat rooms and monthly e-mails. Participants self-recorded body weight and food intake directly on to the Internet site. Weight, BMI and waist circumference were measured, and dietary data collected, at baseline and 6 months. Seventy participants completed the 6-month weight-loss programme. Among these, mean weight, BMI and waist circumference significantly decreased by 3.5 kg (95% CI = 2.3-4.7), 1.2 kg m (95% CI = 0.8-1.7) and 4.8 cm (95% CI = 2.8-6.8), of baseline values respectively ( P < 0.001). Twenty-five (36%) of the 70 participants lost a clinically significant amount of weight (>5% of initial body weight). This descriptive study has shown that an Internet-based weight-loss programme with low GL principles can promote weight loss. This type of intervention and approach could be used to enhance other weight-loss strategies. [ABSTRACT FROM AUTHOR]

Research measuring whole-body protein turnover (WBPT) after both exercise and nutrition has generally focused on resistance exercise; however, there is a paucity of data regarding the effect of postaerobic exercise nutrition, especially in older adults. It is not known if postexercise protein feeding has a beneficial effect on protein turnover after low- to moderate-intensity exercise. We investigated whether consuming protein plus carbohydrate (PRO) immediately after an acute bout of aerobic exercise has an additive effect over carbohydrate alone (CHO) on WBPT in older individuals. Twelve healthy older adults (age, 59 ± 4 years) were studied on 2 separate occasions after 1 h of exercise at approximately 50% of maximal rate of oxygen uptake, followed by 4 h of recovery. Immediately following exercise, subjects ingested a CHO (60 g) or an isocaloric PRO beverage (40 g carbohydrate, 20 g whey protein). Whole-body protein metabolism was determined using [1-13C]leucine infusion (60 mg prime; 75 mg·h-1 continuous), and sampling blood and expired breath. Rates of whole-body leucine appearance and oxidation, and nonoxidative leucine disposal during the third and fourth hours of postexercise recovery were higher in the PRO group (2.51 ± 0.55, 0.78 ± 0.37, and 1.71 ± 0.44 µmol·kg-1·min-1, respectively) than in the CHO group (1.81 ± 0.27, 0.33 ± 0.14, and 1.47 ± 0.25 µmol·kg-1·min-1, respectively; p = 0.001). Our results indicate that consumption of a PRO beverage after aerobic exercise increased WBPT to a greater extent than a CHO beverage. Les études s'intéressant à la mesure du renouvellement global des protéines dans l'organisme (WBPT) à la suite d'un exercice physique et d'un apport alimentaire traitent généralement du rôle des exercices de force; néanmoins, il y a peu d'études sur les effets d'un apport alimentaire à la suite d'un exercice aérobie particulièrement chez les personnes âgées. On ne sait pas si un apport protéique après un exercice suscite un effet bénéfique sur le renouvellement protéique consécutif à un exercice d'intensité légère à modérée. Cette étude se propose de vérifier si, comparativement à un apport de sucres seulement (CHO), un apport protéique combiné à des sucres (PRO) immédiatement après un bref effort aérobie apporte des effets additionnels concernant le WBPT chez des personnes âgées. On invite en deux occasions douze adultes en bonne santé et âgés de 59 ± 4 ans à participer à une séance d'exercice d'une durée de 60 min et d'intensité suscitant 50 % du consommation d'oxygene maximale suivie d'une récupération d'une durée de 4 h. Immédiatement après la fin de l'exercice, les sujets consomment soit une boisson contenant des sucres (CHO; 60 g) soit une boisson contenant des sucres et des protéines (PRO; 40 g de sucres et 20 g de protéines lactosériques) totalisant la même quantité d'énergie. On évalue le métabolisme protéique de l'organisme en entier par l'administration de [1-13C] leucine (infusion immédiate de 60 mg suivie d'une perfusion à raison de 75 mg·h-1) et l'analyse des échantillons de sang et des gaz expirés. Les taux corporels d'apparition de la leucine, de son oxydation et de l'élimination de la fraction non oxydée au cours de la 3e et de la 4e heure de la période de récupération postexercice sont plus importants dans la condition PRO (2,51 ± 0,55, 0,78 ± 0,37 et 1,71 ± 0,44 μmol·kg-1·min-1 respectivement) que dans la condition CHO (1,81 ± 0,27, 0,33 ± 0,14 et 1,47 ± 0,25 μmol·kg-1·min-1 respectivement) (p = 0,001). Nos observations révèlent qu'un apport de protéines à la suite d'un exercice aérobie suscite une plus grande augmentation du WBPT que ne le fait un apport de sucres. Un apport protéique à la suite d'un exercice semble favorable à l'amélioration de la qualité des protéines contenues dans l'organisme en entier et pourrait apporter des gains en matière de capacité physique chez les personnes âgées. [ABSTRACT FROM AUTHOR]

The article focuses on a longitudinal study that analyse sleep duration in children in relation to body mass index (BMI) and body fat. The study used anthropometry, dual energy x-ray absorptiometry and bioelectrical impedance to measure body compositions. Other information including birth weight, smoking during pregnancy and maternal BMI were collected at baseline. The study found that children with less hours of sleep are more likely to be overweight as they grow older.