Latest News & Research: 5 November 2019

This week: Vitamin D deficient? Join an outdoor boot camp! • Study pinpoints best exercises to beat back pain • Genders at risk of different obesity-related conditions

Vitamin D deficient? Join an outdoor boot camp!

As we head towards summer, a Deakin researcher says that most Australians don’t need vitamin D added to food, should ditch the vitamin D supplements which can lead to overdose, and that a couple of minutes in the sun daily is enough to keep vitamin D levels normal.

Emeritus Professor Caryl Nowson, from Deakin’s Institute for Physical Activity and Nutrition, said that in late spring and summer it’s important to wear sunscreen during the day, but that it’s just as vital to get enough vitamin D from its natural source – ultra violet rays from the sun.

‘For many people the fix for not getting enough sunshine is a vitamin D supplement. While supplements have a place, it’s for the minority of the population’ Nowson said; ‘Supplements are only useful for those where the risk of vitamin D deficiency is high and low vitamin D status has been identified with a blood test. It is preferable for the body to make natural vitamin D because, unlike with supplements, there is no possibility of an overdose.

‘However, this is not possible for everyone. Frail elderly people or those who are in hospital or rehabilitation are at genuine risk of not getting enough ultra violet rays from the sun. Also people with naturally very dark skin, nightshift workers with limited sun exposure and breastfed babies of vitamin D deficient mothers are at the greatest risk of deficiency.’

Nowson said those in the high-risk group taking supplements must ensure they stick to the prescribed daily amount.

‘Vitamin D supplements are available in supermarkets and over the counter at chemists. There appears to be a view among the general population that vitamin D tablets are safe and you can’t have too much, as the body will expel what it uses, but that’s misguided’ she said; ‘Overdoses are caused by megadoses of supplements, not diet or sun exposure, and are toxic.’

How much time the average person – free of deficiency – needs to spend in the sun to naturally make the hormone depends on skin colour and their distance from the equator. People with darker skin need longer exposure to UV light to produce vitamin D.

‘These requirements change with the seasons. In summer most people make enough vitamin D because UV levels are high and we spend more time outdoors.' Nowson said.

She added that longer stints of sunshine after a long winter and cold start to spring won’t expedite vitamin D production and storage.

‘People make the mistake of thinking they can spend more time in the sun to bring vitamin D levels back up quickly, but that’s not the case. The minute your skin starts to go a little pink, or red, your body stops making vitamin D. It’s the body’s natural way of preventing a vitamin D overdose. Vitamin D needs to be produced by the body, from sunshine, daily. It is a nutrient that is needed for health, particularly to maintain strong bones and teeth by helping the body to absorb calcium.’

Source: Deakin University


Study pinpoints best exercises to beat back pain

Active treatments including Pilates, stabilisation exercises, weight training and aerobic exercise could be the most effective to help beat chronic low back pain, according to new research from Deakin’s Institute for Physical Activity and Nutrition (IPAN).

The world-first analysis, funded by Musculoskeletal Australia and published in the British Journal of Sports Medicine, compared 89 studies that examined a range of back pain treatments. It found that moving the body beats passive treatment or rest, and pinpointed the types of exercise that lead to the best outcomes for different back pain symptoms.

Lead researcher IPAN Associate Professor Daniel Belavy said the study showed the most effective exercises to improve pain, physical function and mental health were:

  • resistance exercise, using weight machines or free weights at increasing loads to build strength
  • Pilates
  • stabilisation or motor control exercise training, which focuses on training specific muscles
  • aerobic exercise training, such as walking or cycling.

‘There was evidence that Pilates and stabilisation or motor control exercise training were the best of these exercises for reducing pain’ Belavy said; ‘The least likely treatments to be effective included hands-off treatment, such as only educating people about chronic pain or doing psychological interventions alone, and hands-on treatment, like manual therapy, massage and acupuncture.

‘Importantly, stretching and McKenzie exercises, which is a treatment approach that uses a classification system to prescribe exercise, were found to be the least effective kinds of exercises.’

Belavy said spinal pain represented the greatest cost to Australian society of any disease in terms of disability and lost productivity.

‘Low back pain affects 80 to 90% of Australians in their lifetime and while the majority of spinal pain cases resolve without specific intervention, it’s chronic or persistent low back pain that presents the greatest challenge’ Belavy said; ‘In the vast majority of chronic low back pain cases the pain is ‘non-specific’ meaning that clinicians cannot define a specific diagnosis, or cause, of the pain.’

Belavy said there was an increasing body of evidence that showed active treatments were the most effective way to relieve the symptoms of chronic low back pain, compared to passive treatments.

‘Researchers and clinicians have believed for some time now that exercise is beneficial for low back pain, however nobody has been able to demonstrate which exercise is more beneficial than another’ he said; ‘We sought to address this by implementing an analytical procedure called 'network meta-analysis' which enabled us to compare two treatments across a network of studies, even if a single study has not directly compared both. This allowed us to look at data from 5578 patients across 89 different studies, building up a better picture of effective interventions.’

But Belavy said it was unlikely that one kind of exercise training was the single best approach to treating non-specific chronic low back pain.

‘Rather, our study provides evidence that active therapies where the patient is guided, actively encouraged to move and exercise in a progressive fashion are the most effective’ he said; ‘There is a common misconception that if someone is in pain, they should be resting, but our research shows that when the pain has been there for a long time, exercise is an important part of treatment. Active exercise where the person is taken though a structured program to regain confidence with their body and movement can help reduce pain.’

Source: Deakin University


Genders at risk of different obesity-related conditions

The risks of developing additional health problems as a consequence of obesity are different for women and men, according to a new study from the University of Oxford, UK.

The study suggests that obesity may increase the risk for more – and more diverse – health conditions than doctors had previously realised. The researchers published a summary of their findings in PLOS Genetics.

‘It is increasingly evident that obesity negatively impacts human health, and the prevalence of obesity is increasing worldwide. Both overall obesity and fat distribution [...] have been linked to cardiometabolic diseases and death in observational studies’ the authors note in the introduction to their study paper; ‘However, sex-specific relationships are largely unexplored, as is the role that obesity traits play in the leading causes of death beyond these cardiometabolic diseases.’

For the current research, first author Dr Jenny Censin and colleagues analysed genetic information and three different measures of obesity in a cohort of 228,466 women and 195,041 men. The measures of obesity were:body mass index (BMI), waist-hip ratio, and waist-hip ratio adjusted for BMI. The investigators were able to access these data via the UK Biobank.

Through this analysis, Censin and the team found that obesity can increase a person's risk of a range of health conditions, including coronary artery disease, stroke, type 1 diabetes, type 2 diabetes, chronic obstructive pulmonary disease, nonalcoholic fatty liver disease, chronic liver disease, kidney failure, and lung cancer.

Moreover, they found some differences in risk when comparing data from men and women with obesity. Women with obesity face a higher risk of type 2 diabetes than men with obesity. Men, on the other hand, have a higher risk of chronic obstructive pulmonary disease and chronic kidney disease, compared with women who have obesity.

‘This study shows just how harmful carrying excess weight can be to human health, and that women and men may experience different diseases as a result’ said Censin.

These findings, the team notes, add to the evidence that preventing and treating obesity is a crucial step in preventing the emergence of other health conditions.

‘Given the compelling evidence of harm that arises as a consequence of obesity across a broad range of diseases that result in death, our findings highlight the critical need for public health measures to stem the tide of obesity’ said study co-author Michael Holmes, PhD.

Going forward, the evidence that obesity likely contributes to such a wide range of health conditions could reshape public health strategies aimed at prevention, the investigators note.

Source: Medical News Today