A block in endoplasmic reticulum-to-Golgi trafficking inhibits phospholipid synthesis and induces neutral lipid accumulation

Seeking to better understand how membrane trafficking is coordinated with phospholipid synthesis in yeast, we investigated lipid synthesis in several Sec(-) temperature-sensitive mutants, including sec13-1. Upon shift of sec13-1 cells to the restrictive temperature of 37 degrees C, phospholipid synthesis decreased dramatically relative to the wild type control, whereas synthesis of neutral lipids, especially triacylglycerol (TAG), increased. When examined by fluorescence microscopy, the number of lipid droplets appeared to increase and formed aggregates in sec13-1 cells shifted to 37 degrees C. Electron microscopy confirmed the increase in lipid droplet number and revealed that many were associated with the vacuole. Analysis of lipid metabolism in strains lacking TAG synthase genes demonstrated that the activities of the products of these genes contribute to accumulation of TAG in sec13-1 cells after the shift to 37 degrees C. Furthermore, the permissive temperature for growth of the sec13-1 strain lacking TAG synthase genes was 3 degrees C lower than sec13-1 on several different growth media, indicating that the synthesis of TAG has physiological significance under conditions of secretory stress. Together these results suggest that following a block in membrane trafficking, yeast cells channel lipid metabolism from phospholipid synthesis into synthesis of TAG and other neutral lipids to form lipid droplets. We conclude that this metabolic switch provides a degree of protection to cells during secretory stress.

The lysophospholipid acyltransferase antagonist CI-976 inhibits a late step in COPII vesicle budding

The mechanism of coat protein (COP)II vesicle fission from the endoplasmic reticulum (ER) remains unclear. Lysophospholipid acyltransferases (LPATs) catalyze the conversion of various lysophospholipids to phospholipids, a process that can promote spontaneous changes in membrane curvature. Here, we show that 2,2-methyl-N-(2,4,6,-trimethoxyphenyl)dodecanamide (CI-976), a potent LPAT inhibitor, reversibly inhibited export from the ER in vivo and the formation of COPII vesicles in vitro. Moreover, CI-976 caused the rapid and reversible accumulation of cargo at ER exit sites (ERESs) containing the COPII coat components Sec23/24 and Sec13/31 and a marked enhancement of Sar1p-mediated tubule formation from ERESs, suggesting that CI-976 inhibits the fission of assembled COPII budding elements. These results identify a small molecule inhibitor of a very late step in COPII vesicle formation, consistent with fission inhibition, and demonstrate that this step is likely facilitated by an ER-associated LPAT.

Adipocyte differentiation-related protein reduces the lipid droplet association of adipose triglyceride lipase and slows triacylglycerol turnover

Although neutral lipid storage droplets are ubiquitous in eukaryotic cells, very little is known about how their synthesis and turnover are controlled. Adipocyte differentiation-related protein (ADRP; also known as adipophilin) is found on the surface of lipid droplets in most mammalian cell types. To learn how ADRP affects lipid storage, we stably expressed the protein in human embryonic kidney 293 (HEK 293) cells, which express little endogenous ADRP. As expected, ADRP was targeted to the surface of lipid droplets and caused an increase in triacylglycerol (TAG) mass under both basal and oleate-supplemented conditions. At least part of the increased mass resulted from a 50% decrease in the rate of TAG hydrolysis in ADRP-expressing cells. Furthermore, ADRP expression increased the fraction of total cellular TAG that was stored in lipid droplets. ADRP expression induced a striking decrease in the association of adipose triglyceride lipase (ATGL) and mannose-6-phosphate receptor tail-interacting protein of 47 kDa with lipid droplets and also decreased the lipid droplet association of several other unknown proteins. Transient expression of ADRP in two other cell lines also reduced the lipid droplet association of catalytically inactive ATGL. We conclude that the reduced lipid droplet association of ATGL and/or other lipases may explain the decrease in TAG turnover observed in ADRP-expressing HEK 293 cells.

Quantitative phase microscopy with asynchronous digital holography

We demonstrate a new method of measuring quantitative phase in imaging of biological materials. This method, asynchronous digital holography, employs knowledge of a moving fringe created by acousto-optic modulators to execute phase-shifting interferometry using two near-simultaneous interferograms. The method can be used to obtain quantitative phase images of dynamic biological samples on millisecond time scales. We present results on a standard sample, and on live cell samples.

Measurement properties of the CHAMPS physical activity questionnaire in a sample of older Australians

BACKGROUND

The effective evaluation of physical activity interventions for older adults requires measurement instruments with acceptable psychometric properties that are sufficiently sensitive to detect changes in this population.

AIM

To assess the measurement properties (reliability and validity) of the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire in a sample of older Australians.

METHODS

CHAMPS data were collected from 167 older adults (mean age 79.1 S.D. 6.3 years) and validated with tests of physical ability and the SF-12 measures of physical and mental health. Responses from a sub-sample of 43 older adults were used to assess 1-week test-retest reliability.

RESULTS

Approximately 25% of participants needed assistance to complete the CHAMPS questionnaire. There were low but significant correlations between the CHAMPS scores and the physical performance measures (rho=0.14-0.32) and the physical health scale of the SF-12 (rho=0.12-0.24). Reliability coefficients were highest for moderate-intensity (ICC=0.81-0.88) and lowest for vigorous-intensity physical activity (ICC=0.34-0.45). Agreement between test-retest estimates of sufficient physical activity for health benefits (> or =150min and > or =5 sessions per week) was high (percent agreement=88% and Cohen's kappa=0.68).

CONCLUSION

These findings suggest that the CHAMPS questionnaire has acceptable measurement properties, and is therefore suitable for use among older Australian adults, as long as adequate assistance is provided during administration.

ATGL has a key role in lipid droplet/adiposome degradation in mammalian cells

Lipid droplets (LDs), also called adiposomes, are found in many eukaryotic cells, and are highly upregulated in lipid-storage cells, such as adipocytes. The mechanism by which adiposomes and their component neutral lipids are degraded is an important health issue with the rapidly spreading epidemic of obesity. Recently, a novel triglyceride lipase (adipose triglyceride lipase (ATGL)) that catalyses the initial step in triglyceride hydrolysis in adipocyte LDs was identified. Here, we show that ATGL also functions in non-adipocyte cells, and has an important role in LD degradation in these cells. Overexpression of wild-type ATGL causes a marked decrease in LD size, whereas a catalytically inactive mutant retains the ability to localize to LDs, but is unable to decrease their size. Depletion of ATGL by RNA interference leads to a significant increase in the size of LDs. These results show that ATGL has an important role in LD/adiposome turnover in mammalian cells.

Antibiotic susceptibilities of Yersinia enterocolitica recovered from children over a 12-year period☆

Antibiotic susceptibility testing by the microdilution technique was performed on 184 Yersinia enterocolitica isolates recovered from children with gastroenteritis in the Detroit area during a 12-year period. The majority of isolates were resistant to ampicillin, ticarcillin and cefazolin. The most active agents were cefotaxime, ceftriaxone, cefepime, gentamicin, tobramycin, sulphamethoxazole/trimethoprim, imipenem and ciprofloxacin. Cefotaxime and ceftriaxone were effective in the treatment of bacteraemia in 12 patients.

Sitting time and socio-economic differences in overweight and obesity

OBJECTIVES

To examine (1) the inter-relationships between socio-economic status (SES), physical activity, three different domains of sitting time (weekday, weekend day and leisure-time sitting), and being overweight or obese (body mass index>/=25 kg/m(2)); and (2) the potential mediation effects of sitting time in the relationship between socio-economic factors and being overweight or obese in working Australian adults.

DESIGN

Observational epidemiological study.

SUBJECTS

One thousand forty eight working adults. Using a multistage sampling design on neighbourhood SES, participants were from high and low SES neighbourhoods of an Australian capital city.

MEASUREMENTS

Neighbourhood SES was assessed using census data; individual SES was based on self-reported educational attainment and household income. There were three sitting time variables: sitting time on weekdays, weekend days and in leisure time. Overweight and obesity were determined using self-reported body weight and height.

RESULTS

Gender, age, neighbourhood SES, education, working hours and physical activity were independently associated with weekday, weekend day and leisure-related sitting time. With the exception of education and working hours, these variables were also independently associated with being overweight or obese. Leisure-time sitting was found to be a mediator in the relationships between gender, education and being overweight or obese.

CONCLUSION

Strategies to promote less sitting in leisure time are required to combat overweight and obesity in Australian adults, especially among those from low SES neighbourhoods, and among those with high levels of education and income who work long hours.

A comparative study of secretory immunoglobulin A and immunoglobulin G in host defense in an in vitro pneumonia model

BACKGROUND

An exaggerated inflammatory response to infections including nosocomial pneumonia may be detrimental to the host and contribute to morbidity and mortality. Both secretory immunoglobulin A (SIgA) and IgG contribute to the immune defense of respiratory surfaces. However, their relative ability to protect against invasive infections and the resultant host inflammatory response are unknown and were the basis for this study.

METHODS

Calu-3 cell (a respiratory epithelial cell line) monolayers were established in a Transwell system (Costar Corp., Cambridge, MA). Escherichia coli and either polyclonal SIgA or IgG were inoculated into the apical chamber and neutrophils (polymorphonuclear neutrophils) were added to the basal chamber. PMN cytotoxic potential was indexed by %CD11b expression, superoxide anion (O(2)-) production, and % elastase release. Bacterial translocation into the basal chamber was quantitated after log transformation. Calu-3 monolayer integrity was indexed by permeability to dextran fluorescein isothiocyanate.

RESULTS

The addition of E coli to Calu-3/polymorphonuclear cocultures led to increases in O(2)- generation, elastase release, and CD11b expression. These effects were diminished by the addition of SIgA but not IgG. A similar effect was noted with Calu-3 barrier function.

CONCLUSIONS

SIgA may function to protect against microbial invasion of respiratory surfaces and protect against tissue injury from an exaggerated inflammatory response.

Weight gained in two years by a population of mid-aged women: how much is too much?

OBJECTIVE

To establish the prevalence of weight change in mid-aged women over a 2-year period, and to assess the relationship between weight change and physical and mental well-being (SF36) in order to begin debate about the need for quantified standards of weight gain.

DESIGN

Prospective study of weight change and well-being over a 2-year period among mid-aged women participating in a large national survey.

SUBJECTS

Seven thousand two hundred and seventy women without surgical menopause aged between 45 and 50 years (termed mid-aged), enrolled in the Australian Longitudinal Study on Women's Health.

MEASUREMENTS

Weight change (self-reported weight at two time points) and physical and mental well-being (SF-36) explored using linear regression, while adjusting for potential confounders.

RESULTS

Only half the women maintained their weight within 2.25 kg, and one-third gained more than this amount in a 2-year period. While weight gain (> or = 2.25 kg) was negatively associated with physical well-being, both weight loss and weight gain were associated with poorer mental well-being.

CONCLUSION

This is the first prospective study using a large, population-based cohort to demonstrate that small changes in weight are associated with changes in well-being in mid-aged Australian women. It provides further evidence of the need for public health messages to specify the actual amount that constitutes weight gain, but further research is needed to establish these standards for the entire population.

Immunoglobulin a modulates inflammatory responses in an in vitro model of pneumonia

BACKGROUND

Preservation of mucosal immunity has been shown to affect the risk and outcome of pneumonia in severely injured patients. Secretory immunoglobulin A (SIgA) is the principle humoral defense of mucosal surfaces in the body and has several antiinflammatory properties. Polymorphonuclear neutrophils (PMN) function to kill invading microorganisms, but their exaggerated inflammatory responses may cause tissue injury to the host. The purpose of this study was to compare the ability of different immunoglobulin (Ig) isotypes to modulate PMN cytotoxic potential cocultured with respiratory epithelial cells challenged with bacteria.

METHODS

Calu-3 cell monolayers were established on membranes (0.1-microm pore) in a two-chamber culture system. Escherichia coli (EC) incubated with either polyclonal SIgA or IgG was inoculated into the apical chamber and PMNs (10/mL) added to the basal chamber. PMN cytotoxic potential was indexed by % CD11b expression, superoxide anion (O2) production, and elastase release. Dextran flux was used to index Calu-3 monolayer permeability.

RESULTS

Addition of EC to PMN-Calu-3 cell coculture increased % CD11b expression, O2 production, and elastase release. IgG had no effect on PMN activation after EC challenge. SIgA abrogated PMN activation and the increase in Calu-3 cell monolayer permeability noted with EC or EC + IgG treatment groups.

CONCLUSION

PMN cytotoxic potential was decreased by the presence of SIgA but not IgG in an in vitro model to simulate pneumonia in vivo. SIgA may not only function to protect against microbial invasion of mucosal surfaces, but may also protect against tissue injury from an exaggerated inflammatory response.

Promoting physical activity to older adults: A preliminary evaluation of three general practice-based strategies

The aim of this study was to explore the feasibility of an exercise scientist (ES) working in general practice to promote physical activity (PA) to 55 to 70 year old adults. Participants were randomised into one of three groups: either brief verbal and written advice from a general practitioner (GP) (G1, N=9): or individualised counselling and follow-up telephone calls from an ES, either with (G3, N=8) or without a pedometer (G2, N=11). PA levels were assessed at week 1, after the 12-wk intervention and again at 24 weeks. After the 12-wk intervention, the average increase in PA was 116 (SD=237) min/wk: N=28, p<0.001. Although there were no statistically significant between-group differences, the average increases in PA among G2 and G3 participants were 195 (SD=207) and 138 (SD=315) min/wk respectively, compared with no change (0.36, SD=157) in G1. After 24 weeks, average PA levels remained 56 (SD=129) min/wk higher than in week 1. The small numbers of participants in this feasibility study limit the power to detect significant differences between groups, but it would appear that individualised counselling and follow-up contact from an ES, with or without a pedometer, can result in substantial changes in PA levels. A larger study is now planned to confirm these findings.

A unique lysophospholipid acyltransferase (LPAT) antagonist, CI-976, affects secretory and endocytic membrane trafficking pathways

Previous studies have shown that inhibition of a Golgi-complex-associated lysophospholipid acyltransferase (LPAT) activity by the drug CI-976 stimulates Golgi tubule formation and subsequent redistribution of resident Golgi proteins to the endoplasmic reticulum (ER). Here, we show that CI-976 stimulates tubule formation from all subcompartments of the Golgi complex, and often these tubules formed independently, i.e. individual tubules usually did not contain markers from different subcompartments. Whereas the cis, medial and trans Golgi membranes redistributed to the ER, the trans Golgi network (TGN) collapsed back to a compact juxtanuclear position similar to that seen with brefeldin A (BFA) treatment. Also similar to BFA, CI-976 induced the formation of endosome tubules, but unlike BFA, these tubules did not fuse with TGN tubules. Finally, CI-976 produced an apparently irreversible block in the endocytic recycling pathway of transferrin (Tf) and Tf receptors (TfRs) but had no direct effect on Tf uptake from the cell surface. Tf and TfRs accumulated in centrally located, Rab11-positive vesicles indicating that CI-976 inhibits export of cargo from the central endocytic recycling compartment. These results, together with previous studies, demonstrate that CI-976 inhibits multiple membrane trafficking steps, including ones found in the endocytic and secretory pathways, and imply a wider role for lysophospholipid acyltransferases in membrane trafficking.

Intestinal Epithelial Cells Modulate PMN Activation and Apoptosis Following Bacterial and Hypoxic Challenges

BACKGROUND

The post-ischemic gut may serve to prime and activate neutrophils which may lead to the subsequent development of the systemic inflammatory response syndrome (SIRS) and multiple organ failure. However, the initiating event which may trigger this immunoinflammatory cascade from the gut is unknown. Recent studies have indicated that intestinal epithelial cells (IEC) play an integral role in generating and transmitting signals between luminal bacteria and the host cells in the underlying gut tissues. The purpose of this study was to investigate the ability of IEC to modulate PMN responses to bacteria and/or hypoxia/reoxygenation (H/R) challenges in vitro.

METHODS

Caco2 cell monolayers were established in a two-chamber cell culture system. Neutrophils from normal human volunteers were placed in the basal chamber and the cell co-culture exposed to either apical bacteria (E. coli) and/or H/R challenge. PMN apoptosis, and percentage of CD11b expression, superoxide anion production, and elastase release were subsequently quantitated.

RESULTS

Coculture of PMNs with Caco2 cells led to a significant reduction in neutrophil apoptosis in both normoxic and H/R conditions. CD11b expression was increased in PMNs exposed to bacteria but the greatest expression was noted with PMN cocultured with Caco2 cells and H/R. Superoxide anion production was increased in all groups following either H/R or bacterial challenge and H/R. Elastase release was highest in neutrophils following H/R and exposure to E. coli.

CONCLUSION

IEC modulate PMN response to bacteria and H/R insults. This results in the production of activated neutrophils with an exaggerated lifespan which may promote remote organ failure. Attempts to modulate this response may be useful in preventing multiple organ failure following severe traumatic shock.

The Pivotal Role of Tumor Necrosis Factor-?? in Signaling Apoptosis in Intestinal Epithelial Cells under Shock Conditions

BACKGROUND

Apoptosis is essential for the regulation of cell number and function of intestinal epithelial cells but may contribute to intestinal barrier failure after shock and other low-flow conditions to the gut.

METHODS

Caco2 intestinal cell monolayers were challenged with recombinant tumor necrosis factor (TNF). In a second group of experiments, Caco2 cells were exposed to bacteria and/or hypoxia followed by reoxygenation. Apoptosis was detected using annexin-V propidium-iodide staining. Cell culture supernatants were also obtained in the second group of experiments and TNF levels quantitated. Monolayer integrity was assessed by measurement of paracellular permeability and transepithelial electrical resistance.

RESULTS

Apical but not basal recombinant TNF increased Caco2 apoptosis. Exposure to either bacteria alone or hypoxia/reoxygenation alone did not increase apoptosis; however, the combined insults significantly increased apoptosis. The increased apoptosis occurred in a delayed fashion in both groups. TNF was released in a polar fashion, and the greatest levels were noted after exposure to both bacteria and hypoxia-reoxygenation. There was also an increase in paracellular permeability in this group; however, no change in transepithelial electrical resistance was noted. The effects on apoptosis and permeability were abrogated by anti-TNF antibodies.

CONCLUSION

Intestinal epithelial cell apoptosis contributes to barrier failure after shock conditions and is related to augmented TNF release.

Evaluation of four commercially available extended-spectrum beta-lactamase phenotypic confirmation tests

Extended-spectrum beta-lactamase (ESBL) production in members of the Enterobacteriaceae can confer resistance to extended-spectrum cephalosporins, aztreonam, and penicillin. As such, the accurate detection of ESBL producers is essential for the appropriate selection of antibiotic therapy. Twenty previously characterized isolates and 49 clinical isolates suspected of ESBL production were tested by four ESBL phenotypic confirmatory methods for accuracy and ease of use. The four ESBL phenotypic confirmation tests included Dried MicroScan ESBL plus ESBL Confirmation panels (Dade Behring, Inc., West Sacramento, Calif.), Etest ESBL (AB BIODISK, Piscataway, N.J.), Vitek GNS-120 (bioMerieux, Inc., Hazelwood, Mo.), and BD BBL Sensi-Disk ESBL Confirmatory Test disks (BD Biosciences, Sparks, Md.). Results were compared to frozen microdilution panels prepared according to NCCLS specifications, and discrepant isolates were sent for molecular testing. The test sensitivities for the ESBL phenotypic confirmatory test methods used in this study were as follows: MicroScan ESBL plus ESBL confirmation panel, 100%; VITEK 1 GNS-120, 99%; Etest ESBL, 97%; and BD BBL Sensi-Disk ESBL Confirmatory Test disks, 96%. The test specificities were as follows: BD BBL Sensi-Disk ESBL Confirmatory Test disks, 100%; MicroScan ESBL plus ESBL confirmation panel and VITEK 1 GNS-120, 98%; and Etest ESBL, 94%. All methods were easy to perform; however, the Etest method required more expertise to interpret the results. All tests offer a feasible solution for confirming ESBL production in the clinical laboratory.

Use of Acyltransferase Inhibitors to Block Vesicular Traffic Between the ER and Golgi Complex

This article describes the use of acyltransferase inhibitors as probes for studying the potential role of lysophospholipid acyltransferases (LPAT) in intracellular membrane trafficking in the secretory and endocytic pathways. The small molecule inhibitors that are described here were originally found as acyl-CoA:cholesterol acyltransferase (ACAT) inhibitors. One of these, CI-976 (2,2-methyl-N-(2,4,6,-trimethoxyphenyl)dodecanamide), was also found to be a potent LPAT inhibitor. CI-976 is a small, hydrophobic, membrane-permeant compound and both in vivo and in vitro studies have shown that it, but not other ACAT inhibitors, has a profound effect on multiple membrane trafficking pathways in eukaryotic cells including: (1) inhibition of COPII vesicle budding from the endoplasmic reticulum (ER), (2) inhibition of transferrin and transferrin receptor export from the endocytic recycling compartment, and (3) stimulation of tubule-mediated retrograde trafficking of Golgi membranes to the ER. Here we describe the use of CI-976 and other ACAT inhibitors for studies with both cultured mammalian cells and in vitro reconstitution assays, with a particular emphasis on COPII vesicle budding from the ER. All of these studies strongly suggest that CI-976-sensitive LPATs play a role in coated vesicle fission, and therefore, CI-976 is a valuable addition to the arsenal of small molecule inhibitors that can be used to study secretory and endocytic membrane trafficking pathways.

Immunoglobulin A protease is a virulence factor for gram-negative pneumonia

BACKGROUND

Secretory immunoglobulin A (SIgA) is the principal immunologic defense of respiratory and other mucosal surfaces in the body. SIgA is relatively stable in mucosal secretions. However, cleavage of SIgA by bacterial proteases might render it immunologically inactive and thus contribute to the development of pneumonia as well as other infections. Bacterial species and infection sites might be important in the expression of bacterial protease activity and serve as the impetus to this study.

METHODS

Bacterial isolates from respiratory and nonrespiratory sites were incubated with SIgA in vitro. SIgA degradation was determined by size exclusion ultrafiltration and gel electrophoresis.

RESULTS

IgA protease activity was evident in gram-negative but not gram-positive respiratory isolates. Gram-negative isolates from nonrespiratory sources did not exhibit IgA protease activity.

CONCLUSIONS

Expression of IgA protease activity might be important in the development and subsequent outcome of gram-negative pneumonia in the patient in the surgical intensive care unit.

In vitro activities of a novel cephalosporin, CB-181963 (CAB-175), against methicillin-susceptible or -resistant Staphylococcus aureus and glycopeptide-intermediate susceptible staphylococci

We examined the activity of CB-181963, a novel cephalosporin, against methicillin-resistant Staphylococcus aureus (MRSA) (n = 200), methicillin-susceptible S. aureus (MSSA) (n = 50), glycopeptide-intermediate Staphylococcus species (GISS) (n = 47), and VRSA (n = 2) isolates. CB-181963 exhibited MIC profiles similar to those of linezolid against MRSA and GISS; however, activity against MSSA was similar to that of vancomycin. Time-kill study results of investigations of activity against MRSA, MSSA, and GISS at 24 h were as follows: CB-181963 activity = vancomycin activity > linezolid activity (P < 0.001); CB-181963 = quinupristin-dalfopristin = vancomycin > linezolid (P < 0.05); CB-181963 > linezolid (P = 0.003); and CB-181963 = quinupristin-dalfopristin = vancomycin. CB-181963 may provide an alternative treatment for multidrug-resistant staphylococci.

Physical activity among Aboriginal and Torres Strait Islander people and communities

The epidemiological rationale for a focus on physical activity (PA) among Aboriginal and Torres Strait Islander (ATSI) people is compelling. PA programs have significant potential to benefit ATSI people and their communities through their contribution to reducing chronic disease, improving physical and mental health and well-being, and improving social factors such as community connectedness. Despite the powerful rationale for a focus on PA in ATSI communities, few published intervention studies have demonstrated the effectiveness of community strategies to promote increased PA among ATSI people. There are however, some examples of ongoing community programs in the 'grey' literature, which illustrate ongoing work in this domain. In view of the paucity of work in this area, there is an urgent need for (1) more research into the effectiveness of innovative strategies for increasing PA among ATSI people: (2) translation of effective strategies into dissemination trials; and (3) fast tracking of research in this area into the scientific literature.

Test-retest reliability of four physical activity measures used in population surveys

Accurate monitoring of prevalence and trends in population levels of physical activity (PA) is a fundamental public health need. Test-retest reliability (repeatability) was assessed in population samples for four self-report PA measures: the Active Australia survey (AA, N=356), the short International Physical Activity Questionnaire (IPAQ, N=104), the physical activity items in the Behavioral Risk Factor Surveillance System (BRFSS, N=127) and in the Australian National Health Survey (NHS, N=122). Percent agreement and Kappa statistics were used to assess reliability of classification of activity status as 'active', 'insufficiently active' or 'sedentary'. Intraclass correlations (ICCs) were used to assess agreement on minutes of activity reported for each item of each survey and for total minutes. Percent agreement scores for activity status were very good on all four instruments, ranging from 60% for the NHS to 79% for the IPAQ. Corresponding Kappa statistics ranged from 0.40 (NHS) to 0.52 (AA). For individual items, ICCs were highest for walking (0.45 to 0.78) and vigorous activity (0.22 to 0.64) and lowest for the moderate questions (0.16 to 0.44). All four measures provide acceptable levels of test-retest reliability for assessing both activity status and sedentariness, and moderate reliability for assessing total minutes of activity.

Updating the evidence relating to physical activity intervention studies in older people

For older adults, physical activity (PA) plays a central role in the prevention and management of chronic disease, and has the potential to reduce physical decline, maintain functional ability and prevent injuries. This review provides an update of the evidence relating to the effectiveness of PA intervention studies (both general PA and trials specific to progressive resistance training (PRT)) for older adults. The following electronic databases were searched for articles published since 1999: Medline, PubMed, EMBASE, CINAHL and Sport Discus. For the PRT section, a 2002 Cochrane review was also used. Eight general PA intervention studies were included in this review, ranging from one-on-one counselling in general practice to the community-wide promotion of walking. The aim of most of the trials was to increase moderate and/or vigorous activity levels. Most of the studies reviewed had some degree of success in getting older people to be more active. However, a major limitation was the use of self-report measures of PA. The review of PRT interventions included 21 trials. Participants in half the studies had either functional limitations or a chronic condition. Most trials were conducted in a supervised setting using specialised equipment. Increased strength and improvement in basic functional tasks were generally reported, but there was a paucity of strong evidence linking PRT with reduced physical disability and improved health-related quality of life. While considerable progress is being made in this area, further population-based studies that include home and whole-community interventions are required.

Inhibition of membrane tubule formation and trafficking by isotetrandrine, an antagonist of G-protein-regulated phospholipase A2 enzymes

Previous studies have established a role for cytoplasmic phospholipase A(2) (PLA(2)) activity in tubule-mediated retrograde trafficking between the Golgi complex and the endoplasmic reticulum (ER). However, little else is known about how membrane tubule formation is regulated. This study demonstrates that isotetrandrine (ITD), a biscoclaurine alkaloid known to inhibit PLA(2) enzyme activation by heterotrimeric G-proteins, effectively prevented brefeldin A (BFA)-induced tubule formation from the Golgi complex and retrograde trafficking to the ER. In addition, ITD inhibited BFA-stimulated tubule formation from the trans-Golgi network and endosomes. ITD inhibition of the BFA response was potent (IC(50) approximately 10-20 microM) and rapid (complete inhibition with a 10-15-min preincubation). ITD also inhibited normal retrograde trafficking as revealed by the formation of nocodazole-induced Golgi mini-stacks at ER exit sites. Treatment of cells with ITD alone caused the normally interconnected Golgi ribbons to become fragmented and dilated, but cisternae were still stacked and located in a juxtanuclear position. These results suggest that a G-protein-binding PLA(2) enzyme plays a pivotal role in tubule mediated trafficking between the Golgi and the ER, the maintenance of the interconnected ribbons of Golgi stacks, and tubule formation from endosomes.

Bactericidal activities of daptomycin, quinupristin-dalfopristin, and linezolid against vancomycin-resistant Staphylococcus aureus in an in vitro pharmacodynamic model with simulated endocardial vegetations

In search of treatment alternatives against vancomycin-resistant S. aureus (VRSA), an in vitro pharmacodynamic model with simulated endocardial vegetations incorporating protein and a high inoculum was used to simulate daptomycin, linezolid, quinupristin-dalfopristin, and vancomycin against the Michigan VRSA strain. Daptomycin and quinupristin-dalfopristin exhibited the greatest bacterial reductions, and all tested agents except vancomycin exhibited bactericidal activity against the VRSA.

Characterization of a novel CI-976-sensitive lysophospholipid acyltransferase that is associated with the Golgi complex

Recent studies have identified a novel lysophospholipid acyltransferase (LPAT) that is associated with the Golgi complex and that is sensitive to the previously characterized acyl-CoA cholesterol acyltransferase inhibitor, 2,2-methyl-N-(2,4,6-trimethoxyphenyl)dodecanamide (CI-976). Here we show that besides acting on exogenous lysophospholipid (LPL) substrates, the CI-976-sensitive LPAT is also capable of reacylating endogenous Golgi LPL substrates, preferentially lysophosphatidylcholine (LPC) and lysophosphatidylethanolamine (LPE). Moreover, using exogenous substrates, we find that the CI-976-sensitive LPAT is capable of using a variety of fatty acyl-CoA donors ranging in chain length from 10 to 20 carbons. Additional characterization demonstrates that the CI-976-sensitive LPAT is ubiquitously expressed in rat tissues, is tightly associated with Golgi membranes, and has a pH optimum between pH 7.0 and 8.0. These studies further define a unique LPC/LPE-specific LPAT from Golgi membranes that likely has a novel function in membrane trafficking.

Sitting time and work patterns as indicators of overweight and obesity in Australian adults

BACKGROUND

Increasing levels of physical inactivity and sedentariness are contributing to the current overweight and obesity epidemic. In this paper, the findings of two recent studies are used to explore the relationships between sitting time (in transport, work and leisure), physical activity and body mass index (BMI) in two contrasting samples of adult Australians.

METHODS

Data on sitting time, physical activity, BMI and a number of demographic characteristics were compared for participants in two studies-529 women who were participants in a preschool health promotion project ('mothers'), and 185 men and women who were involved in a workplace pedometer study ('workers'). Relationships between age, number of children, physical activity, sitting time, BMI, gender and work patterns were explored. Logistic regression was used to predict the likelihood of being overweight or obese, among participants with different physical activity, sitting time and work patterns.

RESULTS

The total reported time spent sitting per day (across all domains) was almost 6 h less among the mothers than the workers (P<0.001), and compared with the mothers, a significantly greater proportion of the workers was classified as overweight or obese (BMI > or =25 kg/m(2)). Univariate analysis found that, compared with men in full-time work, women who worked full-time (OR=0.42, CI: 0.24-0.74), part-time (OR=0.35, CI: 0.20-0.59) or in full-time home duties (OR=0.51, CI: 0.29-0.88) were about half as likely to be overweight or obese. Participants who reported high daily levels of sitting (> or =7.4 h) were also significantly more likely than those who reported 'low' levels (<4.7 h/day) to be overweight or obese (OR=1.68, CI: 1.16-2.42). Multivariate analysis (including physical activity, work patterns and sitting time) confirmed that full-time and part-time working women (but not 'home duties' women) were less likely to report BMI > or =25 kg/m(2) than full-time working men (full-time: OR=0.44, CI: 0.25-0.78; part-time: OR=0.45, CI: 0.24-0.86), but the OR for BMI > or =25 among those in the high sitting category was attenuated (OR=1.61, CI 0.96-2.71).

CONCLUSIONS

The findings suggest a need for inclusion of measures of both activity and inactivity in future studies, so that the complex relationships between these behavioural determinants of BMI can be clarified.

Enterocyte apoptosis and barrier function are modulated by SIgA after exposure to bacteria and hypoxia/reoxygenation

BACKGROUND

Secretory immunoglobulin A (SIgA) is the principal immune defense against luminal pathogens at gut mucosal surfaces. It also has anti-inflammatory activities that may be important for the maintenance of mucosal surface integrity. Enterocyte apoptosis (Apo) is increased after challenge with invasive bacteria and ischemia-reperfusion insults. Increased Apo also has been associated with impaired intestinal barrier function. However, the impact of SIgA on enterocyte apoptosis and mucosal barrier integrity after challenge with commensal bacteria and ischemia-reperfusion is unknown.

METHODS

Caco2 intestinal epithelial cell monolayers were subjected to 21% O(2) (control) or 95% N(2)/15% CO(2) (hypoxic) conditions for 90 minutes, followed by 21% O(2). Escherichia coli and SIgA were added in subsets. Caco2 cell Apo was identified by flow cytometry and barrier function indexed by permeability to dextran-fluorescein isothiocyanate.

RESULTS

There were no differences in the percentage of Apo Caco2 cells after exposure to either bacteria or hypoxic-reoxygenation versus control. There was a significant increase in Apo after the combined bacteria/hypoxia-reoxygenation challenge. SIgA abrogated the Apo response and preserved barrier function after this combined challenge.

CONCLUSION

Modulation of enterocyte Apo by SIgA may serve to maintain intestinal barrier function and thereby decrease the systemic inflammatory response after clinical conditions associated with gut ischemia-reperfusion insults.

Plasmid content of a vancomycin-resistant Enterococcus faecalis isolate from a patient also colonized by Staphylococcus aureus with a VanA phenotype

Vancomycin-resistant Enterococcus faecalis coisolated with vancomycin-resistant (VanA) Staphylococcus aureus was found to contain two plasmids, designated pAM830 (45 kb) and pAM831 (95 kb). pAM830, found to be conjugative and closely related to the Inc18 family of broad-host-range conjugative plasmids, encodes resistances to vancomycin (via a Tn1546-like element) and erythromycin; pAM831 encodes resistances to gentamicin, streptomycin, and erythromycin.

Inhibition of a Golgi complex lysophospholipid acyltransferase induces membrane tubule formation and retrograde trafficking

Recent studies have suggested that formation of Golgi membrane tubules involves the generation of membrane-associated lysophospholipids by a cytoplasmic Ca2+-independent phospholipase A2 (PLA2). Herein, we provide additional support for this idea by showing that inhibition of lysophospholipid reacylation by a novel Golgi-associated lysophosphatidylcholine acyltransferase (LPAT) induces the rapid tubulation of Golgi membranes, leading in their retrograde movement to the endoplasmic reticulum. Inhibition of the Golgi LPAT was achieved by 2,2-dimethyl-N-(2,4,6-trimethoxyphenyl)dodecanamide (CI-976), a previously characterized antagonist of acyl-CoA cholesterol acyltransferase. The effect of CI-976 was similar to that of brefeldin A, except that the coatomer subunit beta-COP remained on Golgi-derived membrane tubules. CI-976 also enhanced the cytosol-dependent formation of tubules from Golgi complexes in vitro and increased the levels of lysophosphatidylcholine in Golgi membranes. Moreover, preincubation of cells with PLA2 antagonists inhibited the ability of CI-976 to induce tubules. These results suggest that Golgi membrane tubule formation can result from increasing the content of lysophospholipids in membranes, either by stimulation of a PLA2 or by inhibition of an LPAT. These two opposing enzyme activities may help to coordinately regulate Golgi membrane shape and tubule formation.

The synergistic effects of hypoxia/reoxygenation or tissue acidosis and bacteria on intestinal epithelial cell apoptosis

BACKGROUND

Clinical data indicate that gut perfusion deficits must be rectified within 24 hours after traumatic injury to decrease organ failure and death. Ischemia/reperfusion injury to the gut causes enterocyte apoptosis (Apo), which may contribute to intestinal barrier failure. The temporal response of enterocyte Apo to acidosis and hypoxia/reoxygenation (H/R) in vitro is unknown. The purpose of this study was to examine the effect of various time points of acidosis or H/R on enterocyte apoptosis and monolayer integrity in an in vitro model.

METHODS

Caco-2 cell monolayers were made acidic (Dulbecco's modified Eagle's medium, pH 6.9) by hydrochloric acid or exposed to 95% nitrogen/5% carbon dioxide (hypoxia) and then 21% oxygen (reoxygenation). Escherichia coli C-25 were added to the apical media in subsets. Apo and necrosis were quantified by flow cytometry. Permeability was determined by fluorescein isothiocyanate-dextran. Transepithelial electrical resistance (TEER) indexed monolayer.

RESULTS

Extracellular acidosis and C-25 significantly increased apoptosis of Caco-2 cells at 18 hours (extracellular acidosis [EC] + C-25, 14.5 +/- 3.0; control, 3.8 +/- 0.8; p < 0.001 by analysis of variance). Similarly, the H/R + C-25 group showed a significant increase in apoptosis at 12 hours (H/R + C-25 vs. control, 22.86 +/- 2.12 vs. 3.74 +/- 0.7; p < 0.001 by analysis of variance). The permeability difference was not significant for EC + C-25 versus control at 18 hours (0.68 +/- 0.25 vs. 0.43 +/- 0.0.0.36, respectively; p > 0.05). The H/R + C-25 group had a profound increase in permeability over control at 12 hours (10.8 +/- 0.5 vs. 2.1 +/- 0.3, respectively; p < 0.001). The TEER was significantly lowered for EC versus control at 18 hours (458 +/- 1.5 vs. 468 +/- 8.2) and at 0, 6, and 18 hours for EC + C-25 (409 +/- 28.1, 443 +/- 16.8, and 438 +/- 8.9 vs. 455 +/- 6.5, 467 +/- 6.5, and 469 +/- 8.2, respectively). There was no significant change in the H/R and H/R + C-25 groups.

CONCLUSION

Synergism of H/R or tissue acidosis and bacteria caused increased Apo, TEER, and permeability in vitro.

Phospholipase A2 (PLA2) enzymes in membrane trafficking: mediators of membrane shape and function

Since the mid-1990s, there have been tremendous advances in our understanding of the roles that lipid-modifying enzymes play in various intracellular membrane trafficking events. Phospholipases represent the largest group of lipid-modifying enzymes and accordingly display a wide range of functions. The largest class of phospholipases are the phospholipase A(2) (PLA2) enzymes, and these have been most extensively studied for their roles in the generation lipid signaling molecules, e.g. arachidonic acid. In recent years, however, cytoplasmic PLA2 enzymes have also become increasingly associated with various intracellular trafficking events, such as the formation of membrane tubules from the Golgi complex and endosomes, and membrane fusion events in the secretory and endocytic pathways. Moreover, the ability of cytoplasmic PLA2 enzymes to directly affect the structure and function of membranes by altering membrane curvature suggests novel functional roles for these enzymes. This review will focus on the role of cytoplasmic PLA2 enzymes in intracellular membrane trafficking and the mechanisms by which they influence membrane structure and function.

The effects of varying oxygen conditions and immunoglobulin A on barrier defense to bacterial invasion

Tissue oxygenation is a critical factor in host defense against bacteria. Gut mucosal tissue oxygenation (partial pressure of O2) is normally low putting the gut at risk of invasion by luminal microbes. Secretory immunoglobulin (Ig) A (sIgA) is the principal immune defense at mucosal surfaces. The protective effect of IgA under low oxygen conditions is unknown. We studied the interaction of varying O2 environments and sIgA on protection against bacterial invasion in our in vitro model. Cell monolayers of Madin-Darby canine kidney (MDCK) cells transfected with the cDNA for polymeric immunoglobulin receptor were established in a two-chamber cell culture system. A commensal strain of Escherichia coli (10(8) colony-forming units) was added to the apical medium and cell cultures were placed in either a 5, 21, or 95 per cent O2 environment at 37 degrees C. Polyclonal sIgA (100 microg/mL) was added to the apical chamber in subsets. Basal medium was sampled at intervals and bacterial translocation quantitated. The cell monolayers of MDCK transfected cells then had 100 microg/mL IgA added to the basal compartment at 4 degrees C for 2 hours followed by various oxygen environments for 90 minutes. Afterwards apical medium was removed at one, 3, and 12 (overnight) hours. The bacterial translocation data showed a significance increase in translocation with hypoxia. Both increased oxygen and IgA abrogated these effects significantly. The transcytosis of IgA was increased during hypoxic conditions. Normal and hyperoxic conditions did not produce any significant difference in IgA transcytosis. We conclude that O2 and sIgA are protective against bacterial invasion at epithelial surfaces. Effects to either boost O2 delivery to the gut or enhance mucosal IgA production and delivery may be protective in the critically ill surgical patient.

The Effects of Varying Oxygen Conditions and Immunoglobulin A on Barrier Defense to Bacterial Invasion

Tissue oxygenation is a critical factor in host defense against bacteria. Gut mucosal tissue oxygenation (partial pressure of O2) is normally low putting the gut at risk of invasion by luminal microbes. Secretory immunoglobulin (Ig) A (sIgA) is the principal immune defense at mucosal surfaces. The protective effect of IgA under low oxygen conditions is unknown. We studied the interaction of varying O2 environments and sIgA on protection against bacterial invasion in our in vitro model. Cell monolayers of Madin-Darby canine kidney (MDCK) cells transfected with the cDNA for polymeric immunoglobulin receptor were established in a two-chamber cell culture system. A commensal strain of Escherichia coli (108 colony-forming units) was added to the apical medium and cell cultures were placed in either a 5, 21, or 95 per cent O2 environment at 37° C. Polyclonal sIgA (100 μg/mL) was added to the apical chamber in subsets. Basal medium was sampled at intervals and bacterial translocation quantitated. The cell monolayers of MDCK transfected cells then had 100 μg/mL IgA added to the basal compartment at 4° C for 2 hours followed by various oxygen environments for 90 minutes. Afterwards apical medium was removed at one, 3, and 12 (overnight) hours. The bacterial translocation data showed a significance increase in translocation with hypoxia. Both increased oxygen and IgA abrogated these effects significantly. The transcytosis of IgA was increased during hypoxic conditions. Normal and hyperoxic conditions did not produce any significant difference in IgA transcytosis. We conclude that O2 and sIgA are protective against bacterial invasion at epithelial surfaces. Effects to either boost O2 delivery to the gut or enhance mucosal IgA production and delivery may be protective in the critically ill surgical patient.

The influence of famous athletes on health beliefs and practices: Mark McGwire, child abuse prevention, and Androstenedione

When Mark McGwire broke Roger Maris's home run record in September of 1998, he was instantly declared an American hero and held up as a positive role model for teenagers and young adults. The extensive media attention focused on McGwire made the general public aware of his use of a muscle-building dietary supplement, Androstenedione. It also increased the public's awareness of McGwire's public service to prevent child abuse. The present research assesses audience involvement with McGwire through parasocial interaction and identification, and the effects of that involvement on audience knowledge of and attitudes toward Androstenedione and child abuse prevention. Results indicate parasocial interaction with an athlete regarded as a public role model likely leads to audience identification with that person, which in turn promotes certain attitudes and beliefs. In this case, parasocial interaction and identification with Mark McGwire was strongly associated with knowledge of Androstenedione, intended use of the supplement, and concern for child abuse. Implications of this research for featuring celebrities in health communication campaigns are discussed.

Chlamydial antigens colocalize within IncA-laden fibers extending from the inclusion membrane into the host cytosol

Chlamydial IncA localizes to the inclusion membrane and to vesicular fibers extending away from the inclusion. Chlamydial outer membrane components, in the absence of developmental forms, are found within these fibers. This colocalization may explain how chlamydial developmental form antigens are localized outside of the inclusion within infected cells.

Ethanol impairs intestinal barrier defense by modulation of immunoglobulin A transport

BACKGROUND

Increased epithelial permeability may contribute to septic complications after alcohol intoxication. Prior ethanol (EtOH) exposure leads to structural and functional effects on cytoskeletal components important in maintaining barrier integrity. The cytoskeleton is also important in the transcellular transport of proteins including the polymeric immunoglobulin receptor (pIgR) mediated transport of immunoglobulin A (IgA) to the luminal surface of mucosal tissues. We (1) investigated the effects of acute EtOH exposure on cell monolayer barrier integrity and IgA transport and (2) assessed the importance of microtubule function on these functions in vitro.

METHODS

Confluent Madin-Darby canine kidney (MDCK) epithelial cells transfected with pIgR cDNA were exposed to 1% or 5% EtOH, and transcytosis of dimeric IgA was measured. Paclitaxel was used to pretreat a subset of MDCK cells. Results. EtOH exposure resulted in a concentration and time dependent decrease in IgA transcytosis. This was associated with physical derangements in the integrity of the cell monolayer. Pretreatment with paclitaxel completely abrogated these effects.

CONCLUSIONS

EtOH causes both physical and immune derangement of epithelial cell barrier function. Decreased secretory IgA at mucosal surfaces may initiate septic complications after EtOH intoxication.

Actin mediates secretory immunoglobulin A transport: effect of ethanol

Secretory immunoglobulin A (IgA) is the principle antibody protecting against pathogens at mucosal sites. Ethanol (EtOH) exposure is related to adverse effects on the enterocyte cytoskeleton. The aim of this study was to assess the role of normal cytoskeletal function on IgA transcytosis and its modulation by EtOH by studying Madin-Darby canine kidney (MDCK) cells transfected with the polyimmunoglobulin receptor. MDCK cells were grown as confluent monolayers and treated with 5 per cent EtOH, cytochalasin D (Cyto-D, a cytoskeletal destabilizer), or pretreatment with prostaglandin E2 (a cytoskeletal stabilizer) followed by EtOH. Media alone served as control. IgA was then added to the basolateral side of the chambers, and apical samples were taken for enzyme-linked immunosorbent assay analysis at 0, 3, and 12 hours. Dimeric IgA transcytosis increased in all groups and was significantly depressed by 5 per cent EtOH and Cyto-D. Morphological slides revealed aggregation of actin after Cyto-D treatment. Prostaglandin E2 prevented the decrease in IgA transcytosis seen otherwise with 5 per cent EtOH treatment. We conclude that IgA transcytosis is dependent on actin microfilaments of the cytoskeleton. Decreased IgA transport may lead to mucosal immunodeficiency and infectious complications after EtOH exposure.

Actin Mediates Secretory Immunoglobulin a Transport: Effect of Ethanol

Secretory immunoglobulin A (IgA) is the principle antibody protecting against pathogens at mucosal sites. Ethanol (EtOH) exposure is related to adverse effects on the enterocyte cytoskeleton. The aim of this study was to assess the role of normal cytoskeletal function on IgA transcytosis and its modulation by EtOH by studying Madin-Darby canine kidney (MDCK) cells transfected with the polyimmunoglobulin receptor. MDCK cells were grown as confluent monolayers and treated with 5 per cent EtOH, cytochalasin D (Cyto-D, a cytoskeletal destabilizer), or pretreatment with prostaglandin E2 (a cytoskeletal stabilizer) followed by EtOH. Media alone served as control. IgA was then added to the basolateral side of the chambers, and apical samples were taken for enzyme-linked immunosorbent assay analysis at 0, 3, and 12 hours. Dimeric IgA transcytosis increased in all groups and was significantly depressed by 5 per cent EtOH and Cyto-D. Morphological slides revealed aggregation of actin after Cyto-D treatment. Prostaglandin E2 prevented the decrease in IgA transcytosis seen otherwise with 5 per cent EtOH treatment. We conclude that IgA transcytosis is dependent on actin microfilaments of the cytoskeleton. Decreased IgA transport may lead to mucosal immunodeficiency and infectious complications after EtOH exposure.

Inhibition of transferrin recycling and endosome tubulation by phospholipase A2 antagonists

We report here that a broad spectrum of phospholipase A(2) (PLA(2)) antagonists produce a concentration-dependent, differential block in the endocytic recycling pathway of transferrin (Tf) and Tf receptors (TfRs) but have no acute affect on Tf uptake from the cell surface. At low concentrations of antagonists (approximately 1 microm), Tf and TfR accumulated in centrally located recycling endosomes, whereas at higher concentrations (approximately 10 microm), Tf-TfR accumulated in peripheral sorting endosomes. Several independent lines of evidence suggest that this inhibition of recycling may result from the inhibition of tubule formation. First, BFA-stimulated endosome tubule formation was similarly inhibited by PLA(2) antagonists. Second, endocytosed tracers were found in larger spherical endosomes in the presence of PLA(2) antagonists. And third, endosome tubule formation in a cell-free, cytosol-dependent reconstitution system was equally sensitive PLA(2) antagonists. These results are consistent with the conclusion that endosome membrane tubules are formed by the action of a cytoplasmic PLA(2) and that PLA(2)-dependent tubules are involved in intracellular recycling of Tf and TfR. When taken together with previous studies on the Golgi complex, these results also indicate that an intracellular PLA(2) activity provides a novel molecular mechanism for inducing tubule formation from multiple organelles.

Too wet to exercise? Leaking urine as a barrier to physical activity in women

Leaking urine is frequently mentioned (anecdotally) by women as a barrier to physical activity. The aim of this paper was to use results from the Australian Longitudinal Study on Women's Health (ALSWH) to explore the prevalence of leaking urine in Australian women, and to ascertain whether leaking urine might be a barrier to participation for women. More than 41,000 women participated in the baseline surveys of the ALSWH in 1996. More than one third of the mid-age (45-50 years) and older (70-75) women and 13% of the young women (18-23) reported leaking urine. There was a cross-sectional association between leaking urine and physical activity, such that women with more frequent urinary leakage were also more likely to report low levels of physical activity. More than one thousand of those who reported leaking urine at baseline participated in a follow-up study in 1999. Of these, more than 40% of the mid-age women (who were aged 48-53 in 1999), and one in seven of the younger (21-26 years) and older (73-79 years) women reported leaking urine during sport or exercise. More than one third of the mid-age women and more than one quarter of the older women, but only 7% of the younger women said they avoided sporting activities because of leaking urine. The data are highly suggestive that leaking urine may be a barrier to physical activity, especially among mid-age women. As current estimates suggest that fewer than half of all Australian women are adequately active for health benefit, health professionals could be more proactive in raising this issue with women and offering help through non-invasive strategies such as pelvic floor muscle exercises.

Dietary treatment of iron deficiency in women of childbearing age

BACKGROUND

The Australian Iron Status Advisory Panel advocates dietary intervention as the first treatment option for mild iron deficiency [serum ferritin (SF) = 10-15 microg/L]. However, there appear to be no studies on the efficacy of dietary treatment for iron deficiency.

OBJECTIVE

We compared the effects of iron supplementation and of a high-iron diet on serum ferritin (SF) and hemoglobin in iron-deficient women of childbearing age.

DESIGN

Forty-four iron-deficient women (SF <15 microg/L or SF = 15-20 microg/L plus serum iron <10 micromol/L and total-iron-binding capacity >68 micromol/L) and 22 iron-replete women (hemoglobin > or =120 g/L and SF >20 microg/L) matched for age and parity categories were enrolled and completed 7-d weighed food records at baseline. The iron-deficient women were randomly allocated to receive iron supplementation (105 mg/d; supplement group) or a high-iron diet (recommended intake of absorbable iron: 2.25 mg/d; diet group) for 12 wk. Hematologic and dietary assessments were repeated at the end of the intervention and again after a 6-mo follow-up.

RESULTS

Mean SF in the supplement group increased from 9.0 +/- 3.9 microg/L at baseline to 24.8 +/- 10.0 microg/L after the intervention and remained stable during follow-up (24.2 +/- 9.8 microg/L), whereas the diet group had smaller increases during the intervention (8.9 +/- 3.1 to 11.0 +/- 5.9 microg/L) but continued to improve during follow-up (to 15.2 +/- 9.5 microg/L). Mean hemoglobin tended to improve in both intervention groups, but the change was only significant in the supplement group.

CONCLUSIONS

In iron-deficient women of childbearing age, a high-iron diet produced smaller increases in SF than did iron supplementation but resulted in continued improvements in iron status during a 6-mo. follow-up.