In the 1950s and ’60s, people were concerned that vitamin D could cause birth defects, according to Carol L. Wagner, MD, lead author of the study and a pediatric researcher at Medical University of South Carolina. It now is known that vitamin D is important for maternal and infant health, including bone health and immune function.

Recent studies have shown that vitamin D deficiency during pregnancy is a serious public health issue.

“Diet doesn’t provide enough vitamin D, and we don’t go in the sun as much as we need,” Dr. Wagner said.

Therefore, she and her colleagues, including Bruce W. Hollis, PhD, who has worked in the field of vitamin D research for the last 30 years, set out to determine the optimal dose of vitamin D supplements for pregnant women without doing harm.

Researchers randomized 494 pregnant women at 12-16 weeks’ gestation into three treatment groups. Group one received 400 International Units (IU) of vitamin D a day until delivery; group two received 2,000 IU and group three received 4,000 IU. The women were evaluated monthly to ensure safety.

“No adverse events related to vitamin D dosing were found in any of the three arms of the study,” Dr. Wagner said.

Investigators also looked at the effects of vitamin D supplementation on complications during pregnancy, including preeclampsia, gestational diabetes, infections, and preterm labor and birth.

“The spectacular part of the study was it showed women replete in vitamin D had lower rates of preterm labor and preterm birth, and lower rates of infection,” Dr. Wagner said.

The greatest effects were seen among women taking 4,000 IU of vitamin D per day. Therefore, the researchers recommend this daily regimen for all pregnant women.

The two abstracts for parts 1 and 2 of the study are free online here:

Safety of vitamin D supplements during pregnancy

Vitamin D supplementation reduces infections and complications of pregnancy

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“If you want to bring about physiological change to help the development and endurance of back muscles, you must focus your training on those specific muscles and not other muscular groups such as hip extensors,” says Christian Larivière, a professor at the Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), who conducted the physical therapy study with other Université de Montréal researchers.

The investigation requested that subjects aged 18 to 65 – some healthy and others with low back pain – complete various exercises. Electromyography (EMG) sensors were used to measure the level of activity and fatigue in various muscles during the routine. “Thanks to this technique, we can target tired muscles which aren’t yet showing a decrease in strength,” says Larivière.

Test subjects also used a machine designed for back exercises in a semi-sitting position. Results clearly showed that using this machine was beneficial. Using a cushion to stabilize the pelvis brought about a better response from the back muscles. In addition, extending the legs strengthened muscles. “Therefore, we can decrease the use of hip muscles and in turn increase the use of the back muscles,” says Larivière.

Such exercises can only help reduce pain and disabilities caused by back pain, says Larivière. He recommends those who suffer severe hurt begin with stretches on the ground with low to medium effort. “Progressively, the individual will gain confidence and can use machines that require superior strength,” he says.

Larivière highlights the fact that six out of 10 Quebecers will suffer from back pain in their lifetime. “Musculoskeletal disorders are a serious public health issue,” says Larivière. “They’re also an economic problem. In 2007, back pain cost Quebec’s Commission de la santé et de la sécurité du travail $516 million in worker compensations.”

The abstract of the study is available online free here:

Specific back muscle exercise for low back pain

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RWIs are illnesses that are spread by swallowing, breathing, or having contact with germs in the water of swimming pools, spas, lakes, rivers, or oceans. To highlight the importance of healthy swimming habits, the CDC has designated May 19–25, 2008, the week before Memorial Day, as National Recreational Water Illness Prevention Week.

“The leading cause of RWI outbreaks is Cryptosporidium or Crypto, a chlorine-resistant parasite, primarily associated with treated swimming places, such as pools and water parks,” explained Michele Hlavsa, an epidemiologist at the CDC. “This RWI has been a public health issue in the past and will likely pose an even bigger challenge in the future.”

During 2004-2007, the number of Crypto cases tripled. At the same time, the number of Crypto outbreaks linked to swimming pools more than doubled. Because Crypto is chlorine resistant, even a well-maintained pool can transmit this parasite.

“People need to practice healthy swimming habits, such as not swimming when they have diarrhea, not swallowing the water, taking a shower before swimming, washing their hands after using the toilet or changing diapers, and washing their children thoroughly — especially their bottoms — with soap and water before swimming. To prevent outbreaks, we encourage pool operators to add supplemental disinfection to conventional chlorination and filtration methods,” adds Hlavsa.

Symptoms generally begin two to 10 days (average seven days) after becoming infected with the parasite.

Crypto is characterized by watery diarrhea lasting one to three weeks. It can be spread by swallowing recreational water contaminated with Crypto or by putting something in your mouth or accidentally swallowing something that has come in contact with the stool of a person or infected animal. Other symptoms include stomach cramps or pain, dehydration, nausea, vomiting, fever, and weight loss. Crypto is not spread by contact with blood.

Some people with Crypto will have no symptoms at all, and most people who have healthy immune systems will recover without treatment. People with weakened immune systems are at risk for severe or life-threatening illness.

For more information about crypto and healthy swimming, check your state′s Web site (www.cdc.gov/healthyswimming/state.htm), www.cdc.gov/crypto, CDC′s Healthy Swimming Web site (www.cdc.gov/healthyswimming), and the Environmental Protection Agency′s beaches Web site (www.epa.gov/beaches).

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Recall Insider

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