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Item Enzootic calcinosis in Toggenburg goats in New Zealand.(Taylor and Francis Group, 2024-01-01) Brown SE; Collett MG; Matthews ZM; Marshall JC; Dittmer KECASE HISTORY: Necropsies on Toggenburg goats culled from a small farm in the Manawatū district of New Zealand, performed at Massey University (Palmerston North, NZ) over a period of 29 years (1991-2019), revealed soft tissue mineralisation, particularly of cardiovascular tissues. The farm spans 10 acres and runs between 15 and 30 Toggenburg goats. The goats are predominantly on pasture comprising a variety of types. PATHOLOGICAL FINDINGS: Necropsies were performed on all adult goats (n = 45) that died or were euthanised. Histopathology was performed on 42 goats (93%), of which 33 (73%) included sufficient tissues diagnostically relevant to soft tissue mineralisation. The most significant gross findings were in various arteries, with the aorta most commonly affected, followed by the heart and lungs. The aortic intima showed prominent, multifocal to coalescing, raised, wrinkled, white plaques. Microscopically there were multiphasic lesions of mineralisation, chondroid, and osseous metaplasia in the elastic arteries, aorta, heart and lungs. A lumbar vertebra from one goat had prominent, basophilic, fibrillar, tangled matrix lining Haversian canals and lamellae. LABORATORY FINDINGS: Blood samples were collected from 15 adult goats in the affected herd and from 10 adult Toggenburg goats from an unaffected herd. Samples were collected by jugular venipuncture at 2-month intervals for 12 months (April 2018-March 2019). Concentrations of calcium, phosphorus, 25-hydroxyvitamin D2 and D3 (25OHD2, 25OHD3) in serum were analysed. The concentration of total 25OHD in serum was 34.2 (95% CI = 18.9-49.4) nmol/L (p < 0.001) higher in goats from the affected herd than in goats from the unaffected herd. Serum 25OHD2 concentration was 46.2 (95% CI = 39.2-53.2) nmol/L higher (p < 0.001) in goats from the affected herd compared to the unaffected herd. Serum Ca concentrations in affected goats were 0.101 (95% CI = 0.005-0.196) mmol/L higher (p = 0.039) than unaffected goats, but remained within the reference range. There was no evidence of a difference in serum 25OHD3 and P concentration between the herds. VEGETATION SURVEY: All paddocks on the property were surveyed every 2 months along evenly spaced line transects, and then further traversed perpendicularly to form a grid. No known calcinogenic species were identified. Known plant sources of vitamin D identified on the farm included mushrooms (species not defined), Dactylis glomerata, lichen, pine pollen, and algae. DIAGNOSIS: Soft tissue mineralisation and enzootic calcinosis. CLINICAL RELEVANCE: Veterinarians are alerted to the possibility of either enzootic calcinosis in goats and the potential occurrence of calcinogenic plants in New Zealand; or chronic vitamin D toxicosis of non-plant origin.Item A nutritional supplement during preconception and pregnancy increases human milk vitamin D but not B-vitamin concentrations.(Elsevier B.V., 2023-10-29) Han SM; Huang F; Derraik JGB; Vickers MH; Devaraj S; Redeuil K; Campos-Giménez E; Pang WW; Godfrey KM; Chan S-Y; Thakkar SK; Cutfield WS; NiPPeR Study GroupBACKGROUND & AIMS: Optimal maternal vitamin status during pregnancy and lactation is essential to support maternal and infant health. For instance, vitamin D3 is involved in infant bone development, and B-vitamins are involved in various metabolic processes, including energy production. Through a double-blind randomised controlled trial, we investigated the effects of maternal supplementation from preconception throughout pregnancy until birth on human milk (HM) concentrations of vitamin D3 and B-vitamins. In addition, we aimed to characterise longitudinal changes in milk concentrations of these vitamins. METHODS: Both control and intervention supplements contained calcium, iodine, iron, β-carotene, and folic acid, while the intervention also contained zinc, vitamins B2, B6, B12, and D3, probiotics, and myo-inositol. HM samples were collected across 4 time points from 1 week to 3 months post-delivery from 158 mothers in Singapore, and 7 time points from 1 week to 12 months from 180 mothers in New Zealand. HM vitamin D was quantified using supercritical fluid chromatography and B-vitamins with mass spectrometry. Potential intervention effects on HM vitamins D3, B2, B6, and B9, as well as other B-vitamin (B1 and B3) concentrations were assessed using linear mixed models with a repeated measures design. RESULTS: Over the first 3 months of lactation, HM 25-hydroxyvitamin D3 concentrations were 20% (95% CI 8%, 33%, P = 0.001) higher in the intervention group, with more marked effects in New Zealand. There were no observed intervention effects on HM concentrations of vitamins B1, B2, B3, B6, and B9. In New Zealand mothers, longitudinally, vitamin D3 concentrations gradually increased from early lactation up to 12 months, while vitamins B1 and B2 peaked at 6 weeks, B3 at 3 weeks, and B6 and B9 at 3 months. CONCLUSIONS: Maternal supplementation during preconception and pregnancy increased HM vitamin D, but not B-vitamin concentrations in lactation. Further studies are required to examine the discrete benefits of vitamin D supplementation starting preconception vs during pregnancy, and to further characterise the effects of supplementation on later offspring health outcomes. CLINICAL TRIAL REGISTRATION: Registered at ClinicalTrials.gov on the 16 July 2015 (identifier NCT02509988); Universal Trial Number U1111-1171-8056. This study was academic-led by the EpiGen Global Research Consortium.Item Relationship between vitamin D, iron, and hepcidin in premenopausal females, potentially confounded by ethnicity.(Springer Nature, 2023-08-29) Greenwood A; Von Hurst PR; Beck KL; Mazahery H; Lim K; Badenhorst CEPURPOSE: To investigate the associations between vitamin D, hepcidin, and iron status in premenopausal females of different ethnic cohorts residing in Auckland, New Zealand (NZ). METHODS: A total of 160 females aged 18-45 years participated in a cross-sectional study. Demographics, body composition, serum 25(OH)D, inflammatory markers (C-reactive protein and interleukin-6, IL-6), and iron biomarkers (serum ferritin, haemoglobin, soluble transferrin receptor, and hepcidin) were measured. Comparisons between parametric, non-parametric, and categorical variables were completed by using one-way ANOVA, Kruskal-Wallis, and Chi-squared tests, respectively. ANCOVA was used to compare serum 25(OH)D across iron parameter categories. RESULTS: Of the 160 participants, 60 were NZ European, 67 were South Asian, and 33 were from the 'other' ethnic groups. South Asians had significantly higher body fat percentage (BF%) and IL-6 concentration (38.34% and 1.66 pg·mL-1, respectively), compared to NZ Europeans (27.49% and 0.63 pg·mL-1, respectively, p < 0.001). South Asians had significantly lower 25(OH)D concentrations compared to NZ Europeans (33.59 nmol·L-1 vs 74.84 nmol·L-1, p < 0.001). In NZ Europeans, higher 25(OH)D concentration was seen in those with lower (≤ 3.5 nM) hepcidin concentration, p = 0.0046. In South Asians, higher 25(OH)D concentration was seen in those with higher (> 3.5 nM) hepcidin concentrations, p = 0.038. There were no associations between serum 25(OH)D and serum ferritin. CONCLUSION: Within South Asian women, an unexpected positive relationship between 25(OH)D and hepcidin concentration was observed which may be due to significantly higher IL-6 concentrations, BF%, and lower 25(OH)D concentrations. Future research is required to confirm these observations in this ethnic cohort.Item Knowledge, attitudes and behaviours towards vitamin D and sun exposure of parents of infants and young children and health professionals in New Zealand.(SAGE Publications, 2023-07-02) Von Hurst P; Mazahery H; Reynolds E; Thomson A; Franklin M; Conlon CBACKGROUND: Vitamin D deficiency may result in adverse long-term health consequences in adulthood if it occurs during fetal development, infancy and childhood. To effectively improve vitamin D status of infants/toddlers, there needs to be knowledge and awareness of vitamin D among parents and health professionals. AIMS: The aim of this study was to investigate parents' and health professionals' knowledge, attitudes and behaviours towards vitamin D and sun exposure over two timepoints. METHODS: The study was an ecological study over two timepoints (Parents 2009 and 2021; Health professionals 2010 and 2019) and used an online questionnaire. RESULTS: The analysis included 9834 parents (2009 n = 8032; 2021 n = 1802) and 283 health professionals (2010 n = 193; 2019 n = 90). Parents and health professionals had good knowledge of vitamin D sources, roles and risk factors for deficiency over two timepoints. There were however some confusions regarding the vitamin D content of breast milk, exclusive breastfeeding as a risk factor for deficiency, and ineffectiveness of sun exposure through glass windows in relation to vitamin D synthesis. In 2019, only 37% of health professionals indicated giving advice on supplements for infants/toddlers. Most parents and health professionals believed there was not enough information available to parents regarding vitamin D (>90%) and that skin cancer prevention messages make it difficult to get information about vitamin D across (>70%). CONCLUSION: Although parents and health professionals had good knowledge in most areas, knowledge of some specific sources and risk factors for vitamin D deficiency was poor.Item Inflammation and the Association of Vitamin D and Depressive Symptomatology.(MDPI (Basel, Switzerland), 2021-06) Dogan-Sander E; Mergl R; Willenberg A; Baber R; Wirkner K; Riedel-Heller SG; Röhr S; Schmidt FM; Schomerus G; Sander CDepression and vitamin D deficiency are major public health problems. The existing literature indicates the complex relationship between depression and vitamin D. The purpose of this study was to examine whether this relationship is moderated or mediated by inflammation. A community sample (n = 7162) from the LIFE-Adult-Study was investigated, for whom depressive symptoms were assessed via the German version of CES-D scale and serum 25-hydroxyvitamin D (25(OH)D) levels and inflammatory markers (IL-6 and CRP levels, WBC count) were quantified. Mediation analyses were performed using Hayes’ PROCESS macro and regression analyses were conducted to test moderation effects. There was a significant negative correlation between CES-D and 25(OH)D, and positive associations between inflammatory markers and CES-D scores. Only WBC partially mediated the association between 25(OH)D levels and depressive symptoms both in a simple mediation model (ab: −0.0042) and a model including covariates (ab: −0.0011). None of the inflammatory markers showed a moderation effect on the association between 25(OH)D levels and depressive symptoms. This present work highlighted the complex relationship between vitamin D, depressive symptoms and inflammation. Future studies are needed to examine the effect of vitamin D supplementation on inflammation and depressive symptomatology for causality assessment.Item Factors Associated with Bone Mineral Density and Bone Resorption Markers in Postmenopausal HIV-Infected Women on Antiretroviral Therapy: A Prospective Cohort Study(MDPI (Basel, Switzerland), 2021-06-18) Ellis C; Kruger HS; Viljoen M; Dave JA; Kruger MC; Weaver CThe study aimed to determine factors associated with changes in bone mineral density (BMD) and bone resorption markers over two years in black postmenopausal women living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART). Women (n = 120) aged > 45 years were recruited from Potchefstroom, South Africa. Total lumbar spine and left femoral neck (LFN) BMD were measured with dual energy X-ray absorptiometry. Fasting serum C-Telopeptide of Type I collagen (CTx), vitamin D and parathyroid hormone were measured. Vitamin D insufficiency levels increased from 23% at baseline to 39% at follow up. In mixed linear models serum CTx showed no change from baseline to end (p = 0.363, effect size = 0.09). Total and LFN BMD increased significantly over two years, but effect sizes were small. No significant change in spine BMD over time was detected (p = 0.19, effect size = 0.02). Age was significantly positively associated with CTx over time, and negatively with total and LFN BMD. Physical activity (PA) was positively associated with LFN BMD (p = 0.008). Despite a decrease in serum vitamin D, BMD and CTx showed small or no changes over 2 years. Future studies should investigate PA interventions to maintain BMD in women living with HIV.Item "I don't want to manage it, I want to get rid of it" : a narrative analysis of living with chronic plaque psoriasis, and an investigation into vitamin D as a treatment : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science at Massey University, Albany, New Zealand(Massey University, 2017) Ingram, Michelle AnneAs a chronic skin disease, plaque psoriasis can cause significant psychosocial, emotional and physical burden. Psoriasis sufferers perceive others as lacking understanding around what it is like to live with this condition, and there has been little research exploring the experience of psoriasis in depth. The burden of psoriasis can be compounded by the difficulty of treating it, and the inconveniences, side effects and risks of available treatments, suggesting the importance of finding a safe, effective and convenient treatment for psoriasis. Vitamin D and psoriasis have a long-standing relationship, with topical vitamin D analogues used to treat mild-tomoderate disease, and observational studies suggesting an association between higher systemic vitamin D (serum calcidiol) concentrations and less severe psoriasis. These findings suggest vitamin D3 supplements, which raise serum calcidiol concentrations, might improve psoriasis. In this thesis, two studies were conducted to address the limited in-depth understanding of the experience of psoriasis, and the need for a safe, effective treatment, respectively. The aims were 1) to gain a deeper understanding of the experience of living with psoriasis; and 2) to investigate whether oral vitamin D3 supplements can effectively treat psoriasis. For 1), data from semi-structured interviews with 10 men and women with psoriasis was analysed using narrative analysis. Narrative trajectories involving three predominant narrative forms shaped participants’ stories: restitution, where the focus was on overcoming psoriasis through trying to find an effective treatment or cure; chaos, where psoriasis was experienced as overwhelming and brought about a sense of hopelessness, and resignation, which was centred on begrudgingly accepting psoriasis in order to be able to get on with life. Participants had different narrative trajectories and shifted between forms over time, with the nature of experience linked with the relative stability and severity of a person’s psoriasis and their beliefs about their ability to manage it. For 2), a randomised, double-blinded, placebo-controlled trial was conducted with 101 participants ≥ 18 years allocated to 100,000 International Units (IU) vitamin D3/month (n = 67) for 12 months (200,000 IU at baseline), or an identical placebo (n = 34). Psoriasis severity (Psoriasis Area and Severity Index [PASI]) and serum calcidiol concentrations were assessed at 3-monthly intervals. The primary outcome was the difference in PASI between treatment and placebo over time, assessed using a linear mixed model. Psoriasis severity did not differ between groups at any time (group F(1, 106) = 0.59, p = 0.44, group*time F(4, 370) = 0.52, p = 0.72). Yet these findings are inconclusive, as serum calcidiol significantly increased from baseline in both the treatment and the placebo group, and a mild improvement in PASI score from baseline also occurred in each group. A non-predetermined secondary analysis was performed by assessing the strength of the relationship between serum calcidiol concentration and PASI score across the whole sample, and this showed a significant inverse relationship between the two variables, in that elevation of serum calcidiol concentration by increments from 25 nmol/L to 125 nmol/L was associated with very mild decreases in PASI (estimated range of decrease 0 – 2.6; p = 0.002). Therefore, despite being unable to determine a benefit of vitamin D3 supplements for psoriasis, these findings support the notion of a potential benefit of increasing serum calcidiol concentrations across the psoriatic population. In conclusion, this thesis offers insight into ways in which people can experience psoriasis over time: as a temporary and fixable condition that must be overcome, as an overpowering force and source of significant suffering, and as a permanent condition that is reluctantly accepted. As the findings emphasise the negative influence of the difficulties around managing and treating psoriasis on the experience of psoriasis, they provide further support for the need for an effective, safe and convenient treatment. While the findings were inconclusive in regards to whether oral vitamin D3 can help people to manage their psoriasis, the significant association between psoriasis severity and systemic vitamin D concentration supports continued research into this potential.Item The relationship between nutritional adequacy and 24-month fracture occurence in Māori and non-Māori of advanced age : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand(Massey University, 2015) Towgood, AliceAbstract Background The life expectancy of both Māori and non-Māori is continually increasing with more New Zealanders expected to live into advanced age. Adults over the age of 80 experience greater health loss than any other age group, with chronic disease and associated disability increasing substantially with age. Osteoporosis and the morbidity associated with fractures, particularly hip fracture, are of critical concern for an ageing population and may diminish quality of life and independence for older people, thus placing an increased burden on health and disability support services. The role of nutrition in the maintenance of bone mineral density (BMD), bone integrity, and subsequent fracture prevention, particularly in octogenarians is unclear. The ability to meet adequate energy requirements decrease with increasing age and may compromise intake of nutrients related to bone health. Nutrients necessary for bone health including: protein, calcium, vitamin D, phosphorous, magnesium and potassium are modifiable factors. Achieving optimal bone nutrient intakes may influence potential for maintenance of good bone health in adults of advanced age. This study aims firstly to investigate food and nutrient intakes of Māori and Non-Māori octogenarians to establish an understanding of nutrient adequacy. Secondly, to investigate the energy and nutrient intakes of participants who experience a fracture compared with those non-fractured to identify nutrient specific risk factors for fracture in adults of advanced age. Method Comprehensive nutritional parameters were collected using two separate 24-hour multi-pass recalls. FOOD files were used to analyse food sources and nutrient intake. Face to face interviews were conducted to ascertain specific social, demographic, health and fracture information. Fracture occurrence was measured over a 24 month period following the 2 x 24-hour Multi Pass Recall’s and included self-reported and hospitalised fracture occurrences. Hospitalisation data was obtained with permission from the participants. National Health Index New Zealand (NHI) numbers were used to identify fractures. Results There were 317 participants (113 Māori and 204 non-Māori), aged 80-90 years in this study. For men and women respectively the median energy intakes were 6,943kJ vs. 5,603kJ for Māori; and 8,203kJ vs. 6,225kJ for non-Māori; protein as a percentage of energy was 15.5% vs. 15.9% for Māori and 15.7% vs. 15.5% for non-Māori. The top foods contributing to energy were bread, butter and margarine for all Maori and non-Maori with beef and veal contributed the most protein for Māori men, bread for Māori women and milk for non-Māori, men and women. Compared to the Estimated Average Requirement (EAR) intakes of calcium, vitamin D, magnesium and potassium were inadequate for all participants. Compared to an EAR of 1100mg for men and women, median calcium intakes were low, 559mg vs. 539mg for Māori and 748mg vs. 672mg for non-Māori, men and women respectively. The primary food groups contributing to calcium were milk, cheese and bread. Compared to the EAR (15 μg/day in men and women) and vitamin D intake from food was low (≤ 4 μg) for all participants. Compared to the EAR (350mg/day men and 265mg/day women), median magnesium intakes were 259 mg/day vs. 204mg/day for Māori and 271 mg/day vs. 238 mg/day for non-Māori, men and women respectively. The primary food groups contributing to magnesium were bread, breakfast cereals and fruit. A total of 18.6% of Māori and 20.6% of non-Māori sustained a fracture over a 24 month period. One in five Māori and non-Māori women sustained fractures. Among non-Māori women those who fractured were 1.1 times more likely to be financially insecure than non-fractured women (p=0.033). For Māori women who were fractured, inability to afford to eat properly was 3.3 times more likely (p=0.012), and previous fractures were 1.5 times (p=0.015) more likely than for non-fractured women. Fractured Māori women consumed significantly less vitamin D (2.0μg vs 3.0μg) (P=0.01) and magnesium (143.0mg vs 211mg) (P=0.033) compared to non-fractured Māori women. Conclusion Energy intakes were low for all participants and may have manifested the suboptimal intakes of calcium, vitamin D, potassium and magnesium prevalent in Māori and non-Māori, men and women. Fractures were more frequent in women than men, and both Māori and non-Māori sustained similar rates of fracture over the 24 month period. Magnesium and vitamin D intakes were significantly related to fracture occurrence in Māori women; this relationship diminished with further regression analysis. Increased intake of energy in adults of advanced age, with a focus on protein rich and nutrient dense foods, particularly calcium and magnesium, should be encouraged through consuming a variety of foods from the major food groups. Greater intakes of calcium can be achieved through higher consumption of milk and dairy products including yoghurt and cheese; and magnesium through increased green leafy vegetables, seafood, dairy, mushrooms, avocado, beans and bananas. Vitamin D intakes were minimal from food; however it is possible participants were receiving supplementary vitamin D and further investigation is warranted. For fractured Māori women, magnesium intake was significantly lower than those with no fractures. Promoting increased intakes of culturally acceptable foods such as vegetables and seafood may be advantageous to increase magnesium intakes.Item The effects of a vitamin D randomised controlled trial on muscle strength and power in female adolescent athletes : a thesis presented in partial fulfillment of the requirements for the degree of Master of Science in Human Nutrition at Massey University, Albany, New Zealand(Massey University, 2013) Mitchell, SarahBackground: Vitamin D deficiency is widespread in the general public and emerging evidence has revealed it is common in athletic populations, particularly those who train indoors. Recent studies suggest that vitamin D deficiency is correlated with impaired skeletal muscle function; however there is limited evidence from randomised controlled trials that vitamin D supplementation can improve muscle strength and power in trained athletes. Objective: To investigate the effects of vitamin D3 supplementation on serum 25(OH)D concentrations and muscle strength and power in female adolescent athletes training predominantly indoors. Methods: Female adolescent dancers, gymnasts, and swimmers (n = 61) who trained regularly for at least five hours per week participated in this randomised double blind placebo controlled trial. Participants were stratified to receive 50,000 IU vitamin D3 or placebo every month for six months. Serum 25(OH)D concentrations, muscle strength (handgrip and isokinetic knee extensor and flexor torque), power (vertical jump), and anthropometric measurements were assessed at baseline and endpoint (n = 54). Results: At baseline, the median 25(OH)D concentration was 77.5 [63.5,92] nmol/L for the vitamin D group and 74 [64.5,88.5] nmol/L for the placebo group. Following six months of supplementation, serum 25(OH)D concentrations increased significantly in the vitamin D group (16.5 [7,46] nmol/L) (P = 0.001), but not the placebo group (-6.25 [-21,44] nmol/L). Peak torque (Nm) of the knee extensors in concentric and eccentric extension increased significantly for both groups (P <0.05), and there was no significant difference in change in peak torque between groups. After controlling for change in 25(OH)D and baseline 25(OH)D separately, supplementation with vitamin D was not associated with any of the strength or power variables. Conclusions: Supplementation of 50,000 IU of vitamin D3 per month improved vitamin D status but did not improve the chosen measures of muscle strength and power in this group of female adolescent athletes. This may be due in part to the small sample size and high baseline serum 25(OH)D concentrations seen in this cohort. Keywords: skeletal muscle strength, skeletal muscle power, athletes, dancers, gymnasts, vitamin D, 25(OH)DItem Study protocol - metabolic syndrome, vitamin D and bone status in South Asian women living in Auckland, New Zealand: A randomised, placebo-controlled, double-blind vitamin D intervention(BioMed Central Ltd part of Springer Science+Business Media, 2008) von Hurst PR; Stonehouse W; Matthys C; Conlon C; Kruger MC; Coad JBackground The identification of the vitamin D receptor in the endocrine pancreas suggests a role for vitamin D in insulin secretion. There is also some limited evidence that vitamin D influences insulin resistance, and thus the early stages of the development of type 2 diabetes. Methods Eighty-four women of South Asian origin, living in Auckland, New Zealand, were randomised to receive either a supplement (4000IU 25(OH)D3 per day) or a placebo for 6 months. At baseline, all participants were vitamin D deficient (serum 25(OH)D3 <50 nmol/L), insulin resistant (HOMA-IR > 1.93) and/or hyperinsulinaemic, hyperglycemic or had clinical signs of dislipidaemia. Changes in HOMA-IR, lipids, parathyroid hormone, calcium and bone markers were monitored at 3 months and 6 months. Discussion This randomised, controlled trial will be the first to investigate the effect of vitamin D supplementation on insulin resistance in non-diabetic subjects. It will subsequently contribute to the growing body of evidence about the role of vitamin D in metabolic syndrome.Registered clinical. Trial registration Registered clinical trial – Registration No. ACTRN12607000642482