Influence of age and gender on fat mass, fat-free mass and skeletal muscle mass among Australian adults: the Australian diabetes, obesity and lifestyle study (AUSDIAB)

Background
Bioelectrical impedance (BIA) represents a simple, inexpensive and non-invasive method that is often used to assess fat-mass (FM) and fat-free mass (FFM) in large population-based cohorts.

Objective
The aim of this study was to describe the reference ranges and examine the influence of age and gender on FM, FFM and skeletal muscle mass (SMM) as well as height-adjusted estimates of FM [fat mass index (FMI)], FFM [fat-free mass index (FFMI)] and SMM [SMM index (SMI)] in a national, population-based cohort of Australian adults.

Design and Participants
The analytical sample included a total of 8,582 adults aged 25–91 years of Europid origin with complete data involved in the cross-sectional 1999–2000 Australian, Diabetes, Obesity and Lifestyle (AusDiab) Study.

Measurements
Bioelectrical impedance analysis was used to examine components of body composition. Demographic information was derived from a household interview.

Results
For both genders, FFM, SMM and SMI decreased linearly from the age of 25 years, with the exception that in men SMI was not related to age and FFM peaked at age 38 years before declining thereafter. The relative loss from peak values to ≥75 years in FFM (6–8%) and SMM (11–15%) was similar between men and women. For FM and FMI, there was a curvilinear relationship with age in both genders, but peak values were detected 6–7 years later in women with a similar relative loss thereafter. For FFMI there was no change with age in men and a modest increase in women.

Conclusion
In Australian adults there is heterogeneity in the age of onset, pattern and magnitude of changes in the different measures of muscle and fat mass derived from BIA, but overall the agerelated losses were similar between men and women.

I wish I was 21 now beyond doping in the Australian peloton

An investigation into the reasons for doping among professional athletes (cyclists) and attitudes towards and assessments of current attempts and form of legislation and regulation of doping, inlcuding prospects for reform, and types of reform required.

Exploration of the Australian Early Development Index for children with language backgrounds other than English

The Australian Early Development Index (AEDI) is a teacher-administered measure that indicates if children are starting school with the developmental capacity to take advantage of the school learning environment. A key question that arises for schools, communities, and policy makers is how valid the AEDI is for children from a Language Background Other Than English (LBOTE). This study investigated how adequately the AEDI captures the cultural variety of different behaviours and different ways of learning. The study also examined the cultural inclusivity and relevance of the AEDI materials (e.g., teacher training guidelines; administration manual). Ten focus groups (n=84) and various community consultations were conducted with early childhood education and development professionals, representing key service providers, and school personnel. The findings from these studies led to the following recommendations: For LBOTE children, the AEDI should ideally be completed in collaboration, for example, between the child’s teacher and a multicultural consultant. The teacher guidelines for the AEDI need to be enhanced with respect to issues pertaining to LBOTE children, and the AEDI should include additional domains, such as cultural competence and home based/first language skills. Finally, teacher preparation and the AEDI administration guidelines need to clarify and emphasize the intent of the AEDI.

Diabetes mellitus in the australian indigenous community

This report aims to investigate the higher prevalence of type 2 diabetes (T2D) among Indigenous Australians, with recommendations to Australians Health Professionals in order to increase awareness of Indigenous health peculiarities related to diabetes mellitus (DM). Diabetes has become one of the most common public health problems of the 21st century. The proportion of Aborigines Australians developing T2D is 5 to 10 times greater than non-Aborigines. Although DM in Aboriginal community is multifactorial, this report shows three perceived causes: (i) obesity and the "Thrifty Gene Hypothesis", (ii) geographical position and (iii) smoking. It concluded that the combination of these causes have increased the incidence of DM among Indigenous Australians. Therefore, the following are recommended: improvement of genetic research, improvement of medical facilities, and increased employment of Indigenous Health Professionals and improvement of anti-smoking policies.

The Australian multiple sclerosis (MS) immunotherapy study: A prospective, multicentre study of drug utilisation using the MSBase platform

To prospectively characterise treatment persistence and predictors of treatment discontinuation in an Australian relapsing-remitting multiple sclerosis (RRMS) population. Tertiary MS treatment centres participating in the MSBase registry prospectively assessed treatment utilisation, persistence, predictors of treatment discontinuation and switch rates. Multivariable survival analyses were used to compare treatment persistence between drugs and to identify predictors of treatment discontinuation. 1113 RRMS patients were studied. Patients persisted on their first disease-modifying therapy (DMT) for a median of 2.5 years. Treatment persistence on GA was shorter than on all IFNβ products (p<0.03). Younger age at treatment initiation and higher EDSS were predictive of DMT discontinuation. Patients persisted on subsequent DMTs, for 2.3 years. Patients receiving natalizumab (NAT) as a subsequent DMT persisted longer on treatment than those on IFNβ or GA (p<0.000). The primary reason for treatment discontinuation for any drug class was poor tolerability. Annualised switch or cessation rates were 9.5–12.5% for individual IFNβ products, 11.6% for GA and 4.4% for NAT. This multicentre MS cohort study is the first to directly compare treatment persistence on IFNβ and GA to NAT. We report that treatment persistence in our Australian RRMS population is short, although patients receiving IFNβ as a first DMT persisted longer on treatment than those on GA. Additionally, patients receiving NAT as a subsequent DMT were more likely to persist on treatment than those switched to IFNβ or GA. EDSS and age at DMT initiation were predictive of DMT discontinuation. Treatment intolerance was the principal reason for treatment cessation.