Category: 8. Health

Investigation and Results

Housing and Prophylaxis for Trainees on Arrival at Joint Base San Antonio-Lackland

U.S. Air Force basic training takes place at Joint Base San Antonio-Lackland in San Antonio, Texas. Trainees are organized into rolling military units averaging 900 entering and graduating trainees per week, with each unit further divided into groups of approximately 52 trainees. Trainees are assigned to specific dormitories, which typically house 50–60 persons, sleeping in beds that alternate head directions, creating a foot-to-head orientation in the bay. Trainees arrive weekly and undergo a standardized 7.5-week basic military training (BMT) curriculum organized by week of training, resulting in training activities and associated exposures that are typically consistent for each class.

To prevent invasive meningococcal and streptococcal disease outbreaks, all trainees receive quadrivalent meningococcal (Groups A, C, Y, and W) (Menveo) vaccine within 72 hours of arrival and a single dose of penicillin G benzathine injectable suspension, respectively, within 7 days of arrival (1). Penicillin-allergic trainees receive weekly oral azithromycin to prevent streptococcal disease during BMT.

Identification of First Two Conjunctivitis Cases

On February 5, 2025, a case of N. meningitidis bacterial conjunctivitis was identified in an otherwise healthy BMT trainee who had experienced 2 days of mucopurulent ocular discharge; the trainee had no known exposure to N. meningitidis. Although the symptoms initially suggested viral conjunctivitis (2), the copious unilateral discharge led the health care provider to culture the exudate, which was positive for N. meningitidis 6 days later. Microbial isolates were tested and identified by Vitek 2 (bioMerieux). On February 21, a second trainee (from a different training unit) was also evaluated for unilateral copious mucopurulent ocular discharge associated with periocular edema without corneal involvement. The culture of the exudate from this trainee’s eye was positive for N. meningitidis, raising concern about potential cases of invasive meningococcal disease. An investigation was initiated to identify additional cases, determine the risk for invasive meningococcal disease, and describe the patients and evaluate their response to treatment. The local human research protection program, Defense Health Agency San Antonio Market Office of Research Protocol Support, determined these activities not to be research.*

Surveillance for Conjunctivitis

The first two cases, which occurred among trainees who started training 2 weeks apart, both occurred during both patients’ fourth week of BMT. On February 23, the day that the second patient’s culture result was received, the Trainee Health Surveillance team (a group of epidemiologists and preventive medicine physicians responsible for active and passive disease surveillance of the BMT population) established a registry and began active surveillance to identify cases of mucopurulent conjunctivitis and ensure that a sample was obtained for culture for each case. A confirmed case was defined as a positive N. meningitidis culture result from ocular discharge collected from a person with conjunctivitis. A probable case was defined as symptomatic conjunctivitis with exudate in a patient who had contact with a person with a confirmed case of meningococcal conjunctivitis but without laboratory confirmation. A suspected case was defined as symptomatic conjunctivitis with exudate in a person with no known contact with a confirmed case. Clinicians who worked in emergency departments or primary care on the base were requested to assist in active surveillance by submitting samples of ocular discharge from patients with conjunctivitis to the microbiology laboratory for culture and reporting suspected or probable cases to the Trainee Health Surveillance registry rather than providing standard empiric treatment without culture. Patients with confirmed meningococcal conjunctivitis received topical ocular erythromycin, ciprofloxacin, or moxifloxacin and were referred for an ophthalmologic assessment of corneal involvement.

Identification of Additional Cases

During February 23–May 9, 2025, a total of 79 cases of mucopurulent conjunctivitis were identified among 11,797 trainees who started BMT in San Antonio (6.7 per 1,000); cultures from 41 (52%) patients were positive for N. meningitidis, and 32 (41%) were positive for Haemophilus species. Four (5%) patients received negative culture results, one patient’s ocular culture was positive for Corynebacterium macginleyi, a known cause of conjunctivitis (3), and for one patient, no specimen was collected for culture. Among the 41 laboratory-confirmed cases of N. meningitidis conjunctivitis, 23 (56%) occurred within 1 month of onset of the second case (Figure 1). Among the 32 Haemophilus species conjunctivitis cases, 29 (91%) were identified during the first 3 weeks of training, whereas 36 (87.8%) of the positive N. meningitidis ocular cultures were identified during or after the fourth week of training (Figure 2).

Clinical Characteristics of Patients with N. meningitidis Conjunctivitis

The 41 confirmed cases of N. meningitidis conjunctivitis occurred in trainees in 37 unique BMT groups. During this period, men constituted 78% of the BMT population but accounted for 90% of the N. meningitidis cases. Among trainees with confirmed N. meningitidis conjunctivitis, 33 (80%) reported an antecedent upper respiratory infection (Table). Overall, 35 (85%) patients had unilateral eye involvement. All patients improved within 24 hours of starting treatment with topical moxifloxacin, ciprofloxacin, or erythromycin. One patient was hospitalized after a delay in initiating topical moxifloxacin that led to progression of infection to periorbital cellulitis, requiring a short course of intravenous antibiotics. No patients developed invasive corneal ulceration or orbital cellulitis. Contact tracing, including prophylactic antibiotics for close contacts, was deferred, because prophylaxis is currently recommended only for close contacts of persons with invasive disease (bacteremia or meningitis) (4). Whereas cases of Haemophilus species conjunctivitis occurred in patients who received either penicillin or azithromycin prophylaxis, N. meningitidis infections only occurred in patients who received penicillin.

Whole Genome Sequencing

While serogrouping and sequencing are commonly performed by local, state, and federal public health laboratories for N. meningitidis isolates from cases of invasive meningococcal disease, neither is typically performed for isolates from noninvasive disease cases. However, after diagnosis of the second case, and to guide the public health response, whole genome sequencing of isolates from the first two ocular cultures was performed to determine whether they were related, predict antimicrobial resistance, and ascertain whether virulence factors associated with invasive disease were present. As has been reported for other cases of meningococcal conjunctivitis (5), both isolates were nongroupable, without the presence of csaB, csb, csc, csw, and csy genes associated with encapsulation, suggesting low risk for development of invasive disease. Sequencing demonstrated that the two isolates were both sequence type (ST) 32 and were closely related. ST-32 has previously been associated with meningococcal disease outbreaks caused by the encapsulated serogroup B N. meningitidis; however, because this strain was not encapsulated, it was not expected to cause invasive disease in otherwise healthy patients. The sequenced isolates indicated decreased susceptibility to penicillin based on a mutation in the penA gene, otherwise no other genetic correlates of antimicrobial resistance were identified.

Environmental Investigation and Training Activity Evaluation

The Trainee Health Surveillance team evaluated dormitory cleanliness, including the showers and common areas, and reviewed established cleaning protocols. No environmental specimens were collected for testing. Various field training activities during the fourth week of training were also evaluated to ascertain their risk as a source of transmission and to confirm adherence to cleaning protocols. The health team who observed gas mask cleaning noted that staff members followed recommended cleaning and sanitizing protocols, using liquid sodium hypochlorite disinfecting solution (bleach) at recommended concentrations. As the outbreak continued, other potential common sources of transmission were investigated, including cardiopulmonary resuscitation training. However, because trainees did not practice rescue breathing on the mannequin, this activity posed a low risk for transmission. Evaluation of the military shooting range also did not identify any potential common source of transmission; safety goggles were not shared and were cleaned with hypochlorite disinfectant wipes at the end of each training session.

From sandwich bags to tire treads, humans produce and discard about 400 million tons of plastic every year. Most of it is left behind to break down, releasing greenhouse gases and degrading into microscopic fragments that travel far beyond the point of origin

Microscopic pieces of plastic are turning up in Earth’s water, soil and air. They are everywhere.

A new article in the journal Nature highlights the global scope of this problem and features the research of Janice Brahney, a biogeochemist in Utah State University’s Quinney College of Agriculture and Natural Resources. Microplastics are altering the way Earth’s natural processes function on a planetary scale, according to the researchers.

Plastics often enter the atmosphere not directly from garbage, but from roadways, agricultural fields and the ocean. Tires grind against pavement and launch tiny particles into the air through turbulence. Wind lifts debris from plowed fields. Ocean waves churn insoluble plastic fragments — once food wrappers, soda bottles and shopping bags — into the sky to be carried across the globe.

“When these microscopic pieces of plastic are pulled into the atmosphere they can move almost everywhere,” Brahney said.

That includes lakes, rivers, national parks, forests, rangelands and more. Each year more than 1,000 tons of microplastics fall from the atmosphere onto the western United States — the equivalent of about 300 million plastic water bottles raining down onto the landscape.

This is more than just a pollution problem, Brahney said. This material is likely shifting the complex systems on which the planet runs.

Brahney is working with University of Utah’s snow hydrology expert, McKenzie Skiles, to examine how plastic dust changes the way sunlight is reflected or absorbed on snow surfaces, influencing the rate of snowmelt. She is also working to understand how plastic moves through terrestrial ecosystems, altering fundamental biological processes. These are critical and understudied pieces of the plastic pollution puzzle.

Other researchers are investigating how microplastics affect the ocean’s ability to store carbon, a process known as the biological carbon pump, one of Earth’s natural defenses against rising greenhouse gases. Findings like these add layers of complexity to the already challenging task of modeling climate change.

“Plastic pollution is one of the most pressing environmental and social issues of the century,” Brahney said. “There is still so much we don’t know about this issue, and it is already in motion, altering the future of the planet. The data we collect is crucial to understanding how plastic could reshape our world.”

Brahney’s ongoing research aims to change the conversation around plastic dust with a major synthesis of dust research that compiles research on dust pollution and details major gaps that still need to be urgently puzzled out.

A research team at the Medical University of South Carolina reports in Cells that the complement system, part of the body’s natural immune defenses, is a key driver of inflammatory responses that contribute to fetal brain inflammation and preterm birth, the latter of which is the leading cause of complications and death in newborns. The study, led by Eliza McElwee, M.D., an assistant professor of Obstetrics and Gynecology, focuses on finding the root cause of preterm birth itself, rather than just treating the complications left in its wake.

A major health concern

Preterm birth, or delivery before 37 weeks, affects about 12% of pregnancies in the U.S. and is linked to serious complications, such as brain hemorrhage, cerebral palsy, sepsis and death. South Carolina ranks fifth in the nation for preterm deliveries, highlighting a significant public health concern for the Lowcountry.

A few options are available to mitigate preterm birth once it has already begun.

“We have some strategies and medications that have a goal of stopping preterm labor after it’s happening,” McElwee explained. However, there are limited therapies that prevent preterm birth by addressing its root cause. “As a result, rates of preterm delivery remain high in the U.S.”

Looking for root causes

Previous studies have shown a link between inflammation brought on by infection in the amniotic fluid and preterm birth, but the source of the inflammation remained unknown. Using a well-studied animal model, McElwee and her team set out to pinpoint what causes the inflammation associated with preterm birth. They focused on the complement system, an area of expertise for Stephen Tomlinson, Ph.D., professor of Pharmacology and Immunology, whose lab supported the study. Often referred to simply as complement, this group of proteins in the blood helps to defend the body against infection and plays an important role in immunity.

When activated, complement enlists leukocytes – white blood cells – to respond. These cells create and sustain inflammation, which can lead to weakening of the cervix. The cervix can be thought of as the gateway of the pregnancy, keeping the baby safely inside until birth, when it thins and dilates to allow the baby’s passage. When weakened by inflammation, the cervix can’t guard the gates effectively, leading to the baby being delivered prematurely.

To investigate complement’s role in preterm birth, researchers used a mouse model that simulates a uterine infection-induced inflammation in pregnant women. They found increased complement activation and leukocyte infiltration in the cervix as early as one hour after inducing inflammation, with a marked rise at nine hours, and that these immune changes were associated with preterm delivery. Team member Devin Hatchell, a trainee in the South Carolina Clinical and Translational Research Institute’s TL1 predoctoral training program, helped to perform these experiments and analyze the data.

The results strongly support the team’s theory that complement is a key factor in preterm birth. “We found that complement activation is increased in inflammatory-mediated preterm birth,” explained McElwee.

“I am never surprised to find that complement plays a significant role in a disease process,” Tomlinson said.

Setting the stage for potential new therapies

The team then went a step further – showing that these changes could be prevented in this animal model by administering a drug called a complement inhibitor, which blocks complement activation and limits its ability to recruit leukocytes. Compared to mice receiving a placebo, pregnant mice induced for preterm birth and treated with the complement inhibitor saw reduced inflammation in both the maternal uterus and the fetal brain. This treatment also reduced leukocyte infiltration and decreased levels of pro-inflammatory cytokines associated with fetal brain inflammation. Pregnant mice treated with the complement inhibitor carried their babies longer and gave birth to more viable offspring.

The hope is that these findings could provide the scientific groundwork for a new therapeutic approach.

By targeting complement with a complement inhibitor, we could decrease rates of preterm birth and reduce fetal neural inflammation.”

Eliza McElwee, M.D., Assistant Professor of Obstetrics and Gynecology, MUSC

Hatchell, whose research before joining the McElwee team focused on developing therapies to reduce brain hemorrhages in premature babies, says what stood out most for him about the results is the possibility of using complement inhibitors in mothers as a preventive therapy. “All the therapy was given to the mother,” he said. “This suggests that we can take care of the mother as well as take care of the offspring at the same time.”

In other words, treating mothers during pregnancy with complement inhibitors could stop preterm birth before it happens and prevent serious complications for both mother and child. “Healthy pregnancies mean healthy babies,” McElwee added.

Several drugs that block complement are in clinical trials, including one with a similar mechanism of action to the mouse complement inhibitor used in the study. However, very few have been approved for medical use – and none is approved for preventing preterm birth or fetal brain inflammation. Still, this study’s findings offer hope for future treatments of preterm birth and beyond.

“This study by Dr. McElwee certainly paves the way for expanding the investigation of complement inhibitors as potential therapies for infection-induced preterm birth, and it is noteworthy that many new complement inhibitors are in clinical development,” said Tomlinson.

Pneumococcal disease mortality trends changed significantly in the US following the onset of the COVID-19 pandemic, according to a study published in the International Journal of Infectious Diseases.¹ With lower rates than normal from the start of the pandemic to early 2021, followed by a spike in pneumococcus mortality in mid-2021, the study highlighted the complexities behind the confluence of respiratory viruses.

“Pneumococcus is an important bacterial pathogen that causes a range of conditions, including pneumonia, otitis media, and invasive pneumococcal disease (IPD),” wrote the authors of the study. “IPD is defined based on the isolation of pneumococcus from normally sterile sites such as blood and cerebrospinal fluid.”

As continuous research on the COVID-19 pandemic’s overall impact is released, one aspect of the phenomenon’s events is how the pandemic impacted other respiratory disease rates. According to a study published in Viruses, SARS-CoV-2 unsurprisingly became the dominant pathogen amid respiratory viruses. As a result, researchers saw influenza pathogens “virtually disappear,” while influenza A, rhinovirus, and enterovirus all experienced a resurgence in the postpandemic time period.²

READ MORE: PCV10 Among Children Indirectly Protected Unvaccinated Adults

With notable decreases and increases in respiratory viruses throughout the pandemic, many researchers may share the sentiment that COVID-19 significantly staggered the public’s understanding and surveillance of other respiratory diseases.

For pneumococcal diseases specifically, the trends in disease and hospitalization rates during and after the pandemic further reinforce the complexities of COVID-19. In a study from the Journal of the Pediatric Infectious Diseases Society, pediatric IPD rates per 100,000 hospital admissions decreased dramatically following COVID-19 lockdowns.³

Despite nonCOVID-19 respiratory viruses declining during the pandemic, possibly due to countrywide shutdowns and a decreased risk of spreading diseases, there is still conflicting evidence regarding pneumococcus disease and mortality before, after, and during the pandemic.

“While prior studies have documented decreases in the rate of IPD during the pandemic, there has been little consideration for how the pandemic might have influenced rates of death due to pneumococcal disease,” continued the authors.¹ “In this study, we evaluated changes in rates of deaths recorded as being related to pneumococcus during the post-pandemic period using nationwide vital statistics data from the United States and evaluated changes in the characteristics of these deaths.”

Using National Center for Health Statistics data, researchers explored the death statistics of patients 25 or older. Their primary study outcome was death from pneumococcal disease. They also further stratified the data and detailed the mortality rates from patients with pneumococcal pneumonia and nonrespiratory IPD.

From 2014 to 2022, encompassing pre- and postpandemic time periods, pneumococcal disease was responsible for a total of 8590 deaths (53% men; 26.2% aged 50 to 64 years) in US patients 25 and older. Of these pneumococcal-related mortality rates, pneumococcal pneumonia accounted for 6068 deaths and nonrespiratory IPD for 2522 deaths.

Researchers then delved into the patterns in mortality rate changes during the pandemic, as well as the additional changes observed following its peak.

“For most of 2020, including the early months of the COVID-19 pandemic when the US was experiencing lockdowns, the reported deaths were not notably different from the prepandemic period and largely followed the typical seasonal pattern,” they wrote.¹ “However, at the end of 2020 and early 2021, when pneumococcal deaths would typically peak, the rates of death remained lower than normal and stayed lower than expected in the spring of 2021.”

Following these trends, pneumococcal deaths reverted in mid-2021, spiking above baseline alongside the surge of the Delta COVID-19 wave. By the time the winter season of 2021 rolled around, pneumococcal mortality rates had returned to the normal seasonal trends observed prior to the pandemic.

The researchers of this study observed unprecedented pneumococcal mortality trends triggered by the COVID-19 pandemic. With a significant decrease followed by an immediate spike that was later reduced, data show that disease surveillance was even further impacted than experts once expected.

Reasons behind the decrease in pneumococcal carriage, according to the authors, may be how public health interventions disrupted disease transmission. For the subsequent spike that followed, researchers believe that the SARS-CoV-2 virus could be a trigger for pneumococcal disease, the same way it can trigger influenza and respiratory syncytial virus.

“In summary, pneumococcal mortality patterns changed significantly after the onset of the COVID-19 pandemic, as reflected by a marked reduction during the initial winter wave that aligned with changes in respiratory virus activity,” concluded the authors.¹ “There was a notable surge of pneumococcal death coinciding with Delta wave of COVID-19 which could not be explained by influenza or RSV, suggesting the potential role of SARS-CoV-2 as a trigger for pneumococcal disease. Our findings highlighted the influence of respiratory viruses on the development and severity of pneumococcal disease.”

READ MORE: Pneumococcal Resource Center

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References

1. Shang L, Perniciaro S, Weinberger DM. Changes in pneumococcal deaths in the United States following the COVID-19 pandemic. IJID. Published online August 29, 2025:108020. https://doi.org/10.1016/j.ijid.2025.108020

2. Manno M, Pavia G, Gigliotti S, et al. Respiratory virus prevalence across pre-, during-, and post-SARS-CoV-2 pandemic periods. Viruses. 2025 Jul 25;17(8):1040. doi: 10.3390/v17081040.

3. Sarmiento Clemente A, Kaplan SL, Barson WJ, et al. Decrease in pediatric invasive pneumococcal disease during the COVID-19 pandemic. JPIDS. 2022;11(9):426-428. https://doi.org/10.1093/jpids/piac056

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Results

Identification of the Index Patient

The index patient’s illness began on December 13, 2024. Signs and symptoms included, fever, abdominal pain, myalgias, and conjunctivitis, which lasted approximately 1 week and resulted in two health care visits (December 16 and 17). The first visit was to a local emergency department on December 16, where testing for influenza, respiratory syncytial virus, and COVID-19 was performed on a nasopharyngeal specimen. That day, an influenza A–positive rRT-PCR result was received, and the specimen was subsequently sent to SFDPH PHL for further testing as a part of enhanced surveillance. On January 9, 2025, the original specimen tested positive for A(H5) (cycle threshold [Ct] value approximately 29, with Ct values <38 considered positive) using the CDC assay at SFDPH PHL and was confirmed by CDC using the same A(H5) primer and probe set on January 14. A second specimen (oropharyngeal) collected by SFDPH on January 10 (25 days after the first specimen, when the child had been asymptomatic for 21 days), was positive for A(H5) (Ct value approximately 37); specimens collected 4 days later were negative.

Sequencing revealed clade 2.3.4.4b, genotype B3.13 viruses, closely related to B3.13 viruses detected in humans and animals in California (Figure 1). Phylogenetic analyses revealed that the sequences clustered together on an independent branch relative to other California human and dairy cattle sequences. Nucleotide and amino acid changes in the hemagglutinin (HA) and nucleoprotein (NP) genes were observed between the two sequences, consistent with viral replication, and no critical markers of mammalian adaptation (increased virulence or transmission risk) were identified.

Index Case Investigation

The index patient lived in an urban environment, did not travel, and had no reported exposure to dairy cows, cats, poultry, birds or other wild animals in the 10 days prior to the illness onset; the family had a pet dog. There were no animals at school, and the patient’s family did not work in occupations that increase risk for A(H5N1) virus infection (handling, slaughtering, defeathering, butchering, culling, caring for, or milking infected animals). A member of the patient’s family purchased raw poultry at a live bird market 2 weeks before the child’s illness onset; the poultry was cooked and consumed the same day it was purchased.

Investigation of Close Contacts

Among 84 persons identified as possible contacts of the index patient (seven household, 53 school, and 24 health care), 67 (80%) met the close contact definition (Figure 2). No household contacts reported illness. School absences were reported for 34 (64.2%) school contacts, 26 (76.5%) of whom were interviewed (one teacher and parents of 25 children). All interviewed parents reported respiratory illnesses in their children, including seven who were symptomatic at the time of interview. The teacher had had influenza-compatible symptoms but was asymptomatic at the time of interview. Four persons were tested for one or more respiratory viruses (COVID-19, RSV, or influenza) previously while ill; all test results for influenza were negative. Among the 24 health care worker contacts from three facility visits (two urgent care, one emergency department), 11 (45.8%) completed a survey, including seven who had close contact with the patient; none reported influenza-compatible symptoms. All 11 available respiratory (oropharyngeal and nasal) specimens from close contacts (seven household and four school) were A(H5)-negative by rRT-PCR.

Serum specimens were collected from the index patient (32 days from onset to convalescent serum collection), three adult household contacts, two school contacts, and four health care contacts. Among these nine contacts, the median interval between their first exposure to the index patient and serum collection was 45 days (range = 9–47 days), and the median interval between their last exposure and serum collection was 26 days (range = 0–46 days). The patient had antibodies to all three wild-type A(H5N1) viruses, with elevated antibody titers in all assays, consistent with recent H5N1 infection: A/Texas/37/2024 (B3.13) (MN titer = 160, HI titer = 320); A/Michigan/90/2024 (B3.13) (MN titer = 320, HI titer = 226); and A/Washington/240/2024 (D1.1) (MN titer = 113, HI titer = 320). All nine close contacts’ serology results were negative for all three wild-type A(H5N1) viruses.

With so much confusion around what makes a grain food truly healthy, new research now offers a clearer picture: a combination of grain foods can support better nutrition and metabolic health when they deliver on nutrient density. A new study published in Nutrients, which analyzed the diets of more than 14,000 Americans over five years, found that both whole and refined grain foods play a role in improved diet quality, nutrient intake and everyday accessibility.

Conducted by researchers at the Center for Public Health Nutrition at the University of Washington, the peer-reviewed study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2023. The analysis found that many everyday grain foods – including some breads, cereals and tortillas – ranked surprisingly high for nutrient density and affordability. The findings offer a more nuanced view of grain foods, moving beyond assumptions and highlighting a broader range of options that can support health.

Using two new nutrient profiling models to evaluate carbohydrate quality and overall nutrient density, the Carbohydrate Food Quality Score CFQS-3 and the Nutrient Rich Food (NRF9.3) index, the study identified which grain foods qualify as “healthy grain foods” based on higher levels of fiber, protein and essential nutrients, and lower amounts of added sugars, saturated fat and sodium. This approach revealed that both whole and refined grain foods can meet the mark, contributing meaningfully to diet quality and health. People who consumed more of these healthy grain foods had better overall nutrient intake, healthier eating patterns and more favorable markers of metabolic health.

Key findings include:

• Improved diet quality and nutrient intake. People who consumed more healthy grain foods had better overall diet quality and higher intakes of fiber, protein, iron, calcium, potassium and magnesium.
• Includes both whole and refined grain foods. Both types scored highly for nutrient density, with many refined or enriched options – like certain breads, cereals and tortillas – delivering strong nutritional value alongside whole grain choices.
• Part of healthier overall eating patterns. People who ate the most healthy grain foods also consumed more fruits, vegetables and lean proteins, suggesting these grain foods may support or reflect broader healthy habits.
• Linked to better metabolic health. Adults with higher intakes of these grain foods were less likely to be obese and had lower fasting insulin levels, a key marker of metabolic function.
• No added cost. Healthy grain foods were no more expensive than less healthy options and were often more affordable per gram or calorie.

“Healthy grains are a critical component of healthy diets” said Dr. Adam Drewnowski, Professor of Epidemiology at the University of Washington. “Our evaluation took whole grain content into account, along with fiber, vitamins and minerals. By delivering key nutrients such as fiber, iron, B vitamins and folate, grain foods can make a meaningful contribution to healthier eating patterns among all population groups.”

As nutrition guidance continues to evolve, this study adds important clarity around the role of grain foods in supporting public health. The findings highlight the value of balance – not just in overall eating patterns, but in the types of grain foods we include. Recognizing the nutritional contributions of both whole and refined/enriched options offers a more inclusive and realistic path to better outcomes for Americans’ diet and overall health. To learn more, visit GrainFoodsFoundation.org.

This study was supported through an unrestricted grant from the Grain Foods Foundation (GFF), a nonprofit organization dedicated to nutrition science and education to better understand the role of grain foods in healthful diets. GFF had no influence over the study design, data analysis or interpretation of findings.

A major study has investigated the relationship between walking and the risk of developing chronic lower back problems. The findings could save the healthcare system significant amounts of money while also alleviating many people’s back pain – if we just follow the simple advice provided.

The results are clear: People who walk a lot have less back pain than people who do not walk much – and the volume is what matters most, not the intensity.. It is better to walk a lot than to walk fast.

People who walk more than 100 minutes every day have a 23 per cent lower risk of lower back problems than those who walk 78 minutes or less.”

Rayane Haddadj

He is a PhD candidate at the Department of Public Health and Nursing at the Norwegian University of Science and Technology (NTNU), and is part of a research group that specifically studies musculoskeletal disorders.

The results of the new study were published in the JAMA Network Open journal. The article has already received a lot of attention.

Even leisurely strolls are beneficial

It probably comes as no surprise that physical activity is good for your back, but until now we have not actually known whether the amount of low-intensity walking we do also helps.

“Intensity also plays a role in the risk of long-term back problems, but not as much as the daily amount of walking,” emphasized Haddadj.

A total of 11,194 people participated in the study, which is part of the Trøndelag Health Study (The HUNT Study). What makes this study unique is that the volume and intensity of daily walking were measured using two sensors that participants wore on their thigh and back for up to a week.

The results may be important in relation to preventing chronic back problems. Until now, there has been little research on the prevention of these types of musculoskeletal problems. It is well known that physical activity can prevent a wide range of illnesses and ailments. This study is important because it confirms that physical activity, and especially daily walking, can help prevent long-term lower back problems.

Back pain is a very common ailment

“The findings highlight the importance of finding time to be physically active – to prevent both chronic back problems and a number of other diseases. Over time, this could lead to major savings for society,” said Paul Jarle Mork, a professor at NTNU’s Department of Public Health and Nursing.

Back and neck problems cost society several billion kroner every year. Musculoskeletal disorders are likely the largest expense within the Norwegian healthcare system.

Back pain is one of the most common health problems in Norway. Depending on what you include, between 60 and 80 per cent of us will experience back problems at some point in our lives. At any given time, around one in five Norwegians has back trouble.

The causes are many and complex, but the solution might be as simple as putting on your shoes and going for a walk – each and every day.