Diet matters, particularly in pregnancy – Results from MoBa studies of maternal diet and pregnancy outcomes

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Awareness that maternal diet may influence the outcome of pregnancy as well as the long-term health of mother and child has increased in recent years. A new food frequency questionnaire (FFQ) was developed and validated specifically for the Norwegian Mother and Child Cohort Study (MoBa). The MoBa FFQ is a semi-quantitative tool which covers the average intake of food, beverages and dietary supplements during the first 4 to 5 months of pregnancy. It includes questions about intakes of 255 foods and dishes and was used from 2002 onwards. Data assessed by the MoBa FFQ is available for 87,700 pregnancies. Numerous sub-studies have examined associations between dietary factors and health outcomes in MoBa. The aim of this paper is to summarize the results from 19 studies of maternal diet and pregnancy outcomes, which is the complete collection of studies based on the MoBa FFQ and published before September 2014. The overall research question is whether maternal diet – from single substances to dietary patterns – matters for pregnancy outcome. The pregnancy outcomes studied till now include birth size measures, infants being small and large for gestational age, pregnancy duration, preterm delivery, preeclampsia, as well as maternal gestational weight gain and postpartum weight retention. As a whole, the results from these studies corroborate that the current dietary recommendations to pregnant women are sound and that maternal diet during pregnancy is likely to contribute to reduce the risk of pregnancy complications including preterm birth, preeclampsia, and reduced foetal growth. The results provide supporting evidence for recommending pregnant women to consume vegetables, fruit, whole grain, fish, dairy, and water regularly and lower the intake of sugar sweetened beverages, processed meat products and salty snacks. The results showing negative impact of even low levels of environmental contaminants support the precautionary advice on consumption of foods containing these. New findings are that particularly lean fish explained the positive association between seafood intake and foetal growth, and the indications of a protective effect of probiotic and antimicrobial foods on pregnancy outcomes. This points to the importance of diet composition for a healthy gut flora and the body’s immune response. Although these studies are observational and cannot infer causality, the results identify diet as an important modifiable lifestyle factor, suggesting that healthy eating, defined as following the official recommendations, is particularly important in pregnanc

Testing the climate intervention potential of ocean afforestation using the Great Atlantic Sargassum Belt

Ensuring that global warming remains 2 emissions reduction. Additionally, 100–900 gigatons CO2 must be removed from the atmosphere by 2100 using a portfolio of CO2 removal (CDR) methods. Ocean afforestation, CDR through basin-scale seaweed farming in the open ocean, is seen as a key component of the marine portfolio. Here, we analyse the CDR potential of recent re-occurring trans-basin belts of the floating seaweed Sargassum in the (sub)tropical North Atlantic as a natural analogue for ocean afforestation. We show that two biogeochemical feedbacks, nutrient reallocation and calcification by encrusting marine life, reduce the CDR efficacy of Sargassum by 20–100%. Atmospheric CO2 influx into the surface seawater, after CO2-fixation by Sargassum, takes 2.5–18 times longer than the CO2-deficient seawater remains in contact with the atmosphere, potentially hindering CDR verification. Furthermore, we estimate that increased ocean albedo, due to floating Sargassum, could influence climate radiative forcing more than Sargassum-CDR. Our analysis shows that multifaceted Earth-system feedbacks determine the efficacy of ocean afforestation

Recruiting Rural Healthcare Providers Today: a Systematic Review of Training Program Success and Determinants of Geographic Choices

BackgroundRural areas have historically struggled with shortages of healthcare providers; however, advanced communication technologies have transformed rural healthcare, and practice in underserved areas has been recognized as a policy priority. This systematic review aims to assess reasons for current providers' geographic choices and the success of training programs aimed at increasing rural provider recruitment.MethodsThis systematic review (PROSPERO: CRD42015025403) searched seven databases for published and gray literature on the current cohort of US rural healthcare practitioners (2005 to March 2017). Two reviewers independently screened citations for inclusion; one reviewer extracted data and assessed risk of bias, with a senior systematic reviewer checking the data; quality of evidence was assessed using the GRADE approach.ResultsOf 7276 screened citations, we identified 31 studies exploring reasons for geographic choices and 24 studies documenting the impact of training programs. Growing up in a rural community is a key determinant and is consistently associated with choosing rural practice. Most existing studies assess physicians, and only a few are based on multivariate analyses that take competing and potentially correlated predictors into account. The success rate of placing providers-in-training in rural practice after graduation, on average, is 44% (range 20-84%; N = 31 programs). We did not identify program characteristics that are consistently associated with program success. Data are primarily based on rural tracks for medical residents.DiscussionThe review provides insight into the relative importance of demographic characteristics and motivational factors in determining which providers should be targeted to maximize return on recruitment efforts. Existing programs exposing students to rural practice during their training are promising but require further refining. Public policy must include a specific focus on the trajectory of the healthcare workforce and must consider alternative models of healthcare delivery that promote a more diverse, interdisciplinary combination of providers

Life Cycle Assessment of Seaweed Cultivation Systems

Life cycle assessment (LCA) is a holistic methodology that identifies the impacts of a production system on the environment. The results of an LCA are used to identify which processes can be improved to minimize impacts and optimize production. LCA is composed of four phases: (1) goal and scope definition, (2) life cycle inventory analysis, (3) life cycle impact assessment, and (4) interpretation. The goal and scope define the purpose of the analysis; describe the system and its function, establish a functional unit to collect data and present results, set the system boundaries, and explain the assumptions made and data quality requirements. Life cycle inventory analysis is the collection, processing and organization of data. Life cycle impact assessment associates the results from the inventory phase to one or multiple impacts on environment or human health. The interpretation evaluates the outcome of each phase of the analysis. In this phase the practitioner decides whether it is necessary to amend other phases, e.g., collection of more data or adjustments of goal of the analysis. In the interpretation, the practitioner draws conclusions, exposes the limitations, and provides recommendations to the readers. The quality of LCA of seaweed production and conversion is based on data availability and detail level. Performing an LCA at the initial stage of seaweed production in Europe is an advantage: the recommended design improvements can be implemented without significant economic investments. The quality of LCA will keep improving with the increase of scientific publications, data sharing, and public reports.</p