Maternal macronutrient and energy intake during pregnancy: a systematic review and meta-analysis

Background: Nutritional status during pregnancy can have a significant impact on infant and maternal health outcomes. To maintain maternal homeostasis and support fetal growth, adequate macronutrient and energy intake during pregnancy is essential. Therefore, this study sought to systematically review and meta-analyze macronutrient and energy intakes during pregnancy. Methods: A systematic review and meta-analysis was carried out based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The required data were collected from four databases including: Web of Sciences, ProQuest, Scopus, and PubMed, from 1 January 1980 to 30 May 2023, by using a combination of search terms (dietary pattern" OR "diet quality" OR "food habits" OR "nutrition surveys" OR "diet surveys" OR "food-frequency questionnaire" OR "diet record" OR "dietary recall") AND ( "pregnancy" OR "reproduction" OR "maternal health" OR "neonatal outcomes") among interventional and observational studies. Excel and STATA version 11 were used for data analysis. Results: Among 7081 published articles, 54 studies were included in the review. Most of the 33 (61%) studies were cohort studies and a total of 135,566 pregnant women were included. The overall average of energy, carbohydrate, fat, and protein intake was 2036.10 kcal/day, 262.17 gr/day, 74.17 gr/day, and 78.21 gr/day, respectively. Also, energy intake during pregnancy was higher in American (2228.31 kcal/day, CI95%: 2135.06–2325.63) and Eastern Mediterranean regions (2226.70 kcal/day, CI95%: 2077.23–2386.92) than other regions (P < 0.001). Energy intake was higher in the third trimester than others (2115.64 kcal/day, CI95%: 1974.15–2267.27). Furthermore, based on the findings, there was a significant difference between energy intake in different World Health Organization (WHO) regions (P < 0.05). Conclusions: According to the results of meta-analysis, the average total energy was below than average total energy required during pregnancy. More efforts are needed to encourage women to adopt healthy eating habits during pregnancy to support healthy fetal and infant development

Training/Match External Load Ratios in Professional Soccer Players: A Full-Season Study

The aim of this study was two-fold: (i) to describe the training/match ratios of different external load measures during a full professional soccer season while analyzing the variations between different types of weeks (three, four and five training sessions/week) and (ii) to investigate the relationship between weekly accumulated training loads and the match demands of the same week. Twenty-seven professional soccer players (24.9 ± 3.5 years old) were monitored daily using a 10-Hz global positioning system with a 100-Hz accelerometer. Total distance (TD), running distance (RD), high-speed running (HSR), sprinting distance (SD), player load (PL), number of high accelerations (ACC), and number of high decelerations (DEC) were recorded during training sessions and matches. An individual training/match ratio (TMr) was calculated for each external load measure. Weeks with five training sessions (5dW) presented meaningfully greater TMr than weeks with four (4dW) or three (3dW) training sessions. Additionally, TDratio (TDr) was significantly greater in 5dW than in 3dW (mean differences dif: 1.23 arbitray units A.U.) and 4dW (dif: 0.80 A.U.); HSRr was significantly greater in 5dW than in 3dW (dif: 0.90 A.U.) and 4dW (dif: 0.68 A.U.); and SDr was significantly greater in 5dW than in 3dW (dif: 0.77 A.U.) and 4dW (dif: 0.90 A.U.). Correlations between the weekly training loads and the match demands of the same week were small for PL (r = 0.250 [0.13;0.36]), ACC (r = 0.292 [0.17;0.40]) and DEC (r = 0.236 [0.11;0.35]). This study reveals that ratios of above 1 were observed for specific measures (e.g., HSR, SD). It was also observed that training sessions are not adjusted according to weekly variations in match demands

School-Time Movement Behaviors and Fundamental Movement Skills in Preschoolers:An Isotemporal Reallocation Analysis

Little is known of how reallocations of time spent in different movement behaviors during preschool might relate to preschoolers’ fundamental movement skills (FMS), a key predictor of later physical activity (PA). Thus, the aim of this study was to examine (a) whether preschoolers’ school-time movement was associated with their FMS and (b) the effects on FMS of reallocating time between PA and sedentary behavior (SB). This was a cross-sectional study, using intervention data with Brazilian low-income preschoolers. We observed Brazilian preschoolers of both sexes (Mage¼ 4.5, SD¼ 0.8 years-old; 101boys) over 10 hours of school-time and objectively assessed their PA and SB with Actigraph wGT3X and their FMS with the Test of Gross Motor Development – Second Edition. We explored the associations between schooltime movement behaviors and FMS and between reallocated school-time movement behaviors and FES using compositional analysis in R (version 1.40-1), robCompositions (version 0.92-7), and lmtest (version 0.9-35) packages. This isotemporal reallocation showed that, for manipulative skills, reallocating time (5, 10, and 15 minutes, respectively) from light PA to SB was associated with increasing skill (0.14, 0.28, and 0.42 FMS units), raising questions as to whether fine motor activity occurred during SB. Thus, school-time movement significantly predicted FMS, with a modest increase in SB, at the expense of light PA eliciting improved manipulative skills

Sleep as a Priority:24-Hour Movement Guidelines and Mental Health of Chinese College Students during the COVID-19 Pandemic

Research on the combined role of 24-hour movement behaviors (sleep, sedentary behavior [SB], and physical activity) in adult mental health, though important, is in its infancy. In the context of Canadian 24-hour movement guidelines integrating quantitative recommendations for sleep, SB, and moderate-to-vigorous physical activity (MVPA), this study aimed to examine the associations between meeting guidelines and mental health among college students. The study used a cross-sectional sample of 1846 Chinese college students surveyed online in August 2020. Through network analysis and multivariate analysis of covariance, the individual and combined associations between meeting 24-hour movement guidelines and the levels of depression and anxiety after adjusting sociodemographic factors were analyzed. Results indicated that meeting the sleep guideline had stronger associations with depression and anxiety than meeting the SB or MVPA guideline. Specifically, compared to meeting no guidelines, meeting the sleep guideline (alone or in combination with other guidelines) was associated with significantly lower levels of depression and anxiety; meeting both SB and MVPA guidelines was also associated with a significantly lower level of depression. Hence, meeting more guidelines, especially adhering to a healthy sleep routine, may play an important role in promoting the mental health of young adults

Training/Match External Load Ratios in Professional Soccer Players:A Full-Season Study

The aim of this study was two-fold: (i) to describe the training/match ratios of different external load measures during a full professional soccer season while analyzing the variations between different types of weeks (three, four and five training sessions/week) and (ii) to investigate the relationship between weekly accumulated training loads and the match demands of the same week. Twenty-seven professional soccer players (24.9 ± 3.5 years old) were monitored daily using a 10-Hz global positioning system with a 100-Hz accelerometer. Total distance (TD), running distance (RD), high-speed running (HSR), sprinting distance (SD), player load (PL), number of high accelerations (ACC), and number of high decelerations (DEC) were recorded during training sessions and matches. An individual training/match ratio (TMr) was calculated for each external load measure. Weeks with five training sessions (5dW) presented meaningfully greater TMr than weeks with four (4dW) or three (3dW) training sessions. Additionally, TDratio (TDr) was significantly greater in 5dW than in 3dW (mean differences dif: 1.23 arbitray units A.U.) and 4dW (dif: 0.80 A.U.); HSRr was significantly greater in 5dW than in 3dW (dif: 0.90 A.U.) and 4dW (dif: 0.68 A.U.); and SDr was significantly greater in 5dW than in 3dW (dif: 0.77 A.U.) and 4dW (dif: 0.90 A.U.). Correlations between the weekly training loads and the match demands of the same week were small for PL (r = 0.250 [0.13;0.36]), ACC (r = 0.292 [0.17;0.40]) and DEC (r = 0.236 [0.11;0.35]). This study reveals that ratios of above 1 were observed for specific measures (e.g., HSR, SD). It was also observed that training sessions are not adjusted according to weekly variations in match demands

24- hour movement behaviors and fitness in preschoolers: acompositional and isotemporal reallocation analysis

This study analyzed the associations between the 24-hour movement behaviors composition and fitness in preschoolers and investigated predicted changes in fitness when time in active behaviors is reallocated. This cross-sectional study was carried out with 270 preschoolers (132 boys; 3.97 ± 0.80 years-old). Light and moderate-to-vigorous physical activity (LPA and MVPA), and sedentary behavior (SB) were verified using an accelerometer. Sleep time was obtained through interviews with parents. Components of physical fitness (cardiorespiratory fitness—CRF, speed-agility, and lower-body muscular strength) were assessed using the PREFIT Battery. To verify the association between 24-hour movement behaviors and physical fitness, the compositional analysis was used, and for the time reallocation, the compositional isotemporal substitution analysis was used for active behaviors (LPA and MVPA). The daily composition, adjusted for body mass index, sex, and age, was significantly associated with CRF (P = .007; r2 = 0.29), speed-agility (P < .001; r2 = 0.14), and lower-body muscular strength (P = .01; r2 = 0.07). For CRF, the addition of MVPA, at the expense of any other behavior, was associated with significant improvements. For speed-agility and lower-body muscular strength, only reallocations between sleep and LPA yielded significant associations. The variation in CRF, speed-agility, and lower-body muscular strength was associated with the 24 hours movement composition, and reallocating 5, 10 or 15 minutes of SB or sleep for MVPA was significantly positive for CRF (P < .05). The present findings highlight the relevance of decreasing SB and increasing physical activity practice, particularly at high intensities, to promote a better CRF profile for preschoolers

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Relationship among some coordinative and dynamic strength capabilities and constructive and conceptual thinking among preschool-age children

BackgroundExisting research underscores the positive influence of consistent physical activity, fitness, and motor coordination on school-aged children’s cognitive and academic performance. However, a gap exists in fully understanding this relationship among preschoolers, a critical age group where the development of cognitive functions is significant. The study aims to expand upon existing evidence that connects motor and cognitive development by examining the correlation between specific motor coordination and physical fitness skills and the development of constructive and conceptual thinking in preschool-aged children.MethodsData from 56 children aged 4–5 years (mean age 4.5 ± 0.36y), comprising 30 girls and 26 boys, participated in this study. We assessed muscular strength (via standing long jump, wall toss test, flexibility), agility (4 × 5 m shuttle), cardiorespiratory fitness (20 m pacer test), and motor coordination (lateral jumping, platform shifting). Cognitive abilities were measured using the IDS-P.ResultsLinear regression models showed that significant predictors of constructive thinking scores were observed solely for flexibility (p = 0.02) and shifting platforms (p = 0.01). Notably, flexibility exhibited a negative relationship (β = −1.68). In the context of conceptual thinking, significant predictors (p &lt; 0.05) included standing long jump (p = 0.01), jumping laterally (p = 0.005), shifting platforms (p = 0.001), throwing (p = 0.02).ConclusionCoordination-demanding activities seem to be related considerably to conceptual thinking in preschoolers. Integrating such motor activities into preschool curricula that demand cognitive engagement can positively influence the development of cognitive functions

Additional file 1 of Maternal macronutrient and energy intake during pregnancy: a systematic review and meta-analysis

Additional file 1

Food Insecurity and Bullying Victimization Among 170,618 Adolescents in 59 Countries

Background: Bullying victimization can impose long-lasting impacts on adolescent's current and subsequent well-being. Understanding the correlates of bullying victimization and how to prevent its occurrence is an urgent need. Food insecurity, an indicator of low socioeconomic status, may be related to bullying victimization. However, research on the association between food insecurity and bullying victimization is limited. Using a representative global sample, this study aimed to investigate the association between food insecurity and bullying victimization in adolescents and whether the association varied between country income levels, sexes, and age groups.Methods: Using cross-sectional, school-based data by 170,618 adolescents in 59 countries from the Global School-based Student Health Survey, multivariable logistic regression and meta-analysis were conducted to investigate the overall, country-stratified, sex-stratified, and age-stratified associations.Results: The prevalence of bullying victimization was 33.3%. In the total sample, adolescents with food insecurity showed significantly higher odds for bullying victimization than those without no food insecurity with a pooled odds ratio (OR) being 1.37 (1.28, 1.47). Further, the association was stronger in higher-income countries, females, and older adolescents.Conclusions: Bullying victimization is prevalent among global adolescents with food insecurity being a significant correlate. The identification of adolescents with perceptions of food insecurity and remedying this condition may be important to reduce the prevalence of bullying. This highlights the need to design and implement sex- and age-specific interventions focusing on remedying food insecurity and bullying victimization among in-school adolescents by taking country income levels into account