Associations of body composition and physical fitness with gestational diabetes and cardiovascular health in pregnancy: Results from the HealthyMoms trial

Open access funding provided by Linkoping UniversityWe gratefully thank the participating women in the HealthyMoms trial. The authors also acknowledge Eva Flinke and Ellinor Nilsson for invaluable help with the data collection and the midwifes in Region Östergötland for help with the recruitment. The HealthyMoms trial is funded by the Swedish Research Council (2016-01147 to M.L.) and additionally supported by the Swedish Research Council for Health, Working Life and Welfare (Forte, 2017-00088 to P.H.; 2018-01410 to M.L.); Bo and Vera Ax:son Johnsons’ Foundation (to M.L.); the Strategic Research Area Health Care Science, Karolinska Institutet/Umeå University (to P.H.); the Swedish Society of Medicine (to P.H.); Karolinska Institutet (to P.H. and M.L.); and Lions Forskningsfond (to P.H.). M.H.L. was supported by a grant from Yrjö Jahnsson Foundation.The aim of this study was to examine associations of body composition (fat mass index, % fat mass, fat-free mass index, body mass index) and physical fitness (cardiorespiratory fitness and handgrip strength) with gestational diabetes and cardiovascular health in early pregnancy. This cross-sectional study utilized baseline data (n = 303) collected in early pregnancy from the HealthyMoms trial. Body composition was measured using air-displacement plethysmography, cardiorespiratory fitness was assessed by means of the 6-min walk test and handgrip strength using a dynamometer. Logistic regression was used to estimate odds ratios (ORs) for gestational diabetes as well as high (defined as 1 SD above the mean) blood pressure, homeostatic model assessment for insulin resistance (HOMA-IR), and metabolic syndrome score (MetS score) per 1 SD increase in body composition and fitness variables. Fat mass index, % fat mass and body mass index were all strongly associated with gestational diabetes (ORs: 1.72-2.14, P = 0.61). In conclusion, accurately measured fat mass index or % fat mass were strongly associated with gestational diabetes risk and markers of cardiovascular health although associations were not stronger than the corresponding ones for body mass index. Fat-free mass index had only weak associations with gestational diabetes and cardiovascular health which support that the focus during clinical care would be on excess fat mass and not fat-free mass.Linkoping Universit

Offentlig budgetering - En fallstudie av budgetprocessen i Malmö stad stadsdel Centrum

Syfte: Syftet är att beskriva och analysera budgetprocessen i en kommun indelad i stadsdelsnämnder och speciellt diskutera budgetprocessen internt inom en stadsdelsnämnd. Metod: Vår studie av budgetprocessen i Stadsdel Centrum är att karaktärisera som en fallstudie. Teoretiska perspektiv: Litteraturen behandlar budgetprocessens olika delar. I huvudsak används litteratur inriktad på offentlig verksamhet. Även allmän företagsekonomisk litteratur används dock för att visa på skillnader mellan offentlig och privat verksamhet. Empiri: Datainsamlingen har i huvudsak baserats på intervjuer av politiker och tjänstemän inom stadsdel Centrum och observationer av Centrum stadsdelsfullmäktiges sammanträden. Slutsatser: Stadsdel Centrum misslyckas med att konkretisera kommunens och sina egna målsättningar och saknar därmed riktlinjer för de ekonomiska prioriteringarna i budgetarbetet. Budgetprocessen i stadsdelen är nedbrytningsorienterad, vilket medför bristande engagemang i processen och skapar bristande helhetsförståelse för stadsdelens ekonomiska situation. Det politiska spelet i en parlamentarisk organisation medför en, ur ett budgetperspektiv, ineffektiv beslutsprocess

Измерение капиллярного давления тканей периодонта при протезировании дефектов зубов и зубных рядов

КАПИЛЛЯРЫМИКРОЦИРКУЛЯЦИЯПЕРИОДОНТКРОВЯНОЕ ДАВЛЕНИЕЗУБНОЕ ПРОТЕЗИРОВАНИЕЗУБНОЙ РЯДСТОМАТОЛОГИЧЕСКАЯ ИМПЛАНТАЦИ

DNA methylation in infants with low and high body fatness

The authors gratefully thank the parents and children that participated in the PATHOS study.Background: Birth weight is determined by the interplay between infant genetics and the intrauterine environment and is associated with several health outcomes in later life. Many studies have reported an association between birth weight and DNA methylation in infants and suggest that altered epigenetics may underlie birthweight-associated health outcomes. However, birth weight is a relatively nonspecific measure of fetal growth and consists of fat mass and fat-free mass which may have different effects on health outcomes which motivates studies of infant body composition and DNA methylation. Here, we combined genome-wide DNA methylation profiling of buccal cells from 47 full-term one-week old infants with accurate measurements of infant fat mass and fat-free mass using air-displacement plethysmography. Results: No significant association was found between DNA methylation in infant buccal cells and infant body composition. Moreover, no association between infant DNA methylation and parental body composition or indicators of maternal glucose metabolism were found. Conclusions: Despite accurate measures of body composition, we did not identify any associations between infant body fatness and DNA methylation. These results are consistent with recent studies that generally have identified only weak associations between DNA methylation and birthweight. Although our results should be confirmed by additional larger studies, our findings may suggest that differences in DNA methylation between individuals with low and high body fatness may be established later in childhood.Swedish Research Council FormasSwedish Research Council 2015-03495Swedish Cancer Society CAN 2017/625Spanish Ministry of Economy, Industry and Competitiveness (MINE CO)European Union (EU) RYC-2016-21199 ENDORE SAF2017-87526Linkoping University LibraryBo and Vera Ax:son Johnsons Foundatio

Associations of sleep-related outcomes with behavioral and emotional functioning in children with overweight/obesity

Objective To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and deviceassessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/ obesity. Study design A total of 109 children with overweight/obesity (mean age, 10.0 (±) 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). Results SDB was positively associated with all clinical scale variables (all b > 0.197, P ≤ .041) and with lower adaptability and leadership (all b 0.196, P ≤ .045) and lower adaptability (b = 0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all b > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. Conclusions Our study suggests that SDB symptoms, but not deviceassessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability. (J Pediatr 2022;246:170-8).The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the Fondo Europeo de Desarrollo Regional (DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC-2011-09011). L.V.T.-L. is supported by a grant from the Spanish Ministry of Science, Innovation and Universities (FPU17/04802). C.C.-S. is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). J.H.M. is supported by a grant from the Spanish Ministry of Education, Culture, and Sport (FPU15/02645). Additional support was provided by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health, by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, and European Regional Development Fund (SOMM17/6107/UGR). Funding was also provided by the SAMID III network, RETICS , funded by the PNI + D + I 2017-2021 (Spain), ISCIII Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (RD16/0022 ), the EXERNET Research Network on Exercise and Health ( DEP2005-00046/ACTI ; 09/UPB/19; 45/UPB/20; 27/UPB/21), the European Union's 2020 Research and Innovation Program under Grant Agreement 667302, and the HL-PIVOT network Healthy Living for Pandemic Event Protection . Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Fund (project B-CTS-355-UGR18)

A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial

Background: Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. Objective: The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. Methods: HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. Results: Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. Conclusions: This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy

Associations of Mediterranean diet with psychological ill‑being and well‑being throughout the pregnancy course: The GESTAFIT project

Purpose The relation between diet and maternal mental health during pregnancy might be relevant to prevent adverse materno-foetal outcomes. This study examined the association of Mediterranean diet (MD) adherence and MD components with mental health during pregnancy. Methods This secondary analysis of the GESTAFIT trial included longitudinal data from 152 pregnant women. Dietary habits were assessed with a food frequency questionnaire, and MD adherence was derived from it using the Mediterranean Food pattern. Psychological ill-being (i.e., negative affect, anxiety, and depression) and well-being (i.e., emotional intelligence, resilience, positive affect) were assessed with the Spanish version of well-established self-reported questionnaires. Cross-sectional (16th gestational week [g.w.]) and longitudinal associations (34th g.w.) between MD and mental health were studied using linear regression models. Results A greater MD adherence was inversely associated with negative affect and anxiety; and positively associated with emotional regulation, resilience and positive affect at the 16th and 34th g.w. (|β| ranging from 0.179 to 0.325, all p < 0.05). Additionally, a higher intake of whole grain cereals, fruits, vegetables, fish, olive oil and nuts, and a lower intake of red meat and subproducts and sweets were associated with lower negative affect, anxiety, depression and higher emotional regulation, resilience and positive affect throughout gestation (|β| ranging from 0.168 to 0.415, all p < 0.05). Conclusion A higher intake of whole grain cereals, fruits, vegetables, fish, olive oil and nuts, together with a lower intake of red meat and sweets, resulted in a higher MD adherence, which was associated with a better mental health during pregnancy.Universidad de Granada /CBUA The Regional Ministry of Health of the Junta de Andalucía (PI-0395–2016) The Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme: Scientific Units of Excellence (UCEES), and the Regional Ministry of Economy, Knowledge, Enterprises and University, European Regional Development Funds (SOMM17/6107/UGR) of the University of Granada. Spanish Ministry of Education, Culture and Sports (Grant number FPU17/03715). The Swedish Council for Health, Working Life and Welfare (2021-00036)

Association of Neck Circumference with Anthropometric Indicators and Body Composition Measured by DXA in Young Spanish Adults

Background: Due to a clinical and public health interest of neck circumference (NC), a better understanding of this simple anthropometric measurement, as a valid marker of body composition is necessary. Methods: A total of 119 young healthy adults participated in this study. NC was measured over the thyroid cartilage and perpendicular to the longitudinal axis of the neck. Body weight, height, waist circumference (WC), and hip circumference were measured. A Dual X-ray absorptiometry (DXA) scan was used to determine fat mass, lean mass, and visceral adipose tissue (VAT). Additionally, body mass index (BMI) and triponderal mass index (TMI), the waist to hip and waist to height ratios, and the fat mass and lean mass indexes (FMI and LMI, respectively) were calculated. Results: NC was positively associated in women (W) and men (M), with BMI (rW = 0.70 and rM = 0.84, respectively), TMI (rW = 0.63 and rM = 0.80, respectively), WC (rW = 0.75 and rM = 0.86, respectively), VAT (rW = 0.74 and rM = 0.82, respectively), Waist/hip (rW = 0.51 and rM = 0.67, respectively), Waist/height (rW = 0.68 and rM = 0.83, respectively) and FMI (rW = 0.61 and rM = 0.81, respectively). The association between NC and indicators of body composition was however weaker than that observed by BMI, TMI, WC and Waist/height in both women and men. It is of note that in women, NC was associated with FMI, VAT and LMI independently of BMI. In men, adding NC to anthropometric variables did not improve the prediction of body composition, while slight improvements were observed in women. Conclusions: Taken together, the present study provides no indication for NC as a useful proxy of body composition parameters in young adults, yet future studies should explore its usefulness as a measure to use in combination with BMI, especially in women.This study was supported by the Spanish Ministry of Economy and Competitiveness Grants (DEP2016-79512-R and PTA 12264-I), Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI13/01393), and Retos de la Sociedad (DEP2016-79512-R), Fondos Estructurales de la Unión Europea (FEDER), by the Spanish Ministry of Education (FPU 13/04365), by the Fundación Iberoamericana de Nutrición (FINUT), by the Redes temáticas de investigación cooperativa RETIC (Red SAMID RD16/0022), by AstraZeneca HealthCare Foundation and by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Scientific Unit of Excellence on Exercise and Health (UCEES), Plan Propio de Investigación 2018: Programa Contratos-Puente and Programa Perfeccionamiento de Doctores, by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, the European Regional Development Funds (ref. SOMM17/6107/UGR), by the Fundación Alfonso Martín Escudero, and by the Fundación Carolina (C.2016-574961). This study is part of a Ph.D. Thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spain

Effects of an exercise program on cardiometabolic and mental health in children with overweight or obesity: a secondary analysis of a randomized clinical trial

Importance: Childhood obesity is a risk factor associated with type 2 diabetes, cardiovascular disease, and mental disorders later in life. Investigation of the parallel effects of a defined exercise program on cardiometabolic and mental health in children with overweight or obesity may provide new insights on the potential benefits of exercise on overall health. Objective: To investigate the effects of a 20-week exercise program on cardiometabolic and mental health in children with overweight or obesity. Design, Setting, and Participants: This secondary analysis of a parallel-group randomized clinical trial was conducted in Granada, Spain, from November 1, 2014, to June 30, 2016. Data analyses were performed between February 1, 2020, and July 14, 2022. Children with overweight or obesity aged 8 to 11 years were eligible, and the study was performed in an out-of-school context. Intervention: The exercise program included 3 to 5 sessions/wk (90 min/session) of aerobic plus resistance training for 20 weeks. The wait-list control group continued with their usual routines. Main Outcomes and Measures: Cardiometabolic outcomes as specified in the trial protocol included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness (cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference, blood lipid levels, glucose levels, insulin levels, and blood pressure). Cardiometabolic risk score (z score) was calculated based on age and sex reference values for levels of triglycerides, inverted high-density lipoprotein cholesterol, and glucose, the mean of systolic and diastolic blood pressure, and waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness. Mental health outcomes included an array of psychological well-being and ill-being indicators. Results: The 92 participants included in the per-protocol analyses (36 girls [39%] and 56 boys [61%]) had a mean (SD) age of 10.0 (1.1) years. The exercise program reduced the cardiometabolic risk score by approximately 0.38 (95% CI, -0.74 to -0.02) SDs; decreased low-density lipoprotein cholesterol level by -7.00 (95% CI, -14.27 to 0.37) mg/dL (to convert to mmol/L, multiply by 0.0259), body mass index (calculated as weight in kilograms divided by height in meters squared) by -0.59 (95% CI, -1.06 to -0.12), fat mass index by -0.67 (95% CI, -1.01 to -0.33), and visceral adipose tissue by -31.44 (95% CI, -58.99 to -3.90) g; and improved cardiorespiratory fitness by 2.75 (95% CI, 0.22-5.28) laps in the exercise group compared with the control group. No effects were observed on mental health outcomes. Conclusions and Relevance: In this secondary analysis of a randomized clinical trial, an aerobic plus resistance exercise program improved cardiometabolic health in children with overweight or obesity but had no effect on mental health. Trial Registration: ClinicalTrials.gov Identifier: NCT02295072.This project was supported with grants DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC-2011-09011 from the Spanish Ministry of Economy and Competitiveness and the Fondo Europeo de Desarrollo Regional (FEDER) and by grant PID2020-120249RB-I00 from the MCIN/AEI /10.13039/501100011033. Additional funding was obtained from the Andalusian Operational Programme supported with grant B-CTS-355-UGR18 from the European Regional Development Fund (FEDER in Spanish). Dr Cardenas-Sanchez is supported by grant FJC2018-037925-I from the Spanish Ministry of Science and Innovation and by a grant from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska Curie grant agreement No 101028929. Dr Migueles is supported by grant FPU15/02645 from the Spanish Ministry of Education, Culture and Sport, and grant 2012–00036 from the Swedish Research Council for Health, Working Life and Welfare. Dr Torres-Lopez is supported by grant FPU17/04802 from the Spanish Ministry of Science, Innovation and Universities. Dr Rodriquez-Ayllon was funded by grant DEP2017-91544-EXP from the Ramón Areces Foundation. Additional support was obtained from grant ALICIAK-2018 from the Alicia Koplowitz Foundation, University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Unit of Excellence on Exercise, Nutrition and Health, the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades; and grant DEP2005-00046/ACTI from the EXERNET Research Network on Exercise and Health in Special Populations. This research was supported by grant CB22/03/00058 from the Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea–European Regional Development Fund