Modern dietary guidelines for healthy pregnancy; maximising maternal and foetal outcomes and limiting excessive gestational weight gain

Abstract

Maternal dietary habits influence maternal and foetal health, representing a pathway for intervention to maximise pregnancy outcomes. Advice on energy intake is provided on a trimester basis, with no additional calories required in the first trimester and an additional 340?kcal?d^?1 and 452?kcal?d^?1 needed for the second and third trimesters. Energy intake depends on pre-gravid body mass index (BMI); underweight women are recommended an increase of 150, 200 and 300?kcal?d^?1 during the first, second and third trimester, normal weight women an increase of 0, 350 and 500?kcal?d^?1 and obese women an increase of 0, 450 and 350?kcal?day^?1. The recommendations for carbohydrate and protein intake are 175?g?d^?1 and 0.88–1.1?g?kgBM?d^?1, with no change to fat intake. The number of pre-gravid obese women is rising; therefore, we need to regulate weight in women of childbearing age and limit gestational weight gain to within the recommended ranges [overweight women 6.8–11.3?kg and obese women 5.0–9.1?kg]. This can be achieved using nutritional interventions, as dietary changes have been shown to help with gestational weight management. As pregnancy has been identified as a risk factor for the development of obesity, normal weight women should gain 11.5–16.0?kg during pregnancy. While some research has shown that dietary interventions help to regulate gestational weight gain and promote postpartum weight loss to some extent, future research is needed to provide safe and effective guidelines to maximise these effects, while benefitting maternal and foetal health.     

The effect of 14 weeks of vitamin D3 supplementation on antimicrobial peptides and proteins in athletes

Heavy training is associated with increased respiratory infection risk and antimicrobial proteins are important in defence against oral and respiratory tract infections. We examined the effect of 14 weeks of vitamin D₃ supplementation (5000 IU/day) on the resting plasma cathelicidin concentration and the salivary secretion rates of secretory immunoglobulin A (SIgA), cathelicidin, lactoferrin and lysozyme in athletes during a winter training period. Blood and saliva were obtained at the start of the study from 39 healthy men who were randomly allocated to vitamin D₃ supplement or placebo. Blood samples were also collected at the end of the study; saliva samples were collected after 7 and 14 weeks. Plasma total 25(OH)D concentration increased by 130% in the vitamin D₃ group and decreased by 43% in the placebo group (both P = 0.001). The percentage change of plasma cathelicidin concentration in the vitamin D₃ group was higher than in the placebo group (P = 0.025). Only in the vitamin D₃ group, the saliva SIgA and cathelicidin secretion rates increased over time (both P = 0.03). A daily 5000 IU vitamin D₃ supplement has a beneficial effect in up-regulating the expression of SIgA and cathelicidin in athletes during a winter training period, which could improve resistance to respiratory infections.     

Short-term heat acclimation prior to a multi-day desert ultra-marathon improves physiological and psychological responses without compromising immune status

Multistage, ultra-endurance events in hot, humid conditions necessitate thermal adaptation, often achieved through short term heat acclimation (STHA), to improve performance by reducing thermoregulatory strain and perceptions of heat stress. This study investigated the physiological, perceptual and immunological responses to STHA prior to the Marathon des Sables. Eight athletes (age 42 ± 4 years and body mass 81.9 ± 15.0 kg) completed 4 days of controlled hyperthermia STHA (60 min·day^?1, 45°C and 30% relative humidity). Pre, during and post sessions, physiological and perceptual measures were recorded. Immunological measures were recorded pre-post sessions 1 and 4. STHA improved thermal comfort (P = 0.02), sensation (P = 0.03) and perceived exertion (P = 0.04). A dissociated relationship between perceptual fatigue and T_re was evident after STHA, with reductions in perceived Physical (P = 0.04) and General (P = 0.04) fatigue. Exercising T_re and HR did not change (P > 0.05) however, sweat rate increased 14% (P = 0.02). No changes were found in white blood cell counts or content (P > 0.05). Four days of STHA facilitates effective perceptual adaptations, without compromising immune status prior to an ultra-endurance race in heat stress. A greater physiological strain is required to confer optimal physiological adaptations.     

Psychometric Properties of a Parental Questionnaire for Assessing Correlates of Toddlers’ Physical Activity and Sedentary Behavior

This study examined the psychometric properties of a questionnaire developed with the guidance of the socialization model of child behaviour to understand modifiable correlates of toddlers’ physical activity and sedentary behaviour. Findings are based on 118 parents (33.7 ± 4.9 years; 86% female) of toddlers (19.3 ± 2.7 months; 48% female) from Edmonton, Canada in The Parents’ Role in Establishing healthy Physical activity and Sedentary behaviour habits study (PREPS). The PREPS questionnaire encompassed 21 variables across the constructs of the socialization model of child behaviour. Of the nine variables assessed for internal consistency reliability, eight had good (α ≥ 0.70) reliability. Of the 15 continuous variables assessed for 1-week test–retest reliability, 10 had moderate (intra-class correlation = 0.50–0.74) and 5 had good (intra-class correlation ≥ 0.75) reliability. Of the six categorical variables assessed for 1-week test–retest reliability, two had fair (К = 0.21–0.40), one had moderate (К = 0.41–0.60), one had substantial (К = 0.61–0.80), and two had almost perfect (К = 0.81–1.00) reliability. Of the 12 sedentary behaviour variables assessed for convergent validity, 7 were significantly correlated with children’s screen time, of which three were small (r ≤ 0.29), two were medium (r = 0.30–0.49), and two were large (r ≥ 0.50) effect sizes.     

Enabling integrated knowledge acquisition and management in health care teams

Basing treatment, policy and planning decisions on the best available research knowledge remains a central principle in modern health care around the world, yet many health professionals find acquiring and managing published research knowledge challenging. In this paper, we report on a Soft Systems Methodology-based collaborative action research initiative with a specialist mental health service from the United Kingdom's National Health Service. Our objective was to design and implement improvements to their knowledge acquisition and management activities in order to facilitate sustained and effective evidence-based practices. We report on both the factors found to impede effective research knowledge acquisition and management and the development of more integrated knowledge management processes designed to improve the situation.     

Attentional bias for exercise-related images

This research examined attentional bias toward exercise-related images using a visual probe task. It was hypothesized that more-active participants would display attentional bias toward the exercise-related images. The results showed that men displayed attentional bias for the exercise images. There was a significant interaction of activity level by gender, and simple slopes analysis showed that active women displayed attentional bias toward the exercise-related images and inactive women displayed attentional bias toward the control images. A similar analysis with explicit attention to the pictures as the outcome variable was not significant. These findings confirm that attention for exercise-related images can be captured automatically regardless of whether people report they are attending to them.     

Developing and sustaining a sense of place: The role of social information

This exploration of the role of information in helping people to develop and sustain feelings of belonging, or a sense of place, is based on a study that investigated the reasons for the high population turnover in the Northern Territory of Australia. The Northern Territory along with Darwin, its capital, has a number of unusual characteristics including geographical isolation. A key component of the theoretical framework for the research focuses on social information, which has similarities to the more commonly termed everyday life information. The specific concern is with the kind of information that helps people connect to a community and is clearly linked with social networking. The sample for the major empirical component for the article was recruited at Darwin's Mindil Beach Market. In telephone phone interviews with those who had agreed to participate, participants discussed how they learned about Darwin and the Northern Territory, and their views of Darwin as a place to live. Interpersonal contacts, including at the Market and at special events, were most often mentioned in relation to information, confirming literature findings on the importance of family and friends as an information source. Other sources were newspapers and physical markers around the City of Darwin. The conclusion is that the processes of social networking, which work well for some residents, could be enhanced through the use of information grounds, a concept widely discussed in the library and information science literature. Obvious information grounds in Darwin, where the usual processes could be enhanced by the distribution of information by formal information providers, include Mindil Beach Market and the special events for which Darwin is renowned.