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Background: Obesity in pregnancy increases the risk of gestational diabetes mellitus (GDM) and associated adverse outcomes. Despite metabolic differences, all pregnant women with obesity are considered to have the same risk of developing GDM. Improved risk stratification is required to enable targeted intervention in women with obesity who would benefit the most. The aim of this study is to identify pregnant women with obesity at higher risk of developing GDM and, in a pilot randomised controlled trial (RCT), test feasibility and assess the efficacy of a lifestyle intervention and/or metformin to improve glycaemic control.
Methods: Women aged 18 years or older with a singleton pregnancy and body mass index (BMI) ≥ 30kg/m will be recruited from one maternity unit in London, UK. The risk of GDM will be assessed using a multivariable GDM prediction model combining maternal age, mid-arm circumference, systolic blood pressure, glucose, triglycerides and HbA1c. Women identified at a higher risk of developing GDM will be randomly allocated to one of two intervention groups (lifestyle advice with or without metformin) or standard antenatal care. The primary feasibility outcomes are study recruitment, retention rate and intervention adherence and to collect information needed for the sample size calculation for the definitive trial. A process evaluation will assess the acceptability of study processes and procedures to women. Secondary patient-centred outcomes include a reduction in mean glucose/24h of 0.5mmol/l as assessed by continuous glucose monitoring and changes in a targeted maternal metabolome, dietary intake and physical activity. A sample of 60 high-risk women is required.
Discussion: Early risk stratification of GDM in pregnant women with obesity and targeted intervention using lifestyle advice with or without metformin could improve glucose tolerance compared to standard antenatal care. The results from this feasibility study will inform a larger adequately powered RCT should the intervention show trends for potential effectiveness.
Trial Registration: This study has been approved by the NHS Research Ethics Committee (UK IRAS integrated research application system; reference 18/LO/1500). EudraCT number 2018-000003-16 .
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http://dx.doi.org/10.1186/s40814-022-01021-3 | DOI Listing |
Mil Med
December 2024
United States Army Research Institute of Environmental Medicine (USARIEM), Natick, MA 01760, USA.
Introduction: Military body fat standards were implemented in the 1980s to prevent obesity and associated poor military readiness. In the past 2 decades, enforcement of existing Army body composition standards has been eroded by the steady increase in national obesity rates, the demand for new recruits especially during the 2007 surge in Iraq, and the COVID epidemic in 2020. The diminishing qualified recruit pool puts a new focus on accession standards.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States.
Background: Indexing peak oxygen uptake (VOpeak) to total body mass can underestimate cardiorespiratory fitness (CRF) in women, older adults, and individuals with obesity. The primary objective of this multicenter study was to derive and validate a body size-independent scaling metric for VOpeak. This metric was termed exercise body mass (EBM).
View Article and Find Full Text PDFBMJ Open Sport Exerc Med
December 2024
Department of Community Medicine and Rehabilitation - Physiotherapy Section, Umeå University, Umea, Västerbotten, Sweden.
Physical activity guidelines targeting different populations with and without chronic diseases or disabilities are required to meet the diverse functional and physiological needs experienced by different subgroups of people to achieve optimal health benefits. As the importance of physical activity guidelines in promoting optimal health and well-being becomes increasingly recognised, there is a critical need for their systematic evaluation to ensure they remain effective, applicable and aligned with evolving health needs and scientific insights. This study aims to systematically review, critically evaluate, and compare global physical activity and sedentary behaviour guidelines on frequency, intensity, time, and type of exercise for adults, pregnant and postpartum women, and people living with chronic conditions and/or disabilities.
View Article and Find Full Text PDFWei Sheng Yan Jiu
November 2024
NHC Key Laboratory of Public Nutrition and Health, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Objective: To describe the prevalence of overweight, obesity, and central obesity among adult residents aged 18 years and above in 10 provinces(autonomous regions) of China in 2023, and to analyze the trends in 2000-2023.
Methods: Adults aged 18 and over with complete height, weight and waist circumference measurements who participated in the 2000-2018 China Health and Nutrition Survey and the 2022-2023 China Development and Nutrition Health Impact Cohort Survey from the same 10 provinces(autonomous regions) were selected as the study subjects. Overweight, obesity, pre-central obesity, and central obesity were defined according to the Chinese Adult Weight criteria(WS/T 428-2013).
Pharmacol Ther
December 2024
Institute of Microbiology and Molecular Genetics, University of the Punjab, New Campus, Lahore 54590, Pakistan. Electronic address:
Polycystic Ovarian Syndrome is one of the major prevalent causes of infertility reported worldwide nearly 6-26 %, especially in girls hitting puberty and women at their childbearing age. The main clinical manifestations include irregular menstrual cycle, small cysts on one or both ovaries, chronic oligo-anovulation, and hirsutism. The etiological criteria are very complex and related to many factors like obesity, insulin sensitivity, inflammation, hyperandrogenism, diabetes mellitus type II, cardiovascular diseases, and dysbiosis of gut microbiota.
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