A prospective analysis of optimal total weight gain ranges and trimester-specific weight gain rates for Chinese pregnant women.

BACKGROUND: Gestational weight gain (GWG) criteria recommended by the Institute of Medicine may not be appropriate for Asians. Our aims are to investigate the association between GWG and adverse pregnancy outcomes, and to propose optimal total GWG and rates of GWG for Chinese women. METHODS: Prospective data of 51,125 mother-child pairs from 27 hospitals and community health care centers from Guizhou, Yunnan and Sichuan provinces in China between 2014 and 2018 were analyzed. Generalized Additive Models were performed to determine the associations of GWG with the risk of aggregated adverse outcomes (gestational diabetes mellitus, preeclampsia, cesarean delivery, stillbirth, preterm birth, macrosomia, large for gestational age, and small for gestational age). The range that did not exceed a 2.5% increase from the lowest risk of aggregated adverse outcomes was defined as the optimal GWG range. RESULTS: Among all participants, U-shaped prospective association was found between GWG and the risk of aggregated adverse pregnancy outcomes. The optimal GWG range of 8.2-13.0 kg was proposed for underweight, 7.3-12.5 kg for normal weight, and 2.0-9.4 kg for overweight/obese women. Meanwhile, a higher GWG rate in the first two trimesters than that in the last trimester was suggested, except for overweight/obese women. After stratified by maternal age, mothers ≥35 years were suggested to gain less weight compared to younger mothers. CONCLUSIONS: To keep a balance between maternal health and neonatal growth, optimal GWG ranges based on Asia-specific BMI categories was suggested for Chinese women with different pre-gravid BMIs and maternal ages.

Study of a Modified Time Hardening Model for the Creep Consolidation Effect of Asphalt Mixtures.

In the past, most researchers have explained the three-stage creep behavior of asphalt mixture in detail. Still, there is no reasonable model to describe the creep of the consolidation effect. To accurately describe the consolidation effect of an asphalt mixture during the viscoelastic deformation process, a modified time hardening model was established by using the Malthus model and the Logistic function to change its creep strain and creep compliance. According to the characteristics of asphalt mixture creep, a single penetration creep test was conducted for high-elasticity modified asphalt mixtures at different temperatures (20 °C, 40 °C, 60 °C) and various loading levels (0.55 MPa, 0.70 MPa, 0.85 MPa, 1.00 MPa). The test results showed that the effect of stress on deformation within the normal range of variation was more significant than that of temperature. In addition, the test results were simulated by the modified time hardening model using surface fitting and compared with a time hardening model and a modified Burgers model. A fitting analysis showed that the modified time hardening model more accurately represents the asphalt mixture's consolidation effect and creep behavior. Therefore, the modified time hardening model can better show the consolidation effect in the creep process.

[Relationship between nutritional status and breakfast behaviors of rural primary and middle school students in a minority area of a city in Guizhou Province in 2019].

OBJECTIVE: To investigate the nutritional status and influencing factors of rural primary and middle school students in a minority area in a certain city of Guizhou Province, so as to provide scientific evidence for prevention and intervention. METHODS: A multi-stage stratified cluster random sampling method was adopted in this study, 3952 students from 6 primary and middle schools in a certain city of Guizhou Province were selected from April to June 2019 for height and weight measurement(1966 boys, 1986 girls, age(10.81±2.88) years old), among which 2833 students in grade 4 and above were surveyed(1374 boys and 1459 girls, age(13.44±1.94) years old), through the questionnaire to understand students& apos; basic information, breakfast and eating behaviors and so on, Using multi-factor Logistic regression to analyze the relationship between nutritional status and breakfast behavior. RESULTS: The height and weight of Han male students and female students in all age groups were slightly higher than those of ethnic minorities, but they tended to overlap gradually by the age of 16.The general height and weight of students in this area were lower than the 2014 national average. The general malnutrition rate of students was 21.39%, and the growth retardation rate was 13.13%, the moderate-to-severe wasting rate 3.04% and the mild wasting rate 5.22%. The malnutrition rate of minority students(24.72%) was higher than that of Han students(18.73%)(χ~2=14.93, P& lt; 0.05), the malnutrition rate of boys(26.49%) was higher than that of girls(16.59%)(χ~2=41.29, P& lt; 0.05). The sum of the rate of overweight and obesity of the students was 8.65%, among which the overweight rate was 6.42% and the obesity rate was 2.22%. There was no statistically significant difference in the variables between overweight and obese students(P& gt; 0.05). The breakfast behavior situation showed that rice noodle products(71.66%) were the most frequently consumed by primary and middle school students in the city. Multivariate Logistic regression analysis showed that the frequency of breakfast, the quality of breakfast, fresh vegetables, milk and products, and the frequency of meat/egg/fish were the main influencing factors of malnutrition. The differences were statistically significant(P& lt; 0.05). CONCLUSION: The growth and development status of primary and middle school students in a city of Guizhou Province mainly includes malnutrition, and the rate of overweight and obesity is not high, but prevention and control should still be paid attention to. The frequency and quality of breakfast are important influencing factors of malnutrition.

Relevance of dietary glycemic index, glycemic load and fiber intake before and during pregnancy for the risk of gestational diabetes mellitus and maternal glucose homeostasis.

BACKGROUND & AIMS: To date, the prevalence of Gestational diabetes mellitus (GDM) in China was 17.5%. Given the substantial relevance of GDM for medium- and long-term health of both mother and offspring and the paucity of existing data on the link between maternal diet and glucose homeostasis during pregnancy in Asian population, additional studies are needed. To examine the relevance of dietary glycemic index (GI), glycemic load (GL) and fiber intake before and during pregnancy for the development of GDM and glucose homeostasis over the course of pregnancy. METHODS: Cox proportional hazards analysis and linear mixed effects regressions were performed on data from 9317 women for whom three food frequency questionnaires (pre-pregnancy, 1st and 2nd trimesters) and biochemical measures during pregnancy were available. Investigated outcome variables included GDM risk, fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and homeostasis model assessment insulin resistance (HOMA-IR) in the 1st, 2nd and 3rd trimesters. RESULTS: Women in the highest tertile of dietary GI (or GL) before pregnancy, in the 1st, or the 2nd trimester respectively had a 12% (15%), 25% (23%) or 29% (25%) higher risk of developing GDM than those in the lowest tertile (all p for trend ≤ 0.02). Women with the highest dietary fiber intake before pregnancy, in the 1st or 2nd trimester had a 11%, 17% or 18% lower GDM risk (all p for trend ≤ 0.03). Moreover, increases in GI or GL and decreases in fiber intake over the course of pregnancy (1st to 3rd trimesters) were independently associated with adverse concurrent developments in FPG, HbA1C and HOMA-IR (p ≤ 0.03). CONCLUSIONS: Our study indicates that dietary GI, GL and fiber intake before and during pregnancy affects glucose homeostasis of pregnant Chinese women.

Assessing the relationship between pregravid body mass index and risk of adverse maternal pregnancy and neonatal outcomes: prospective data in Southwest China.

The relevance of pregestational body mass index (BMI) on adverse pregnancy outcomes remained unclear in Southwest China. This study aimed to investigate the overall and age-category specific association between pre-gestational BMI and gestational diabetes mellitus (GDM), preeclampsia, cesarean delivery, preterm delivery, stillbirth, macrosomia, and small-for-gestational age (SGA) or large-for-gestational age (LGA) neonates in Southwest China. Furthermore, it explores the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. 51,125 Chinese singleton pregnant women were recruited as study subjects. Multiple logistic regression models were used to examine the influence of pre-pregnancy BMI on adverse pregnancy outcomes. Gradient boosting machine was used to evaluate the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. It is found that women who were overweight or obese before pregnancy are at higher risk of adverse pregnancy outcomes except for SGA neonates, while pre-pregnancy underweight is a protective factor for GDM, preeclampsia, cesarean delivery, macrosomia and LGA, but not SGA. Younger mothers are more susceptible to GDM and macrosomia neonates, while older mothers are more prone to preeclampsia. Pre-pregnancy BMI has more influence on various pregnancy outcomes than maternal age. To improve pregnancy outcomes, normal BMI weight as well as relatively young maternal ages are recommended for women in child-bearing age.

Beyond protein intake: does dietary fat intake in the year preceding pregnancy and during pregnancy have an impact on gestational diabetes mellitus?

PURPOSE: Studies regarding the association between dietary fat intake and gestational diabetes mellitus (GDM) are limited and provide conflicting findings. Thus, the study aims to examine the association of dietary fat intake in the year preceding pregnancy and during pregnancy with the risk of GDM, taking the relevance of dietary protein intake on GDM into consideration. METHODS: A prospective study was conducted in 6299 singleton pregnancies, using the data from the Nutrition in Pregnancy and Growth in Southwest China (NPGSC). A validated food frequency questionnaire was used to assess dietary fat intake in the year preceding pregnancy and during the first and second trimesters of pregnancy. Logistic regression analysis was used to assess the prospective associations of dietary fat intake and the type and source of dietary fats in different time windows with GDM risk. RESULTS: Higher intake of total fat [OR (95% CI): 2.21 (1.19-4.20), P = 0.02] during 12-22 weeks of gestation was associated with higher GDM risk. However, adjustment for animal protein intake greatly attenuated this association [OR (95% CI): 1.81 (0.93, 3.64), P = 0.11]. Total fat intake neither in the year preceding pregnancy nor during the early pregnancy was associated with GDM risk. Moreover, insignificant associations were observed between intakes of vegetable fat, animal fat, cholesterol, saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid one year before pregnancy and during the first and second trimesters and GDM risk. CONCLUSION: Our study indicated that dietary fat intake one year before pregnancy and across the two pregnancy trimesters preceding the diagnosis of GDM has no relevance on GDM risk among Chinese women, particularly those with normal BMI, low, or normal calorie intake.

Prognostic value of serum heart-type fatty acid-binding protein in patients with sepsis: A protocol for systematic review and meta-analysis.

BACKGROUND: Sepsis is commonly acute and critical illness with high morbidity and high mortality, and requires timely diagnosis and treatment. Septic patients had elevated serum H-FABP levels, which may correlate with disease severity and mortality. However, previous studies showed that the association between H-FABP and mortality during the sepsis remains unclear. Thus, we performed a study to analyze this relationship. METHODS: The electronic databases such as Cochrane Library, PubMed, Embase, Web of Science, Cochrane Clinical Trials Database, Wanfang Database, and China National knowledge Infrastructure (CNKI) were systematically searched to determine the qualified clinical trials. The study language is limited to English or Chinese. The 2 authors used Cochrane Risk of Bias Tool v.2.0 to independently check the quality of papers and extract relevant data. Comprehensive analysis of data extracted in the research using appropriate statistical methods. RESULTS: Evaluation of the relationship between the prognosis of patients with sepsis and serum H-FABP is the result of this study. CONCLUSION: The analysis results of this study can infer that H-FABP may be an independent risk factor for the prognosis of patients with sepsis. It is also helpful for clinical workers to make early evaluation and early treatment of patients with sepsis. ETHICS AND DISSEMINATION: The conclusions of this meta-analysis study are based on the published evidence. Therefore, moral recognition is unnecessary. OSF REGISTRATION NUMBER: DOI: 10.17605/ OSF.IO / 2V4HN.(https://osf.io/2v4hn/).

Nutrition in Pregnancy and Growth in Southwest China (NPGSC) cohort: Design, implementation, and characteristics.

BACKGROUND: Pregnancy and birth cohorts addressing maternal nutrition and its impact on health outcomes have been rare in China, especially in Southwest China. OBJECTIVES: To describe the design, implementation, baseline characteristics, and initial results of the Nutrition in Pregnancy and Growth in Southwest China (NPGSC) cohort. POPULATION: Pregnant women with their children in Southwest China. DESIGN: NPGSC participants have been prospectively recruited since 2014. Pregnant women were invited to participate in the study at their first routine ultrasound examination in gestational weeks 9-11. Data were assessed three times during pregnancy (9-11, 20-22, and 33-35 gestation weeks), and eight times in infants and toddlers. METHODS: Pre-pregnancy body weight and height were self-reported; gestational weight gain was measured at regular intervals. Both food frequency questionnaires (FFQ) and 24-hour dietary recalls were used to collect dietary intakes during pregnancy, and FFQ for diet before pregnancy. Information on pregnancy outcomes was extracted from the medical birth registry. Anthropometry of children in the first 3 years of life was measured by trained investigators. Other child outcomes, including feeding practices (self-reported by mothers) and cognitive development (assessed by the Chinese version of Ages and Stages Questionnaire), were recorded. PRELIMINARY RESULTS: Between 2014 and 2018, 12 989 pregnant women were enrolled, and 2296 children completed the 3 years follow-up. Among them, 115 pregnancies ended in stillbirth. Mean maternal pre-pregnancy BMI was 21.1 kg/m2 and mean gestational weight gain was 13.5 kg 18.6% of mothers developed gestational diabetes and 1.5% of mothers were diagnosed with preeclampsia. Mean birthweight and birth length of children were, respectively, 3329 g and 49.4 cm. CONCLUSION: We built a prospective cohort in Southwest China, which can provide valuable data to investigate the relevance of nutrition for the health of mothers and children.

Breakfast consumption and influencing factors of primary and middle school students in rural poor areas of Guizhou Province / 中国学校卫生

Objective@#To understand the current situation of breakfast consumption and its influencing factors in primary and middle school students in a poor rural area in a city in Guizhou Province, and to provide scientific basis for child nutrition education and intervention.@*Methods@#A stratified cluster sampling method was used to conduct a questionnaire survey of breakfast behavior and influencing factors among 2 833 students from 3 primary schools and 3 middle schools in a area of Guizhou Province from April to June 2019.@*Results@#The most frequently consumed breakfast was rice noodle products(71.66%), followed by fresh vegetables(45.89%), milk(35.55%), meat/egg/fish(29.33%), beans(19.52%), and fresh fruits(18.74%). The proportion of having breakfast everyday among elementary and middle school students who was 62.97%, and having breakfast 4-6 days peer week was 22.80%, and 14.23% with ≤3 days peer week, and the proportion of boys who ate breakfast every day(65.07%) was higher than girls(61.00%)(χ2=10.01, P<0.05). The proportion of low quality breakfast was 71.87%, and girls(73.68%) were higher than boys(69.94%)(χ2=9.29, P<0.05). Logistic regression analysis showed that grade of school, boarding school, and sleep quality are all influencing factors for whether to eat breakfast every day; grade of school, whether to stay at school were factors that affect breakfast quality(P<0.05).@*Conclusion@#The frequency and quality of breakfast need more improvement among middle and primary school students in a poor rural area of a city in Guizhou Province. Students, parents, and teachers should be educated on nutrition to promote healthy eating and sleeping habits and improve student health.

[Associations of Pre-pregnancy Body Mass Index and Gestational Weight Gain with Gestational Diabetes Mellitus: a Cohort Study in Southwest China].

OBJECTIVE: To determine the associations of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with gestational diabetes mellitus (GDM). METHODS: A prospective cohort of pregnant women were screened for GDM at 24-28 weeks of gestation between 2013 and 2015, resulting in a sample of 3 593 with GDM and 15 346 without GDM. The body mass, plasma glucose, and height data of the participants were collected by the local medical workers. Multivariate logistic regression analyses were performed to determine the associations of pre pregnancy body mass index and weight gain during pregnancy with GDM. RESULTS: The participants with pre pregnancy overweight [odds ratio(OR)=2.44, 95% cofidence interval(CI)1.98-2.99] and obesity (OR=4.98, 95%CI 2.52-9.91) were more likely to develop GDM. According to the Institute of Medicine (IOM) criteria, excessive GWG in the first trimester occurred in 8.46% of the women, compared with 55.07% in the second trimester. After adjustment for age at delivery and pre pregnancy BMI, high GWG in the first trimesters in advanced maternal age (age at delivery≥35 yr.) group (OR=1.42, 95%CI 1.02-2.28) was a risk factor for GDM while the OR value of the non-advanced maternal age (age at delivery≤35 yr.) group was not statistically significant. In second trimesters, both advanced maternal age group (OR=1.59, 95%CI 1.14-1.88) and non-advanced maternal age group (OR=1.49, 95%CI 1.20-1.72) in high GWG were associated with high risk of GDM. CONCLUSION: Pre pregnancy overweight and obesity and excessive GWG during early and second trimesters of pregnancy may increase the risk of GDM in women in Southwestern China.

[Association of dietary energy intake and energy density with gestational weight gain in Chengdu City].

OBJECTIVE: To determine the association of dietary energy intake and energy density( ED) with gestational weight gain among pregnant women in Chengdu. METHODS: A total of 503 pregnant women who took the prenatal examination in West China Second University Hospital were selected in the prospective study in 2015. ED, computed as the ratio of energy intake( kcal) per weight( g) of foods( kcal/g), was calculated using three methods as follows:( 1) ED1 included foods only, excluding all beverages;( 2) ED2 included foods and milk;( 3) ED3 included foods and beverages. Energy intake were calculated using dietary data respectively collected in the first, second and third trimester of pregnancy by validated 24-hour recalls, in which ED was calculated based on three calculation method. Data on gestational weight gain was calculated by using pre-pregnancy weight and prenatal weight. Excessive gestational weight gain was determined by the 2009 Institute of Medicine( IOM) recommendations for gestational weight gain. Logistic regression analyses were performed to explore the association of energy intake and ED with excessive gestational weight gain. RESULTS: The risk of excessive gestational weight gain was higher among pregnant women whose dietary energy intake during the third trimester of pregnancy was higher( OR = 1. 94, 95% CI 1. 18-3. 23). After adjusting for covariates, ED based on foods and milk during the third trimester of pregnancy was identified as a protect factor of excessive gestational weight gain( OR = 0. 56, 95% CI 0. 34-0. 93). Dietary energy intake and ED in the first and second trimester of pregnancy were not associated with excessive gestational weight gain after adjustment of all covariates. CONCLUSION: Dietary energy intake in the third trimester of pregnancy might be the risk factor of excessive gestational weight gain, while moderate ED may be the protect factor.

Dietary Protein Intake, Meat Consumption, and Dairy Consumption in the Year Preceding Pregnancy and During Pregnancy and Their Associations With the Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study in Southwest China.

Background: Gestational diabetes mellitus (GDM) has become a public health problem in China. Objective: To examine the association of dietary protein intake before and during pregnancy with the risk of GDM. Design: Dietary intake before pregnancy and during the first and second trimesters of pregnancy was assessed using food frequency questionnaires in a prospective cohort of pregnant women. To screen GDM, participants underwent an OGTT test during 24-28 weeks of gestation. Cox proportional hazards were used to estimate RRs and 95% CIs for the associations between tertiles of dietary protein and the source of protein intake in different time windows with GDM status. Results: Higher intake of total protein [RR (95% CI): 1.92 (1.10-3.14), p for trend = 0.04] or animal protein [1.67 (1.19-2.93), p for trend = 0.03] in mid-pregnancy was associated with higher risk of GDM. Vegetable protein intake before or during pregnancy was not related to GDM risk (p for trend > 0.05). Moreover, in the mid-pregnancy, participants with higher meat consumption or dairy consumption had a higher risk of GDM. Conclusion: Our study indicated that higher dietary intakes of total protein and animal protein in mid-pregnancy were associated with an increased risk of GDM among pregnant Chinese women.

Glabridin attenuates lipopolysaccharide-induced acute lung injury by inhibiting p38MAPK/ERK signaling pathway.

BACKGROUND: Acute respiratory distress syndrome (ARDS) is a complication caused by pulmonary and/or external factors. In this study, we investigated the protective mechanisms of glabridin in lipopolysaccharide (LPS) induced ARDS in rats. RESULTS: GLA treatment at dose of 30 mg/kg decreased LPS-induced lung W/D ratio and alleviated evident lung histopathological changes. Expressions of TNF-α and IL-18 were suppressed by GLA in plasma. The levels of SPA, MDA and NO in lung were down-regulated significantly in groups administrated with GLA. While the SOD level increased after GLA administration. Additionally, the attenuation of inflammatory responses by GLA was closely associated with p38MAPK/ERK pathway, and the expressions of protein p-p38MAPK and pERK were inhibited by GLA in LPS-induced ARDS rats. MATERIALS AND METHODS: Sixty-four Wistar rats were randomly assigned into control group, Glabridin (GLA) alone group, LPS groups (6 h, 12 h, 24 h), GLA with LPS groups (6 h, 12 h, 24 h). ARDS was induced in rats by intraperitoneal administration of LPS (10 mg/kg). The degree of lung edema was evaluated by calculating the wet/dry weight ratio. The levels of inflammatory mediators, tumor necrosis factor-α (TNF-α) and interleukin-18 (IL-18) were assayed by enzyme-linked immunosorbent assay (ELISA). Surfactant protein A (SPA), malondialdehyde (MDA), nitric oxide (NO) and superoxide dismutase (SOD) were analyzed. Pathological changes of lung tissues were observed by H&E staining. The protein expression of p38MAPK and ERK was detected using immunohistochemical techniques. Lung phosphorylated p38MAPK (p-p38MAPK) and pERK protein expression changes were detected by Western blotting. CONCLUSIONS: Glabridin significantly ameliorated the lung injury induced by LPS in rats via the inhibition of p38MAPK and ERK signaling pathway, antioxidant effect and reducing inflammation.