Designing an educational intervention to prevent excessive gestational weight gain: a protocol for a randomized controlled trial.

BACKGROUND: Pregnancy as one of the critical stages of life carries a high risk to the health of pregnant women. The amount of weight gained during pregnancy can affect the woman and her infant health immediately or in the future. The present study is conducted to design and explore the effectiveness of an educational intervention based on health belief model (HBM) to preventing excessive gestational weight gain (GWG). METHODS: This research-based planning is designed in three phases and will be conducted on pregnant women in first trimester. In the first phase of this randomized controlled trial study, body mass index (BMI), the level of knowledge and the level of the HBM constructs will be measured using a questionnaire. The HBM questionnaire is designed based on a literature review and experts opinions. In the next phase the educational program content will be designed based on the results of the first phase of the study on the level of women's knowledge, and HBM constructs as well as a literature review and experts opinions. The intervention will be designed in four training sessions about the importance of behaviors, especially physical activity and nutrition, in the prevention of excessive weight gain during pregnancy. The tired phase includes the implementation of educational intervention with two intervention and control groups. The efficacy of the program will be evaluated by measuring the level of the knowledge, HBM constructs and women's weight gain during pregnancy in the second and third trimesters. Appreciate weight gain will be considered according to the BMI in first trimester. DISCUSSION: The present study will provide strong information regarding the effetiness of the HBM and appropriate framework to develop educational interventions together with enhancing pregnant women's knowledge and belief toward weight management behaviors. TRIAL REGISTRATION: Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20180703040325N1 . Date of registration: 2018-08-20.

Institutional factors associated with college students' healthy physical activity and body composition: A first semester follow-up.

Objective: The first aim of this study was to examine changes in freshman college students' health-enhancing physical activity (PA) and body composition across the first semester. Secondly, this study aimed to explore the role of socio-ecological variables on these processes. Methods: A sample of 166 participants (108 females, 58 males, Mage = 18.14[.96]) completed self-report pre-and posttest data on vigorous PA (VPA), moderate-to-vigorous PA (MVPA), and body mass index (BMI). Results: The results showed a statistically significant increase in BMI, but no statistically significant changes in VPA or MVPA. The findings revealed that our socio-ecological model predicted .71, .39, and .92 percent of the end of the year VPA, MVPA, and BMI, respectively. The findings highlighted the positive role of peer support, positive motivation, and university's Recreational Services on measured healthy behaviors. Conclusions: These findings suggest a need to increase college students' VPA.

The Progress and Pitfalls of Pharmacogenetics-Based Precision Medicine in Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analysis.

The inadequate efficacy and adverse effects of antipsychotics severely affect the recovery of patients with schizophrenia spectrum disorders (SSD). We report the evidence for associations between pharmacogenetic (PGx) variants and antipsychotics outcomes, including antipsychotic response, antipsychotic-induced weight/BMI gain, metabolic syndrome, antipsychotic-related prolactin levels, antipsychotic-induced tardive dyskinesia (TD), clozapine-induced agranulocytosis (CLA), and drug concentration level (pharmacokinetics) in SSD patients. Through an in-depth systematic search in 2010-2022, we identified 501 records. We included 29 meta-analyses constituting pooled data from 298 original studies over 69 PGx variants across 39 genes, 4 metabolizing phenotypes of CYP2D9, and 3 of CYP2C19. We observed weak unadjusted nominal significant (p < 0.05) additive effects of PGx variants of DRD1, DRD2, DRD3, HTR1A, HTR2A, HTR3A, and COMT (10 variants) on antipsychotic response; DRD2, HTR2C, BDNF, ADRA2A, ADRB3, GNB3, INSIG2, LEP, MC4R, and SNAP25 (14 variants) on weight gain; HTR2C (one variant) on metabolic syndrome; DRD2 (one variant) on prolactin levels; COMT and BDNF (two variants) on TD; HLA-DRB1 (one variant) on CLA; CYP2D6 (four phenotypes) and CYP2C19 (two phenotypes) on antipsychotics plasma levels. In the future, well-designed longitudinal naturalistic multi-center PGx studies are needed to validate the effectiveness of PGx variants in antipsychotic outcomes before establishing any reproducible PGx passport in clinical practice.

Metabolomics-based understanding of the olanzapine-induced weight gain in female first-episode drug-naïve patients with schizophrenia.

Previous studies have demonstrated that patients with schizophrenia (SZ) have greater rate of metabolic disorder as compared with the control population, which likely be the consequence of use of atypical antipsychotics. Olanzapine is a widely used antipsychotic, which increases the weight of SZ patients. However, the underlying mechanism remains poorly understood. Here we report the metabolomics-based understanding of the weight gain induced by olanzapine. 57 first-episode drug-naïve patients (FEDN) were recruited, of whom 27 patients completed a 4-week clinical trial. We then profiled the metabolomes of their plasma with the LC-MS-based nontargeted metabolomics approach at the baseline and after olanzapine monotherapy for 4 weeks. We observed that the plasma of the olanzapine-treated patient had significantly higher lysophosphatidylcholine (LysoPC), lysophosphatidylethanolamine (LysoPE) and lower carnitine as compared with that of the baseline plasma samples. Moreover, regression analyses indicated that the change of LysoPC(14:0) level was an independent contributor to the olanzapine-induced weight gain. Our study suggests that the metabolomics-based approach may facilitate the identification of biomarkers associated with the metabolic disorder causing by antipsychotic in schizophrenia patients.

Glucose-lowering Strategies in Diabetes: Pharmacological Development of New Antidiabetic Drugs.

BACKGROUND: Insulin increases glucose uptake in muscles and fat and inhibits hepatic glucose production, thus serving as the primary regulator of the blood glucose level. In type 2 diabetes, insufficient insulin release and suppressed insulin action [named insulin resistance] lead to increased glucose production in liver and decreased glucose uptake by muscles and fat tissues, resulting in elevated blood glucose concentration which is dangerous to human health. Therefore, the anti-diabetic therapies are aimed at inhibiting excess blood glucose. METHODS: A comparative analysis of two distinct glucose-lowering modes was used to develop a new feedback model for the purpose of identification of pharmacological targets in diabetes treatment. RESULTS: The current brief opinion proposes an original feedback control of glucose-lowering regulation and its models which allow comparing two distinct strategies of glucose level correction, i.e., one of them allows reducing the increased threshold of insulin resistance, whereas the other allows overcoming this threshold/barrier using exogenous insulin treatment. Also, this analytic research presents selected examples comparing the influence of the two analyzed strategies on the normalization of glucose metabolism, their therapeutic potential and side effects associated with additional weight gain. These models show the pathological mechanism by which exogenous insulin provokes formation of a «vicious cycle¼ by its side effects associated with additional weight gain. CONCLUSION: The presented model and findings can contribute to the development of new anti-diabetic targets and drugs with minimal side effects.