There are no randomised controlled trials to demonstrate whether lifestyle modifications can improve pregnancy outcomes of gestational diabetes mellitus (GDM) diagnosed by the International Association of Diabetes and Pregnancy Study Group’s (IADPSG) criteria. We tested the effectiveness of lifestyle modifications implemented in a 3-tier’s shared care (SC) on pregnancy outcomes of GDM. Between December 2010 and October 2012, we randomly assigned 700 women with IADPSG-defined GDM but without diabetes at 26.3 (interquartile range: 25.4-27.3) gestational weeks in Tianjin, China, to receive SC or usual care (UC). The SC group received individual consultations and group sessions and performed regular self-monitoring of blood glucose compared to one hospital-based education session in the UC group. The outcomes were macrosomia defined as birth weight ≥ 4.0 kg and the pregnancy-induced hypertension (PIH). Women in the SC (n = 339) and UC (n = 361) groups delivered their infants at similar gestational weeks. Birth weight of infants in the SC group was lower than that in the UC group (3469 vs. 3371 grams, P = 0.021). The rate of macrosomia was 11.2% (38/339) in the SC group compared to 17.5% (63/361) in the UC group with relative risk (RR) of 0.64 (95% CI: 0.44-0.93). The rate of PIH was 8.0% (27/339) in the SC compared to 4.4% (16/361) in the UC with RR of 1.80 (0.99-3.28). Apgar score at 1 min <7 was lower but preeclampsia was higher in the SC than in the UC. Lifestyle modifications using a SC system improved pregnancy outcomes in Chinese women with GDM. Clinicaltrials.gov; NCT01565564 .

Objectives: The prevalence of obesity among populations in the Atlantic provinces is the highest in Canada. Some studies suggest that adequate fruit and vegetable consumption may help body weight management. We assessed the associations between fruit and vegetable intake with body adiposity among individuals who participated in the baseline survey of the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) cohort study.Methods: We carried out a cross-sectional analysis among 26 340 individuals (7979 men and 18 361 women) aged 35–69 years who were recruited in the baseline survey of the Atlantic PATH study. Data on fruit and vegetable intake, sociodemographic and behavioural factors, chronic disease, anthropometric measurements and body composition were included in the analysis.Results: In the multivariable regression analyses, 1 SD increment of total fruit and vegetable intake was inversely associated with body mass index (−0.12 kg/m²; 95% CI −0.19 to –0.05), waist circumference (−0.40 cm; 95% CI −0.58 to –0.23), percentage fat mass (−0.30%; 95% CI −0.44 to –0.17) and fat mass index (−0.14 kg/m²; 95% CI −0.19 to –0.08). Fruit intake, but not vegetable intake, was consistently inversely associated with anthropometric indices, fat mass, obesity and abdominal obesity.Conclusions: Fruit and vegetable consumption was inversely associated with body adiposity among the participant population in Atlantic Canada. This association was primarily attributable to fruit intake. Longitudinal studies and randomised trials are warranted to confirm these observations and investigate the underlying mechanisms.

Objective: The objective was to investigate associations of regional fat depots with adipokines, inflammatory markers, and risk of metabolic syndrome (MetS) in a Chinese population. Design and Methods: Trunk and leg fat mass were determined in a population-based sample of 1150 Chinese (479 men and 671 women) aged 50–70 yr by using whole-body dual-energy x-ray absorptiometry scan. Plasma adiponectin, plasminogen activator inhibitor-1 (PAI-1), retinol-binding protein 4 (RBP4), resistin, C-reactive protein, and IL-6 were measured. The updated National Cholesterol Education Program Adult Treatment Panel III criterion for Asian Americans was used to define MetS. Results: Larger body-size adjusted trunk fat mass was significantly associated with lower adiponectin and higher PAI-1, RBP4, C-reactive protein, and IL-6 levels in both genders (P < 0.05). Larger body-size adjusted leg fat mass was significantly associated with higher adiponectin levels in both genders but lower RBP4 and PAI-1 concentrations in men (P < 0.05). Comparing with the lowest body-size adjusted leg fat mass tertile, the odds ratio (95% confidence interval) of MetS in the highest tertile was 0.33 (0.18–0.62; P for trend <0.001) for men and 0.43 (0.28–0.65; P for trend <0.001) for women. The association was attenuated with further controlling adipokines and inflammatory markers (P = 0.09 for men and P = 0.004 for women). Conclusion: In contrast to trunk fat, large leg fat appears to have favorable effects on adipokines, inflammatory markers, and MetS risk among Chinese. The opposite associations between regional fat depots and MetS risk may partially mediated by adipokines and inflammatory status.

Consumption of coffee and diet drinks and the use of non-nutritive sweeteners is commonplace worldwide. We conducted a cross-sectional analysis to investigate the associations between coffee consumption and non-nutritive sweetener use and depression among populations in Atlantic Canada. During 2009 to 2013, we recruited 18838 participants aged 35–69 years (5854 men and 12984 women) for the baseline survey of the Atlantic Partnership for Tomorrow’s Health cohort study. Coffee consumption, sweetener use, and major depression were assessed using a set of standardized questionnaires. We utilized multiple logistic regression models to assess the associations of coffee drinking and non-nutritive sweetener use with major depression. Compared with non-coffee drinkers, female participants who drank coffee ≥4 cups/day had an odds ratio of 1.38 (95% confidence interval, 1.15–1.64) for major depression with adjustment for sociodemographic and behavioral factors, chronic disease status, and body mass index. We found a significant association between depression and consumption of sweeteners and diet drinks, which was more apparent among women than men. We conclude that heavy coffee drinking and non-nutritive sweetener use were associated with depression among populations in Atlantic Canada. Further studies are warranted to investigate the underlying biological mechanisms.