Alex Harley Crisp

Background: Childhood obesity is a major public health concern that increases cardiovascular disease (CVD) risk. The Developmental Origins of Health and Disease theory posits that obesity and CVD risk is, in part, programmed in utero. A greater understanding of modifiable maternal factors that associate with offspring obesity and CVD risk in childhood could inform primordial prevention interventions during pregnancy. Maternal sedentary behavior, physical activity, and sleep during pregnancy are modifiable and plausible determinants of offspring obesity and CVD risk yet remain insufficiently studied. This protocol describes the design of the Pregnancy 24/7 Offspring Study (NCT07172880), developed to address this gap in knowledge. Methods: This study examines associations between device‐based maternal 24‐hour movement behavior (sedentary behavior, physical activity, and sleep) measured in each pregnancy trimester and analyzed via trajectories and as compositions with offspring obesity and CVD risk through 24 months of age. Maternal 24‐hour movement behavior data and birth outcomes were previously collected in the Pregnancy 24/7 Cohort Study (N=500, Iowa, Pennsylvania, and West Virginia). The Offspring study extends this cohort by enrolling up to 450 maternal‐offspring dyads and collecting new measures in the offspring, including body mass index z‐score from birth through 24 months obtained via medical record abstraction, anthropometry, indicators of CVD risk, and maternal questionnaires. The primary outcome is body mass index z‐score trajectory; secondary outcomes include adiposity, blood pressure, and brachial‐femoral pulse wave velocity. Conclusions: Findings from this study will advance understanding of how maternal 24‐hour activity associates with early‐life obesity and CVD risk, informing primordial prevention strategies during pregnancy.

Premenstrual syndrome (PMS) is a set of symptoms related to hormonal changes occurring during the premenstrual period. Effective coping strategies for managing PMS have not been clearly established, and it remains unclear whether these strategies are modified by physical activity. Exercise may reduce PMS symptoms; however, the minimum effective exercise dose remains unknown. This study aimed to analyze the effects of an 8‐week minimum‐dose exercise protocol on psychological PMS symptoms and coping strategies. Thirty‐three university students with PMS were assigned to two groups: the Resistance Training Group (RTG), which followed an 8‐week minimum‐dose training protocol, and the Control Group (CG), which underwent only physical testing. The Premenstrual Symptom Screening Tool (PSST) and the Brief COPE were used for assessments. A mixed linear model with Restricted Maximum Likelihood (REML), ANOVA III table application, and Tukey's post hoc test was used for PMS analysis. For coping strategies, a mixed linear model was applied to each domain, with descriptive and exploratory analyses. These analyses were performed in R Studio. For the physical tests, the mean and standard deviation of the variables in each group at the three protocol time points were calculated, and differences between groups were analyzed using Student's t ‐test conducted in Jamovi. A reduction in both physical and psychological PMS symptoms ( χ ² = 7.64, df = 2, p = 0.02) and functional impacts ( χ ² = 6.37, df = 2, p = 0.04) was observed in the RTG compared to the CG during the second evaluation. Coping strategy patterns remained stable, showing no influence from the minimum‐dose protocol. The minimum‐dose exercise approach effectively reduced PMS symptom severity and functional impairments but did not affect coping strategies. Trial Registration: Brazilian Clinical Trials Registry (ReBEC) number: RBR‐4pp65c6

Background: Physical activity (PA) during pregnancy has well‐documented benefits, yet pregnant rural residents may face additional barriers to PA. Objective: To examine whether leisure‐time physical activity (LTPA) and correlates of LTPA, including exercise outcome expectations, barriers, and environmental supports for PA, differ by rurality, and explore whether rurality moderates the associations between these correlates and LTPA during pregnancy. Methods: Pregnant individuals from Iowa and West Virginia ( n = 374) completed questionnaires assessing LTPA, exercise outcome expectations and barriers during each trimester, and environmental supports for PA at the first trimester. Rurality status was categorized as urban, micropolitan, or small town rural using Rural–Urban Commuting Area codes. Robust linear mixed effects models included trimester as a fixed effect and a random intercept for participant. Environmental supports were analyzed using a robust linear model restricted to first‐trimester data. Models were adjusted for site, age, pre‐pregnancy body mass index, education, parity, and minority status. Results: In unadjusted models, small‐town rural participants engaged in less LTPA than urban participants (9.02 vs. 12.14 MET‐h/week, p = 0.021), though this was not significant after adjustment. Small‐town rural participants reported fewer environmental supports for PA than urban participants ( β = −0.42 SD, p = 0.002). Rurality did not moderate the associations between examined correlates and LTPA. Conclusions: Rurality was not associated with LTPA, exercise expectations, or barriers after adjustment. Although small‐town rural participants reported fewer environmental supports for PA, this was not associated with LTPA, warranting further investigation in larger samples to determine whether improving environmental supports would translate into increased LTPA during pregnancy.

Objective: The aim of this study was to analyze the relationship between musculoskeletal spinal pain and individual, behavioral, and contextual factors in children and adolescents. Methods: A cross-sectional study was conducted with 189 children and adolescents (10–16 years), of both genders, enrolled in public and private schools in Belém, Pará, Brazil. Musculoskeletal pain and postural habits were assessed using the Back Pain and Posture Evaluation Instrument for Children and Adolescents, a validated questionnaire for this population. Network analysis using the EBICglasso estimator explored associations between individual (age, gender), behavioral (physical activity in school and leisure contexts), and contextual factors (school type and postural habits related to daily activities and electronic device use) and the presence of neck and low back pain. Results: The prevalence of low back pain was 62.6% and neck pain 65.4%. Low back pain was negatively associated with family history of pain (r=-0.14) and positively associated with female gender (r=0.19) and neck pain (r=0.12). Sitting posture during electronic device use was negatively associated with neck pain (r=-0.19). Gender and age showed higher centrality, indicating greater influence within the network, while physical activity showed a negative influence on pain outcomes. Conclusions: Musculoskeletal spinal pain was highly prevalent and associated with multiple interrelated factors. Network analysis highlights its multifactorial nature and provides relevant insights into key variables that may guide integrated health promotion and early prevention strategies in pediatric populations.

Background : Identifying the factors that may influence adolescent physical activity behaviors is essential for designing targeted interventions. This study investigated the associations between school environment characteristics and participation in physical education (PE) classes and active commuting to school. Methods : A cross-sectional multilevel study was conducted with 1719 adolescents (14–19 y, 49% female) from 46 schools (28 public) in Belém, a Brazilian Amazonian capital. Self-reported time spent in PE classes and active commuting was collected via questionnaire. School environment data were obtained through principal surveys and on-site observation. Zero-inflated negative binomial hierarchical models, adjusted for individual and school covariates, were used to estimate the associations. Results : In the logit component (estimating 0-min participation), more PE teachers (odds ratios [OR] = 0.79; 95% CI, 0.71–0.87), usable locker rooms (OR = 0.66; 95% CI, 0.54–0.83), and school accessibility (OR = 0.68; 95% CI, 0.54–0.86) reduced the odds of no PE participation. In the count component (time spent), sidewalks (rate ratios = 1.13; 95% CI, 1.01–1.26) and bike racks (rate ratios = 1.13; 95% CI, 1.02–1.26) were associated with greater commuting time among active commuters, whereas speed bumps were associated with lower odds of no commuting (OR = 0.59; 95% CI, 0.43–0.81). Subgroup analyses revealed that sidewalks and bike racks were particularly associated with commuting behaviors in peripheral districts, whereas pedestrian crossings and speed-limit signs showed associations in central areas. Conclusions : Better school infrastructure is associated with lower reported nonparticipation in PE classes in this Amazonian setting. Active commuting patterns, however, emerged as a more complex behavior, reflecting interactions between urban infrastructure and socioeconomic conditions.

Purpose: Poor diet during pregnancy compromises maternal–fetal health and may reflect broader environmental and structural inequities. This study investigated differences in dietary intake across pregnancy among rural and urban women in the United States and assessed whether socioeconomic status (SES) modified rural–urban differences. Methods: In this prospective study, pregnant women ( n = 495; 22.4% rural) from three sites (Iowa, Pennsylvania, West Virginia) had dietary intake estimated via the 26‐item Dietary Screener Questionnaire (DSQ) during each trimester. Rural was defined as Rural–Urban Commuting Area (RUCA) code ≥ 4. A SES score was derived using Principal Component Analysis of education, annual household income, and insurance type. Adjusted robust linear mixed‐effects models (controlled for site, age, minority status, pre‐pregnancy BMI) compared dietary intakes between rural and urban participants, with trimester and SES interactions. Findings: Compared to their urban counterparts, rural participants had higher predicted intakes of added sugars from sugar‐sweetened beverages (SSBs) in the first (0.61 tsp eq/day; 95% CI: [0.04, 1.18]) and second trimesters (0.62 tsp eq/day [0.05, 1.21]), and less fiber across all trimesters (ranging from –0.90 g/day [–1.7, –0.1] to –1.2 g/day [–2.0, –0.3]). Women in the high‐SES urban group had higher intakes of fiber and calcium, and lower intakes of SSBs compared to their low‐SES counterparts in both rural and urban settings. Conclusions: Although rurality was associated with greater SSBs and lower fiber intake, differences were modest. Low‐SES was related to a poorer diet regardless of geography, highlighting the need for targeted interventions for both rural and urban low‐SES pregnant women.

Background: It is crucial to monitor blood lipid levels accurately in older adults to assess cardiovascular risk. Although several portable strip-based devices are commercially available, their accuracy has not been well established. Objective: To evaluate the agreement of the Mission Cholesterol device and standard laboratory method results, using samples from older adults. Methods: Forty-nine patients (42 females) with an average age of 70 ± 8 years were included. The participants were instructed to fast for 12 hours before undergoing [...] Abstract Background: It is crucial to monitor blood lipid levels accurately in older adults to assess cardiovascular risk. Although several portable strip-based devices are commercially available, their accuracy has not been well established. Objective: To evaluate the agreement of the Mission Cholesterol device and standard laboratory method results, using samples from older adults. Methods: Forty-nine patients (42 females) with an average age of 70 ± 8 years were included. The participants were instructed to fast for 12 hours before undergoing

The aim of the study was to map and synthesize the scientific production of knowledge regarding front-of-package food labeling in South American countries. A scoping review was conducted in 2023, based on the Joanna Briggs Institute guide, using a search strategy across five electronic databases: LILACS, SciELO, PubMed, Web of Science, and Scopus, with no restrictions on language or year of publication. The analysis process was carried out through blinded review by two reviewers: 1) article selection using the Rayyan platform, 2) data extraction using a standardized form, 3) PRISMA flowchart and checklist, 4) frequency calculations, and organization of findings. The search strategy identified 2,711 records, of which 94 articles met the inclusion criteria. There was a prevalence of studies from Uruguay and from the year 2020; 61% of the studies were cross-sectional observational, and 57% had a local scope. Study outcomes addressed the nutritional quality and composition of foods, the food industry, types of labeling, and consumer food choices. The synthesis revealed heterogeneity in results regarding the effectiveness of labeling types and the nutritional quality of packaged foods due to different populations studied. The mapping allowed the identification of resistance from the food industry to policy implementation, even in the face of evidence of improved consumer food choices, regardless of the type of front-of-package labeling used. It is suggested that new studies investigate different labeling methodologies more robustly across different countries.

This systematic scoping review aimed to map and characterize the scientific production of researchers from Portuguese-speaking African institutions that align with the Food and Nutrition Security Strategy of the Community of Portuguese-Speaking Countries. The literature search was conducted using six electronic databases (PubMed, EMBASE, Virtual Health Library, Scientific Electronic Library Online, Scopus, and Web of Science), with no restrictions on the year of publication nor language. Through the search strategy, 10,061 records were identified, of which 502 documents and 654 researchers were selected by Food and Nutrition Security specialists along three axes: 1) Policy governance; 2) Access to food; 3) Availability of food. Institutional researchers from Mozambique (66.9%), Guinea-Bissau (15.9%), and Angola (11.4%) presented the most publications and international collaborations. Researchers from Cape Verde, Sao Tome and Principe, and Equatorial Guinea institutions added only 5.8% of the total production. A greater number of publications (61%) was related to axis two of the Food and Nutrition Security Strategy of the Community of Portuguese-Speaking Countries. The most studied themes were sustainable development, child malnutrition, and agricultural production for the first, second, and third axis, respectively. In general, scientific publications have shown limitations in their approaches due to the challenge imposed by the complexity of the food system. However, there has been a quantitative evolution in publications in the last decade, with a greater participation of researchers from Portuguese-speaking African institutions.

Physical distancing and restrictions have been implemented to reduce the transmission rate of the novel coronavirus (COVID-19). In contrast, the impact of the pandemic on levels of physical activity has been the subject of studies worldwide. Since the first reported case in December 2019, the number of scientific studies on COVID-19 has grown in a way that has never been seen before. The current study aimed to perform a bibliometric analysis of primary studies on physical activity and COVID-19 during the first two years of the pandemic. The search was carried out using the SCOPUS and Web of Science databases. Our analysis identified a total of 2023 published documents from 10,199 authors, with an annual growth rate of 330% between 2020 and 2021. Open-access scientific journals were the main sources of publication, and the level of collaboration among the most influential researchers contributed to productivity. A co-occurrence analysis of the authors’ keywords indicated a high prevalence of themes related to mental health, depression, anxiety, stress, sleep, and quality of life. In conclusion, the bibliometric analysis revealed a high volume of primary studies on physical activity and COVID-19 during the first two years of the pandemic, and mental health was a much discussed topic.