Filippe Falcão-Tebas

Digital health information is an important source of preventive health advice during pregnancy. Its public health value depends on whether advice is guideline-concordant, safe, transparent and understandable. This study aimed to assess the guideline concordance, content coverage, safety information, transparency and readability of Australian consumer-facing webpages providing advice about physical activity during pregnancy. We conducted a systematic, cross-sectional audit of English-language, freely accessible webpages affiliated with Australian organisations that provided substantive advice about physical activity or exercise during pregnancy. Searches were undertaken between June and July 2025, with data collection continuing until September 2025. Data were extracted using a structured checklist mapped to Australian pregnancy physical activity guidelines. Transparency was assessed using Journal of the American Medical Association (JAMA) benchmarks and readability using Flesch Reading Ease (FRE), Flesch–Kincaid Grade Level (FKGL) and Simplified Measure of Gobbledygook (SMOG). Sixty webpages were included. Most encouraged physical activity during pregnancy, but practical guidance and essential safety information were often incomplete. Fourteen webpages (23.3%) reported weekly exercise volume consistent with current guidelines. Fourteen (23.3%) included no warning signs, relative contraindications or absolute contraindications, and only four (6.7%) covered all three safety domains. Transparency was limited: authorship was reported by 12 webpages (20.0%), attribution by 16 (26.7%), disclosure by three (5.0%), and currency by none. Readability exceeded recommended levels for consumer materials; no webpage met the SMOG threshold of 8 or below. Australian online information about physical activity during pregnancy is often not fit for purpose as public-facing preventive health guidance. Minimum standards for safety content, transparency and readability may improve the quality and accessibility of digital antenatal health information.

Key points Paternal obesity negatively influences metabolic outcomes in adult rat offspring. Maternal voluntary physical activity has previously been reported to improve glucose metabolism in adult rat offspring sired by healthy fathers. Here, we investigated whether a structured programme of maternal exercise training before and during gestation can attenuate the negative impacts that paternal obesity has on insulin sensitivity and secretion in female adult offspring. Exercise before and during pregnancy normalised the lower insulin sensitivity in skeletal muscle and the lower insulin secretion observed in female offspring sired by obese fathers. This paper presents a feasible, low-cost and translatable intervention strategy that can be applied perinatally to support multifactor interventions to break the cycle of metabolic dysfunction caused by paternal obesity. We investigated whether maternal exercise before and during gestation could attenuate the negative metabolic effects of paternal high-fat diet-induced obesity in female adult rat offspring. Fathers consumed a normal chow or high-fat diet before mating. Mothers exercised on a treadmill before and during gestation or remained sedentary. In adulthood, female offspring were assessed using intraperitoneal insulin and glucose tolerance tests (IPITT and IPGTT, respectively), pancreatic morphology,ex vivoskeletal muscle insulin-stimulated glucose uptake and mitochondrial respiratory function. Paternal obesity impaired whole-body and skeletal muscle insulin sensitivity and insulin secretion in adult offspring. Maternal exercise attenuated the lower insulin-stimulated glucose uptake in offspring sired by obese fathers but distal insulin signalling components (p-AKT Thr308 and Ser473, p-TBC1D4 Thr642 and GLUT4) remained unchanged (P > 0.05). Maternal exercise increased citrate synthase activity only in offspring sired by obese fathers. Maternal exercise also reversed the lower insulin secretionin vivoobserved in offspring of obese fathers, probably due to an attenuation of the decrease in pancreatic beta cell mass. In summary, maternal exercise before and during pregnancy in rats attenuated skeletal muscle insulin resistance and attenuated the decrease in pancreatic beta cell mass and insulin secretion observed in the female offspring of obese fathers.

Key points: A paternal high‐fat diet/obesity before mating can negatively influence the metabolism of offspring. Exercise only early in life has a remarkable effect with respect to reprogramming adult rat offspring exposed to detrimental insults before conception. Exercise only early in life normalized adult whole body and muscle insulin resistance as a result of having a high‐fat fed/obese father. Unlike the effects on the muscle, early exercise did not normalize the reduced adult pancreatic beta cell mass as a result of having a high‐fat fed/obese father. Early‐life exercise training may be able to reprogram an individual whose father was obese, inducing long‐lasting beneficial effects on health. A paternal high‐fat diet (HFD) impairs female rat offspring glucose tolerance, pancreatic morphology and insulin secretion. We examined whether only 4 weeks of exercise early in life could reprogram these negative effects. Male Sprague–Dawley rats consumed a HFD for 10 weeks before mating with chow‐fed dams. Female offspring remained sedentary or performed moderate intensity treadmill exercise (5 days week⁻¹, 60 min day⁻¹, 20 m min⁻¹) from 5 to 9 weeks of age. Paternal HFD impaired (P < 0.05) adult offspring whole body insulin sensitivity (i.p. insulin sensitivity test), as well as skeletal muscle ex vivo insulin sensitivity and TBC1D4 phosphorylation. It also lowered β‐cell mass and reduced in vivo insulin secretion in response to an i.p. glucose tolerance test. Early‐life exercise in offspring reprogrammed the negative effects of a paternal HFD on whole body insulin sensitivity, skeletal muscle ex vivo insulin‐stimulated glucose uptake and TBC1D4 phosphorylation and also increased glucose transporter 4 protein. However, early exercise did not normalize the reduced pancreatic β‐cell mass or insulin secretion. In conclusion, only 4 weeks of exercise early in life in female rat offspring reprograms reductions in insulin sensitivity in adulthood caused by a paternal HFD without affecting pancreatic β‐cell mass or insulin secretion.

Aim: The aim of this study was to investigate the effects of 4 consecutive simulated night shifts on glucose homeostasis, mitochondrial function and central and peripheral rhythmicities compared with a simulated day shift schedule.Methods: Seventeen healthy adults (8M:9F) matched for sleep, physical activity and dietary/fat intake participated in this study (night shift work n = 9; day shift work n = 8). Glucose tolerance and insulin sensitivity before and after 4 nights of shift work were measured by an intravenous glucose tolerance test and a hyperinsulinaemic euglycaemic clamp respectively. Muscles biopsies were obtained to determine insulin signalling and mitochondrial function. Central and peripheral rhythmicities were assessed by measuring salivary melatonin and expression of circadian genes from hair samples respectively.Results: Fasting plasma glucose increased (4.4 ± 0.1 vs. 4.6 ± 0.1 mmol L⁻¹; P = .001) and insulin sensitivity decreased (25 ± 7%, P < .05) following the night shift, with no changes following the day shift. Night shift work had no effect on skeletal muscle protein expression (PGC1α, UCP3, TFAM and mitochondria Complex II‐V) or insulin‐stimulated pAkt Ser473, pTBC1D4Ser318 and pTBC1D4Thr642. Importantly, the metabolic changes after simulated night shifts occurred despite no changes in the timing of melatonin rhythmicity or hair follicle cell clock gene expression across the wake period (Per3, Per1, Nr1d1 and Nr1d2).Conclusion: Only 4 days of simulated night shift work in healthy adults is sufficient to reduce insulin sensitivity which would be expected to increase the risk of T2D.

In healthy humans and rodents, chronic and acute exercise improves subsequent insulin sensitivity of skeletal muscle. A large animal species with similar metabolic responses to exercise would permit longitudinal studies, including repeated biopsies of muscle and other tissues not possible in rodents, and enable study of interactions with insulin-resistant physiological states not feasible in humans. Therefore, we examined whether acute exercise increases insulin sensitivity in adult sheep. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp (HEC) in mature female sheep ( n = 7). Sheep were familiarized to treadmill walking and then performed an acute exercise bout (30 min, 8% slope, up to 4.4 km/h). A second HEC was conducted ∼18 h after the acute exercise. Musculus semimembranosus biopsies were obtained before and after each HEC. Glucose infusion rate during the HEC increased 40% ( P = 0.003) and insulin sensitivity (glucose infusion rate/plasma insulin concentration) increased 32% ( P = 0.028) after acute exercise. Activation of proximal insulin signaling in skeletal muscle after the HEC, measured as Ser⁴⁷³phosphorylation of Akt, increased approximately five-fold in response to insulin ( P < 0.001) and was unaltered by acute exercise performed 18 h earlier. PGC_1αand GLUT4 protein, glycogen content and citrate synthase activity in skeletal muscle did not change in response to insulin or exercise. In conclusion, improved insulin sensitivity and unchanged proximal insulin signaling on the day after acute exercise in sheep are consistent with responses in humans and rodents, suggesting that the sheep is an appropriate large-animal model in which to study responses to exercise.

Individuals born after intrauterine growth restriction (IUGR) are at an increased risk of developing diabetes in their adult life. IUGR impairs β-cell function and reduces β-cell mass, thereby diminishing insulin secretion. IUGR also induces insulin resistance, with impaired insulin signaling in muscle in adult humans who were small for gestational age (SGA) and in rodent models of IUGR. There is epidemiological evidence in humans that exercise in adults can reduce the risk of metabolic disease following IUGR. However, it is not clear whether adult IUGR individuals benefit to the same extent from exercise as do normal-birth-weight individuals, as our rat studies suggest less of a benefit in those born IUGR. Importantly, however, there is some evidence from studies in rats that exercise in early life might be able to reverse or reprogram the long-term metabolic effects of IUGR. Studies are needed to address gaps in current knowledge, including determining the mechanisms involved in the reprogramming effects of early exercise in rats, whether exercise early in life or in adulthood has similar beneficial metabolic effects in larger animal models in which insulin resistance develops after IUGR. Human studies are also needed to determine whether exercise training improves insulin secretion and insulin sensitivity to the same extent in IUGR adults as in control populations. Such investigations will have implications for customizing the recommended level and timing of exercise to improve metabolic health after IUGR.

The effects of maternal moderate–low physical training on postnatal development, glucose homeostasis and leptin concentration in adult offspring subjected to a low-protein diet during the perinatal period were investigated. Male Wistar rats (aged 150 d old) were divided into four groups according to maternal group: untrained (NT_p, n 8); trained (T_p, n 8); untrained with a low-protein diet (NT+LP_p, n 8); trained with a low-protein diet (T+LP_p, n 8). The trained mothers were subjected to a protocol of moderate physical training over a period of 4 weeks (treadmill, 5 d/week, 60 min/d, at 65 % VO_2max) before mating. At pregnancy, the intensity and duration of exercise was progressively reduced (50–20 min/d, at 65–30 % VO_2max). The low-protein diet groups received an 8 % casein diet, and their peers received a 17 % casein diet during gestation and lactation. The pups' birth weight and somatic growth were recorded weekly up to the 150th day. Fasting blood glucose, cholesterol, serum leptin concentration, glucose and insulin tolerance tests were evaluated. The T_p animals showed no changes in somatic and biochemical parameters, while the NT+LP_p group showed a greater abdominal circumference, hyperglycaemia, hypercholesterolaemia, glucose intolerance and lower plasma leptin. In the T+LP_p animals, all of those alterations were reversed except for plasma leptin concentration. In conclusion, the effects of a perinatal low-protein diet on growth and development, glucose homeostasis and serum leptin concentration in the offspring were attenuated in pups from trained mothers.

A incompatibilidade entre a desnutrição perinatal e uma nutrição adequada durante o desenvolvimento aumenta o risco de aparecimento precoce de doenças não transmissíveis na vida adulta. Todavia, acredita-se que a atividade física materna possa atenuar estas consequências. O presente estudo teve como objetivo avaliar os efeitos do treinamento físico durante a gestação na evolução ponderal, circunferência abdominal, glicemia e colesterolemia de filhotes adultos submetidos à desnutrição perinatal. Ratas Wistar (n = 12) foram divididas em quatro grupos: controle (C, n = 3), treinada (T, n = 3), desnutrida (D, n = 3) e treinada desnutrida (T+D, n = 3). Durante a gestação e lactação, os grupos D e T+D receberam dieta baixa em proteína (8% caseína) e os grupos C e T receberam dieta normoproteica (caseína a 17%). O protocolo de treinamento físico moderado foi realizado em esteira ergométrica (cinco dias/semana, 60 min/dia, a 65% do VO2max) e iniciou quatro semanas antes da gestação. Na gestação, a duração e a intensidade do treinamento foram reduzidas (cinco dias/semana, 20 min/dia, a 30% do VO2max) até o 19º dia pré-natal. Após o desmame, os filhotes (C F = 9, T F = 9, D F = 7, T+D F = 9) receberam dieta padrão de biotério e foram avaliados aos 270 dias de idade. A circunferência abdominal (CA) foi avaliada relativa ao peso corporal. Para avaliação da glicemia e colesterolemia foi utilizado o método enzimático colorimétrico da glicose-oxidase/peroxidase e da colesterol-oxidase, respectivamente. Ratos do grupo D F apresentaram um maior ganho de peso corporal ao longo do crescimento, maiores valores de CA, glicemia e colesterolemia quando comparados ao grupo C F. Para o grupo T+D F, o ganho de peso foi atenuado, e a CA, a glicemia e a colesterolemia foram normalizadas (p < 0,05). Esses resultados demonstram que o treinamento físico durante a gestação atenua os efeitos da desnutrição perinatal sobre alguns indicadores murinométricos e bioquímicos nos filhotes adultos.

To verify whether moderate physical training affects the muscle fibre composition of adult rats subjected to a low protein diet during the perinatal period.