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Another research result from the American Gut Project, an amazing crowdsourced project. While differences were found in the fecal microbiome (microbial community) of adults born by cesarean section vs vaginal delivery, it is unknown whether this has any possible effects on diseases or risks of diseases during adulthood. This study is online as of 8 November 2014, but still In Press. From EBioMedicine:

Diversity and Composition of the Adult Fecal Microbiome Associated with History of Cesarean Birth or Appendectomy: Analysis of the American Gut Project

Adults born by cesarean section appear to have a distinctly different composition of their fecal microbial population. Whether this distinction was acquired during birth, and whether it affects risk of disease during adulthood, are unknown.

Prenatal and early postnatal exposures and events can affect the entire life course. As one example, cesarean birth has been associated with an increased likelihood of asthma and cardiovascular disease in children (Renz-Polster et al., 2005, Thavagnanam et al., 2008 and Friedemann et al., 2012), hypertension in young adults (Horta et al., 2013), and obesity in both children and adults (Pei et al., 2014, Darmasseelane et al., 2014,Blustein et al., 2013 and Mueller et al., 2014). ... As well summarized by Arrieta and colleagues, several studies have noted differences in the neonatal fecal microbiota by route of delivery (Arrieta et al., 2014). ... More recently, with comprehensive analysis based on next generation sequencing of 16S rRNA genes, Dominguez-Bello and colleagues reported that route of delivery was associated with differences in the composition of the microbial populations that initially colonized the offspring. Notably, neonates who were born vaginally were colonized by vagina-associated bacteria, whereas those born by cesarean section were initially colonized by skin-associated bacteria ( Dominguez-Bello et al., 2010).

Early life alteration of the gut microbiota may have a lasting effect. Trasande et al. observed that exposure to antibiotics up to age 6 months was associated with elevated body mass index (BMI) up to age 7 years (Trasande et al., 2013).

The 16S rRNA V4 region was sequenced by the American Gut Project....Of the 1097 participants, cesarean birth was reported as “yes” by 92, “no” by 948, and missing or uncertain by 57. Likewise, appendectomy was reported as “yes” by 155, “no” by 961, and missing or uncertain by 21.

This analysis was primarily motivated by the observation that the composition of the microbiome of neonates differed significantly between those born vaginally and those born by cesarean section (Arrieta et al., 2014 and Dominguez-Bello et al., 2010). With vaginal delivery, the neonatal microbiome resembled the vaginal microbiome, with high relative abundance of Prevotella and especially Lactobacillus taxa. In contrast, cesarean-delivered neonates had a diverse array of taxa resembling the skin microbial community, including Staphylococcus, Streptococcus, Propionibacterineae, Haemophilus, and Acinetobacter ( Dominguez-Bello et al., 2010). Cesarean-delivered neonates and infants typically have a paucity of Bifidobacterium and Bacteroides species ( Arrieta et al., 2014).

In the current analysis, we observed that the fecal microbiome composition differed in adults who reported that they had been delivered by cesarean section. This suggests that a difference by route of delivery may persist into adulthood. Of the taxa noted to be increased in cesarean-delivered neonates and infants ( Arrieta et al., 2014, Penders et al., 2006 and Dominguez-Bello et al., 2010), only Haemophilus and certain Clostridia genera had elevated abundance in the fecal microbiome of cesarean-delivered adults ( Table 3).

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Yes! An approach to ADHD that makes sense. Nice piece from Richard A. Friedman, professor of clinical psychiatry and director of the psychopharmacology clinic at the Weill Cornell Medical College. From NY Times:

A Natural Fix for A.D.H.D.

Attention deficit hyperactivity disorder is now the most prevalent psychiatric illness of young people in America, affecting 11 percent of them at some point between the ages of 4 and 17. The rates of both diagnosis and treatment have increased so much in the past decade that you may wonder whether something that affects so many people can really be a disease.

And for a good reason. Recent neuroscience research shows that people with A.D.H.D. are actually hard-wired for novelty-seeking — a trait that had, until relatively recently, a distinct evolutionary advantage. Compared with the rest of us, they have sluggish and underfed brain reward circuits, so much of everyday life feels routine and understimulating.

To compensate, they are drawn to new and exciting experiences and get famously impatient and restless with the regimented structure that characterizes our modern world. In short, people with A.D.H.D. may not have a disease, so much as a set of behavioral traits that don’t match the expectations of our contemporary culture.

From the standpoint of teachers, parents and the world at large, the problem with people with A.D.H.D. looks like a lack of focus and attention and impulsive behavior. But if you have the “illness,” the real problem is that, to your brain, the world that you live in essentially feels not very interesting.The more novel and unpredictable the experience, the greater the activity in your reward center. But what is stimulating to one person may be dull — or even unbearably exciting — to another. There is great variability in the sensitivity of this reward circuit.

These findings suggest that people with A.D.H.D are walking around with reward circuits that are less sensitive at baseline than those of the rest of us. Having a sluggish reward circuit makes normally interesting activities seem dull and would explain, in part, why people with A.D.H.D. find repetitive and routine tasks unrewarding and even painfully boring.

Another patient of mine, a 28-year-old man, was having a lot of trouble at his desk job in an advertising firm. Having to sit at a desk for long hours and focus his attention on one task was nearly impossible. He would multitask, listening to music and texting, while “working” to prevent activities from becoming routine. Eventually he quit his job and threw himself into a start-up company, which has him on the road in constantly changing environments. He is much happier and — little surprise — has lost his symptoms of A.D.H.D.

My patient “treated” his A.D.H.D simply by changing the conditions of his work environment from one that was highly routine to one that was varied and unpredictable. All of a sudden, his greatest liabilities — his impatience, short attention span and restlessness — became assets. And this, I think, gets to the heart of what is happening in A.D.H.D.

Consider that humans evolved over millions of years as nomadic hunter-gatherers. It was not until we invented agriculture, about 10,000 years ago, that we settled down and started living more sedentary — and boring — lives. As hunters, we had to adapt to an ever-changing environment where the dangers were as unpredictable as our next meal. In such a context, having a rapidly shifting but intense attention span and a taste for novelty would have proved highly advantageous in locating and securing rewards — like a mate and a nice chunk of mastodon. In short, having the profile of what we now call A.D.H.D. would have made you a Paleolithic success story.

So if you are nomadic, having a gene that promotes A.D.H.D.-like behavior is clearly advantageous (you are better nourished), but the same trait is a disadvantage if you live in a settled context.

You may wonder what accounts for the recent explosive increase in the rates of A.D.H.D. diagnosis and its treatment through medication. The lifetime prevalence in children has increased to 11 percent in 2011 from 7.8 percent in 2003 — a whopping 41 percent increase — according to the Centers for Disease Control and Prevention. And 6.1 percent of young people were taking some A.D.H.D. medication in 2011, a 28 percent increase since 2007. Most alarmingly, more than 10,000 toddlers at ages 2 and 3 were found to be taking these drugs, far outside any established pediatric guidelines.

Some of the rising prevalence of A.D.H.D. is doubtless driven by the pharmaceutical industry, whose profitable drugs are the mainstay of treatment. Others blame burdensome levels of homework, but the data show otherwise. Studies consistently show that the number of hours of homework for high school students has remained steady for the past 30 years.

I think another social factor that, in part, may be driving the “epidemic” of A.D.H.D. has gone unnoticed: the increasingly stark contrast between the regimented and demanding school environment and the highly stimulating digital world, where young people spend their time outside school. Digital life, with its vivid gaming and exciting social media, is a world of immediate gratification where practically any desire or fantasy can be realized in the blink of an eye. By comparison, school would seem even duller to a novelty-seeking kid living in the early 21st century than in previous decades, and the comparatively boring school environment might accentuate students’ inattentive behavior, making their teachers more likely to see it and driving up the number of diagnoses.

Perhaps one explanation is that adults have far more freedom to choose the environment in which they live and the kind of work they do so that it better matches their cognitive style and reward preferences. If you were a restless kid who couldn’t sit still in school, you might choose to be an entrepreneur or carpenter, but you would be unlikely to become an accountant. 

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The studies are adding up that phthalates are harmful to humans of all ages, but uniquely so to the developing fetus. Boys exposed to high levels of phthalates before birth may have slightly altered genitals, specifically a shortened anogenital distance (the length between the anus and the genitals). This is concerning because in adulthood, this is associated with reduced semen quality and lower fertility in males - and considered a sign of incomplete masculinization. So try to avoid or lower exposure to phthalates during pregnancy (see posts on ENDOCRINE DISRUPTORS). From Environmental Health Perspectives:

Plastics chemical linked to changes in baby boys' genitals

Boys exposed in the womb to high levels of a chemical found in vinyl products are born with slightly altered genital development, according to research published today.The study of nearly 200 Swedish babies is the first to link the chemical di-isononyl phthalate (DiNP) to changes in the development of the human male reproductive tract.

Previous studies of baby boys in three countries found that a similar plastics chemical, DEHP, was associated with the same type of changes in their genitalia. Less is known about the reproductive risks of DiNP, a chemical which scientists say may be replacing DEHP in many products such as vinyl toys, flooring and packaging. In mice, high levels block testosterone and alter testicular development.

“Our data suggest that this substitute phthalate may not be safer than the chemical it is replacing,” wrote the researchers, led by Carl-Gustaf Bornehag at Sweden’s Karlstad University, in the journal Environmental Health Perspectives. Levels of DiNP in U.S. adults and children have more than doubled in the past decade.

The researchers measured metabolites of five phthalates in the urine of pregnant women during the first trimester. Development of male reproductive organs begins during that period, said senior study author Shanna Swan, a professor of reproductive science at Mount Sinai Hospital in New York. The researchers then measured the anogenital distance – the length between the anus and the genitals – when the boys were on average 21 months old. Boys who had been exposed to the highest levels of DiNP in the womb averaged a distance that was slightly shorter – about seven-hundredths of an inch – than the boys with the lowest exposures. “These were really subtle changes,” Swan said.

Considered a sign of incomplete masculinization, shortened anogenital distance in men has been associated with abnormal testicular development and reduced semen quality and fertility. In men, this measurement is typically 50 to 100 percent longer than in women. But it’s unknown whether a slightly shorter distance in infants corresponds with any fertility problems later in life.

For other phthalates, the study found shorter anogenital distance with higher concentrations, but the findings were not statistically significant, meaning they may have been due to chance. The Swedish women in the new study had phthalate levels similar to U.S. women in Swan's previous studies. Those studies, published in 2005 and 2008, linked several phthalates to shorter anogenital distance.

The scientists said exposures to the chemical can come from food or through skin contact with home furnishings or child-care articles. In 2008, the United States temporarily banned use of DiNP and two other phthalate plasticizers in toys and other children's products.... While it’s nearly impossible to eliminate exposure to phthalates, Swan suggested that pregnant women may be able to reduce their exposures by incorporating unprocessed, unpackaged foods into the diet and by avoiding heating or storing foods in plastic containers.

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An assortment of vitamin and health articles from the past year. (Note: Some other major Vitamin D study results were posted earlier this year, as well as today - search Vitamin D). Whether one should take vitamins is still being debated, with the most support being for supplementation with Vitamin D (specifically D3).The first summary is from pubmed.gov:

Taking vitamin D with the largest meal improves absorptioncally D3) and results in higher serum levels of 25-hydroxyvitamin D.

Many patients treated for vitamin D deficiency fail to achieve an adequate serum level of 25-hydroxyvitamin D [25(OH)D] despite high doses of ergo- or cholecalciferol. The objective of this study was to determine whether administration of vitamin D supplement with the largest meal of the day would improve absorption and increase serum levels of 25(OH)D.... it is concluded that taking vitamin D with the largest meal improves absorption and results in about a 50% increase in serum levels of 25(OH)D levels achieved. Similar increases were observed in a wide range of vitamin D doses taken for a variety of medical conditions.

 The following are all from Science Daily:

Long-term daily multivitamin supplement use decreases cataract risk in men, study finds

Long-term daily multivitamin supplement use may lower cataract risk in men, according to a study of nearly 15,000 male physicians. Half took a common daily multivitamin, as well as vitamin C, vitamin E and beta carotene supplements. The other half took a placebo. The researchers followed the participants to identify how many participants in each group developed new cases of two common eye diseases: cataract and age-related macular degeneration. Results showed a 9 percent decrease in risk for those that took the supplements.

Taking B vitamins won't prevent Alzheimer's disease, researchers conclude

Taking B vitamins doesn't slow mental decline as we age, nor is it likely to prevent Alzheimer's disease, conclude researchers who have assembled all the best clinical trial data involving 22,000 people to offer a final answer on this debate. When looking at measures of global cognitive function -- or scores for specific mental processes such as memory, speed or executive function -- there was no difference between those on B vitamins and those receiving placebo to a high degree of accuracy.

Children who drink non-cow's milk are twice as likely to have low vitamin D

Children who drink non-cow's milk such as rice, almond, soy or goat's milk, have lower levels of vitamin D in their blood than those who drink cow's milk, according to a new study. In North America, every 100 millilitres of cow's milk is required to be fortified with 40 units of vitamin D. Adding vitamin D to non-cow's milk, however, is voluntary.

Vitamin E intake critical during 'the first 1,000 days'

Amid conflicting reports about the need for vitamin E and how much is enough, a new analysis published today suggests that adequate levels of this essential micronutrient are especially critical for the very young, the elderly, and women who are or may become pregnant... "It's important all of your life, but the most compelling evidence about vitamin E is about a 1000-day window that begins at conception," Traber said. "Vitamin E is critical to neurologic and brain development that can only happen during that period. It's not something you can make up for later." Some of the best dietary sources of vitamin E -- nuts, seeds, spinach, wheat germ and sunflower oil -- don't generally make the highlight list of an average American diet. 

Vitamin D deficiency linked to higher risk of cardiovascular, cancer death

Analysis of pooled data showed a strong association between low vitamin D levels and risk of death in general death from cardiovascular diseases, death in from cancer, at least in older people with a history of cancer. "Going into our study, the effect of vitamin D supplementation on risk of death was not clear," said the lead investigator. "Our analysis confirms the protective nature of this substance especially in elderly patients."

High-dose vitamin D for ICU patients who are vitamin D deficient does not improve outcomes

Administration of high-dose vitamin D3 compared with placebo did not reduce hospital length of stay, intensive care unit length of stay, hospital mortality, or the risk of death at 6 months among patients with vitamin D deficiency who were critically ill, according to a study.

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This research supports the growing evidence for the importance of microbes in the health of young children. Even the type of milk a child drinks is important. From Science Daily:

Pediatric allergology: Fresh milk keeps infections at bay

A study by researchers of Ludwig-Maximilians-Universitaet (LMU) in Munich shows that infants fed on fresh rather than UHT (ultra-pasteurized) cow's milk are less prone to infection. 

A pan-European study, led by Professor Erika von Mutius, Professor of Pediatric Allergology at LMU and Head of the Asthma and Allergy Department at Dr. von Hauner's Children's Hospital, reports that fresh cow's milk protects young children from respiratory infections, febrile illness and inflammation of the middle ear. As untreated cow's milk may itself contain pathogenic microorganisms and could pose a health risk, the researchers argue for the use of processing methods that preserve the protective agents present in raw milk.

The findings are the latest to emerge from the long-term PASTURE study, which is exploring the role of dietary and environmental factors in the development of allergic illness. The study initially recruited 1000 pregnant women who were asked to document their children's diet and state of health at weekly intervals during the first year of life.

"Among children who were fed on fresh, unprocessed cow's milk the incidence of head colds and other respiratory infections, febrile and middle-ear inflammation was found to be significantly lower than in the group whose milk ration consisted of the commercially processed ultra-pasteurized product," says Dr. Georg Loss. Ingestion of farm milk reduced the risk of developing these conditions by up to 30%, and the effect was diminished if the milk was heated at home before consumption. Conventionally pasteurized milk retained the ability to reduce the risk of febrile illness, while exposure to the higher temperatures used in UHT processing eliminated the effect altogether. 

"The effects of diverse milk treatments are presumably attributable to differentially heat-resistant components present in fresh milk. Compounds that are sensitive to heating seem to play a particularly important role in protection against respiratory-tract and ear infections," says Loss.

At the end of the first year of life, blood samples were obtained from the children enrolled in the study, and tested for biochemical indicators of immunological function. Infants fed on unprocessed milk were found to have lower levels of the C-reactive protein, which is a measure of inflammation status. "Other studies have shown that higher levels of inflammation are related to the subsequent emergence of chronic conditions such as asthma and obesity. Consumption of unprocessed milk may therefore reduce the risk of developing asthma," Loss explains.

Industrial processing of milk involves short-term heating of the raw product. Conventionally pasteurized milk has been exposed to temperatures of 72-75°C for 15 seconds, while ultra-pasteurized milk undergoes heating at around 135°C for a few seconds. The latter is also homogenized to disperse the milk fats, which prevents the formation of cream. 

In addition to fats and carbohydrates, cow's milk contains proteins that can modulate the function of the immune system. "In many respects, the composition of cow's milk is similar to that of human milk," says Loss. It has long been known that breast-feeding protects infants from infection, although how milk actually affects the early immune function remains unclear. It is possible that some of the factors involved interact directly with viruses or that they promote the development of a healthy immune system by altering the composition of the gut microflora.

That living in the country has positive effects on the immune system has been demonstrated in several previous studies. Together these investigations show, as Erika von Mutius notes, that "children who grow up on traditional dairy farms are least likely to develop allergies.

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Another reason to be concerned about air pollution. And another study showing a link with environmental chemicals (this time coarse and fine particulate matter, known as PM10, which arises in part from traffic-related air pollution) and autism. From Science Daily:

Researcher adds to evidence linking autism to air pollutants

A researcher at the University of Wisconsin-Milwaukee (UWM) has added to a growing body of evidence that links autism to air pollutants such as those generated by cars and trucks.

Amy Kalkbrenner's study, published this week online at the journal Epidemiology, showed that pollution's impact on autism rates in North Carolina is similar to results of pollution-autism studies in California -- despite weather and climate differences between the two states. In addition, the work of Kalkbrenner and her colleagues, building on previous studies, showed that women in the third trimester of pregnancy were more susceptible to the damaging effects of air pollution on their unborn child.

"It adds another piece supporting the hypothesis that environmental chemicals are part of the autism puzzle," says Kalkbrenner, an assistant professor in UWM's Joseph J. Zilber School of Public Health. Autism, a spectrum of disorders affecting interpersonal relations and work achievement, now affects some 1 in 68 children in the U.S.

Her research team focused on exposure to coarse and fine particulate matter, known as PM10, which arises in part from traffic-related air pollution...Researchers used a new, more exact tool to measure the levels of particulate matter in smaller slices of time, based on pollution at the family's address during pregnancy. With this method, they were able to compare exposures during specific weeks of pregnancy. The approximately one thousand children who later developed some form of autism spectrum disorders were then compared to all other children.

Reasons for increased susceptibility in the third trimester of pregnancy are not known at this time. However, Kalkbrenner says this finding is consistent with theories that show links between autism and altered brain network development, specifically synaptic connections that are developing during the final months of pregnancy.

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There have been a number of recent studies finding various harms from air pollution - both for children and adults.The following are all from Science Daily:

Living near major roads may increase risk of sudden cardiac death in women

Living near a major road was associated with an increased risk of sudden cardiac death in women. Environmental exposure may increase heart disease risk as much as smoking, poor diet or obesity.

In 523 cases of sudden cardiac death, living within 50 meters (164 feet) of a major road increased the risk of sudden cardiac death by 38 percent, compared to living at least 500 meters (.3 miles) away. Each 100 meters (328 feet) closer to roadways was associated with a 6 percent increased risk for sudden cardiac death.

Air pollution harmful to young brains, study finds

Pollution in many cities threatens the brain development in children. Findings from a recent study reveal that children living in megacities are at increased risk for brain inflammation and neurodegenerative changes, including Alzheimer's or Parkinson's disease.

The study found when air particulate matter and their components such as metals are inhaled or swallowed, they pass through damaged barriers, including respiratory, gastrointestinal and the blood-brain barriers and can result in long-lasting harmful effects..."We asked why a clinically healthy kid is making autoantibodies against their own brain components," Calderón-Garcidueñas said. "That is indicative of damage to barriers that keep antigens and neurotoxins away from the brain. Brain autoantibodies are one of the features in the brains of people who have neuroinflammatory diseases like multiple sclerosis."

High-pollution days linked to increased risk of cardiac arrest

Rates of out-of-hospital cardiac arrest are elevated after days with high levels of air pollutants, reports a Japanese study. For example, 48 to 72 hours after days with high levels of particulate air pollution, the risk of out-of-hospital cardiac arrest increased by 17 percent, the researchers report.

Strong link between higher levels of pollution, lung health of European citizens

New data has identified a clear link between higher levels of exposure to air pollution and deteriorating lung health in adult European citizens. This study confirms previous findings that children growing up in areas with higher levels of pollution will have lower levels of lung function and a higher risk of developing symptoms such as cough and bronchitis symptoms. The new study also identified that people suffering from obesity are particularly vulnerable to the negative effects of air pollution, possibly due to an increased risk of lung inflammation.

Air pollution linked to irregular heartbeat, lung blood clots

Air pollution is linked to an increased risk of developing an irregular heartbeat -- a risk factor for stroke -- and blood clots in the lung, finds a large study. The evidence suggests that high levels of certain air pollutants are associated with a higher risk of cardiovascular problems, but exactly how this association works has not been clarified.

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Very exciting new way to use probiotics! Huge potential. From Science Daily:

Probiotics protect children, pregnant women against heavy metal poisoning

Yogurt containing probiotic bacteria successfully protected children and pregnant women against heavy metal exposure in a recent study. Canadian and Tanzanian researchers created and distributed a special yogurt containing Lactobacillus rhamnosus bacteria and observed  the outcomes against a control group.

A research team from the Canadian Centre for Human Microbiome and Probiotics, led by Dr. Gregor Reid, studied how microbes could protect against environmental health damage in poor parts of the world. Their lab research indicated that L. rhamnosus had a great affinity for binding toxic heavy metals. Working with this knowledge, the team hypothesized that regularly consuming this probiotic strain could prevent metals from being absorbed from the diet.

Working with the Western Heads East organization, Dr. Reid had already established a network of community kitchens in Mwanza, Tanzania to produce a probiotic yogurt for the local population. Mwanza is located on the shores of Lake Victoria, which is known to be polluted with pesticides and toxic metals including mercury. The team utilized this network to produce and distribute a new type of yogurt containing L. rhamnosus. The special yogurt was distributed to a group of pregnant women and a group of children. The researchers measured the baseline and post-yogurt levels of toxic metals.

The team found a significant protective effect of the probiotic against mercury and arsenic in the pregnant women. This is important as "reduction in these compounds in the mothers could presumably decrease negative developmental effects in their fetus and newborns," according to Dr. Reid. While the results obtained in the children studied showed benefits and lower toxin levels, the sample size and duration of treatment did not allow statistical significance.

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The link between pesticide exposure (pesticides used in the home or in the garden or lawn) and childhood brain tumors has been known for years. From Science Daily:

Factors associated with childhood brain tumors identified

Older parents, birth defects, maternal nutrition and childhood exposure to CT scans and pesticides are increasingly being associated with brain tumors in children, according to new research. Brain and central nervous system tumors are the second leading cause of cancer death in children.

A team of researchers, led by Kimberly Johnson, PhD, assistant professor of social work at the Brown School, a member of the Institute for Public Health and a research member of Siteman Cancer Center, examined studies published since 2004 that analyzed the incidence of childhood brain tumors and survival in different parts of the world.

In this research, binge drinking was defined as drinking four or more units of alcohol in a day on at least one occasion during the pregnancy.From Science Daily:

Binge drinking in pregnancy can affect child's mental health, school results

Binge drinking during pregnancy can increase the risk of mental health problems (particularly hyperactivity and inattention) in children aged 11 and can have a negative effect on their school examination results, according to new research on more than 4,000 participants.  This builds on earlier research on the same children that found a link between binge drinking in pregnancy and their mental health when aged four and seven, suggesting that problems can persist as a child gets older. Other effects, such as on academic performance, may only become apparent later in a child's life.

Women who are pregnant or who are planning to become pregnant should be aware of the possible risks associated with episodes of heavier drinking during pregnancy, even if this only occurs on an occasional basis.'The consumption of four or more drinks in a day may increase the risk for hyperactivity and inattention problems and lower academic attainment even if daily average levels of alcohol consumption during pregnancy are low.

From Science Daily: Healthy lifestyle could prevent nearly half of all diabetic pregnancies

Nearly half of all cases of diabetes during pregnancy, known as gestational diabetes, could be prevented if young women eat well, exercise regularly and stop smoking before and during pregnancy, finds a study.

Several modifiable risk factors before pregnancy have been identified over the past decade. These include maintaining a healthy weight, consuming a healthy diet, regular physical activity, and not smoking.So a team of researchers based in the United States set out to examine the effect of these "low risk" lifestyle factors on the risk of gestational diabetes -- and measure the portion of the condition that may be preventable through adhering to them.

The strongest individual risk factor for gestational diabetes was pre-existing overweight or obesity -- having a body mass index (BMI) above 25 before pregnancy. Women with a BMI above 33 were over four times more likely to develop gestational diabetes than women who had a normal BMI before pregnancy. ..Compared with women who did not meet any of the low risk lifestyle factors, those meeting all four criteria had an 83% lower risk of developing gestational diabetes.

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Two related stories that look at children, exercise, and academic performance. Boys, in general, have higher activity levels than girls, and they need exercise and recess to be able to get through the rest of the school day. Sitting quietly in class and doing classwork is hard when one has lots of excess energy. In fact, sitting still for hours on end is NOT healthy in any way for anyone! Fidget, fidget, fidget... From Science Daily:

High levels of physical activity linked to better academic performance in boys

Higher levels of physical activity are related to better academic achievement during the first three school years, particularly in boys, research shows. For instance, boys with higher levels of physical activity, and especially walking and bicycling to and from school, had better reading skills than less active boys....The findings of the present study highlight the potential of physical activity during recess and participation in organized sports in the improvement of academic achievement in children. 

 Instead of medicine, why aren't doctors prescibing exercise? From The Atlantic:

Exercise Is ADHD Medication

Physical movement improves mental focus, memory, and cognitive flexibility; new research shows just how critical it is to academic performance.

...More insipid but also more clearly critical to addressing what's being called the ADHD epidemic is plain old physical activity.

This morning the medical journal Pediatrics published research that found kids who took part in a regular physical activity program showed important enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, "demonstrate a causal effect of a physical program on executive control, and provide support for physical activity for improving childhood cognition and brain health." If it seems odd that this is something that still needs support, that's because it is odd, yes. Physical activity is clearly a high, high-yield investment for all kids, but especially those attentive or hyperactive. This brand of research is still published and written about as though it were a novel finding, in part because exercise programs for kids remain underfunded and underprioritized in many school curricula, even though exercise is clearly integral to maximizing the utility of time spent in class.

Earlier this month, another study found that a 12-week exercise program improved math and reading test scores in all kids, but especially in those with signs of ADHD.

Last year a very similar study in the Journal of Attention Disorders found that just 26 minutes of daily physical activity for eight weeks significantly allayed ADHD symptoms in grade-school kids. The modest conclusion of the study was that "physical activity shows promise for addressing ADHD symptoms in young children." 

"If physical activity is established as an effective intervention for ADHD," they continued, "it will also be important to address possible complementary effects of physical activity and existing treatment strategies ..." Which is a kind of phenomenal degree of reservation compared to the haste with which millions of kids have been introduced to amphetamines and other stimulants to address said ADHD. The number of prescriptions increased from 34.8 to 48.4 million between 2007 and 2011 alone. The pharmaceutical market around the disorder has grown to several billion dollars in recent years while school exercise initiatives have enjoyed no such spoils of entrepreneurialism. 

Over all, the pandemic of physical inactivity, as Hillman and colleagues put it in their Pediatrics journal article today, is "a serious threat to global health" responsible for around 10 percent of premature deaths from noncommincable diseases. 

John Ratey, an associate professor of psychiatry at Harvard, suggests that people think of exercise as medication for ADHD. Even very light physical activity improves mood and cognitive performance by triggering the brain to release dopamine and serotonin, similar to the way that stimulant medications like Adderall do.