Background: The efficacy of Resistance training (RT) is highly dependent on the precise manipulation of training program variables, such as frequency, load, sets, repetitions, and rest intervals. However, the independent effect of frequency remains controversial, with existing systematic evidence primarily focused on muscle mass and muscle strength, and the potential moderating role of training protocols and participant characteristics is insufficiently examined in muscle mass and muscle strength. Critical gaps persist regarding its impact on functional performance and athletic performance. Therefore, the independent effects of RT frequency and its key moderators across these physiological and performance adaptations are still unclear. Objective: This study aims to (i) investigate the effects of lower frequency versus higher frequency (e.g., two vs. three sessions per week) of RT on physiological and performance adaptations, (ii) explore the moderating factors, including the training protocol (training volume, targeted body part, intervention duration, and outcome measurements), participant characteristics (RT experience, population, and gender), and study design. Methods: Systematic searches across multiple databases up to October 2024 identified 47 studies (1665 participants). A three-level meta-analysis was performed using Standardized Mean Difference (Hedges’ g ). Subgroup and meta-regression analyses examined moderators. Results: When comparing higher to lower frequency RT conditions, significantly greater improvement in muscle strength was found for higher frequency ( g = −0.17, I 2 = 0%, p < 0.0001). However, training frequency did not affect changes in muscle mass ( g = −0.13, I 2 = 77.29%, p = 0.34), functional performance ( g = −0.13, I 2 = 25.19%, p = 0.18), and athletic performance ( g = 0.00, I 2 = 68.30%, p = 0.69). Training protocol (e.g., body-part specific training), participant characteristics, and study design moderated strength improvements. Only intervention duration significantly moderated muscle mass (≥6 weeks needed). No moderators influenced functional or athletic performance. Conclusion: RT frequency independently predicts strength gains but not muscle mass or performance adaptations. Strength improvements are moderated by multiple factors, while muscle mass changes depend primarily on training specificity and duration.

OBJECTIVES:Does 12-weeks of high-intensity interval training or moderate-to-vigorous intensity continuous training lead to changes in hypertensive responses to exercise in adults with atrial fibrillation? DESIGN:Non-prespecified post-hoc analysis of a randomized clinical trial. METHODS:Participants were randomised to a 12-week, twice weekly intervention of high-intensity interval training (2 × 8-minute blocks with 30 s high-intensity intervals at 80-100% peak power output interspersed with 30-seconds active recovery) or moderate-to-vigorous intensity continuous training (60 minutes of continuous aerobic training at 67-95% heart rate peak). To examine hypertensive responses to exercise, blood pressure was taken immediately following a six-minute walk test at baseline and follow-up. RESULTS:Eighty-six participants were randomized to high-intensity interval training (n = 43, age: 68 (8) years, 33% female) or moderate-to-vigorous intensity continuous training (n = 43, age: 71 (7) years, 33% female). A higher proportion of moderate-to-vigorous intensity continuous training participants had clinically meaningful reductions in peak systolic blood pressure (Δ=-10mmHg or more) than high-intensity interval training (43% vs 19%, p = 0.029). A trend for a small reduction in hypertensive responses to exercise relative to fitness after aerobic training, with 55% of the cohort experiencing a reduction (baseline: 42 ± 8 mmHg/METs; follow-up: 41 + 14 mmHg/METs; p = 0.0501). Within-sex analyses showed that a higher proportion of females had clinically meaningful reductions in peak systolic blood pressure following moderate-to-vigorous intensity continuous training than high-intensity interval training (43% vs 7%). CONCLUSIONS:Both high-intensity interval training and moderate-to-vigorous intensity continuous training may reduce hypertensive responses to exercise in adults with atrial fibrillation. No sex differences were observed.

COVID-19 transmission can be influenced by various factors, including weather and climate conditions, population density, and the availability of medical facilities. To gain a deeper understanding of this topic, an in-depth analysis of recent studies is needed. Our objective was to investigate previous systematic reviews that have examined the seasonal variation of COVID-19 and the impact of climate on its transmission and mortality. Online databases that included PubMed, Scopus, Web of Science, and Cochrane were searched using relevant keywords up to November 2021. Negative associations were found between temperature and COVID-19 spread and mortality (6/9 studies, 66.6%). These negative correlations imply a decrease in the spread and mortality of COVID-19 with an increase in temperature. Similarly, seven systematic reviews reported a negative correlation between humidity and transmission or mortality of COVID-19 (7/9 studies, 77.7%). COVID-19 spread was not associated with precipitation (three studies) but was negatively correlated with sunlight or UV radiation (two studies), COVID-19 incidence and mortality were positively associated with wind speed (one study). One study reported that the effect of air pressure and UV radiation on COVID-19 activity was unknown. The effects of air pollution, seasonal changes, wind speed, precipitation, and UV radiation on COVID-19 incidence or mortality remain unclear. However, factors proposed as having the greatest influence on COVID-19 incidence or mortality include air pollution, wind speed, and wastewater. Sunlight exposure and warm climates likely assist with reducing COVID-19 incidence or mortality, with the infection having a winter seasonality.

One of the recommended protease inhibitor treatments for HIV is Atazanavir boosted with Ritonavir (ATV/r). However, hyperbilirubinemia is a well-recognized adverse effect of this therapy. This retrospective cross-sectional study analyzed 121 clinical records of people living with HIV (PLHIV) receiving Atazanavir/Ritonavir treatment at the Iranian Research Center for HIV/AIDS between 2014 and 2020. Study variables were extracted from the digital and physical records at the clinic and recorded using a structured data extraction form developed by the research team. For qualitative variables, results are presented as numbers and percentages, and for quantitative variables, results are presented as medians with interquartile ranges (IQR). The authors evaluated the association between demographics, clinical characteristics and laboratory profile with hyperbilirubinemia through univariate and multivariate logistic regression. Hyperbilirubinemia was present in over 85

Identifying factors which more or less account for performance improvement during developmental stages is essential for sports science knowledge and coaching practice. Accordingly, this study examined the longitudinal, changing, influences of Volleyball-specific Training Engagement (VTE) and Maturity Status on physical test performance development. Participants were N = 139 Swiss female competitive volleyball players, aged 10-14 years at baseline (M = 12.93, SD = 1.15 years). Annually for 3 years, participants completed the 9-3-6-3-9 Agility Sprint; Standing Long Jump [SLJ] and Jump & Reach test. Linear Mixed Models (LMMs) examined longitudinal independent and interactive relationships between VTE (hours/week) and Maturity Status (YPHV) with test performance indices. LMMs identified both interactive and independent relationships on test indices. Interactions highlighted the influence of VTE generally reduced during peak-post maturational stages (- 0.5-2.5 YPHV), while maturational growth was predominantly more influential on performance development. Findings identified that lowered weekly VTE during maturational peak-post growth periods led to equivalent performance development. With maturational growth more influential, findings highlight the potential to misattribute longitudinal performance development toward training engagement and question the benefit of heightened physiological-focused engagement circa-post PHV stages. However, such questioning may not necessarily apply to skill acquisition or technical-focused training.

BACKGROUND:Low adherence to Oral Antidiabetic Drugs (OADs) in adults with Type 2 Diabetes Mellitus (T2DM) leads to complications, death, and increased healthcare costs. OBJECTIVE:This study aimed to evaluate the effectiveness of medication adherence education interventions for the clinical outcomes of adults with T2DM. MATERIALS AND METHODS:Seventy adults with T2DM from an outpatient clinic in the City of Ardabil, Iran, participated in this study. The participants were randomized into an intervention group (n=35) or a non-interventional group (n=35). The intervention group underwent four educational sessions focused on adherence to OADs. Content within classes was influenced by a participant's Stage of Change (SOC) result, which was related to behavior change modeling. Participants in the non-interventional group were placed on a waiting list to receive educational content after the follow- up. Assessments were conducted at baseline, four weeks, and six months. RESULTS:Significant improvements in Fasting Plasma Glucose (FPG) (P = 0.018) and 2-hour Plasma Glucose (2-hPG) (P < 0.001) levels were found in the intervention group compared to the noninterventional group post-intervention. Additionally, HbA1C was significantly lower at follow-up in the intervention group than in the non-intervention group (P < 0.001). The Homeostasis Model of Insulin Resistance Assessment (HOMA-IR) revealed a significant increase in target cell sensitivity to insulin in the intervention group compared to that in the non-interventional during the follow- up period (P = 0.009). The SOC for adherence to OADs was significantly improved in the intervention group compared to that in the non-intervention group at the follow-up timepoint (P< 0.001). CONCLUSION:Medication adherence education interventions may improve the clinical outcomes of adults with T2DM.

Exercise is vital in managing sarcopenia in people living with HIV (PLWH). This study explores the role of exercise in reducing sarcopenia in HIV patients. A systematic search of electronic databases including PubMed, Scopus, and Web of Science identifed relevant articles published in English up to April 2024. Inclusion criteria were: 1) humans aged 18 or older, 2) clinical trials involving exercise interventions, 3) outcomes addressing aging-related effects, and 4) English-language original articles. Study quality and risk of bias were assessed using the Newcastle-Ottawa scale (NOS).Ten studies with 2039 participants met the criteria. Exercise interventions included resistance training, cardiorespiratory training, and combined approaches at various intensities. Regular exercise can help prevent muscle wasting in PLWH and mitigate age-related sarcopenia. HIV itself is a risk factor for sarcopenia, but resistance training combined with moderate to high-intensity cardiorespiratory training, can increase muscle mass, reducing sarcopenia risk and improving life expectancy in PLWH. The findings emphasize the effectiveness of exercise, particularly combined resistance and cardiorespiratory training, in mitigating sarcopenia in PLWH. Healthcare providers are urged to promote exercise interventions as a preventive measure against sarcopenia in this clinical population.

All Abilities Touch Football (AATF) is a modified version of touch football for players with intellectual and/or physical impairments. Its rapid growth has revealed structural limitations, highlighting the need to move beyond rule modifications and a two-tiered competition system to better accommodate players’ diverse abilities. This study assessed the physical and technical demands of AATF players and explored associations with functional and field-based performance measures. Twenty-one players participated in four matches over two days at the National Touch League competition. Significant differences were observed between Tier 1 and Tier 2 players for maximum speed ( p = 0.042), accelerations ( p = 0.041), distance in the jogging zone ( p = 0.010), dummy half pickups ( p = 0.002), and successful passes ( p = 0.018). A subgroup of 11 players completed assessments measuring flexibility, balance, coordination, strength, power, speed, change of direction speed (CODS) and endurance, showing strong associations between match maximum speed and power ( r = 0.77, p = 0.006), speed ( r s = 0.90, p < 0.001), and CODS ( r s = 0.82, p = 0.002). These findings highlight performance differences within and across tiers and suggest the importance of power, speed and CODS in AATF performance, offering preliminary insights that may guide the future development of the sport.

ABSTRACT Context Combined (arm + leg) cycling ergometry engages more muscle mass than isolated limb modalities, likely producing greater physiological responses. However, differences in key cardiometabolic outcomes across maximal arm, leg, and arm + leg ergometry have not been systematically quantified in healthy adults. Objective This systematic review and meta-analysis compared maximal arm, leg, and arm + leg cycling ergometry on peak oxygen uptake (V̇O 2peak ), heart rate, blood lactate, and power output. Design Acute studies were sourced from PubMed/Medline, Web of Science, SPORTDiscus, Scopus, Embase, and CINAHL (earliest records to November 23, 2024). The search strategy included keywords related to arm, leg, and arm + leg cycle ergometry. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool. Eligibility Criteria Acute studies on healthy adults (≥18 yr old) comparing maximal ergometer-based arm, leg, and arm + leg exercises. Study Selection Two reviewers independently screened 12,211 abstracts. Main Outcome Measures Means and standard deviations for V̇O 2peak , heart rate, blood lactate, and power output were extracted to calculate standard mean differences. Hedges’ g effect size analyzed differences between isolated limb and arm + leg cycling. Subgroup analyses examined training status, sex, and arm position. Results Fourteen studies (187 healthy adults) met the eligibility criteria. Twelve studies were rated high quality, and two studies were medium quality. Arm + leg cycling showed significantly greater V̇O 2peak compared to arm ( g = −2.43, P < 0.001) or leg cycling ( g = −0.82, P < 0.001), with moderate heterogeneity. Heart rate and power output were higher in arm + leg compared to isolated limb conditions ( P < 0.001), and blood lactate was higher in arm + leg compared to only arm ( P = 0.005). Conclusion Arm + leg cycling elicits higher V̇O 2peak , heart rate, and power output than isolated limb cycling, supporting its use as a robust and inclusive non-weight-bearing cardiopulmonary testing modality. This synthesis quantifies normative responses in healthy adults and reinforces its clinical relevance.

Athlete development is considered a multi-factorial and dynamic overtime process. Thus, understanding what factors and behavioural activities contribute most to development is important. The present study examined longitudinal relationships between training time and maturity status with physical performance indices in youth volleyball players. Prospective mixed longitudinal tracking over 3 years. Participants were N = 78 selected male volleyball players, aged 11-15 years (M = 13.81, SD = 1.20 years) from N = 41 competitive Swiss clubs. Alongside coach-reported weekly training time, participants completed standardised anthropometric and physical performance tests (e.g., standing long jump [SLJ]; 9-3-6-3-9 agility sprint). Linear mixed models (LMM) examined longitudinal independent and interacting relationships between training time and maturity status (years from peak height velocity; PHV) with physical performance. For SLJ, both training time and maturity status explained curvilinear longitudinal performance development, but nonlinear maturation status interactions were most influential, moderating relationships. In agility sprint, similar trends were apparent, with training time influences diminishing when maturity status was added in LMM analyses. Across time points of maturational growth, increased training engagement was not associated with enhanced physical performance benefits, whereas maturational status progression better accounted for performance differences and development. For coaches and sports-science practitioners, findings question the rationale for heightened training engagement at circa-PHV directed towards physical performance development purposes, a recommendation aligned with the need for maturational-growth associated injury prevention. Instead, due to musculoskeletal and proprioceptive disturbance during maturational growth, training emphasis on technical/biomechanical skill acquisition remains important.

INTRODUCTION & AIMS Lower limb muscle weakness and reduced balance due to disease progression in multiple sclerosis (MS) may make robust aerobic exercise difficult. Functional electrical stimulation (FES) cycling combined with voluntary cycling may allow people with advanced MS to enhance the intensity of aerobic exercise. The aim of this study was to investigate the cardiorespiratory, power, and participant perceptions during acute bouts of FES cycling, voluntary cycling, and FES cycling combined with voluntary cycling (FES assist cycling). METHODS Participants with advanced MS (Expanded Disability Status Scale [EDSS] ≥ 6.0) undertook three exercise trials on a leg cycle ergometer. Trial 1: 30 minutes of FES cycling; Trial 2: two 10-minute bouts of voluntary cycling separated by 10 minutes rest; and Trial 3: a combination of trials 1 and 2 (FES assist cycling). Outcome measures included VO2, cycle power output, heart rate, exertion, and post-exercise perceptions of fatigue. RESULTS Ten people with advanced MS participated (9 female; age 52.4±9.98 y; EDSS 7.1±0.6). Average VO2 during the 30-minute trials was significantly higher for FES assist cycling compared to voluntary cycling (429.7 ± 111.0 vs 388.5 ± 101.0 mL/min, 95% CI 23.4 to 113.0 mL/min, p=0.01), with a large effect size (Hedges’ g=1.04). Participants reported similar perceptions of exertion at the end of each trial (p=0.14). There was no difference in self-reported fatigue at the end of each trial (p=0.21). CONCLUSION This study found FES assist cycling produced significantly higher VO2 values than voluntary cycling, although the clinical significance of these differences is unknown. Participants performed FES assist cycling at a self-reported levels of exertion consistent with moderate to vigorous intensity, however it was considered light-intensity exercise when expressed by METS. FES assist cycling was no more fatiguing post-exercise than the other modes.

INTRODUCTION:An asymptomatic population has the same infection as symptomatic individuals, so these individuals can unknowingly spread the virus. It is not possible to predict the rate of epidemic growth by considering only the identified isolated or hospitalized population. In this study, we want to estimate the size of the COVID-19 population, based on information derived from patients visiting medical centers. So, individuals who do not receive a formal diagnosis in those medical centers can be considered as hidden.METHODOLOGY:To estimate the Bayesian size of the hidden population of COVID-19 a respondentdriven sampling (RDS) method was used. Twenty-three people infected with COVID-19 seeds and who had positive PCR test results were selected as seeds. These participants were asked whether any of their friends and acquaintances who had COVID-19 did not visit a medical center or hid their illness. Access to other patients was gained through friendship and kinship, hence allowing the sampling process to proceed.RESULTS:Out of 23 selected seeds, only 15 seeds remained in the sample and the rest were excluded due to not participating in the further sampling process. After 5 waves, 50 people with COVID-19 who had hidden their disease and were not registered in the official statistics were included in the sample. It was estimated that 12,198 people were infected with COVID-19 in Khalkhal city in 2022. This estimate was much higher than recorded in the official COVID-19 statistics.CONCLUSIONS:The study findings indicate that the estimated 'true' numbers of COVID-19 patients in one town in Iran were significantly higher compared to the official numbers. The RDS method can help capture the potential size of infections in further pandemics or outbreaks globally.

INTRODUCTION & AIMS Improving aerobic fitness in people with multiple sclerosis (MS) can reduce fatigue, and lower the risk of cardiovascular disease. Aerobic training can be challenging due to paresis, access to suitable equipment and fatigue. The aim was to investigate whether functional electrical stimulation (FES) cycling combined with arm crank interval exercise (hybrid FES interval training) is feasible for people with advanced MS, and its effects on aerobic fitness and fatigue. METHODS Hybrid FES interval training was performed 2 d/wk for 12 weeks. Each session consisted of 40 minutes of continuous FES cycling with arm crank intervals of 30 seconds work/30 seconds rest added concurrently for 20 minutes. The intensity target was a minimum of 60% of arm crank power and ‘hard’ measured by rate of perceived exertion (RPE) on a scale of 6-20. Feasibility was measured by attendance, compliance to intensity and time targets, adverse events, and drop outs. Aerobic fitness was assessed by an arm crank maximal test. Fatigue was measured via the Modified Fatigue Impact Scale (MFIS). RESULTS Seven participants (6 female; age 57.1±7.8y; Expanded Disability Status Scale 7.1±0.8) with advanced MS attended 80±10.4% of the scheduled sessions and there were no adverse events or drop outs. Average RPE at the end of each training session was 15±2, representing vigorous intensity exercise. Aerobic fitness did not change pre- to post-intervention [14.2±5.7 to 14.78±6.0 mL/kg/min (p=0.43)]. There was a trend towards a reduction in the MFIS score pre- to post-intervention [31.0±10.4 to 21.7±11.4 (p=0.10)]. CONCLUSION Hybrid FES interval training is feasible for people with advanced MS who need exercise equipment appropriate for their condition, and can represent vigorous intensity exercise. The positive findings support the need for future randomized control trials that can assess the aerobic fitness changes and associated health benefits of hybrid FES interval training.

INTRODUCTION:Currently, the ongoing COVID-19 pandemic is posing a challenge to health systems worldwide. Unfortunately, the true number of infections is underestimated due to the existence of a vast number of asymptomatic infected individual's proportion. Detecting the actual number of COVID-19-affected patients is critical in order to treat and prevent it. Sampling of such populations, so-called hidden or hard-to-reach populations, is not possible using conventional sampling methods. The objective of this research is to estimate the hidden population size of COVID-19 by using respondent-driven sampling (RDS) methods. METHODS:This study is a systematic review. We have searched online databases of PubMed, Web of Science, Scopus, Embase, and Cochrane to identify English articles published from the beginning of December 2019 to December 2022 using purpose-related keywords. The complete texts of the final chosen articles were thoroughly reviewed, and the significant findings are condensed and presented in the table. RESULTS:Of the 7 included articles, all were conducted to estimate the actual extent of COVID-19 prevalence in their region and provide a mathematical model to estimate the asymptomatic and undetected cases of COVID-19 amid the pandemic. Two studies stated that the prevalence of COVID-19 in their sample population was 2.6% and 2.4% in Sierra Leone and Austria, respectively. In addition, four studies stated that the actual numbers of infected cases in their sample population were significantly higher, ranging from two to 50 times higher than the recorded reports. CONCLUSIONS:In general, our study illustrates the efficacy of RDS in the estimation of undetected asymptomatic cases with high cost-effectiveness due to its relatively trouble-free and low-cost methods of sampling the population. This method would be valuable in probable future epidemics.

ObjectiveSpirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of high-dose Spirulina platensis for SARS-CoV-2 infection.Study DesignWe conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital discharge within seven days, while the overall discharge or mortality was considered the secondary outcome.ResultsWithin seven days, there were no deaths in the Spirulina group, while 15 deaths (15.3%) occurred in the control group. Moreover, within seven days, there was a greater number of patients discharged in the Spirulina group (97.7%) in non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the Spirulina group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, 0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received Spirulina showed a significant reduction in the levels of IL-6, TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who received Spirulina showed a significant decrease in the levels of MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU and non-ICU subgroups as intervention time increased. No side effects related to Spirulina supplements were observed during the trial.ConclusionHigh-dose Spirulina supplements coupled with the standard treatment of COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with COVID-19.Clinical Trial Registrationhttps://irct.ir/trial/54375, Iranian Registry of Clinical Trials number (IRCT20210216050373N1)

As the focus of classification shifts towards an evidence-based approach, it is crucial to establish a robust system that relies on valid and reliable measures of impairment to ensure legitimate and competitive opportunities for all Para athletes. However, the lack of methods that possess the necessary measurement properties for assessing impairments in Para sporting populations presents significant challenges to developing an evidence-based classification system. This review aimed to identify and evaluate measures of impairment and activity limitation measures that have been used to assess eligible impairments in Para sport athletes for potential use in evidence-based classification. Six electronic databases (MEDLINE, Embase, SPORTDiscus, CINAHL, Scopus, Web of Science) were searched from their earliest record to December 2023. Fifty-one articles were identified, with twenty-one studies focusing on physical impairment measures. Isometric and grip strength emerged as effective measures. Coordination measures, such as tapping tasks, showed variations with performance. Additionally, six studies focused on intellectual impairments, revealing differences between impaired and non-impaired athletes through generic cognitive tests. Vision impairment measures, including visual acuity and visual field assessments, displayed varying associations with performance across sports. Although research on evidence-based classification in Para sport is limited, this review provides valuable insights for sports in developing a testing battery that adheres to evidence-based protocols. Ongoing research efforts by sport governing bodies to prioritise research in this area will improve our understanding of the impairment–performance relationship, leading to better decision making and increased credibility in Para sport classification systems.

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The objective of this study is to determine the healthy behaviors of mothers with gestational diabetes mellitus (GDM) in Ardabil in 2020. An analytic cross-sectional study was conducted on 360 mothers with GDM in Ardabil in 2020. Self-reported data was collected using a sociodemographic and a lifestyle questionnaire (LSQ) with assistance from health staff. Univariate and multivariate linear regression tests were used to assess risk variables associated with health behaviors and GDM. The total score of the LSQ was 123.6 +/- 9.9, which was considered fair or average. The participants' age had a significant relationship with physical health (beta = -.093, P = .004), weight control and nutrition (beta = .094, P = .010), and psychological health (beta = .081, P = .005). Higher educational level was associated with accident prevention (beta = .453, P = .001). Participants' occupation had a significant positive relationship with the prevention of diseases (beta = .925, P = .003). A gravida of the participants was associated with weight control and nutrition (beta = -.497, P = .016). Body mass index was associated with physical health (beta = -.179, P = .001), exercise and fitness (beta = -.149, P = .016), psychological health (beta = -.158, P = .001), accident prevention (beta = .098, P = .023), and total score of LSQ (beta = -.559, P = .006). The findings of this study showed that mothers with GDM had LSQ subscales scores considered fair or average, except for the prevention of diseases and avoidance of drugs, alcohol, and opiates subscales, which were considered good.