Impact of coronavirus 2019 pandemic on post-traumatic stress disorder symptoms among pregnant women in Jordan

Objective:

To examine the prevalence of psychological symptoms of the coronavirus disease 2019 outbreak among pregnant women and its association with gestational age and post-traumatic stress disorder symptoms.

Methods:

A cross-sectional study was conducted between June and November 2020 to assess the impact of the COVID-19 pandemic on mental health in pregnancy using the Impact of Event Scale-Revised. Pregnant women 18 years and older were recruited from antenatal and obstetrics clinics in Jordan. A total of 481 pregnant women participated in an online survey developed on Google Forms. A self-administered structured questionnaire was used to collect sociodemographic data, mental health information, and lifestyle changes. The Impact of Event Scale-Revised, the Perceived Support Scale, and the Mental Health Lifestyle Scale were administered. Variables related to sociodemographic information and dietary behavior and perception during the COVID-19 pandemic were also assessed.

Results:

The results showed that 58.6% of pregnant women reported the presence of post-traumatic stress disorder symptoms and women in the second trimester were more likely to show post-traumatic stress disorder symptoms compared with the first and third trimesters (p = 0.001). Moreover, a higher level of education, employment, poor dietary habits, and changes due to the pandemic were significantly associated with the Impact of Event Scale-Revised score and the presence of post-traumatic stress disorder symptoms.

Conclusion:

The COVID-19 pandemic was associated with high rates of psychological distress among pregnant women. Identifying mothers at risk of post-traumatic stress disorder symptoms may help improve maternity services and prevent adverse child outcomes.

Time-Restricted Feeding and Aerobic Performance in Elite Runners: Ramadan Fasting as a Model

A distance runner's performance is generally limited by energy availability when competing or training. Modifying meal frequency and timing by abstaining from eating or drinking, from dawn to dusk, during Ramadan fasting is hypothesized to induce hypohydration and reduced caloric and nutrient intake. The purpose of this study was to investigate the impact of Ramadan fasting on runners' performances. Fifteen trained male distance runners who observed Ramadan participated in this study (Age = 23.9 ± 3.1 years; Peak VO₂ = 71.1 ± 3.4 ml/kg/min). Each participant reported to the human performance lab on two testing occasions (pre-Ramadan and the last week of Ramadan). In each visit, participants performed a graded exercise test on the treadmill (Conconi protocol) and their VO₂, Heart Rate, time to exhaustion, RPE, and running speed were recorded. Detailed anthropometrics, food records, and exercise logs were kept for the entire period of the study. Repeated measure ANOVA, paired t-test, and Cohen's effect size analysis were carried out. Results indicated no significant influence for Ramadan fasting on body mass (p = 0.201), body fat (p = 0.488), lean body mass (p = 0.525), VO₂max (p = 0.960), energy availability (p = 0.137), and protein intake (p = 0.124). However, carbohydrate (p = 0.026), lipid (p = 0.009), water (p < 0.001), and caloric intakes (p = 0.002) were significantly reduced during Ramadan Fasting. Daily training duration (p < 0.001) and exercise energy expenditure (p = 0.001) were also reduced after Ramadan. Time to exhaustion (p = 0.049), and maximal running speed (p = 0.048) were improved. Overall, time to exhaustion and maximal running speed of the distance runners was improved during Ramadan fasting, independent of changes in nutrients intake observed during the current study. With proper modulation of training, distance runners performance can be maintained or even slightly improved following the month of Ramadan fasting.

No significant effect of caffeine on five kilometer running performance after muscle damage

Caffeine has documented hypoalgesic effects during exercise. However, there is a lack of research focusing on caffeine's potential analgesic effects to ameliorate delayed onset muscle soreness. A placebo controlled randomized cross-over trial was carried out to determine if 5 mg/kg of body weight (mg/kgBW) of caffeine attenuates muscle pain and improves 5 k running performance following delayed onset muscle soreness. Prior to participating, eleven runners (9 male; 2 female; age, 24.5 ± 6.3 years; height, 173.6 ± 7.8 cm; body mass, 66.3 ± 7.5 kg; BMI, 23.18 kg/m² ± 1.6; VO_2max 61.0 ± 6.1 ml/kg/min^-1), were asked to discontinue supplement use for 72 hours and abstain from caffeine consumption for 48 hours. Participants performed a 30-minute downhill run on a treadmill set at -10% grade at 70% VO_2max to induce delayed onset of muscle soreness. Participants then returned 48 hours after to complete a 5 k time trial run where they consumed either 5 mg/kgBW of caffeine or a placebo. Rate of perceived exertion and heart rate were taken every two minutes during the trial. There was no detectable statistical difference between 5 k performance between caffeine (1074.9 ± 119.7 sec) or placebo (1053.8 ± 86.8 sec) (p = .41). Algometer readings were similar between both treatments for muscle soreness in the rectus femoris (p = .791) and the vastus medialis oblique (p = .371). Muscle soreness ratings were found to be greater in the caffeine condition compared to the placebo condition (p = .030). There was no effect of treatment on rating of perceived exertion between conditions (p = .574). The present study suggests that caffeine is not effective at reducing muscle soreness, rating of perceived exertion, or improving running performance in a time trial in the presence of muscle soreness.

Impact of carbohydrate mouth rinsing on time to exhaustion during Ramadan: A randomized controlled trial in Jordanian men

Mouth rinsing using a carbohydrate (CHO) solution has been suggested to improve physical performance in fasting participants. This study examined the effects of CHO mouth rinsing during Ramadan fasting on running time to exhaustion and on peak treadmill speed (V_peak). In a counterbalanced crossover design, 18 sub-elite male runners (Age: 21 ± 2 years, Weight: 68.1 ± 5.7 kg, VO_2max: 55.4 ± 4.8 ml/kg/min) who observed Ramadan completed a familiarization trial and three experimental trials. The three trials included rinsing and expectorating a 25 mL bolus of either a 7.5% sucrose solution (CHO), a flavour and taste matched placebo solution (PLA) for 10 s, or no rinse (CON). The treatments were performed prior to an incremental treadmill test to exhaustion. Three-day dietary and exercise records were obtained on two occasions and analysed. Anthropometric characteristics were obtained and recorded for all participants. A main effect for mouth rinse on peak velocity (V_peak) (CHO: 17.6 ± 1.5 km/h; PLA: 17.1 ± 1.4 km/h; CON: 16.7 ± 1.2 km/h; P < .001, η_p² = 0.49) and time to exhaustion (CHO: 1282.0 ± 121.3 s; PLA: 1258.1 ± 113.4 s; CON: 1228.7 ± 98.5 s; P = .002, η_p² = 0.41) was detected, with CHO significantly higher than PLA (P < .05) and CON (P < .05). Oxygen consumption, heart rate, respiratory exchange ratio, and rating of perceived exertion were not significantly different between treatments or trials (P > .05). Energy availability from dietary analysis, body weight, and fat-free mass did not change during the last two weeks of Ramadan (P > .05). This study concludes that carbohydrate mouth rinsing improves running time to exhaustion and peak treadmill speed under Ramadan fasting conditions.

Sweat gland density and response during high-intensity exercise in athletes with spinal cord injuries

Sweat production is crucial for thermoregulation. However, sweating can be problematic for individuals with spinal cord injuries (SCI), as they display a blunting of sudomotor and vasomotor responses below the level of the injury. Sweat gland density and eccrine gland metabolism in SCI are not well understood. Consequently, this study examined sweat lactate (S-LA) (reflective of sweat gland metabolism), active sweat gland density (SGD), and sweat output per gland (S/G) in 7 SCI athletes and 8 able-bodied (AB) controls matched for arm ergometry VO2peak. A sweat collection device was positioned on the upper scapular and medial calf of each subject just prior to the beginning of the trial, with iodine sweat gland density patches positioned on the upper scapular and medial calf. Participants were tested on a ramp protocol (7 min per stage, 20 W increase per stage) in a common exercise environment (21±1°C, 45-65% relative humidity). An independent t-test revealed lower (p<0.05) SGD (upper scapular) for SCI (22.3 ±14.8 glands · cm(-2)) vs. AB. (41.0 ± 8.1 glands · cm(-2)). However, there was no significant difference for S/G between groups. S-LA was significantly greater (p<0.05) during the second exercise stage for SCI (11.5±10.9 mmol · l(-1)) vs. AB (26.8±11.07 mmol · l(-1)). These findings suggest that SCI athletes had less active sweat glands compared to the AB group, but the sweat response was similar (SLA, S/G) between AB and SCI athletes. The results suggest similar interglandular metabolic activity irrespective of overall sweat rate.