Search Results (975)

Background/Objectives: Physical activity (PA) has been associated with better inhibitory control (IC), which may support self-regulatory processes related to eating. However, whether regular PA is related to food-specific IC and its neural correlates remains insufficiently understood. This cross-sectional study aimed to examine the relationship between regular PA, behavioral performance, and neural correlates of IC, with a focus on high-reward food-related contexts. Methods: Sixty-one healthy right-handed young Chinese adults were classified into a regular physical activity group (RPG; n = 30, 24 males) or an inactive group (IAG; n = 31, 17 males) based on self-reported frequency and volume of PA. Stop-signal tasks performed during functional MRI under high-calorie food and neutral image conditions were used to assess IC. Stop-signal reaction time (SSRT) indexed IC performance. Neural correlates of IC were examined using whole-brain and region-of-interest analyses, with brain activation values derived from general linear models including age, sex, body mass index, depressive scores, and subjective appetite ratings as covariates. Given the relatively small sample size and unbalanced distribution of sex and body mass index, sensitivity analyses were performed by varying covariate adjustments to assess the robustness of the primary results. Results: RPG demonstrated significantly shorter SSRT than IAG across both high-calorie food and neutral stimulus conditions. In contrast to successful-stop trials relative to baseline, IAG showed lower activation in the bilateral precuneus than RPG under the high-calorie food condition. In comparison, RPG showed lower activation than IAG under the neutral condition. In contrast to failed-stop trials relative to successful-go trials, IAG exhibited greater activation in the left caudate than RPG under the high-calorie food condition. These behavioral and neural patterns were generally robust across sensitivity analyses. Conclusions: Regular PA was associated with superior general IC, and this advantage was maintained in the presence of high-calorie food cues. At the neural level, regular PA was associated with stimulus-dependent neural responses in the bilateral precuneus and left caudate. Future studies using larger, more representative samples, objective measures of PA, and stratification by sex or BMI are warranted. Full article

Background/Objectives: While excessive body fat is commonly linked to metabolic disorders (metabolically unhealthy obesity, MUO), a subset of individuals remain metabolic healthy despite obesity (metabolically healthy obesity, MHO). This work aims to determine how these phenotypes influence responses to lifestyle modification (LSM) in older adults. Methods: A 12-month lifestyle modification (LSM) intervention based on the Mediterranean Diet (MedDiet) and regular physical activity (PA) was conducted in 43 older adults (70% women) classified according to World Health Organization (WHO) criteria as MHO (22 subjects) or MUO (21 subjects). Clinical, dietary, and PA parameters were assessed at baseline and follow-up. Peripheral blood mononuclear cells were analyzed for mitochondrial fusion (OPA1, MFN2), mitophagy (PINK1), biogenesis (TFAM), and the respiratory chain (COX IV) using Western blot and RT-qPCR techniques. Results: At baseline, MUO showed significant lower OPA1-L, MFN2, and TFAM along with MFN2 degradation products and PINK1 accumulation. After 12 months of LSM, MUO participants exhibited greater metabolic profile improvements, such as significantly reduced MFN2 degradation products and higher COX IV. Changes in mitochondrial proteins were associated with nutrient intake and PA and clinical parameters with phenotype-specific patterns. In MUO, protein and cholesterol intake improved MFN2 fusion (rho = 0.446, p = 0.043; rho = 0.581, p = 0.006), while carbohydrates were negatively associated with OPA1 in MHO (rho = −0.596, p = 0.025). PA was positively related to fusion proteins in both phenotypes. Clinically, significant improvements in BMI, waist circumference, and HDL were found in MUO but not in MHO. Conclusions: Older adults with obesity show phenotype-specific mitochondrial impairments that shape distinct responses to LSM, highlighting the relevance of tailoring LSM interventions by metabolic phenotype. Full article

Background/Objectives: Sleep is fundamental to physical and mental health, yet many individuals experience impaired sleep quality. Although pharmacological interventions are available, they are associated with risks of dependency and adverse effects, underscoring the urgent need for safer, food-based alternatives. Blueberry leaves, rich in hyperoside, are suggested to influence sleep through serotonergic and melatonergic pathways; however, while their potential to help maintain sleep quality has been noted, the sleep-enhancing effects of fermented blueberry leaf tea have not yet been demonstrated. This present randomized, double-blind, placebo-controlled trial evaluated the sleep-enhancing effects of fermented blueberry leaf tea on sleep quality. Methods: Fifty adults (aged 20–69 years) reporting poor sleep were randomly assigned to consume either fermented blueberry leaf tea (n = 25) or placebo tea (n = 25) three times daily for two weeks. Objective sleep parameters—sleep efficiency, wake after sleep onset (WASO), sleep latency, and total sleep time—were assessed using actigraphy, while subjective sleep quality was evaluated using the Oguri–Shirakawa–Azumi Sleep Inventory MA (OSA-MA) version questionnaire. Results: In the per-protocol analysis (active: n = 22; placebo: n = 20), the active group exhibited significant improvements in sleep efficiency and WASO compared with the placebo (p < 0.05). No significant differences were observed for sleep latency, total sleep time, or subjective assessments. Importantly, baseline sleep efficiency and WASO were negatively correlated with their respective improvements, suggesting that individuals with poorer initial sleep benefited most. Conclusions: These findings demonstrate that fermented blueberry leaf tea may enhance sleep continuity within two weeks, particularly among individuals with fragmented sleep, and support the potential role of functional foods in sleep health strategies. Trial registration: University Hospital Medical Information Network (UMIN), UMIN000055879; registered on 21 October 2024. Full article

Self-rated health is a comprehensive indicator reflecting an individual’s subjective assessment of their overall health status. The health condition of students in elite universities is directly related to the quality of talent reserves and the long-term development of the country. However, the multiple challenges they face make them prone to subhealth issues. To understand and effectively intervene in the health dilemmas of this group from a psychological perspective, this study constructed a cross-lagged model to examine the potential bidirectional relationship between anxiety and self-rated health. We utilized two-wave longitudinal data from a sample of 896 undergraduate students (mean age 21.37 years, 60.27% male, 92.08% Han nationality) from five elite universities in Beijing, China. Anxiety was measured using the Depression Anxiety Stress Scales, while self-rated health was assessed via a single-item score. The study revealed that during the two survey periods, the anxiety levels of elite university students decreased (7.682/7.462), whereas their self-rated health scores increased (81.781/83.255). Higher levels of anxiety were significantly associated with lower levels of self-rated health in both the concurrent and cross-lagged analyses (r = −0.299~−0.173, p < 0.01). Prior anxiety could predict later self-rated health (β = −0.081, p < 0.05), but the reverse path from self-rated health to anxiety was not confirmed. Our findings indicate that anxiety among elite university students has a unidirectional prospective effect on self-rated health. On the basis of these findings, universities should integrate mental health services into their routine work systems, and students should also increase their sense of personal responsibility for their own health, actively seeking effective pathways to improve their physical and mental well-being. Full article

Aim: This study compared the effects of standard evening smartphone restriction with an adapted intervention combining progressive restriction, psychoeducational guidance, and pre-sleep relaxation on sleep, psychological state, cognitive performance, and physical performance in physically active physical education students with moderate-to-high nomophobia. Methods: Thirty participants (age 21.9 ± 1.2 years; intermediate chronotype) completed a randomized controlled trial consisting of a 7-day baseline period, a 14-day intervention phase, and post-intervention assessments. The standard group (n = 15) implemented a 2-h pre-bedtime smartphone restriction combined with general sleep hygiene guidance. The adapted group (n = 15) followed a progressive restriction protocol (30→60→120 min) supplemented with psychoeducational guidance targeting smartphone-related anxiety and a nightly slow-paced breathing routine. Objective sleep parameters were quantified using wrist-worn actigraphy. Subjective sleep quality, pre-sleep anxiety, and stress were assessed using visual analog scales. Cognitive performance (psychomotor vigilance task and choice reaction time) and physical performance (vertical jumps and agility) were evaluated at both morning and afternoon time points. Results: The adapted intervention produced significantly greater improvements in sleep efficiency (time × group: F(1,28) = 6.84, p = 0.014, ηp² = 0.20; d = 0.78) and sleep onset latency (F(1,28) = 5.97, p = 0.021, ηp² = 0.18; d = 0.72) compared with standard restriction. Significant reductions were also observed in pre-sleep anxiety (F(1,28) = 7.12, p = 0.012, ηp² = 0.20; d = 0.81) and stress (F(1,28) = 6.45, p = 0.017, ηp² = 0.19; d = 0.74). Cognitive performance showed significant time × group × time-of-day interactions, with improvements during afternoon assessments in psychomotor vigilance (F(1,28) = 7.48, p = 0.011; d = 0.83) and choice reaction time (F(1,28) = 6.89, p = 0.014; d = 0.79) exclusively in the adapted group. Physical performance outcomes remained stable across interventions. Conclusions: Progressive smartphone restriction combined with psychoeducational strategies and pre-sleep relaxation yields clinically meaningful improvements in sleep continuity, psychological arousal, and afternoon cognitive performance, exceeding the benefits achieved through behavioral restriction alone. Full article

Firefighting requires high and multidimensional fitness to ensure operational readiness and public safety. In Portugal, there is limited data regarding firefighters’ fitness and exercise programs to improve readiness are lacking. This study evaluated the effects of a 6-month minimal-equipment exercise program on the physical fitness of firefighter recruits. Thirty-five male subjects (23.0 ± 2.72 years) were assessed at baseline,3 and 6 months for body composition, handgrip strength, running speed, cardiovascular endurance, anaerobic power, and upper- and lower-body strength. The intervention entailed daily sessions with 15 min of continuous running (50–65% HRmax) and active stretching, followed by alternating routines, including endurance running, free weights, interval sprints, calisthenics, and drills. A repeated-measures ANOVA and Bonferroni adjusted post hoc comparisons identified time-based changes. Significant improvements occurred across all fitness variables. Body fat fell by 8.4% and VO₂max increased (p < 0.001), surpassing occupational thresholds required for extended suppression tasks. Bench press and sit-up performance improved by 88% and 81%, respectively, while countermovement jump showed double-digit gains (13%), all of which can translate directly to hose advancement, victim rescue, and forcible entry. These results highlight that resource-constrained departments can implement effective, low-cost exercise programs for enhancing pivotal fitness components, supporting policy initiatives to include structured training throughout firefighters’ careers. Full article

Background: Emergency rescuers frequently carry heavy equipment for extended periods, making musculoskeletal disorders a major occupational concern. Loading type and road slope play important roles in inducing physical fatigue; however, the assessment of physical fatigue under these conditions remains limited. Aim: This study aims to investigate physical fatigue under different loading types and road slope conditions using both electromyography (EMG) and eye movement metrics. In particular, this work focuses on eye movement metrics as a non-contact data source in comparison with EMG, which remains largely unexplored for physical fatigue assessment. Method: Prolonged load-bearing walking was simulated to replicate the physical demands experienced by emergency rescuers. Eighteen male participants completed experimental trials incorporating four loading types and three road slope conditions. Results: (1) Loading type and road slope significantly affected EMG activity, eye movement metrics, and perceptual responses. (2) Saccade time (ST), saccade speed (SS), and saccade amplitude (SA) exhibited significant differences in their rates of change across three stages defined by perceptual fatigue. ST, SS, and SA showed strong correlations with subjective fatigue throughout the entire load-bearing walking process, whereas pupil diameter demonstrated only a moderate correlation with subjective ratings. (3) Eye movement metrics were incorporated into multivariate quadratic regression models to quantify physical fatigue under different loading types and road slope conditions. Conclusions: These findings enhance the understanding of physical fatigue mechanisms by demonstrating the potential of eye movement metrics as non-invasive indicators for multidimensional fatigue monitoring in work environments involving varying loading types and road slopes. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is often accompanied by metabolic syndrome (MetS), forming a high-risk phenotype with elevated cardiometabolic burden. The contribution of lifestyle behaviors—particularly eating mechanics and psychological eating cues—to disease severity remains unclear. This study examined independent associations of dietary behaviors and physical activity (PA) with OSA severity, sleep quality, and metabolic health. Methods: Forty-four OSA patients (mean age 38.3 ± 9.1 years; 89% male) underwent attended polysomnography, dual-energy X-ray absorptiometry, and metabolic profiling. Validated questionnaires assessed dietary behaviors, PA, and sleep quality. Hierarchical logistic regression identified predictors of MetS, severe OSA, and poor sleep quality. Results: The prevalence of MetS was 45%. Compared with those with OSA alone, participants with MetS demonstrated significantly greater central adiposity and more severe nocturnal hypoxemia, despite similar apnea–hypopnea indexes. In multivariable models, MetS was independently associated with higher body mass index (adjusted odds ratio [aOR] = 1.64; p = 0.008) and reward eating (aOR = 3.34; p = 0.041), whereas higher total PA was associated with reduced odds (aOR = 0.96; p = 0.026). Poor subjective sleep quality was significantly associated with younger age (aOR = 0.91; p = 0.037). For severe OSA, slow chewing was associated with significantly reduced odds (aOR = 0.24; p = 0.038), while emotional eating was associated with increased odds (aOR = 2.40; p = 0.048). Conclusions: This hypothesis-generating study identifies a high-risk OSA phenotype marked by metabolic dysfunction and hypoxemia. Eating speed (a proxy for mindful eating), emotional and reward-driven eating, and PA independently shape metabolic and respiratory outcomes. These findings support incorporating behavioral nutrition into multidisciplinary OSA management. Full article

Children and adolescents with disabilities experience disproportionate challenges in achieving recommended levels of physical activity (PA) and adequate sleep, two core determinants of health and functional well-being. This systematic review examined associations between meeting PA guidelines and sleep duration among youth with disabilities. Following PRISMA guidelines, MEDLINE, PsycARTICLES, and SPORTDiscus were searched through Spring 2024 for studies assessing PA and sleep in children and adolescents (<18 years) with disabilities using subjective or objective measures. Data were extracted from 28 studies (N = 138,016) and synthesized using qualitative methods and regression-based quantitative analyses to examine the effects of diagnosis category and PA guideline adherence on sleep duration. The diagnosis type was associated with sleep duration, with youth with autism spectrum disorder (ASD) exhibiting shorter sleep than those with physical disabilities. Meeting PA guidelines (≥60 min/day) was associated with longer sleep duration among youth with ASD, but not consistently across other diagnostic groups. Qualitative findings further indicated diagnosis-specific variability, with PA positively associated with sleep outcomes in ASD, attention deficit/hyperactivity disorder, and epilepsy, and mixed associations observed for cerebral palsy and intellectual disability. These findings suggest that PA may support sleep health in specific disability groups. Given persistently low PA participation among youth with disabilities, integrating accessible, diagnosis-specific PA opportunities within school, community, and clinical settings may represent a feasible strategy to improve sleep and overall health. Full article

Background/Objectives: Parkinson’s disease is the second most common neurodegenerative disorder, affecting patients’ daily lives in multiple domains, including functional status, health-related quality of life, and psychological well-being. This study examined the relationship between self-reported global activity level, functional status, Health Related QoL (HRQoL), and psychological state among patients with Parkinson’s disease in Greece. Methods: Thirty volunteers (mean age = 69.07, SD = 11.24), members of the Greek Parkinson’s Patients and Caregivers Association, completed (a) the Parkinson’s Disease Questionnaire to evaluate HRQoL and (b) the Hospital Anxiety and Depression Scale (HADS) to assess psychological state. Participants then performed (a) the Five Times Sit to Stand Test (FTSST) and (b) the Berg Balance Scale (BBS) to evaluate functional status. All questionnaires and the test used in the present study have been validated in Greek. Correlation analysis with Spearman r tests with Bonferroni correction was performed between the above variables. Subsequent linear regression models were used to identify independent predictors of HRQoL and balance using SPSS 29.0.2.0. Results: Participants reported elevated anxiety (M = 9.67, SD = 4.44) and depressive symptoms (M = 8.97, SD = 4.08), alongside relatively high HRQoL scores (M = 40.09, SD = 18.40). Impaired functional performance was observed, with 22 participants failing to complete the FTSST within 16 s and 16 scoring below 40 on the BBS. Functional status was strongly correlated with HRQoL (r = −0.696, p < 0.001) and activity level (r = −0.521, p < 0.008). Depression was also significantly associated with poorer HRQoL (r = 0.618, p < 0.008) and lower activity levels (r = −0.545, p < 0.008). Regression analyses revealed that balance (β = −0.526), disease duration (β = 0.437), anxiety (β = 0.411), and lower limb function (β = −0.351) were significant independent predictors of HRQoL (R² = 0.785; F(9, 20) = 12.69; p < 0.001), while HRQoL (β = −0.738) and lower limb function (β = −0.391) independently predicted balance (R² = 0.699; F(9, 20) = 4.72; p = 0.002), suggesting a bidirectional relationship between physical function and subjective well-being. Conclusions: Activity level, HRQoL, functional status, and psychological state in patients with Parkinson’s disease are interrelated factors. Increased levels of anxiety and depression, as well as reduced HRQoL, were observed. The findings point to a potentially reinforcing cycle between poor balance and diminished quality of life, with anxiety and age playing key roles. Overall, the results illustrate that functional, psychological, and HRQoL measures interact in complex ways, emphasizing the multidimensional profile of patients with Parkinson’s disease. Further studies with larger samples are required to confirm these findings. Full article

This work examines resistance drift in FPGA I/O paths subjected to combined electrical and thermal stress, using a Xilinx Spartan-6 device as a representative platform. A multiplexed measurement approach was employed, in which multiple I/O pins were externally shorted and sequentially activated, enabling precise tracking of voltage, current, and effective series resistance over time, under controlled bias conditions. Two accelerated stress modes were investigated: high-temperature dwell in the range of 80–120 °C and thermal cycling between 80 and 140 °C. Both stress modes exhibited similar sub-linear (power-law) time dependence on resistance change, indicating cumulative degradation behavior. However, Arrhenius analysis revealed a strong contrast in effective activation energy: approximately 0.62 eV for high-temperature dwell and approximately 1.3 eV for thermal cycling. This divergence indicates that distinct physical mechanisms dominate under each stress regime. The lower activation energy is consistent with electrically and thermally driven on-die degradation within the FPGA I/O macro, including bias-related aging of output drivers and pad-level structures. In contrast, the higher activation energy observed under thermal cycling is characteristic of diffusion- and creep-dominated thermo-mechanical damage in package-level interconnects, such as solder joints. These findings demonstrate that resistance-based monitoring of FPGA I/O paths can discriminate between device-dominated and package-dominated aging mechanisms, providing a practical foundation for reliability assessment and self-monitoring methodologies in complex electronic systems. Full article

Background/Objectives: Frailty has been associated with various physical, psychological, and social factors; however, the influence of the residential environment—particularly walk-up buildings without elevators—remains unclear. This study aimed to examine the association between the floor of residence and frailty among functionally independent older adults. Methods: A total of 793 older adults (mean age: 76.46 ± 6.29 years; 58.83% women) living in walk-up buildings without elevators and not certified as requiring long-term care participated in a questionnaire survey. Frailty was assessed using the Kihon Checklist (KCL) and the FRAIL Scale (FS). Logistic regression analyses were conducted to examine the association between floor of residence and frailty status (non-frail vs. frail), adjusting for potential confounders. Sensitivity analyses were performed using stratified models based on age group, functional status, and living conditions. Results: Frailty prevalence was 23.28% (KCL) and 16.88% (FS). Higher floor of residence was significantly associated with lower odds of frailty (KCL: odds ratio [OR] = 0.82, 95% confidence interval [CI]: 0.69–0.97; FS: OR = 0.80, 95% CI: 0.65–0.97). Stratified analyses showed consistent associations in subgroups including those aged ≥ 75 years, with full Instrumental Activities of Daily Living scores, non-homebound status, poor subjective economic status, and living alone (all p < 0.05). Conclusions: Living on higher floors in walk-up buildings without elevators may be protective against frailty among functionally independent older adults. While barrier-free environments are essential for those with functional decline or disabilities, moderate physical challenges such as stairs may contribute to frailty prevention in populations who maintain independence. Full article

Physical activity often remains low after hospitalisation for acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Although post-hospitalisation rehabilitation has shown to support recovery, its impact on daily activity levels in the early post-exacerbation phase is unclear. This study describes the changes in physical activity (PA) and clinical outcomes during an 8-week rehabilitation following hospitalisation for AECOPD. This prospective observational cohort study included patients recently discharged after AECOPD from Aalborg University Hospital, Denmark. Participants received municipality-delivered post-hospitalisation rehabilitation consisting of tailored physiotherapy and occupational therapy of individually determined frequency. PA was assessed using thigh-worn triaxial accelerometers measuring 24 h/day over 8 weeks. Clinical outcomes included lung function (FEV1% predicted), dyspnoea scores, health-related quality of life (EuroQol 5-dimension, 5-level (EQ-5D-5L); EuroQol visual analogue scale (EQ-VAS)), frailty (Clinical Frailty Scale (CFS)), functional status (Short Physical Performance Battery (SPPB)), and symptom burden (COPD Assessment Test (CAT); St. George’s Respiratory Questionnaire (SGRQ)). Changes from baseline to 8 weeks were analysed using linear mixed-effects models and bootstrap resampling. Forty-three participants with a mean age 73.4 years, 67.4% female, and moderate frailty (CFS 5.4 ± 1.3) were included. Physical activity remained largely unchanged. Gait speed and total SPPB declined, whereas self-perceived health improved (EQ-VAS Δ +7.8, p = 0.008). Lung function, dyspnoea, and health related quality of life scores showed no significant change. In this frail, recently admitted COPD population, physical activity did not increase during the rehabilitation period, and some functional parameters declined. The improvement in self-perceived health suggests a divergence between subjective and objective outcomes. These findings highlight the need for long-term, tailored, and flexible approaches to support recovery after AECOPD. Full article

Background/Objectives: Childhood metabolic dysregulation exerts a profound influence on the development of obesity and metabolic diseases. The human gut microbiota, with highly personalized characteristics, plays an important role in host metabolism. However, the dynamics of gut microbial features during this developmental phase are still unclear. This longitudinal observational study collected 204 fecal samples and 153 blood samples from 51 children (aged 8.90 ± 0.78 years) at four timepoints over 52 weeks, aiming to identify dynamic changes in individual gut microbiota and underlying mechanistic interactions that predict measures of pediatric metabolic health. Methods: Fecal samples were subjected to 16S rRNA gene amplicon sequencing and short-chain fatty acid quantification. Serum samples were analyzed for biochemical tests. Dietary intake, physical activity, clinical phenotypes, early-life factors, and fecal characteristics were further assessed. Results: In the results, the fecal microbiota dynamics exhibit inter-individual variation among children, allowing classification into high- and low-stability subgroups based on intra-individual β-diversity variability. Children with low-stability microbiota had adverse blood lipid profiles (p < 0.05). Compared to the high-stability group, the low-stability microbiota demonstrated significant association with low dietary fiber and highly variable amino acid consumption (|r| > 0.3, q < 0.05). Low-stability microbiota exhibited marked fluctuations in Phocaeicola vulgatus, which was strongly linked to both blood triglycerides and lipoprotein(a) levels, as well as dietary fiber and amino acid intake. Baseline depletion of P. vulgatus and Faecalibacterium duncaniae, combined with the children’s physiological status, lifestyle behaviors, and early-life factors, predicted microbial stability classification (AUROC = 0.93). Conclusions: These findings suggested that the variation in the gut microbiota dynamics could be considered as a possible complementary biomarker to understand the individualized responses within dietary interventions aimed at improving metabolic health in childhood. Further well-designed intervention study is needed to define these observational associations. Full article

Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications of pregnancy, and its prevalence continues to rise worldwide. Dietary management is the cornerstone of therapy, yet adherence may impose a substantial everyday burden. This study aimed to assess perceived burden and practical challenges related to following a diabetic diet in women with GDM. Methods: A cross-sectional anonymous online questionnaire study was conducted among 109 women with a current or past diagnosis of GDM within the previous five years. The survey addressed self-reported difficulties in maintaining normal blood glucose levels, adherence to a diabetic diet, perceived increases in grocery expenses, time required for meal preparation, dietary preferences, and family attitudes toward the diet. Associations between categorical variables were analyzed using contingency tables and the contingency coefficient. Results: Women with insulin-treated GDM (GDM2) reported more difficulties maintaining normal blood glucose levels than women treated with diet and physical activity alone (GDM1) (p = 0.014). Educational level was associated with perceived financial burden (p = 0.013) and meal preparation time (p = 0.003). These patterns likely reflect both differences in economic resources and the extent of dietary changes undertaken, rather than uniform differences in nutritional awareness. Pregnancy status was associated with dietary preferences, as non-pregnant respondents more often reported liking diabetic-diet meals than pregnant respondents (p = 0.037). Overall, 53.2% of respondents reported that a diabetic diet made daily functioning more difficult, mainly due to increased time and financial demands. Conclusions: Dietary management of GDM is associated with a meaningful perceived burden, especially among women requiring insulin therapy and those facing financial and time constraints. Understanding these subjective challenges may support more individualized dietary counseling and patient-centered care. Full article