No abstract

ECK DISORDERS REMAIN A common problem in modern, industrialized countries. Neck pain has been the most common chief complaint among working-aged women visiting their physicians. 1,2 In a Canadian study, 3 54% of the general population had experienced neck pain during the past 6 months, and approximately 5% were highly disabled by neck pain. The prevalence of chronic neck pain has been reported to be 7% in women and 5% in men in Finland. 4 Patients with chronic neck pain used health care services twice as much as the population on average. 2 Sick leave, therapy, and specialist care form the major part of the costs incurred by neck pain, whereas investigations at the primary health care level play a minor role. 5 The origin and exact pathophysiologic mechanisms of chronic neck pain often remain obscure because trauma or severe degenerative conditions at working age are found only in Author Affiliations are listed at the end of this article.

OBJECTIVETo assess whether gestational diabetes mellitus (GDM) can be prevented by a moderate lifestyle intervention in pregnant women who are at high risk for the disease. RESEARCH DESIGN AND METHODSTwo hundred ninety-three women with a history of GDM and/or a prepregnancy BMI of ‡30 kg/m 2 were enrolled in the study at <20 weeks of gestation and were randomly allocated to the intervention group (n = 155) or the control group (n = 138). Each subject in the intervention group received individualized counseling on diet, physical activity, and weight control from trained study nurses, and had one group meeting with a dietitian. The control group received standard antenatal care. The diagnosis of GDM was based on a 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation. RESULTSA total of 269 women were included in the analyses. The incidence of GDM was 13.9% in the intervention group and 21.6% in the control group ([95% CI 0.40-0.98%]; P = 0.044, after adjustment for age, prepregnancy BMI, previous GDM status, and the number of weeks of gestation). Gestational weight gain was lower in the intervention group (20.58 kg [95% CI 21.12 to 20.04 kg]; adjusted P = 0.037). Women in the intervention group increased their leisure time physical activity more and improved their dietary quality compared with women in the control group. CONCLUSIONSA moderate individualized lifestyle intervention reduced the incidence of GDM by 39% in high-risk pregnant women. These findings may have major health consequences for both the mother and the child. A slide set summarizing this article is available online.Clinical trial reg. no. NCT01698385, clinicaltrials.gov.