Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effect of Micronutrients and Exercise During Pregnancy on Factors Related With Non-Transmissible Chronic Diseases
Brief Summary: At the moment, most of efforts to prevent non-transmissible chronic diseases at population level have been centered in promoting healthful behaviors like physical activity, consumption of fruits and vegetables, and discouraging from the consumption of tobacco and alcohol in adult population, but the results have been little hopeful. In the last years, manifold studies have indicated the relation between metabolic alterations and of the fetal growth with the development of non-transmissible chronic diseases in adult age. More recently, it has been proposed that maternal factors (endothelial function, oxidative stress and alterations in adipokines) and placental ones (mitochondrial dysfunction) are the precursory mechanisms of fetal metabolic alterations and of the later development of non-transmissible chronic diseases. Also, it has been suggested that possibly supplementation with micronutrients and the physical exercise during the gestation can regulate these maternal and placental factors. For the reasons just mentioned, it is necessary to clarify if these proposed factors are related to fetal metabolic alterations and if the supplementation during the gestation with micronutrients and/or the physical exercise can regulate them, which would be an early and novel alternative to fortify the prevention of non-transmissible chronic diseases in the population.

Purpose

1. To evaluate the effect of associated both the maternal and placental metabolic factors to non-transmissible chronic diseases in newborn.
2. To evaluate the effect of the physical exercise and the complementation with micronutrients during the pregnancy either in the endothelial function, the levels of adipokines, the oxidative stress of the mother and the newborn, as in the placental mitochondrial function and the anthropometry of newborn.


Options:
A: Inclusion Criteria:

* A diagnosis of major depression according to DSM-IV
* Patient with major depression as part of a bipolar disorder should be in adequate mood stabilizing therapy at entry to the study
* Age of 18 or above
* A score on the Hamilton Depression Scale, 17 items version of at least 18

Exclusion Criteria:

* Primary psychotic disorder
* Psychotic depression
* Drug or alcohol abuse
* Severe organic brain disease
* Severe suicidal ideation (a score of 2 or above on the Hamilton Depression Scale, 17-items version)
* Mental retardation
* Pregnancy or lactation period
B: Inclusion Criteria:

* Primiparous women who have not participated in a structured exercise program, including significant amounts of walking for the past four months are eligible for the trial.
* Live fetus at the routine ultrasound scan and a normal pregnancy.
* Gestational age 16 to 20 weeks
* Written informed consent will be obtained from each woman prior to the inclusion in the study.

Exclusion Criteria:

* History of high blood pressure
* Chronic medical illnesses (cancer, renal, endocrinologic, psychiatric, neurologic, infectious and cardiovascular diseases)
* Persistent bleeding after week 12 of gestation
* Poorly controlled thyroid disease
* Placenta praevia, incompetent cervix, polyhydramnios, oligohydramnios
* History of miscarriage in the last twelve months
* Diseases that could interfere with participation (following recommendations from ACSM 2000, ACOG 2003).
C: Inclusion Criteria. Patients must meet all of the following criteria:

* Active Diabetes (Type 1 \& 2)
* Diagnosis of depression
* Using hypoglycemic medications
* At least 1 outpatient visit in last 12 months
* At least 21 years old

Exclusion Criteria. Patients who have any of the following will be excluded:

* Limited life expectancy (heart failure/ on oxygen/ advanced stage cancer/ dialysis)
* End stage renal disease
* Lung cancer
* Dementia
* Bipolar
* Schizophrenia
* Can't speak English
* Memory problems
* Alcohol problems
* Illegal drug use
* Minimal depressive symptoms
* Blood pressure 180/110 or higher
* Problems with loss of consciousness
* Can't walk 10 minutes on level surface
* Not planning to get their care at study site
* PCP not affiliated with study site
* Are not on a stable regimen (change in depression Rx in last 28-30 days)
* Type 1 diabetic if diagnosed before age 15
D: Inclusion Criteria:

* Meets DSM-IV criteria for major depressive disorder
* Score of 12 to 24 on Hamilton Depression Rating Scale (HDRS)
* Body mass index (BMI) of 30 to 40 kg

Exclusion Criteria:

* Plans to move out of the area during the study
* Current smoker
* Diagnosis of bipolar disorder, a psychotic disorder, bulimia, or post-traumatic stress disorder
* Meets criteria for severe depression (HDRS score greater than 24)
* Diagnosis of type 1 or 2 diabetes
* Plans to have bariatric surgery during the study
* No access to a telephone
* Unable to walk unaided or unable to walk 1/4 mile without stopping
* Does not have written clearance from primary care physician for physical activity
* Presence of a condition that precludes dietary changes (e.g., ulcerative colitis, Crohn's disease, active diverticulitis, renal disease)
* Presence of medical conditions likely to limit lifespan
* Taking prescription weight loss medications
* Initiation of anti-depressant medication within the 3 months prior to study entry
* Taking mood stabilizers, antipsychotic medication, or medications known to affect appetite and/or weight (e.g., corticosteroids)
* Reports active suicidal ideation via SCID interview, a score of 3 on item 24 of the HDRS (active suicidal ideation), or determined to have suicidal potential by clinical staff
* Psychiatric hospitalization in the 12 months prior to study entry
* Currently receiving psychotherapy

Answer: B