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Women who smoke during pregnancy are 2.6 times more likely to give birth prematurely compared with non-smokers – more than double the previous estimate, new research suggests. The University of Cambridge study also found smoking meant the baby was four times more likely to be small for its gestational age, putting it at risk of potentially serious complications including breathing difficulties and infections. There was no evidence caffeine intake was linked to negative outcomes. We’ve known for a long time that smoking during pregnancy is not good for the baby, but our study shows that it’s potentially much worse than previously thought Professor Gordon Smith, University of Cambridge Professor Gordon Smith, head of the department of obstetrics and gynaecology at the University of Cambridge, said: “We’ve known for a long time that smoking during pregnancy is not good for the baby, but our study shows that it’s potentially much worse than previously thought. “It puts the baby at risk of potentially serious complications from growing too slowly in the womb or from being born too soon. “We hope this knowledge will help encourage pregnant mums and women planning pregnancy to access smoking-cessation services. “Pregnancy is a key time when women quit and if they can remain tobacco free after the birth there are lifelong benefits for them and their child.” The NHS recommends that women who are pregnant should stop smoking and limit their caffeine intake because of the risk of complications to the baby. When the toxins from smoke travel through the bloodstream to the baby, it struggles for oxygen. When this happens it affects their development, and is linked to premature birth and low birthweight, though it has also been linked to a reduced risk of pre-eclampsia (high blood pressure during pregnancy). High caffeine intake has also been linked to lower birthweight and possibly foetal growth restriction. But caffeine can be more difficult to avoid than cigarette smoke as, as well as being found in coffee and tea, it can be found in chocolate, energy drinks, soft drinks and certain medications. Researchers say studies looking at the links between smoking and caffeine and their impact on pregnancy tend to rely on people reporting how much they have consumed, or exposure to smoke, data which is not always reliable. Blood tests for metabolites – chemical by-products created when substances such as tobacco and caffeine are processed in the body – might be more accurate. Researchers at Cambridge and the Rosie Hospital, part of Cambridge University Hospitals NHS Foundation Trust, recruited more than 4,200 women who attended the hospital between 2008 and 2012 as part of the Pregnancy Outcome Prediction (POP) study. The team analysed blood samples taken from a group of these women four times during their pregnancies. To assess exposure to cigarette smoke, the team looked at levels of cotinine, which can be detected in blood, urine and saliva. Only two out of three women with detectable levels of cotinine in every blood sample were self-reported smokers, showing that this measure is a more objective way of assessing smoking behaviour, researchers say. A total of 914 women were included in the smoking analysis. Of these, 78.6% were classified as having no exposure to smoking while pregnant, 11.7% as having some exposure and 9.7% as having consistent exposure. The study, published in the International Journal of Epidemiology, found that compared with those without smoke exposure while pregnant, those with consistent exposure were 2.6 times more likely to experience spontaneous preterm birth. According to the researchers, this is more than double the previous estimate of 1.27 from an analysis of multiple studies. They were also 4.1 times as likely to experience foetal growth restriction. Additionally, babies born to smokers were found to be on average 387g lighter than babies born to non-smokers – that is, more than 10% smaller than the weight of an average newborn. This increases the risk that the baby will have a low birth weight (2.5kg or less), which in turn is linked to an increased risk of developmental problems as well as poorer health in later life. Unlike in previous studies, the team found no evidence that smoking reduced the risk of pre-eclampsia. To assess caffeine intake, researchers looked for the metabolite paraxanthine in 915 women. Of these women, 12.8% had low levels of paraxanthine throughout pregnancy (suggesting low caffeine intake), 74.0% had moderate levels and 13.2% had high levels. The researchers say there was little evidence of an association between caffeine intake and any of the negative outcomes. However, because the researchers did not study all possible adverse outcomes of pregnancy, and some of the outcomes not studied – such as stillbirth – have been associated with higher caffeine intake in previous studies, they cannot interpret the findings as indicating that current recommendations around caffeine intake should be changed. The work was supported by the National Institute for Health and Care Research (NIHR), Cambridge Biomedical Research Centre and the Medical Research Council. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Female students ‘more than twice as likely’ to be affected by poor mental health, research shows Many parents of under 5s on less than £50k ‘quit work due to childcare costs’ – survey 5 trainer trends that will be everywhere this autumn

Amid flashing strobe lights at a SoulCycle class in Notting Hill, our instructor MJ stands on a platform, his baseball cap flipped backward and his facial hair trimmed into designer stubble, looking as if he’s straight out of a boy band. “I’ve had a f***ing s*** day and I didn’t want to come to work,” he says, softly, through his head mic. “But I’m so glad I did, as the energy is bringing me to life!” Everyone around me – women between the ages of 25 and 35, all of them dressed in one-shoulder leisurewear – roars in response. “Sit up tall, don’t let anyone make you feel down,” MJ continues. “You’re all legends, don’t let anybody judge you!” I pause for breath after yet another manic burst of energy cycling on the spot. Then we have to pick up dumbbells while atop stationary bikes and do a choreographed workout to a Taylor Swift song. This special Swift-themed class is taking place at 8.30 on a Monday night and in the same venue where First Lady Jill Biden and Rishi Sunak’s wife Akshata Murty attended a spinning class together after King Charles’s coronation in May – reportedly with 10 security guards in tow. I feel slightly out of my depth. I spent two hours looking for my lycra leggings and I’m totally unfit. Apart from walking my dog, I haven’t done any real exercise since 2017, when I had a go at clean eating and did a few weeks of high-intensity training at the gym. But now I’m ready for SoulCycle’s “unique mind-body-soul experience”. This leap back into exercise is partly inspired by Apple TV+’s dark comedy Physical, which is returning for its final season next month. It’s about a housewife played by Rose Byrne who battles her demons and a vicious and self-critical inner voice while finding solace in aerobics. Could it work for me, too? Is exercise the answer to my endlessly spinning mind? Would it serve as an instant catapult into a world of empowerment and success? Everyone in this class knows the words to every Taylor Swift song that booms from the speakers. “Drop everything now/Meet me in the pouring rain”, she sings on “Sparks Fly”. “Kiss me on the sidewalk/Take away the pain.” But all I can think about is the pain I’m currently in. We’re wearing special shoes that click into the pedals of the bike, so it’s not easy to detach oneself. But soon I become grateful for it: if I’m superglued into this class, I can’t give up so easily. As MJ says: “No struggle... no progress”. It doesn’t matter if you can’t move the wheel at the front of the SoulCycle bike, or if you’re peddling down on it like a gazelle; if you’re sweating and panting, you’re part of this love-in. And wow, it feels great. I’m not alone in adoring it, and some of my fellow riders were here even earlier, for “part one” of a class modelled after Swift’s setlist on her current US tour. (Each class costs £26, while a renewable package of four is £86, or eight at £160). It’s a little pocket of joy I knew nothing about while I was sitting at home snacking in front of my laptop and gaining weight. As I leave the SoulCycle studio and wander into the night, I take a deep breath. It feels good to be back in the saddle – even though my legs are like jelly. I have to ask my friend to drive me home because I’m not sure I’ll make it on foot. There are a few reasons I haven’t been hitting the gym, or even doing the occasional relaxed yoga class. Having children on my own has been an intense journey. For years my idea of exercise has been holding a baby or running after two kids in a park with an unruly dog. But when I read a few different headlines lately (“Fit and fabulous at 54: Jennifer Aniston emerges from her new workout class”; “Nicole Kidman, 56, flashes her incredible abs in revealing black dress”), I felt a pang of guilt. These women are older than me but super fit. My daughters, aged five and seven, are both at school now, so there’s no excuse for being so inactive. I had some blood tests done and my cholesterol is creeping up. I’ve been told I need to give up sugar and take up exercise. How can I be a good role model to my kids if all they do is see me eating the chocolate rolls meant for their pack lunches? And where do I even begin with fitness? After the excitement of my Taylor Swift class, the idea of strolling along to my local Virgin Active feels mundane. I ponder whether it’d be easier to stay fit if I was super-rich. I can see myself signing up for four workout sessions rigged up to an electrical current. Because why not? I can’t possibly afford the bespoke, members-only gym Bodyism in London’s Westbourne Grove, whose clients include heiress Tamara Ecclestone. It caters for high-intensity, low-impact training, with top-tier packages costing £23,000 a year. More affordable, though, is their class membership – which costs £1,500 a year for 72 classes and promises to help elongate and tone the body. But it’s also full of the clean-eating squad – I might not fit in. Then there’s London’s BXR, a private, boutique boxing-themed gym that’s spread over two floors. From the street below I can glimpse a massive boxing ring behind enormous glass panels – a manifestation of the idea that celebrities feel they live in a goldfish bowl. It’s also packed with A-listers who get free guest passes while staying at the luxury hotel Chiltern Firehouse that’s located opposite. Membership costs from £2,500 a year and up (by a lot), and the Vogue editor Edward Enniful and fashion designer Julian Macdonald are apparently fans of BXR’s Versaclimbing – a high-intensity, low-impact workout on a Versaclimber. This cardio fitness machine has a 75-degree vertical rail with pedals and handles that mimic the natural motion of climbing. When I hear that the machine burns up to 800 calories in a 45-minute session – well, I’m on the phone to the bookings team in a flash. Unlike treadmill or spin classes, it’s exercise that is full body but low impact – meaning it “minimises unnecessary stress or trauma to your body”. At the state of the art Repose, a wellness clinic in London’s High Street Kensington with members including Made in Chelsea’s Millie Mackintosh, the speciality is “anti-gravity fitness”. It might sound unusual to exercise from a silk hammock suspended from the ceiling for £40 a class – but sessions include pilates, suspension fitness, air bar and both restorative and aerial yoga. Models and celebrities, including Poppy Delevingne, are also queuing up for personal training at London’s E-Pulsive, which costs £85 a session. The electrical muscle stimulation class (EMS) sees you strap yourself into a full-body vest that zaps you with low-frequency electric impulses to manually contract your muscle fibres while you exercise, increasing the intensity of your workout. It seems ideal for people like me who are too busy to exercise but who want superfast results – apparently, a 20-minute EMS workout burns 500 calories and can offer the same results as a 90-minute high-intensity gym class. It sounds like heaven. Then there’s roller-skating at model Liberty Ross’ glamorous Flipper’s Roller Boogie Palace in West London or New York – the original LA Flipper’s in the 1970s was run by Ross’s dad Ian Flipper-Ross, and was so associated with glam fitness that it was dubbed “Studio 54 on wheels”. A one-to-one beginner’s class at the new skate school costs £50, or £35 in a group lesson of up to 12 skaters. Or you can just book in for a general skate with your kids – which kills two birds with one stone as they have fun while you burn calories. A two-hour skate session for adults starts from £15.50 and from £11.50 for children. All of this sounds great – but if I went for a workout schedule of my choice, I can’t see it totalling less than £30,000 a year. Bearing in mind that exercise is addictive and makes you feel good, it might be far more in the long run, too. It’s also a tad out of my price range – I don’t plan on dropping into Equinox on Kensington Roof Gardens or the Bulgari Hotel gym any time soon. Instead, I can see myself signing up for four workout sessions rigged up to an electrical current. Because why not? If money wasn’t an obstacle, I would install a gym and a pilates studio in my own house, with a cryotherapy chamber and a personal trainer on tap. But until then, I plan to start running with the dog, my two kids behind me on their scooters. It’s far cheaper and – unlike the late-night Taylor Swift class – won’t require a babysitter. Read More I keep forgetting my dog’s birthday – could a luxury pet party make it up to him? ‘I’m here anyway, why not?’: My non-surgical facelift has got me thinking about more procedures I’ve never had a platonic relationship with a man – sex can’t help but get in the way Husband fired from family business after wife roleplayed with reborn dolls Montana Brown explains why she chose a home birth as a ‘non-white person’ 8 healthy habits to help you live longer – according to a new study

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Female university students are more than twice as likely as male students to say they have been affected by poor mental health, new analysis suggests. Data shows 12% of female students say they have been affected, compared to 5% of males. Reported mental health problems among university students have almost tripled in recent years, according to the analysis. The percentage of undergraduate students at universities across the UK who said they had experienced mental health difficulties rose from 6% to 16% between the 2016/17 and 2022/23 academic years. It means one in six undergraduates now reports experiencing mental health challenges. The findings suggest further action should be taken to prevent mental health difficulties arising wherever possible, and that services are adequately resourced to support students quickly when they need help Professor Michael Sanders, King’s College London Analysis by the Policy Institute at King’s College London and the Centre for Transforming Access and Student Outcomes in Higher Education (TASO) found a significant part of this increase occurred in the last 12 months, a period during which the cost-of-living crisis intensified. Poor mental health is by far the most common reason for students wanting to drop out of university. Among those considering dropping out, the proportion citing financial distress as the main reason has risen from 3.5% to 8% between 2022 and 2023. But the general upward trend in mental health problems predates both the rise in inflation and the Covid-19 pandemic, indicating that other factors are likely to be at play, researchers said. The analysis – which drew on a dataset of 82,682 full-time UK undergraduates over seven years – shows some groups are more affected than others. Of the non-binary respondents, 42% said they have been affected by poor mental health, along with 30% of trans people. Bisexual people (28%) have the highest average levels of mental health difficulties among LGBTQ groups across the data, while gay men (14%) have the lowest – although this is still greater than the level seen among straight people (7%). White students (12%) have on average worse mental health than their peers from other ethnicities, but those with a “mixed” ethnicity (12%) are just as likely to have mental health difficulties. Undergraduates who attended state schools (15%) have on average worse mental health than their peers who attended private school (11%), while students who get most of their money through a maintenance loan, grant or paid work are more likely to have mental health difficulties than those on scholarships or with family support. Michael Sanders, professor of public policy at the Policy Institute and author of the study, said: “It’s clear the experiences of mental ill-health among students are deeply unequal, and exist along much the same lines as in society at large, with those from the most disadvantaged backgrounds or who often face discrimination being most likely in general to report struggles with their mental health. “The findings suggest further action should be taken to prevent mental health difficulties arising wherever possible, and that services are adequately resourced to support students quickly when they need help.” Dr Omar Khan, chief executive officer of TASO, said: “This report highlights the persistent and widespread mental health challenges faced by students. “While Covid and the cost-of-living crisis have clearly exacerbated such challenges, the upward trend is not new. “We’re working with the higher education sector to better understand what works to improve mental health outcomes for all students.” It comes as a separate report from the NHS Race and Health Observatory calls for more mental health support for people from Gypsy, Roma and Traveller Communities in England. It said that it is estimated that suicide rates among these groups are up to seven times higher than in other communities. Dr Habib Naqvi, chief executive of the NHS Race and Health Observatory, said: “We know that Gypsy, Roma, and Traveller communities face stark challenges in accessing psychological therapies and other mental health services. “This report lays bare the mental health issues and stigma faced by these communities first hand.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Many parents of under 5s on less than £50k ‘quit work due to childcare costs’ – survey 5 trainer trends that will be everywhere this autumn 11 ways to work autumnal wonder at home

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