1.
Mishra, A, et al.
(författare)
Diminishing benefits of urban living for children and adolescents' growth and development
2023
Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 615:7954, s. 874-883
Tidskriftsartikel (refereegranskat) abstract
Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
2.
Bixby, H., et al.
(författare)
Rising rural body-mass index is the main driver of the global obesity epidemic in adults
2019
Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4
Tidskriftsartikel (refereegranskat) abstract
Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
3.
Onerup, Aron, 1983, et al.
(författare)
Associations between cardiorespiratory fitness in youth and the incidence of site-specific cancer in men: a cohort study with register linkage.
2023
Ingår i: British journal of sports medicine. - : BMJ Publishing Group Ltd. - 1473-0480 .- 0306-3674. ; 57:19, s. 1248-1256
Tidskriftsartikel (refereegranskat) abstract
To assess the associations between cardiorespiratory fitness (CRF) in young men and the incidence of site-specific cancer.A Swedish population-based cohort study with register linkage of men who underwent military conscription in 1968-2005 was undertaken. CRF was assessed by maximal aerobic workload cycle test at conscription. Cox regression models assessed linear associations and included CRF, age, year and site of conscription, body mass index and parental level of education. CRF was also categorised into low, moderate and high for facilitated interpretation and results comparing high and low CRF are reported.Primary analyses were performed in 1 078 000 men, of whom 84117 subsequently developed cancer in at least one site during a mean follow-up of 33 years. Higher CRF was linearly associated with a lower hazard ratio (HR) of developing cancer in the head and neck (n=2738, HR 0.81, 95% CI 0.74 to 0.90), oesophagus (n=689, HR 0.61, 95% CI 0.50 to 0.74), stomach (n=902, HR 0.79, 95% CI 0.67 to 0.94), pancreas (n=1280, HR 0.88, 95% CI 0.76 to 1.01), liver (n=1111, HR 0.60, 95% CI 0.51 to 0.71), colon (n=3222, HR 0.82, 95% CI 0.75 to 0.90), rectum (n=2337, HR 0.95, 95% CI 0.85 to 1.05), kidney (n=1753, HR 0.80, 95% CI 0.70 to 0.90) and lung (n=1635, HR 0.58, 95% CI 0.51 to 0.66). However, higher CRF predicted a higher hazard of being diagnosed with prostate cancer (n=14232, HR 1.07, 95% CI 1.03 to 1.12) and malignant skin cancer (n=23064, HR 1.31, 95% CI 1.27 to 1.36).We report a number of protective associations between higher CRF in healthy young men and the subsequent hazard of site-specific cancers. These results have implications for public health policymaking, strengthening the incentive to promote health through improving CRF in youth.
4.
Magnusson, Maria B, 1957, et al.
(författare)
Childhood obesity and prevention in different socio-economic contexts
2011
Ingår i: Preventive medicine. - : Elsevier. - 0091-7435 .- 1096-0260. ; 53:6, s. 402-407
Tidskriftsartikel (refereegranskat) abstract
To assess recent trends in obesity, health beliefs, and lifestyles in Swedish schoolchildren, with focus on socioeconomic disparities. The study was conducted in two areas with high and low socioeconomic status (SES). 340 11-12 year olds participated in three cross-sectional surveys assessing food-related behaviours, physical activity and health beliefs, together with anthropometric examinations. Comparisons were made before and after a community-based intervention (2003 versus 2008) within the low-SES school, and between the low and high-SES school (2008 only). In the low-SES school BMI z-score decreased over 5 years (0.80 vs 0.46) as did the percentage of children frequently consuming sweet drinks (43.5 vs 26.8%), statistically significant in girls only (p<0.05). Children increasingly perceived benefits of healthy life-styles (37 vs 55%). In 2008, consumption of breakfast, vegetables, sweets and sweet drinks differed between schools, as did screen-time and physical activity, all in favour of the high SES-school where the obesity-prevalence was significantly lower (0.8 vs 6.7%). Positive changes in diet and weight status were observed, especially in girls, within a low-income multi-ethnic community undergoing a health promotion intervention. Our results underscore the multifactorial etiology of childhood obesity and the importance of continuing tailored, gender-sensitive prevention efforts.
5.
Johansson, Lena, 1972, et al.
(författare)
Midlife Psychological Distress Associated With Late-Life Brain Atrophy and White Matter Lesions: A 32-Year Population Study of Women.
2012
Ingår i: Psychosomatic medicine. - 0033-3174. ; 74:2, s. 120-125
Tidskriftsartikel (refereegranskat) abstract
Long-standing psychological distress increases the risk of dementia, especially Alzheimer's disease. The present study examines the relationship between midlife psychological distress and late-life brain atrophy and white matter lesions (WMLs), which are common findings on neuroimaging in elderly subjects. A population-based sample of 1462 women, aged 38 to 60 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, and 2000. Computed tomography (CT) of the brain was done in 379 survivors in 2000, and of those, 344 had responded to a standardized question about psychological distress in 1968, 1974, and 1980. WMLs, cortical atrophy, and central atrophy (ventricular sizes) were measured at CT scans. Compared with women reporting no distress, those reporting frequent or constant distress at one examination or more (in 1968, 1974, and 1980) more often had moderate-to-severe WMLs (multiadjusted odds ratio = 2.39, 95% confidence interval = 1.16-4.92) and moderate-to-severe temporal lobe atrophy (multiadjusted odds ratio = 2.51, 95% confidence interval = 1.04-6.05) on brain CT in 2000. Frequent/constant distress was also associated with central brain atrophy, that is, higher bicaudate ratio, higher cella media ratio, and larger third-ventricle width. Long-standing psychological distress in midlife increases risks of cerebral atrophy and WMLs on CT in late life. More studies are needed to confirm these findings and to determine potential neurobiological mechanisms of these associations.
6.
7.
Blomstrand, Ann, et al.
(författare)
Forty-four-year longitudinal study of stroke incidence and risk factors - the Prospective Population Study of Women in Gothenburg
2022
Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 40:1, s. 139-147
Tidskriftsartikel (refereegranskat) abstract
Objective To assess stroke incidence over 44 years and association with risk factors. To study total stroke incidence at 60-82 years of age and risk factors. Design Prospective population study. Setting Gothenburg, Sweden, with similar to 450,000 inhabitants. Subjects A representative sample of a general population of women (1462 in total) in 5 age strata aged 38-60 years in 1968-1969 (the Population Study of Women in Gothenburg, PSWG) were followed up to the ages of 82-104 years in 2012. Further, analysis was also performed for the age interval 60-82 years. Main outcome measures Incidence of total stroke (TS), ischaemic (IS), haemorrhagic (HS), non-specified (NS) and fatal (FS) strokes and association with baseline classic risk factors (such as hypertension, atrial fibrillation, low physical activity, diabetes, high waist-hip-ratio, hyperlipidaemia, smoking), low education, mental stress, pre-eclampsia and oral health as expressed by loss of teeth and bone score. Blood pressure in levels 1-3 according to modern guidelines. Associations with atrial fibrillation, diabetes and myocardial infarction shown in survival analyses. The five cohorts contributed to risk time data concerning associations with TS in the 60-82 age interval from the examination performed when they were 60. Results Three hundred and thirty-seven (23%) women had a first-ever stroke, 64 (19%) fatal. TS was associated with physical inactivity, high triglycerides and low education in multivariable analysis. The main sub-type IS was associated with systolic blood pressure, physical inactivity and low education. Pre-eclampsia showed association with IS only in the univariable analysis. FS was associated with systolic blood pressure and smoking. During 60-82 years of age, having <20 teeth (HR 1.74, CI 1.25-2.42), diabetes (HR 2.28 CI 1.09-4.76), WHR (HR 1.29 per 0.1 units CI 1.01-1.63), systolic blood pressure (HR 1.11 per 10 units CI 1.04-1.18) and smoking (HR 1.57, CI 1.14-2.16), were associated with TS in the combined five cohorts. Conclusions Several classic risk factors showed independent associations with stroke. Vulnerability factors as low education and oral health, reflected by loss of teeth, also showed association with stroke. All these factors are possible to target in primary care preventive interventions.
8.
Fridolfsson, Jonatan, 1992, et al.
(författare)
Effects of Frequency Filtering on Intensity and Noise in Accelerometer-Based Physical Activity Measurements.
2019
Ingår i: Sensors. - : MDPI. - 1424-8220. ; 19:9
Tidskriftsartikel (refereegranskat) abstract
In objective physical activity (PA) measurements, applying wider frequency filters than the most commonly used ActiGraph (AG) filter may be beneficial when processing accelerometry data. However, the vulnerability of wider filters to noise has not been investigated previously. This study explored the effect of wider frequency filters on measurements of PA, sedentary behavior (SED), and capturing of noise. Apart from the standard AG band-pass filter (0.29-1.63 Hz), modified filters with low-pass component cutoffs at 4 Hz, 10 Hz, or removed were analyzed. Calibrations against energy expenditure were performed with lab data from children and adults to generate filter-specific intensity cut-points. Free-living accelerometer data from children and adults were processed using the different filters and intensity cut-points. There was a contribution of acceleration related to PA at frequencies up to 10 Hz. The contribution was more pronounced at moderate and vigorous PA levels, although additional acceleration also occurred at SED. The classification discrepancy between AG and the wider filters was small at SED (1-2%) but very large at the highest intensities (>90%). The present study suggests an optimal low-pass frequency filter with a cutoff at 10 Hz to include all acceleration relevant to PA with minimal effect of noise.
9.
Hunsberger, Monica, 1973, et al.
(författare)
Bidirectional associations between psychosocial well-being and body mass index in European children: longitudinal findings from the IDEFICS study
2016
Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16
Tidskriftsartikel (refereegranskat) abstract
Background: The negative impact of childhood overweight on psychosocial well-being has been demonstrated in a number of studies. There is also evidence that psychosocial well-being may influence future overweight. We examined the bidirectional association between childhood overweight and psychosocial well-being in children from a large European cohort. The dual aim was to investigate the chronology of associations between overweight and psychosocial health indicators and the extent to which these associations may be explained by parental education. Methods: Participants from the IDEFICS study were recruited from eight countries between September 2007 and June 2008 when the children were aged 2 to 9.9 years old. Children and families provided data on lifestyle, psychosocial well-being, and measured anthropometry at baseline and at follow-up 2 years later. This study includes children with weight, height, and psychosocial well-being measurements at both time points (n = 7,831). Psychosocial well-being was measured by the KINDL (R) and Strengths and Difficulties Questionnaire respectively. The first instrument measures health-related quality of life including emotional well-being, self-esteem, parent relations and social relations while the second measures well-being based on emotional symptoms, conduct problems and peer-related problems. Logistic regression was used for modeling longitudinal associations. Results: Children who were overweight at baseline had increased risk of poor health-related quality of life (odds ratio (OR) = 1.23; 95 % confidence interval (CI): 1.03-1.48) measured 2 years later; this association was unidirectional. In contrast to health-related quality of life, poor well-being at baseline was associated with increased risk of overweight (OR = 1.39; 95 % CI: 1.03-1.86) at 2 year follow-up; this association was also only observed in one direction. Adjustment for parental education did not change our findings. Conclusion: Our findings indicate that the association between overweight and psychosocial well-being may be bidirectional but varies by assessment measures. Future research should further investigate which aspects of psychosocial well-being are most likely to precede overweight and which are more likely to be consequences of overweight.
10.
Björkelund, Cecilia, 1948, et al.
(författare)
Secular trends in cardiovascular risk factors with a 36-year perspective: observations from 38- and 50-year-olds in the Population Study of women in Gothenburg
2008
Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 26:3, s. 140-6
Tidskriftsartikel (refereegranskat) abstract
Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy, University of Gothenburg, Sweden. cecilia.bjorkelund@allmed.gu.se OBJECTIVES: To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. DESIGN: Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. SETTING: Gothenburg, Sweden with approximately 450,000 inhabitants. SUBJECTS: Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). MAIN OUTCOME MEASURES: Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. RESULTS: There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. CONCLUSIONS: Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.
