| 1. |
- Blane, David, et al.
(författare)
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What can the life course approach contribute to an understanding of longevity risk?
- 2016
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Ingår i: Longitudinal and Life Course Studies. - : Bristol University Press. - 1757-9597. ; 7:2, s. 165-196
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Tidskriftsartikel (refereegranskat)abstract
- Longevity risk means living longer than predicted. Attempts to understand longevity risk to date have concentrated on single diseases, usually coronary heart disease, and sought explanations in terms of risk factor change and medical innovation. In an opening paper, David Blane and colleagues point to evidence that suggests changes in positive health also should be considered; and that a life course approach can do so in a way that is socially and biologically plausible. Applying this approach to UK citizens currently aged 85 years suggests that life course research should give priority to trajectories across the whole life course and to the social and material contexts through which each cohort has passed. Testing these ideas will require inter-disciplinary and international comparative research. The opening paper is followed by commentaries from Hans-Werner Wahl, Mark Hayward, Aart Liefbroer and Gita Mishra. Finally Blane and colleagues respond to the points raised by the commentators.
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| 2. |
- Blodgett, Joanna M., et al.
(författare)
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Device-measured physical activity and cardiometabolic health : the Prospective Physical Activity, Sitting, and Sleep (ProPASS) consortium
- 2023
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Ingår i: European Heart Journal. - 0195-668X .- 1522-9645.
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: Physical inactivity, sedentary behaviour (SB), and inadequate sleep are key behavioural risk factors of cardiometabolic diseases. Each behaviour is mainly considered in isolation, despite clear behavioural and biological interdependencies. The aim of this study was to investigate associations of five-part movement compositions with adiposity and cardiometabolic biomarkers.Methods: Cross-sectional data from six studies (n = 15 253 participants; five countries) from the Prospective Physical Activity, Sitting and Sleep consortium were analysed. Device-measured time spent in sleep, SB, standing, light-intensity physical activity (LIPA), and moderate-vigorous physical activity (MVPA) made up the composition. Outcomes included body mass index (BMI), waist circumference, HDL cholesterol, total:HDL cholesterol ratio, triglycerides, and glycated haemoglobin (HbA1c). Compositional linear regression examined associations between compositions and outcomes, including modelling time reallocation between behaviours.Results: The average daily composition of the sample (age: 53.7 ± 9.7 years; 54.7% female) was 7.7 h sleeping, 10.4 h sedentary, 3.1 h standing, 1.5 h LIPA, and 1.3 h MVPA. A greater MVPA proportion and smaller SB proportion were associated with better outcomes. Reallocating time from SB, standing, LIPA, or sleep into MVPA resulted in better scores across all outcomes. For example, replacing 30 min of SB, sleep, standing, or LIPA with MVPA was associated with −0.63 (95% confidence interval −0.48, −0.79), −0.43 (−0.25, −0.59), −0.40 (−0.25, −0.56), and −0.15 (0.05, −0.34) kg/m2 lower BMI, respectively. Greater relative standing time was beneficial, whereas sleep had a detrimental association when replacing LIPA/MVPA and positive association when replacing SB. The minimal displacement of any behaviour into MVPA for improved cardiometabolic health ranged from 3.8 (HbA1c) to 12.7 (triglycerides) min/day.Conclusions: Compositional data analyses revealed a distinct hierarchy of behaviours. Moderate-vigorous physical activity demonstrated the strongest, most time-efficient protective associations with cardiometabolic outcomes. Theoretical benefits from reallocating SB into sleep, standing, or LIPA required substantial changes in daily activity.
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| 3. |
- Gao, Menghan, et al.
(författare)
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Developmental origins of endometriosis : a Swedish cohort study
- 2019
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 73:4, s. 353-359
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Endometriosis is a chronic condition affecting women of reproductive age and is associated with multiple health burdens. Yet, findings regarding its 'developmental origins' are inconsistent. We aimed to investigate the associations of birth characteristics with endometriosis. We also explored potential mediation by adult social and reproductive factors.METHODS: This cohort study consisted of 3406 women born in Uppsala, Sweden, between 1933 and 1972. We used data from archived birth records and endometriosis diagnoses at ages 15-50 recorded in the national patient registers. Socioeconomic and reproductive characteristics were obtained from routine registers. HRs were estimated from Cox regression.RESULTS: During the follow-up, 111 women have been diagnosed with endometriosis, and most cases are external endometriosis (ie, outside the uterus, n=91). Lower standardised birth weight for gestational age was associated with increased rate of endometriosis (HR 1.35 per standard deviation decrease; 95% CI 1.08 to 1.67). This increased rate was also detected among women with fewer number of live births (HR 2.38; 95% CI 1.40 to 4.07 for one child vs ≥2 children; HR 6.09; 95% CI 3.88 to 9.57 for no child vs ≥2 children) and diagnosed infertility problem (HR 2.00; 95% CI 1.10 to 3.61) prior to endometriosis diagnosis. All the observed associations were stronger for external endometriosis. However, no evidence was found that number of births was the mediator of the inverse association between standardised birth weight and endometriosis.CONCLUSION: This study supports the developmental origins theory and suggests that exposure to growth restriction during the fetal period is associated with increased risk of endometriosis during reproductive years.
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| 5. |
- Heshmati, Amy Frances, et al.
(författare)
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Childhood and adulthood socio-economic position and hypertensive disorders in pregnancy: the Uppsala Birth Cohort Multigenerational Study
- 2013
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 67:11, s. 939-946
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Tidskriftsartikel (refereegranskat)abstract
- Background Childhood and adulthood socio-economic position (SEP) is associated with cardiovascular disease in later life, but associations with hypertensive disorders in pregnancy are not well established. Objective The aim of this study was to investigate the association of childhood and adulthood SEP with hypertensive disorders in pregnancy (chronic hypertension, gestational hypertension and pre-eclampsia/eclampsia). Method Study participants were Swedish women (n=9507) from generation 3 of the Uppsala Birth Cohort Multigenerational Study (UBCoS Multigen) who delivered a live singleton offspring between 1982 and 2008. Social and health data were obtained from routine Swedish registers. Associations of own education (adulthood SEP), and parental education and social class (childhood SEP) with hypertensive disorders were studied using logistic regression with adjustments for age, calendar period, parity, smoking and body mass index. Results Low own education was associated with chronic hypertension, but not with gestational hypertension or pre-eclampsia/eclampsia. Increased risk of chronic hypertension was seen in women whose mothers had medium education compared with women whose mothers had high education (OR 2.18, 95% CI 1.03 to 4.62). Women from a manual social class during childhood had twice the risk of chronic hypertension compared with those from non-manual backgrounds (OR 2.19, 95% CI 1.28 to 3.75). Childhood SEP was not associated with gestational hypertension or pre-eclampsia/eclampsia. Conclusions Childhood and adulthood SEP was associated with chronic hypertension in pregnancy. In contrast, no association with childhood or adulthood SEP was seen for gestational hypertension or pre-eclampsia/eclampsia.
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| 6. |
- Heshmati, Amy, et al.
(författare)
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Socio-economic position at four time points across the life course and all-cause mortality : updated results from the Uppsala Birth Cohort Multigenerational Study
- 2020
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Ingår i: Longitudinal and Life Course Studies. - 1757-9597. ; 11:1, s. 27-54
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Tidskriftsartikel (refereegranskat)abstract
- Socio-economic position (SEP) is associated with all-cause mortality across all stages of the life course; however, it is valuable to distinguish at what time periods SEP has the most influence on mortality. Our aim was to investigate whether the effect of SEP on all-cause mortality accumulates over the life course or if some periods of the life course are more important. Our study population were from the Uppsala Birth Cohort Multigenerational Study, born 1915–29 at Uppsala University Hospital, Sweden. We followed 3,951 men and 3,601 women who had SEP at birth available, during childhood (at age ten), in adulthood (ages 30–45) and in later life (ages 50–65) from 15 September 1980 until emigration, death or until 31 December 2010. We compared a set of nested Cox proportional regression models, each corresponding to a specific life course model (critical, sensitive and accumulation models), to a fully saturated model, to ascertain which model best describes the relationship between SEP and mortality. Analyses were stratified by gender. For both men and women the effect of SEP across the life course on all-cause mortality is best described by the sensitive period model, whereby being advantaged in later life (ages 50–65 years) provides the largest protective effect. However, the linear accumulation model also provided a good fit of the data for women suggesting that improvements in SEP at any stage of the life course corresponds to a decrease in all-cause mortality.
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| 7. |
- Holowko, Natalie, et al.
(författare)
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Combined effect of education and reproductive history on weight trajectories of young Australian women : A longitudinal study
- 2016
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Ingår i: Obesity. - : Wiley. - 1930-7381 .- 1930-739X. ; 24:10, s. 2224-2231
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo investigate the combined effect of education and reproductive history on weight trajectory.MethodsThe association of education with weight trajectory (1996–2012) in relation to reproductive history was analyzed among 9,336 women (born 1973–1978) from the Australian Longitudinal Study on Women's Health using random effects models.ResultsCompared with women with a university degree/higher, lower-educated women were 2 kg heavier at baseline and gained an additional 0.24 kg/year. Giving birth was associated with an increase in weight which was more pronounced among women having their first birth <26 years of age (2.1 kg, 95% CI: 1.5–2.7), compared with 26 to 32 years or >32 years. While younger first-time mothers had a steeper weight trajectory (∼+0.16 kg/year, 95% CI: 0.1–0.3), this was less steep among lower-educated women. High-educated women with a second birth between 26 and 32 years had 0.9 kg decreased weight after this birth, while low-educated women gained 0.9 kg.ConclusionsWhile the effect of having children on weight in young adulthood was minimal, women having their first birth <26 years of age had increased risk of weight gain, particularly primiparous women. Educational differences in weight persisted after accounting for reproductive history, suggesting a need to explore alternative mechanisms through which social differences in weight are generated.
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| 8. |
- Holowko, Natalie, et al.
(författare)
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Educational mobility and weight gain over 13 years in a longitudinal study of young women
- 2014
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 14, s. 1219-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Limited evidence exists about the role of education and own educational mobility on body weight trajectory. A better understanding of how education influences long term weight gain can help us to design more effective health policies. Methods: Using random effects models, the association between i) highest education (n = 10 018) and ii) educational mobility over a 9 year period (n = 9 907) and weight gain was analysed using five waves of data (over 13 years) from the Australian Longitudinal Study on Women's Health 1973-78 cohort (from 18-23 years to 31-36 years). Results: Highest educational attainment was inversely associated with weight at baseline and weight gain over 13 years. Compared to high educated women, those with a low (12 years or less) or intermediate (trade/certificate/diploma) education, respectively, weighed an additional 2.6 kg (95% CI: 1.9 to 3.1) and 2.5 kg (95% CI: 1.9 to 3.3) at baseline and gained an additional 3.9 kg (95% CI: 2.6 to 5.2) and 3.1 kg (95% CI: 2.6 to 3.9) over 13 years. Compared to women who remained with a low education, women with the greatest educational mobility had similar baseline weight to the women who already had a high education at baseline (2.7 kg lighter (95% CI:-3.7 to -1.8) and 2.7 kg lighter (95% CI:-3.4 to -1.9), respectively) and similarly favourable weight gain (gaining 3.1 kg less (95% CI:-4.0 to -2.21) and 4.2 kg less (95% CI:-4.8 to -3.4) over the 13 years, respectively). Conclusions: While educational attainment by mid-thirties was positively associated with better weight management, women's weight was already different in young adult age, before their highest education was achieved. These findings highlight a potential role of early life factors and personality traits which may influence both education and weight outcomes.
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| 9. |
- Holowko, Natalie, et al.
(författare)
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High education and increased parity are associated with breast-feeding initiation and duration among Australian women
- 2016
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 19:14, s. 2551-2561
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Breast-feeding is associated with positive maternal and infant health and development outcomes. To assist identifying women less likely to meet infant nutritional guidelines, we investigated the role of socio-economic position and parity on initiation of and sustaining breast-feeding for at least 6 months.Design: Prospective cohort study.Setting: Australia.Subjects: Parous women from the Australian Longitudinal Study on Women’s Health (born 1973–78), with self-reported reproductive and breast-feeding history (N 4777).Results: While 89 % of women (83 % of infants) had ever breast-fed, only 60 % of infants were breast-fed for at least 6 months. Multiparous women were more likely to breast-feed their first child (~90 % v. ~71 % of primiparous women), and women who breast-fed their first child were more likely to breast-feed subsequent children. Women with a low education (adjusted OR (95 % CI): 2·09 (1·67, 2·62)) or a very low-educated parent (1·47 (1·16, 1·88)) had increased odds of not initiating breast-feeding with their first or subsequent children. While fewer women initiated breast-feeding with their youngest child, this was most pronounced among high-educated women. While ~60 % of women breast-fed their first, second and third child for at least 6 months, low-educated women (first child, adjusted OR (95 % CI): 2·19 (1·79, 2·68)) and women with a very low (1·82 (1·49, 2·22)) or low-educated parent (1·69 (1·33, 2·14)) had increased odds of not breast-feeding for at least 6 months.Conclusions: A greater understanding of barriers to initiating and sustaining breastfeeding, some of which are socio-economic-specific, may assist in reducing inequalities in infant breast-feeding.
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| 10. |
- Holowko, Natalie, et al.
(författare)
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Social inequality in excessive gestational weight gain
- 2014
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 38:1, s. 91-96
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Optimal gestational weight gain (GWG) leads to better outcomes for both the mother and child, whereas excessive gains can act as a key stage for obesity development. Little is known about social inequalities in GWG. This study investigates the influence of education level on pre-pregnancy body mass index (BMI) and GWG.Design: Register-based population study.Setting: SwedenParticipants: Four thousand and eighty women born in Sweden who were a part of the third generation Uppsala Birth Cohort Study. Register data linkages were used to obtain information on social characteristics, BMI and GWG of women with singleton first births from 1982 to 2008.Main outcome measure: Pre-pregnancy BMI and the Institute of Medicine’s (IOM) categories of GWG for a given pre-pregnancy BMI. Results were adjusted for calendar period, maternal age, living arrangements, smoking, history of chronic disease and pre-pregnancy BMI when appropriate.Results: Although most women (67%) were of healthy pre-pregnancy BMI, 20% were overweight and 8% were obese. Approximately half of all women in the sample had excessive GWG, with higher pre-pregnancy BMI associated with higher risk of excessive GWG, regardless of education level; this occurred for 76% of overweight and 75% of obese women. Lower educated women with a healthy pre-pregnancy BMI were at greater risk of excessive GWG—odds ratio 1.76 (95% confidence interval 1.28–2.43) for elementary and odds ratio 1.32 (1.06–1.64) for secondary compared with tertiary educated, adjusted for age and birth year period. Nearly half of women with an elementary or secondary education (48%) gained weight excessively.Conclusion: Education did not provide a protective effect in avoiding excessive GWG among overweight and obese women, of whom ~75% gained weight excessively. Lower educated women with a BMI within the healthy range, however, are at greater risk of excessive GWG. Health professionals need to tailor their pre-natal advice to different groups of women in order to achieve optimal pregnancy outcomes and avoid pregnancy acting as a stage in the development of obesity.
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