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1.
  • Arvidsson, Daniel, et al. (författare)
  • Med accelerometrar kan fysisk aktivitet mätas objektivt
  • 2019
  • Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 116, s. 1654-1658
  • Tidskriftsartikel (refereegranskat)abstract
    • Accelerometrar används i stor utsträckning inom forskning och i viss grad i klinisk verksamhet för att fastställa fysisk aktivitet, men de ställer krav på användarna. God kännedom krävs om utformning av mätprotokoll och bearbetning av rådata till användbara mått, som kan användas i lämpliga statistiska analyser för att undvika mätfel.Mätfel medför felskattning av den fysiska aktiviteten, uteblivna gruppskillnader, försvagade samband med hälsa och felaktiga slutsatser om interventionseffekter.Mätning av fysisk aktivitet i klinisk verksamhet främjas genom samarbete mellan kliniskt verksamma, kliniska forskare och forskare med metodologisk kompetens inom fysisk aktivitetsmätning.
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2.
  • Arvidsson, Daniel, et al. (författare)
  • Med accelerometrar kan fysisk aktivitet mätas objektivt : [Physical activity measured with accelerometers].
  • 2019
  • Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 116
  • Tidskriftsartikel (refereegranskat)abstract
    • The development of accelerometers has revolutionized measurement of physical activity, and they are used to a large extent in research and have started to be implemented into clinical settings. However, achievement of reliable outcomes requires good methodological knowledge and skills by the user. Otherwise, significant measurement errors may occur, interfering with assessment of the physical activity level in the population, group differences, associations with health parameters or effect of treatments. This paper by the Swedish Network for Objective Measurement of Movement (NORM) provides an overview of physical activity measurement including sections of data collection, processing of raw data into useful metrics and statistical analysis. It targets users of accelerometer in research, health care and national surveys.
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3.
  • Arvidsson, Daniel, 1974, et al. (författare)
  • Med accelerometrar kan fysisk aktivitet mätas objektivt- Snabb metodutveckling, men mer kompetens krävs för användning fullt ut i klinisk praxis : Physical Activity Measured With Accelerometers
  • 2019
  • Ingår i: Läkartidningen. - 1652-7518. ; 116
  • Forskningsöversikt (refereegranskat)abstract
    • The development of accelerometers has revolutionized measurement of physical activity, and they are used to a large extent in research and have started to be implemented into clinical settings. However, achievement of reliable outcomes requires good methodological knowledge and skills by the user. Otherwise, significant measurement errors may occur, interfering with assessment of the physical activity level in the population, group differences, associations with health parameters or effect of treatments. This paper by the Swedish Network for Objective Measurement of Movement (NORM) provides an overview of physical activity measurement including sections of data collection, processing of raw data into useful metrics and statistical analysis. It targets users of accelerometer in research, health care and national surveys.
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4.
  • Lundgren, Markus, et al. (författare)
  • Analgesic antipyretic use among young children in the TEDDY study : No association with islet autoimmunity
  • 2017
  • Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 17:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.
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5.
  • Ahlqvist, Viktor H, et al. (författare)
  • Birth Weight and Cardiorespiratory Fitness Among Young Men Born at Term : The Role of Genetic and Environmental Factors
  • 2020
  • Ingår i: Journal of the American Heart Association. - : American Heart Association. - 2047-9980. ; 9:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Preterm delivery and low birth weight are prospectively associated with low cardiorespiratory fitness (CRF). However, whether birth weight, within the at-term range, is associated with later CRF is largely unknown. Thus, the aim of the current study was to examine this issue and whether such association, if any, is explained by shared and/or nonshared familial factors.Methods and Results: We conducted a prospective cohort study, including 286 761 young male adults and a subset of 52 544 siblings born at-term. Objectively measured data were retrieved from total population registers. CRF was tested at conscription and defined as the maximal load obtained on a cycle ergometer. We used linear and nonlinear and fixed-effects regression analyses to explore associations between birth weight and CRF. Higher birth weight, within the at-term range, was strongly associated with increasing CRF in a linear fashion. Each SD increase in birth weight was associated with an increase of 7.9 (95% CI, 7.8-8.1) and 6.6 (95% CI; 5.9-7.3) Wmax in the total and sibling cohorts, respectively. The association did not vary with young adulthood body mass index.Conclusions: Birth weight is strongly associated with increasing CRF in young adulthood among men born at-term, across all categories of body mass index. This association appears to be mainly driven by factors that are not shared between siblings. Hence, CRF may to some extent be determined already in utero. Prevention of low birth weight, also within the at-term-range, can be a feasible mean of increasing adult CRF and health.
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6.
  • Ahlqvist, Viktor H., et al. (författare)
  • Birth weight and grip strength in young Swedish males : a longitudinal matched sibling analysis and across all body mass index ranges
  • 2019
  • Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • Low birth weight is associated with a lower grip strength later in life. However, associations between birth weight among infants born at-term and factors driving associations between birth weight and grip strength are largely unknown. A cohort of 144,369 young men born at-term, including 10,791 individuals who had at least one male sibling/s, were followed until conscription where they performed a grip strength test. We used linear and non-linear regression analyses in the full cohort, and fixed-effects regression analyses in the sibling cohort, to address confounding by factors that are shared between siblings. After adjustment, each unit increase in birth weight z-score was associated with increases of 17.7 (95% CI, 17.2-18.2) and 13.4 (10.1-16.6) newton grip strength, which converts to approximately 1.8 and 1.4 kilogram-force in the full and within-families cohorts, respectively. The associations did not vary with young adulthood BMI. Birth weight, within the at-term range, is robustly positively associated with grip strength in young adulthood among men across all BMI categories and associations appears to be mainly driven by factors that are not shared between siblings. These findings underline the importance of recognizing the influence of low birth weight, also within the at-termrange, on young adulthood muscle strength.
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7.
  • Ahlqvist, Viktor H., et al. (författare)
  • Caesarean section and its relationship to offspring general cognitive ability : a registry-based cohort study of half a million young male adults
  • 2022
  • Ingår i: Evidence-Based Mental Health. - : BMJ Publishing Group Ltd. - 1362-0347 .- 1468-960X. ; 25, s. 7-14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A relationship between caesarean section and offspring cognitive ability has been described, but data are limited, and a large-scale study is needed.Objective: To determine the relationship between mode of delivery and general cognitive ability.Methods: A cohort of 579 244 singleton males, born between 1973 and 1987 who conscripted before 2006, were identified using the Swedish population-based registries. Their mode of delivery was obtained from the Swedish Medical Birth registry. The outcome measure was a normalised general cognitive test battery (mean 100, SD 15) performed at military conscription at around age 18.Findings: Males born by caesarean section performed poorer compared with those born vaginally (mean score 99.3 vs 100.1; adjusted mean difference -0.84; 95% CI -0.97 to -0.72; p<0.001). Both those born by elective (99.3 vs 100.2; -0.92; 95% CI -1.24 to -0.60; p<0.001) and non-elective caesarean section (99.2 vs 100.2; -1.03; 95% CI -1.34 to -0.72; p=0.001), performed poorer than those born vaginally. In sibling analyses, the association was attenuated to the null (100.9 vs 100.8; 0.07; 95% CI -0.31 to 0.45; p=0.712). Similarly, neither elective nor non-elective caesarean section were associated with general cognitive ability in sibling analyses.Conclusion: Birth by caesarean section is weakly associated with a lower general cognitive ability in young adult males. However, the magnitude of this association is not clinically relevant and seems to be largely explained by familial factors shared between siblings.Clinical implication: Clinicians and gravidas ought not to be concerned that the choice of mode of delivery will impact offspring cognitive ability.
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8.
  • Ahlqvist, Viktor H., et al. (författare)
  • Elective and nonelective cesarean section and obesity among young adult male offspring : A Swedish population-based cohort study
  • 2019
  • Ingår i: PLoS Medicine. - : PUBLIC LIBRARY SCIENCE. - 1549-1277 .- 1549-1676. ; 16:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous studies have suggested that cesarean section (CS) is associated with offspring overweight and obesity. However, few studies have been able to differentiate between elective and nonelective CS, which may differ in their maternal risk profile and biological pathway. Therefore, we aimed to examine the association between differentiated forms of delivery with CS and risk of obesity in young adulthood.Methods and findings: Using Swedish population registers, a cohort of 97,291 males born between 1982 and 1987 were followed from birth until conscription (median 18 years of age) if they conscripted before 2006. At conscription, weight and height were measured and transformed to World Health Organization categories of body mass index (BMI). Maternal and infant data were obtained from the Medical Birth Register. Associations were evaluated using multinomial and linear regressions. Furthermore, a series of sensitivity analyses were conducted, including fixed-effects regressions to account for confounders shared between full brothers. The mothers of the conscripts were on average 28.5 (standard deviation 4.9) years old at delivery and had a prepregnancy BMI of 21.9 (standard deviation 3.0), and 41.5% of the conscripts had at least one parent with university-level education.Out of the 97,291 conscripts we observed, 4.9% were obese (BMI ≥ 30) at conscription. The prevalence of obesity varied slightly between vaginal delivery, elective CS, and nonelective CS (4.9%, 5.5%, and 5.6%, respectively), whereas BMI seemed to be consistent across modes of delivery. We found no evidence of an association between nonelective or elective CS and young adulthood obesity (relative risk ratio 0.96, confidence interval 95% 0.83–1.10, p = 0.532 and relative risk ratio 1.02, confidence interval 95% 0.88–1.18, p = 0.826, respectively) as compared with vaginal delivery after accounting for prepregnancy maternal BMI, maternal diabetes at delivery, maternal hypertension at delivery, maternal smoking, parity, parental education, maternal age at delivery, gestational age, birth weight standardized according to gestational age, and preeclampsia. We found no evidence of an association between any form of CS and overweight (BMI ≥ 25) as compared with vaginal delivery. Sibling analysis and several sensitivity analyses did not alter our findings. The main limitations of our study were that not all conscripts had available measures of anthropometry and/or important confounders (42% retained) and that our cohort only included a male population.Conclusions: We found no evidence of an association between elective or nonelective CS and young adulthood obesity in young male conscripts when accounting for maternal and prenatal factors. This suggests that there is no clinically relevant association between CS and the development of obesity. Further large-scale studies are warranted to examine the association between differentiated forms of CS and obesity in young adult offspring.Trial registration: Registered as observational study at ClinicalTrials.gov Identifier: NCT03918044.
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9.
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10.
  • Ballin, Marcel, et al. (författare)
  • Genetic and Environmental Factors and Cardiovascular Disease Risk in Adolescents
  • 2023
  • Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 6:11
  • Tidskriftsartikel (refereegranskat)abstract
    • Importance  Cardiovascular risk factors in youth have been associated with future cardiovascular disease (CVD), but conventional observational studies are vulnerable to genetic and environmental confounding.Objective  To examine the role of genetic and environmental factors shared by full siblings in the association of adolescent cardiovascular risk factors with future CVD.Design, Setting, and Participants  This is a nationwide cohort study with full sibling comparisons. All men who underwent mandatory military conscription examinations in Sweden between 1972 and 1995 were followed up until December 31, 2016. Data analysis was performed from May 1 to November 10, 2022.Exposures  Body mass index (BMI), cardiorespiratory fitness, blood pressure, handgrip strength, and a combined risk z score in late adolescence.Main Outcomes and Measures  The primary outcome was fatal or nonfatal CVD, as recorded in the National Inpatient Register or the Cause of Death Register before 2017.Results  A total of 1 138 833 men (mean [SD] age, 18.3 [0.8] years), of whom 463 995 were full brothers, were followed up for a median (IQR) of 32.1 (26.7-37.7) years, during which 48 606 experienced a CVD outcome (18 598 among full brothers). All risk factors were associated with CVD, but the effect of controlling for unobserved genetic and environmental factors shared by full siblings varied. In the sibling analysis, hazard ratios for CVD (top vs bottom decile) were 2.10 (95% CI, 1.90-2.32) for BMI, 0.77 (95% CI, 0.68-0.88) for cardiorespiratory fitness, 1.45 (95% CI, 1.32-1.60) for systolic blood pressure, 0.90 (95% CI, 0.82-0.99) for handgrip strength, and 2.19 (95% CI, 1.96-2.46) for the combined z score. The percentage attenuation in these hazard ratios in the sibling vs total cohort analysis ranged from 1.1% for handgrip strength to 40.0% for cardiorespiratory fitness. Consequently, in the sibling analysis, the difference in cumulative CVD incidence at age 60 years (top vs bottom decile) was 7.2% (95% CI, 5.9%-8.6%) for BMI and 1.8% (95% CI, 1.0%-2.5%) for cardiorespiratory fitness. Similarly, in the sibling analysis, hypothetically shifting everyone in the worst deciles of BMI to the middle decile would prevent 14.9% of CVD at age 60 years, whereas the corresponding number for cardiorespiratory fitness was 5.3%.Conclusions and Relevance  In this Swedish national cohort study, cardiovascular risk factors in late adolescence, especially a high BMI, were important targets for CVD prevention, independently of unobserved genetic and environmental factors shared by full siblings. However, the role of adolescent cardiorespiratory fitness in CVD may have been overstated by conventional observational studies.
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11.
  • Barclay, Kieron, et al. (författare)
  • Birth order and hospitalization for alcohol and narcotics use in Sweden
  • 2016
  • Ingår i: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 167, s. 15-22
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous studies have shown that birth order is an important predictor of later life health as well as socioeconomic attainment. In this study, we examine the relationship between birth order and hospitalization for alcohol and narcotics use in Sweden. Methods: We study the relationship between birth order and hospitalization related to alcohol and narcotics use before and after the age of 20 using Swedish register data for cohorts born 1987-1994. We apply Cox proportional hazard models and use sibling fixed effects, eliminating confounding by factors shared by the siblings. Results: Before age 20 we find that later born siblings are hospitalized for alcohol use at a higher rate than first-borns, and there is a monotonic increase in the hazard of hospitalization with increasing birth order. Second-borns are hospitalized at a rate 47% higher than first-borns, and third-borns at a rate 65% higher. Similar patterns are observed for hospitalization for narcotics use. After age 20 the pattern is similar, but the association is weaker. These patterns are consistent across various sibling group sizes. Conclusions: Later born siblings are more likely to be hospitalized for both alcohol and narcotics use in Sweden. These birth order effects are substantial in size, and larger than the estimated sex differences for the risk of hospitalization related to alcohol and drug use before age 20, and previous estimates for socioeconomic status differences in alcohol and drug abuse.
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12.
  • Beldowski, Jacek, et al. (författare)
  • Chemical Munitions Search & Assessment-An evaluation of the dumped munitions problem in the Baltic Sea
  • 2016
  • Ingår i: Deep-sea research. Part II, Topical studies in oceanography. - : Elsevier BV. - 0967-0645 .- 1879-0100. ; 128, s. 85-95
  • Tidskriftsartikel (refereegranskat)abstract
    • Chemical Munitions Search & Assessment (CHEMSEA) project has performed studies on chemical weapon (CW) detection, sediment pollution and spreading as well as biological effects of chemical warfare agents (CWAs) dumped in the Baltic Sea. Results suggest that munitions containing CWAs are more scattered on the seafloor than suspected, and previously undocumented dumpsite was discovered in Gdansk Deep. Pollution of sediments with CWA degradation products was local and close to the detected objects; however the pollution range was larger than predicted with theoretical models. Bottom currents observed in the dumpsites were strong enough for sediment re-suspension, and contributed to the transport of polluted sediments. Diversity and density of the faunal communities were poor at the dumping sites in comparison to the reference area, although the direct effects of CWA on benthos organisms were difficult to determine due to hypoxic or even anoxic conditions near the bottom. Equally, the low oxygen might have affected the biological effects assessed in cod and caged blue mussels. Nonetheless, both species showed significantly elevated molecular and cellular level responses at contaminated sites compared to reference sites.
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13.
  • Berglind, Daniel, et al. (författare)
  • An eHealth program versus a standard care supervised health program and associated health outcomes in individuals with mobility disability : study protocol for a randomized controlled trial.
  • 2018
  • Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Young adults with mobility disability (MD) are less likely to engage in regular physical activity (PA) compared with their able-bodied peers and inactive adults with a MD are more likely to report one or more chronic diseases compared to those who are physically active. Despite the vast amount of research published in the field of PA interventions over the past decades, little attention has been focused on interventions aiming to increase PA among individuals with MD. Thus, we propose to compare the effects of an eHealth program compared to a usual care supervised health program on levels of PA and other health behaviors.METHODS: The current intervention will use a randomized controlled trial (RCT) design with two treatment groups (an eHealth program and a usual care supervised health program) in young adults with newly acquired MD. In total, 110 young adults (aged 18-40 years) with a MD, acquired within the past 3 years, will be recruited to participate in a 12-week intervention. The primary study outcome is accelerometer-measured time spent in moderate to vigorous PA. Secondary outcomes includes health-related quality of life, depression, stress, fitness, body composition, diet, musculoskeletal pain, motivation to exercise and work ability.DISCUSSION: There is a lack of RCTs investigating effective ways to increase levels of PA in young adults with MD. Increased levels of PA among this physically inactive population have the potential to substantially improve health-related outcomes, possibly more so than in the general population. The trial will put strong emphasis on optimizing exercise adherence and investigating feasibility in the two treatment programs. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (2017/1206-31/1).TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN), reference number ISRCTN22387524 . Prospectively registered February 4, 2018.
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14.
  • Berglind, Daniel, et al. (författare)
  • Longitudinal assessment of physical activity in women undergoing Roux-en-Y gastric bypass
  • 2015
  • Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 25:1, s. 119-125
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patients undergoing bariatric surgery do not seem to increase objectively measured physical activity (PA) after surgery, despite substantial weight loss. The aims of the present study were (i) to objectively characterize 3 months pre-surgery to 9 months postsurgery PA and sedentary behavior changes in women undergoing Roux-en-Y gastric bypass (RYGB) using tri-axial accelerometers and (ii) to examine associations between pre-surgery versus postsurgery PA and sedentary behavior with anthropometric measures taken in home environment.Methods: Fifty-six women, with an average pre-surgery body mass index (BMI) of 37.6 (SD 2.6) and of age 39.5 years (SD 5.7), were recruited at five Swedish hospitals. PA was measured for 1 week by the Actigraph GT3X+ accelerometer, and anthropometric measures were taken at home visits 3 months pre-surgery and 9 months postsurgery, thus limiting seasonal effects.Results: Average BMI loss, 9 months postsurgery, was 11.7 (SD 2.7) BMI units. There were no significant pre- to postsurgery differences in PA or sedentary behavior. However, pre-surgery PA showed negative association with PA change and positive association with postsurgery PA. Adjustments for pre-surgery BMI had no impact on these associations.Conclusions: No significant differences were observed in objectively measured changes in PA or time spent sedentary from 3 months pre-surgery to 9 months postsurgery among women undergoing RYGB. However, women with higher pre-surgery PA decreased their PA postsurgery while women with lower pre-surgery PA increased their PA.
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15.
  • Berglind, Daniel (författare)
  • Maternal obesity surgery : effects in women, spouses and offspring
  • 2014
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: Bariatric surgery is an important treatment for the worldwide increasing epidemic of obesity. However, the effects of such surgery on offspring epigenetic profile and effects on objectively measured physical activity and sedentary behavior in women undergoing bariatric surgery and family members are essentially unknown. Aim: The aim of this thesis was to investigate possible effects of maternal weight loss after bariatric surgery and effects on differences in maternal gestational weight gain in repeated pregnancies of the same women on sibling body size in childhood, epigenetic profile and physical activity among siblings and spouses. Methods: Longitudinal studies with repeated objective measures in the same women, spouses and offspring before and after maternal bariatric surgery. Results: There were positive associations, in women undergoing bariatric surgery (n = 124), between differences in total and second trimester gestational weight gain and differences in offspring birth weight. Maternal bariatric surgery, with subsequent weight loss between pregnancies, is associated with overrepresentation of differences in methylated sites in genes involved in inflammation and type-2 diabetes signaling when comparing offspring born before (n = 31) and after (n = 31) maternal bariatric surgery. There were no significant differences in objectively measured physical activity or time spent sedentary from three months before to nine months after surgery in women undergoing Roux- en-Y Gastric Bypass (n = 56), despite substantial weight loss. Objectively measured physical activity and time spent sedentary three months before and nine months after the women’s Roux-en-Y Gastric Bypass did not differ significantly in spouses (n = 33). However, during the same period, physical activity decreased significantly in children (n = 75), while time spent sedentary increased significantly. Conclusion: Interpregnancy differences in gestational weight gain, in women undergoing bariatric surgery, are associated with increased differences in offspring birth weights and differences in the epigenetic regulation of obesity-related genes in comparison of siblings born before and after maternal bariatric surgery. Furthermore, large weight loss after maternal Roux-en-Y Gastric Bypass is not associated with significant change in physical activity or time spent sedentary in women or spouses, while children decrease physical activity and increase time spent sedentary from three months before to nine months after maternal Roux-en-Y Gastric Bypass.
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16.
  • Berglind, Daniel, et al. (författare)
  • The influence of the COVID-19 pandemic on physical activity in Stockholm County : Evidence from time series models of smartphone measured daily steps data spanning over 3 years
  • 2024
  • Ingår i: Preventive Medicine. - : Elsevier Inc. - 1096-0260 .- 0091-7435. ; 183
  • Tidskriftsartikel (refereegranskat)abstract
    • It has been reported that physical activity levels decreased during the COVID-19 pandemic. Previous studies often relied on self-reported physical activity, which has low accuracy. Studies based on objectively measured physical activity have had short data collection periods, thereby not allowing the consideration of pre-pandemic levels of physical activity or the influence over the different waves of the pandemic. In this study, we utilize smartphone-measured step data from a nonprobability sample in Stockholm County, Sweden, where measures to limit the spread of COVID-19 differed from those in many other countries. The results are based on 522 individuals and 532,739 person-days with step data spanning from 2019 to 2021. Generalized additive models were fitted for each individual, and meta-regression was used to combine the results from individual models. Daily steps decreased during the first wave but increased during the third wave compared to individual pre-pandemic levels. The decrease in daily steps occurred primarily in young individuals and those with occupations allowing remote work. Individuals of retirement age on the contrary increased their daily steps during the same period. This study reveal that the influence of the COVID-19 pandemic was temporary and that younger age and the possibility of working from home were associated with a decreasing trend in physical activity. •Using mobile phone derived daily steps data over three years.•Negative influence of Covid-19-pandemic on walking steps only exists during the early stage of the pandemic.•Being younger and having the possibility of working from home are associated with fewer steps per day.•Individual modeling with meta-analysis is an ideal method for large scale physical activity studies.
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17.
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18.
  • Chen, Chu, et al. (författare)
  • Preschool environment and preschool teachers physical activity and their association with childrens activity levels at preschool
  • 2020
  • Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 15:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective The aim of this study was to investigate the association between preschool playground size, formalized physical activity (PA) policies, time spent outdoors and preschool teachers levels of PA and childrens objectively assessed levels of PA and sedentary time (ST) during preschool hours. Methods In total, 369 children and 84 preschool teachers from 27 preschools in Sodermalm municipally, Stockholm Sweden wore an Actigraph GT3X+ accelerometer during 7 consecutive days. Preschool environmental and structural characteristics were measured via the Environment and Policy Evaluation Self-Report ( EPAO-SR) instrument and time in- and outdoors was recorded by preschool teachers during the PA measurements. Weight and height of children were measured via validated scales and parents filled out a questionnaire on demographical and descriptive variables. Linear mixed models, nested on preschool level, were used to assess the association between predictors and outcomes. Results The mean child age was 4.7 years (SD 0.8) and 45% were girls. We found that children were more active in preschools with a formalized PA policy, compared to preschools without such a policy, but not less sedentary. The association between policy and activity seemed to be more pronounced when accounting for other environmental factors. Similar associations were found in children spent most time outdoors (uppermost quartile) compared with children spent least time outdoors (Lowermost quartile). Preschool teachers light PA (LPA) (beta = 0.25, P = 0.004) and steps (beta = 0.52, P<0.001) were associated with childrens LPA and steps while the preschool playground size showed no association with PA in children, when accounting for other environmental factors. Conclusion The current study showed that preschool structural characteristics such as formalized PA policies and more time spent outdoors were positively associated with childrens PA. These findings suggest that formalized PA policies and time outdoors may be of importance for promoting childrens PA during preschool hours.
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19.
  • Christiansen, Filip, et al. (författare)
  • Physical activity through a classroom-based intervention : A pragmatic non-randomized trial among swedish adolescents in an upper secondary school
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:21
  • Tidskriftsartikel (refereegranskat)abstract
    • Schools are an important arena to curb the decline in physical activity (PA) in youth. School-based interventions with accelerometer-measured PA are warranted. This study aimed to increase accelerometer-measured PA in adolescents following a 12-month school-based intervention. Two school-classes of 16–18-year-old Swedish students were allocated to intervention group and control group. Accelerometer-measured PA was gathered at baseline, 6-and 12-month follow-up. Mixed-effects linear regression was used to investigate between-group and within-group differences in mean minutes per day (min/day) of moderate to vigorous PA (MVPA), light PA (LPA) and sedentary time (ST). Fifty-seven students participated (intervention group = 31, control group = 26). At 12-month follow-up, the intervention group performed 5.9 (95% CI: −4.3, 16.2) min/day more in MVPA, 1.8 (95% CI: −17.9, 14.2) min/day less in LPA, and 4.1 (95% CI: −27.3, 19.2) min/day less in ST compared to the control group. Within the intervention group, there was no significant change in PA. Within the control group, LPA decreased (95% CI: −19.6, −0.2; p = 0.044) and ST increased (95% CI: 1.8, 30.8; p = 0.028). Although no between-group differences in PA were statistically significant, the within-group changes may suggest a preventive impact on the decline in PA during adolescence.
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20.
  • Ekström, Lucas, et al. (författare)
  • The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
  • 2020
  • Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • Birth by cesarean section is increasing worldwide and associates with offspring morbidities capable of adversely impacting cardiorespiratory fitness later in life. Whether birth by cesarean section associates with lower levels of cardiorespiratory fitness later in life is unknown and is of interest to public health. Four Swedish national registers were linked to follow 339,451 singleton males, born between 1973–1987 until December 31 2005, for Watt-maximum achieved on a cycle ergometer test at conscription into the Swedish military. Main exposure was birth by cesarean section which was compared to vaginal birth. A sub-population of 45,999 males born between 1982–1987 was identified to explore differentiated associations between elective and non-elective cesarean section with Watt-maximum. Within-family analyses of 34,252 families with 70,632 biological male siblings, who conscripted during the study period, were performed to explore the role of familial confounding on Watt-maximum. Swedish males born by cesarean section achieved lower mean Watt-maximum (− 2.32 W, 95%C.I. − 2.90 to − 1.75) and displayed excess odds of low cardiorespiratory fitness (aOR = 1.08, 95%C.I. 1.05 to 1.11) at conscription in the eighteenth life-year compared to males born vaginally after adjusting for birth characteristics, maternal morbidities and parental socioeconomic position. In the sub-population, males born 1982–1987, there was a greater negative association of elective cesarean section with cardiorespiratory fitness (− 4.42 W, 95%C.I. − 6.27 to − 2.57, p < 0.001) than non-elective cesarean sections (− 1.96 W, 95%C.I. − 3.77 to − 0.16, p = 0.033) as compared to vaginal births. No associations between modes of cesarean delivery and cardiorespiratory fitness levels persisted in the within-family analyses where biological male siblings were compared whilst controlling for factors shared within families. Males born by cesarean section had lower levels of cardiorespiratory fitness eighteen years later compared to males born vaginally. These findings appear to be largely explained by factors of familial confounding.
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21.
  • Guerra, Matheus, et al. (författare)
  • Effects of a 10-Week Physical Activity Intervention on Asylum Seekers' Physiological Health
  • 2022
  • Ingår i: Brain Sciences. - : MDPI. - 2076-3425. ; 12:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: The rise in armed conflicts has contributed to an increase in the number of asylum seekers. Prolonged asylum processes may negatively affect asylum seekers' health and lead to inactivity. Studies show that physical activity interventions are associated with improvements in health outcomes. However, there are a limited number of studies investigating the associations of physical activity on asylum seekers' health. Methods: Participants (263 males and 204 females), mostly from Syria, were assessed before and after a 10-week intervention for VO2 max, body mass index (BMI), skeletal muscle mass (SMM), body fat, and visceral fat. Linear mixed models were used to test differences within groups, and a linear regression model analysis was performed to test whether physiological variables predicted adherence. Results: Participants' VO2 max increased: males by 2.96 mL/min/kg and females 2.57 mL/min/kg. Increased SMM percentages were seen in both genders: females by 0.38% and males 0.23%. Visceral fat area decreased: males by 0.73 cm(2) and females 5.44 cm(2). Conclusions: Participants showed significant increases in VO2 max and SMM and decreased visceral fat. This study provides an insight into asylum seekers' health and serves as a starting point to new interventions in which physical activity is used as a tool to promote and improve vulnerable populations' health.
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22.
  • Guerra, Matheus, et al. (författare)
  • Effects of a 10-Week Physical Activity Program on Asylum Seekers’ Physiological Health
  • 2020
  • Ingår i: 32nd Association for Psychological Science Annual Convention. Chicago, Illinois, USA.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • We evaluated the effect of a 10-week training program on physiological health among a sample of 465 asylum seekers in Sweden, most of them from Syria. We found increases on the overall maximum aerobic fitness along with body composition (e.g., skeletal muscle mass) and a decrease in body fat.
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23.
  • Hebib, Lana, et al. (författare)
  • Life’s Essential 8 is inversely associated with high-sensitivity C-reactive protein
  • 2024
  • Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 14:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Life’s Essential 8 (LE8) is a score that includes modifiable risk factors for cardiovascular disease. Four health behaviors (diet, physical activity, nicotine exposure and sleep health) and four health factors (non-HDL cholesterol, blood glucose, blood pressure and body mass index) are included. These modifiable risk factors promote inflammation, and inflammation is one of the biological mechanisms of cardiovascular disease development. Thus, we examined the relationship between cardiovascular health measured by LE8 and low-grade inflammation measured by high-sensitivity C-reactive protein (hs-CRP) in the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (SCAPIS). The study consisted of 28,010 participants between 50 and 64 years (51.5% women, mean age 57.5 years). All individual LE8 components were assigned a score between 0 (unhealthy) and 100 (healthy) points, and a global score was calculated. The association between LE8 scores and high-risk hs-CRP (defined as > 3.0 mg/L) was analyzed using adjusted logistic regression with spline analyses. There was a strong, dose response and inverse association between LE8 scores and levels of hs-CRP. Thus, those with a low LE8 score (= 50.0 points) had 5.8 higher (95% confidence interval [CI] 5.2–6.4) odds ratio (OR) of having high hs-CRP as compared to those with a high LE8 score (= 80.0 points). In conclusion, our findings show strong inverse associations between LE8 scores and levels of hs-CRP.
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24.
  • Hebib, Lana, et al. (författare)
  • Life's Essential 8 is inversely associated with high-sensitivity C-reactive protein
  • 2024
  • Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 14:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Life's Essential 8 (LE8) is a score that includes modifiable risk factors for cardiovascular disease. Four health behaviors (diet, physical activity, nicotine exposure and sleep health) and four health factors (non-HDL cholesterol, blood glucose, blood pressure and body mass index) are included. These modifiable risk factors promote inflammation, and inflammation is one of the biological mechanisms of cardiovascular disease development. Thus, we examined the relationship between cardiovascular health measured by LE8 and low-grade inflammation measured by high-sensitivity C-reactive protein (hs-CRP) in the cross-sectional population-based Swedish CArdioPulmonary bioImage Study (SCAPIS). The study consisted of 28,010 participants between 50 and 64 years (51.5% women, mean age 57.5 years). All individual LE8 components were assigned a score between 0 (unhealthy) and 100 (healthy) points, and a global score was calculated. The association between LE8 scores and high-risk hs-CRP (defined as > 3.0 mg/L) was analyzed using adjusted logistic regression with spline analyses. There was a strong, dose response and inverse association between LE8 scores and levels of hs-CRP. Thus, those with a low LE8 score (= 50.0 points) had 5.8 higher (95% confidence interval [CI] 5.2-6.4) odds ratio (OR) of having high hs-CRP as compared to those with a high LE8 score (= 80.0 points). In conclusion, our findings show strong inverse associations between LE8 scores and levels of hs-CRP.
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25.
  • Henriksson, Hanna, et al. (författare)
  • Cardiorespiratory fitness, muscular strength, and obesity in adolescence and later chronic disability due to cardiovascular disease: a cohort study of 1 million men
  • 2020
  • Ingår i: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645. ; 41:15, s. 1503-
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims Cardiorespiratory fitness, muscular strength, and obesity in adulthood are risk factors for cardiovascular disease (CVD). However, Little is known regarding the associations of these risk factors, already in adolescence, with later disability due to chronic CVD. Hence, we investigated associations of cardiorespiratory fitness, muscular strength, and body mass index (BMI) in adolescence with Later chronic disability due to specific causes of CVD disability (i.e. cerebrovascutar disease, ischaemic heart disease and heart failure). Methods and results This population-based cohort study included 1 078 685 male adolescents (16-19 years) from the Swedish military conscription register from 1972 to 1994. Cardiorespiratory fitness (bicycle ergometer test), muscular strength (knee extension strength), and BMI were measured during the conscription examination. Information about disability pension due to CVD was retrieved from the Social Insurance Agency during a mean follow-up of 28.4 years. Cardiorespiratory fitness was strongly and inversely associated with later risk of chronic CVD disability for all investigated causes. The association was particularly strong for ischaemic heart diseases (hazard ratio 0.11, 95% confidence interval 0.05-0.29 for highest vs. lowest fitness-quintiles). Furthermore, overweight/obesity were associated with CVD disability for all investigated causes. Conversely, associations of muscular strength with CVD disability were generally weak. Conclusions This study provides evidence for associations between low levels of cardiorespiratory fitness and obesity with later risk of chronic disability due to CVD. Preventive actions may begin at young ages and include promotion of cardiorespiratory fitness and healthy body weight.
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26.
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27.
  • Henriksson, Pontus, et al. (författare)
  • Fitness and Body Mass Index During Adolescence and Disability Later in Life A Cohort Study
  • 2019
  • Ingår i: Annals of Internal Medicine. - : AMER COLL PHYSICIANS. - 0003-4819 .- 1539-3704. ; 170:4, s. 230-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Low physical fitness, obesity, and the combination of the two in adolescence may be related to risk for disability in adulthood, but this has rarely been studied. Objective: To examine individual and combined associations of cardiorespiratory fitness and obesity in male adolescents with later receipt of a disability pension due to all and specific causes. Design: Population-based cohort study. Setting: Sweden. Participants: 1 079 128 Swedish adolescents aged 16 to 19 years who were conscripted into the military between 1972 and 1994. Measurements: Cardiorespiratory fitness and body mass index (BMI) were measured at conscription and were related to information on later receipt of a disability pension obtained from the Social Insurance Agency. Results: Over a median follow-up of 28.3 years, 54 304 men were granted a disability pension. Low cardiorespiratory fitness was strongly associated with later receipt of a disability pension due to all causes (hazard ratio, 3.74 [95% CI, 3.55 to 3.95] for lowest vs. highest fitness decile) and specific causes (psychiatric, musculoskeletal, injuries, nervous system, circulatory, and tumors). Obesity was associated with greater risk for receipt of a disability pension due to all and specific causes, with the greatest risks observed for class II and III obesity. Compared with being unfit, being moderately or highly fit was associated with attenuated risk for receipt of a disability pension across BMI categories. Limitation: The cohort did not include women, had data on smoking and alcohol intake only in a subsample, and lacked repeated measures of exposures and covariates. Conclusion: Low cardiorespiratory fitness, obesity, and the combination of the two were strongly associated with later chronic disability due to a wide range of diseases and causes. Although additional well-designed studies are required, these findings support the importance of high cardiorespiratory fitness and healthy body weight during adolescence to prevent later chronic disease.
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28.
  • Herraiz-Adillo, Ángel, et al. (författare)
  • Life's Essential 8 and Life's Simple 7 in Relation to Coronary Atherosclerosis: Results From the Population-Based SCAPIS Project.
  • 2024
  • Ingår i: Mayo Clinic proceedings. - : Elsevier. - 1942-5546 .- 0025-6196. ; 99:1, s. 69-80
  • Tidskriftsartikel (refereegranskat)abstract
    • To examine the associations between the American Heart Association scores ("Life's Essential 8" [LE8] and "Life's Simple 7" [LS7]) and 2 subclinical coronary atherosclerosis indicators: coronary computed tomographic angiography (CCTA)-stenosis and coronary artery calcium (CAC).We included a population-based sample, aged 50 to 64 years, recruited between 2013 and 2018 from the Swedish Cardiopulmonary Bioimage Study (n=24,819, 50.3% women). CCTA-stenosis was graded as no stenosis, stenosis (1%-49%) or severe stenosis (≥50%), whereas CAC was graded as 0, 1 to 99, 100 to 399, or ≥400 Agatston units. Multinomial logistic regression and receiver operating characteristic (ROC) curves were used to study the associations between cardiovascular health scores and subclinical coronary atherosclerosis.Odds ratios (ORs) for CCTA-stenosis and severe CCTA-stenosis between the lowest (<50 points) vs the highest (≥80 points) LE8 group were 4.18 (95% CI, 3.56 to 4.91) and 11.17 (95% CI, 8.36 to 14.93), respectively. For corresponding CAC results, ORs were 3.36 (95% CI, 2.84 to 3.98), 7.72 (95% CI, 6.03 to 9.89), and 14.94 (95% CI, 10.47 to 21.31) for CAC scores of 1 to 99, 100 to 399, and ≥400, respectively. Area under ROC curves for predicting any stenosis were 0.642 (95% CI, 0.635 to 0.649) and 0.631 (95% CI, 0.624 to 0.638, P<.001) for LE8 and LS7, respectively.Our data indicate that LE8 showed a strong, graded, and inverse association with CCTA-stenosis and CAC score. The capacity to predict CCTA-stenosis was comparable between LE8 and LS7, although LE8 had slightly higher prediction capacity of any stenosis. This study provides novel evidence that the LE8 score may be a useful tool for monitoring cardiovascular health.
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29.
  • Herraiz-Adillo, Ángel, et al. (författare)
  • Life’s Essential 8 in relation to self-rated health and health-related quality of life in a large population-based sample : the SCAPIS project
  • 2024
  • Ingår i: Quality of Life Research. - : Springer Nature. - 0962-9343 .- 1573-2649. ; 33, s. 1003-1014
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To monitor cardiovascular health, in 2022, the American Heart Association (AHA) updated the construct “Life’s Simple 7” (LS7) to “Life’s Essential 8” (LE8). This study aims to analyze the associations and capacity of discrimination of LE8 and LS7 in relation to self-rated health (SRH) and health-related quality of life (HRQoL).Methods: This study from the Swedish CArdioPulmonary bioImage Study (SCAPIS) included 28 731 Swedish participants, aged 50–64 years. Three different scores were derived from the SF-12 questionnaire: 1-item question SRH (“In general, would you say your health is …?”), mental-HRQoL and physical-HRQoL. Logistic regression, restricted cubic splines, and ROC analysis were used to study the associations between the AHA scores in relation to SRH and HRQoL.Results: Compared to those with a LE8 score of 80, participants with a LE8 score of 40 were 14.8 times more likely to report poor SRH (OR: 14.8, 95% CI: 13.0–17.0), after adjustments. Moreover, they were more likely to report a poor mental-HRQoL (OR: 4.9, 95% CI: 4.2–5.6) and a poor physical-HRQoL (OR: 8.0, 95% CI: 7.0–9.3). Area under curves for discriminating poor SRH were 0.696 (95% CI: 0.687–0.704), 0.666 (95% CI: 0.657–0.674), and 0.643 (95% CI: 0.634–0.651) for LE8, LS7 (0–14), and LS7 (0–7), respectively, all p values < 0.001 in the DeLong’s tests.Conclusion: LE8 and LS7 had strong and inverse associations with SRH, mental-HRQoL, and physical-HRQoL, though LE8 had a somewhat higher capacity of discrimination than LS7. The novel LE8, a construct initially conceived to monitor cardiovascular health, also conveys SRH and HRQoL.
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30.
  • Herraiz-Adillo, Ángel, et al. (författare)
  • Physical fitness in male adolescents and atherosclerosis in middle age: a population-based cohort study
  • 2024
  • Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480.
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives To examine the associations between physical fitness in male adolescents and coronary and carotid atherosclerosis in middle age.Methods This population-based cohort study linked physical fitness data from the Swedish Military Conscription Register during adolescence to atherosclerosis data from the Swedish CArdioPulmonary bioImage Study in middle age. Cardiorespiratory fitness was assessed using a maximal cycle-ergometer test, and knee extension muscular strength was evaluated through an isometric dynamometer. Coronary atherosclerosis was evaluated via Coronary Computed Tomography Angiography (CCTA) stenosis and Coronary Artery Calcium (CAC) scores, while carotid plaques were evaluated by ultrasound. The associations were analysed using multinomial logistic regression, adjusted (marginal) prevalences and restricted cubic splines.Results The analysis included 8986 male adolescents (mean age 18.3 years) with a mean follow-up of 38.2 years. Physical fitness showed a reversed J-shaped association with CCTA stenosis and CAC, but no consistent association was observed for carotid plaques. After adjustments, compared with adolescents in the lowest tertile of cardiorespiratory fitness and muscular strength, those in the highest tertile had 22% (OR 0.78; 95% CI 0.61 to 0.99) and 26% (OR 0.74; 95% CI 0.58 to 0.93) lower ORs for severe (>= 50%) coronary stenosis, respectively. The highest physical fitness group (high cardiorespiratory fitness and muscular strength) had 33% (OR 0.67; 95% CI 0.52 to 0.87) lower OR for severe coronary stenosis compared with those with the lowest physical fitness.Conclusion This study supports that a combination of high cardiorespiratory fitness and high muscular strength in adolescence is associated with lower coronary atherosclerosis, particularly severe coronary stenosis, almost 40 years later.
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31.
  • Higueras-Fresnillo, Sara, et al. (författare)
  • Associations of psychological factors with atherosclerosis and cardiovascular health in middle-age : the population-based Swedish CArdioPulmonary bioImage study (SCAPIS)
  • 2024
  • Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 24:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Cardiovascular disease (CVD) is a major global health issue, primarily caused by atherosclerosis. Psychological factors may play a role in the development and progression of CVD. However, the relationship between psychological factors and atherosclerosis is complex and poorly understood. This study, therefore, aimed to examine the association of psychological factors with (i) coronary and carotid atherosclerosis and (ii) cardiovascular health according to Life’s Essential 8, in a large Swedish cohort.Methods: This study utilized data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), a large population-based project including individuals aged 50 to 65 years. Several psychological factors were analysed: general stress, stress at work, financial stress, major adverse life events, locus of control, feeling depressed, and depression. Coronary atherosclerosis was assessed as the degree of stenosis by coronary computed tomography angiography (CCTA) and coronary artery calcification (CAC) scores. Carotid atherosclerosis was examined using ultrasound. In addition, cardiovascular health was examined using the Life’s Essential 8 concept created by the American Heart Association, which includes four health behaviors and four health factors. Associations were examined through binomial logistic regression (atherosclerosis variables) and linear regression (Life’s Essential 8).Results: A total of 25,658 participants were included in the study. The presence of financial stress, higher locus of control, and depression was weakly associated with increased odds of CCTA stenosis, CAC ≥ 1 and the presence of carotid plaques (all odds ratios: 1.10–1.21, 95% CI: 1.02–1.32) after adjusting for sex, age, and study site. However, these associations were attenuated and not statistically significant after additional adjustments for socioeconomic factors and health behaviors. Conversely, we observed inverse associations between the worst category for all psychological factors and cardiovascular health according to Life’s Essential 8 score (all standardized β-Coefficient ≤-0.033, p < 0.001).Conclusion: While there were no strong and consistent associations between psychological factors and atherosclerosis, the consistent associations of psychological factors with cardiovascular health by Life’s Essential 8 may have relevance for future CVD risk. However, further studies are needed to elucidate the long-term effects of psychological factors on atherosclerosis development and cardiovascular health.
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32.
  • Higueras-Fresnillo, Sara, et al. (författare)
  • Associations of psychological factors with atherosclerosis and cardiovascular health in middle-age: the population-based Swedish CArdioPulmonary bioImage study (SCAPIS)
  • 2024
  • Ingår i: BMC Public Health. - : BMC. - 1471-2458. ; 24:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Cardiovascular disease (CVD) is a major global health issue, primarily caused by atherosclerosis. Psychological factors may play a role in the development and progression of CVD. However, the relationship between psychological factors and atherosclerosis is complex and poorly understood. This study, therefore, aimed to examine the association of psychological factors with (i) coronary and carotid atherosclerosis and (ii) cardiovascular health according to Life's Essential 8, in a large Swedish cohort. Methods This study utilized data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), a large population-based project including individuals aged 50 to 65 years. Several psychological factors were analysed: general stress, stress at work, financial stress, major adverse life events, locus of control, feeling depressed, and depression. Coronary atherosclerosis was assessed as the degree of stenosis by coronary computed tomography angiography (CCTA) and coronary artery calcification (CAC) scores. Carotid atherosclerosis was examined using ultrasound. In addition, cardiovascular health was examined using the Life's Essential 8 concept created by the American Heart Association, which includes four health behaviors and four health factors. Associations were examined through binomial logistic regression (atherosclerosis variables) and linear regression (Life's Essential 8). Results A total of 25,658 participants were included in the study. The presence of financial stress, higher locus of control, and depression was weakly associated with increased odds of CCTA stenosis, CAC >= 1 and the presence of carotid plaques (all odds ratios: 1.10-1.21, 95% CI: 1.02-1.32) after adjusting for sex, age, and study site. However, these associations were attenuated and not statistically significant after additional adjustments for socioeconomic factors and health behaviors. Conversely, we observed inverse associations between the worst category for all psychological factors and cardiovascular health according to Life's Essential 8 score (all standardized beta-Coefficient <=-0.033, p < 0.001). Conclusion While there were no strong and consistent associations between psychological factors and atherosclerosis, the consistent associations of psychological factors with cardiovascular health by Life's Essential 8 may have relevance for future CVD risk. However, further studies are needed to elucidate the long-term effects of psychological factors on atherosclerosis development and cardiovascular health.
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33.
  • Krischer, Jeffrey P, et al. (författare)
  • Predicting Islet Cell Autoimmunity and Type 1 Diabetes : An 8-Year TEDDY Study Progress Report
  • 2019
  • Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 42:6, s. 1051-1060
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Assessment of the predictive power of The Environmental Determinants of Diabetes in the Young (TEDDY)-identified risk factors for islet autoimmunity (IA), the type of autoantibody appearing first, and type 1 diabetes (T1D).RESEARCH DESIGN AND METHODS: A total of 7,777 children were followed from birth to a median of 9.1 years of age for the development of islet autoantibodies and progression to T1D. Time-dependent sensitivity, specificity, and receiver operating characteristic (ROC) curves were calculated to provide estimates of their individual and collective ability to predict IA and T1D.RESULTS: HLA genotype (DR3/4 vs. others) was the best predictor for IA (Youden's index J = 0.117) and single nucleotide polymorphism rs2476601, in PTPN22, was the best predictor for insulin autoantibodies (IAA) appearing first (IAA-first) (J = 0.123). For GAD autoantibodies (GADA)-first, weight at 1 year was the best predictor (J = 0.114). In a multivariate model, the area under the ROC curve (AUC) was 0.678 (95% CI 0.655, 0.701), 0.707 (95% CI 0.676, 0.739), and 0.686 (95% CI 0.651, 0.722) for IA, IAA-first, and GADA-first, respectively, at 6 years. The AUC of the prediction model for T1D at 3 years after the appearance of multiple autoantibodies reached 0.706 (95% CI 0.649, 0.762).CONCLUSIONS: Prediction modeling statistics are valuable tools, when applied in a time-until-event setting, to evaluate the ability of risk factors to discriminate between those who will and those who will not get disease. Although significantly associated with IA and T1D, the TEDDY risk factors individually contribute little to prediction. However, in combination, these factors increased IA and T1D prediction substantially.
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34.
  • Kumar, Parvin, et al. (författare)
  • Physical exercise is associated with a reduction in plasma levels of fractalkine, TGF-beta 1, eotaxin-1 and IL-6 in younger adults with mobility disability
  • 2022
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Mobility disability (MD) refers to substantial limitations in life activities that arise because of movement impairments. Although MD is most prevalent in older individuals, it can also affect younger adults. Increasing evidence suggests that inflammation can drive the development of MD and may need to be targeted for MD prevention. Physical exercise has anti-inflammatory properties and has been associated with MD prevention. However, no studies to date have examined whether exercise interventions affect the peripheral inflammatory status in younger adults with MD. To this end, we used blood samples from young and middle-aged adults with MD (N = 38; median age = 34 years) who participated in a 12-week intervention that included aerobic and resistance exercise training. A pre-post assessment of inflammatory biomarkers was conducted in plasma from two timepoints, i.e., before the exercise trial and at follow-up (3-7 days after the last exercise session). We successfully measured 15 inflammatory biomarkers and found that exercise was associated with a significant reduction in levels of soluble fractalkine, transforming growth factor beta 1 (TGF-beta 1), eotaxin-1 and interleukin (IL) 6 (corrected alpha = 0.004). We also found significant male-specific effects of exercise on (i) increasing IL-16 and (ii) decreasing vascular endothelial growth factor-A (VEGF-A). In line with our results, previous studies have also found that exercise can reduce levels of TGF-beta 1, eotaxin-1 and IL-6. However, our finding that exercise reduces plasma levels of fractalkine in younger adults with MD, as well as the sex-dependent findings, have not been previously reported and warrant replication in larger cohorts. Given the suggested role of inflammation in promoting MD development, our study provides additional support for the use of physical exercise as a treatment modality for MD.
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35.
  • Lang, Justin J., et al. (författare)
  • Top 10 International Priorities for Physical Fitness Research and Surveillance Among Children and Adolescents : A Twin-Panel Delphi Study
  • 2023
  • Ingår i: Sports Medicine. - New Zealand : Adis International Ltd.. - 0112-1642 .- 1179-2035. ; 53:2, s. 549-564
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. Objective This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. Methods Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. Results There was strong between-panel agreement (panel 1: r(s) = 0.76, p < 0.01; panel 2: r(s) = 0.77, p < 0.01) in the priorities identified. The list of the final top 10 priorities included (i) "conduct longitudinal studies to assess changes in fitness and associations with health". This was followed by (ii) "use fitness surveillance to inform decision making", and (iii) "implement regular and consistent international/national fitness surveys using common measures". Conclusions The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.
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36.
  • Leffler, Per, et al. (författare)
  • Toxicity and accumulation of trinitrotoluene (TNT) and its metabolites in atlantic salmon alevins exposed to an industrially polluted water
  • 2014
  • Ingår i: Journal of Toxicology and Environmental Health. - : Taylor & Francis Group. - 1528-7394 .- 1087-2620. ; 77:19, s. 1183-1191
  • Tidskriftsartikel (refereegranskat)abstract
    • A pond in an industrial area in Sweden was selected to study adverse effects on salmon alevins from 2,4,6-trinitrotoluene (TNT)-contaminated water. Chemical screening revealed heavy contamination of TNT and its degradation products, 2-amino-4,6-dinitrotoluene (2-ADNT) and 4-amino-2,6-dinitrotoluene (4-ADNT), ranging from 0.05 to 230 g/kg in the sediment (dry weight) within the water system. Pond water contained 3 mg/L TNT. A dilution series of pond water mixed with tap water revealed increased death frequency in alevins down to fivefold dilution (approximate 0.4 mg TNT/L). Uptake was concentration dependent, reaching 7, 9, and 22 μg/g tissue for TNT, 2-ADNT, and 4-ADNT at the highest test concentration. A time-dependent uptake of TNT and its degradation products was found at a water concentration of 0.08 mg TNT/L. Degradation products of TNT showed a more efficient uptake compared to native TNT, and accumulation of 4-ADNT was more pronounced during the late phase of the 40-d exposure study. Bioconcentration factors (BCF) (0.34, 52, and 134 ml/g for TNT, 2-ADNT, and 4-ADNT, respectively) demonstrated a significant uptake of the metabolite 4-ADNT in alevin tissue. Disturbed physiological conditions and delayed development in alevins were not studied, but may not be excluded even at 125-fold diluted pond water (0.016 mg TNT/L). BCF data indicated that bioaccumulation of TNT metabolites need to be considered in TNT chronic toxicity. Fish species and age differences in the accumulation of TNT metabolites need to be further studied.
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37.
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38.
  • Ludvigsson, Jonas F., 1969-, et al. (författare)
  • The Swedish military conscription register : opportunities for its use in medical research
  • 2022
  • Ingår i: European Journal of Epidemiology. - : Springer. - 0393-2990 .- 1573-7284. ; 37:7, s. 767-777
  • Tidskriftsartikel (refereegranskat)abstract
    • In Sweden, conscription around age 18y was mandatory for young men until June 30, 2010. From July 1, 2017, it became mandatory again for both sexes but the proportion of summoned people for standardised testing has so far been low. This paper describes the history, structure and content of the Swedish Military Conscription Register (SMCR). We retrieved information about the SMCR from written sources and through e-mail interviews with key personnel at the Swedish Defence Conscription and Assessment Agency. We also analysed data from the SMCR between 1969 and 2018. Between 1969 and 2018 the SMCR contains digital data on approximately 2 million individuals (98.6% men). Most conscripts were born between 1951 and 1988 (n = 1,900,000; tested between 1969 and 2006). For the 1951-1987 birth cohorts, the register has a population coverage of approximately 90% for men. Conscripts underwent written tests focusing on verbal, spatial, logical and technical ability, medical, physical, and psychological tests. The medical assessment included hearing, vision, muscle and exercise capacity, height, weight, blood pressure and resting heart rate. The SMCR has been widely used to study, e.g., obesity, cardiovascular disease, mental health, crime, cardiovascular fitness, muscle strength, sick leave and disability pension. Severe disease could qualify for exemption from military service. Thus, the prevalence of such diseases is underestimated in the SMCR population. Between 1990 and 2018, about 25,000 women also volunteered for testing. The SMCR contains population-based data on physical and psychological health in about 90% of all men born between 1951 and 1987 (corresponding to testing between 1969 and 2006), and can be used to address a host of research questions.
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39.
  • Maurice, Christian, et al. (författare)
  • Improving soil investigations at brownfield sites using a flexible work strategy and screening methods inspired by the US Environmental Protection Agency's Triad approach
  • 2007
  • Ingår i: Ambio. - 0044-7447 .- 1654-7209. ; 36:6, s. 502-11
  • Tidskriftsartikel (refereegranskat)abstract
    • Investigations of polluted brownfield sites and sample analyses are expensive, and the resulting data are often of poor quality. Efforts are needed, therefore, to improve the methods used in investigations of brownfield sites to both reduce costs and improve the quality of the results. One approach that could be useful for both of these purposes is the triad strategy, developed by the US Environmental Protection Agency, in which managing uncertainty is a central feature. In the investigations reported here, a field study was conducted to identify possible ways in which uncertainties could be managed in practice. One example considered involves optimizing the uncertainty by adjusting the sizes of samples and the efforts expended in analytical work according to the specific aims of the project. In addition, the potential utility of several toxicity assessment methods for screening sites was evaluated. As well as presenting the results of these assessments, in this contribution we discuss ways in which a flexible work strategy and screening methods inspired of the triad philosophy could be incorporated into the Swedish approach to remediate brownfield sites. A tiered approach taking advantage of field and screening methods is proposed to assess brownfield sites focusing on the response and acceptable uncertainty that are required for the task.
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40.
  • Possmark, Sofie, et al. (författare)
  • Accelerometer-measured versus selfreported physical activity levels in women before and up to 48months after Roux-enY Gastric Bypass
  • 2020
  • Ingår i: BMC Surgery. - : BioMed Central. - 1471-2482. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Roux-en-Y Gastric Bypass (RYGB) patients overestimate their time spent in moderate-to-vigorous physical activity (MVPA) to a greater extent post-surgery than pre-surgery. However, there is no data on discrepancy between self-reported and accelerometer-measured MVPA beyond nine months post-RYGB. The aim was to investigate how the duration of MVPA (main outcome) differs when comparing a self-administered questionnaire to accelerometer-data from pre-surgery and up to 48months post-RYGB.Methods: Twenty-six (38%) RYGB-treated women with complete data from the original cohort (N=69) were included. Participants were recruited from five Swedish hospitals. Mean pre-surgery BMI was 38.9 (standard deviation (SD)=3.4) kg/m2 and mean age 39.9 (SD=6.5) years. MVPA was subjectively measured by a selfadministered questionnaire and objectively measured by the ActiGraph GT3X+ accelerometer at 3months pre-RYGB and 9- and 48months post-RYGB. Means and SD were calculated at 3months pre- and 9- and 48months postRYGB. We calculated the P-values of the differences with Wilcoxon Signed-Rank test. For correlations between the self-administered questionnaire and the accelerometers, Spearman’s rank correlation was used.Results: Participants significantly overestimated (i.e. self-reported more time spent in MVPA compared to accelerometry) their MVPA in a higher degree post- compared to pre-RYGB surgery. Compared to pre-surgery, selfreported MVPA increased with 46.9 and 36.5% from pre- to 9- and 48months, respectively, whereas changes were a 6.1% increase and 3.5% decrease with accelerometers. Correlations between self-reported and accelerometermeasured MVPA-assessments were poor at all measurement points (r=0.21–0.42) and only significant at 48months post-RYGB (P=0.032).Conclusions: The discrepancy between self-reported and objectively assessed MVPA within the same individual is greater up to 48months post-RYGB compared to before surgery. To help bariatric patients understand and hopefully increase their physical activity behaviors post-surgery, objective measures of physical activity should be used.
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41.
  • Possmark, Sofie, et al. (författare)
  • Physical activity in women attending a dissonance-based intervention after Roux-en-Y Gastric Bypass : A 2-year follow-up of a randomized controlled trial
  • 2021
  • Ingår i: PLOS ONE. - : Public Library of Science (PLOS). - 1932-6203. ; 16:11
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The majority of Roux-en-Y gastric bypass (RYGB) patients are not sufficiently physically active post-surgery, yet little support from the Swedish healthcare system is offered. We investigated if a dissonance-based group intervention, aiming to increase health-related quality of life after surgery, had any effect on patients' physical activity two years post-RYGB.METHODS: Women undergoing RYGB surgery were recruited from five Swedish hospitals and randomized to intervention or control group (standard post-surgery care). The dissonance-based intervention was conducted three months post-RYGB and consisted of four group sessions, each with a specific topic, of which one addressed physical activity. ActiGraph GT3X+ accelerometers were used to measure physical activity at pre-RYGB, one- and two-years post-surgery.RESULTS: At pre-RYGB, 259 women were recruited and randomized (intervention n = 156 and control n = 103). Participants had a mean age of 44.7 years (SD 10.3) and pre-RYGB body mass index of 40.8 (SD 4.5) kg/m2. At two-years follow-up, 99 participants (63.5%) in intervention group and 68 (66.0%) in control group had valid accelerometer-measurements. Pre- to post-surgery increases were seen in all physical activity outcomes, but no statistically significant differences between the groups were observed at the two-years follow-up, and intervention effects were poor (d = 0.02-0.35).CONCLUSION: To our knowledge, this is the first dissonance-based intervention targeting women undergoing RYGB surgery. At two-years follow-up, we did not observe any differences in physical activity levels between the intervention group and control group.Trial registration number: ISRCTN16417174.
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42.
  • Possmark, Sofie, et al. (författare)
  • To be or not to be active – a matter of attitudes and social support? : Women’s perceptions of physical activity five years after Roux-en-Y Gastric Bypass surgery
  • 2019
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 14:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Despite positive health advantages of post-surgery physical activity (PA) for bariatric surgery patients, the majority is not sufficiently physically active. The aim was to explore women’s perceptions and experiences concerning PA five years after Roux-en-Y Gastric Bypass (RYGB) surgery.Methods: Eleven women were interviewed five years post-surgery. Grounded Theory approach was applied.Results: The core-category “Attitudes and surrounding environment influence activity levels” includes three attitudes towards PA: “Positive attitudes”, “Shifting attitudes” and “Negative attitudes”. Participants with a positive attitude were regularly physically active, felt supported and proud of their achievements. Contrary, participants with a negative attitude didn’t prioritize PA, didn’t feel supported and saw no need or benefit of PA. Some participants revealed an on-off behaviour, hovering between the attitudes of vigorous PA and sedentary lifestyle, without sustainable balance. The majority mostly viewed PA as a mean to lose weight.Conclusion: The level of perceived post-surgery PA was related to the participants’ attitudes towards PA and whether or not they had a supportive environment. These findings might explain why bariatric surgery patients often fail to be sufficiently active post-surgery, and highlight the need for prolonged support and motivational interventions to promote sustainable PA post-bariatric surgery.
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43.
  • Ragnvaldsson, Daniel, et al. (författare)
  • Environmental Hazard Screening of a Metal-polluted Site Using Pressurized Liquid Extraction and Two In Vitro Bioassays
  • 2007
  • Ingår i: Ambio. - 0044-7447 .- 1654-7209. ; 36:6, s. 494-501
  • Tidskriftsartikel (refereegranskat)abstract
    • Rapid screening methods can improve the cost effectiveness, throughput, and quality of risk assessments of contaminated sites. In the present case study, the objective was to evaluate a combination of pressurized liquid extraction and 2 in vitro bioassays for the hazard assessment of surface soil sampled from 46 points across a pyrotechnical industrial site. Pressurized liquid extraction was used to rapidly produce soil-water extracts compatible with 2 high-capacity bioassays. Hazard assessment using combined toxicological and chemical screening revealed zones with relatively high potential risks of metal pollution. Multivariate data analysis provided indications that significant inhibition in the bioassays was correlated with levels of metals in the extracts, suggesting an elevated toxic potential from certain metals. Low pH and high concentrations of dissolved organic carbon were associated with increased cytotoxicity of extracts, indicating that these factors influence metal bioavailability. The cytotoxicity observed was more strongly correlated to metal concentrations in the extracts than in the soil, suggesting that measurements of total metal concentrations in soils do not provide good indications of the soil's potential toxicity.
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44.
  • Rohde, Jeanett Friis, et al. (författare)
  • Cross-sectional associations between maternal self-efficacy and dietary intake and physical activity in four-year-old children of first-time Swedish mothers
  • 2018
  • Ingår i: Appetite. - : Elsevier BV. - 0195-6663 .- 1095-8304. ; 125, s. 131-138
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Healthy dietary and physical activity behaviours are established early in life where children learn by observing their parents. Therefore, parents can act as role models and influence their children toward a healthier lifestyle. Besides a strong association between parental and child health behaviours, parents also influence their children's health behaviours through socio-cognitive processes, where perceived self-efficacy is the central component. The objective was to examine if parental self-efficacy among Swedish mothers was associated with their four-year-old children's dietary and physical activity behaviours. Methods: This cross-sectional study was based on information from control participants that took part in the Swedish primary prevention trial of childhood obesity (PRIMROSE) (n = 420 mother-child pairs). Linear regression models were used to examine the associations between parental self-efficacy (Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviours in Children Scale) and children's dietary intake (parent reported) and levels of physical activity (accelerometer) with adjustments for potential confounders. Results: Mothers' efficacy beliefs in promoting healthy dietary or physical activity behaviours in their children were associated with a slightly higher consumption of fruit and vegetables among their children (β: 0.03 [95%CI: 0.01; 0.04] P < 0.001) and slightly higher levels of moderate-to-vigorous activity (β: 0.43 [95%CI: 0.05; 0.81] P = 0.03). Mothers' belief in their ability to limit unhealthy dietary and physical activity behaviours was inversely associated with children's intake of unhealthy snacks (β: −0.06 [95%CI: −0.10; −0.02] P < 0.01). Conclusion: Our cross-sectional study suggests weak positive correlations between maternal self-efficacy and healthy dietary and physical activity behaviours, and weak inverse associations between maternal self-efficacy and unhealthy dietary and physical activity behaviours among their children.
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45.
  • Sellberg, Fanny, et al. (författare)
  • A dissonance-based intervention for women post roux-en-Y gastric bypass surgery aiming at improving quality of life and physical activity 24 months after surgery : study protocol for a randomized controlled trial
  • 2018
  • Ingår i: BMC Surgery. - : BioMed Central. - 1471-2482. ; 18:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery is the most common bariatric procedure in Sweden and results in substantial weight loss. Approximately one year post-surgery weight regain for these patient are common, followed by a decrease in health related quality of life (HRQoL) and physical activity (PA). Our aim is to investigate the effects of a dissonance-based intervention on HRQoL, PA and other health-related behaviors in female RYGB patients 24 months after surgery. We are not aware of any previous RCT that has investigated the effects of a similar intervention targeting health behaviors after RYGB.METHODS: The ongoing RCT, the "WELL-GBP"-trial (wellbeing after gastric bypass), is a dissonance-based intervention for female RYGB patients conducted at five hospitals in Sweden. The participants are randomized to either control group receiving usual follow-up care, or to receive an intervention consisting of four group sessions three months post-surgery during which a modified version of the Stice dissonance-based intervention model is used. The sessions are held at the hospitals, and topics discussed are PA, eating behavior, social and intimate relationships. All participants are asked to complete questionnaires measuring HRQoL and other health-related behaviors and wear an accelerometer for seven days before surgery and at six months, one year and two years after surgery. The intention to treat and per protocol analysis will focus on differences between the intervention and control group from pre-surgery assessments to follow-up assessments at 24 months after RYGB. Patients' baseline characteristics are presented in this protocol paper.DISCUSSION: A total of 259 RYGB female patients has been enrolled in the "WELL-GBP"-trial, of which 156 women have been randomized to receive the intervention and 103 women to control group. The trial is conducted within a Swedish health care setting where female RYGB patients from diverse geographical areas are represented. Our results may, therefore, be representative for female RYGB patients in the country as a whole. If the intervention is effective, implementation within the Swedish health care system is possible within the near future.TRIAL REGISTRATION: The trial was registered on February 23th 2015 with registration number ISRCTN16417174.
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46.
  • Sellberg, Fanny, et al. (författare)
  • A dissonance-based randomized intervention study to improve quality of life and physical activity 24 months post roux-en-Y gastric bypass surgery
  • 2018
  • Ingår i: Obesity Surgery. - 0960-8923 .- 1708-0428. ; 28:S2, s. 224-224
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Roux-en-Y gastric bypass (RYGB) surgery is usually followed by great weight loss and improved health related quality of life (HRQoL). However, weight regains are seen in some patients approximately 1-2 years post-surgery, associated with a decrease in HRQoL and physical activity (PA).Objectives: To investigate if a dissonance-based group intervention post RYGB surgery has an effect on women’s HRQoL, PA and other health-related behaviors: a protocol paper.Methods: The ongoing RCT is a dissonance-based intervention for female RYGB patients from five Swedish hospitals. Participants are randomized to either control (usual follow-up care) or intervention group (4 sessions, 3 months post-surgery). Main topics of intervention sessions are (1) PA, (2) eating behavior, (3) social and (4) intimate relationships. Participants are asked to wear an accelerometer and complete questionnaires measuring HRQoL (SF-36), social adjustment, eating behavior and body esteem, pre-surgery and 6, 12 and 24 months post-surgery. Planned analysis includes intention to treat and per protocol analysis on differences between intervention and control group. Trial registration number: ISRCTN16417174.Results: We recruited 259 women (156 intervention and 103 controls). Mean BMI was 40.9 ± 4.7, mean SF36 score was 42.1 ± 9.5 (physical component summary score) and 45.8 ± 11.1 (mental component summary score). Mean time spent in moderate to vigorous PA was 28.8 ± 19.4 min/day and sedentary was 458.3 ± 100.4 min/day.Conclusions: This trial aims to improve outcomes after RYGB. If the intervention is effective, implementation within the Swedish health care system is possible within the near future.
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47.
  • Sellberg, Fanny, et al. (författare)
  • Change in Children's Self-Concept, Body-Esteem, and Eating Attitudes Before and 4 Years After Maternal RYGB
  • 2018
  • Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 28:10, s. 3276-3283
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: The aim of the present study was to look at longitudinal changes in children's self-concept, body-esteem, and eating attitudes before and 4 years after maternal RYGB surgery.METHODS: Sixty-nine women and 81 appurtenant children were recruited from RYGB waiting lists at 5 hospitals in Sweden. Families were visited at home pre-surgery, 9 months, and 4 years post-maternal RYGB to measure BMI. Furthermore, all participating family members completed questionnaires. Mothers' questionnaires measured eating behavior, depression, anxiety, and sleep quality, and children's questionnaires measured body-esteem, self-concept, and eating attitudes.RESULTS: Thirty-five/sixty-nine mothers and 43/81 children participated in all 3 measurements. Mothers reduced their BMI from pre-surgery (39.2) to 9 months (27.0) and 4 years post-surgery (27.4). Children's prevalence of overweight/obesity was lower 9 months post-surgery (48.8%) but at the same levels again 4 years post-surgery (58.1%), compared to pre-surgery (58.1%). The same rebound pattern was seen among children's eating attitudes, mothers' symptoms of depression and anxiety, and sleep quality. We found no correlations between mothers' BMI or eating behavior and children's BMI or eating behavior.CONCLUSION: Children's prevalence of overweight/obesity and eating attitudes improves soon after their mothers' RYGB, but then return to pre-surgery levels at 4 years post-surgery, as do mothers' sleep quality and symptoms of depression and anxiety, even though their weight loss was maintained.
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48.
  • Sellberg, Fanny, et al. (författare)
  • Four years' follow-up changes of physical activity and sedentary time in women undergoing roux-en-Y gastric bypass surgery and appurtenant children
  • 2017
  • Ingår i: BMC Surgery. - : Springer Science and Business Media LLC. - 1471-2482. ; 17:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Objectively measured levels of physical activity (PA) in patients undergoing Roux-en-Y Gastric Bypass (RYGB) surgery remain essentially unchanged from before to one year after surgery. Effects from RYGB on objectively measured levels of PA among women undergoing RYGB and appurtenant children beyond one year post-surgery are unknown. The aim of the present study was to objectively assess longitudinal changes in PA and sedentary time (ST), among women undergoing RYGB and appurtenant children, from three months before to nine and 48 months after maternal surgery.METHODS: Thirty women undergoing RYGB and 40 children provided anthropometric measures during home visits and valid accelerometer assessed (Actigraph GT3X+) PA data, three months before and nine and 48 months after maternal RYGB surgery.RESULTS: Women undergoing RYGB decreased time spent in moderate to vigorous PA (MVPA) with 2.0 min/day (p = 0.65) and increased ST with 14.4 min/day (p = 0.35), whereas their children decreased time spent in MVPA with 13.2 min/day (p = 0.04) and increased ST with 110.5 min/day (p < 0.001), from three months before to 48 months after maternal surgery. Twenty, 27 and 33% of women, and 60, 68 and 35% of children reached current PA guidelines three months before and nine and 48 months after maternal RYGB, respectively.CONCLUSIONS: Objectively measured PA in women remains unchanged, while appurtenant children decrease time spent in MVPA and increase ST, from three months before through nine and 48 months after maternal RYGB. The majority of both women undergoing RYGB and children are insufficiently active 48 months after maternal RYGB.
  •  
49.
  • Sellberg, Fanny, et al. (författare)
  • Meeting physical activity recommendations is associated with health-related quality of life in women before and after Roux-en-Y gastric bypass surgery
  • 2019
  • Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 28:6, s. 1497-1507
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Meeting physical activity (PA) recommendations is positively associated with health-related quality of life (HRQoL), but it is still unclear whether PA (specifically objectively measured) is associated with HRQoL in bariatric surgery candidates, both before and after surgery. Thus, the aim of this study was to examine the cross-sectional association between meeting objectively measured PA recommendations and HRQoL before and after Roux-en-Y gastric bypass (RYGB) surgery.METHODS: Sixty-six women undergoing RYGB with pre-surgery and 62 women with post-surgery valid PA and HRQoL data were included from the control group of a RCT study aiming at improving HRQoL and PA post-RYGB surgery. Measures before and 12 months after RYGB included the Short Form Health Survey (SF-36) and objectively measured PA, sedentary time (ST), and step counts with GT3X+ accelerometers. Multiple linear regression models were used to analyze the associations between PA and HRQoL.RESULTS: Participants who engaged in more than 150 min of moderate to vigorous PA (MVPA)/week (PA recommendations) had considerably higher SF-36 scores (HRQoL) than those who did not, both pre and 12-month post-surgery, with greatest difference in the subscale bodily pain, 15.5 (p = 0.021) higher score (higher scores means less pain) pre-surgery and a 19.7 (p = 0.004) higher score post-surgery. Higher LPA and step counts and lower ST also showed positive associations in some of the subscales of SF-36.CONCLUSIONS: Meeting the PA recommendations and overall engaging in more PA was associated with higher HRQoL, pre-, and post-RYGB surgery, highlighting the importance of PA both pre- and post-surgery.
  •  
50.
  • Sellberg, Fanny, et al. (författare)
  • One-year follow-up of a dissonance-based intervention on quality of life, wellbeing, and physical activity after Roux-en-Y gastric bypass surgery : a randomized controlled trial
  • 2019
  • Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 15:10, s. 1731-1737
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Health-related quality of life (HRQoL) peaks around 1 year after Roux-en-Y gastric bypass (RYGB) surgery, and thereafter, in many patients, slowly deteriorates.OBJECTIVES: The aim of the present study was to test early effects (study endpoint 2 years) of a dissonance-based group intervention on HRQoL (primary outcome) and wellbeing among women who underwent RYGB: a 1-year follow-up of the WELL-GBP trial.SETTING: Women were recruited from 5 different hospitals in Sweden pre-RYGB surgery. Participants were randomized to intervention or a control group (regular care).METHODS: The intervention consisted of 4 group sessions, 2 to 3 months post-surgery, comprising the following 4 different topics: (1) physical activity, (2) eating behavior, (3) social relationships, and (4) intimate relationships. Participants answered questionnaires about HRQoL (SF-36, Short-Form Health Survey), social adjustment, body esteem, eating behavior, and wore an accelerometer for 7 days at pre- and 1 year post-RYGB.RESULTS: Two hundred fifty-nine women were recruited and 203 (78%) completed 1-year follow-up measurements. Mean body mass index pre-surgery was 40.8 (standard deviation = 4.5), mean age 44.7 (standard deviation = 10.3) years, and 61 of 120 women in the intervention group received the intervention according to protocol (≥3 group sessions). We observed no difference between the intervention and the control group at 1-year post-RYGB surgery. All scales improved in both groups from pre- to 1 year post-surgery.CONCLUSIONS: We did not observe any 1-year early effects on HRQoL from a dissonance-based group intervention among female RYGB patients. Future studies may investigate long-term effects of the intervention.
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