| 1. |
- Larsson, Robert, et al.
(författare)
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‘We get to learn as we move’: effects and feasibility of lesson-integrated physical activity in a Swedish primary school
- 2024
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Ingår i: BMC Public Health. - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPhysical activity (PA) promotes health in adults as well as children. At the same time, a large proportion of children do not meet the recommendations for PA, and more school-based efforts to increase PA are needed. This study investigates the effectiveness and feasibility of lesson-integrated PA in a Swedish primary school.MethodsWe evaluate a new method called ‘Physical Activity and Lesson in Combination’ (abbreviated FALK in Swedish) using a mixed methods approach; a quasi-experimental study followed by qualitative interviews. Two schools participated in the study, one constituting the intervention group (I-school, n = 83) and the other the control group (C-school, n = 81). In addition to regular physical education, the I-school had three 30-minute FALK lessons each week. A total of 164 students aged 7–9 years wore pedometers for a whole week, four times over two semesters, and the number of steps per day (SPD) and the proportion of students with < 10,000 SPD were compared. Statistical differences between the schools were tested with ANOVA, Chi2, t-tests, and ANCOVA. Interviews with students (n = 17), parents (n = 9) and teachers (n = 9) were conducted and analysed using qualitative content analysis.ResultsThe results show that FALK led to the I-school getting more SPD and fewer students with < 10,000 SPD. Also, FALK was experienced as a positive, clear, and flexible method, simultaneously encouraging PA and learning. Challenges experienced concerned the teachers’ work situation, time, finding suitable learning activities, outdoor school environment changes, and extreme weather conditions.ConclusionsThis study indicates that FALK has the desired effects on PA and is a feasible method of integrating PA into theoretical teaching. We conclude that FALK is worth testing at more schools, given that implementation and sustainment of FALK considers both general enablers and barriers, as well as context-specific factors at the individual school.
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| 2. |
- Larsson, Robert, et al.
(författare)
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Ämnesintegrerad fysisk aktivitet i skolan: En intervjustudie om upplevda möjligheter, hinder och förbättringsförslag
- 2022
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X .- 2000-4192. ; 99:2, s. 266-279
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Studiens syfte var att undersöka hur elever, vårdnadshavare och pedagoger upplever implementering av ämnesintegrerad fysisk aktivitet (FA) vid en kommunal grundskola. En kvalitativ forskningsansats användes där datainsamling genomfördes genom intervjuer med lågstadieelever, vårdnadshavare och pedagoger (n = 35). Insamlade data analyserades med hjälp av kvalitativ innehållsanalys. Resultaten visar att det nya arbetssättet kallat Fysisk Aktivitet ochLektion i Kombination (FALK) har upplevts positivt, tydligt och flexibelt. Att arbetssättet uppmuntrar till ökad rörelse och lärande parallellt beskrivs som en möjliggörande faktor. Svårigheter avseende pedagogernas arbetsplanering, tidsåtgång och praktiska utmaningar att kombinera FA med lämpliga läraktiviteter beskrivs som hinder. Förändringar av den yttre skolmiljön och utmanande väderbetingelser är ytterligare hinder. Slutsatsen är att FALK bedöms vara ett användbart och praktiskt genomförbart arbetssätt för att integrera FA i den teoretiska undervisningen.
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| 3. |
- Ljung, Thomas, Docent, 1961-, et al.
(författare)
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Fysisk Aktivitet och Lektion i Kombination (FALK) : Ett arbetssätt för mera fysisk aktivitet i skolan.
- 2022
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X .- 2000-4192. ; 99:2, s. 252-265
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Tidskriftsartikel (refereegranskat)abstract
- Fysisk aktivitet (FA) främjar hälsan hos såväl vuxna som barn. En stor andel av skolbarnen uppfyller inte rekommendationerna för FA. Få vetenskapliga studier har undersökt både effektivitet och genomförbarhet när det gäller skolbaserade insatser för att öka FA. Vi har utvärderat en metod vi kallar Fysisk Aktivitet och Lektion i Kombination (FALK). Två skolor deltog, en utgjorde kontrollgrupp (K), den andra interventionsgrupp (I). Totalt 164 elever i åldern 7–9 år bar stegräknare en vecka i sträck vid fyra tillfällen under två terminer. Utöver samma FA som K-gruppen så hade I-gruppen under dessa två terminer tre FALK-pass à 30 minuter varje vecka. Antalet steg per dag (SPD) och andelen elever med <10 000 SPD jämfördes. FALK resulterade i att I-gruppen fick fler SPD och mindre andel med <10 000 SPD. Slutsatsen är att ämnesintegrerad FA har önskad effekt och fungerar i praktiken. FALK kräver inga extra resurser, men det behövs en öppenhet för alternativa undervisningsmetoder.
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| 4. |
- Ahlberg, AC, et al.
(författare)
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Depression and anxiety symptoms in relation to anthropometry and metabolism in men
- 2002
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Ingår i: Psychiatry Research. - 0925-4927 .- 1872-7506. ; 112:2, s. 101-110
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Tidskriftsartikel (refereegranskat)abstract
- Depression is associated with an increased risk of developing cardiovascular disease and type 2 diabetes mellitus. Abdominal obesity is also a high risk factor for these diseases. Therefore, symptoms of depression and anxiety were examined in relation to abdominal obesity. A total of 59 middle-aged men volunteered for measurements with the Hamilton Depression Scale (HDS), the Montgomery-Asberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAS). These results were examined in relation to body mass index (BMI), waist/hip ratio (WHR) and sagittal abdominal diameter, a measurement of intra-abdominal fat mass, and metabolic variables. Men with WHR > 1.0 (n=26) in comparison with men with normal WHR (< 1.0, n=33) showed significantly higher sum scores in all the scales used. There were positive correlations between the sum scores of all the depression scales and the WHR or the sagittal abdominal diameter. BMI correlated comparatively weakly only with the HDS. The correlations with the WHR remained when the influence of BMI was eliminated, suggesting that obesity is less involved than centralization of body fat. Insulin and glucose were significantly related to the HDS. Morning cortisol levels were negatively related to the BDI and (borderline) to the MADRS, suggesting perturbations of the regulation of the hypothalamic-pituitary-adrenal axis.. We conclude that men with abdominal obesity have symptoms of depression and anxiety.
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| 5. |
- Andersson, Björn, et al.
(författare)
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Urinary albumin excretion and heart rate variability in obese women
- 1998
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 22:5, s. 399-405
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this work was to examine the relationship between cardiac autonomic function and urinary albumin excretion in obesity.SUBJECTS: These were 27 obese non-diabetic postmenopausal women and 18 non-obese healthy postmenopausal women.MEASUREMENTS: Urinary albumin excretion as well as plasma nitrate, both indices of capillary function, were measured. Power spectral analysis of heart rate variability was performed, as a measurement of vagal function. An oral glucose tolerance test (OGTT) was performed and blood lipids were analysed.RESULTS: The obese women were characterized by higher fasting insulin, sum of glucose, triglycerides and lower high density lipoprotein cholesterol (HDL), the latter of borderline significance, than controls. Urinary albumin excretion (UAE), plasma nitrate and heart rate variability were not different between obese and control women. However, in obese women log UAE correlated positively with systolic and diastolic blood pressure, and inversely with heart rate variability, the latter independent of body mass index (BMI) and the waist/hip circumference ratio.CONCLUSION: It was concluded that this inverse association between UAE and parasympathetic activity in obese women may be an early sign of derangements of endothelial function and autonomic nervous system control, which may contribute to the increased risk of cardiovascular mortality in abdominal obesity.
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| 6. |
- Gerber, M, et al.
(författare)
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Fitness moderates the relationship between stress and cardiovascular risk factors
- 2016
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Ingår i: Medicine & Science in Sports & Exercise. - 0195-9131 .- 1530-0315. ; 48:11, s. 2075-2081
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This cross-sectional observational study examined the degree to which cardiorespiratory fitness (CRF) and self-perceived stress are associated with cardiometabolic risk factors and the overall risk score for cardiovascular diseases. The second aim was to determine whether participants' CRF levels moderate the relationships between stress and cardiometabolic risk.Methods A gender-matched stratified sample (N = 197, 51% men, M-age = 39.2 yr) was used to ensure that participants with varying stress levels were equally represented. CRF was assessed with the angstrom strand bicycle test, and perceived stress was assessed with a single-item question. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), glycated hemoglobin, and total cardiometabolic risk score (sum of the z-standardized residuals of the previously mentioned indicators) were assessed as outcomes.Results Higher LDL-C, TG, and total metabolic risk were found in participants with high stress scores (P < 0.05). In addition, lower SBP, DBP, BMI, LDL-C, TG, and total metabolic risk were observed in participants with high CRF (P < 0.05). Two-way ANCOVA provided significant interaction effects for five of the nine outcome variables (P < 0.05, 3.6%-4.8% of explained variance). Participants with high stress who also had high CRF levels had lower SBP, DBP, LDL-C, TG, and total cardiometabolic risk than participants with high stress but low or moderate CRF levels. No significant main or interaction effects occurred for BMI, total cholesterol, high-density lipoprotein cholesterol, and glycated hemoglobin.Conclusion Better CRF is associated with more favorable levels of several cardiometabolic risk factors, specifically in participants experiencing high stress. Higher CRF may provide some protection against the health hazards of high chronic stress by attenuating the stress-related increase in cardiovascular risk factors.
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| 7. |
- Jonsdottir, IH, et al.
(författare)
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Working memory, attention and excecutive functions are still impaired after three years in patients with stress-related exhaustion
- 2017
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 58:6, s. 504-509
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive impairment is one of the most pronounced symptoms reported by patients with stress-related mental health problems. Impairments related to executive function and to some extent speed and attention are therefore common in patients with stress-related burnout/exhaustion. In this paper we present a follow-up of cognitive performance in patients with stress-related exhaustion several years after they initially sought medical care. Thirty patients and 27 healthy controls, mean age 49 years (SD 6.5) and 55 years (SD 6.7) respectively, were included, all of whom had undergone baseline measurements of neuropsychological functioning. The mean follow-up time was three years. Half of the patients still reported mental health problems at follow-up and over time no major changes in cognitive performance were noted. The patients still performed significantly poorer than controls with regard to cognitive functions, mainly related to speed, attention and memory function. Long-lasting impairment of cognitive functions related to speed, attention and memory function noted in patients with stress-related exhaustion should be acknowledged and taken into consideration during treatment and when discussing a return to work. Follow-up periods longer than three years are needed to explore the persistence of the cognitive impairment.
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| 8. |
- Ljung, Thomas, 1961-, et al.
(författare)
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Central and peripheral glucocorticoid receptor function in abdominal obesity.
- 2002
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Ingår i: Journal of endocrinological investigation. - 0391-4097 .- 1720-8386. ; 25:3, s. 229-35
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Tidskriftsartikel (refereegranskat)abstract
- Abdominal obesity seems to be associated with a moderately deranged feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis where central glucocorticoid receptors (GR) are involved. Therefore, functions of central and peripheral GR were compared in this study. Furthermore, since trinucleotide repeats in early exons of steroid hormone receptor genes influence transcription, and therefore may influence receptor density, this was also studied. Ten middle-aged men, 5 with abdominal obesity and 5 controls, were studied. The suppression of dexamethasone (dex) on serum cortisol was used in dose-response tests to assess the function of central GR. Abdominal adipose tissue biopsies were incubated and exposed to cortisol in different concentrations, and the function of the peripheral GR assayed as induction of lipoprotein lipase (LPL) activity. Aberrant expansion of exonic trinucleotide repeats in the first coding exon of the GR gene was studied by sequencing of genomic DNA. Results showed that men with abdominal obesity showed less inhibition of serum cortisol by dex, particularly at lower concentrations, while in the controls cortisol secretion was inhibited in an apparent dose-response manner. LPL activity in adipose tissue was lower in abdominal obese men than in controls. However, the sensitivity to cortisol was not different between the groups. There was no evidence for expansion of trinucleotide repeats. These results suggest that the central GR and the peripheral GR in adipose tissue exhibit functional differences in abdominal obesity.
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| 9. |
- Ljung, Thomas, Docent, 1961-, et al.
(författare)
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FALK, a method to increase physical activity in school
- 2023
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Konferensbidrag (refereegranskat)abstract
- Background: Physical activity (PA) promotes health in adults as well as children. A large proportion of schoolchildren don´t meet the recommendations for PA. Few scientific studies have investigated both effectiveness and feasibility regarding school-based efforts to increase PA. We have evaluated a method we call Physical Activity and Lesson in Combination (In Swedish: Fysisk Aktivitet och Lektion i Kombination, FALK).Purpose: To investigate the effectiveness and feasibility of FALK.Methods: Two schools participated, one constituted control group (C), the other intervention group (I). In addition to the same PA as C-group, the I-group had three FALK sessions of 30 minutes each week.We used pedometers to assess changes in physical activity and interviews to evaluate feasibility. A total of 164 pupils aged 7-9 wore pedometers for a whole week on four occasions over two semesters. The number of steps per day (SPD) and the proportion of pupils with <10,000 SPDs were compared.Interviews were carried out with students, parents, and educators (n = 35) and were analyzed by qualitative content analysis.Findings: Pedometer data shows that students who perform FALK sessions are more physically active, and the proportion of students with insufficient PA is smaller, compared to students who don´t have FALK.The interviews show both enabling factors and barriers, but overall FALK is experienced as positive, clear, and flexible.Conclusions: FALK increases PA and is assessed as a useful and feasible practice to integrate PA into theoretical teaching.
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| 10. |
- Ljung, Thomas, 1961-, et al.
(författare)
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Inhibition of cortisol secretion by dexamethasone in relation to body fat distribution: a dose-response study
- 1996
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Ingår i: Obesity Research. - : Wiley. - 1071-7323 .- 1550-8528. ; 4:3, s. 277-282
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Tidskriftsartikel (refereegranskat)abstract
- There is now evidence of a hypersensitive hypothalamo-pituitary-adrenal (RPA) axis in subjects with an elevated waist/hip circumference ratio (WHR), an indicator of the centralization of body fat stores. The activity of the HPA axis is regulated by central glucocorticoid receptors, whose activity can be tested by the administration of exogenous glucocorticoids, which normally inhibit cortisol secretion.In this study, dexamethasone (dex) was administered in random order in doses of 0.05, 0.125, 0.25 and 0.5 mg at 10 p.m. with measurements of serum cortisol in the morning (8 a.m.) of this and the following day. The test was performed on 22 apparently healthy men, 40 to 60 years of age, recruited from laboratory personnel, outpatient clinics or advertisements in a newspaper. Eight had a body mass index (BMI) (kg/m(2)) of <25 and 14 of >25. Twelve men had a waist hip ratio (WHR) of <1.0 and 10 men had a WHR of >1.0.Cortisol values at baseline were correlated inversely with WHR and were usually lower in men with a high (>1.0) rather than a low than low (<1.0) WHR after dex inhibition. There was apparently no inhibition by dex at 0.05 and 0.125 mg on average in men with a WHR of >1.0. In addition, the inhibition at 0.5 mg dex correlated negatively with the WHR and was significantly lower (p<0.05) in men with a WHR of >1.0 than in men with a WHR of <1.0. None of these differences or relationships was found to be dependent on BMI.It is concluded that men with an elevated WHR experience a decrease in the inhibition of cortisol secretion by dex. It is suggested that this could explain or contribute to the elevated sensitivity of their HPA axis. Furthermore, lower morning cortisol concentrations suggest a change in diurnal secretion patterns.
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| 11. |
- Ljung, Thomas, 1961
(författare)
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Stress system function in abdominal obesity. The hypothalamic-pituitary-adrenal axis and the sympathetic nervous system in middle-aged men
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: There is a strong relationship between central (abdominal, visceral) obesity, impaired glucose tolerance, insulin resistance, dyslipidemia and elevated blood pressure. These abnormalities are included in the term Metabolic Syndrome, and indicate an elevated risk for cardiovascular disease and diabetes type 2. Although obesity per se is considered to be a major health hazard, a predominance of abdominal distribution of adipose tissue has shown a higher predictive power for various forms of health problems. Aims: The objective of these studies was to further elucidate the neuroendocrine perturbations found in abdominal obesity.Subjects and Methods: Healthy, middle-aged men with varying body fat distribution were examined. Dexamethasone (dex) suppression tests, using different dexamethasone doses, were performed and the activity of lipoprotein lipase (LPL) in adipose tissue was studied, exposing the tissue for cortisol in a dose-response manner. The men underwent oral glucose tolerance test (OGTT), stimulation with corticotropin releasing hormone (CRH) and arithmetic stress test. Furthermore, diurnal concentrations of adrenocorticotropic hormone (ACTH), cortisol and growth hormone (GH) were measured. Some of the abdominally obese men were treated for six months with the selective serotonin reuptake inhibitor (SSRI) citalopram and for six months with placebo using a double-blind, cross-over design, with a two months wash-out period between treatment periods.Results: Men with abdominal obesity showed less inhibition of serum cortisol by dex, and LPL activity in adipose tissue was blunted, compared to controls. Men with a high waist/hip circumference ratio (WHR), in comparisons with men with a low WHR but similar body mass index (BMI), had higher insulin, glucose and triglyceride concentrations in the basal state and higher glucose and insulin concentrations during OGTT. They also had elevated diurnal ACTH values but similar cortisol values, except lower cortisol values in the morning. Diurnal growth hormone concentrations showed reduced peak size. Stimulation of the HPA axis with CRH and acute laboratory stress showed no difference in ACTH concentrations, but cortisol concentrations were lower in men with high WHR. Men with a high WHR also had elevated pulse pressure and heart rate in the basal state and after challenges by CRH and acute laboratory stress. Furthermore, men with a high WHR had increased 24 h urinary excretion of catecholamine metabolites. After treatment with citalopram morning cortisol rose to normal. Cortisol concentrations after stimulation with CRH or stress were elevated by citalopram treatment but urinary cortisol excretion was unchanged. Glucose concentrations during OGTT were reduced, with unchanged insulin concentrations, while other metabolic values did not change during treatment. Heart rate, in the basal state and after administration of CRH or during laboratory stress test, and diurnal urinary excretion of metoxycatecholamines, decreased by citalopram treatment. Neither BMI nor WHR decreased. Depression scores were within normal limits before treatment and did not change.Conclusions: Visceral obesity is associated with not only aberrations in the HPA axis, but also in the sympathetic nervous system. These neuroendocrine abnormalities, which act in concert, are most likely the origin of the increased risk for disease in visceral obesity, and are reminiscent of those seen in mental depression. SSRI might be a useful tool in the treatment of the metabolic syndrome.
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| 12. |
- Ljung, Thomas, 1961-, et al.
(författare)
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Stressreaktionernas biologi
- 2004
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 101:18, s. 1089-1094
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Tidskriftsartikel (refereegranskat)
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| 13. |
- Ljung, Thomas, 1961-, et al.
(författare)
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The activity of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system in relation to waist/hip circumference ratio in men
- 2000
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Ingår i: Obesity Research. - : Wiley. - 1071-7323 .- 1550-8528. ; 8, s. 487-495
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate possible differences, between generally and abdominally obese men, in activity and regulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system.Research Methods and Procedures: Fifty non-diabetic, middle-aged men were selected to obtain two groups with similar body mass index (BMI) but different waist/hip circumference ratio (WHR). Measurements were performed of the activity of the HPA axis and the sympathetic nervous system, as well as metabolic and endocrine variables.Results: Men with a high WHR, in comparisons with men with a low WHR, had higher insulin, glucose, and triglyceride values in the basal state and higher glucose and insulin after an oral glucose tolerance test. Men with high WHR had elevated diurnal adrenocorticotropic hormone (ACTH) values but similar cortisol values, except lower cortisol values in the morning. Diurnal growth hormone concentrations showed reduced peak size. Stimulation of the HPA axis with corticotropin-releasing hormone (CRH) and laboratory stress showed no difference in ACTH values between groups, but cortisol values were lower in-men with high WHR. In comparison with men with a low WHR, men with a high WHR had elevated pulse pressure and heart rate in the basal state and after challenges by CRH and laboratory stress. They also had increased urinary excretion of catecholamine metabolites.Discussion: These results suggest a mild dysregulation of the HPA axis, occurring with elevated WHR independent of the BMI. The results also indicate a central activation of the sympathetic nervous system, such as in the early phases of hypertension, correlating with insulin resistance.
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| 14. |
- Ljung, Thomas, 1961-, et al.
(författare)
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Treatment of abdominally obese men with a serotonin reuptake inhibitor: a pilot study.
- 2001
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Ingår i: Journal of internal medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 250:3, s. 219-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the effects of a selective serotonin reuptake inhibitor (SSRI) on the neuroendocrine and autonomic nervous system perturbations found in abdominal obesity. DESIGN: Treatment for 6 months with citalopram and for 6 months with placebo using a double-blind, cross-over design, with a 2-month wash-out period between treatment periods. SUBJECTS: Sixteen healthy men, 45-60 years, moderately obese and with an abdominal fat distribution. MEASUREMENTS: Anthropometry, three different depression rating scales, serum lipids, testosterone, IGF-I, oral glucose tolerance test (OGTT), pituitary stimulation with corticotropin releasing hormone (CRH), arithmetic stress test, and excretion of cortisol and metoxycatecholamines in urine, collected during 24 h. RESULTS: Cortisol concentrations in the morning were low before treatment, indicating a perturbed function of the hypothalamic-pituitary-adrenal (HPA) axis. After treatment with citalopram morning cortisol concentrations rose to normal. Cortisol concentrations after stimulation with CRH or stress were elevated by citalopram treatment, but urinary cortisol excretion was unchanged. The glucose concentrations after OGTT (120 min) tended to be reduced, with unchanged insulin concentrations, whilst other metabolic values did not change during treatment. Heart rate after administration of CRH, and during laboratory stress test, decreased by treatment with citalopram. Diurnal urinary excretion of metoxycatecholamines tended to decrease. Neither body mass index nor waist/hip circumference ratio decreased. Depression scores were within normal limits before treatment and did not change. CONCLUSION: The results of this pilot study indicate improvements in the regulation of neuroendocrine-autonomic systems as well as metabolism in abdominal obesity during treatment with an SSRI.
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| 15. |
- Sjörs, Anna, et al.
(författare)
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Long-term follow-up of cortisol awakening response in patients treated for stress-related exhaustion
- 2012
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 2:4
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Studies on hypothalamus-pituitary-adrenal (HPA) axis activity in stress-related exhaustion Design: HPA axis activity was assessed through the cortisol awakening response (CAR). Salivary cortisol Setting: An outpatient clinic specialising in stress-related illness. Participants: Patients with clinically diagnosed stress-related exhaustion (n = 162) and healthy controls Primary and secondary outcome measures: The primary measure was CAR measured as the difference Results: Patients showed similar CAR as the controls and their CAR did not change significantly during Conclusions: The authors conclude that CAR does not seem to discriminate clinically defined patients
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| 16. |
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