| 1. |
- Collan, Camilla, et al.
(författare)
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To capture the child's interest - nurses experiences of 'Saga stories in health talks'.
- 2024
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As unhealthy lifestyle habits have been found to be established early in life and often track into adulthood, early preventive initiatives are important. 'Saga Stories in health talks' is a newly developed material that is intended to be used as a support for nurses at child health care (CHC) centers in their health talks with children and parents in Sweden. The aim of this study is to explore how CHC nurses experience the usability of the 'Saga Stories in health talks' material.METHODS: This study used a qualitative design. The material 'Saga Stories in health talks' was tested by 33 CHC nurses working in 11 CHC centers in three regions in Sweden. All CHC nurses were invited to participate in the interviews and 17 agreed. The interviews were transcribed and analysed using content analysis.RESULTS: Three categories and eight sub-categories emerged. The categories were: (1) An appreciated tool suitable for health talks, (2) Illustrations to capture children's interest in the conversation with families, and (3) Barriers and facilitators. Saga Stories in health talks' was experienced by the CHC nurses as an appreciated tool with content highly relevant to what should be discussed during the health talks. The CHC nurses described the material as well-designed with illustrations that helped them capture the child's interest and increase their participation, while still involving the parents. Support from colleagues, the researchers, and managers were seen as important facilitators. Challenges included structural factors such as how and when to best use the material, especially concerning that the 4-year visit contained many other mandatory parts.CONCLUSIONS: This pilot study show that the material 'Saga Stories in health talks' was highly appreciated by CHC nurses and facilitated their health talks with families in CHC. Important aspects with the material were the relevant content and the focus on healthy living habits, as well as the child friendly illustrations. These findings can be used when similar material is developed to facilitate health talks with families in other contexts. Our results also highlight the importance to adjust the implementation of a new material with already established practice and routines.
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| 2. |
- Delisle Nyström, Christine
(författare)
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A web- and mobile phone-based obesity prevention intervention in 4-year-olds : a population-based randomized controlled trial
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Childhood overweight and obesity has increased significantly over the past two decades. Many well-conducted obesity prevention trials have been conducted in pre-school aged children but the majority have not been able to show changes in obesity related markers. These trials have used traditional face-to-face methods to conduct the interventions, which are expensive and difficult to scale up. Therefore, new dissemination methods for intervention studies such as mobile health (mHealth) should be explored. Aims: The overall aim of this thesis was to determine whether a mHealth intervention targeted towards parents could improve obesity markers in pre-school aged children. Paper I: To outline the study design and methodologies utilized in the MINISTOP trial. Paper II: To evaluate the validity of reported energy and food intake assessed using the mobile based Tool for Energy Balance in Children (TECH) against total energy expenditure (TEE) and 24hr dietary recalls, respectively. Paper III: To evaluate the capacity of the wrist-worn ActiGraph wGT3x-BT accelerometer to capture variations in free-living activity energy expenditure (AEE) and to assess wear compliance of the ActiGraph using a seven day 24hr protocol. Paper IV: To assess the effectiveness of the MINISTOP intervention on body composition, intakes of fruits, vegetables, candy, and sweetened beverages, as well as the amount of time spent sedentary and in moderate-to-vigorous physical activity after the 6-month intervention. Paper V: To investigate if the MINISTOP intervention 12-months after baseline improved fat mass index (FMI) and had a maintained effect on a composite score (made up of FMI as well as dietary and physical activity variables). Methods Paper II: A nested validation study including 39 children aged 5.5 years. Energy and food intakes were measured using TECH and compared to TEE assessed using the doubly labelled water method and 24hr dietary recalls, respectively. Paper III: A nested validation study including 40 children aged 5.5 years. TEE was assessed using the doubly labelled water method and AEE was calculated as TEE minus a predicted basal metabolic rate. The ActiGraph was worn on the non-dominant wrist and the utilized outputs were mean of daily filtered vector magnitudes (mean VM total) and mean of awake filtered vector magnitudes (mean VM waking). Papers IV and V: A randomized controlled trial including 315 children aged 4.5 years. After baseline assessments, the children were randomly allocated into the intervention or control group for six months. The intervention group and control group received the MINISTOP app or a pamphlet on dietary and physical activity behaviors for pre-school children, respectively. The outcome measures were FMI (primary) and intakes of fruits, vegetables, candy, and sweetened beverages, as well as time spent sedentary and in moderate-to-vigorous physical activity (secondary). Two composite scores, a seven component (including all primary and secondary outcomes) and a six component (including only secondary outcomes) were computed. Results Paper II: No significant difference between mean energy intake and TEE was found (P = 0.064). For all eight food groups assessed no significant differences in the mean intakes were observed when using TECH and 24hr dietary recalls and all intakes were correlated when using both methods (range for rho: 0.665 to 0.896, all P < 0.001). Paper III: Mean VM total and mean VM waking alone were able to explain 14% (P = 0.009) and 24% (P = 0.001) of the variation in AEE. When adding fat and fat free mass to the models 58% and 62% (P < 0.001) of the variation in AEE was explained, using mean VM total and mean VM waking, respectively. Paper IV: No intervention effect for the primary outcome FMI was observed between the intervention and control group (P = 0.922). At the 6-month follow-up, for the seven component composite score the intervention group significantly increased their score compared to the control group (+0.36 ± 1.47 units vs. -0.06 ± 1.33 units, respectively, P = 0.021 between groups), with the difference being more evident in children with a higher FMI. For the six component composite score the children in the intervention group had a higher odds of increasing their score in comparison to the control group (odds ratio: 1.99; 95% confidence interval: 1.20, 3.30, P = 0.008). Paper V: For FMI there was no significant difference observed between the intervention and control group (P = 0.566) between the 12-month follow-up and baseline. Furthermore, there was no maintained effect observed in the change in the difference in the seven component composite score between the intervention and control group (P = 0.248). Conclusions: The results from this thesis suggest that both TECH and the wrist-worn ActiGraph have the potential to provide useful information in studies where diet and physical activity in young children are assessed. Furthermore, this thesis presents results from the first mHealth obesity prevention study in pre-school aged children. Although no difference between the intervention and control group for FMI was observed, the intervention group showed a significantly higher seven component composite score difference than the control group at the 6-month follow-up, especially in children with a higher FMI. Topics for future research include modifications of the MINISTOP app to more specifically target high risk children as well as further studies on to how maintain behavior changes in mHealth interventions.
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| 3. |
- Delisle Nyström, Christine, et al.
(författare)
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Physical activity and screen time in Swedish children and adolescents: The generation pep study 2018–2021
- 2023
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 112:3
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Tidskriftsartikel (refereegranskat)abstract
- Aim To analyse physical activity and screen time trends annually between 2018 and 2021 in large population-based samples of Swedish children and adolescents. Methods This is a repeated cross-sectional study using data collected over 4years (2018–2021) using simple probability sampling of Swedish children and adolescents aged 4–17years. The web-based questionnaire, including questions on physical activity and screen time, was filled out by a parent if the child was <12years of age and by the adolescents themselves if they were≥12years. Sociodemographic data was collected from the parents. Results No significant difference in physical activity was observed in 2020 and 2021 compared to 2019. However, older children/adolescents and girls have higher odds to be in a lower physical activity category (p-values<0.001). With regards to screen time, there was a significant increase in reported screen time from 2018 to 2021 for children and adolescents, with screen time peaking in 2020 (p-values<0.001). Conclusion This is the first study in Sweden evaluating trends in physical activity and screen time in large population-based samples spanning from pre-school to adolescence. Interventions to promote physical activity, especially in the older age groups and to reduce screen time in a Swedish context are warranted.
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| 4. |
- Delisle Nyström, Christine, et al.
(författare)
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Study protocol for an effectiveness-implementation hybrid trial to evaluate a health promotion intervention in parents and their 5-year-old child : Saga Stories in health talks in Swedish child healthcare.
- 2022
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 22:1, s. 2184-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Unhealthy lifestyle behaviours such as a poor diet, inadequate physical activity, and excessive screen time have been shown to be established in childhood and track into adulthood, demonstrating the need for health promotion interventions in the pre-school years. The overall aim of this project is to: (i) evaluate the effectiveness of `Saga Stories in health talks´ within child healthcare (CHC) on parental self-efficacy to promote healthy diet, physical activity, and screen time behaviours in their child; children's intake of key dietary indicators and screen time and (ii) evaluate and explore the implementation of `Saga Stories in health talks´ with regards to acceptability, appropriateness, feasibility, fidelity, adoption, sustainability, satisfaction, and usage.METHODS: A hybrid type I effectiveness-implementation trial will be conducted. A cluster randomized controlled trial will be used to assess the effectiveness of `Saga Stories in health talks´ in 42 CHC centers across six regions in Sweden. `Saga Stories in health talks´ consists of material for CHC nurses to use to facilitate the health talk with both the child and parent(s) and is complemented with take-home material. Parent and child dyads are recruited (n = 450) from participating CHC centers when they attend their 5-year routine visit. The intervention group receives the health talk using Saga Stories and take-home material, whereas the control group receives the standard health talk. The primary outcome is parental self-efficacy to promote healthy diet, physical activity, and screen time behaviours in their child and secondary outcomes include children's intake of key dietary indicators and screen time. All outcomes are assessed at baseline and 2-months post-intervention. The implementation outcomes that will be assessed are: acceptability, appropriateness, feasibility, satisfaction, usage, fidelity, adoption, and sustainability (assessed quantitatively and qualitatively).DISCUSSION: The Swedish National Board of Health and Welfare have identified the need of more material, education, and working methods for promoting healthy lifestyle behaviours in CHC. Following this trial `Saga Stories in health talks´ has great potential to be implemented in CHC across Sweden to aid nurses to promote and support healthy lifestyle behaviours in pre-school children and their families.TRIAL REGISTRATION: ClinicalTrials.gov , NCT05237362 . Registered 2 February 2022.
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| 5. |
- Delisle Nyström, Christine, et al.
(författare)
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The paediatric option for BodPod to assess body composition in preschool children: what fat-free mass density values should be used?
- 2018
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Ingår i: British Journal of Nutrition. - : CAMBRIDGE UNIV PRESS. - 0007-1145 .- 1475-2662. ; 120:7, s. 797-802
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Tidskriftsartikel (refereegranskat)abstract
- Air displacement plethysmography utilises a two-component model to assess body composition, which relies on assumptions regarding the density of fat-free mass (FFM). To date, there is no evidence as to whether Lohmans or Wells et al.s FFM density values are more accurate in young children. Therefore, the aims of this study were to compare total body fat percentage (TBF%) assessed using the BodPod with both Lohmans and Wells et al.s FFM density values with TBF% from the three-component (3C) model in forty healthy Swedish children aged 5.5 years. Average TBF% calculated using Lohmans FFM density values underestimated TBF% in comparison with the corresponding value assessed using the 3C model (22.2 (SD 5.7) and 25.1 (SD 5.5)%, respectively; P amp;lt;0.001). No statistically significant difference was observed between TBF% assessed using Wells et al.s FFM density values and the 3C model (24.9 (so 5.5) and 251 (so 5.5)%, respectively; P= 0.614). The Bland and Altman plots for TBF% using both Lohmans and Wells et al.s FFM density values did not show any bias across the range of body fatness (Lohman: r0.056, P= 0.733 and Wells el al.: r-0.006, P= 0.970). These results indicate that Wells Cl al.s FFM density values should be used when assessing body composition with the paediatric option for BodPod in 5-year-old children. However, future studies are needed to confirm these results in other populations, including a wider age range of children.
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| 6. |
- Ek, Anna, et al.
(författare)
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A randomized controlled trial for overweight and obesity in preschoolers : the More and Less Europe study – an intervention within the STOP project
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Childhood overweight and obesity is a serious public health issue with an increase being observed in preschool-aged children. Treating childhood obesity is difficult and few countries use standardized treatments. Therefore, there is a need to find effective approaches that are feasible for both health care providers and families. Thus, the overall aim of this study is to assess the acceptance and effectiveness of a parent support program (the More and Less, ML) for the management of overweight and obesity followed by a mobile health (mHealth) program (the MINISTOP application) in a socially diverse population of families.METHODS/DESIGN: A two-arm, parallel design randomized controlled trial in 300 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden (n = 100 from each). Following baseline assessments children are randomized into the intervention or control group in a 1:1 ratio. The intervention, the ML program, consists of 10-weekly group sessions which focus on evidence-based parenting practices, followed by the previously validated MINISTOP application for 6-months to support healthy eating and physical activity behaviors. The primary outcome is change in body mass index (BMI) z-score after 9-months and secondary outcomes include: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire), physical activity (ActiGraph wGT3x-BT), dietary patterns (based on metabolic markers from urine and 24 h dietary recalls), epigenetic and gut hormones (fasting blood samples), and the overall acceptance of the overweight and obesity management in young children (semi-structured interviews). Outcomes are measured at baseline and after: 10-weeks (only BMI z-score, waist circumference), 9-months (all outcomes), 15- and 21-months (all outcomes except physical activity, dietary patterns, epigenetics and gut hormones) post-baseline.DISCUSSION: This study will evaluate a parent support program for weight management in young children in three European countries. To boost the effect of the ML program the families will be supported by an app for 6-months. If the program is found to be effective, it has the potential to be implemented into routine care to reduce overweight and obesity in young children and the app could prove to be a viable option for sustained effects of the care provided.
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| 7. |
- Ek, Anna, et al.
(författare)
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Effectiveness of a 3-Month Mobile Phone-Based Behavior Change Program on Active Transportation and Physical Activity in Adults : Randomized Controlled Trial.
- 2020
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 8:6, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking.OBJECTIVE: The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA).METHODS: For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months.RESULTS: No effect on MVPA was observed after 3 months (P=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; P=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day.CONCLUSIONS: No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA.TRIAL REGISTRATION: ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-018-5658-4.
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| 8. |
- Ek, Anna, et al.
(författare)
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Physical Activity and Mobile Phone Apps in the Preschool Age: Perceptions of Teachers and Parents
- 2019
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Physical activity (PA) is already beneficial at the preschool age. In many countries, young children spend most of their days in the preschool setting, making it a common arena for PA interventions. Mobile health tools are becoming increasingly popular to promote PA in different populations; however, little is known about the interest for and how the preschool setting could incorporate such a tool.OBJECTIVE:This study aimed to examine how teachers and parents perceive PA in preschool-aged children in general and their perceptions of how a mobile phone app could be used to promote PA in the preschool setting.METHODS:Semistructured interviews were conducted with 15 teachers (93%, [14/15] women, mean age 43.5 years, 47%, [7/15] with a university degree and 10 parents [91%, 9/10] women, mean age 38.9 years, all with a university degree) recruited from 2 urban preschools in central Sweden. The interviews were recorded, fully transcribed, coded, and analyzed using thematic analysis by means of an inductive approach.RESULTS:The analysis revealed 4 themes: (1) children are physically active by nature, (2) the environment as a facilitator or a barrier, (3) prerequisites of the adult world, and (4) an app in the preschool setting-challenges and possibilities. Parents and teachers perceived preschoolers as being spontaneously physically active; however, high-intensity PA was perceived as low. The PA was specifically performed during the day in the preschool. Identified facilitators of PA were access to safe and engaging outdoor environments such as forests, spacious indoor areas, and adult involvement. Adult involvement was considered especially important for children preferring sedentary activities. Identified barriers for PA were restricted indoor and outdoor space, rules for indoor activities, and lack of adult involvement because of time constraints. The teachers perceived that they had limited skills and experiences using apps in general, although they also acknowledged the increasing role of technological tools in the curriculum. Thus, the teachers expressed an interest for an app designed as a support tool for them, especially for situations when PA was limited because of perceived barriers. They suggested the app to include accessible information regarding the health benefits of PA in children linked to a library of activities for different settings and seasons. Parents suggested interactive app features including problem-solving tasks and music and dance, but not video clips as they made children passive.CONCLUSIONS:Vigorous PA was perceived as low in preschool-aged children. Future tailoring of interventions in the preschool setting should work around barriers and support facilitators to PA, especially PA of high intensity. In such work, an app could serve as a source of inspiration for PA in different ages, settings, and seasons and thus reduce environmental and structural inequalities in the preschool setting.
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| 9. |
- Ek, Anna, et al.
(författare)
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Responding positively to "children who like to eat" : Parents' experiences of skills-based treatment for childhood obesity
- 2020
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Ingår i: Appetite. - : Elsevier BV. - 0195-6663 .- 1095-8304. ; 145
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to understand the challenges parents of preschoolers with obesity face. We assessed parents' experiences of a group treatment program focused on parenting skills; the treatment program was evaluated in a randomized controlled trial in Stockholm County. After completing the program's 10 weekly sessions, parents were invited to participate in a semi-structured interview. The interviews were audio recorded, transcribed and analyzed using thematic analysis. In total, 36 parents (67% mothers, mean age 39 years, 33% foreign background, 50% with university degree) were interviewed. Two main themes were developed: Emotional burden and Skills and strength from others. Emotional burden encompassed the parents' experiences of raising a child with obesity. Parents spoke about the difficulties of managing their child's appetite and of seeking help and treatment, as well as their feelings about the social stigma attached to obesity. Skills and strength from others encompassed the parents' experiences of participating in group treatment. Parents reported that they appreciated the practical behavior change techniques taught, especially those regarding food and how to make everyday life more predictable, and said the focus on parenting skills gave them the confidence to apply the techniques in everyday life. Parents also highlighted the strength of the group setting, saying it enabled them to discuss perceived challenges and learn from other parents. Our findings show that childhood obesity carries social and emotional implications for parents, and that an intervention that provides parents with skill-building and a discussion space can help in negotiating these implications. This suggests that childhood obesity intervention programs benefit from including a parent-based approach which offers training in parenting skills and support in managing socially and emotionally challenging situations.
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| 10. |
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| 11. |
- Henriksson, Hanna, et al.
(författare)
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Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers
- 2017
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Ingår i: Medicine & Science in Sports & Exercise. - : LIPPINCOTT WILLIAMS & WILKINS. - 0195-9131 .- 1530-0315. ; 49:10, s. 2078-2085
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to investigate longitudinal associations of objectively measured physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness at a 12-month follow-up in healthy Swedish 4-yr-old children. Methods: The data from the population-based MINISTOP trial were collected between 2014 and 2016, and this study included the 138 children who were in the control group. PA and SB were assessed using the wrist-worn ActiGraph (wGT3x-BT) accelerometer during seven 24-h periods and, subsequently, defined as SB, light-intensity PA, moderate-intensity PA, vigorous-intensity PA (VPA), and moderate-to-vigorous PA (MVPA). Body composition was measured using air-displacement plethysmography and physical fitness (cardiorespiratory fitness, lower and upper muscular strength as well as motor fitness) by the PREFIT fitness battery. Linear regression and isotemporal substitution models were applied. Results: Greater VPA and MVPA at the age of 4.5 yr were associated with higher fat-free mass index (FFMI) at 5.5 yr (P amp;lt; 0.001 and P = 0.044, respectively). Furthermore, greater VPA and MVPA at the age of 4.5 yr were associated with higher scores for cardiorespiratory fitness, lower body muscular strength, and motor fitness at 12-month follow-up (P = 0.001 to P = 0.031). Substituting 5 min.d(-1) of SB, light-intensity PA, or moderate-intensity PA for VPA at the age of 4.5 yr were associated with higher FFMI, and with greater upper and lower muscular strength at 12-month follow-up (P amp;lt; 0.001 to P = 0.046). Conclusion: Higher VPA and MVPA at the age of 4.5 yr were significantly associated with higher FFMI and better physical fitness at 12-month follow-up. Our results indicate that promoting high-intensity PA at young ages may have long-term beneficial effects on childhood body composition and physical fitness, in particular muscular strength.
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| 12. |
- Henriksson, Pontus, et al.
(författare)
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Body composition, physical fitness and cardiovascular risk factors in 9-year-old children
- 2022
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Ingår i: Scientific Reports. - : Nature Portfolio. - 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- The independent associations of body composition and physical fitness components with cardiovascular disease (CVD) risk factors in childhood are not fully understood. Thus, this cross-sectional study examined the independent associations of body composition and physical fitness with CVD risk factors in Swedish 9-year-old children (n = 411). Unadjusted linear regression analyses showed that body mass index (BMI), % fat mass and fat mass index were all positively associated with systolic and diastolic blood pressure, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Metabolic Syndrome (MetS) score (all β ≥ 0.229, P ≤ 0.001). These associations were virtually unaffected by adjustments for basic covariates (child’s age and sex, maternal educational level and maternal BMI), fat-free mass and physical fitness. Fat-free mass index had generally weak associations with CVD risk factors and no associations were statistically significant after adjustments (all P > 0.27). Greater cardiorespiratory fitness and motor fitness were associated with lower HOMA-IR and MetS score in unadjusted models (all β ≤ − 0.158, P ≤ 0.039) but not after adjustments for basic covariates and body composition. These findings indicate that cardiovascular health promotion in childhood may focus on the maintenance of a healthy fat mass.
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| 13. |
- Hidalgo Migueles, Jairo Hidalgo, et al.
(författare)
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Revisiting the cross-sectional and prospective association of physical activity with body composition and physical fitness in preschoolers : A compositional data approach
- 2022
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Ingår i: Pediatric Obesity. - : Wiley. - 2047-6302 .- 2047-6310. ; 17:8
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Tidskriftsartikel (refereegranskat)abstract
- Background Information is limited for the benefits of physical activity (PA) in preschoolers. Previous research using accelerometer-assessed PA may be affected for multicollinearity issues. Objectives This study investigated the cross-sectional and prospective associations of sedentary behaviour (SB) and PA with body composition and physical fitness using compositional data analysis. Methods Baseline PA and SB were collected in 4-year-old (n = 315) using wrist-worn GT3X+ during seven 24 h-periods. Body composition (air-displacement plethysmography) and physical fitness (PREFIT test battery) were assessed at baseline and at the 12-month follow-up. Results Increasing vigorous PA at expenses of lower-intensity behaviours for 4-year-old was associated with body composition and physical fitness at cross-sectional and longitudinal levels. For example, reallocating 15 min/day from lower intensities to vigorous PA at baseline was associated with higher fat-free mass index (+0.45 kg/m(2), 95% confidence intervals [CI]: 0.18-0.72 kg/m(2)), higher upper-body strength (+0.6 kg, 95% CI: 0.1-1.19 kg), higher lower-body strength (+8 cm, 95% CI: 3-13 cm), and shorter time in completing the motor fitness test (-0.4 s, 95% CI: -0.82 to [-0.01] s) at the 12-month follow-up. Pairwise reallocations of time indicated that the behaviour replaced was not relevant, as long as vigorous PA was increased. Conclusions More time in vigorous PA may imply short- and long-term benefits on body composition and physical fitness in preschoolers. These findings using compositional data analysis corroborate our previously published results using isotemporal substitution models.
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| 14. |
- Islam, Mohammad Redwanul, 1986-, et al.
(författare)
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Accelerometer-measured physical activity, fitness and indicators of cardiometabolic risk among rural adolescents: a cross-sectional study at 15-year follow-up of the MINIMat cohort
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among adolescents in resource-limited settings of low- and middle-income countries. We sought to examine the associations of accelerometer-measured PA and objective measures of physical fitness with conventional indicators of cardiometabolic risk along with difference in associations by gender in a birth cohort of rural adolescents. Methods: This cross-sectional study availed data from the 15-year follow-up of the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort in southeast Bangladesh (n = 2253). Wrist-mounted ActiGraph wGT3x-BT devices were used to estimate sedentary time (ST), total PA and time spent in intensity-specific PA. Fitness was assessed through: handgrip strength, standing long jump and maximal oxygen consumption (VO2max) estimated from Chester Step Test. Anthropometric parameters and systolic blood pressure (SBP) were recorded. Fasting plasma triglyceride (TG), total cholesterol (TC), low- and high-density lipoproteins (LDL and HDL), insulin and glucose levels were measured. We calculated insulin resistance (IR) using the Homeostasis Model Assessment equation (HOMA-IR). Three right-skewed outcome variables were natural log (Ln) transformed: WC, TG and HOMA-IR. Omnibus and gender-specific multiple linear regression models were fitted.Results: Total PA displayed weak, negative associations; whereas ST showed weak, positive associations with WC and IR. A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% CI: 2.9%–6.8%; P < 0.001) lower WC, 3.2 mm of Hg (95% CI: 1.5–4.8; P < 0.001) lower SBP, 10.4% (95% CI: 2.9%–17.3%; P = 0.008) lower TG, 24.4% (95% CI: 11.3%–34.9%; P < 0.001) lower IR. Time engaged in moderate-to-vigorous PA showed similar associations of notably smaller magnitude with the indicators. Except for WC, the associations were more pronounced among the boys. Weight-normalized grip strength was favorably associated with all seven indicators and the unstandardized effect sizes were considerably large. Higher VO2max was only associated with a small reduction in HOMA-IR. Conclusion: Our findings highlight the beneficial role of VPA, moderate-to-vigorous PA and muscular fitness in shaping cardiometabolic risk profile at mid-adolescence. VPA and handgrip strength represent potential targets for preventive strategies targeting adolescents in a rural context.
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| 15. |
- Nyström, Christine Delisle, et al.
(författare)
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A 12-month follow-up of a mobile-based (mHealth) obesity prevention intervention in pre-school children: the MINISTOP randomized controlled trial
- 2018
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Ingår i: BMC Public Health. - : BIOMED CENTRAL LTD. - 1471-2458. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: To date, few mobile health (mHealth) interventions aimed at changing lifestyle behaviors have measured long term effectiveness. At the 6-month follow-up the MINISTOP trial found a statistically significant intervention effect for a composite score comprised of fat mass index (FMI) as well as dietary and physical activity variables; however, no intervention effect was observed for FMI. Therefore, the aim of this study was to investigate if the MINISTOP intervention 12-months after baseline measurements: (i) improved FMI and (ii) had a maintained effect on a composite score comprised of FMI and dietary and physical activity variables. Methods: A two-arm parallel randomized controlled trial was conducted in 315 healthy 4.5 year old children between January 2014 and October 2015. Parents of the participating children either received the MINISTOP intervention or a basic pamphlet on dietary and physical activity behaviors (control group). After 6 months, participants did not have access to the intervention content and were measured again 6 months later (i.e. the 12-month follow-up). The Wilcoxon rank-sum test was then used to examine differences between the groups. Results: At the 12-month follow-up, no statistically significant difference was observed between the intervention and control groups for FMI (p = 0.57) and no maintained effect for the change in composite score was observed (mean +/- standard deviation for the intervention and control group: + 0.53 +/- 1.49 units and + 0.35 +/- 1.27 units respectively, p = 0.25 between groups). Conclusions: The intervention effect observed at the 6-month follow-up on the composite score was not maintained at the 12-month follow-up, with no effect on FMI being observed at either follow-up. Future studies using mHealth are needed to investigate how changes in obesity related markers in young children can be maintained over longer time periods.
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| 16. |
- Nyström, Christine Delisle, et al.
(författare)
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Results From Sweden's 2016 Report Card on Physical Activity for Children and Youth.
- 2016
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Ingår i: Journal of physical activity & health. - : Human Kinetics. - 1543-5474 .- 1543-3080. ; 13:11 Suppl 2
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Tidskriftsartikel (refereegranskat)abstract
- The 2016 Swedish Report Card on Physical Activity (PA) for Children and Youth is a unique compilation of the existing physical and health related data in Sweden. The aim of this article is to summarize the procedure and results from the report card.Nationally representative surveys and individual studies published between 2005-2015 were included. Eleven PA and health indicators were graded using the Active Healthy Kids Canada grading system. Grades were assigned based on the percentage of children/youth meeting a defined benchmark (A: 81% to 100%, B: 61% to 80%, C: 41% to 60%, D: 21% to 40%, F: 0% to 20%, or incomplete (INC).The assigned grades were Overall Physical Activity, D; Organized Sport Participation, B+; Active Play, INC; Active Transportation, C+; Sedentary Behaviors, C; Family and Peers, INC; School, C+; Community and the Built Environment, B; Government Strategies and Investments, B; Diet, C-; and Obesity, D.The included data provides some support that overall PA is too low and sedentary behavior is too high for almost all age groups in Sweden, even with the many national policies as well as an environment that is favorable to the promotion of PA.
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| 17. |
- Parekh, Niyati, et al.
(författare)
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Associations of Parental Self-Efficacy With Diet, Physical Activity, Body Composition, and Cardiorespiratory Fitness in Swedish Preschoolers: Results From the MINISTOP Trial
- 2018
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Ingår i: Health Education & Behavior. - : SAGE PUBLICATIONS INC. - 1090-1981 .- 1552-6127. ; 45:2, s. 238-246
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Tidskriftsartikel (refereegranskat)abstract
- Background. High parental self-efficacy (PSE) has been associated with healthy diets and higher levels of physical activity (PA) in children; however, data on PSE in relation to body weight and body composition are scarce. The objective of this study was to investigate associations of PSE with measures of diet, PA, body composition, and physical fitness in early childhood. Method. We used baseline data from the MINISTOP trial in healthy Swedish children (n = 301; 4.5 +/- 0.15 years). PSE was assessed using a questionnaire, dietary data were collected using a mobile technology-assisted methodology, and PA was obtained (sedentary behavior and moderate-to-vigorous) by accelerometry. Body composition was measured using the pediatric option for BodPod and cardiorespiratory fitness by the 20 m shuttle run. Linear regression was conducted to evaluate cross-sectional associations of the outcomes in relation to total PSE and scores computed for the individual PSE factors: (1) diet, (2) limit setting of unhealthful behaviors, and (3) PA. Results. Higher scores of total PSE and the diet factor were associated with higher fruit intake ( = 0.82 g/point and 1.99 g/point; p = .014 and .009, respectively) and lower consumption of unhealthy snacks ( = -0.42 g/point and -0.89 g/point; p = .012 and .020, respectively) after adjustment for parental body mass index and education, respondent, and childs sex and age. No associations were observed between PSE and PA, body composition, or cardiorespiratory fitness. Conclusions. Our study noted that PSE should be considered in conjunction with other strategies for a sustainable impact on childhood obesity.
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