| 61. |
- Orsini, Nicola
(författare)
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Physical activity and health benefits
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Physical activity (PA), due to its role in health promotion and disease prevention, is of particular interest to be investigated. The aims of this thesis were: to assess the associations between PA and different health outcomes (lower urinary tract symptoms, cancer incidence, and mortality) in the Cohort of Swedish Men (COSM); to perform a dose-response meta- analysis of published associations between walking and incidence of coronary heart disease (CHD); and to provide user-friendly software packages for dose-response meta-analysis and for sensitivity analysis of biases in observational studies. The COSM is a population-based prospective cohort of 45,906 men between 45 to 79 years of age in central Sweden who were cancer-free and completed a questionnaire about current and historical PA, diet, and other life- style factors at enrollment in 1997. At baseline 6905 men reported moderate to severe lower urinary tract symptoms (LUTS). A significant inverse relationship was seen between total PA and moderate and severe LUTS (highest vs lowest quartile odds ratio=0.72; 95% confidence interval (CI)=0.66-0.79). Men who were physically active at work as well as during leisure-time showed 50% reduction in risk of moderate to severe LUTS (95% CI=0.40-0.60) compared to those who were sedentary. Conversely, men with long-term sedentary lifestyles (5 hours/day watching TV both at age 30 years and current) reported a 2-fold increase (95% CI=1.41-2.59) risk to these symptoms when compared to men more active at both time periods. After 7 years of study enrollment 3714 men of the COSM were diagnosed with cancer and 1153 of them died due to the disease. We observed a strong inverse linear association between total daily PA and death from any form of cancer. For each increment of 4 metabolic equivalent (MET)-hours/day of total PA (approximately 1 hour daily of moderate effort) cancer incidence tended to be decreased by 2% and cancer mortality decreased significantly by 12% (95% CI = 6-18%). During 9.7 years of follow-up, we identified a total of 4086 deaths from all causes. Compared to men who were lean and active (BMI < 25 kg/m2; top tertile total PA) the adjusted rate ratios of death from all causes were 1.44 (95% CI=1.11-1.86) for obese-active men (BMI 30 kg/m2), 1.54 (95% CI=1.34-1.77) for lean but inactive men (bottom tertile total PA), and 1.81 (95% CI=1.48-2.23) for obese-inactive men. After excluding the first 3 years of follow-up, current and former smokers, those who had lost weight from age 20 years to baseline, and heavy manual workers, the adjusted rate ratios of death from all causes were 1.65 (95% CI=1.20-2.27) for overweight-to-obese and active men, 2.15 (95% CI=1.59-2.91) for lean-inactive men, and 2.04 (95% CI=1.52-2.74) for overweight-to-obese and inactive men compared to lean-active men. During 10 years of follow-up a total of 2735 men were diagnosed with prostate cancer, of which 190 were fatal. We observed an inverse linear association between lifetime (average of age 30, 50 and baseline) walking/bicycling duration and incidence of total prostate cancer risk. The multivariable-adjusted rate ratio decreased by 8% (95% CI=2-13%) for every 30 min/day increment of lifetime walking/bicycling in the range of 30 to 120 min/day. The fatal prostate cancer rate among those men who hardly ever walked or biked was two-fold that of men in the highest average lifetime walking/bicycling of 120 min/day, although this increased rate was not significant. In the dose-response meta-analysis of eight epidemiological studies we found that every increment of 8 MET-hours/week of walking (moderate-intensity about 30 min/day on 5 days of the week) was associated with 19% decrease (95% CI=14-23%) of CHD risk. In conclusion, we observed that increased PA levels may lower the risk of LUTS, all-cause and cancer mortality, prostate cancer, and CHD. Furthermore, the two statistical components developed for Stata® software can greatly facilitate dose-response meta-analyses (glst) and support sensitivity analysis (episens) of epidemiological findings.
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| 62. |
- Orsini, Nicola, et al.
(författare)
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Reproducibility of the past year and historical self-administered total physical activity questionnaire among older women.
- 2007
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 22:6, s. 363-8
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have evaluated the reliability of a self-administered current and historical physical activity questionnaire (PAQ) among middle-aged and elderly women. We evaluated the reliability of a self-administered PAQ designed to assess total (24 h) current and historical physical activity at age 15, 30, and 50 years, which was completed by a subgroup of 303 women aged 56-75 years from the Swedish Mammography Cohort (SMC). Total physical activity covered occupational and household activity as well as walking/bicycling, exercise, and inactivity (sitting watching TV/reading). Reliabilities (1-year test-retest) of continuous activity measures in metabolic equivalents were evaluated using an intraclass correlation coefficient (ICC); classification consistency was evaluated using sensitivity and specificity statistics. The ICC for total current physical activity was 0.69; for specific types of activities the ICC ranged from 0.49 to 0.59; for historical physical activity, the reliabilities for total activity ranged from 0.75 for age 50 to 0.81 for age 30 years, being substantial for occupational activities (ICC = 0.73-0.75), and fair to moderate for inactivity (ICC = 0.31-0.60). These data indicate that the PAQ used in the SMC is a satisfactory and reproducible measure of current and historical physical activity, for total as well as for different types of activities.
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| 63. |
- Orsini, Nicola
(författare)
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Total physical activity in middle-aged and elderly women from a population-based cohort
- 2006
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Regularly performed physical activity (PA) is associated with a reduced risk of coronary heart disease, stroke, type 2 diabetes, some forms of cancer, osteoporosis, and all-cause mortality. Due to its role in health promotion and disease prevention, PA is a particularly important health behavior to be investigated. The first aim of this thesis was to investigate temporal trends and correlates of total PA using data from the Swedish Mammography Cohort (SMC). The second aim was to evaluate the reproducibility and validity of self-reported PA and to make a profile of PA behaviors using accelerometer data from a subset of the SMC. The SMC is a population-based prospective cohort established between 1987 and 1990 in Uppsala and Västmanland Counties. In our analyses among 38,988 women between the ages of 48 and 83 years, we observed a decreasing trend of total PA by calendar time between the 1930s and the 1990s. Total activity level decreased in all age groups (15, 30, and 50 years of age) by an average of 3 MET-hours/day corresponding to about 45 minutes of brisk walking. The likelihood of engaging in higher total daily PA levels linearly decreased with age (for 5-year increase: odds ratio (OR) = 0.87; 95% confidence interval (Cl): 0.85-0.89) and body mass index (for 5-unit, kg/m2, increase: OR= 0.81; 95% Cl: 0.79-0.84). Total PA levels were inversely associated with smoking (OR= 0.83; 95% Cl: 0.79-0,88), drinking (OR= 0.88 95% Cl: 0.82-0.94), educational level (university vs. primary: OR=0.54, 95% Cl: 0.51-0.58), and childhood environment (city vs. countryside: OR= O.62, 95% Cl: 0.59-0.65). Reproducibility, as measured among 303 women by intraclass correlation (ICC) for total current PA, was 0.69. For historical PA, the reliabilities for total activity were from 0.75 for age 50 to 0.81 for age 30 years, being substantial for occupational activities (ICC=0.73-0.75), and fair to moderate for inactivity (ICC=0.31-0.60). Validity, as measured among 116 women by de-attenuated concordance correlations comparing total daily activity estimated by the questionnaire with the accelerometers and the records were 0.72 and 0.67, respectively. According to the PA recommendation to accumulate at least 30 minutes per day (in either 1 continuous bout or several shorter bouts lasting 8-10 minutes) of moderate-to-vigorous activity 5 days per week or more, we found that among 133 women the proportion who met this recommendation was 31% which decreased to 18% among obese women. In conclusion, our findings from a large population-based prospective cohort of middle-aged and elderly women show that total PA has been decreasing by calendar time during the last 60 years of the 20th century. The likelihood of engaging in higher total daily PA levels decreased with age, body mass index, educational level, smoking, drinking, and growing up in urban places. Our short self-administered PA questionnaire was reasonably reproducible and valid. The fact that only a third of the women were not meeting the PA recommendation suggests that counselling messages may need to Place more emphasis on the correct number of days per week and in which way moderate activity should be obtained to achieve health benefits.
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| 64. |
- Orsini, Nicola, et al.
(författare)
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Validity of self-reported total physical activity questionnaire among older women
- 2008
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Ingår i: European Journal of Epidemiology. - : SPRINGER. - 0393-2990 .- 1573-7284. ; 23:10, s. 661-667
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Tidskriftsartikel (refereegranskat)abstract
- Aim of this study was to assess the validity of a short self-administered physical activity questionnaire, intended to measure past year total daily physical activity, by comparison with activity records and accelerometers. Over a 1-year period, data from a questionnaire, 7-day activity records and accelerometers were obtained from a subset of 116 women between the ages of 56 and 75 years from the population-based Swedish Mammography Cohort. We estimated concordance correlations as measure of validity, deattenuated for intraindividual variation in the reference method. Deattenuated concordance correlations comparing total daily activity measured by the questionnaire with the accelerometers and the records were 0.38 (95% CI: 0.22-0.54) and 0.64 (95% CI: 0.45-0.83), respectively. Validity of leisure-time activity (walking/bicycling and exercise) and inactivity (watching TV/reading) estimates comparing the records with the questionnaire were 0.42 (95% CI: 0.22-0.62) and 0.52 (95% CI: 0.36-0.69), respectively. These data indicate that the average past year total physical activity, leisure-time activity and inactivity can be estimated with a reasonable validity using our short self-administered questionnaire.
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| 65. |
- Oskarsson, Viktor, et al.
(författare)
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A prospective cohort study on the association between coffee drinking and risk of non-gallstone-related acute pancreatitis
- 2016
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Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 115:10, s. 1830-1834
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Tidskriftsartikel (refereegranskat)abstract
- Only one previous study has examined the association between coffee consumption and risk of acute pancreatitis, and it found a reduced risk for alcohol-related episodes among high consumers of coffee. Therefore, we examined (1) the association between coffee consumption and risk of non-gallstone-related acute pancreatitis and (2) whether this association was modified by alcohol intake. Data were obtained from two prospective cohorts, the Cohort of Swedish Men and the Swedish Mammography Cohort, including 76 731 men and women (born 1914-1952). Coffee consumption was assessed at baseline with a FFQ, and the cohorts were followed up between 1998 and 2012 via linkage to national health registries. Hazard ratios were estimated using Cox models, with adjustment for potential confounding factors. During 1 035 881 person-years of total follow-up, 383 cases (246 in men and 137 in women) of incident non-gallstone-related acute pancreatitis were identified. Overall, and irrespective of whether a categorical or a continuous exposure model was used, we observed no association between coffee consumption and risk of non-gallstone-related acute pancreatitis (e.g. the multivariable-adjusted hazard ratio for each 1 cup/d increase in coffee consumption was 0.97; 95% CI 0.92, 1.03). There was no evidence of effect modification by alcohol intake (P-interaction = 0.77). In conclusion, coffee consumption was not associated with risk of non-gallstone-related acute pancreatitis in this large prospective cohort study. Because of the limited number of epidemiological studies and their conflicting results, further research is needed to elucidate this potential association.
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| 66. |
- Oskarsson, Viktor, et al.
(författare)
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Fish consumption and risk of non-gallstone-related acute pancreatitis : a prospective cohort study
- 2015
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Ingår i: American Journal of Clinical Nutrition. - : AMER SOC NUTRITION-ASN. - 0002-9165 .- 1938-3207. ; 101:1, s. 72-78
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Tidskriftsartikel (refereegranskat)abstract
- Background: Epidemiologic data on the role of diet in acute pancreatitis are sparse. Objective: We examined the association of total fish consumption, as well as of consumption of fatty fish and lean fish separately, with risk of non gallstone-related acute pancreatitis. Design: We used data from 2 prospective cohorts, the Cohort of Swedish Men and the Swedish Mammography Cohort, that included 39,267 men and 32,191 women who were aged 45-84 y at the start of a 13-y follow-up period (1998-2010). Fish consumption was assessed by using a food-frequency questionnaire at baseline, and cases of incident non gallstone-related acute pancreatitis were identified by linkage to the Swedish National Patient Register. HRs were estimated by using Cox proportional hazard models. Results: During a total follow-up of 860,176 person-years, 320 cases (209 cases in men and 111 cases in women) of incident non gallstone-related acute pancreatitis were identified. We observed that total fish consumption <= 2.0-3.0 servings/wk was associated with a significantly decreased risk of the disease (P-nonlinearity = 0.017). In comparison with 0.9 servings/wk, multivariable-adjusted HRs were 0.86 (95% CI: 0.76, 0.96), 0.77 (95% CI: 0.62, 0.96), and 0.85 (95% CI: 0.65, 1.10) for 1.4, 2.4, and 3.5 servings/wk, respectively. In the analysis of fatty fish and lean fish, we observed that the consumption of each subtype had a similarly shaped association with risk of non gallstone-related acute pancreatitis as that observed for total fish consumption, although neither was significant. Multivariable-adjusted HRs were 0.83 for fatty fish (95% CI: 0.65, 1.04) and 0.87 for lean fish (95% CI: 0.69, 1.11) when 0.6-2.0 servings/wk was compared with 5.0.5 servings/wk. Conclusion: Our data suggest that the consumption of total fish (fatty fish and lean fish combined) may be associated with decreased risk of non gallstone-related acute pancreatitis.
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| 67. |
- Oskarsson, Viktor, et al.
(författare)
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High Dietary Glycemic Load Increases the Risk of Non-Gallstone-Related Acute Pancreatitis : A Prospective Cohort Study
- 2014
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Ingår i: Clinical Gastroenterology and Hepatology. - : ELSEVIER SCIENCE INC. - 1542-3565 .- 1542-7714. ; 12:4, s. 676-682
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Obesity and type 2 diabetes-diseases linked to glucose intolerance and insulin resistance-have been positively associated with the risk of acute pancreatitis. However, it is unclear whether consumption of foods that increase postprandial glycemia and insulinemia have similar associations. We examined the association between dietary glycemic load and risk of non-gallstone-related acute pancreatitis. METHODS: We performed a prospective study of 44,791 men and 36,309 women (aged 45-84 years), without a history of acute pancreatitis, from the Cohort of Swedish Men and the Swedish Mammography Cohort. Glycemic loads were calculated from food frequency questionnaire data collected in 1997, and participants were followed for the development of non-gallstone-related acute pancreatitis through 2010 via linkage to the Swedish National Patient Register. Hazard ratios (HRs) were estimated using Cox proportional hazard models. RESULTS: During a total follow-up of 967,568 person-years, there were 364 cases of incident non-gallstone-related acute pancreatitis (236 in men and 128 in women). Incidence rates, standardized for age and sex, were 49 cases per 100,000 person-years in the highest quartile of glycemic load and 33 cases per 100,000 person-years in the lowest. The multivariate-adjusted HR of nongallstone-related acute pancreatitis was 1.60 (95% confidence interval [CI], 1.17-2.18) for the highest compared with the lowest quartile. Every 50-unit increase in glycemic load per day (similar to 3 servings of white bread) had an HR of 1.38 in men (95% CI, 1.11-1.72) and women (95% CI, 1.02-1.86). CONCLUSIONS: Based on a large, prospective cohort study, diets with high glycemic load are associated with an increased risk of non-gallstone-related acute pancreatitis.
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| 68. |
- Oskarsson, Viktor, et al.
(författare)
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Overall diet quality and risk of recurrence and progression of non-gallstone-related acute pancreatitis : a prospective cohort study.
- 2018
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Ingår i: European Journal of Nutrition. - : Springer Berlin/Heidelberg. - 1436-6207 .- 1436-6215. ; 57:7, s. 2537-2545
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: An incident episode of acute pancreatitis is often followed by recurrent attacks and/or progression to chronic pancreatitis, especially if the etiology is non-gallstone-related. We examined whether overall diet quality influences the natural history of non-gallstone-related acute pancreatitis.METHODS: Three hundred and eighty-six individuals (born 1914-1952) were included in a prospective study, all of whom had an incident diagnosis of non-gallstone-related acute pancreatitis in the Swedish National Patient Register between 1998 and 2013. Participants were already enrolled in two population-based cohorts and had completed a food frequency questionnaire in 1997. Overall diet quality was calculated using a recommended food score (RFS), which was based on 25 food items. Post-diagnosis follow-up was conducted throughout 2014 for recurrence of acute pancreatitis and/or progression to chronic pancreatic disease (including cancer). Hazard ratios were estimated using Cox models.RESULTS: During 1859 person-years of follow-up, 23.3% of the study population (n = 90) developed recurrent or progressive pancreatic disease. An inverse association was observed between the RFS and risk of recurrent and progressive pancreatic disease after adjustment for age and sex (hazard ratio for each 2-unit increase 0.90, 95% confidence interval 0.81-1.01) (P overall association = 0.06). However, the association became weaker and was not statistically significant after adjustment for other potential confounders, including alcohol drinking and cigarette smoking (P overall association = 0.27).CONCLUSIONS: In this prospective study of individuals with non-gallstone-related acute pancreatitis, there was no clear association between overall diet quality and risk of recurrent and progressive pancreatic disease.
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| 69. |
- Oskarsson, Viktor, et al.
(författare)
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Postmenopausal hormone replacement therapy and risk of acute pancreatitis : a prospective cohort study.
- 2014
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Ingår i: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel. - : CMA Joule Inc.. - 0820-3946 .- 1488-2329. ; 186:5, s. 338-344
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Several case reports have suggested that women's use of exogenous sex hormones is associated with acute pancreatitis; however, relevant epidemiologic data are sparse. We examined the association between postmenopausal hormone replacement therapy and risk of acute pancreatitis. METHODS:We conducted a prospective study involving 31 494 postmenopausal women (aged 48-83 yr) from the population-based Swedish Mammography Cohort. Participants completed a baseline questionnaire in 1997 assessing their use of hormone replacement therapy. We linked the cohort to the hospital-based Swedish National Patient Register to determine hospital admissions for acute pancreatitis through 2010. Relative risks (RRs) were calculated using Cox proportional hazard models. RESULTS:Over a total follow-up of 389 456 person-years, we identified 237 cases of incident acute pancreatitis. The age-standardized incidence rates per 100 000 person-years were 71 cases among women who had ever used hormone replacement therapy and 52 cases among women who had never used such hormones. Among ever users of hormone replacement therapy, the multivariable-adjusted RR of acute pancreatitis was 1.57 (95% confidence interval [CI] 1.20-2.05) compared with never users. The risk did not differ by current or past use, but it seemed to be higher among women who used systemic therapy (RR 1.92, 95% CI 1.38-2.66) and among those with duration of therapy of more than 10 years (RR 1.87, 95% CI 1.11-3.17). INTERPRETATION:Use of postmenopausal hormone replacement therapy was associated with increased risk of acute pancreatitis. Physicians should consider this potential increase in risk when prescribing such therapy.
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| 70. |
- Oskarsson, Viktor, et al.
(författare)
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Vegetables, fruit and risk of non-gallstone-related acute pancreatitis : a population-based prospective cohort study
- 2013
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Ingår i: Gut. - : BMJ PUBLISHING GROUP. - 0017-5749 .- 1468-3288. ; 62:8, s. 1187-1192
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine the association of vegetable and fruit consumption with the risk of non-gallstone-related acute pancreatitis. Design A population-based prospective cohort of 80?019 women and men, aged 46-84years, completed a food-frequency questionnaire at baseline and was followed up for incidence of non-gallstone-related acute pancreatitis from 1 January 1998 to 31 December 2009. Participants were categorised into quintiles according to consumption of vegetables and consumption of fruit. Cox proportional hazards models were used to estimate RRs and 95% CIs. Results In total, 320 incident cases (216 men and 104 women) with non-gallstone-related acute pancreatitis were identified during 12years of follow-up (891?136 person-years). After adjustment for potential confounders, the authors observed a significant inverse linear dose-response association between vegetable consumption and risk of non-gallstone-related acute pancreatitis; every two additional servings per day were associated with 17% risk reduction (RR=0.83; 95% CI 0.70 to 0.98; p=0.03). Among participants consuming >1 drink of alcohol per day and among those with body mass index 25kg/m(2), the RR for the highest compared with the lowest quintile of vegetable consumption was 0.29 (95% CI 0.13 to 0.67) and 0.49 (95% CI 0.29 to 0.85), respectively. Fruit consumption was not significantly associated with the risk of non-gallstone-related acute pancreatitis; the RR comparing extreme quintiles of consumption was 1.20 (95% CI 0.81 to 1.78). Conclusions Vegetable consumption, but not fruit consumption, may play a role in the prevention of non-gallstone-related acute pancreatitis.
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