| 1. |
- Ahlqvist, Viktor H, et al.
(författare)
-
Birth Weight and Cardiorespiratory Fitness Among Young Men Born at Term : The Role of Genetic and Environmental Factors
- 2020
-
Ingår i: Journal of the American Heart Association. - : American Heart Association. - 2047-9980 .- 2047-9980. ; 9:3
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Preterm delivery and low birth weight are prospectively associated with low cardiorespiratory fitness (CRF). However, whether birth weight, within the at-term range, is associated with later CRF is largely unknown. Thus, the aim of the current study was to examine this issue and whether such association, if any, is explained by shared and/or nonshared familial factors.Methods and Results: We conducted a prospective cohort study, including 286 761 young male adults and a subset of 52 544 siblings born at-term. Objectively measured data were retrieved from total population registers. CRF was tested at conscription and defined as the maximal load obtained on a cycle ergometer. We used linear and nonlinear and fixed-effects regression analyses to explore associations between birth weight and CRF. Higher birth weight, within the at-term range, was strongly associated with increasing CRF in a linear fashion. Each SD increase in birth weight was associated with an increase of 7.9 (95% CI, 7.8-8.1) and 6.6 (95% CI; 5.9-7.3) Wmax in the total and sibling cohorts, respectively. The association did not vary with young adulthood body mass index.Conclusions: Birth weight is strongly associated with increasing CRF in young adulthood among men born at-term, across all categories of body mass index. This association appears to be mainly driven by factors that are not shared between siblings. Hence, CRF may to some extent be determined already in utero. Prevention of low birth weight, also within the at-term-range, can be a feasible mean of increasing adult CRF and health.
|
|
| 2. |
- Ahlqvist, Viktor H., et al.
(författare)
-
Birth weight and grip strength in young Swedish males : a longitudinal matched sibling analysis and across all body mass index ranges
- 2019
-
Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 9
-
Tidskriftsartikel (refereegranskat)abstract
- Low birth weight is associated with a lower grip strength later in life. However, associations between birth weight among infants born at-term and factors driving associations between birth weight and grip strength are largely unknown. A cohort of 144,369 young men born at-term, including 10,791 individuals who had at least one male sibling/s, were followed until conscription where they performed a grip strength test. We used linear and non-linear regression analyses in the full cohort, and fixed-effects regression analyses in the sibling cohort, to address confounding by factors that are shared between siblings. After adjustment, each unit increase in birth weight z-score was associated with increases of 17.7 (95% CI, 17.2-18.2) and 13.4 (10.1-16.6) newton grip strength, which converts to approximately 1.8 and 1.4 kilogram-force in the full and within-families cohorts, respectively. The associations did not vary with young adulthood BMI. Birth weight, within the at-term range, is robustly positively associated with grip strength in young adulthood among men across all BMI categories and associations appears to be mainly driven by factors that are not shared between siblings. These findings underline the importance of recognizing the influence of low birth weight, also within the at-termrange, on young adulthood muscle strength.
|
|
| 3. |
- Ahlqvist, Viktor H., et al.
(författare)
-
Elective and nonelective cesarean section and obesity among young adult male offspring : A Swedish population-based cohort study
- 2019
-
Ingår i: PLoS Medicine. - : PUBLIC LIBRARY SCIENCE. - 1549-1277 .- 1549-1676. ; 16:12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies have suggested that cesarean section (CS) is associated with offspring overweight and obesity. However, few studies have been able to differentiate between elective and nonelective CS, which may differ in their maternal risk profile and biological pathway. Therefore, we aimed to examine the association between differentiated forms of delivery with CS and risk of obesity in young adulthood.Methods and findings: Using Swedish population registers, a cohort of 97,291 males born between 1982 and 1987 were followed from birth until conscription (median 18 years of age) if they conscripted before 2006. At conscription, weight and height were measured and transformed to World Health Organization categories of body mass index (BMI). Maternal and infant data were obtained from the Medical Birth Register. Associations were evaluated using multinomial and linear regressions. Furthermore, a series of sensitivity analyses were conducted, including fixed-effects regressions to account for confounders shared between full brothers. The mothers of the conscripts were on average 28.5 (standard deviation 4.9) years old at delivery and had a prepregnancy BMI of 21.9 (standard deviation 3.0), and 41.5% of the conscripts had at least one parent with university-level education.Out of the 97,291 conscripts we observed, 4.9% were obese (BMI ≥ 30) at conscription. The prevalence of obesity varied slightly between vaginal delivery, elective CS, and nonelective CS (4.9%, 5.5%, and 5.6%, respectively), whereas BMI seemed to be consistent across modes of delivery. We found no evidence of an association between nonelective or elective CS and young adulthood obesity (relative risk ratio 0.96, confidence interval 95% 0.83–1.10, p = 0.532 and relative risk ratio 1.02, confidence interval 95% 0.88–1.18, p = 0.826, respectively) as compared with vaginal delivery after accounting for prepregnancy maternal BMI, maternal diabetes at delivery, maternal hypertension at delivery, maternal smoking, parity, parental education, maternal age at delivery, gestational age, birth weight standardized according to gestational age, and preeclampsia. We found no evidence of an association between any form of CS and overweight (BMI ≥ 25) as compared with vaginal delivery. Sibling analysis and several sensitivity analyses did not alter our findings. The main limitations of our study were that not all conscripts had available measures of anthropometry and/or important confounders (42% retained) and that our cohort only included a male population.Conclusions: We found no evidence of an association between elective or nonelective CS and young adulthood obesity in young male conscripts when accounting for maternal and prenatal factors. This suggests that there is no clinically relevant association between CS and the development of obesity. Further large-scale studies are warranted to examine the association between differentiated forms of CS and obesity in young adult offspring.Trial registration: Registered as observational study at ClinicalTrials.gov Identifier: NCT03918044.
|
|
| 4. |
- Berglind, Daniel, et al.
(författare)
-
An eHealth program versus a standard care supervised health program and associated health outcomes in individuals with mobility disability : study protocol for a randomized controlled trial.
- 2018
-
Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 19:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Young adults with mobility disability (MD) are less likely to engage in regular physical activity (PA) compared with their able-bodied peers and inactive adults with a MD are more likely to report one or more chronic diseases compared to those who are physically active. Despite the vast amount of research published in the field of PA interventions over the past decades, little attention has been focused on interventions aiming to increase PA among individuals with MD. Thus, we propose to compare the effects of an eHealth program compared to a usual care supervised health program on levels of PA and other health behaviors.METHODS: The current intervention will use a randomized controlled trial (RCT) design with two treatment groups (an eHealth program and a usual care supervised health program) in young adults with newly acquired MD. In total, 110 young adults (aged 18-40 years) with a MD, acquired within the past 3 years, will be recruited to participate in a 12-week intervention. The primary study outcome is accelerometer-measured time spent in moderate to vigorous PA. Secondary outcomes includes health-related quality of life, depression, stress, fitness, body composition, diet, musculoskeletal pain, motivation to exercise and work ability.DISCUSSION: There is a lack of RCTs investigating effective ways to increase levels of PA in young adults with MD. Increased levels of PA among this physically inactive population have the potential to substantially improve health-related outcomes, possibly more so than in the general population. The trial will put strong emphasis on optimizing exercise adherence and investigating feasibility in the two treatment programs. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (2017/1206-31/1).TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN), reference number ISRCTN22387524 . Prospectively registered February 4, 2018.
|
|
| 5. |
- Ekström, Lucas, et al.
(författare)
-
The association between birth by cesarean section and adolescent cardiorespiratory fitness in a cohort of 339,451 Swedish males
- 2020
-
Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 10
-
Tidskriftsartikel (refereegranskat)abstract
- Birth by cesarean section is increasing worldwide and associates with offspring morbidities capable of adversely impacting cardiorespiratory fitness later in life. Whether birth by cesarean section associates with lower levels of cardiorespiratory fitness later in life is unknown and is of interest to public health. Four Swedish national registers were linked to follow 339,451 singleton males, born between 1973–1987 until December 31 2005, for Watt-maximum achieved on a cycle ergometer test at conscription into the Swedish military. Main exposure was birth by cesarean section which was compared to vaginal birth. A sub-population of 45,999 males born between 1982–1987 was identified to explore differentiated associations between elective and non-elective cesarean section with Watt-maximum. Within-family analyses of 34,252 families with 70,632 biological male siblings, who conscripted during the study period, were performed to explore the role of familial confounding on Watt-maximum. Swedish males born by cesarean section achieved lower mean Watt-maximum (− 2.32 W, 95%C.I. − 2.90 to − 1.75) and displayed excess odds of low cardiorespiratory fitness (aOR = 1.08, 95%C.I. 1.05 to 1.11) at conscription in the eighteenth life-year compared to males born vaginally after adjusting for birth characteristics, maternal morbidities and parental socioeconomic position. In the sub-population, males born 1982–1987, there was a greater negative association of elective cesarean section with cardiorespiratory fitness (− 4.42 W, 95%C.I. − 6.27 to − 2.57, p < 0.001) than non-elective cesarean sections (− 1.96 W, 95%C.I. − 3.77 to − 0.16, p = 0.033) as compared to vaginal births. No associations between modes of cesarean delivery and cardiorespiratory fitness levels persisted in the within-family analyses where biological male siblings were compared whilst controlling for factors shared within families. Males born by cesarean section had lower levels of cardiorespiratory fitness eighteen years later compared to males born vaginally. These findings appear to be largely explained by factors of familial confounding.
|
|
| 6. |
- Possmark, Sofie, et al.
(författare)
-
Accelerometer-measured versus selfreported physical activity levels in women before and up to 48months after Roux-enY Gastric Bypass
- 2020
-
Ingår i: BMC Surgery. - : BioMed Central. - 1471-2482 .- 1471-2482. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Roux-en-Y Gastric Bypass (RYGB) patients overestimate their time spent in moderate-to-vigorous physical activity (MVPA) to a greater extent post-surgery than pre-surgery. However, there is no data on discrepancy between self-reported and accelerometer-measured MVPA beyond nine months post-RYGB. The aim was to investigate how the duration of MVPA (main outcome) differs when comparing a self-administered questionnaire to accelerometer-data from pre-surgery and up to 48months post-RYGB.Methods: Twenty-six (38%) RYGB-treated women with complete data from the original cohort (N=69) were included. Participants were recruited from five Swedish hospitals. Mean pre-surgery BMI was 38.9 (standard deviation (SD)=3.4) kg/m2 and mean age 39.9 (SD=6.5) years. MVPA was subjectively measured by a selfadministered questionnaire and objectively measured by the ActiGraph GT3X+ accelerometer at 3months pre-RYGB and 9- and 48months post-RYGB. Means and SD were calculated at 3months pre- and 9- and 48months postRYGB. We calculated the P-values of the differences with Wilcoxon Signed-Rank test. For correlations between the self-administered questionnaire and the accelerometers, Spearman’s rank correlation was used.Results: Participants significantly overestimated (i.e. self-reported more time spent in MVPA compared to accelerometry) their MVPA in a higher degree post- compared to pre-RYGB surgery. Compared to pre-surgery, selfreported MVPA increased with 46.9 and 36.5% from pre- to 9- and 48months, respectively, whereas changes were a 6.1% increase and 3.5% decrease with accelerometers. Correlations between self-reported and accelerometermeasured MVPA-assessments were poor at all measurement points (r=0.21–0.42) and only significant at 48months post-RYGB (P=0.032).Conclusions: The discrepancy between self-reported and objectively assessed MVPA within the same individual is greater up to 48months post-RYGB compared to before surgery. To help bariatric patients understand and hopefully increase their physical activity behaviors post-surgery, objective measures of physical activity should be used.
|
|
| 7. |
- Possmark, Sofie, et al.
(författare)
-
Physical activity in women attending a dissonance-based intervention after Roux-en-Y Gastric Bypass : A 2-year follow-up of a randomized controlled trial
- 2021
-
Ingår i: PLOS ONE. - : Public Library of Science (PLOS). - 1932-6203. ; 16:11
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The majority of Roux-en-Y gastric bypass (RYGB) patients are not sufficiently physically active post-surgery, yet little support from the Swedish healthcare system is offered. We investigated if a dissonance-based group intervention, aiming to increase health-related quality of life after surgery, had any effect on patients' physical activity two years post-RYGB.METHODS: Women undergoing RYGB surgery were recruited from five Swedish hospitals and randomized to intervention or control group (standard post-surgery care). The dissonance-based intervention was conducted three months post-RYGB and consisted of four group sessions, each with a specific topic, of which one addressed physical activity. ActiGraph GT3X+ accelerometers were used to measure physical activity at pre-RYGB, one- and two-years post-surgery.RESULTS: At pre-RYGB, 259 women were recruited and randomized (intervention n = 156 and control n = 103). Participants had a mean age of 44.7 years (SD 10.3) and pre-RYGB body mass index of 40.8 (SD 4.5) kg/m2. At two-years follow-up, 99 participants (63.5%) in intervention group and 68 (66.0%) in control group had valid accelerometer-measurements. Pre- to post-surgery increases were seen in all physical activity outcomes, but no statistically significant differences between the groups were observed at the two-years follow-up, and intervention effects were poor (d = 0.02-0.35).CONCLUSION: To our knowledge, this is the first dissonance-based intervention targeting women undergoing RYGB surgery. At two-years follow-up, we did not observe any differences in physical activity levels between the intervention group and control group.Trial registration number: ISRCTN16417174.
|
|
| 8. |
- Possmark, Sofie, et al.
(författare)
-
To be or not to be active – a matter of attitudes and social support? : Women’s perceptions of physical activity five years after Roux-en-Y Gastric Bypass surgery
- 2019
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 14:1
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Despite positive health advantages of post-surgery physical activity (PA) for bariatric surgery patients, the majority is not sufficiently physically active. The aim was to explore women’s perceptions and experiences concerning PA five years after Roux-en-Y Gastric Bypass (RYGB) surgery.Methods: Eleven women were interviewed five years post-surgery. Grounded Theory approach was applied.Results: The core-category “Attitudes and surrounding environment influence activity levels” includes three attitudes towards PA: “Positive attitudes”, “Shifting attitudes” and “Negative attitudes”. Participants with a positive attitude were regularly physically active, felt supported and proud of their achievements. Contrary, participants with a negative attitude didn’t prioritize PA, didn’t feel supported and saw no need or benefit of PA. Some participants revealed an on-off behaviour, hovering between the attitudes of vigorous PA and sedentary lifestyle, without sustainable balance. The majority mostly viewed PA as a mean to lose weight.Conclusion: The level of perceived post-surgery PA was related to the participants’ attitudes towards PA and whether or not they had a supportive environment. These findings might explain why bariatric surgery patients often fail to be sufficiently active post-surgery, and highlight the need for prolonged support and motivational interventions to promote sustainable PA post-bariatric surgery.
|
|
| 9. |
- Sellberg, Fanny, et al.
(författare)
-
Meeting physical activity recommendations is associated with health-related quality of life in women before and after Roux-en-Y gastric bypass surgery
- 2019
-
Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 28:6, s. 1497-1507
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Meeting physical activity (PA) recommendations is positively associated with health-related quality of life (HRQoL), but it is still unclear whether PA (specifically objectively measured) is associated with HRQoL in bariatric surgery candidates, both before and after surgery. Thus, the aim of this study was to examine the cross-sectional association between meeting objectively measured PA recommendations and HRQoL before and after Roux-en-Y gastric bypass (RYGB) surgery.METHODS: Sixty-six women undergoing RYGB with pre-surgery and 62 women with post-surgery valid PA and HRQoL data were included from the control group of a RCT study aiming at improving HRQoL and PA post-RYGB surgery. Measures before and 12 months after RYGB included the Short Form Health Survey (SF-36) and objectively measured PA, sedentary time (ST), and step counts with GT3X+ accelerometers. Multiple linear regression models were used to analyze the associations between PA and HRQoL.RESULTS: Participants who engaged in more than 150 min of moderate to vigorous PA (MVPA)/week (PA recommendations) had considerably higher SF-36 scores (HRQoL) than those who did not, both pre and 12-month post-surgery, with greatest difference in the subscale bodily pain, 15.5 (p = 0.021) higher score (higher scores means less pain) pre-surgery and a 19.7 (p = 0.004) higher score post-surgery. Higher LPA and step counts and lower ST also showed positive associations in some of the subscales of SF-36.CONCLUSIONS: Meeting the PA recommendations and overall engaging in more PA was associated with higher HRQoL, pre-, and post-RYGB surgery, highlighting the importance of PA both pre- and post-surgery.
|
|
