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1.
  • Björkman, Frida, et al. (author)
  • Validity of the revised Ekblom Bak cycle ergometer test in adults.
  • 2016
  • In: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 116:9, s. 1627-1638
  • Journal article (peer-reviewed)abstract
    • PURPOSE: To further develop the Ekblom Bak-test prediction equation for estimation of VO2max from submaximal cycle ergometry.METHODS: The model group (117 men and 100 women, aged 48.3 ± 15.7 and 46.1 ± 16.8 years, VO2max 46.6 ± 11.1 and 40.4 ± 9.6 mL kg(-1) min(-1), respectively) and the cross-validation group (60 men and 55 women, aged 40.6 ± 17.1 and 41.6 ± 16.7 years, VO2max 49.0 ± 12.1 and 43.2 ± 8.9 mL min(-1) kg(-1), respectively) performed 4 min of cycling on a standard work rate (30 W) directly followed by 4 min on a higher work rate. Heart rate (HR) at each work rate was recorded. Thereafter, participants completed a graded maximal treadmill test for direct measurement of oxygen uptake. The new prediction equation was cross-validated and accuracy compared with the original Ekblom Bak equation as well as by the Åstrand test method.RESULTS: The final sex-specific regression models included age, change in HR per-unit change in power (ΔHR/ΔPO), the difference in work rates (ΔPO), and HR at standard work rate as independent variables. The adjusted R (2) for the final models were 0.86 in men and 0.83 in women. The coefficient of variation (CV) was 8.7 % and SEE 0.28 L min(-1). The corresponding CV and SEE values for the EB-test2012 and the Åstrand tests were 10.9 and 18.1 % and 0.35 and 0.48 L min(-1), respectively.CONCLUSION: The new EB-test prediction equation provides an easy administered and valid estimation of VO2max for a wide variety of ages (20-86 years) and fitness levels (19-76 mL kg(-1) min(-1)).
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2.
  • Blom, Victoria, et al. (author)
  • Lifestyle Habits and Mental Health in Light of the Two COVID-19 Pandemic Waves in Sweden, 2020
  • 2021
  • In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 18:6
  • Journal article (peer-reviewed)abstract
    • The COVID-19 pandemic has become a public health emergency of international concern, which may have affected lifestyle habits and mental health. Based on national health profile assessments, this study investigated perceived changes of lifestyle habits in response to the COVID-19 pandemic and associations between perceived lifestyle changes and mental health in Swedish working adults. Among 5599 individuals (50% women, 46.3 years), the majority reported no change (sitting 77%, daily physical activity 71%, exercise 69%, diet 87%, alcohol 90%, and smoking 97%) due to the pandemic. Changes were more pronounced during the first wave (April-June) compared to the second (October-December). Women, individuals <60 years, those with a university degree, white-collar workers, and those with unhealthy lifestyle habits at baseline had higher odds of changing lifestyle habits compared to their counterparts. Negative changes in lifestyle habits and more time in a mentally passive state sitting at home were associated with higher odds of mental ill-health (including health anxiety regarding one's own and relatives' health, generalized anxiety and depression symptoms, and concerns regarding employment and economy). The results emphasize the need to support healthy lifestyle habits to strengthen the resilience in vulnerable groups of individuals to future viral pandemics and prevent health inequalities in society.
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3.
  • Blom, Victoria, et al. (author)
  • Self-Reported General Health, Overall and Work-Related Stress, Loneliness, and Sleeping Problems in 335,625 Swedish Adults from 2000 to 2016.
  • 2020
  • In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:2
  • Journal article (peer-reviewed)abstract
    • The prevalence of poor health, in particular stress-related mental ill-health, is increasing over time and birth cohorts. As rapid societal changes have occurred in the last decade and still are occurring, there is an interest in investigating the trends in health-related factors. The aim of the present study was to investigate trends in self-reported general health, overall stress, work-related stress, feelings of loneliness, and sleeping problems in 335,625 Swedish adults across categories of gender, geographic regions, length of education, and age from 2000 to 2016. On population level, sleeping problems and poor general health have increased markedly and significantly, while experiences of work stress decreased between 2000 and 2016 (p < 0.05). Overall stress and level of loneliness were unchanged (p > 0.05). The risk of having ≥3 symptoms (any of poor or very poor general health, often or very often perceived overall stress, loneliness, or sleeping problems) has increased significantly from 2000 to 2016 (ß = 1034 (1027-1040)). This increase was significantly higher in young (ß = 1052 (1038-1065)) and individuals with lower education (ß = 1056 (1037-1076)) compared to older and high length of education.
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4.
  • Ekblom Bak, Elin, 1981-, et al. (author)
  • Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.
  • 2019
  • In: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 29:2, s. 232-239
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Long-term trend analyses of cardiorespiratory fitness (VO2 max) in the general population are limited.OBJECTIVES: To describe trends in VO2 max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions.METHODS: 354.277 participants (44% women, 18-74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L·min-1 ) and relative (ml·min-1 ·kg-1 ) VO2 max, and the proportion with low (<32) relative VO2 max are reported. VO2 max was estimated using a submaximal cycle test.RESULTS: Absolute VO2 max decreased by -6.7% (-0.19 L·min-1 ) in the total population. Relative VO2 max decreased by -10.8% (-4.2 ml·min-1 ·kg-1 ) with approximately one-third explained by a simultaneous increase in body mass. Decreases in absolute fitness were more pronounced in men vs. women (8.7% vs. 5.3%), in younger vs. older (6.5% vs 2.3%), in short (11.4%) vs. long (4.5%) education, and in rural vs. urban regions (6.5% vs 3.5%), all p<0.001. The proportions with low VO2 max increased from 27% to 46% (p<0.001).CONCLUSION: Between 1995 and 2017, there was a steady and pronounced decline in mean cardiorespiratory fitness in Swedish adults. Male gender, young age, short education and living in a rural area were predictive of greater reductions. The proportion with low cardiorespiratory fitness almost doubled. Given the strong associations between cardiorespiratory fitness and multiple morbidities and mortality, preventing further decreases is a clear public health priority, especially for vulnerable groups. This article is protected by copyright. All rights reserved.
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5.
  • Ekblom-Bak, Elin, et al. (author)
  • Fitness and abdominal obesity are independently associated with cardiovascular risk.
  • 2009
  • In: Journal of internal medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; :21 May
  • Journal article (peer-reviewed)abstract
    • Objectives. To examine the relationship between cardiovascular fitness (VO(2)max) and abdominal obesity (waist circumference) and individual cardiovascular disease (CVD) risk factors, as well as a clustered risk factor profile, and to study the impact of gender, age and smoking on these relationships. Design. Cross-sectional. Setting. Astrand Laboratory of Work Physiology, Swedish School of Sport and Health Sciences, Stockholm, Sweden. Subjects. Men (n = 781) and women (n = 890) from two random population-based samples of Swedish women and men aged 20 to 65 years. Main outcomes. Odds ratios. Results. Each unit of higher fitness was associated with a decrease in all individual risk factors ranging from 2% to 4% independent of waist circumference, each unit of higher waist circumference was associated with an increased risk ranging from 2% to 5% independent of fitness. For clustering of three or more of the risk factors, each unit of fitness was associated with a 5% decrease in risk and each unit of waist circumference with a 5% increase in risk. The clustered risk was higher in unfit participants who were older or smoked daily, regardless of waist circumference. Obese participants were at higher risk if they were men or older, regardless of fitness level. However, neither a higher fitness level nor lean status reduced the risk associated with smoking. Conclusions. Higher fitness and lower waist circumference are each independently associated to a similar extent with a lower CVD risk. Simultaneous evaluation of both fitness and abdominal obesity status in clinical practice is important.
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6.
  • Ekblom-Bak, Elin, et al. (author)
  • Independent associations of physical activity and cardiovascular fitness with cardiovascular risk in adults.
  • 2010
  • In: European Journal of Cardiovascular Prevention & Rehabilitation. - 1741-8267 .- 1741-8275. ; 17:2, s. 175-80
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Uncertainty still exists whether physical activity (PA) and cardiovascular fitness (CF) contribute separately to cardiovascular disease (CVD) risk. This study examined the associations of PA and CF on individual as well as clustered CVD risk factors. DESIGN: Cross-sectional. METHODS: Seven hundred and eighty-one men and 890 women, aged 20-65 years, from two random population-based samples of Swedish women and men were included. PA was assessed by questionnaire and CF was predicted by a submaximal cycle ergometry test. Waist circumference, blood pressure, and fasting levels of blood lipids were assessed and dichotomized by conventional cut-off points. RESULTS: Participants reporting high PA level benefited from lower triglycerides and atherogenic cholesterol levels, regardless of CF. Higher CF level was, regardless of PA, associated with lower risk for all risk factors. With regard to clustering of risk factors, each higher CF level was associated with a gradually reduced risk by half or more, independent of PA. Furthermore, being unfit but reporting high PA was associated with a 50% lower risk compared with being unfit and inactive. Furthermore, high reported PA was associated with an additional reduced risk among fit participants. In addition, an excess risk of interaction was found for waist circumference, triglycerides, and the clustered CVD risk between neither being sufficiently active nor being fit. CONCLUSION: This study suggests that both PA and CF are independently associated with lower cardiovascular risk, and that both variables should be taken into account when CVD risk is estimated.
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7.
  • Ekblom Bak, Elin, 1981-, et al. (author)
  • Latent profile analysis patterns of exercise, sitting and fitness in adults – Associations with metabolic risk factors, perceived health, and perceived symptoms
  • 2020
  • In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:4
  • Journal article (peer-reviewed)abstract
    • Aim To identify and describe the characteristics of naturally occurring patterns of exercise, sitting in leisure time and at work and cardiorespiratory fitness, and the association of such profiles with metabolic risk factors, perceived health, and perceived symptoms. Methods 64,970 participants (42% women, 18–75 years) participating in an occupational health service screening in 2014–2018 were included. Exercise and sitting were self-reported. Cardiorespiratory fitness was estimated using a submaximal cycle test. Latent profile analysis was used to identify profiles. BMI and blood pressure were assessed through physical examination. Perceived back/neck pain, overall stress, global health, and sleeping problems were self-reported. Results Six profiles based on exercise, sitting in leisure time and at work and cardiorespiratory fitness were identified and labelled; Profile 1 “Inactive, low fit and average sitting in leisure, with less sitting at work”; Profile 2 “Inactive, low fit and sedentary”; Profile 3 “Active and average fit, with less sitting at work”; Profile 4 “Active, average fit and sedentary in leisure, with a sedentary work” (the most common profile, 35% of the population); Profile 5 “Active and fit, with a sedentary work”; Profile 6 “Active and fit, with less sitting at work”. Some pairwise similarities were found between profiles (1 and 2, 3 and 4, 5 and 6), mainly based on similar levels of exercise, leisure time sitting and fitness, which translated into similar dose-response associations with the outcomes. In general, profile 1 and 2 demonstrated most adverse metabolic and perceived health, profile 4 had a more beneficial health than profile 3, as did profile 6 compared to profile 5. Conclusions The present results implies a large variation in exercise, sitting, and fitness when studying naturally occurring patterns, and emphasize the possibility to target exercise, sitting time, and/or fitness in health enhancing promotion intervention and strategies. © 2020 Ekblom-Bak et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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8.
  • Ekblom-Bak, Elin, et al. (author)
  • LIV 2000 : Motionsvanor, fysisk prestationsförmåga och levnadsvanor bland svenska kvinnor och män i åldrarna 20-65 år
  • 2011
  • Reports (pop. science, debate, etc.)abstract
    • LIV 2000; syfte och frågeställningarLIV 90-studien avspeglade för första gången motionsvanor, fysisk status och övergripande hälsostatus i en väl definierad grupp av hela svenska befolkningen. Följaktligen ledde de resultat som LIV 90-studien redovisade till en rad direkta, centrala och övergripande frågor rörande vilka förändringar av det i många avseenden turbulenta 1990-talet som kunde iakttas i den svenska befolkningen vad gäller fysisk aktivitet, levnadsvanor, fysisk kapacitet och hälsotillstånd. Dessutom finns ett intressant perspektiv att jämföra hur den fysiska aktivitetsgraden, prestationsförmågan och hälsorelaterade variabler ser ut i samma ålderskohort med 10 års mellanrum.I stort sett sammanfaller undersökta variabler i LIV 2000 av naturliga skäl med den tidigare LIV 90-studiens, men vissa enkätfrågor har med erfarenheter från denna och andra studier, och den forskning som därefter bedrivits, ytterligare preciserats. Det gäller framförallt frågor om den totala fysiska aktiviteten samt frågor som rör inställning till den egna kroppen, den fysiska förmågan liksom frågor om hinder och förutsättningar att ägna sig åt motion. För att säkerställa möjligheterna att studera trender och eventuella förändringar i befolkningen under 1990-talet var designen och genomförandet av LIV 2000 studien i stort sett identisk med LIV 90. Förutom ett samlat tabellverk över de ingående undersökningsvariablerna i LIV 2000-studien (Bilaga B.1),  belyser denna rapport mer specifikt följande  områden och frågeställningar:I. Omfattning och inriktning av den vuxna befolkningens motionsvanor samt totala fysiska aktivitet. Hur många är motionärer? Hur många är tillräckligt fysiskt aktiva? Motionär och fysiskt aktiv – är det samma  sak?II. Fysisk prestationsförmåga; kondition, balans, ben- och bukmuskelstyrka. Hur skiljer det mellan könen och olika åldrar? Hur många har en låg fysisk prestationsförmåga?III. Psykisk och fysisk hälsa. Hur är den upplevda hälsan? Och hur är den metabola hälsan? Hur många har en samlad metabol riskbild?IV. Förändringar och trender av motionsvanor, total fysisk aktivitet, fysisk prestationsförmåga, livsstil och hälsotillstånd mellan LIV 90 och LIV 2000. Vad hände mellan 1990 och början av 2000-talet? Vilka hälsomässiga riskgrupper finns i befolkningen?Innehåll1. Bakgrund2. Metod och genomförande3. Deltagare4. Motionsvanor och fysisk aktivitet5. Fysisk prestationsförmåga6. Hälsa7. LIV 90 och LIV 2000 - Vad har hänt över 10 år?8. SammanfattningB. 1 TabellverkB. 2 Enkät och testprotokoll
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9.
  • Ekblom Bak, Elin, 1981-, et al. (author)
  • Physical Education and Leisure-Time Physical Activity in Youth Are Both Important for Adulthood Activity, Physical Performance, and Health.
  • 2018
  • In: Journal of Physical Activity and Health. - : Human Kinetics. - 1543-3080 .- 1543-5474. ; 15:9, s. 661-670
  • Journal article (peer-reviewed)abstract
    • Background: The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated. Methods: A total of 258,146 participants (49% women), aged 19–70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VO2max) were obtained. Results: Women participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81–0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17–1.23) for exercising regularly and a normal/high VO2max in adulthood. For men, the ORs were significantly lower (range: 0.66–0.86) for poor perceived overall health, general, and abdominal obesity. These associations were seen for participants up to 70 years. Increased PA outside school hours revealed even stronger beneficial associations. In joint analyses, both youth and current PA were important for lower OR of poor health and being obese in adulthood. Conclusions: Physical education class participation and additional PA after school hours were both important for perceived health, PA, VO2max, and metabolic health in adulthood up to 70 years.
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10.
  • Ekblom-Bak, Elin, et al. (author)
  • SCAPIS Pilot Study: Sitness, Fitness and Fatness-Is Sedentary Time Substitution by Physical Activity Equally Important for Everyone's Markers of Glucose Regulation?
  • 2016
  • In: Journal of Physical Activity & Health. - : Human Kinetics. - 1543-3080 .- 1543-5474. ; 13:7, s. 697-703
  • Journal article (peer-reviewed)abstract
    • Background: Although moderate-to-vigorous physical activity (MVPA) is mainly recommended for glucose control, light physical activity (LIPA) may also have the potential to induce favorable changes. We investigated sedentary time (SED) substitution with equal time in LIPA and MVPA, and the association with markers of glucose regulation and insulin sensitivity after stratification by waist circumference, fitness and fasting glucose levels. Methods: A total of 654 men and women, 50 to 64 years, from the SCAPIS pilot study were included. Daily SED, LIPA and MVPA were assessed using hip-worn accelerometers. Fasting plasma glucose, insulin and HOMA-IR were determined. Results: Substituting 30 min of SED with LIPA was significantly associated with 3.0% lower fasting insulin values and 3.1% lower HOMA-IR values, with even lower levels when substituting SED with MVPA. Participants with lower fitness and participants with high fasting glucose levels benefited significantly more from substituting 30 min of SED with LIPA compared with participants with normal to high fitness levels and participants with normal glucose levels, respectively. Conclusions: LIPA, and not only MVPA, may have beneficial associations with glucose regulation. This is of great clinical and public health importance, not least because it may confer a higher compliance rate to regular PA.
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  • Ekblom Bak, Elin, 1981-, et al. (author)
  • Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults
  • 2019
  • In: Preventive Medicine. - : Elsevier BV. - 0091-7435 .- 1096-0260. ; 127
  • Journal article (peer-reviewed)abstract
    • The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO(2)max) using a submaximal cycle test. Incident cases of first-time CVD event and death from any cause were ascertained through national registers. There were 4244 CVD events and 2750 cases of all-cause mortality during mean 7.6 years follow-up. Male gender, higher age and lower estVO(2)max were associated with higher all-cause mortality and CVD morbidity incidence rates. Risk reductions with increasing estVO(2)max were present in all age-groups of men and women. No obvious levelling off in risk was identified in the total cohort. However, women and older age-groups showed no further reduction in higher aggregated estVO(2)max levels. CVD specific mortality was more associated with estVO(2)max compared to tumor specific mortality. The risk for all-cause mortality and CVD morbidity decreased by 2.3% and 2.6% per increase in 1 ml.min(-) (1).kg(-1) with no significant sex-differences but more pronounced in the three lower estVO(2)max categories for all-cause mortality (9.1%, 3.8% and 3.3%, respectively). High compared to lower levels of estVO(2)max was not related to a significantly elevated mortality or morbidity. In this large cohort study, CVD morbidity and all-cause mortality were inversely related to estVO(2)max in both men and women of all age-groups. Increasing cardiorespiratory fitness is a clear public health priority.
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  • Ekblom Bak, Elin, et al. (author)
  • Större studier vid GIH
  • 2013
  • In: Idrottsmedicin. - 2001-3302. ; :2, s. 5-10
  • Journal article (other academic/artistic)abstract
    • På Åstrandslaboratoriet vid Gymnastik- och idrotthögskolan i Stockholm finns tradition och erfarenhet av att göra populationsundersökningar. För närvarande finns tre pågående projekt av populationskaraktär; Skola-Idrott-Hälsa (SIH), SCAPIS-undersökningen samt LIV-studierna.
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  • Ekblom Bak, Elin, et al. (author)
  • Svenskar rör sig för lite
  • 2015
  • In: Svensk Idrottsforskning. - 1103-4629. ; 24:2, s. 30-31
  • Journal article (other academic/artistic)abstract
    • För den som betraktar svenskarna som ett aktivt folk är det dags att tänka om. Bara sju procent av 50-65 åringarna är tillräckligt fysiskt aktiva, visar  resultat från den stora SCAPIS-studien.
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16.
  • Ekblom-Bak, Elin, et al. (author)
  • The Daily Movement Pattern and Fulfilment of Physical Activity Recommendations in Swedish Middle-Aged Adults: The SCAPIS Pilot Study
  • 2015
  • In: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 10:5
  • Journal article (peer-reviewed)abstract
    • Different aspects of the daily movement pattern-sitting, light intensity physical activity, and moderate-and vigorous intensity physical activity-have each independently been associated with health and longevity. Previous knowledge of the amount and distribution of these aspects in the general Swedish population, as well as the fulfilment rate of physical activity recommendations, mainly relies on self-reported data. More detailed data assessed with objective methods is needed. The aim of the study was to present descriptive data on the daily movement pattern in a middle-aged Swedish population assessed by hip-worn accelerometers. The cohort consisted of 948 participants (51% women), aged 50 to 64 years, from the Swedish CArdioPulmonary bioImage pilot Study. In the total sample, 60.5% of accelerometer wear time was spent sitting, 35.2% in light physical activity and 3.9% in moderate- and vigorous physical activity. Men and participants with high educational level spent a larger proportion of time sitting, compared to women and participants with low educational level. Men and participants with a high educational level spent more time, and the oldest age-group spent less time, in moderate-and vigorous physical activity. Only 7.1% of the study population met the current national physical activity recommendations, with no gender, age or education level differences. Assessment of all three components of the daily movement pattern is of high clinical relevance and should be included in future research. As the fulfilment of national physical activity recommendations is very low and sitting time is very high in our middle-aged population, the great challenge remains to enhance the implementation of methods to increase the level of physical activity in this population.
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17.
  • Ekblom, Örjan B, 1971-, et al. (author)
  • Cross-sectional trends in cardiovascular fitness in Swedish 16-year-olds between 1987 and 2007.
  • 2011
  • In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 100:4, s. 565-9
  • Journal article (peer-reviewed)abstract
    • AIM: We sought to investigate the temporal trends in estimated maximal aerobic capacity in adolescents (mean age 16.1).METHODS: Analyses were based on data from three population-based samples, collected in 1987 (n=221), 2001 (n=537) and 2007 (n=265). Subjects underwent sub-maximal ergometer testing. Absolute and relative aerobic capacities were estimated using the Åstrand-Ryhming nomogram.RESULTS: Compared to 1987, values for estimated relative and absolute maximal aerobic capacities were lower in 2001 and 2007, and values in 2007 were lower compared to 2001, in both boys and girls, except for absolute capacity between 1987 and 2001 in girls. The differences over time did not differ between genders. Absolute values changed from 3.0 and 2.5 L/min in 1987 to 2.5 and 2.2 L/min in 2007, for boys and girls, respectively. Relative values changed from 46.5 and 45.9 mL/min/kg in 1987 to 35.0 and 36.6 mL/min/kg, in 2007, for boys and girls, respectively.CONCLUSION: Based on earlier reports on the relationship between aerobic capacity and metabolic risk, the results from the present study provide argument that future public health will be affected negatively.
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18.
  • Ekblom, Örjan, 1971-, et al. (author)
  • Concurrent and predictive validity of physical activity measurement items commonly used in clinical settings- data from SCAPIS pilot study
  • 2015
  • In: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15
  • Journal article (peer-reviewed)abstract
    • Background: As the understanding of how different aspects of the physical activity (PA) pattern relate to health and disease, proper assessment is increasingly important. In clinical care, self-reports are the most commonly used assessment technique. However, systematic comparisons between questions regarding concurrent or criterion validity are rare, as are measures of predictive validity. The aim of the study was to examine the concurrent (using accelerometry as reference) and predictive validity (for metabolic syndrome) of five PA questions. Methods: A sample of 948 middle-aged Swedish men and women reported their PA patterns via five different questions and wore an accelerometer (Actigraph GT3X) for a minimum of 4 days. Concurrent validity was assessed as correlations and ROC-analyses. Predictive validity was assessed using logistic regression, controlling for potential confounders. Results: Concurrent validity was low-to-moderate (r < 0.35 and ROC AUC < 0.7) with large misclassifications regarding time spent sitting/sedentary and in moderate-to vigorous PA. The predictive validity of the questions was good, and one question (PHAS) showed an 80 % decreased odds-ratio of having metabolic syndrome, after taking potential confounders into consideration. Discussion: In this mixed sample of adults, both concurrent and predictive validity vaired between items and between measures of the physical activity pattern. The PHAS and WALK items are proposed for assessment of adherence to PA recommendations. Conclusion: Assessing PA patterns using self-report measures results in methodological problems when trying to predict individual risk for the metabolic syndrome, as the concurrent validity generally was low. However, several of the investigated questions may be useful for assessing risk at a group level, showing better predictive validity.
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22.
  • Hemmingsson, Erik, et al. (author)
  • Prevalence and time trends of overweight, obesity and severe obesity in 447,925 Swedish adults, 1995–2017
  • 2021
  • In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 49:4, s. 377-383
  • Journal article (peer-reviewed)abstract
    • Aims: The purpose of this research was to describe the current prevalence and historic trends in overweight, obesity and severe obesity in Sweden. Methods: Data on BMI, age, gender, education and geographic region were obtained in n=447,925 Swedish adults through a nationwide screening test (1995?2017). To account for sampling variations, we quantified prevalence estimates and time trends using standardized values (direct method) to all 18?74-year-old Swedes, using nationwide databases. Rates of overweight (BMI ?25 kg/m2), obesity (BMI ?30 kg/m2) and severe obesity (BMI ?35 kg/m2) were calculated across gender, age, education and geographic categories. Years were grouped into two-year sampling periods (except the first period where we used three years) for increased power. We used multivariable logistic regression to quantify independent associations between age, gender, education and region with obesity development and current prevalence rates. Results: In 2016/17 the unstandardized prevalence of overweight, obesity and severe obesity were 55.1%, 16.6% and 4.2%, respectively. Factors associated with a higher obesity prevalence were male gender, older age, lower education and residing in a rural region (all P<0.001). Between 1995 and 2017 the prevalence of severe obesity increased by 153%, compared to obesity (+86%) and overweight (+23%). While there were similar increases in obesity across gender and age groups, people with low education (vs high) and rural areas (vs urban) had a higher prevalence increase (both P<0.001). Conclusions: Rates of overweight, obesity and severe obesity have increased markedly in Swedish adults since 1995. Priority groups for prevention efforts include individuals with low education and those living in rural areas.
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24.
  • Olsson, Sven Johan Gustav, et al. (author)
  • Association of perceived physical health and physical fitness in two Swedish national samples from 1990 and 2015.
  • 2018
  • In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 28:2, s. 717-724
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Perceived health and physical fitness have been shown to correlate, and low levels of either variable increase the risk for future illness and mortality. However, risk factors and their interrelationship may vary between societies and over time. In this study, the associations of physical fitness and perceived health were therefore assessed in two Swedish national samples 25 years apart.METHODS: Perceived physical health, dichotomized as "good" or "bad", maximal oxygen uptake (VO2 max), counter movement jump (CMJ), balance (one-legged 60 second stance), and self-reported demographics and lifestyle were recorded in two cross-sectional samples (sample size, number of eligible participants) of Swedish adults, aged 20 - 65 years, in 1990 - 1991 (2203, 1365), and 2013 - 2015 (3357, 422).RESULTS: The odds for good perceived physical health increased by 5% per mL · kg(-1) · min(-1) of VO2 max, 3% per cm CMJ height, and decreased by 4% per 1 time of overbalancing, in both samples. Mutually adjusted regression models showed that perceived physical health was best predicted by VO2 max and chronic illness in 1990 and by age, BMI, and educational level in 2015.CONCLUSION: Perceived physical health was related to physical fitness in two samples of Swedish adults from 1990 and 2015. However, multivariate, and mutually adjusted models, indicate that the most important covariates of perceived physical health may have changed from VO2 max and chronic illness in 1990, to age, BMI, and educational level in 2015. This article is protected by copyright. All rights reserved.
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25.
  • Salier Eriksson, Jane, et al. (author)
  • Active commuting in Swedish workers between 1998 and 2015 - trends, characteristics and cardiovascular disease risk.
  • 2020
  • In: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 30:2
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Trend analyses of active commuting and potential variations in trends and association with cardiovascular disease (CVD) risk within sub-groups are unknown.OBJECTIVES: To a) describe trends in active commuting between 1998 to 2015 and b) to study the association between different amounts of active commuting and the incidence risk of CVD in a large sample of Swedish workers, and analyses of potential variations across sub-groups of socio-demographics, physical activity and BMI.METHODS: A total of 318,309 participants (47% women, 18-74 years) who participated in a nationwide occupational health service screening between 1998 and 2015 were included. Commuting habits were self-reported, and data on first-time CVD events were derived from national registers.RESULTS: Self-reported passive commuters decreased between 1998 and 2015 (64% to 56%), transferring to an increase in mainly moderate/high-dose active commuters (12% to 19%). Changes were seen in all subgroups. The characteristics and life-style habits of the typical passive and active commuter changed little over the study period. Low- and moderate/high-dose active commuters had significantly decreased risks for a first time CVD during follow-up. This was accentuated in men, middle-aged and in participants with light physical work situations, irregular exercise habits, being overweight/obese and with low fitness.CONCLUSION: Increases in active commuting were observed between 1998 and 2015, however still leaving a majority who do not actively commute. As active commuting, regardless dose, is associated with a lower CVD risk, encouraging more people to actively commute may provide an easily accessible and time-efficient possibility to increase physical activity and health in the general population.
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