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Tcymbal A, Messing S, Mait R, Perez RG, Akter T, Rakovac I, Gelius P, Abu-Omar K. Validity, reliability, and readability of single-item and short physical activity questionnaires for use in surveillance: A systematic review. PLoS One 2024; 19:e0300003. [PMID: 38470871 PMCID: PMC10931432 DOI: 10.1371/journal.pone.0300003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Accurate and fast measurement of physical activity is important for surveillance. Even though many physical activity questionnaires (PAQ) are currently used in research, it is unclear which of them is the most reliable, valid, and easy to use. This systematic review aimed to identify existing brief PAQs, describe and compare their measurement properties, and assess their level of readability. METHODS We performed a systematic review based on the PRISMA statement. Literature searches were conducted in six scientific databases. Articles were included if they evaluated validity and/or reliability of brief (i.e., with a maximum of three questions) physical activity or exercise questionnaires intended for healthy adults. Due to the heterogeneity of studies, data were summarized narratively. The level of readability was calculated according to the Flesch-Kincaid formula. RESULTS In total, 35 articles published in English or Spanish were included, evaluating 32 distinct brief PAQs. The studies indicated moderate to good levels of reliability for the PAQs. However, the majority of results showed weak validity when validated against device-based measurements and demonstrated weak to moderate validity when validated against other PAQs. Most of the assessed PAQs met the criterion of being "short," allowing respondents to complete them in less than one minute either by themselves or with an interviewer. However, only 17 questionnaires had a readability level that indicates that the PAQ is easy to understand for the majority of the population. CONCLUSIONS This review identified a variety of brief PAQs, but most of them were evaluated in only a single study. Validity and reliability of short and long questionnaires are found to be at a comparable level, short PAQs can be recommended for use in surveillance systems. However, the methods used to assess measurement properties varied widely across studies, limiting the comparability between different PAQs and making it challenging to identify a single tool as the most suitable. None of the evaluated brief PAQs allowed for the measurement of whether a person fulfills current WHO physical activity guidelines. Future development or adaptation of PAQs should prioritize readability as an important factor to enhance their usability.
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Affiliation(s)
- Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Rachel Mait
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Roberto Galindo Perez
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Taiyeba Akter
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ivo Rakovac
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Peter Gelius
- Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Årnes AP, Fjeld MK, Stigum H, Nielsen CS, Stubhaug A, Johansen A, Hopstock LA, Morseth B, Wilsgaard T, Steingrímsdóttir ÓA. Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study. Pain 2024:00006396-990000000-00543. [PMID: 38442413 DOI: 10.1097/j.pain.0000000000003209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/28/2024] [Indexed: 03/07/2024]
Abstract
ABSTRACT Knowledge is needed regarding mechanisms acting between physical activity (PA) and chronic pain. We investigated whether cold pain tolerance mediates an effect of leisure-time physical activity on the risk of chronic pain 7 to 8 years later using consecutive surveys of the population-based Tromsø Study. We included participants with information on baseline leisure-time PA (LTPA) and the level of cold pressor-assessed cold pain tolerance, who reported chronic pain status at follow-up as any of the following: chronic pain for ≥3 months, widespread chronic pain, moderate-to-severe chronic pain, or widespread moderate-to-severe chronic pain. We included 6834 participants (52% women; mean age, 55 years) in counterfactual mediation analyses. Prevalence decreased with severity, for example, 60% for chronic pain vs 5% for widespread moderate-to-severe chronic pain. People with one level higher LTPA rating (light to moderate or moderate to vigorous) at baseline had lower relative risk (RR) of 4 chronic pain states 7 to 8 years later. Total RR effect of a 1-level LTPA increase was 0.95 (0.91-1.00), that is, -5% decreased risk. Total effect RR for widespread chronic pain was 0.84 (0.73-0.97). Indirect effect for moderate-to-severe chronic pain was statistically significant at RR 0.993 (0.988-0.999); total effect RR was 0.91 (0.83-0.98). Statistically significantly mediated RR for widespread moderate-to-severe chronic pain was 0.988 (0.977-0.999); total effect RR was 0.77 (0.64-0.94). This shows small mediation of the effect of LTPA through pain tolerance on 2 moderate-to-severe chronic pain types. This suggests pain tolerance to be one possible mechanism through which PA modifies the risk of moderate-to-severe chronic pain types with and without widespread pain.
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Affiliation(s)
- Anders Pedersen Årnes
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Mats Kirkeby Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hein Stigum
- Institute of Health and Society, University of Oslo, Norway
| | - Christopher Sivert Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Aslak Johansen
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Sagelv EH, Casolo A, Eggen AE, Heitmann KA, Johansen KR, Løchen ML, Mathiesen EB, Morseth B, Njølstad I, Osborne JO, Hagerupsen K, Pedersen S, Wilsgaard T. Females Display Lower Risk of Myocardial Infarction From Higher Estimated Cardiorespiratory Fitness Than Males: The Tromsø Study 1994-2014. Mayo Clin Proc Innov Qual Outcomes 2024; 8:62-73. [PMID: 38268988 PMCID: PMC10806283 DOI: 10.1016/j.mayocpiqo.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Objective To examine the dose-response association between estimated cardiorespiratory fitness (eCRF) and risk of myocardial infarction (MI). Patients and Methods Adults who attended Tromsø Study surveys 4-6 (Janurary 1,1994-December 20, 2008) with no previous cardiovascular disease were followed up through December 31, 2014 for incident MI. Associations were examined using restricted cubic splines Fine and Gray regressions, adjusted for education, smoking, alcohol, diet, sex, adiposity, physical activity, study survey, and age (timescale) in the total cohort and subsamples with hyperlipidemia (n=2956), hypertension (n=8290), obesity (n=5784), metabolic syndrome (n=1410), smokers (n=3823), and poor diet (n=3463) and in those who were physically inactive (n=6255). Results Of 14,285 participants (mean age ± SD, 53.7±11.4 years), 979 (6.9%) experienced MI during follow-up (median, 7.2 years; 25th-75th, 5.3-14.6 years). Females with median eCRF (32 mL/kg/min) had 43% lower MI risk (subdistributed hazard ratio [SHR], 0.57; 95% CI, 0.48-0.68) than those at the 10th percentile (25 mL/kg/min) as reference. The lowest MI risk was observed at 47 mL/kg/min (SHR, 0.02; 95% CI, 0.01-0.11). Males had 26% lower MI risk at median eCRF (40 mL/kg/min; SHR, 0.74; 95% CI, 0.63-0.86) than those at the 10th percentile (32 mL/kg/min), and the lowest risk was 69% (SHR, 0.31; 95% CI, 0.14-0.71) at 60 mL/kg/min. The associations were similar in subsamples with cardiovascular disease risk factors. Conclusion Higher eCRF associated with lower MI risk in females and males, but associations were more pronounced among females than those in males. This suggest eCRF as a vital estimate to implement in medical care to identify individuals at high risk of future MI, especially for females.
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Affiliation(s)
- Edvard H. Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andrea Casolo
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kim Arne Heitmann
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristoffer R. Johansen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - John O. Osborne
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Karianne Hagerupsen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sigurd Pedersen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Sagelv EH, Dalene KE, Eggen AE, Ekelund U, Fimland MS, Heitmann KA, Holtermann A, Johansen KR, Løchen ML, Morseth B, Wilsgaard T. Occupational physical activity and risk of mortality in women and men: the Tromsø Study 1986-2021. Br J Sports Med 2024; 58:81-88. [PMID: 37914386 DOI: 10.1136/bjsports-2023-107282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Associations between occupational physical activity (OPA) and mortality risks are inconclusive. We aimed to examine associations between (1) OPA separately and (2) jointly with leisure time physical activity (LTPA), and risk of all-cause, cardiovascular disease (CVD) and cancer mortality, over four decades with updated exposure and covariates every 6-8 years. METHODS Adults aged 20-65 years from the Tromsø Study surveys Tromsø3-Tromsø7 (1986-2016) were included. We categorised OPA as low (sedentary), moderate (walking work), high (walking+lifting work) or very high (heavy manual labour) and LTPA as inactive, moderate and vigorous. We used Cox/Fine and Gray regressions to examine associations, adjusted for age, body mass index, smoking, education, diet, alcohol and LTPA (aim 1 only). RESULTS Of 29 605 participants with 44 140 total observations, 4131 (14.0%) died, 1057 (25.6%) from CVD and 1660 (40.4%) from cancer, during follow-up (median: 29.1 years, 25th-75th: 16.5.1-35.3). In men, compared with low OPA, high OPA was associated with lower all-cause (HR 0.83, 95% CI 0.74 to 0.92) and CVD (subdistributed HR (SHR) 0.68, 95% CI 0.54 to 0.84) but not cancer mortality (SHR 0.99, 95% CI 0.84 to 1.19), while no association was observed for moderate or very high OPA. In joint analyses using inactive LTPA and low OPA as reference, vigorous LTPA was associated with lower all-cause mortality combined with low (HR 0.75, 95% CI 0.64 to 0.89), high (HR 0.67, 95% CI 0.54 to 0.82) and very high OPA (HR 0.74, 95% CI 0.58 to 0.94), but not with moderate OPA. In women, there were no associations between OPA, or combined OPA and LTPA, with mortality. CONCLUSION High OPA, but not moderate and very high OPA, was associated with lower all-cause and CVD mortality risk in men but not in women. Vigorous LTPA was associated with lower mortality risk in men with low, high and very high OPA, but not moderate OPA.
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Affiliation(s)
- Edvard H Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ulf Ekelund
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Kim Arne Heitmann
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sport Science and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kristoffer Robin Johansen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Wilhelmsen T, Lannem AM, Sørensen M, Augutis M, Gustafsson H. Experiences of Participants with Spinal Cord Injury at an Active Rehabilitation Camp. J Funct Morphol Kinesiol 2023; 9:7. [PMID: 38249084 PMCID: PMC10801526 DOI: 10.3390/jfmk9010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
This study explored the physical, social, and psychological benefits of an active rehabilitation (AR) camp as experienced by participants with spinal cord injury (SCI), and perceived fitness and mastery of being physically active six months after the camp. The study used a mixed-method design with pre- (n = 23), post- (n = 23), and follow-up questionnaires (n = 18) and individual interviews (n = 8). Fuzzy qualitative comparative analysis (fsQCA) was used to analyze the quantitative data and qualitative content analysis was used to analyze the qualitative data. Results showed that benefits were mainly experienced in the social and psychological domains. As for the physical domain, younger and more recently injured persons with tetraplegia reported more benefits. Six months after the camp, being in the preparation stage of change and being somewhat physically active were necessary and sufficient conditions for experiencing mastery of physical activity regardless of injury type, but only persons with paraplegia experienced fitness benefits. Qualitative data shed further light on the perceived benefits of the camp. The knowledge gained from this study might help practitioners to tailor interventions to individual needs and researchers to ask questions that take into consideration the complexity of active rehabilitation and changes in physical activity behavior for people with SCI.
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Affiliation(s)
- Terese Wilhelmsen
- Department of Educational Sciences, University of South-Eastern Norway, 3045 Drammen, Norway;
| | - Anne Marie Lannem
- Research Department, Sunnaas Rehabilitation Hospital, 1450 Nesoddtangen, Norway;
- Department of Sport and Social Sciences, Norwegian University of Sport Sciences, 0806 Oslo, Norway;
| | - Marit Sørensen
- Department of Sport and Social Sciences, Norwegian University of Sport Sciences, 0806 Oslo, Norway;
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, 141-83 Stockholm, Sweden;
| | - Henrik Gustafsson
- Department of Sport and Social Sciences, Norwegian University of Sport Sciences, 0806 Oslo, Norway;
- Department of Educational Sciences, Karlstad University, 651 88 Karlstad, Sweden
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Dalene KE, Lergenmuller S, Sund ER, Hopstock LA, Robsahm TE, Nilssen Y, Nystad W, Larsen IK, Ariansen I. Clustering and trajectories of key noncommunicable disease risk factors in Norway: the NCDNOR project. Sci Rep 2023; 13:14479. [PMID: 37660221 PMCID: PMC10475033 DOI: 10.1038/s41598-023-41660-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023] Open
Abstract
Noncommunicable diseases (NCDs) are a leading cause of premature death globally and have common preventable risk factors. In Norway, the NCDNOR-project aims at establishing new knowledge in the prevention of NCDs by combining information from national registries with data from population-based health studies. In the present study, we aimed to harmonize data on key NCD risk factors from the health studies, describe clustering of risk factors using intersection diagrams and latent class analysis, and identify long-term risk factor trajectories using latent class mixed models. The harmonized study sample consisted of 808,732 individuals (1,197,158 participations). Two-thirds were exposed to ≥ 1 NCD risk factor (daily smoking, physical inactivity, obesity, hypertension, hypercholesterolaemia or hypertriglyceridaemia). In individuals exposed to ≥ 2 risk factors (24%), we identified five distinct clusters, all characterized by fewer years of education and lower income compared to individuals exposed to < 2 risk factors. We identified distinct long-term trajectories of smoking intensity, leisure-time physical activity, body mass index, blood pressure, and blood lipids. Individuals in the trajectories tended to differ across sex, education, and body mass index. This provides important insights into the mechanisms by which NCD risk factors can occur and may help the development of interventions aimed at preventing NCDs.
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Affiliation(s)
- Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway.
| | - Simon Lergenmuller
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Oslo, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Oslo, Norway
| | | | - Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Wenche Nystad
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
| | - Inger Kristin Larsen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Inger Ariansen
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
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Beldo SK, Aars NA, Christoffersen T, Furberg AS, Halvorsen PA, Hansen BH, Horsch A, Sagelv EH, Syed S, Morseth B. Criterion validity of the Saltin-Grimby Physical Activity Level Scale in adolescents. The Fit Futures Study. PLoS One 2022; 17:e0273480. [PMID: 36048815 PMCID: PMC9436064 DOI: 10.1371/journal.pone.0273480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background The Saltin-Grimby Physical Activity Level Scale (SGPALS) is commonly used to measure physical activity (PA) in population studies, but its validity in adolescents is unknown. This study aimed to assess the criterion validity of the SGPALS against accelerometry in a large sample of adolescents. A secondary aim was to examine the validity across strata of sex, body mass index (BMI), parental educational level, study program and self-reported health. Methods The study is based on data from 572 adolescents aged 15–17 years who participated in the Fit Futures Study 2010–11 in Northern Norway. The participants were invited to wear an accelerometer (GT3X) attached to their hip for seven consecutive days. We used Spearman’s rho and linear regression models to assess the validity of the SGPALS against the following accelerometry estimates of PA; mean counts/minute (CPM), steps/day, and minutes/day of moderate-to-vigorous physical activity (MVPA). Results The SGPALS correlated with mean CPM (ρ = 0.40, p<0.01), steps/day (ρ = 0.35, p<0.01) and MVPA min/day (ρ = 0.35, p<0.01). We observed no differences between correlations within demographic strata (all p>0.001). Higher scores on SGPALS were associated with a higher CPM, higher number of steps per day and more minutes of MVPA per day, with the following mean differences in PA measurements between the SGPALS ranks: CPM increased by 53 counts (95% CI: 44 to 62), steps/day increased by 925 steps (95% CI: 731 to 1118), and MVPA by 8.4 min/day (95% CI: 6.7 to 10.0). Mean difference between the highest and lowest SGPALS category was 2947 steps/day (6509 vs. 9456 steps/day) and 26.4 min/day MVPA (35.2 minutes vs 61.6 minutes). Conclusion We found satisfactory ranking validity of SGPALS measured against accelerometry in adolescents, which was fairly stable across strata of sex, BMI, and education. However, the validity of SGPALS in providing information on absolute physical activity levels seem limited.
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Affiliation(s)
- Sigurd K. Beldo
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Alta/Tromsø, Norway
- * E-mail:
| | | | - Tore Christoffersen
- Finnmark Hospital Trust, Alta, Norway
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Alta/Tromsø, Norway
| | - Anne-Sofie Furberg
- Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Peder A. Halvorsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørge Herman Hansen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Alexander Horsch
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Edvard H. Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Alta/Tromsø, Norway
| | - Shaheen Syed
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Alta/Tromsø, Norway
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Lofterød T, Frydenberg H, Veierød MB, Jenum AK, Reitan JB, Wist EA, Thune I. The influence of metabolic factors and ethnicity on breast cancer risk, treatment and survival: The Oslo ethnic breast cancer study. Acta Oncol 2022; 61:649-657. [PMID: 35348396 DOI: 10.1080/0284186x.2022.2053573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/10/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Breast cancer risk remains higher in high-income compared with low-income countries. However, it is unclear to what degree metabolic factors influence breast cancer development in women 30 years after immigration from low- to a high-incidence country. METHODS Using Cox regression models, we studied the association between pre-diagnostic metabolic factors and breast cancer development, and whether this association varied by ethnicity among 13,802 women participating in the population-based Oslo Ethnic Breast Cancer Study. Ethnic background was assessed and pre-diagnostic metabolic factors (body mass index, waist:hip ratio, serum lipids and blood pressure) were measured. A total of 557 women developed invasive breast cancer, and these women were followed for an additional 7.7 years. RESULTS Among women with an unfavorable metabolic profile, women from south Asia, compared with western European women, had a 2.3 times higher breast cancer risk (HR 2.30, 95% CI 1.18-4.49). Compared with the western European women, the ethnic minority women were more likely to present with triple-negative breast cancer (TNBC) (OR 2.11, 95% CI 0.97-4.61), and less likely to complete all courses of planned taxane treatment (OR 0.26, 95% CI 0.08-0.82). Among TNBC women, above-median triglycerides:HDL-cholesterol (>0.73) levels, compared with below-median triglycerides:HDL-cholesterol (≤0.73) levels, was associated with 2.9 times higher overall mortality (HR 2.88, 95% CI 1.02-8.11). CONCLUSIONS Our results support the importance of metabolic factors when balancing breast cancer prevention and disease management among all women, and in particular among non-western women migrating from a breast cancer low-incidence to a high-incidence country.
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Affiliation(s)
- Trygve Lofterød
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
| | - Hanne Frydenberg
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jon B Reitan
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
| | - Erik A Wist
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Inger Thune
- Department of Oncology, Oslo University Hospital, Ullevål, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Health Services, UiT The Arctic University of Norway, Oslo, Norway
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9
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Engen T, Owe KM, Horn J, Sulo G, Næss ØE, Juliusson PB, Morken NH, Egeland GM. Preconception leisure-time physical activity and family history of stroke and myocardial infarction associate with preterm delivery: findings from a Norwegian cohort. BMC Pregnancy Childbirth 2022; 22:341. [PMID: 35443622 PMCID: PMC9019953 DOI: 10.1186/s12884-022-04528-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Preterm birth poses short and long-term health consequences for mothers and offspring including cardiovascular disease sequelae. However, studies evaluating preexisting family history of cardiovascular disease and risk factors, such as physical activity, as they relate prospectively to risk of delivering preterm are lacking. Objectives To evaluate whether preconception past-year weekly leisure-time physical activity or a family history of stroke or of myocardical infarction prior to age 60 years in first degree relatives associated, prospectively, with preterm delivery. Design Cohort study. Baseline data from Cohort Norway (1994–2003) health surveys were linked to the Medical Birth Registry of Norway for identification of all subsequent births (1994–2012). Logistic regression models provided odds ratios (OR) and 95% confidence intervals (CI) for preterm delivery (< 37 weeks gestation); multinomial logistic regression provided OR for early preterm (< 34 weeks) and late preterm (34 through to end of 36 weeks gestation) relative to term deliveries. Results Mean (SD) length of time from baseline health survey participation to delivery was 5.6 (3.5) years. A family history of stroke associated with a 62% greater risk for late preterm deliveries (OR 1.62; CI 1.07–2.47), while a family history of myocardial infarction associated with a 66% greater risk of early preterm deliveries (OR 1.66; CI 1.11–2.49). Sensitivity analyses, removing pregnancies complicated by hypertensive disorders of pregnancy, diabetes mellitus, and stillbirth deliveries, gave similar results. Preconception vigorous physical activity of three or more hours relative to less than 1 h per week associated with increased risk of early preterm delivery (OR 1.52; 95% CI 1.01–2.30), but not late or total preterm deliveries. Light physical activity of three or more hours per week relative to less activity prior to pregnancy was not associated with early, late, or total preterm deliveries. Conclusions Results suggest that family history of cardiovascular disease may help identify women at risk for preterm delivery. Further, research is needed regarding preconception and very early pregnancy vigorous physical activity and associated risks.
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Affiliation(s)
- Tone Engen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway
| | - Katrine Mari Owe
- Norwegian Research Centre for Women's Health, Oslo University Hospital HF, Riks Hospital, Oslo, Norway and Division of Mental and Physical Health, Norwegian Institute of Public health, Oslo, Norway
| | - Julie Horn
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway & Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger Hospital, Kirkegata 2, N-7600, Levanger, Norway
| | - Gerhard Sulo
- Centre for Disease Burden, Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway; & Oral Health Centre of Expertise in Western Norway-Vestland, Bergen, Norway
| | - Øyvind Erik Næss
- Division of Mental and Physical Health, Norwegian Institute of Public Health & University of Oslo, Oslo, Norway &Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Petur Benedikt Juliusson
- Health Registries Research and Development, Division of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Post Box 973 Sentrum, 5808, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Nils-Halvdan Morken
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway & Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Grace Margrethe Egeland
- Health Registries Research and Development, Division of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Post Box 973 Sentrum, 5808, Bergen, Norway. .,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
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10
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Dalene KE, Tarp J, Selmer RM, Ariansen IKH, Nystad W, Coenen P, Anderssen SA, Steene-Johannessen J, Ekelund U. Occupational physical activity and longevity in working men and women in Norway: a prospective cohort study. LANCET PUBLIC HEALTH 2021; 6:e386-e395. [PMID: 33932334 DOI: 10.1016/s2468-2667(21)00032-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/03/2021] [Accepted: 02/12/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Studies suggest that high occupational physical activity increases mortality risk. However, it is unclear whether this association is causal or can be explained by a complex network of socioeconomic and behavioural factors. We aimed to examine the association between occupational physical activity and longevity, taking a complex network of confounding variables into account. METHODS In this prospective cohort study, we linked data from Norwegian population-based health examination surveys, covering all parts of Norway with data from the National Population and Housing Censuses and the Norwegian Cause of Death Registry. 437 378 participants (aged 18-65 years; 48·7% men) self-reported occupational physical activity (mutually exclusive groups: sedentary, walking, walking and lifting, and heavy labour) and were followed up from study entry (between February, 1974, and November, 2002) to death or end of follow-up on Dec 31, 2018, whichever came first. We estimated differences in survival time (death from all causes, cardiovascular disease, and cancer) between occupational physical activity categories using flexible parametric survival models adjusted for confounding factors. FINDINGS During a median of 28 years (IQR 25-31) from study entry to the end of follow-up, 74 203 (17·0%) of the participants died (all-cause mortality), of which 20 111 (27·1%) of the deaths were due to cardiovascular disease and 29 886 (40·3%) were due to cancer. Crude modelling indicated shorter mean survival times among men in physically active occupations than in those with sedentary occupations. However, this finding was reversed following adjustment for confounding factors (birth cohort, education, income, ethnicity, prevalent cardiovascular disease, smoking, leisure-time physical activity, body-mass index), with estimates suggesting that men in occupations characterised by walking, walking and lifting, and heavy labour had life expectancies equivalent to 0·4 (95% CI -0·1 to 1·0), 0·8 (0·3 to 1·3), and 1·7 (1·2 to 2·3) years longer, respectively, than men in the sedentary referent category. Results for mortality from cardiovascular disease and cancer showed a similar pattern. No clear differences in survival times were observed between occupational physical activity groups in women. INTERPRETATION Our results suggest that moderate to high occupational physical activity contributes to longevity in men. However, occupational physical activity does not seem to affect longevity in women. These results might inform future physical activity guidelines for public health. FUNDING The Norwegian Research Council (grant number 249932/F20).
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Affiliation(s)
- Knut Eirik Dalene
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Randi Marie Selmer
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Wenche Nystad
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.
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11
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Hektoen HH, Robsahm TE, Andreassen BK, Stenehjem JS, Axcrona K, Mondul A, Gislefoss RE. Lifestyle associated factors and risk of urinary bladder cancer: A prospective cohort study from Norway. Cancer Med 2020; 9:4420-4432. [PMID: 32319230 PMCID: PMC7300409 DOI: 10.1002/cam4.3060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/24/2022] Open
Abstract
A number of lifestyle associated factors, such as high body mass index (BMI), low physical activity, and related metabolic disorders, are associated with increased risk of cancer at several sites. For urinary bladder cancer (BC), such studies show inconsistent results, which could result from inadequate adjustment for smoking and occupational exposure. In the population‐based Janus Cohort (n = 292 851), we investigated the independent and combined impact of BMI, physical activity, blood pressure, and blood lipids on the risk of BC, by thorough adjustment for smoking and potential occupational exposure. We used cox proportional hazard regression to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations between the lifestyle associated factors and BC risk. The associations observed were dependent on smoking status and gender. Among men, diastolic blood pressure (DBP) (HR 1.07, 95% CI 1.02‐1.12) and systolic blood pressure (SBP) (HR 1.04, 95% CI 1.01‐1.07) were positively associated with BC risk. Stratification by smoking status revealed a positive association between DBP and BC risk in never smokers (HR 1.14, 95% CI 1.00‐1.30), while no association was seen for current and former smokers. A risk score, integrating information across the lifestyle factors was positively associated with BC risk in men (ptrend = 0.043). In women, physical activity was associated with a decreased BC risk, but only among never smokers (HR 0.65, 95% CI 0.45‐0.94). In conclusion, relations between lifestyle associated factors and BC risk were most evident in never smokers, suggesting that smoking dominates the relation in current smokers.
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Affiliation(s)
- Helga H Hektoen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | - Jo S Stenehjem
- Department of Research, Cancer Registry of Norway, Oslo, Norway.,Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Karol Axcrona
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | - Alison Mondul
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
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12
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Morseth B, Hopstock LA. Time trends in physical activity in the Tromsø study: An update. PLoS One 2020; 15:e0231581. [PMID: 32287319 PMCID: PMC7156055 DOI: 10.1371/journal.pone.0231581] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/26/2020] [Indexed: 01/30/2023] Open
Abstract
Although the health benefits of physical activity are well documented, a large proportion of the population fails to meet current guidelines for physical activity. In order to develop evidence-based public health policies, surveillance of physical activity prevalence and trends is essential. The main aim of this study was to present updated data on physical activity trends in a Norwegian general population over the last decades. Data were collected from 40 690 individuals (50% men) aged ≥20 years participating in at least one of six surveys of the population-based Tromsø Study between 1979 and 2016. Age-standardized prevalences and trends in leisure-time and occupational physical activity were obtained from three questionnaires used in the different surveys. We observed an increase in the proportion engaging in exercise in leisure-time between 1994–95 and 2001 (p <0.001). Based on a different questionnaire, the age-standardized prevalence of engagement in exercise in leisure-time increased significantly from 16% in 2001 to 23% in 2007–08, and further to 28% in 2015–16 (p <0.001). The proportion who reported exercising approximately every day increased from 19% in 2007–08 to 28% in 2015–16 (p <0.001). The age-standardized prevalence of sedentary occupational activity increased from 53% in 2007–08 to 57% in 2015–16 (p <0.001), which extends the gradual increase from 36% in 1979-80.The present study extends previous findings from the Tromsø Study by demonstrating an increase in the proportion exercising regularly over the last three decades. This increase may partially counteract the gradual increase in the proportion with sedentary occupational activity.
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Affiliation(s)
- Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Laila Arnesdatter Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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13
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Sagelv EH, Hopstock LA, Johansson J, Hansen BH, Brage S, Horsch A, Ekelund U, Morseth B. Criterion validity of two physical activity and one sedentary time questionnaire against accelerometry in a large cohort of adults and older adults. BMJ Open Sport Exerc Med 2020; 6:e000661. [PMID: 32153981 PMCID: PMC7047487 DOI: 10.1136/bmjsem-2019-000661] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives We compared the ability of physical activity and sitting time questionnaires (PAQ) for ranking individuals versus continuous volume calculations (physical activity level (PAL), metabolic equivalents of task (MET), sitting hours) against accelerometry measured physical activity as our criterion. Methods Participants in a cohort from the Tromsø Study completed three questionnaires; (1) The Saltin-Grimby Physical Activity Level Scale (SGPALS) (n=4040); (2) The Physical Activity Frequency, Intensity and Duration (PAFID) questionnaire (n=5902)) calculated as MET-hours·week-1 and (3) The International Physical Activity questionnaire (IPAQ) short-form sitting question (n=4896). We validated the questionnaires against the following accelerometry (Actigraph wGT3X-BT) estimates: vector magnitude counts per minute, steps∙day-1, time (minutes·day-1) in sedentary behaviour, light physical activity, moderate and vigorous physical activity (MVPA) non-bouted and ≥10 min bouted MVPA. Results Ranking of physical activity according to the SGPALS and quartiles (Q) of MET-hours∙week-1 from the PAFID were both positively associated with accelerometry estimates of physical activity (p<0.001) but correlations with accelerometry estimates were weak (SGPALS (PAL): r=0.11 to 0.26, p<0.001) and weak-to-moderate (PAFID: r=0.39 to 0.44, p<0.01). There was 1 hour of accelerometry measured sedentary time from Q1 to Q4 in the IPAQ sitting question (p<0.001) and also weak correlations (r=0.22, p<0.01). Conclusion Ranking of physical activity levels measured with PAQs appears to have higher validity than energy expenditure calculations. Self-reported sedentary time poorly reflects accelerometry measured sedentary time. These two PAQs can be used for ranking individuals into different physical activity categories supporting previous studies using these instruments when assessing associations with health outcomes.
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Affiliation(s)
- Edvard H Sagelv
- Faculty of Health Sciences, School of Sport Sciences, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Laila A Hopstock
- Faculty of Health Sciences, Department of Community Medicine, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Jonas Johansson
- Faculty of Health Sciences, Department of Community Medicine, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Bjørge H Hansen
- Faculty of Health and Sport Sciences, Department of Sport Science and Physical Education, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK.,Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Alexander Horsch
- Faculty of Science and Technology, Department of Computer Science, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Oslo, Norway
| | - Bente Morseth
- Faculty of Health Sciences, School of Sport Sciences, UiT Arctic University of Norway, Tromso, Troms, Norway
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14
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Graff-Iversen S, Hewitt S, Forsén L, Grøtvedt L, Ariansen I. Associations of tobacco smoking with body mass distribution; a population-based study of 65,875 men and women in midlife. BMC Public Health 2019; 19:1439. [PMID: 31675936 PMCID: PMC6825363 DOI: 10.1186/s12889-019-7807-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 10/21/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Studies indicate an effect of smoking toward abdominal obesity, but few assess hip and waist circumferences (HC and WC) independently. The present study aimed to assess the associations of smoking status and volume smoked with HC and WC and their ratio in a population with low prevalence of obesity together with high prevalence of smoking. METHODS We used cross-sectional survey data from 11 of a total 19 Norwegian counties examined in 1997-99 including 65,875 men and women aged 39-44 years. Analysis of associations were adjusted for confounding by socioeconomic position, health indicators, and additionally for BMI. RESULTS Compared with never-smokers, when adjusting for confounders and in addition for BMI, mean HC remained lower while mean WC and waist-hip-ratio (WHR) were higher in current smokers. The finding of a lower HC and higher WHR level among smokers was consistent by sex and in strata by levels of education and physical activity, while the finding of higher WC by smoking was less consistent. Among current smokers, BMI-adjusted mean HC decreased whereas WC and WHR increased by volume smoked. Compared with current smokers, former smokers had higher BMI-adjusted HC, lower WHR and among women WC was lower. CONCLUSIONS The main finding in this study was the consistent negative associations of smoking with HC. In line with the hypothesis that lower percentage gluteofemoral fat is linked with higher cardiovascular risk, our results suggest that smoking impacts cardiovascular risk through mechanisms that reduce the capacity of fat storage in the lower body region.
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Affiliation(s)
- Sidsel Graff-Iversen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Stephen Hewitt
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Medical Clinic, Oslo University Hospital Aker, Oslo, Norway
| | - Lisa Forsén
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,National Resource Centre for Women's Health, Division of Obstetrics and Gynaecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Liv Grøtvedt
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Ariansen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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15
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Gill NK, Ly C, Nyberg KD, Lee L, Qi D, Tofig B, Reis-Sobreiro M, Dorigo O, Rao J, Wiedemeyer R, Karlan B, Lawrenson K, Freeman MR, Damoiseaux R, Rowat AC. A scalable filtration method for high throughput screening based on cell deformability. LAB ON A CHIP 2019; 19:343-357. [PMID: 30566156 DOI: 10.1039/c8lc00922h] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cell deformability is a label-free biomarker of cell state in physiological and disease contexts ranging from stem cell differentiation to cancer progression. Harnessing deformability as a phenotype for screening applications requires a method that can simultaneously measure the deformability of hundreds of cell samples and can interface with existing high throughput facilities. Here we present a scalable cell filtration device, which relies on the pressure-driven deformation of cells through a series of pillars that are separated by micron-scale gaps on the timescale of seconds: less deformable cells occlude the gaps more readily than more deformable cells, resulting in decreased filtrate volume which is measured using a plate reader. The key innovation in this method is that we design customized arrays of individual filtration devices in a standard 96-well format using soft lithography, which enables multiwell input samples and filtrate outputs to be processed with higher throughput using automated pipette arrays and plate readers. To validate high throughput filtration to detect changes in cell deformability, we show the differential filtration of human ovarian cancer cells that have acquired cisplatin-resistance, which is corroborated with cell stiffness measurements using quantitative deformability cytometry. We also demonstrate differences in the filtration of human cancer cell lines, including ovarian cancer cells that overexpress transcription factors (Snail, Slug), which are implicated in epithelial-to-mesenchymal transition; breast cancer cells (malignant versus benign); and prostate cancer cells (highly versus weekly metastatic). We additionally show how the filtration of ovarian cancer cells is affected by treatment with drugs known to perturb the cytoskeleton and the nucleus. Our results across multiple cancer cell types with both genetic and pharmacologic manipulations demonstrate the potential of this scalable filtration device to screen cells based on their deformability.
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Affiliation(s)
- Navjot Kaur Gill
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, USA.
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16
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Teigmo MSW, Gundersen TE, Emaus N, Grimnes G. Distribution and determinants of retinol in Norwegian adolescents, and its relation to bone mineral density: the Tromsø Study: Fit Futures. Eur J Clin Nutr 2018; 72:1373-1384. [DOI: 10.1038/s41430-018-0193-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/13/2018] [Accepted: 04/24/2018] [Indexed: 01/11/2023]
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17
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Egeland GM, Tell GS, Næss Ø, Igland J, Klungsøyr K. Association between pregravid physical activity and family history of stroke and risk of stillbirth: population-based cohort study. BMJ Open 2017; 7:e017034. [PMID: 28801430 PMCID: PMC5724104 DOI: 10.1136/bmjopen-2017-017034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To evaluate whether family history of disease and pregravid lifestyle and cardiovascular risk factors are associated with subsequent stillbirth delivery. DESIGN Prepregnancy cohort study. SETTING Cohort Norway regional health surveys (1994-2003) linked to Medical Birth Registry of Norway for deliveries through 2012. PARTICIPANTS 13 497 singleton births (> 22 weeks gestation) in 8478 women. MAIN OUTCOME MEASURE Risk of stillbirth evaluated by Poisson regression. RESULTS Mean (SD) length of follow-up was 5.5 (3.5) years. In analyses adjusting for baseline age and length of follow-up, ≥3 hours of baseline past-year vigorous physical activity per week (resulting in shortness of breath/sweating) was associated with increased risk of stillbirth compared with <1 hour/week of vigorous activity (incidence rate ratio, IRR 2.46; 95% CI 1.23 to 4.90). In contrast, baseline past-year light physical activity of ≥3 hours per week associated with reduced risk of stillbirth compared with <3 hours of light physical activity per week (IRR 0.53; 95% CI 0.30 to 0.93). A family history of stroke associated with increased risk of stillbirth delivery (IRR 2.53; 95% CI 1.06 to 6.01). Because overweight/obese women may experience shortness of breath and sweating with less physical exertion than normal weight women, a sensitivity analysis was conducted limited to women with a normal BMI (> 18.5 and <25 kg/m2). Vigorous activity of ≥3 hours per week (IRR of 4.50; 95% CI 1.72 to 11.79) and a family history of stroke (IRR of 3.81; 95% CI 1.31 to 11.07) were more strongly related to stillbirth risk among women with a normal BMI than that observed for all women combined. Established risk factors also associated with stillbirth risk. CONCLUSIONS The study identified physical activity and family history of stroke as potential new risk factors for stillbirth delivery.
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Affiliation(s)
- Grace M Egeland
- Department of Global Public Health and Primary Care, Norwegian Institute of Public Health, & Professor, University of Bergen, Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, Norwegian Institute of Public Health, & Professor, University of Bergen, Bergen, Norway
| | - Øyvind Næss
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, Norwegian Institute of Public Health, & Professor, University of Bergen, Bergen, Norway
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, Norwegian Institute of Public Health, & Professor, University of Bergen, Bergen, Norway
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18
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Tometich DB, Mosher CE, Winger JG, Badr HJ, Snyder DC, Sloane RJ, Demark-Wahnefried W. Effects of diet and exercise on weight-related outcomes for breast cancer survivors and their adult daughters: an analysis of the DAMES trial. Support Care Cancer 2017; 25:2559-2568. [PMID: 28417203 DOI: 10.1007/s00520-017-3665-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/06/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE Few trials have aimed to promote diet and exercise behaviors in both cancer survivors and their family members and examine their associations with weight-related outcomes. We conducted a secondary analysis to examine associations between change in diet and exercise behaviors and weight-related outcomes for overweight breast cancer survivors and their overweight adult daughters in the Daughters And MothErS Against Breast Cancer (DAMES) randomized trial. METHODS The DAMES trial assessed the impact of two iteratively tailored, mailed print diet and exercise interventions against standard brochures over a 12-month period. This analysis examined change in diet and exercise behaviors and weight-related variables from baseline to post-intervention for the 50 breast cancer survivors and their adult daughters randomized to the intervention arms. To reduce the potential for type II error in this pilot, p values <0.10 were considered statistically significant. RESULTS For mothers, change in diet quality was uniquely related to change in BMI (β = -0.12, p = 0.082), weight (β = -0.12, p = 0.060), and waist circumference (β = -0.38, p = 0.001), whereas change in caloric intake was related to waist circumference (β = 0.21, p = 0.002). For daughters, change in caloric intake was related to change in waist circumference (β = 0.12, p = 0.055). However, change in diet quality was not associated with weight-related outcomes in daughters. Additionally, change in exercise was not associated with weight-related outcomes in mothers or daughters. CONCLUSIONS Findings support mail-based and other tailored interventions for weight loss in this population, with an emphasis on diet quality for breast cancer survivors and caloric intake for their adult daughters.
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Affiliation(s)
- Danielle B Tometich
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 133, Indianapolis, IN, 46202, USA.
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 133, Indianapolis, IN, 46202, USA
| | - Joseph G Winger
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 133, Indianapolis, IN, 46202, USA
| | - Hoda J Badr
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Denise C Snyder
- Duke University School of Medicine, DUMC 2713, Durham, NC, 27710, USA
| | - Richard J Sloane
- Duke Center for the Study of Aging and Human Development, Duke University Medical Center, Duke Box 3003, Durham, NC, 27710, USA
- Duke University School of Nursing, Durham, NC, USA
| | - Wendy Demark-Wahnefried
- Duke University School of Nursing, Durham, NC, USA
- Department of Nutrition Sciences, University of Alabama at Birmingham, 1824 6th Ave. S., WTI 102M, Birmingham, AL, 35294, USA
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19
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Kopperstad Ø, Skogen JC, Sivertsen B, Tell GS, Sæther SMM. Physical activity is independently associated with reduced mortality: 15-years follow-up of the Hordaland Health Study (HUSK). PLoS One 2017; 12:e0172932. [PMID: 28328994 PMCID: PMC5362079 DOI: 10.1371/journal.pone.0172932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/13/2017] [Indexed: 12/25/2022] Open
Abstract
Background Physical activity (PA) is associated with lower risk for non-communicable diseases and mortality. We aimed to investigate the prospective association between PA and all-cause and cause-specific mortality, and the impact of other potentially contributing factors. Method Data from the community-based Hordaland Health Study (HUSK, 1997–99) were linked to the Norwegian Cause of Death Registry. The study included 20,506 individuals born 1950–1957 and 2,225 born in 1925–1927 (baseline age 40–49 and 70–74). Based on self-report, individuals were grouped as habitually performing low intensity, short duration, low intensity, longer duration or high intensity PA. The hazard ratios (HR) for all-cause and cause-specific mortality during follow-up were calculated. Measures of socioeconomic status, physical health, mental health, smoking and alcohol consumption were added separately and cumulatively to the model. Results PA was associated with lower all-cause mortality in both older (HR 0.75 (95% CI 0.67–0.84)) and younger individuals (HR 0.82 (95% CI 0.72–0.92)) (crude models, HR: risk associated with moving from low intensity, short duration to low intensity, longer duration PA, and from low intensity, longer duration to high intensity). Smoking, education, somatic diagnoses and mental health accounted for some of the association between physical activity and mortality, but a separate protective effect of PA remained in fully adjusted models for cardiovascular (HR 0.78 (95% CI 0.66–0.92)) and respiratory (HR 0.45 (95% CI 0.32–0.63) mortality (both age-groups together), as well as all-cause mortality in the older age group (HR 0.74, 95%CI 0.66–0.83). Conclusion Low intensity, longer duration and high intensity physical activity was associated with reduced all-cause, respiratory and cardiovascular mortality, indicating that physical activity is beneficial also among older individuals, and that a moderate increase in PA can be beneficial.
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Affiliation(s)
- Øyvind Kopperstad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - Grethe S. Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Solbjørg Makalani Myrtveit Sæther
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- * E-mail:
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Morseth B, Jacobsen BK, Emaus N, Wilsgaard T, Jørgensen L. Secular trends and correlates of physical activity: The Tromsø Study 1979-2008. BMC Public Health 2016; 16:1215. [PMID: 27912742 PMCID: PMC5135806 DOI: 10.1186/s12889-016-3886-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 11/26/2016] [Indexed: 11/10/2022] Open
Abstract
Background The aim was to describe secular trends in leisure time physical activity (LTPA) and work related physical activity (WPA) from 1979 to 2008. Additionally, we explored potential cross-sectional and longitudinal correlates of LTPA and WPA. Methods Data are collected from 34,898 individuals (49.7% men) aged >20 years who participated in at least one Tromsø Study survey between 1979 and 2008. In each survey, the participants completed a self-administered questionnaire and underwent physical examinations. LTPA and WPA were assessed by the validated “Saltin-Grimby” 4-scale questions. Potential correlates of LTPA and WPA (sex, age, body mass index (BMI), education, smoking, self-reported cardiovascular disease, self-perceived health, and employment status) were tested using ordinal logistic regression. Results The age-adjusted prevalence of participants being inactive in leisure time remained relatively stable around 20% from 1979 to 2008 (range 19.9–23.6%). The age-adjusted prevalence of moderate-vigorous LTPA decreased from 23.2% in 1979–80 to 16.0% in 2001, thereafter the prevalence increased to 24.3% in 2007–08 (P <0.05). The age-adjusted prevalence of being mostly sedentary at work increased gradually from 35.5% in 1979–80 to 53.4% in 2007–08 (P <0.05). Sex, age, education, and smoking were identified as cross-sectional correlates of LTPA and WPA (P <0.05). Men had higher odds of engaging in LTPA than women (adjusted OR 1.52 [95% CI 1.39–1.67] in 2007–08), whereas the association between sex and WPA shifted over time. High education level, not being a smoker, and high WPA were associated with high LTPA, whereas low education level, being a smoker, and high levels of LTPA were associated with high WPA (P <0.05). In general, odds of engaging in LTPA and WPA decreased with age (P <0.05). Individuals with healthy BMI had higher odds of being in a higher LTPA level than those who were underweight and obese (P <0.05). Longitudinal analyses identified sex, age, education, smoking, WPA, and LTPA measured in 1979–80 as determinants of LTPA in 2007–08. Conclusions In Norwegian adults, the proportion of sedentary WPA increased from 1979 to 2008, whereas the proportion of inactive LTPA remained stable. Being female, older, smoker, obese or underweight, and low education level were associated with low LTPA levels. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3886-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bente Morseth
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway. .,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway. .,Centre for Clinical Research and Education, University Hospital of North Norway Trust, Tromsø, Norway.
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lone Jørgensen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Clinical Therapeutic Services, University Hospital of North Norway, Tromsø, Norway
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Grimby G, Börjesson M, Jonsdottir IH, Schnohr P, Thelle DS, Saltin B. The "Saltin-Grimby Physical Activity Level Scale" and its application to health research. Scand J Med Sci Sports 2016; 25 Suppl 4:119-25. [PMID: 26589125 DOI: 10.1111/sms.12611] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 12/22/2022]
Abstract
The use of a four-level questionnaire to assess leisure time physical activity (PA) and its validation is reviewed in this paper. This questionnaire was first published in 1968 and has then been used by more than 600,000 subjects, especially in different population studies in the Nordic countries. A number of modifications to the questionnaire have been published. These are mostly minor changes, such as adding practical examples of activities to illustrate the levels of PA. Some authors have also added duration requirements that were not included for all levels of PA in the original version. The concurrent validity, with respect to aerobic capacity and movement analysis using objective measurements has been shown to be good, as has the predictive validity with respect to various risk factors for health conditions and for morbidity and mortality.
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Affiliation(s)
- G Grimby
- Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Börjesson
- The Swedish School of Sport and Health Sciences and Karolinska University Hospital, Stockholm, Sweden
| | | | - P Schnohr
- The Copenhagen City Heart Study, Copenhagen, Denmark
| | - D S Thelle
- Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - B Saltin
- Copenhagen Muscle Research Centre, University of Copenhagen, Copenhagen, Denmark
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22
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Egeland GM, Klungsøyr K, Øyen N, Tell GS, Næss Ø, Skjærven R. Preconception Cardiovascular Risk Factor Differences Between Gestational Hypertension and Preeclampsia: Cohort Norway Study. Hypertension 2016; 67:1173-80. [PMID: 27113053 PMCID: PMC4861703 DOI: 10.1161/hypertensionaha.116.07099] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/18/2016] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. Preconception predictors of gestational hypertension and preeclampsia may identify opportunities for early detection and improve our understanding of the pathogenesis and life course epidemiology of these conditions. Female participants in community-based Cohort Norway health surveys, 1994 to 2003, were prospectively followed through 2012 via record linkages to Medical Birth Registry of Norway. Analyses included 13 217 singleton pregnancies (average of 1.59 births to 8321 women) without preexisting hypertension. Outcomes were gestational hypertension without proteinuria (n=237) and preeclampsia (n=429). Mean age (SD) at baseline was 27.9 years (4.5), and median follow-up was 4.8 years (interquartile range 2.6–7.8). Gestational hypertension and preeclampsia shared several baseline risk factors: family history of diabetes mellitus, pregravid diabetes mellitus, a high total cholesterol/high-density lipoprotein cholesterol ratio (>5), overweight and obesity, and elevated blood pressure status. For preeclampsia, a family history of myocardial infarction before 60 years of age and elevated triglyceride levels (≥1.7 mmol/L) also predicted risk while physical activity was protective. Preterm preeclampsia was predicted by past-year binge drinking (≥5 drinks on one occasion) with an adjusted odds ratio of 3.7 (95% confidence interval 1.3–10.8) and by past-year physical activity of ≥3 hours per week with an adjusted odds ratio of 0.5 (95% confidence interval 0.3–0.8). The results suggest similarities and important differences between gestational hypertension, preeclampsia, and preterm preeclampsia. Modifiable risk factors could be targeted for improving pregnancy outcomes and the short- and long-term sequelae for mothers and offspring.
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Affiliation(s)
- Grace M Egeland
- From the Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway (G.M.E., K.K., N.Ø., G.S.T., R.S.); Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway (G.M.E., K.K., G.S.T., Ø.N., R.S.); and Institute of Health and Society, Blindern, University of Oslo, Oslo, Norway (Ø.N.).
| | - Kari Klungsøyr
- From the Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway (G.M.E., K.K., N.Ø., G.S.T., R.S.); Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway (G.M.E., K.K., G.S.T., Ø.N., R.S.); and Institute of Health and Society, Blindern, University of Oslo, Oslo, Norway (Ø.N.)
| | - Nina Øyen
- From the Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway (G.M.E., K.K., N.Ø., G.S.T., R.S.); Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway (G.M.E., K.K., G.S.T., Ø.N., R.S.); and Institute of Health and Society, Blindern, University of Oslo, Oslo, Norway (Ø.N.)
| | - Grethe S Tell
- From the Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway (G.M.E., K.K., N.Ø., G.S.T., R.S.); Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway (G.M.E., K.K., G.S.T., Ø.N., R.S.); and Institute of Health and Society, Blindern, University of Oslo, Oslo, Norway (Ø.N.)
| | - Øyvind Næss
- From the Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway (G.M.E., K.K., N.Ø., G.S.T., R.S.); Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway (G.M.E., K.K., G.S.T., Ø.N., R.S.); and Institute of Health and Society, Blindern, University of Oslo, Oslo, Norway (Ø.N.)
| | - Rolv Skjærven
- From the Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway (G.M.E., K.K., N.Ø., G.S.T., R.S.); Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway (G.M.E., K.K., G.S.T., Ø.N., R.S.); and Institute of Health and Society, Blindern, University of Oslo, Oslo, Norway (Ø.N.)
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23
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Morseth B, Graff-Iversen S, Jacobsen BK, Jørgensen L, Nyrnes A, Thelle DS, Vestergaard P, Løchen ML. Physical activity, resting heart rate, and atrial fibrillation: the Tromsø Study. Eur Heart J 2016; 37:2307-13. [PMID: 26966149 DOI: 10.1093/eurheartj/ehw059] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 01/28/2016] [Indexed: 11/14/2022] Open
Abstract
AIMS The objective was to examine the association of physical activity and resting heart rate (RHR) with hospital-diagnosed atrial fibrillation (AF) in a Norwegian cohort. METHODS AND RESULTS This prospective study included 20 484 adults (50.3% men) who participated in the third Tromsø Study survey in 1986-87. At baseline, physical activity was assessed by a validated questionnaire, and RHR was objectively measured. Participants were followed from baseline through 2010 with respect to incident cases of hospital-diagnosed AF documented on an electrocardiogram. During a mean follow-up period of 20 years (409 045 person-years), 750 participants (70.5% men) were diagnosed with AF. Compared with the low physical activity group, moderately active individuals had a 19% lower risk of any AF [adjusted hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.68-0.97], whereas highly active had similar risk of AF. Vigorously active individuals showed a non-significantly higher risk of AF (adjusted HR 1.37, 95% CI 0.77-2.43). Risk of AF increased with decreasing RHR (adjusted HR 0.92, 95% CI 0.86-0.98 for each 10 b.p.m. increase in RHR), and RHR < 50 b.p.m. was a risk factor for AF (P < 0.05). CONCLUSION In this prospective cohort study, leisure time physical activity was associated with AF in a J-shaped pattern. Moderate physical activity was associated with a reduced risk of AF, whereas higher activity levels attenuated the benefits of moderate activity. Low RHR was a risk factor for AF. Our results support the hypothesis that moderate and vigorous physical activity may affect AF risk via different pathophysiological mechanisms.
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Affiliation(s)
- Bente Morseth
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway Centre for Clinical Research and Education, University Hospital of North Norway Trust, Tromsø, Norway
| | - Sidsel Graff-Iversen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lone Jørgensen
- Department of Health and Care Sciences, University of Tromsø, Tromsø, Norway Department of Clinical Therapeutic Services, University Hospital of Northern Norway, Tromsø, Norway
| | - Audhild Nyrnes
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Dag S Thelle
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Department of Community Medicine and Public Health, Institute of Medicine, Gothenburg University, Gothenburg, Sweden
| | - Peter Vestergaard
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
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Winther A, Ahmed LA, Furberg AS, Grimnes G, Jorde R, Nilsen OA, Dennison E, Emaus N. Leisure time computer use and adolescent bone health--findings from the Tromsø Study, Fit Futures: a cross-sectional study. BMJ Open 2015; 5:e006665. [PMID: 26063563 PMCID: PMC4486947 DOI: 10.1136/bmjopen-2014-006665] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Low levels of physical activity may have considerable negative effects on bone health in adolescence, and increasing screen time in place of sporting activity during growth is worrying. This study explored the associations between self-reported screen time at weekends and bone mineral density (BMD). DESIGN In 2010/2011, 1038 (93%) of the region's first-year upper-secondary school students (15-18 years) attended the Tromsø Study, Fit Futures 1 (FF1). A follow-up survey (FF2) took place in 2012/2013. BMD at total hip, femoral neck and total body was measured as g/cm(²) by dual X-ray absorptiometry (GE Lunar prodigy). Lifestyle variables were self-reported, including questions on hours per day spent in front of television/computer during weekends and hours spent on leisure time physical activities. Complete data sets for 388/312 girls and 359/231 boys at FF1/FF2, respectively, were used in analyses. Sex stratified multiple regression analyses were performed. RESULTS Many adolescents balanced 2-4 h screen time with moderate or high physical activity levels. Screen time was positively related to body mass index (BMI) in boys (p=0.002), who spent more time in front of the computer than girls did (p<0.001). In boys, screen time was adversely associated with BMDFF1 at all sites, and these associations remained robust to adjustments for age, puberty, height, BMI, physical activity, vitamin D levels, smoking, alcohol, calcium and carbonated drink consumption (p<0.05). Screen time was also negatively associated with total hip BMD(FF2) (p=0.031). In contrast, girls who spent 4-6 h in front of the computer had higher BMD than the reference (<2 h). CONCLUSIONS In Norwegian boys, time spent on screen-based sedentary activity was negatively associated with BMD levels; this relationship persisted 2 years later. Such negative associations were not present among girls. Whether this surprising result is explained by biological differences remains unclear.
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Affiliation(s)
- Anne Winther
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway
| | - Luai Awad Ahmed
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Anne-Sofie Furberg
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Guri Grimnes
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Rolf Jorde
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Andreas Nilsen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, Southampton, UK
- Victoria University, Wellington, New Zealand
| | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Kostovski E, Hjeltnes N, Eriksen EF, Kolset SO, Iversen PO. Differences in bone mineral density, markers of bone turnover and extracellular matrix and daily life muscular activity among patients with recent motor-incomplete versus motor-complete spinal cord injury. Calcif Tissue Int 2015; 96:145-54. [PMID: 25539858 DOI: 10.1007/s00223-014-9947-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/17/2014] [Indexed: 01/10/2023]
Abstract
Spinal cord injury (SCI) leads to severe bone loss, but the associated mechanisms are poorly described in incomplete SCI individuals. The purpose of the study is to compare alterations in bone mineral density (BMD) and serum biomarkers of bone turnover in recent motor-incomplete to -complete SCI men, as well as to describe their physical activity and spasticity. We studied 31 men with acute SCI. Whole-body DXA scans, serum biomarkers and self-reported activity and spasticity were examined 1 and/or 3 and 12 months after the injury. We observed a decrease in proximal femur BMD (p < 0.02) in both the groups. Serum phosphate and carboxy-terminal-collagen crosslinks were significantly lower in motor-incomplete versus complete SCI men, whereas albumin-corrected Ca(2+) (p = 0.02) were lower only 3 months after injury. When data from all 31 SCI participants were pooled, we observed increased serum matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of MMP-2 (TIMP-2) (p < 0.02) whereas TIMP-1 decreased (p = 0.03). BMD correlated positively with self-reported activity (r = 0.59, p = 0.04) and negatively with spasticity (r = 0.74, p = 0.02) 12 months after injury. As a summary, men with motor-incomplete SCI developed significant proximal femur bone loss 12 months after injury and exhibited increased bone resorption throughout the first year after the injury. Compared with complete SCI men, incomplete SCI men show attenuated bone resorption. Our pooled data show increased turnover of extracellular matrix after injury and that increased exercise before and after injury correlated with reduced bone loss.
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Affiliation(s)
- E Kostovski
- Department of Science, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway,
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Jepsen R, Dogisso TW, Dysvik E, Andersen JR, Natvig GK. A cross-sectional study of self-reported general health, lifestyle factors, and disease: the Hordaland Health Study. PeerJ 2014; 2:e609. [PMID: 25289193 PMCID: PMC4185289 DOI: 10.7717/peerj.609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 09/15/2014] [Indexed: 02/02/2023] Open
Abstract
Background. Information on self-reported health is important for health professionals, and the aim of this study was to examine associations between lifestyle factors and self-reported health and the mediating effect of disease in a Norwegian population. Methods and Materials. The data collection was conducted as part of the Hordaland Health Study (HUSK) 1997–99, which was a cross-sectional epidemiological study. All individuals in Hordaland county born in 1953–1957 were invited to participate (aged 40–44 years). Complete information for the present study was obtained from 12,883 individuals (44% response rate). Height and weight were measured at a physical examination. Information on lifestyle factors, self-reported health, disease (heart attack, apoplexy, angina pectoris, and diabetes), and socio-demographic variables was obtained from a self-administered questionnaire. Self-reported health was measured with a one-item question. Odds ratios for fair or poor self-reported health were calculated using multiple logistic regression analyses adjusted for disease and socio-demographic variables. Results. Respondents reporting adverse lifestyle behaviours (obesity (odds ratio (OR) 1.7, p < 0.001), smoking (OR 1.2, p < 0.001), or excessive intake of alcohol (OR 3.3, p < 0.001)) showed an increased risk of poor self-reported health. Furthermore, a moderate intake of wine (OR 0.6, p < 0.001) or strenuous physical activity (OR 0.5, p < 0.001) decreased the risk of poor health. Disease did not mediate the effect. Conclusion. A one-item question measuring self-reported health may be a suitable measure for health professionals to identify levels of subjective health and reveal a need to target lifestyle factors in relatively young individuals with or without disease.
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Affiliation(s)
- Randi Jepsen
- Department of Global Public Health and Primary Care, University of Bergen , Bergen , Norway ; Faculty of Health Studies, Sogn og Fjordane University College , Førde , Norway
| | - Tadesse Washo Dogisso
- Department of Global Public Health and Primary Care, University of Bergen , Bergen , Norway
| | - Elin Dysvik
- Department of Health Studies, University of Stavanger , Stavanger , Norway
| | - John Roger Andersen
- Faculty of Health Studies, Sogn og Fjordane University College , Førde , Norway ; Førde Health Trust , Førde , Norway
| | - Gerd Karin Natvig
- Department of Global Public Health and Primary Care, University of Bergen , Bergen , Norway
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Winther A, Dennison E, Ahmed LA, Furberg AS, Grimnes G, Jorde R, Gjesdal CG, Emaus N. The Tromsø Study: Fit Futures: a study of Norwegian adolescents' lifestyle and bone health. Arch Osteoporos 2014; 9:185. [PMID: 24893722 DOI: 10.1007/s11657-014-0185-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 05/21/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED Bone mass achievement predicts later fracture risk. This population-based study describes bone mineral density (BMD) levels and associated factors in Norwegian adolescents. Compared with international reference ranges, BMD levels appear higher and physical activity levels are positively associated with BMD. PURPOSE Norway has one of the highest reported incidences of osteoporotic fractures. Maximisation of peak bone mass may prevent later fractures. This population-based study compared BMD levels of Norwegian adolescents with international reference ranges and explored associated factors. METHODS All first-year upper-secondary school students, aged 15-19 years in the Tromsø region were invited to the Fit Futures study in 2010-2011. Over 90 % of the invited participants attended, 508 girls and 530 boys. BMD was measured at total hip, femoral neck and total body by dual X-ray absorptiometry. Lifestyle variables were collected by self-administered questionnaires and interviews. All analyses were performed sex stratified, using linear regression models. RESULTS In girls, mean BMD (SD) was 1.060 g/cm(2) (0.124), 1.066 g/cm(2) (0.123) and 1.142 g/cm(2) (0.077) at the total hip, femoral neck and total body, respectively. In boys, corresponding values were 1.116 (0.147), 1.103 (0.150) and 1.182 (0.097), with significant higher values than the Lunar pediatric reference at 16 years of age. In girls, height and self-reported intensive physical activity of more than 4 h a week and early sexual maturation were positively associated with BMD at both femoral sites (p < 0.047). Among boys age, height, body mass index, physical activity and alcohol intake were positively (p < 0.038), whereas early stages of sexual maturation and smoking was negatively (p < 0.047) related to BMD. CONCLUSIONS Despite the heavy fracture burden, Norwegian adolescents' BMD levels are higher than age-matched Caucasians. Physical activity is associated with 1 SD increased BMD levels in those involved in competition or hard training.
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Affiliation(s)
- Anne Winther
- Department of Health and Care Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway,
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Pinto RZ, Ferreira PH, Kongsted A, Ferreira ML, Maher CG, Kent P. Self-reported moderate-to-vigorous leisure time physical activity predicts less pain and disability over 12 months in chronic and persistent low back pain. Eur J Pain 2014; 18:1190-8. [PMID: 24577780 DOI: 10.1002/j.1532-2149.2014.00468.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND Physical deconditioning in combination with societal and emotional factors has been hypothesized to compromise complete recovery from low back pain (LBP). However, there is a lack of longitudinal studies designed to specifically investigate physical activity as an independent prognostic factor. We conducted a prognostic study to investigate whether levels of leisure time physical activity are independently associated with clinical outcomes in people seeking care for chronic and persistent LBP. METHODS A total of 815 consecutive patients presenting with LBP to an outpatient spine centre in secondary care were recruited. Separate multivariate linear regression analyses were performed to investigate whether levels of leisure time physical activity (i.e., sedentary, light and moderate-to-vigorous leisure time physical activity levels) predict pain and disability at 12-month follow-up, after adjusting for age, pain, episode duration, disability, neurological symptoms, depression and fear of movement. RESULTS Final models showed evidence of an association between baseline physical activity and 12-month outcomes (p < 0.001). In both models, the moderate-to-vigorous physical activity group reported less pain and disability compared with the sedentary group. CONCLUSIONS Our findings suggest that physical activity levels may have a role in the prognosis of LBP. Specific domains of physical activity warrant further investigation to better understand this association.
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Affiliation(s)
- R Z Pinto
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia; Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia, UNESP - Univ Estadual Paulista, Presidente Prudente, São Paulo, Brazil
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Gudmundsdottir SL, Flanders WD, Augestad LB. Physical activity and cardiovascular risk factors at menopause: the Nord-Trøndelag health study. Climacteric 2013; 16:438-46. [PMID: 23347190 DOI: 10.3109/13697137.2013.768231] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Lowered physical activity levels may partially explain changes in metabolic risk factors in women after menopause. OBJECTIVES To evaluate the association between physical activity and metabolic risk factors at baseline and after 11 years, as well as the change in that association over time in women who were premenopausal and ≥ 40 years at baseline. METHODS Subjects in a Norwegian population-based health survey answered questionnaires and had body and serum measurements during 1995-1997 (HUNT 2) and in a follow-up study during 2006-2008 (HUNT 3). Repeated-measures analyses were used to estimate the association between physical activity and metabolic factors, adjusting for age, smoking status, education, alcohol intake, and parity. Adjustment for hormonal treatment and medication was made, as appropriate. RESULTS In women remaining premenopausal, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01) and waist-hip ratio (p < 0.01) and higher high density lipoprotein (HDL) cholesterol in HUNT 3 (p < 0.01). In women that were postmenopausal by the time of follow-up, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01), waist-hip ratio (p < 0.01), triglycerides (p < 0.01), and higher total cholesterol (p < 0.05), HDL cholesterol (p < 0.01), and diastolic blood pressure (p < 0.05) in HUNT 3. The association of total physical activity score with weight and waist-hip ratio was stronger in HUNT 3 than in HUNT 2 (p < 0.01). CONCLUSION Increased physical activity may reduce the risk of adverse outcomes and use of pharmacological management in women of menopausal age.
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Affiliation(s)
- S L Gudmundsdottir
- Department of Human Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Ward CP, York KM, McCoy JG. Risk of obstructive sleep apnea lower in double reed wind musicians. J Clin Sleep Med 2012; 8:251-5. [PMID: 22701381 DOI: 10.5664/jcsm.1906] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is caused by a collapse of the upper airway. Respiratory muscle training with a wind instrument (didgeridoo) in patients with moderate OSA has been previously shown to improve OSA symptomology. However, a survey of orchestra members did not indicate a difference in OSA risk between wind and non-wind instrumentalist. The present study examines whether playing of different wind instrument types may affect the risk of OSA. METHODS A national sample of active musicians (n = 906) was surveyed through the internet. Participants' risk for OSA was determined by the Berlin Questionnaire. Additional survey items included questions about general health and musical experience. RESULTS A binary logistic regression was conducted to determine if OSA risk was predicted by gender, age, number of years playing instrument, number of hours per week playing instrument, and instrument type. Musicians who played a double reed instrument had a lower risk of OSA (p = 0.047) than non-wind instrumentalists. Additionally, in double reed instrumentalists, the number of hours spent playing the instrument predicted lower OSA risk (p = 0.020). The risk for OSA in other wind instruments (i.e., single reed, high brass, and low brass) was not significantly different from non-wind musicians. CONCLUSIONS Playing a double reed musical instrument was associated with a lower risk of OSA.
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Gudmundsdottir SL, Flanders WD, Augestad LB. Physical activity and age at menopause: the Nord-Trøndelag population-based health study. Climacteric 2012; 16:78-87. [PMID: 22339441 DOI: 10.3109/13697137.2011.646344] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Age at menopause may affect women's subsequent morbidity and mortality. In contrast to numerous other health outcomes, little is known about the possible effects of physical activity on age at menopause. OBJECTIVES To assess the relationship between leisure-time physical activity and age at menopause. METHODS Premenopausal women participating in a population-based health survey (HUNT 2) conducted in the county of Nord-Trøndelag, Norway reported their physical activity in the period of 1995-1997. Age at menopause was reported during 2006-2008 (HUNT 3). Cox proportional hazards models were used to estimate hazard ratios for menopause and logistic regression to estimate odds ratios for early menopause, with 95% confidence intervals, adjusting for age at menarche, parity, use of oral contraceptives prior to the 6 months preceding participation in HUNT 2, symptoms of depression, smoking status, and education. RESULTS Women aged 40-49 years at baseline had lower hazard ratios for menopause when participating in any light leisure-time physical activity compared with no activity (p < 0.05) and similar results were observed in 19-39-year-olds. In 50-59-year-old women, the results varied greatly and did not reach statistical significance. CONCLUSIONS The effects of leisure-time physical activity on age at menopause may be age-dependent. We found indications of earlier menopause for the least active women aged 19-49 years at baseline.
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Affiliation(s)
- S L Gudmundsdottir
- Department of Human Movement Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway
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MORSETH BENTE, JØRGENSEN LONE, EMAUS NINA, JACOBSEN BJARNEK, WILSGAARD TOM. Tracking of Leisure Time Physical Activity during 28 yr in Adults. Med Sci Sports Exerc 2011; 43:1229-34. [DOI: 10.1249/mss.0b013e3182084562] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Williams LJ, Bjerkeset O, Langhammer A, Berk M, Pasco JA, Henry MJ, Schei B, Forsmo S. The association between depressive and anxiety symptoms and bone mineral density in the general population: the HUNT Study. J Affect Disord 2011; 131:164-71. [PMID: 21211851 DOI: 10.1016/j.jad.2010.11.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 10/13/2010] [Accepted: 11/18/2010] [Indexed: 01/27/2023]
Abstract
BACKGROUND Psychiatric disorders may be risk factors for reduced bone mineral density (BMD). Longitudinal evidence is limited and this is yet to be examined among community-dwelling adults with anxiety. We aimed to investigate the cross-sectional and longitudinal relationships between anxiety and depressive symptoms and BMD. METHOD This study examined data from the second Nord-Trondelag Health Study (1995-1997; 1194 men and 7842 women) and a follow-up conducted in 2001 (697 men and 2751 women). Symptomatology was ascertained using the Hospital Anxiety and Depression Scale and BMD was measured at the forearm using single-energy X-ray absorptiometry. Information on medication use and lifestyle was self-reported, and these, together with anthropometric measures were tested in multivariate analyses. RESULTS In men, adjusted BMD was 2.6% lower at the ultradistal forearm for those with depressive symptoms and 2.6% lower at the ultradistal and 2.0% lower at the distal forearm for those with anxiety symptoms. In women, adjusted BMD at the distal and ultradistal forearm was lower for heavier women with depressive symptoms but this relationship diminished with decreasing weight. Forearm BMD was similar for women with or without anxiety symptoms. Longitudinally, neither depressive nor anxiety symptoms were associated with bone loss over 4.6 years. LIMITATIONS Findings cannot be generalised to other skeletal sites and a longer follow-up period may be necessary to detect differences in bone loss. CONCLUSIONS These results indicate that depressive and anxiety symptoms are cross-sectionally associated with reduced BMD. These findings provide further evidence to support monitoring BMD in individuals diagnosed with psychiatric illness.
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Affiliation(s)
- Lana J Williams
- University of Melbourne, Department of Clinical and Biomedical Sciences: Barwon Health, Geelong, Australia.
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Vinknes KJ, de Vogel S, Elshorbagy AK, Nurk E, Drevon CA, Gjesdal CG, Tell GS, Vollset SE, Refsum H. Dietary intake of protein is positively associated with percent body fat in middle-aged and older adults. J Nutr 2011; 141:440-6. [PMID: 21248195 DOI: 10.3945/jn.110.133710] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Data on associations between dietary intake of macronutrients and body composition in the general population are sparse. This population-based, cross-sectional study of 4478 middle-aged (47-49 y) and elderly (71-74 y) men and women from the Hordaland Health Study in western Norway was conducted using a validated FFQ and measurements by dual-energy X-ray absorptiometry. The relation between macronutrient intake [percentage of total energy intake (E%)] and percent body fat was investigated in the total population and in a subgroup with intermediate BMI and stable weight (BMI within the 25th-75th percentile and weight change <5% during the last 6 y; n = 975). In the total population, protein intake (E%) was associated with higher percent body fat (partial r = 0.11; P < 0.001) in multivariate linear regression analysis. In the subgroup with intermediate BMI and stable weight, there was no association between protein intake (E%) and percent body fat. Fat intake (E%) was positively associated (partial r = 0.07) whereas carbohydrate intake (E%) was inversely associated (partial r = -0.07) with percent body fat (P = 0.042 for both) in the subgroup with intermediate BMI and stable weight. Both in the total population and in the stable weight group, physical activity was inversely related to adiposity (partial r = -0.15 and -0.12, respectively; P < 0.001). Our results may explain some of the conflicting data on the effects of macronutrients in different populations and suggest the potential importance of protein intake as a factor in obesity.
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Affiliation(s)
- Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Science, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway.
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The Shanghai Changfeng Study: a community-based prospective cohort study of chronic diseases among middle-aged and elderly: objectives and design. Eur J Epidemiol 2010; 25:885-93. [PMID: 21120588 DOI: 10.1007/s10654-010-9525-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 11/18/2010] [Indexed: 12/14/2022]
Abstract
The Shanghai Changfeng Study is a community-based prospective cohort study of chronic diseases ongoing since February 2009 in Shanghai, China. The study focuses on multiple chronic diseases, including obesity and metabolic syndrome, diabetes, osteoporosis, liver diseases, cardiovascular diseases and neurologic diseases. 15,000 subjects of 40 years or over are planned to be recruited. The rationale, objectives and design of this study are described in this paper.
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Jaddoe VWV, van Duijn CM, van der Heijden AJ, Mackenbach JP, Moll HA, Steegers EAP, Tiemeier H, Uitterlinden AG, Verhulst FC, Hofman A. The Generation R Study: design and cohort update 2010. Eur J Epidemiol 2010; 25:823-41. [PMID: 20967563 PMCID: PMC2991548 DOI: 10.1007/s10654-010-9516-7] [Citation(s) in RCA: 196] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Accepted: 09/27/2010] [Indexed: 01/09/2023]
Abstract
The Generation R Study is a population-based prospective cohort study from fetal life until young adulthood. The study is designed to identify early environmental and genetic causes of normal and abnormal growth, development and health during fetal life, childhood and adulthood. The study focuses on four primary areas of research: (1) growth and physical development; (2) behavioural and cognitive development; (3) diseases in childhood; and (4) health and healthcare for pregnant women and children. In total, 9,778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. General follow-up rates until the age of 4 years exceed 75%. Data collection in mothers, fathers and preschool children included questionnaires, detailed physical and ultrasound examinations, behavioural observations, and biological samples. A genome wide association screen is available in the participating children. Regular detailed hands on assessment are performed from the age of 5 years onwards. Eventually, results forthcoming from the Generation R Study have to contribute to the development of strategies for optimizing health and healthcare for pregnant women and children.
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Affiliation(s)
- Vincent W V Jaddoe
- The Generation R Study Group (AE006), Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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van Poppel MNM, Chinapaw MJM, Mokkink LB, van Mechelen W, Terwee CB. Physical activity questionnaires for adults: a systematic review of measurement properties. Sports Med 2010; 40:565-600. [PMID: 20545381 DOI: 10.2165/11531930-000000000-00000] [Citation(s) in RCA: 429] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Many questionnaires have been developed to measure physical activity (PA), but an overview of the measurement properties of PA questionnaires is lacking. A summary of this information is useful for choosing the best questionnaire available. Therefore, the objective of this study was to evaluate and compare measurement properties of self-administered questionnaires assessing PA in adults. We searched MEDLINE, EMBASE and SportDiscus, using 'exercise', 'physical activity', 'motor activity' and 'questionnaire' as keywords. We included studies that evaluated the measurement properties of self-report questionnaires assessing PA. Article selection, data extraction and quality assessment were performed by two independent reviewers. The quality and results of the studies were evaluated using the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist. Construct validity, reliability and responsiveness were rated as positive, negative or indeterminate, depending on the methods and results. We included 85 (versions of) questionnaires. Overall, the quality of the studies assessing measurement properties of PA questionnaires was rather poor. Information on content validity was mostly lacking. Construct validity was assessed in 76 of the questionnaires, mostly by correlations with accelerometer data, maximal oxygen uptake or activity diaries. Fifty-one questionnaires were tested for reliability. Only a few questionnaires had sufficient construct validity and reliability, but these need to be further validated. Responsiveness was studied for only two questionnaires and was poor. There is a clear lack of standardization of PA questionnaires, resulting in many variations of questionnaires. No questionnaire or type of questionnaire for assessing PA was superior and therefore could not be strongly recommended above others. In the future, more attention should be paid to the methodology of studies assessing measurement properties of PA questionnaires and the quality of reporting.
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Affiliation(s)
- Mireille N M van Poppel
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
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Early influences on cardiovascular and renal development. Eur J Epidemiol 2010; 25:677-92. [PMID: 20872047 PMCID: PMC2963737 DOI: 10.1007/s10654-010-9510-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Accepted: 09/09/2010] [Indexed: 12/27/2022]
Abstract
The hypothesis that a developmental component plays a role in subsequent disease initially arose from epidemiological studies relating birth size to both risk factors for cardiovascular disease and actual cardiovascular disease prevalence in later life. The findings that small size at birth is associated with an increased risk of cardiovascular disease have led to concerns about the effect size and the causality of the associations. However, recent studies have overcome most methodological flaws and suggested small effect sizes for these associations for the individual, but an potential important effect size on a population level. Various mechanisms underlying these associations have been hypothesized, including fetal undernutrition, genetic susceptibility and postnatal accelerated growth. The specific adverse exposures in fetal and early postnatal life leading to cardiovascular disease in adult life are not yet fully understood. Current studies suggest that both environmental and genetic factors in various periods of life may underlie the complex associations of fetal growth retardation and low birth weight with cardiovascular disease in later life. To estimate the population effect size and to identify the underlying mechanisms, well-designed epidemiological studies are needed. This review is focused on specific adverse fetal exposures, cardiovascular adaptations and perspectives for new studies.
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Leisure time physical activity in adulthood is positively associated with bone mineral density 22 years later. The Tromsø study. Eur J Epidemiol 2010; 25:325-31. [DOI: 10.1007/s10654-010-9450-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Accepted: 03/17/2010] [Indexed: 11/27/2022]
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Saebu M, Sørensen M. Factors associated with physical activity among young adults with a disability. Scand J Med Sci Sports 2010; 21:730-8. [DOI: 10.1111/j.1600-0838.2010.01097.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Perceived constraints on physical exercise among obese and non-obese older people. Prev Med 2009; 49:506-10. [PMID: 19833148 DOI: 10.1016/j.ypmed.2009.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 09/28/2009] [Accepted: 10/06/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine what older obese people consider as constraints on their physical exercise and to determine whether these constraints can explain the differences in physical activity. METHODS Six hundred nineteen community-living people aged 75-81 years living in Jyväskylä, Central Finland, in 2003 were included in these cross-sectional analyses. Weight and height were measured at the research center, and physical activity and perceived constraints on physical exercise were assessed using validated questionnaires. Participants were categorized as non-obese (n=436), moderately obese (n=127) or severely obese (n=56). RESULTS The risk of physical inactivity was two times higher in the moderately obese group (OR 1.99, 95% CI 1.27-3.12) and over four times higher in the severely obese group (OR 4.58, 95% CI 2.55-8.24) compared to the non-obese group. Higher prevalence of comorbidities, pain, tiredness, fear of falling and injury, discomfort and feelings of insecurity when exercising explained almost half of the increased risk of physical inactivity of older severely obese people. CONCLUSIONS Results suggest that physical activity promotion among older obese people may be well received as long as it focuses on factors that enable participation in physical activity and takes into account their constraints on physical activity.
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Current Opinion in Endocrinology, Diabetes & Obesity. Current world literature. Curr Opin Endocrinol Diabetes Obes 2009; 16:189-202. [PMID: 19300094 DOI: 10.1097/med.0b013e328329fcc2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Physical activity—the more we measure, the more we know how to measure. Eur J Epidemiol 2009; 24:119-22. [DOI: 10.1007/s10654-009-9316-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 01/19/2009] [Indexed: 10/21/2022]
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Hofman A, Breteler MMB, van Duijn CM, Janssen HLA, Krestin GP, Kuipers EJ, Stricker BHC, Tiemeier H, Uitterlinden AG, Vingerling JR, Witteman JCM. The Rotterdam Study: 2010 objectives and design update. Eur J Epidemiol 2009; 24:553-72. [PMID: 19728115 PMCID: PMC2744826 DOI: 10.1007/s10654-009-9386-z] [Citation(s) in RCA: 201] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Accepted: 08/19/2009] [Indexed: 12/19/2022]
Abstract
The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in close to a 1,000 research articles and reports (see www.epib.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.
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Affiliation(s)
- Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam. The Netherlands.
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