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Buli BG, Lehtinen-Jacks S, Larm P, Nilsson KW, Hellström-Olsson C, Giannotta F. Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors. BMC Public Health 2024; 24:878. [PMID: 38515098 PMCID: PMC10958834 DOI: 10.1186/s12889-024-18327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors. METHODS The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS. RESULTS There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01). CONCLUSIONS The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.
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Affiliation(s)
- Benti Geleta Buli
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden.
| | - Susanna Lehtinen-Jacks
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
| | - Peter Larm
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Kent W Nilsson
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
- Center for Clinical Research, Uppsala University, Västmanland County Hospital, Uppsala, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Fabrizia Giannotta
- Department of Public Health Sciences, Mälardalen University, 721 23, Västerås, Box 883, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Turin, Turin, Italy
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2
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Mäki P, Levälahti E, Lehtinen-Jacks S, Laatikainen T. Overweight and Obesity in Finnish Children by Parents' Socioeconomic Position-A Registry-Based Study. Int J Public Health 2023; 68:1605901. [PMID: 37719660 PMCID: PMC10502218 DOI: 10.3389/ijph.2023.1605901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/07/2023] [Indexed: 09/19/2023] Open
Abstract
Objectives: To examine associations between parents' socioeconomic position (SEP) and child overweight and obesity, using registry data. Methods: Data (final n = 194,423) on children's height, weight and parents' SEP were drawn from the national Register of Primary Health Care Visits (Avohilmo) and Statistics Finland. Risk ratios for bernoulli-distributed overweight (RROW) and obesity (RROB) according to SEP were estimated using generalized linear models and using a log -link. Results: The risk for obesity was lower in boys from high-income families (RROB 0.76), for overweight and obesity was lower in boys (RROW 0.72, RROB 0.58) and girls (RROW 0.72, RROB 0.54) with highly educated fathers, in boys (RROW 0.79, RROB 0.58) and girls (RROW 0.78, RROB 0.56) with high-educated mothers and in boys (RROW 0.85, RROB 0.77) and girls (RROW 0.80, RROB 0.69) living in urban areas, as compared to low-income families, low-educated parents, and rural residence, respectively. Conclusion: The risk of overweight and obesity was increased in children with low SEP or rural residence. Administrative registers are a valid approach to monitor childhood obesity by parents' SEP.
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Affiliation(s)
- Päivi Mäki
- Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Esko Levälahti
- Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Susanna Lehtinen-Jacks
- The Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Tiina Laatikainen
- Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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3
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Mohamad MS, Mahadir Naidu B, Virtanen SM, Lehtinen-Jacks S, Abdul Maulud KN. Relationships of Local Food and Physical Activity Environments With Overweight in 5- to 17-Year-Old Malaysian Children. Asia Pac J Public Health 2023; 35:34-41. [PMID: 36321506 DOI: 10.1177/10105395221135407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Evidence on the associations between built environment and overweight in children outside developed countries is scarce. We examined associations between access to local food and physical activity environments and overweight in 5- to 17-year-old Malaysians in two states with differing overweight levels. Information on children was measured in the National Health and Morbidity Survey 2015 and combined with Geographic Information System-derived data on local food and physical activity environments. Access to the built environment was measured by presence and distance from child's residence. Complete data were available for 880 children. Access to local food outlets and parks was higher and associated with higher occurrence of overweight in children living in the state with higher overweight prevalence. When adjusted for sociodemographic factors, higher presence of and shorter distance to convenience stores and parks were associated with overweight. Both built environment and children's sociodemographic backgrounds should be considered when planning interventions to curb the overweight epidemic in Malaysia.
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Affiliation(s)
- Maria Safura Mohamad
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Balkish Mahadir Naidu
- Research and Methodology Unit, Department of Statistics Malaysia, Putrajaya, Malaysia
| | - Suvi M Virtanen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Centre for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland.,The Science Centre of Pirkanmaa Hospital District, Tampere, Finland
| | - Susanna Lehtinen-Jacks
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Khairul Nizam Abdul Maulud
- Earth Observation Centre, Institute of Climate Change, National University of Malaysia, Bangi, Malaysia.,Department of Civil Engineering, Faculty of Engineering and Built Environment, National University of Malaysia, Bangi, Malaysia
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4
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Santa-Paavola R, Lehtinen-Jacks S, Jääskeläinen T, Männistö S, Lundqvist A. The association of high-sensitivity C-reactive protein with future weight gain in adults. Int J Obes (Lond) 2022; 46:1234-1240. [PMID: 35260816 PMCID: PMC9151385 DOI: 10.1038/s41366-022-01101-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
Background Obesity is associated with low-grade systemic inflammation, and it has been suggested that increased inflammation markers could predict future weight gain. Our aim was to investigate the associations of high-sensitivity C-reactive protein (hs-CRP) concentration with changes in weight and waist circumference in adults during 11 years of follow-up. Methods We used data from the Health 2000 and Health 2011 surveys consisting of a population-based sample of Finnish adults. We included those 3143 participants, aged 30–75 years at baseline, whose baseline hs-CRP was measured, and who had information on measured weight and height at both time points. Associations between baseline hs-CRP and changes in weight and waist circumference were analyzed using multinomial logistic regression, adjusted for sociodemographic factors (age, sex, marital status, and educational status), lifestyle factors (smoking, alcohol consumption, leisure-time physical activity, sitting time, sleeping time, and psychological distress), and baseline values of BMI and waist circumference. Results Hs-CRP was not associated with weight gain (≥5%) when adjusted for potential confounders (OR 0.99, 95% CI 0.96–1.01), compared to stable weight (change <±5%). Higher baseline hs-CRP was associated with decrease in weight (≤−5%) in the unadjusted (OR 1.03, 1.01–1.05), but not in the adjusted (OR 1.01, 0.99–1.03) model. No association was observed between hs-CRP and waist circumference. Conclusions Hs-CRP was not associated with future changes in weight or waist circumference in adults. These findings suggest that hs-CRP concentration does not predict future weight gain.
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Affiliation(s)
- Riina Santa-Paavola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | - Susanna Lehtinen-Jacks
- School of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | | | - Satu Männistö
- Finnish Institute for Health and Welfare, Helsinki, Finland
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5
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Cushnie A, Reintjes R, Lehtinen-Jacks S, Figueroa JP. HIV program outcomes for Jamaica before and after "Treat All": A population-based study using the national treatment services database. PLoS One 2021; 16:e0255781. [PMID: 34383797 PMCID: PMC8360520 DOI: 10.1371/journal.pone.0255781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 07/25/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The study aims to assess changes in HIV treatment outcomes for Jamaica after the implementation of the WHO Treat All strategy in January 2017, as well as identify variables associated with clinical stage at diagnosis and viral load status, in order to understand implications for enhancing the HIV clinical cascade and boosting progress towards the UNAIDS 90-90-90 targets. METHOD This is a population-based study using the National Treatment Service Information System. The sample consists of persons 15 years and older, placed on treatment before and after Treat All was implemented, across all 4 regional health authorities in Jamaica. Patients were assessed for two binary outcomes: 1. stage at HIV diagnosis (early/baseline CD4 cell count ≧350 cells/mm3, or late/ baseline CD4 <350 cells/mm3), 2. viral load status achieved after ART initiation (suppressed/<1000 copies/ml or non-suppressed/ ≥1000 copies/ml). Categorical variables: age/years, gender and health regions, were investigated using multivariable logistic regression. Adjusted odds ratios and 95% confidence intervals are reported. RESULTS After Treat All, there was an increase in median baseline CD4 results as the proportion of late diagnoses decreased from 60% to 39%. There was a small increase in viral suppression from 76% to 80%, a decrease in baseline viral load testing from 61% to 46% and an increase in the uptake of first viral load testing after starting treatment from 13% to 19%. Males and persons 40+ years had higher odds of late diagnosis before and after Treat All. CONCLUSION Jamaica's HIV program outcomes have improved after Treat All was implemented. ART initiation time significantly decreased. Early diagnosis, viral load testing uptake and viral suppression increased. However, there is a need to implement targeted testing for men and persons over 40 years to decrease the frequency of late diagnosis.
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Affiliation(s)
- Anya Cushnie
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Ralf Reintjes
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Department of Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Susanna Lehtinen-Jacks
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - J. Peter Figueroa
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Jamaica
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6
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Laitinen U, Lehtinen-Jacks S, Lundqvist A. Early risk factors of obesity in 5-year-old boys and girls in Finland. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Several potential early-life risk factors for childhood overweight and obesity have been identified. Yet results regarding early risk factors and obesity (BMI-for-age ≥30 kg/m2) at pre-school age are mixed and boys and girls have rarely been studied separately. Our aim was to study whether pre- and perinatal factors predict obesity in 5-year-old boys and girls.
Methods
National register data was used to identify children born in Finland between 2007 and 2014 with data available on pre- and perinatal factors as well as on height and weight at 5 years of age (n = 131,818). Multivariable logistic regression models were used to analyze sex-specific associations between pre- and perinatal factors (e.g. maternal age, parity, pre-pregnancy BMI, smoking, diabetes, delivery method, gestational-age-adjusted birth weight) and offspring obesity.
Results
Five percent of boys (n = 3,551) and 3% of girls (n = 1,949) had obesity. Adjusted for potential confounders, the strongest predictor of subsequent obesity at 5 years of age was severe maternal obesity (BMI ≥35 kg/m2) (boys: OR 6.5, 95% CI 5.8-7.4; girls: OR 7.5, 95% CI 6.4-8.8) followed by maternal obesity (BMI 30.0-34.9 kg/m²) (boys: OR 3.9, 95% CI 3.5-4.4; girls: OR 5.5, 95% CI 4.8-6.2) and maternal overweight (BMI 25.0-29.9 kg/m²) (boys: OR 2.3, 95% CI 2.1-2.5; girls: OR 2.6, 95% CI 2.3-3.0). Other factors associated with child obesity were maternal smoking during pregnancy (boys: OR 1.8, 95% CI 1.6-1.9; girls: OR 2.0, 95% CI 1.8-2.2) and being born large for gestational age (boys: OR 1.9, 95% CI 1.6-2.2; girls: OR 2.1, 95% CI 1.8-2.6).
Conclusions
These findings indicate that childhood obesity may partly originate before conception, gestation and birth. As prevention of obesity may be economically and socially more sustainable than treatment of its consequences, emphasis should be put on early interventions. Particular attention should be paid on preventing maternal overweight and obesity.
Key messages
Maternal obesity was the strongest predictor of child obesity at 5 years of age. Investing in maternal health from as early as before conception may help prevent offspring obesity.
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Affiliation(s)
- U Laitinen
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - S Lehtinen-Jacks
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - A Lundqvist
- Public Health Promotion, Finnish Institute for Health and Welfare, Helsinki, Finland
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7
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Frühbeck G, Baker JL, Busetto L, Dicker D, Goossens GH, Halford JCG, Handjieva-Darlenska T, Hassapidou M, Holm JC, Lehtinen-Jacks S, Mullerova D, O'Malley G, Sagen JV, Rutter H, Salas XR, Woodward E, Yumuk V, Farpour-Lambert NJ. European Association for the Study of Obesity Position Statement on the Global COVID-19 Pandemic. Obes Facts 2020; 13:292-296. [PMID: 32340020 PMCID: PMC7250342 DOI: 10.1159/000508082] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Gema Frühbeck
- European Association for the Study of Obesity, Teddington, United Kingdom,
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, IdiSNA, CIBEROBN, Spanish Health Institute Carlos III, Pamplona, Spain,
| | - Jennifer Lyn Baker
- European Association for the Study of Obesity, Teddington, United Kingdom
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Luca Busetto
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Medicine, University of Padova, Padova, Italy
| | - Dror Dicker
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Gijs H Goossens
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jason C G Halford
- European Association for the Study of Obesity, Teddington, United Kingdom
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Teodora Handjieva-Darlenska
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Pharmacology and Toxicology, Medical Faculty, Medical University, Sofia, Bulgaria
| | - Maria Hassapidou
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Jens-Christian Holm
- European Association for the Study of Obesity, Teddington, United Kingdom
- The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Holbæk, Denmark
| | - Susanna Lehtinen-Jacks
- European Association for the Study of Obesity, Teddington, United Kingdom
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Dana Mullerova
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Public Health and Preventive Medicine, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Grace O'Malley
- European Association for the Study of Obesity, Teddington, United Kingdom
- School of Physiotherapy, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jørn V Sagen
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Harry Rutter
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Ximena Ramos Salas
- European Association for the Study of Obesity, Teddington, United Kingdom
- European Association for the Study of Obesity Secretariat, Teddington, United Kingdom
| | - Euan Woodward
- European Association for the Study of Obesity, Teddington, United Kingdom
- European Association for the Study of Obesity Secretariat, Teddington, United Kingdom
| | - Volkan Yumuk
- European Association for the Study of Obesity, Teddington, United Kingdom
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, Istanbul University Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Nathalie J Farpour-Lambert
- European Association for the Study of Obesity, Teddington, United Kingdom
- Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology, Nutrition, and Therapeutic Patient Education, Department of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Leu Agelii M, Lehtinen-Jacks S, Zetterberg H, Sundh V, Björkelund C, Lissner L. Low vitamin D status in relation to cardiovascular disease and mortality in Swedish women - Effect of extended follow-up. Nutr Metab Cardiovasc Dis 2017; 27:1143-1151. [PMID: 29170060 DOI: 10.1016/j.numecd.2017.10.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 08/17/2017] [Accepted: 10/11/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS The impact of vitamin D concentrations on subsequent cardiovascular disease (CVD) and overall mortality has been generally examined for periods under two decades. The magnitude of the association may depend on follow-up length. We aimed to investigate the relationship between baseline vitamin D and risk of total CVD, stroke and all-cause mortality over three decades of follow-up. Secondly, we aimed to assess how follow-up affects the associations. METHODS AND RESULTS Concentrations of 25-hydroxyvitamin D (25D) were measured in a population-based sample of 1227 middle-aged women using serum collected at baseline and categorized into low (lowest 25D quartile) vs high 25D status (upper three 25D quartiles). Hazard ratio (HR) of the endpoints was estimated for low 25D. The impact of follow-up was examined in intermediary analyses where follow-up was interrupted up to four times, each time decreasing it by five years. There were 596 cardiovascular events and 635 participants died. During the first 17 years, the low 25D group experienced a 29% higher CVD risk and 3.3-fold higher stroke risk after accounting for confounders. Longer follow-up diminished significantly these risks and 25D status had no contribution at 32 years. For mortality, the decline over time was less dramatic, with HR = 1.96 (1.25; 3.08) at 17 years and HR = 1.42 (1.17; 1.72) at 37 years. CONCLUSION Low 25D status increased the risk for all endpoints, but a lengthy follow-up diminished these risks towards the null. The impact of follow-up depends on the outcome. Future studies of 25D and disease should use repeated 25D assessments.
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Affiliation(s)
- M Leu Agelii
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - S Lehtinen-Jacks
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - H Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - V Sundh
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Björkelund
- Section for Primary Health Care, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L Lissner
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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9
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Hakola L, Takkinen HM, Niinistö S, Ahonen S, Erlund I, Rautanen J, Veijola R, Ilonen J, Toppari J, Knip M, Virtanen SM, Lehtinen-Jacks S. Maternal fatty acid intake during pregnancy and the development of childhood overweight: a birth cohort study. Pediatr Obes 2017; 12 Suppl 1:26-37. [PMID: 27378525 DOI: 10.1111/ijpo.12170] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 05/24/2016] [Accepted: 06/07/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND Maternal diet during pregnancy may contribute to the risk of offspring adiposity. OBJECTIVES The objective of the study is to explore the associations between maternal antenatal dietary fatty acid intake and the risk of offspring overweight and obesity at the ages of 2 to 7 years. METHODS In a prospective Finnish birth cohort with 3807 mother-child pairs, maternal diet in late pregnancy was assessed with a food frequency questionnaire. Intakes of total fatty acids and individual saturated, monounsaturated and polyunsaturated fatty acids (PUFAs) were calculated. Generalized estimating equation models were used to study the associations of maternal dietary variables with repeatedly measured offspring overweight and obesity. RESULTS In girls, maternal intake ratio of n-6:n-3 PUFAs had a U-shaped association with obesity (adjusted OR for the lowest 2.0 [95% CI 1.27-3.20] and the highest 1.7 [1.03-2.73] vs. the two middle quartiles of n-6:n-3 PUFAs, p = 0.01). In boys, arachidonic acid (20:4n-6): docosahexaenoic acid + eicosapentaenoic acid ratio was associated with obesity (adjusted OR for the lowest 1.0 [0.60-1.57] and the highest 0.5 [0.26-0.88] vs. the two middle quartiles, p = 0.02). Saturated fatty acids and monounsaturated fatty acids were not associated with overweight or obesity in either sex. CONCLUSIONS Maternal intakes of PUFAs in late pregnancy were associated with risk of later obesity differently in girls and boys.
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Affiliation(s)
- L Hakola
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - H-M Takkinen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S Niinistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S Ahonen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - I Erlund
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - J Rautanen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - R Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J Ilonen
- Immunogenetics Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - J Toppari
- Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - M Knip
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Programs Unit, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - S M Virtanen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,The Science Center of Pirkanmaa Hospital District, Tampere, Finland.,Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - S Lehtinen-Jacks
- School of Health Sciences, University of Tampere, Tampere, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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10
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Talibov M, Salmelin R, Lehtinen-Jacks S, Auvinen A. Estimation of occupational cosmic radiation exposure among airline personnel: Agreement between a job-exposure matrix, aggregate, and individual dose estimates. Am J Ind Med 2017; 60:386-393. [PMID: 28262960 DOI: 10.1002/ajim.22705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Job-exposure matrices (JEM) are used for exposure assessment in occupational studies, but they can involve errors. We assessed agreement between the Nordic Occupational Cancer Studies JEM (NOCCA-JEM) and aggregate and individual dose estimates for cosmic radiation exposure among Finnish airline personnel. METHODS Cumulative cosmic radiation exposure for 5,022 airline crew members was compared between a JEM and aggregate and individual dose estimates. RESULTS The NOCCA-JEM underestimated individual doses. Intraclass correlation coefficient was 0.37, proportion of agreement 64%, kappa 0.46 compared with individual doses. Higher agreement was achieved with aggregate dose estimates, that is annual medians of individual doses and estimates adjusted for heliocentric potentials. CONCLUSIONS The substantial disagreement between NOCCA-JEM and individual dose estimates of cosmic radiation may lead to exposure misclassification and biased risk estimates in epidemiological studies. Using aggregate data may provide improved estimates. Am. J. Ind. Med. 60:386-393, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Madar Talibov
- School of Health Sciences; University of Tampere; Tampere Finland
| | - Raili Salmelin
- School of Health Sciences; University of Tampere; Tampere Finland
| | | | - Anssi Auvinen
- School of Health Sciences; University of Tampere; Tampere Finland
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11
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Rutter H, Bes-Rastrollo M, de Henauw S, Lahti-Koski M, Lehtinen-Jacks S, Mullerova D, Rasmussen F, Rissanen A, Visscher TL, Lissner L. Balancing Upstream and Downstream Measures to Tackle the Obesity Epidemic: A Position Statement from the European Association for the Study of Obesity. Obes Facts 2017; 10:61-63. [PMID: 28245444 PMCID: PMC5644948 DOI: 10.1159/000455960] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 11/03/2016] [Indexed: 12/12/2022] Open
Affiliation(s)
- Harry Rutter
- ECOHOST – The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
- *Dr. Harry Rutter, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK,
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, and CIBERobn, Instituto de Salud Carlos III, and Navarra's Health Research Institute (IDISNA), Pamplona, Spain
| | - Stefaan de Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Susanna Lehtinen-Jacks
- Faculty of Social Sciences (SOC) / Health Sciences, University of Tampere, Tampere, Finland
| | - Dana Mullerova
- Department of Public Health and Preventive Medicine, Faculty of Medicine in Pilsen, Charles University, Plzeň, Czech Republic
| | - Finn Rasmussen
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Aila Rissanen
- Obesity Research Unit, Diabetes and Obesity Research Program Unit, University of Helsinki, Helsinki, Finland
| | - Tommy L.S. Visscher
- Research Group Healthy Cities, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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12
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Hunsberger M, Lehtinen-Jacks S, Mehlig K, Gwozdz W, Russo P, Michels N, Bammann K, Pigeot I, Fernández-Alvira JM, Thumann BF, Molnar D, Veidebaum T, Hadjigeorgiou C, Lissner L. Bidirectional associations between psychosocial well-being and body mass index in European children: longitudinal findings from the IDEFICS study. BMC Public Health 2016; 16:949. [PMID: 27608963 PMCID: PMC5017061 DOI: 10.1186/s12889-016-3626-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/01/2016] [Indexed: 11/10/2022] Open
Abstract
Background The negative impact of childhood overweight on psychosocial well-being has been demonstrated in a number of studies. There is also evidence that psychosocial well-being may influence future overweight. We examined the bidirectional association between childhood overweight and psychosocial well-being in children from a large European cohort. The dual aim was to investigate the chronology of associations between overweight and psychosocial health indicators and the extent to which these associations may be explained by parental education. Methods Participants from the IDEFICS study were recruited from eight countries between September 2007 and June 2008 when the children were aged 2 to 9.9 years old. Children and families provided data on lifestyle, psychosocial well-being, and measured anthropometry at baseline and at follow-up 2 years later. This study includes children with weight, height, and psychosocial well-being measurements at both time points (n = 7,831). Psychosocial well-being was measured by the KINDL® and Strengths and Difficulties Questionnaire respectively. The first instrument measures health-related quality of life including emotional well-being, self-esteem, parent relations and social relations while the second measures well-being based on emotional symptoms, conduct problems and peer-related problems. Logistic regression was used for modeling longitudinal associations. Results Children who were overweight at baseline had increased risk of poor health-related quality of life (odds ratio (OR) = 1.23; 95 % confidence interval (CI):1.03–1.48) measured 2 years later; this association was unidirectional. In contrast to health-related quality of life, poor well-being at baseline was associated with increased risk of overweight (OR = 1.39; 95 % CI:1.03–1.86) at 2 year follow-up; this association was also only observed in one direction. Adjustment for parental education did not change our findings. Conclusion Our findings indicate that the association between overweight and psychosocial well-being may be bidirectional but varies by assessment measures. Future research should further investigate which aspects of psychosocial well-being are most likely to precede overweight and which are more likely to be consequences of overweight.
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Affiliation(s)
- Monica Hunsberger
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 40530, Gothenburg, Sweden.
| | | | - Kirsten Mehlig
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 40530, Gothenburg, Sweden
| | - Wencke Gwozdz
- Department of Intercultural Communication and Management, Copenhagen Business School, POR/18.B-1.118, Copenhagen, Denmark
| | - Paola Russo
- Institute of Food Sciences, CNR Via Roma 64-83100, Avellino, Italy
| | | | - Karin Bammann
- Institute for Public Health and Nursing Research, Faculty of Human and Health Sciences (FB 11), University of Bremen, Grazer Str. 2a, 28359, Bremen, Germany
| | - Iris Pigeot
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.,Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstr. 30, 28359, Bremen, Germany
| | - Juan Miguel Fernández-Alvira
- Centro Nacional de Investigaciones Cardiovasculares Carlos III Madrid, Spain and GENUD (Growth, Exercise, Nutrition and Development) Research group, University of Zaragoza, Madrid, Spain
| | - Barbara Franziska Thumann
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstr. 30, 28359, Bremen, Germany
| | - Dénes Molnar
- Department of Pediatrics, Medical Faculty, University of Pécs, H-7623, Pécs, József A. u. 7, Hungary
| | - Toomas Veidebaum
- National Institute for Health and Development, Hiiu 42, 11619, Tallinn, Estonia
| | | | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 40530, Gothenburg, Sweden
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13
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Lumia M, Takkinen HM, Luukkainen P, Kaila M, Lehtinen-Jacks S, Nwaru BI, Tuokkola J, Niemelä O, Haapala AM, Ilonen J, Simell O, Knip M, Veijola R, Virtanen SM. Food consumption and risk of childhood asthma. Pediatr Allergy Immunol 2015; 26:789-96. [PMID: 25693000 DOI: 10.1111/pai.12352] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND The consumption of foods rich in n-3 polyunsaturated fatty acids has been proposed to protect against childhood asthma. This study explores the association of food consumption (including cow's milk (CM)-free diet) in early life and the risk of atopic and non-atopic asthma. METHODS Food intake of 182 children with asthma and 728 matched controls was measured using 3-day food records, within the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study cohort. The diagnoses of food allergies came both from the written questionnaire and from the registers of the Social Insurance Institution. Conditional logistic regression with generalized estimating equations framework was used in the analyses. RESULTS The diagnosis of cow's milk allergy (CMA) led to multiple dietary restrictions still evident at 4 yr of age. Even after adjusting for CMA, higher consumption of CM products was inversely associated with the risk of atopic asthma and higher consumption of breast milk and oats inversely with the risk of non-atopic asthma. Early consumption of fish was associated with a decreased risk of all asthma. CONCLUSIONS Dietary intake in early life combined with atopy history has a clear impact on the risk of developing asthma. Our results indicate that CM restriction due to CMA significantly increases and mediates the association between food consumption and childhood asthma risk.
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Affiliation(s)
- Mirka Lumia
- Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland.,Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Hanna-Mari Takkinen
- Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Päivi Luukkainen
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Minna Kaila
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | | | - Bright I Nwaru
- Allergy & Respiratory Research Group, Centre for Population Health Sciences, The University Of Edinburgh, Edinburgh, UK
| | - Jetta Tuokkola
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, Seinäjoki, Finland
| | - Anna-Maija Haapala
- Center for Laboratory Medicine, Pirkanmaa Hospital District, Tampere, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku, Turku, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Olli Simell
- Department of Pediatrics, University of Turku, Turku, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland.,Folkhälsan Research Institute, University of Helsinki, Helsinki, Finland.,Diabetes and Obesity Research Program, University of Helsinki, Helsinki, Finland
| | - Riitta Veijola
- Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Suvi M Virtanen
- Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland.,Research Center for Child Health and Science Centre of Pirkanmaa Hospital District, Tampere University Hospital and University of Tampere, Tampere, Finland
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14
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Parikka S, Mäki P, Levälahti E, Lehtinen-Jacks S, Martelin T, Laatikainen T. Associations between parental BMI, socioeconomic factors, family structure and overweight in Finnish children: a path model approach. BMC Public Health 2015; 15:271. [PMID: 25885334 PMCID: PMC4371876 DOI: 10.1186/s12889-015-1548-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 02/16/2015] [Indexed: 12/24/2022] Open
Abstract
Background The aim of this study was to assess the less studied interrelationships and pathways between parental BMI, socioeconomic factors, family structure and childhood overweight. Methods The cross-sectional LATE-study was carried out in Finland in 2007–2009. The data for the analyses was classified into four categories: younger boys and girls (ca 3–8 years) (n = 2573) and older boys and girls (ca 11–16 years) (n = 1836). Associations between parental BMI, education, labor market status, self-perceived income sufficiency, family structure and childhood overweight were first examined by logistic regression analyses. As parental BMI and education had the most consistent associations with childhood overweight, the direct and indirect (mediated by parental BMI) associations of maternal and paternal education with childhood overweight were further assessed using a path model. Results Parental BMI and education were the strongest determinants of childhood overweight. Children of overweight parents had an increased risk of being overweight. In younger boys, maternal and paternal education had both direct (b-coefficient paternal −0.21, 95% CI −0.34 to −0.09; maternal −0.17, 95% CI −0.28 to −0.07) and indirect (b-coefficient paternal −0.04, 95% CI −0.07 to −0.02; maternal −0.04, 95% CI −0.06 to −0.02) inverse associations with overweight. Among the older boys, paternal education had both direct (b-coefficient −0.12, 95% CI −0.24 to −0.01) and indirect (b-coefficient −0.03, 95% CI −0.06 to −0.01) inverse associations with overweight, but maternal education had only an indirect association (b-coefficient −0.04, 95% CI −0.07 to −0.02). Among older girls, only an indirect association of maternal education with childhood overweight was found (b-coefficient −0.03, 95% CI −0.06 to −0.01). In younger girls, parental education was not associated with childhood overweight. Conclusion The observed pathways between parental BMI and education and childhood overweight emphasize a need for evidence-based health promotion interventions tailored for families identified with parental overweight and low level of education.
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Affiliation(s)
- Suvi Parikka
- National Institute for Health and Welfare, Department of Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Päivi Mäki
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland.
| | - Esko Levälahti
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland.
| | - Susanna Lehtinen-Jacks
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland. .,University of Tampere, School of Health Sciences, Tampere, Finland.
| | - Tuija Martelin
- National Institute for Health and Welfare, Department of Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Department of Health, Helsinki, Finland. .,University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland. .,Hospital District of North Karelia, Joensuu, Finland.
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15
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Kyttälä P, Erkkola M, Lehtinen-Jacks S, Ovaskainen ML, Uusitalo L, Veijola R, Simell O, Knip M, Virtanen SM. Finnish Children Healthy Eating Index (FCHEI) and its associations with family and child characteristics in pre-school children. Public Health Nutr 2014; 17:2519-27. [PMID: 24152429 PMCID: PMC10284681 DOI: 10.1017/s1368980013002772] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The objective was to develop a Finnish Children Healthy Eating Index (FCHEI), to determine the relative validity of the index and to examine associations between the index and familial sociodemographic and lifestyle characteristics. DESIGN Cross-sectional samples of children participating in a population-based birth cohort study in Finland. SETTING Type I Diabetes Prediction and Prevention (DIPP) Study cohort. SUBJECTS Three-day food records from 1-year-old (n 455), 3-year-old (n 471) and 6-year-old (n 713) children were completed between 2003 and 2005. RESULTS Validity of the FCHEI was assessed by studying the associations between the FCHEI and nutrient intakes of the children. Among all age groups, intakes of SFA and sugars decreased across increasing quartiles of the FCHEI while intakes of PUFA, dietary fibre, vitamin D and vitamin E increased. Among 3- and 6-year-olds, being cared for at home was associated with the lowest FCHEI quartile (diet that deviates most from the recommendations). The lowest FCHEI quartile was also associated with residence in a semi-urban area among the 3-year-olds and low maternal education and smoking during pregnancy among the 6-year-olds. CONCLUSIONS The FCHEI serves as a valid indicator of the quality of Finnish children's diet. Public health programmes aimed at improving the dietary behaviours of pre-school aged children should aim to improve the quality of food served at home. Families with history of lower parental education, maternal smoking during pregnancy or non-urban place of residence may require special attention.
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Affiliation(s)
- Pipsa Kyttälä
- School of Health Sciences, FI-33014 University of Tampere, Tampere, Finland
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Maijaliisa Erkkola
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Susanna Lehtinen-Jacks
- School of Health Sciences, FI-33014 University of Tampere, Tampere, Finland
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
- The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Marja-Leena Ovaskainen
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Liisa Uusitalo
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Veijola
- Department of Paediatrics, University of Oulu, Oulu, Finland
| | - Olli Simell
- Department of Paediatrics, University of Turku, Turku, Finland
| | - Mikael Knip
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Research Center for Child Health, Tampere University Hospital, Tampere, Finland
| | - Suvi Mirjami Virtanen
- School of Health Sciences, FI-33014 University of Tampere, Tampere, Finland
- Unit of Nutrition, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
- The Science Center of Pirkanmaa Hospital District, Tampere, Finland
- Research Center for Child Health, Tampere University Hospital, Tampere, Finland
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16
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Talibov M, Lehtinen-Jacks S, Martinsen JI, Kjærheim K, Lynge E, Sparén P, Tryggvadottir L, Weiderpass E, Kauppinen T, Kyyrönen P, Pukkala E. Occupational exposure to solvents and acute myeloid leukemia: a population-based, case-control study in four Nordic countries. Scand J Work Environ Health 2014; 40:511-7. [PMID: 24840289 DOI: 10.5271/sjweh.3436] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of the current study was to assess the relation between occupational exposure to solvents and the risk of acute myeloid leukemia (AML). METHODS Altogether, this study comprises 15 332 incident cases of AML diagnosed in Finland, Norway, Sweden and Iceland from 1961-2005 and 76 660 controls matched by year of birth, sex, and country. Occupational records were linked with Nordic Occupational Cancer Study job exposure matrix (JEM) to estimate quantitative values for 26 occupational exposure factors. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. RESULTS We did not observe statistically significantly increased risk for exposure to any of the solvents. HR estimates for high levels of toluene (HR 1.35, 95% CI 0.74-2.46), aromatic hydrocarbon solvents (ARHC) (HR 1.18, 95% CI 0.76-1.86), and moderate-to-high levels of trichloroethylene were slightly but non-significantly elevated. We did not observe an association between benzene exposure and AML in this study. CONCLUSIONS This study did not provide clear evidence for an association between occupational solvent exposure and AML. There was some indication for an excess risk in the groups of workers exposed to toluene, trichloroethylene and ARHC.
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Affiliation(s)
- Madar Talibov
- School of Health Sciences, University of Tampere, FI-33014, Tampere, Finland.
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17
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Magnusson M, Sørensen TIA, Olafsdottir S, Lehtinen-Jacks S, Holmen TL, Heitmann BL, Lissner L. Social Inequalities in Obesity Persist in the Nordic Region Despite Its Relative Affluence and Equity. Curr Obes Rep 2014; 3:1-15. [PMID: 24533235 PMCID: PMC3920028 DOI: 10.1007/s13679-013-0087-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Social inequalities in overweight and obesity (OWOB) have persisted in the affluent and reputedly egalitarian Nordic countries. In this review we examine associations between socioeconomic position (SEP) and OWOB, and secular trends in such associations. Determinants and possible causes of the relations are discussed together with opportunities to cope with OWOB as a public health problem. The findings show a persisting inverse social gradient. An interaction between SEP and gender is noted for adults in Denmark, Finland and Iceland and for children in Sweden. There are overall tendencies for increased inequality, however no consistent trend for an increased social gradient in OWOB. Reasons that increased inequality does not unequivocally mirror in a steepened social gradient in obesity may include methodological questions as well as societal efforts to counteract obesity. Multi-level efforts are needed to prevent OWOB.
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Affiliation(s)
- Maria Magnusson
- />Department of Public Health and Community Medicine, University of Gothenburg, Box 454, 405 30 Gothenburg, Sweden
| | - Thorkild I. A. Sørensen
- />Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital – Part of the Copenhagen University Hospital, Copenhagen, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- />Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steingerdur Olafsdottir
- />Department of Food and Nutrition, and Sport Science, University of Gothenburg, Laroverksgatan 5, Box 320, 405 30 Gothenburg, Sweden
| | - Susanna Lehtinen-Jacks
- />School of Health Sciences (HES) Medisiinarinkatu 3, University of Tampere, 33014 Tampere, Finland
- />Nutrition Unit, National Institute for Health and Welfare, Mannerheimintie 166, 00280 Helsinki, Finland
| | - Turid Lingaas Holmen
- />HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Forskningsveien 2, 7600 Levanger, Norway
| | - Berit Lilienthal Heitmann
- />Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital – Part of the Copenhagen University Hospital, Copenhagen, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- />National Institute of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Lauren Lissner
- />Department of Public Health and Community Medicine, University of Gothenburg, Box 454, 405 30 Gothenburg, Sweden
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18
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Valve P, Lehtinen-Jacks S, Eriksson T, Lehtinen M, Lindfors P, Saha MT, Rimpelä A, Anglé S. LINDA - a solution-focused low-intensity intervention aimed at improving health behaviors of young females: a cluster-randomized controlled trial. BMC Public Health 2013; 13:1044. [PMID: 24188719 PMCID: PMC4228239 DOI: 10.1186/1471-2458-13-1044] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 10/23/2013] [Indexed: 11/12/2022] Open
Abstract
Background We aimed to develop and evaluate the effectiveness of an individualized, long-term support lifestyle counseling approach in promoting healthy physical activity, improving dietary and sleeping behaviors, and preventing weight gain in young females. The counseling approach’s intensity was designed to be low enough to be implementable in primary health care. Methods Young women (n = 3,059, age at baseline 17–21 years) attending a population-based human papilloma virus vaccination trial (clinicaltrials.gov identifier: NCT00122681) in 15 vaccination centers in different communities across Finland, were cluster-randomized into intervention and control arms of the LINDA intervention. Both intervention and control arms received counseling on sexual health and contraception from the study nurses as part of the vaccination trial. Additionally, the LINDA intervention arm (n = 1,537) received a 20-minute individualized lifestyle counseling session followed by further support at the six-monthly follow-up visits of the vaccination trial, in total for 1.5–2.5 years. The LINDA solution-focused brief therapy intervention focused on healthy physical activity, and dietary and sleeping behaviors, based on the needs and interests of the participants. Anthropometrics were measured, and data on health-related behaviors were collected using self-report questionnaires at baseline and after the intervention at 1.5–2.5 years. Results In the intervention arm, 37% vs. 31% in the control arm made an overall improvement in their health behaviors concerning physical activity, meal regularity and/or earlier bedtime (NNT = 18, 95% CI = 11–50). The per-protocol analysis further revealed that 30% of those who actually received lifestyle change support on healthy physical activity behaviors improved their physical activity level vs. 23% in the control group (NNT = 15, 95% CI = 9–38). Respectively, 36% of those who received support on healthy sleeping behaviors went to sleep earlier before school-/work-days after the intervention vs. 28% in the control group (NNT = 13, 95% CI = 7–61). Dinner irregularity increased in both groups, but less in the intervention group among those who received support on healthy dietary behaviors (NNT = 15, 95%CI = 9–46). There was no effect on weight gain between baseline and study end-point. Conclusions The solution-focused brief therapy intervention, with individually tailored content, helped to make small, long-term overall improvements in health behaviors concerning physical activity, meal regularity and/or earlier bedtime.
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Affiliation(s)
- Päivi Valve
- School of Medicine, University of Tampere, 33014 Tampere, Finland.
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