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Tieu S, Koivusalo S, Lahti J, Engberg E, Laivuori H, Huvinen E. Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women. BMJ Open Diabetes Res Care 2024; 12:e003942. [PMID: 38631819 PMCID: PMC11029483 DOI: 10.1136/bmjdrc-2023-003942] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/16/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Lifestyle interventions are effective in preventing type 2 diabetes, but genetic background may influence the individual response. In the Finnish gestational diabetes prevention study, RADIEL, lifestyle intervention during pregnancy and first postpartum year was effective in preventing gestational diabetes (GDM) and postpartum glycemic abnormalities only among women at highest genetic risk of type 2 diabetes. This study aimed to assess whether still 5 years postpartum the genetic risk modifies the association between lifestyle and glycemic health. RESEARCH DESIGN AND METHODS The RADIEL study (randomized controlled trial) aimed to prevent GDM with a lifestyle intervention among high-risk women (body mass index ≥30 kg/m2 and/or prior GDM). The follow-up study 5 years postpartum included anthropometric measurements, laboratory assessments, device-measured physical activity (PA), and questionnaires. A Healthy Lifestyle Score (HLS) indicated adherence to lifestyle goals (PA, diet, smoking) and a polygenic risk score (PRS) based on 50 type 2 diabetes risk alleles depicted the genetic risk. RESULTS Altogether 314 women provided genetic and glycemic data 5 years postpartum. The PRS for type 2 diabetes was not associated with glycemic abnormalities, nor was HLS in the total study sample. There was, however, an interaction between HLS and type 2 diabetes PRS on glycemic abnormalities (p=0.03). When assessing the association between HLS and glycemic abnormalities in PRS tertiles, HLS was associated with reduced risk of glycemic abnormalities only among women at the highest genetic risk (p=0.008). CONCLUSIONS These results extend our previous findings from pregnancy and first postpartum year demonstrating that still at 5 years postpartum, healthy lifestyle is associated with a lower risk of prediabetes/diabetes only among women at the highest genetic risk of type 2 diabetes.
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Affiliation(s)
- Sim Tieu
- Helsinki University Central Hospital, Helsinki, Finland
| | | | - Jari Lahti
- Department of Psychology, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, Helsinki University Hospital, Helsinki, Finland
- Tampere University, Tampere, Finland
| | - Emilia Huvinen
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
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Salonsalmi A, Kouvonen A, Rahkonen O, Lahelma E, Lallukka T. Work-family conflicts and sickness absence-a register-linked cohort study among young and early midlife employees. Eur J Public Health 2024; 34:316-321. [PMID: 38332545 PMCID: PMC10990516 DOI: 10.1093/eurpub/ckae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Work-family conflicts (WFC) have been associated with poor mental health, poor self-rated health and sickness absence. However, studies on short sickness absence are lacking and more information is needed also about long sickness absence regarding the direction of WFC, and potential explaining factors particularly among young and early middle-aged employees. METHODS The Helsinki Health Study baseline survey (2017) among 19- to 39-year-old municipal employees (N = 3683, 80% women, response rate 51.5%) was linked to employer's sickness absence data. The associations of work-to-family conflicts (WTFC) and family-to-work conflicts (FTWC) with short (1-7 days) and long (over 7 days) sickness absence were analyzed using negative binomial regression analysis. Covariates were age, gender, family-related factors and work-related factors. Stratified analyses by occupational class were performed. The results are presented as rate ratios and their 95% confidence intervals. RESULTS High WTFC were associated with short (1.25, 1.12-1.40) and long (1.37, 1.11-1.70) sickness absence. High FTWC were also associated with short (1.12, 1.03-1.22) and long (1.24, 1.06-1.45) sickness absence. Adjustment for family-related factors strengthened the associations, whereas adjustment for work-related factors abolished the associations between WTFC and sickness absence. Associations between WFC and sickness absence were observed among two lowest occupational classes only. CONCLUSION WFC are associated with both short and long sickness absence. Work-related factors including the quality of supervisory work and shift work play a role in the association. Intervention studies could determine if improvements in combining work and family life lead to a reduction in sickness absence.
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Affiliation(s)
- Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Suur-Uski J, Fagerlund P, Granroth-Wilding H, Salonsalmi A, Rahkonen O, Lallukka T. Dual trajectories of short-term and long-term sickness absence and their social- and health-related determinants among women in the public sector. Eur J Public Health 2024; 34:322-328. [PMID: 38379312 PMCID: PMC10990561 DOI: 10.1093/eurpub/ckae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Short- and long-term sickness absence (SA) vary in their determinants. We examined short- and long-term SA contemporaneously as two interconnected phenomena to characterize their temporal development, and to identify employees with increasing SA at an early stage. METHODS We extracted 46- to 55-year-old employed women from the Helsinki Health Study occupational cohort during 2000-17 (N = 3206) and examined the development of short- (1-14 days) and long-term (>14 days) SA using group-based dual trajectory modelling. In addition, we investigated the associations of social-, work- and health-related factors with trajectory group membership. RESULTS For short-term SA, we selected a three-group solution: 'no short-term SA' (50%), 'low frequency short-term SA' (40%), and 'high frequency short-term SA' (10%) (7 spells/year). For long-term SA, we also selected three trajectory groups: 'no long-term SA' (65%), 'low long-term SA' (27%), and 'high long-term SA' (8%). No SA in the short-term SA model, indicated a high probability of no SA in the long-term model and vice versa. The developmental pattern was far less certain if participant was assigned to a trajectory of high SA in either one of the models (short- or long-term SA model). Low occupational class and poor health behaviours were associated with the trajectory groups with more SA. CONCLUSION SA does not increase with age among most employees. If either SA rate was high, the developmental patterns were heterogenous. Employers' attention to health behaviours might aid in reducing both short- and long-term SA.
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Affiliation(s)
- Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Pi Fagerlund
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Hanna Granroth-Wilding
- Biostatistics Consulting Service, Medical Faculty, University of Helsinki, Helsinki, Finland
| | - Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Messa GAM, Korhonen MT, Degens H. No ageing-related increase in fibre type grouping in sprint-trained masters runners: A 10-year follow-up study. J Cachexia Sarcopenia Muscle 2024; 15:552-561. [PMID: 38228574 PMCID: PMC10995270 DOI: 10.1002/jcsm.13416] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Previous research suggests that an ageing-associated remodelling and loss of motor units due to motor neuron death contributes significantly to muscle weakness in old age. In histological sections, motor unit remodelling is reflected by increased fibre type grouping. While regular exercise may not attenuate the loss of motor units during ageing, it has been suggested to facilitate reinnervation resulting in larger motor units, and a higher number and larger fibre type groups in histological sections of muscles from aged individuals. METHODS In a 10-year follow-up study, we assessed changes in the prevalence and size of fibre type groups in the vastus lateralis muscle from 34 male masters sprinters (40-85 years at start). RESULTS Over the 10 years, there was an ageing-related reduction in performance in the 60-m sprint (P < 0.001) without significant changes in fibre type composition and fibre cross-sectional area. Neither the number of fibre type groups, defined as a fibre surrounded exclusively by fibres of the same type, nor the group size changed significantly in the 10-year period. CONCLUSIONS These histological data show that there is limited to no significant fibre type grouping over a 10-year period in masters athletes who continued sprint run training. This observation challenges the paradigm that ageing, at least in systematically trained sprinters, is associated with motor unit remodelling.
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Affiliation(s)
- Guy Anselme Mpaka Messa
- Higher Institute of Medical TechnologyISTM‐KinshasaKinshasaDemocratic Republic of Congo
- Faculty of MedicineUniversity Kasa‐Vubu (UKV)BomaDemocratic Republic of Congo
- Faculty of MedicineUniversity de Bandundu (UNIBAND)BandunduDemocratic Republic of Congo
| | - Marko T. Korhonen
- Gerontology Research Center, Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Hans Degens
- Department of Life Sciences, Institute of SportManchester Metropolitan UniversityManchesterUK
- Institute of Sport Science and InnovationsLithuanian Sports UniversityKaunasLithuania
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Joensuu L, Tammelin TH, Syväoja HJ, Barker AR, Parkkari J, Kujala UM. Physical activity, physical fitness and self-rated health: cross-sectional and longitudinal associations in adolescents. BMJ Open Sport Exerc Med 2024; 10:e001642. [PMID: 38562154 PMCID: PMC10982735 DOI: 10.1136/bmjsem-2023-001642] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Objectives To evaluate the independent associations of physical activity and physical fitness with self-rated health in adolescents. Methods Data from a 2-year observational study (2013-2015) were used (n=256, 58% girls, 13.7±0.3 years at baseline). Self-rated health was assessed with a questionnaire, physical activity by an accelerometer and a questionnaire, and physical fitness via the measurements included in the Finnish national Move! monitoring system for physical functional capacity and their z-score average (fitness index). Results Self-reported physical activity had cross-sectional associations with self-rated health (girls β 0.213, p=0.006, β 0.221 boys p=0.021) while accelerometer-based moderate-to-vigorous physical activity did not. Higher self-reported physical activity at baseline was associated with higher self-rated health at follow-up in boys (β 0.289, p<0.001), but not in girls (β -0.056, p=0.430). Accelerometer-based moderate-to-vigorous physical activity had positive longitudinal associations with future self-rated health in boys, but some of these similar associations were negative in girls. Fitness index had a positive cross-sectional association with self-rated health in boys (β 0.282 or β 0.283, p=0.002), but not in girls (β 0.162 or β 0.161, p=0.051). Physical fitness was not longitudinally associated with self-rated health. Conclusions Self-reported physical activity showed potential to explain current and future self-rated health better than accelerometer-based physical activity or physical fitness. We recommended to consider self-reported physical activity as an adequate metric of adolescent health in the population-level surveillance systems.
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Affiliation(s)
- Laura Joensuu
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Likes, JAMK University of Applied Sciences, Jyväskylä, Finland
| | | | - Heidi J Syväoja
- Likes, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Alan R Barker
- Children’s Health and Exercise Research Centre, Public Health and Sports Sciences, University of Exeter, Exeter, UK
| | - Jari Parkkari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Kontturi M, Virtanen M, Myllyntausta S, Prakash KC, Pentti J, Vahtera J, Stenholm S. Are changes in sleep problems associated with changes in life satisfaction during the retirement transition? Eur J Ageing 2024; 21:7. [PMID: 38472554 DOI: 10.1007/s10433-024-00802-4] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Retirement reduces sleep problems, but changes in life satisfaction during the retirement transition are multifactorial and partly unknown. The aim of this prospective cohort study was to examine whether changes in sleep problems are associated with changes in total and domain-specific life satisfaction during the retirement transition (on average 0.5 years before and 0.5 years after retirement). The study population consisted of Finnish public sector employees (n = 3518) from the Finnish Retirement and Aging (FIREA) study who responded to annual surveys before and after transition to statutory retirement. Sleep problems were measured with Jenkins Sleep Problem Scale questionnaire and participants were grouped into four sleep problem groups depending on the state of their sleep problems during the retirement transition: 'Never,' 'Decreasing,' 'Increasing,' and 'Constant' sleep problems. Life satisfaction was measured with the Life Satisfaction Scale questionnaire including four domains (interestingness, happiness, easiness, togetherness). We found that the improvement in total life satisfaction was greatest for participants in the 'Decreasing' (0.17, 95% CI 0.11-0.23, SMD 0.27) and 'Constant' (0.12, 95% CI 0.07-0.18, SMD 0.19) sleep problem groups. Of the specific life satisfaction domains, similar findings were observed only for the easiness domain. It seems that decreasing or constant sleep problems are associated with improved life satisfaction during the retirement transition, especially in the feeling of easiness of life. This may be due to the fact that as the demands of working life are removed, sleep problems are alleviated or it becomes easier to live with them, which improves life satisfaction.
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Affiliation(s)
- Marika Kontturi
- School of Educational Sciences and Psychology, University of Eastern Finland, P.O. Box 111, 80101, Joensuu, Finland.
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, P.O. Box 111, 80101, Joensuu, Finland
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Saana Myllyntausta
- Department of Psychology and Speech-Language Pathology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - K C Prakash
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Aitokari L, Lahti S, Kivelä L, Riekki H, Hiltunen P, Vuorela N, Viitasalo A, Soininen S, Huhtala H, Lakka T, Kurppa K. Alanine aminotransferase cutoffs for the pediatric fatty liver disease: Major impact of the reference population. J Pediatr Gastroenterol Nutr 2024; 78:488-496. [PMID: 38314943 DOI: 10.1002/jpn3.12040] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/07/2023] [Accepted: 10/25/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVES AND STUDY The often-recommended alanine aminotransferase (ALT) cutoffs (girls 21 U/l, boys 25 U/l) are based on a NHANES cohort. A novel concept of metabolic dysfunction associated steatotic liver disease (MASLD) emphasizes the role of ALT. We tested the prevalence of increased ALT and MASLD in children with overweight or obesity applying population-based and NHANES-based cut-offs. METHODS Six- to seventeen-year-old children underwent data collection in a prospective Physical Activity and Nutrition in Children (PANIC) study. ALT 95th percentiles were calculated from 1167 separate measurements considering various confounders. Test cohort comprised 1044 children with overweight/obesity. RESULTS ALT values increased at puberty onset (p = 0.031) and correlated negatively with age in girls (r = -0.222, p < 0.001). Particularly overall and central obesity increased ALT, whereas underweight or metabolic abnormalities had smaller effect. After applying the tested exclusions, the age-related ALT 95th percentiles were 24-29 U/l for girls and 29-32 U/l for boys. In 6-8-year-old children with overweight/obesity, the prevalence of increased ALT and MASLD were 21.6% and 2.4% with age-specific PANIC cutoffs. In older children, when NHANES-based cutoffs were used, there was a trend for higher prevalence of increased ALT and MASLD in all age groups for both sexes, reaching significance for increased ALT in 12-16-year-old boys (NHANES 63.5%, 95% confidence interval [CI]: 56.4%-70.0% vs. PANIC 47.1%, 95% CI [40.1%-54.2%]) and 9-11-year-old girls (60.0% [49.4%-69.8%] vs. 31.8% [22.8%-42.3%]), respectively. Increased ALT/MASLD were more common in boys than in girls, and in boys these increased with age, whereas in girls these peaked at age 9-12 years. CONCLUSION A reference population impacts on the prevalence of increased ALT and MASLD. Considering this help optimizing screening while avoiding unnecessary investigations and surveillance. The prospective part of this study is registered in clinicaltrials.gov; identifier NCT01803776.
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Affiliation(s)
- Linnea Aitokari
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
| | - Siiri Lahti
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
| | - Laura Kivelä
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- Children's Hospital and Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Riekki
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
| | - Pauliina Hiltunen
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Nina Vuorela
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Sonja Soininen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Physician and Nursing Services, Health and Social Services Centre, Wellbeing Services County of North Savo, Varkaus, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Timo Lakka
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Kalle Kurppa
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland
- The University Consortium of Seinäjoki, Seinäjoki, Finland
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Laamanen SE, Eloranta AM, Haapala EA, Sallinen T, Schwab U, Lakka TA. Associations of diet quality and food consumption with serum biomarkers for lipid and amino acid metabolism in Finnish children: the PANIC study. Eur J Nutr 2024; 63:623-637. [PMID: 38127151 PMCID: PMC10899368 DOI: 10.1007/s00394-023-03293-8] [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: 12/10/2022] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To investigate the associations of overall diet quality and dietary factors with serum biomarkers for lipid and amino acid metabolism in a general population of children. METHODS We studied 194 girls and 209 boys aged 6-8 years participating in the Physical Activity and Nutrition in Children study. Food consumption was assessed by 4-day food records and diet quality was quantified by the Finnish Children Healthy Eating Index (FCHEI). Fasting serum fatty acids, amino acids, apolipoproteins, as well as lipoprotein particle sizes were analyzed with high-throughput nuclear magnetic resonance spectroscopy. Data were analyzed using linear regression adjusted for age, sex, and body fat percentage. RESULTS FCHEI was directly associated with the ratio of polyunsaturated (PUFA) to saturated fatty acids (SFA) (PUFA/SFA), the ratio of PUFA to monounsaturated fatty acids (MUFA) (PUFA/MUFA), the ratio of PUFA to total fatty acids (FA) (PUFA%), the ratio of omega-3-fatty acids to total FA (omega-3 FA%), and inversely associated with the ratio of MUFA to total FA (MUFA%), alanine, glycine, histidine and very-low density lipoprotein (VLDL) particle size. Consumption of vegetable oils and vegetable-oil-based margarine (≥ 60% fat) was directly associated with PUFA/SFA, PUFA/MUFA, PUFA%, the ratio of omega-6 FA to total FA (omega-6 FA%), and inversely associated with SFA, MUFA, SFA to total FA (SFA%), MUFA%, alanine and VLDL particle size. Consumption of high-fiber grain products directly associated with PUFA/SFA, PUFA/MUFA, omega-3 FA%, omega-6 FA%, PUFA% and inversely associated with SFA and SFA%. Fish consumption directly related to omega-3 FA and omega-3 FA%. Consumption of sugary products was directly associated with histidine and VLDL particle size. Vegetable, fruit, and berry consumption had direct associations with VLDL particle size and the ratio of apolipoprotein B to apolipoprotein A1. Consumption of low fat (< 1%) milk was directly associated with phenylalanine. A higher consumption of high-fat (≥ 1%) milk was associated with lower serum MUFA/SFA and higher SFA%. Sausage consumption was directly related to SFA% and histidine. Red meat consumption was inversely associated with glycine. CONCLUSIONS Better diet quality, higher in intake of dietary sources of unsaturated fat and fiber, and lower in sugary product intake were associated with more favorable levels of serum biomarkers for lipid and amino acid metabolism independent of adiposity. TRIAL REGISTRATION ClinicalTrials.gov: NCT01803776, registered March 3, 2013.
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Affiliation(s)
- Suvi E Laamanen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.
| | - Aino-Maija Eloranta
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Eero A Haapala
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Taisa Sallinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Lindblom J, Korja R, Karlsson H, Karlsson L, Karukivi M, Pajulo M, Nolvi S. Prepandemic to early COVID-19: Changes in couple functioning and links with harsh parenting. J Fam Psychol 2024:2024-57699-001. [PMID: 38421765 DOI: 10.1037/fam0001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Research has revealed a rise in family relationship problems during the COVID-19 pandemic, especially among couples with young children. However, longitudinal studies spanning the prepandemic and pandemic periods are rare. In this study, we examined changes in couple functioning during these periods. Moreover, we investigated the mediation and moderation effects of couple functioning on the association between COVID-19 stressors and harsh parenting. A total of 545 mothers (mean age 38 years, range 23-48 years) completed questionnaires on couple functioning during the prepandemic (2016-2020) and early pandemic (May-June 2020) periods. During the early pandemic, they also reported exposure to COVID-19 stressors and engaging in harsh parenting (e.g., conflicts and maltreatment). We found no overall deterioration in couple functioning during the early pandemic. Furthermore, COVID-19 stressors did not explain variance in couple functioning changes or correlate with harsh parenting. However, as hypothesized, couple functioning moderated the effect of COVID-19 stressors on harsh parenting. Only for couples with low prepandemic functioning was exposure to COVID-19 stressors associated with harsh parenting. In conclusion, our findings provided no evidence of COVID-19's detrimental effects on couples during the early pandemic. Instead, well-functioning couple relationships appear to mitigate the impact of pandemic stressors on parenting. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Jallu Lindblom
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
| | - Riikka Korja
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
| | - Hasse Karlsson
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
| | - Linnea Karlsson
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
| | - Max Karukivi
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
| | - Marjukka Pajulo
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
| | - Saara Nolvi
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku
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Liimatta J, Jääskeläinen J, Mäntyselkä A, Häkkinen MR, Auriola S, Voutilainen R, Flück CE, Lakka TA. Accelerated Early Childhood Growth Is Associated With the Development of Earlier Adrenarche and Puberty. J Endocr Soc 2024; 8:bvae026. [PMID: 38425434 PMCID: PMC10904224 DOI: 10.1210/jendso/bvae026] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Indexed: 03/02/2024] Open
Abstract
Context Small birth size and increased postnatal growth have been associated with earlier timing of adrenarche and puberty, but it is not well known whether these factors alone or together lead to earlier maturation. Objective This work aimed to search for different growth trajectories using a clustering approach to analyze the effects of birth size and postnatal growth on adrenarchal and pubertal development. Methods Altogether 351 children (48% girls) were examined prospectively at ages 6 to 9 and 9 to 11 years. Birth and early-growth data were collected retrospectively. Main outcome measures included clinical signs of adrenarche and puberty, and serum androgen concentrations (dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, testosterone). Results We detected 4 clusters with different birth sizes and postnatal growth trajectories: 1) children with average birth size and increased postnatal growth (AI), 2) children with small birth size and increased postnatal growth (SI), 3) children with average birth size and postnatal growth (AA), and 4) children with small birth size and average postnatal growth (SA). Thelarche at age 9 to 11 was most common and serum androgens at ages 6 to 9 and 9 to 11 years were highest in girls belonging to the AI and SI groups. Similar patterns in the onset of puberty and in androgen levels were not seen in the SA group. Conclusion Increased early growth and weight gain predict higher serum androgen concentrations and earlier onset of puberty in girls. Adrenarche and puberty do not appear to be shifted earlier in children with small birth size who do not have catch-up growth.
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Affiliation(s)
- Jani Liimatta
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
- Pediatric Endocrinology, Diabetology, and Metabolism, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Jarmo Jääskeläinen
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Aino Mäntyselkä
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Merja R Häkkinen
- School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Health Security, Finnish Institute for Health and Welfare (THL), 70701 Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland
| | - Raimo Voutilainen
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Christa E Flück
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
- Pediatric Endocrinology, Diabetology, and Metabolism, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, 70210 Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, 70211 Kuopio, Finland
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11
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Rautio N, Seppänen M, Timonen M, Puhakka S, Kärmeniemi M, Miettunen J, Lankila T, Farrahi V, Niemelä M, Korpelainen R. Associations between neighbourhood characteristics, physical activity and depressive symptoms: the Northern Finland Birth Cohort 1966 Study. Eur J Public Health 2024; 34:114-120. [PMID: 38081169 PMCID: PMC10843961 DOI: 10.1093/eurpub/ckad215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Due to rapid urbanization, there is a need to better understand the relative roles of residential environment and physical activity in depression. We aimed to investigate whether neighbourhood characteristics are related to the presence of depressive symptoms and whether the association is modified by physical activity. METHODS This cross-sectional study used the 46-year-old follow-up data (n = 5489) from the Northern Finland Birth Cohort 1966. Data on depressive symptoms, measured by Beck Depression Inventory-II, and self-reported and accelerometer-measured physical activity were included. Neighbourhood characteristics, population density, distance to the closest grocery store, bus stops and cycle/pedestrian paths, distance to the nearest parks and forests, residential greenness and level of urbanicity were calculated using Geographic Information System methods based on participants' home coordinates. RESULTS According to ordinal logistic regression analyses adjusted for physical activity at different intensities and individual covariates, living in a neighbourhood with higher population density and urbanicity level were associated with a higher risk of experiencing more severe depressive symptoms. Higher residential greenness was associated with a lower risk of experiencing more severe depressive symptoms after adjustment for self-reported light and moderate-to-vigorous physical activity, accelerometer-measured moderate-to-vigorous physical activity and individual covariates. Both higher self-reported and accelerometer-measured physical activity were independently associated with a lower risk of more severe depressive symptoms. CONCLUSIONS Both residential environment and physical activity behaviour play an important role in depressive symptoms; however, further research among populations of different ages is required. Our findings can be utilized when designing interventions for the prevention of depression.
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Affiliation(s)
- Nina Rautio
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjo Seppänen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Geography Research Unit, University of Oulu, Oulu, Finland
| | - Markku Timonen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Soile Puhakka
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Geography Research Unit, University of Oulu, Oulu, Finland
| | - Mikko Kärmeniemi
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tiina Lankila
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Geography Research Unit, University of Oulu, Oulu, Finland
| | - Vahid Farrahi
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - Maisa Niemelä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Raija Korpelainen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
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12
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Abdollahi AM, Li X, Merikanto I, Leppänen MH, Vepsäläinen H, Lehto R, Ray C, Erkkola M, Roos E. Comparison of actigraphy-measured and parent-reported sleep in association with weight status among preschool children. J Sleep Res 2024; 33:e13960. [PMID: 37282765 DOI: 10.1111/jsr.13960] [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: 08/08/2022] [Revised: 04/07/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023]
Abstract
This study compared weekday and weekend actigraphy-measured and parent-reported sleep in relation to weight status among preschool-aged children. Participants were 3-6 years old preschoolers from the cross-sectional DAGIS-study with sleep data for ≥2 weekday and ≥2 weekend nights. Parents-reported sleep onset and wake-up times were gathered alongside 24 h hip-worn actigraphy. An unsupervised Hidden-Markov Model algorithm provided actigraphy-measured night time sleep without the guidance of reported sleep times. Waist-to-height ratio and age-and-sex-specific body mass index characterised weight status. Comparison of methods were assessed with consistency in quintile divisions and Spearman correlations. Associations between sleep and weight status were assessed with adjusted regression models. Participants included 638 children (49% girls) with a mean ± SD age of 4.76 ± 0.89. On weekdays, 98%-99% of actigraphy-measured and parent-reported sleep estimates were classified in the same or adjacent quintile and were strongly correlated (rs = 0.79-0.85, p < 0.001). On weekends, 84%-98% of actigraphy-measured and parent-reported sleep estimates were respectively classified and correlations were moderate to strong (rs = 0.62-0.86, p < 0.001). Compared with actigraphy-measured sleep, parent-reported sleep had consistently earlier onset, later wake-up, and greater duration. Earlier actigraphy-measured weekday sleep onset and midpoint were associated with a higher body mass index (respective β-estimates: -0.63, p < 0.01 and -0.75, p < 0.01) and waist-to-height ratio (-0.004, p = 0.03 and -0.01, p = 0.02). Though the sleep estimation methods were consistent and correlated, actigraphy measures should be favoured as they are more objective and sensitive to identifying associations between sleep timing and weight status compared with parent reports.
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Affiliation(s)
- Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China
| | - Ilona Merikanto
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Marja H Leppänen
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Reetta Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Carola Ray
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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13
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Kajastus K, Haravuori H, Kiviruusu O, Marttunen M, Ranta K. Associations of generalized anxiety and social anxiety with perceived difficulties in school in the adolescent general population. J Adolesc 2024; 96:291-304. [PMID: 37985185 DOI: 10.1002/jad.12275] [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: 01/28/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Generalized anxiety disorder (GAD), marked by excessive worry, and social anxiety disorder (SAD) are among the clinically most important anxiety disorders in the adolescent population. This study aimed to explore the associations between perceived difficulties in school and heightened levels of self-reported noncomorbid and comorbid GAD and SAD symptoms. METHODS Survey data of 37,905 Finnish upper secondary school students with a mean age of 17.33 years (SD = 0.63) were obtained from the School Health Promotion study, implemented in April and May 2015 in Finland. Exploratory factor analysis was used to determine indicators of academic and social difficulties in school. Logistic regression analysis was conducted to examine multivariate associations between anxiety symptoms and difficulties in the school. The anxiety symptom thresholds were based on the seven-item Generalized Anxiety Disorder Scale (≥10 points) for GAD-related symptoms and the Mini-SPIN (≥6 points) for SAD-related symptoms. RESULTS Self-reported generalized anxiety and social anxiety were both significantly associated with various perceived difficulties in school among this adolescent general population sample. Noncomorbid and comorbid GAD and SAD symptoms were both associated with an increased risk of academic and social difficulties, even when controlling for school performance. Comorbid symptoms were associated with significantly higher rates of social difficulties than noncomorbid symptoms of GAD or SAD. Furthermore, GAD symptoms were associated with a high risk for academic difficulties, irrespective of comorbidity. CONCLUSIONS Excessive worry, a defining feature of GAD, is central to school-related impairments among adolescents. The present study highlights the importance of school-based interventions for anxious adolescents. Interventions to improve adolescents'; school functioning should account for the interference of pathological worry related to GAD.
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Affiliation(s)
- Kati Kajastus
- Department of Psychology, Tampere University, Tampere, Finland
| | - Henna Haravuori
- HUS Helsinki University Hospital, Helsinki, Finland
- Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland
- Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
| | - Olli Kiviruusu
- Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mauri Marttunen
- HUS Helsinki University Hospital, Helsinki, Finland
- Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
| | - Klaus Ranta
- Department of Psychology, Tampere University, Tampere, Finland
- Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
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14
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Lehtovirta M, Pahkala K, Rovio SP, Magnussen CG, Laitinen TT, Niinikoski H, Lagström H, Viikari JSA, Rönnemaa T, Jula A, Ala-Korpela M, Raitakari OT. Association of tobacco smoke exposure with metabolic profile from childhood to early adulthood: the Special Turku Coronary Risk Factor Intervention Project. Eur J Prev Cardiol 2024; 31:103-115. [PMID: 37655930 DOI: 10.1093/eurjpc/zwad285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/04/2023] [Accepted: 08/29/2023] [Indexed: 09/02/2023]
Abstract
AIMS To investigate the associations between passive tobacco smoke exposure and daily smoking with a comprehensive metabolic profile, measured repeatedly from childhood to adulthood. METHODS AND RESULTS Study cohort was derived from the Special Turku Coronary Risk Factor Intervention Project (STRIP). Smoking status was obtained by questionnaire, while serum cotinine concentrations were measured using gas chromatography. Metabolic measures were quantified by nuclear magnetic resonance metabolomics at 9 (n = 539), 11 (n = 536), 13 (n = 525), 15 (n = 488), 17 (n = 455), and 19 (n = 409) years. Association of passive tobacco smoke exposure with metabolic profile compared participants who reported less-than-weekly smoking and had serum cotinine concentration <1 ng/mL (no exposure) with those whose cotinine concentration was ≥10 ng/mL (passive tobacco smoke exposure). Associations of daily smoking with metabolic profile in adolescence were analysed by comparing participants reporting daily smoking with those reporting no tobacco use and having serum cotinine concentrations <1 ng/mL. Passive tobacco smoke exposure was directly associated with the serum ratio of monounsaturated fatty acids to total fatty acids [β = 0.34 standard deviation (SD), (0.17-0.51), P < 0.0001] and inversely associated with the serum ratios of polyunsaturated fatty acids. Exposure to passive tobacco smoke was directly associated with very-low-density lipoprotein particle size [β = 0.28 SD, (0.12-0.45), P = 0.001] and inversely associated with HDL particle size {β = -0.21 SD, [-0.34 to -0.07], P = 0.003}. Daily smokers exhibited a similar metabolic profile to those exposed to passive tobacco smoke. These results persisted after adjusting for body mass index, STRIP study group allocation, dietary target score, pubertal status, and parental socio-economic status. CONCLUSION Both passive and active tobacco smoke exposures during childhood and adolescence are detrimentally associated with circulating metabolic measures indicative of increased cardio-metabolic risk.
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Affiliation(s)
- Miia Lehtovirta
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku FI-20520, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku FI-20520, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku FI-20520, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku FI-20520, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku FI-20520, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Harri Niinikoski
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Hanna Lagström
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Department of Public Health, Turku University Hospital, University of Turku, Turku, Finland
| | - Jorma S A Viikari
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Tapani Rönnemaa
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland
| | - Mika Ala-Korpela
- Systems Epidemiology, Research Unit of Population Health, Faculty of Medicine, University of Oulu & Biocenter Oulu, Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, Turku FI-20520, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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15
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Renlund M, Tulppo MP, Kivelä A, Laivuori H, Heinonen S, Jääskeläinen T, Sarkola T. Preeclampsia-exposed children's heart rate variability 8-12 yr after index pregnancy: FINNCARE study. Am J Physiol Heart Circ Physiol 2024; 326:H74-H81. [PMID: 37921662 DOI: 10.1152/ajpheart.00540.2023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/01/2023] [Indexed: 11/04/2023]
Abstract
Preeclampsia is related with elevated systolic blood pressure (SBP) in children. We studied if preeclampsia-exposed (PE) children develop alterations in heart rate variability (HRV) and if this is reflected in their blood pressure (BP), as well as overall associations with body size and composition, gestational and perinatal factors. We examined 182 PE (46 early-onset PE) and 85 unexposed (non-PE) children 8-12 yr after preeclampsia exposure. HRV monitoring was performed 5 min in supine followed by 5 min in standing position and compared with office, 24-h ambulatory, and central BPs in relation to body anthropometrics and composition, gestational, and perinatal data. There were no major differences in HRV between PE and non-PE children. HRV in supine position was strongly associated with office and ambulatory heart rates (HRs), and HR was independently associated with office BPs. However, HRV was not related with office or 24-h SBP and PP, nor with elevated SBP in PE compared with non-PE children [adjusted mean differences for office and 24-h SBP 4.8 (P < 0.001) and 2.5 mmHg (P = 0.049), respectively]. In supine position, high-frequency (HF) power [β, -0.04 (95% CI -0.06 to -0.01)], root mean square of successive differences in R-R intervals (rMSSD) [-0.015 (-0.028 to -0.002)], and the ratio of low-frequency (LF) to HF power [0.03 (0.01-0.04)] were independently associated with child fat mass. LF and HF power and rMSSD displayed independent inverse associations with child age. There were no significant associations between child HRV and gestational and perinatal factors. During prepuberty, the HRV in children with PE is similar to that in non-PE children. Elevated SBP following preeclampsia exposure is not related with HRV. Child adiposity could be related to decreased cardiac vagal tone.NEW & NOTEWORTHY Heart rate variability in preadolescent children exposed to preeclampsia in utero is no different from age-matched controls. Preeclampsia-exposed children's elevated SBP is not related to alterations in heart rate variability, which is a noninvasive measure of the modulation of heart rate by autonomic tone. However, childhood adiposity might be coupled with diminished cardiac vagal tone.
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Affiliation(s)
- Michelle Renlund
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Mikko P Tulppo
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anni Kivelä
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Technology, Tampere Center for Child, Adolescent, and Maternal Health Research, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Tiina Jääskeläinen
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Taisto Sarkola
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
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Jalanko P, Säisänen L, Kallioniemi E, Könönen M, Lakka TA, Määttä S, Haapala EA. Associations between physical fitness and cerebellar gray matter volume in adolescents. Scand J Med Sci Sports 2024; 34:e14513. [PMID: 37814505 DOI: 10.1111/sms.14513] [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: 03/31/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
Despite the importance of the developing cerebellum on cognition, the associations between physical fitness and cerebellar volume in adolescents remain unclear. We explored the associations of physical fitness with gray matter (GM) volume of VI, VIIb and Crus I & II, which are cerebellar lobules related to cognition, in 40 (22 females; 17.9 ± 0.8 year-old) adolescents, and whether the associations were sex-specific. Peak oxygen uptake (V̇O2peak ) and power were assessed by maximal ramp test on a cycle ergometer, muscular strength with standing long jump (SLJ), speed-agility with the shuttle-run test (SRT), coordination with the Box and Block Test (BBT) and neuromuscular performance index (NPI) as the sum of SLJ, BBT and SRT z-scores. Body composition was measured using a dual-energy X-ray absorptiometry. Cerebellar volumes were assessed by magnetic resonance imaging. V̇O2peak relative to lean mass was inversely associated with the GM volume of the cerebellum (standardized regression coefficient (β) = -0.038, 95% confidence interval (CI) -0.075 to 0.001, p = 0.044). Cumulative NPI was positively associated with the GM volume of Crus I (β = 0.362, 95% CI 0.045 to 0.679, p = 0.027). In females, better performance in SRT was associated with a larger GM volume of Crus I (β = -0.373, 95% CI -0.760 to -0.028, p = 0.036). In males, cumulative NPI was inversely associated with the GM volume of Crus II (β = -0.793, 95% CI -1.579 to -0.008 p = 0.048). Other associations were nonsignificant. In conclusion, cardiorespiratory fitness, neuromuscular performance and speed-agility were associated with cerebellar GM volume, and the strength and direction of associations were sex-specific.
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Affiliation(s)
- Petri Jalanko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Helsinki Clinic for Sports and Exercise Medicine (HULA), Foundation for Sports and Exercise Medicine, Helsinki, Finland
| | - Laura Säisänen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Neurophysiology/Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Elisa Kallioniemi
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Mervi Könönen
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Sara Määttä
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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17
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Ojala R, Hentilä J, Lietzén MS, Arponen M, Heiskanen MA, Honkala SM, Virtanen H, Koskensalo K, Lautamäki R, Löyttyniemi E, Parkkola R, Heinonen OJ, Malm T, Lahti L, Rinne J, Eskola O, Rajander J, Pietiläinen KH, Kaprio J, Ivaska KK, Hannukainen JC. Bone marrow metabolism is affected by body weight and response to exercise training varies according to anatomical location. Diabetes Obes Metab 2024; 26:251-261. [PMID: 37818602 DOI: 10.1111/dom.15311] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023]
Abstract
AIM High body weight is a protective factor against osteoporosis, but obesity also suppresses bone metabolism and whole-body insulin sensitivity. However, the impact of body weight and regular training on bone marrow (BM) glucose metabolism is unclear. We studied the effects of regular exercise training on bone and BM metabolism in monozygotic twin pairs discordant for body weight. METHODS We recruited 12 monozygotic twin pairs (mean ± SD age 40.4 ± 4.5 years; body mass index 32.9 ± 7.6, mean difference between co-twins 7.6 kg/m2 ; eight female pairs). Ten pairs completed the 6-month long training intervention. We measured lumbar vertebral and femoral BM insulin-stimulated glucose uptake (GU) using 18 F-FDG positron emission tomography, lumbar spine bone mineral density and bone turnover markers. RESULTS At baseline, heavier co-twins had higher lumbar vertebral BM GU (p < .001) and lower bone turnover markers (all p < .01) compared with leaner co-twins but there was no significant difference in femoral BM GU, or bone mineral density. Training improved whole-body insulin sensitivity, aerobic capacity (both p < .05) and femoral BM GU (p = .008). The training response in lumbar vertebral BM GU was different between the groups (time × group, p = .02), as GU tended to decrease in heavier co-twins (p = .06) while there was no change in leaner co-twins. CONCLUSIONS In this study, regular exercise training increases femoral BM GU regardless of weight and genetics. Interestingly, lumbar vertebral BM GU is higher in participants with higher body weight, and training counteracts this effect in heavier co-twins even without reduction in weight. These data suggest that BM metabolism is altered by physical activity.
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Affiliation(s)
- Ronja Ojala
- Turku PET Centre, University of Turku, Turku, Finland
| | | | | | - Milja Arponen
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Marja A Heiskanen
- Turku PET Centre, University of Turku, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | | | | | - Kalle Koskensalo
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | | | | | - Riitta Parkkola
- Department of Radiology, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre, Department of Health and Physical Activity, University of Turku, Turku, Finland
| | - Tarja Malm
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Leo Lahti
- Department of Computing, University of Turku, Turku, Finland
| | - Juha Rinne
- Turku PET Centre, University of Turku, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Olli Eskola
- Radiopharmaceutical Chemistry Laboratory, Turku PET Centre, University of Turku, Turku, Finland
| | - Johan Rajander
- Turku PET Centre, Accelerator Laboratory, Åbo Akademi University, Turku, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Healthy Weight Hub, Abdominal Center, Endocrinology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Kaisa K Ivaska
- Institute of Biomedicine, University of Turku, Turku, Finland
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18
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Korpimäki S, Rovio SP, Juonala M, Hutri-Kähönen N, Lehtimäki T, Laitinen TP, Tossavainen P, Jokinen E, Loo BM, Männistö S, Tammelin T, Haarala A, Aatola H, Komar G, Viikari J, Raitakari O, Kähönen M, Pahkala K. Nonalcoholic Fatty Liver Disease Incidence and Remission and Their Predictors During 7 Years of Follow-up Among Finns. J Clin Endocrinol Metab 2023; 109:e291-e305. [PMID: 37463486 PMCID: PMC10735312 DOI: 10.1210/clinem/dgad418] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/12/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
CONTEXT The incidence and remission of nonalcoholic fatty liver disease (NAFLD) are sparsely studied outside Asia. OBJECTIVE This prospective study aimed to investigate NAFLD incidence and remission, and their predictors among a general Finnish population. METHODS The applied cohort included 1260 repeatedly studied middle-aged participants with data on liver ultrasound and no excessive alcohol intake. Hepatic steatosis was assessed by liver ultrasound with a 7.2-year study interval. Comprehensive data on health parameters and lifestyle factors were available. RESULTS At baseline, 1079 participants did not have NAFLD, and during the study period 198 of them developed NAFLD. Of the 181 participants with NAFLD at baseline, 40 achieved NAFLD remission. Taking multicollinearity into account, key predictors for incident NAFLD were baseline age (odds ratio 1.07; 95% CI, 1.02-1.13; P = .009), waist circumference (WC) (2.77, 1.91-4.01 per 1 SD; P < .001), and triglycerides (2.31, 1.53-3.51 per 1 SD; P < .001) and alanine aminotransferase (ALAT) (1.90, 1.20-3.00 per 1 SD; P = .006) concentrations as well as body mass index (BMI) change (4.12, 3.02-5.63 per 1 SD; P < .001). Predictors of NAFLD remission were baseline aspartate aminotransferase (ASAT) concentration (0.23, 0.08-0.67 per 1 SD; P = .007) and WC change (0.38, 0.25-0.59 per 1 SD; P < .001). CONCLUSION During follow-up, NAFLD developed for every fifth participant without NAFLD at baseline, and one-fifth of those with NAFLD at baseline had achieved NAFLD remission. NAFLD became more prevalent during the follow-up period. From a clinical perspective, key factors predicting NAFLD incidence and remission were BMI and WC change independent of their baseline level.
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Affiliation(s)
- Satu Korpimäki
- Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, 20520 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, 20520 Turku, Finland
| | - Markus Juonala
- Division of Medicine, Turku University Hospital, 20521 Turku, Finland
- Department of Medicine, University of Turku, 20500 Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center—Tampere, Tampere University, 33100 Tampere, Finland
| | - Tomi P Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, 70211 Kuopio, Finland
| | - Päivi Tossavainen
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, MRC Oulu and Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, 00290 Helsinki, Finland
| | - Britt-Marie Loo
- Joint Clinical Biochemistry Laboratory, Turku University Hospital and University of Turku, 20500 Turku, Finland
| | - Satu Männistö
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Tuija Tammelin
- Likes, School of Health and Social Studies, Jamk University of Applied Sciences, 40101 Jyväskylä, Finland
| | - Atte Haarala
- Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Heikki Aatola
- Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Gaber Komar
- Department of Radiology, Turku University Hospital, 20521 Turku, Finland
| | - Jorma Viikari
- Division of Medicine, Turku University Hospital, 20521 Turku, Finland
- Department of Medicine, University of Turku, 20500 Turku, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, 20520 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, 20520 Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital and University of Turku, 20500 Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, 20520 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, 20520 Turku, Finland
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, 20500 Turku, Finland
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19
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Koivisto MK, Puljula J, Levola JM, Mustonen A, Miettunen J, Alakokkare AE, Niemelä S. Adolescent alcohol and cannabis use as risk factors for head trauma in the Northern Finland Birth Cohort study 1986. Eur J Public Health 2023; 33:1115-1121. [PMID: 37616019 PMCID: PMC10710361 DOI: 10.1093/eurpub/ckad151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the associations between cannabis use and frequency of alcohol intoxication in adolescence with the risk of traumatic brain injury and craniofacial fractures in early adulthood. Hypothesis was that using alcohol and cannabis in adolescence could increase the risk for head traumas. METHODS Data from the Northern Finland Birth Cohort 1986 (n = 9432 individuals) were used to investigate the prospective association between the self-reported frequency of alcohol intoxication (n = 6472) and cannabis use (n = 6586) in mid-adolescence and register-based, head trauma diagnoses by ages 32-33 years. To test the robustness of these associations, the statistical models were adjusted for a range of other confounders such as illicit drug use, previous head trauma and self-reported mental health problems. RESULTS In multivariate analyses, cannabis use was statistically significantly associated with a greater risk of traumatic brain injury among females [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.1-3.2, P = 0.024). Frequent alcohol intoxication was a statistically significant independent risk factor for both traumatic brain injury (HR 2.6, 95% CI 1.7-3.9, P < 0.001) and craniofacial fractures (HR 2.7, 95% CI 1.6-4.8, P < 0.001) among males. CONCLUSIONS Cannabis use in adolescence appears to associate independently with elevated risk for traumatic brain injury among females, and frequent alcohol intoxication in adolescence seems to associate with elevated risk of both traumatic brain injury and craniofacial fractures among males.
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Affiliation(s)
- Maarit K Koivisto
- Department of Psychiatry, University of Turku, Turku, Finland
- Emergency Services, TYKS Acute, Turku University Hospital, Turku, Finland
| | - Jussi Puljula
- Department of Neurology, Lapland Central Hospital, Rovaniemi, Finland
| | - Jonna M Levola
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Mustonen
- Faculty of Medicine and Health Technology, University Consortium of Seinäjoki, Tampere University, Tampere, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Psychiatry, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anni-Emilia Alakokkare
- Department of Psychiatry, University of Turku, Turku, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Turku, Finland
- Addiction Psychiatry Unit, Department of Psychiatry, Hospital District of South-West, Turku, Finland
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20
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Heikkilä L, Korpelainen R, Aira T, Alanko L, Heinonen OJ, Kokko S, Parkkari J, Savonen K, Toivo K, Valtonen M, Vasankari T, Villberg J, Vanhala M. Is health promotion in sports clubs associated with adolescent participants' fruit and vegetable consumption? Eur J Public Health 2023; 33:1102-1108. [PMID: 37665763 PMCID: PMC10710333 DOI: 10.1093/eurpub/ckad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Although sports clubs' potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs' health promotion orientation, as well as associations between sports clubs' health promotion orientation, coaches' nutritional discussions and sports club participants' (SPs') fruit and/or vegetable consumption. METHODS The cross-sectional study included 554 SPs aged 14-16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs' health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0-22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations. RESULTS Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5-21). SPs' daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23-5.42, P < 0.001], better self-rated health (OR 3.26, 95% CI 1.13-9.41, P = 0.03), higher average school grades (OR 1.67, 95% CI 1.04-2.67, P = 0.03), and SPs' responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41-3.14, P < 0.001). CONCLUSION Although sports clubs' orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches' nutritional discussions were associated with adolescents' fruit and/or vegetable consumption.
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Affiliation(s)
- Laura Heikkilä
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuula Aira
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Sports Medicine Clinic, Foundation for Sports and Exercise Clinic, Helsinki, Finland
- Sports and Exercise Medicine Clinic, Central Finland Hospital Nova, Jyväskylä, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Physical Activity and Health, University of Turku, Turku, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland
- UKK Institute of Health Promotion Research, Tampere, Finland
| | - Maarit Valtonen
- Finnish Institute of High Performance Sports KIHU, Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marja Vanhala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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21
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Rouvinen H, Turunen H, Lindfors P, Kinnunen JM, Rimpelä A, Koivusilta L, Kulmala M, Dadaczynski K, Okan O, Sormunen M. Online health information-seeking behaviour and mental well-being among Finnish higher education students during COVID-19. Health Promot Int 2023; 38:daad143. [PMID: 37935171 PMCID: PMC10635413 DOI: 10.1093/heapro/daad143] [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] [Indexed: 11/09/2023] Open
Abstract
Online health information-seeking behaviour has increased since the World Health Organization declared COVID-19 a global pandemic in March 2020. This study examined whether health-related information on COVID-19 searched on the internet was associated with mental well-being among higher education students. A cross-sectional internet survey was conducted among 18- to 34-year-old students in Finland (N = 2976; mean age 24.61 years and median 24) in the spring of 2020. The data were analysed using descriptive statistics, Pearson's chi-square tests, Kruskal-Wallis nonparametric H tests, and a two-way ANOVA. The results indicated that most students (86% of females, 82% of males) used the internet to search for information on COVID-19. Students' self-perceived abilities to determine the relevance of online information on COVID-19 were associated with mental well-being.
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Affiliation(s)
- Hanna Rouvinen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Yliopistonrinne 3, Canthia Building, PO Box 1627, FI-70211 Kuopio, Finland
| | - Hannele Turunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Yliopistonrinne 3, Canthia Building, PO Box 1627, FI-70211 Kuopio, Finland
- Wellbeing Services County of North Savo, PO Box 1711, FI-70211 Kuopio, Finland
| | - Pirjo Lindfors
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Arvo Ylpön katu 34, FI-33014 Tampere, Finland
| | - Jaana M Kinnunen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Arvo Ylpön katu 34, FI-33014 Tampere, Finland
| | - Arja Rimpelä
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Arvo Ylpön katu 34, FI-33014 Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Elämänaukio 2, FI-33520 Tampere, Finland
| | - Leena Koivusilta
- Department of Social Research, Faculty of Social Sciences, University of Turku, FI-20014, Turku, Finland
| | - Markus Kulmala
- Research Centre for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Keskussairaalankatu 4, Building Liikunta (L), PO Box 35, FI-40014 Jyväskylä, Finland
| | - Kevin Dadaczynski
- Department of Health Science, Fulda University of Applied Sciences, Fulda, Germany
- Centre for Applied Health Science, Leuphana University, Lueneburg, Germany
| | - Orkan Okan
- Center for Health and Medicine in Society and Center for Health Promotion and Prevention Childhood and Adolescence, Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Marjorita Sormunen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Yliopistonrinne 3, Canthia building, PO Box 1627, FI-70211 Kuopio, Finland
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22
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Liimatta J, Flück CE, Mäntyselkä A, Häkkinen MR, Auriola S, Voutilainen R, Jääskeläinen J, Lakka TA. Effects of 2-Year Physical Activity and Dietary Intervention on Adrenarchal and Pubertal Development: The PANIC Study. J Clin Endocrinol Metab 2023; 108:e1603-e1613. [PMID: 37329220 PMCID: PMC10655527 DOI: 10.1210/clinem/dgad367] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/10/2023] [Accepted: 06/15/2023] [Indexed: 06/18/2023]
Abstract
CONTEXT Childhood overweight has been linked to earlier development of adrenarche and puberty, but it remains unknown if lifestyle interventions influence sexual maturation in general populations. OBJECTIVE To investigate if a 2-year lifestyle intervention influences circulating androgen concentrations and sexual maturation in a general population of children. METHODS We conducted a 2-year physical activity and dietary intervention study in which 421 prepubertal and mostly normal-weight 6- to 9-year-old children were allocated either to a lifestyle intervention group (119 girls, 132 boys) or a control group (84 girls, 86 boys). The main outcome measures were serum dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A4), and testosterone concentrations, and clinical adrenarchal and pubertal signs. RESULTS The intervention and control groups had no differences in body size and composition, clinical signs of androgen action, and serum androgens at baseline. The intervention attenuated the increase of DHEA (P = .032), DHEAS (P = .001), A4 (P = .003), and testosterone (P = .007) and delayed pubarche (P = .038) in boys but it only attenuated the increase of DHEA (P = .013) and DHEAS (P = .003) in girls. These effects of lifestyle intervention on androgens and the development of pubarche were independent of changes in body size and composition, but the effects of intervention on androgens were partly explained by changes in fasting serum insulin. CONCLUSION A combined physical activity and dietary intervention attenuates the increase of serum androgen concentrations and sexual maturation in a general population of prepubertal and mostly normal-weight children, independently of changes in body size and composition.
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Affiliation(s)
- Jani Liimatta
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
- Pediatric Endocrinology, Diabetology, and Metabolism, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Christa E Flück
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
- Pediatric Endocrinology, Diabetology, and Metabolism, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Aino Mäntyselkä
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Merja R Häkkinen
- School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Health Security, Finnish Institute for Health and Welfare (THL), 70701 Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland
| | - Raimo Voutilainen
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Jarmo Jääskeläinen
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland, 70029 Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, 70029 Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, 70210 Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, 70211 Kuopio, Finland
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23
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Forsström V, Toivonen L, Homil K, Waris M, Pedersen CET, Bønnelykke K, Jartti T, Peltola V. Association of Asthma Risk Alleles With Acute Respiratory Tract Infections and Wheezing Illnesses in Young Children. J Infect Dis 2023; 228:990-998. [PMID: 36967681 PMCID: PMC10582910 DOI: 10.1093/infdis/jiad075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/21/2022] [Accepted: 04/03/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Genome-wide association studies have identified several risk alleles for early childhood asthma, particularly in the 17q21 locus and in the cadherin-related family member 3 (CDHR3) gene. Contribution of these alleles to the risk of acute respiratory tract infections (ARI) in early childhood is unclear. METHODS We analyzed data from the STEPS birth-cohort study of unselected children and the VINKU and VINKU2 studies on children with severe wheezing illness. Genome-wide genotyping was performed on 1011 children. We analyzed the association between 11 preselected asthma risk alleles and the risk of ARIs and wheezing illnesses of various viral etiologies. RESULTS The asthma risk alleles in CDHR3, GSDMA, and GSDMB were associated with an increased rate of ARIs (for CDHR3, incidence rate ratio [IRR], 1.06; 95% confidence interval [CI], 1.01-1.12; P = .02), and risk allele in CDHR3 gene with rhinovirus infections (IRR, 1.10; 95% CI, 1.01-1.20, P = .03). Asthma risk alleles in GSDMA, GSDMB, IKZF3, ZPBP2, and ORMDL3 genes were associated with wheezing illnesses in early childhood, especially rhinovirus-positive wheezing illnesses. CONCLUSIONS Asthma risk alleles were associated with an increased rate of ARIs and an increased risk of viral wheezing illnesses. Nonwheezing and wheezing ARIs and asthma may have shared genetic risk factors. Clinical Trials Registration. NCT00494624 and NCT00731575.
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Affiliation(s)
- Ville Forsström
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Laura Toivonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Kiara Homil
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Matti Waris
- Virology Unit, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Casper-Emil T Pedersen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tuomas Jartti
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
- Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology, University of Oulu, Oulu, Finland
- Department of Pediatrics and Adolescent Medicine, University of Oulu, Oulu, Finland
| | - Ville Peltola
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
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Renlund M, Jääskeläinen T, Kivelä A, Heinonen S, Laivuori H, Sarkola T. Determinants of vascular structure and function in at-risk children born to mothers managed for pre-eclampsia (FINNCARE study). Front Cardiovasc Med 2023; 10:1264921. [PMID: 37859683 PMCID: PMC10582712 DOI: 10.3389/fcvm.2023.1264921] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/13/2023] [Indexed: 10/21/2023] Open
Abstract
Background and aim Pre-eclampsia (PE) is related to elevated blood pressure (BP) in children. The study aims to investigate if elevated BP is reflected in child arterial health and how anthropometrics, body composition, and gestational and perinatal factors influenced this. Methods In this prospective cohort study, we assessed the arteries of 182 children exposed (46 had an early onset, with a diagnosis before 34 gestational weeks, and 136 had a late onset) and 85 children unexposed (non-PE) to PE at 8-12 years from delivery using ultra-high-frequency ultrasound in addition to ambulatory and central BPs, body composition and anthropometrics, and tonometry-derived pulse wave velocity (PWV). Results No differences were found in intima-media thickness (IMT), adventitia thickness (AT), lumen diameter (LD), local carotid artery stiffness, distensibility, or wall stress between PE-exposed and non-PE-exposed children. All children's brachial, radial, and femoral artery IMTs were associated with 24-h systolic BP (SBP) and pulse pressure, carotid-femoral PWV, and anthropometric measures. The 24-h SBP and anthropometrics, notably lean body mass, were independent predictors of peripheral artery IMTs (brachial R2 = 0.217, radial R2 = 0.208, femoral R2 = 0.214; p < 0.001). Head circumference predicted carotid artery IMT and LD (β = 0.163, p = 0.009; β = 0.417, p < 0.001, respectively), but carotid artery IMT was not associated with BP. No independent associations were found for peripheral artery ATs. Local carotid artery stiffness, distensibility, and wall stress were independently associated with adiposity. No significant associations were found between gestational or perinatal factors and child vascular health parameters. Conclusions The peripheral artery IMT of PE-exposed children is identical to that of non-PE-exposed children, but associated with BP. Adiposity is related to local carotid artery stiffness. These adverse associations in arterial health may reflect the early progression of cardiovascular disease in PE-exposed children.
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Affiliation(s)
- Michelle Renlund
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Tiina Jääskeläinen
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anni Kivelä
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital and Tampere University, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere Center for Child, Adolescent, and Maternal Health Research, Tampere, Finland
| | - Taisto Sarkola
- Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
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Täubel M, Jalanka J, Kirjavainen PV, Tuoresmäki P, Hyvärinen A, Skevaki C, Piippo-Savolainen E, Pekkanen J, Karvonen AM. Fungi in Early-Life House Dust Samples and the Development of Asthma: A Birth Cohort Study. Ann Am Thorac Soc 2023; 20:1456-1464. [PMID: 37535826 PMCID: PMC10559140 DOI: 10.1513/annalsats.202303-187oc] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/03/2023] [Indexed: 08/05/2023] Open
Abstract
Rationale: Fungal exposure has been associated with predisposing and protective effects on the development of childhood asthma. Objectives: To study whether early-life house dust mycobiota composition is associated with the development of asthma. Methods: Mycobiota were determined by amplicon sequencing from 382 dust samples collected from living room floors 2 months after birth in homes of the LUKAS cohort. Asthma status by 10.5 years of age was defined from questionnaires and assigned as ever asthma (n = 68) or current asthma (n = 27). Inhalant atopy was clinically determined at the same age. β-composition was analyzed using PERMANOVA-S, and asthma and atopy analyses were performed using discrete time hazard models and logistic regression, respectively. Results: The house dust mycobiota composition based on Bray-Curtis distance was different in the homes of children who later did or did not develop asthma. The first and the fourth axes scores of principal coordinates analysis based on Bray-Curtis were associated with ever asthma. Of the genera with the strongest correlation with these axes, the relative abundance of Boeremia, Cladosporium, Microdochium, Mycosphaerella, and Pyrenochaetopsis showed protective associations with asthma. None of these associations remained significant after mutual adjustment among the five genera or when mutually adjusted for other microbial cell wall markers and previously identified asthma-protective bacterial indices. Neither fungal α-diversity nor load was associated with asthma in the whole population, but higher fungal richness was a risk factor among children on farms. Higher fungal loads (measured via quantitative polymerase chain reaction) in house dust were associated with the risk of inhalant atopy. Conclusions: The results of our analyses from this well-characterized birth cohort suggest that the early-life house dust mycobiota in Finnish homes, characterized via DNA amplicon sequencing, do not have strong predisposing or protective effects on asthma development.
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Affiliation(s)
- Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Jonna Jalanka
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Pirkka V. Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Pauli Tuoresmäki
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Anne Hyvärinen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany
- Universities of Giessen and Marburg Lung Center, German Center for Lung Research, Marburg, Germany
| | | | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne M. Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
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Lintuaho R, Saltychev M, Pentti J, Vahtera J, Stenholm S. Physical activity and self-rated health during retirement transition: a multitrajectory analysis of concurrent changes among public sector employees. BMJ Open 2023; 13:e073876. [PMID: 37775283 PMCID: PMC10546116 DOI: 10.1136/bmjopen-2023-073876] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVES The aim of the study was to evaluate concurrent changes in physical activity and self-rated health during retirement transition over 4 years by multivariate trajectory analysis and to examine whether sociodemographic and lifestyle factors predict the probability of being classified to a certain subgroup of observed changes. DESIGN Prospective cohort study. SETTING Public sector employees. PARTICIPANTS 3550 participants of the Finnish Retirement and Aging study. PRIMARY AND SECONDARY OUTCOME MEASURES Participants estimated on a yearly questionnaire their weekly hours of different types of activities converted to metabolic equivalent of task-hour/week. Self-rated health was assessed on a 5-point Likert-like scale from poor to excellent and dichotomised as suboptimal and optimal. Multivariate trajectory analysis was used to distinguish different subgroups of trajectories. Multinomial regression analysis was used to describe the associations between covariates and the probability of being classified to a certain trajectory group. RESULTS Three trajectory groups were identified, all displaying increasing activity during retirement with a simultaneous decrease in perceived suboptimal health. Physical activity peaked at 18 months after retirement and then slightly decreased, except for initially highly physically active participants (9%) with good self-rated health, who demonstrated a constant high level of physical activity. Male gender, professional occupation, being married or cohabiting, body mass index <30 kg/m2, not smoking and using alcohol below risk levels were associated with higher physical activity and better self-rated health. CONCLUSION Changes in physical activity and perceived health during retirement transition were interconnected. Both were improved during retirement transition, but the change was temporary. Longer follow-up studies are required to assess the changes over a longer period after retirement.
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Affiliation(s)
- Roosa Lintuaho
- Department of Emergency Medicine, TYKS Turku University Hospital, Turku, Finland
- Department of Physical and Rehabilitation Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
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27
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Huttunen-Lenz M, Raben A, Adam T, Macdonald I, Taylor MA, Stratton G, Mackintosh K, Martinez JA, Handjieva-Darlenska T, Bogdanov GA, Poppitt SD, Silvestre MP, Fogelholm M, Jalo E, Brand-Miller J, Muirhead R, Schlicht W. Socio-economic factors, mood, primary care utilization, and quality of life as predictors of intervention cessation and chronic stress in a type 2 diabetes prevention intervention (PREVIEW Study). BMC Public Health 2023; 23:1666. [PMID: 37649005 PMCID: PMC10466828 DOI: 10.1186/s12889-023-16569-9] [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: 04/24/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW study were examined. METHODS Baseline Quality of Life (QoL), social support, primary care utilization, and mood were examined as predictors of intervention cessation and chronic stress for participants aged 25 to 70 with prediabetes (n = 2,220). Moderating effects of sex and socio-economic status (SES) and independence of predictor variables of BMI were tested. RESULTS Participants with children, women, and higher SES quitted intervention earlier than those without children, lower SES, and men. Lower QoL, lack of family support, and primary care utilization were associated with cessation. Lower QoL and higher mood disturbances were associated with chronic stress. Predictor variables were independent (p ≤ .001) from BMI, but moderated by sex and SES. CONCLUSIONS Policy-based strategy in public health should consider how preventive interventions may better accommodate different individual states and life situations, which could influence intervention completion. Intervention designs should enable in-built flexibility in delivery enabling response to individual needs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01777893.
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Affiliation(s)
- Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education Schwäbisch Gmünd, Oberbettringerstraße 200, 73525, Schwäbisch Gmünd, Germany.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958, Frederiksberg, Denmark
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Ian Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, School of Life Sciences, Nottingham, NG7 2UH, UK
- Nestle Institute of Health Sciences, Nestle Research, Route du Jorat 57, 1000, Lausanne 26, CH, Switzerland
| | - Moira A Taylor
- University of Nottingham, School of Life Sciences, Nottingham, NG7 2UH, UK
| | - Gareth Stratton
- Sport and Exercise Sciences, Swansea University, Swansea, West Glamorgan, UK
| | - Kelly Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, West Glamorgan, UK
| | - J Alfredo Martinez
- Department of Medicine and Endocrinology, University of Valladolid, Valladolid, Spain
- CIBER Fisiopatología Obesidad Y Nutrición (CIBERobn), Instituto de Salud Carlos III, IMDEAfood Madrid, 28029, Madrid, Spain
| | | | - Georgi Assenov Bogdanov
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, 1000, Bulgaria
| | - Sally D Poppitt
- Department of Medicine, University of Auckland, Human Nutrition Unit, School of Biological Sciences, Auckland, 1024, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, 1024, New Zealand
- Nutrition & Metabolism, CINTESIS, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, 00014, Helsinki, Finland
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, 00014, Helsinki, Finland
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Wolfgang Schlicht
- Department of Exercise and Health Sciences, University of Stuttgart, 70569, Stuttgart, Germany
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Schwab U, Lankinen M, Uusitupa M, Laakso M. Lifestyle Intervention Guided by Group and Internet-Based Counseling in the T2D-GENE Trial Supports Its Applicability and Feasibility. Nutrients 2023; 15:nu15071787. [PMID: 37049626 PMCID: PMC10097002 DOI: 10.3390/nu15071787] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Type 2 diabetes (T2D) can be prevented or postponed by lifestyle modifications as shown by previous intervention studies. In most of these studies, participants have received resource-demanding individual counseling. In the 3-year T2D-GENE trial with lifestyle intervention, we investigated whether a less resource-demanding form of group and internet-based counseling is feasible and effective in preventing T2D in people with an increased risk for T2D. Altogether, 628 middle-aged to elderly men either with a high number or low number of T2D risk alleles were recruited. Five to seven group sessions were organized during the intervention, in addition to information and activities delivered via the web portal, and weekly monitoring of body weight and physical activity. Four-day food records with personal feedback were documented five times during the study. Of the 549 participants completing the study, over 90% participated in the group sessions and kept the food records. The four self-feedback tasks delivered during the second and the third years of the study were completed by 80-89% of the participants. In conclusion, a group and web portal-based lifestyle intervention is applicable for middle-aged to elderly men as a lifestyle modification aiming to prevent T2D.
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Affiliation(s)
- Ursula Schwab
- Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70211 Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Maria Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio and Kuopio University Hospital, 70211 Kuopio, Finland
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Silvén H, Savukoski SM, Pesonen P, Pukkala E, Ojaniemi M, Gissler M, Suvanto E, Niinimäki M. Association of genetic disorders and congenital malformations with premature ovarian insufficiency: a nationwide register-based study. Hum Reprod 2023:7109188. [PMID: 37018629 DOI: 10.1093/humrep/dead066] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/30/2023] [Indexed: 04/07/2023] Open
Abstract
STUDY QUESTION Are genetic disorders and congenital malformations associated with premature ovarian insufficiency (POI)? SUMMARY ANSWER A wide range of genetic disorder and congenital malformation diagnoses are associated with POI, especially early onset POI. WHAT IS KNOWN ALREADY POI is known to be associated with some genetic disorders, such as Turner syndrome and Fragile X premutation. Multiple genetic syndromes, such as ataxia teleangiectasia and galactosemia, have also been associated with an increased risk of POI, and many of these genetic syndromes manifest with various congenital malformations. In previous studies, a genetic aetiology has been found for 7-15% of POI cases. STUDY DESIGN, SIZE, DURATION This population-based study included 5011 women diagnosed with POI in 1988-2017. The data were collected from various national registries and covers women with POI nationwide. PARTICIPANTS/MATERIALS, SETTING, METHODS We identified 5011 women diagnosed with POI from 1988 to 2017 from the drug reimbursement registry of the Social Insurance Institution of Finland. Women with surgical POI (bilateral oophorectomy for benign indications) were not included. We selected four population controls per woman with POI matched by month and year of birth and municipality of residence. Diagnostic codes for genetic disorders and congenital malformations (GD/CM) for the cases and controls were searched from the Hospital Discharge Register. Binary logistic regression was used to compare the odds for GD/CM among cases and controls. To minimize bias, for the statistical analyses, we excluded diagnoses which were reported <2 years prior to the index date. MAIN RESULTS AND THE ROLE OF CHANCE Of the women with POI, 15.9% (n = 797) had at least one diagnostic code for GD or CM. The odds ratio (OR) for Turner syndrome was 275 (95% CI 68.1-1110), and for other sex chromosome abnormalities, it was 12.7 (95% CI 4.1-39.1). For autosomal single gene disorders, the OR was 16.5 (95% CI 6.2-43.7). Women with POI had a higher odds of having a GD/CM diagnosis in all categories. The OR for GD/CM diagnoses was highest among the youngest POI patients (10-14 years old, OR 24.1, 95% CI 15.1-38.2). The odds of having POI were higher the more GD or CM diagnoses a woman had. LIMITATIONS, REASONS FOR CAUTION Some women with POI might not have sought help for their symptoms and therefore remain undiagnosed. Due to the register-based nature of our study, we did not have access to more specific genetic diagnoses than international classification of diseases offers. WIDER IMPLICATIONS OF THE FINDINGS GD/CM diagnoses were strongly associated with POI, especially when POI was diagnosed at a young age. The risk of POI was highest in women with multiple GD/CM diagnoses. Early onset POI can be a sign of underlying genetic disorder or congenital anomaly, and this should serve as a reminder for clinicians to consider further examinations. To avoid unnecessary delay in the diagnosis of POI and starting relevant hormone replacement therapy treatment, clinicians should be aware of these associations. STUDY FUNDING/COMPETING INTEREST(S) Oulu University Hospital financially supported this work. H.S. has received personal grants from the Finnish Menopause Society, Oulu Medical Research Foundation, and Finnish Research Foundation of Gynaecology and Obstetrics. S.S. has received grants from the Finnish Menopause Society, the Finnish Medical Foundation, and the Juho Vainio Foundation. None of the authors have any competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- H Silvén
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
| | - S M Savukoski
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
| | - P Pesonen
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - E Pukkala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - M Ojaniemi
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
- Department of Pediatrics, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, Oulu, Finland
| | - M Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
- Academic Primary Health Care Centre, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - E Suvanto
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
| | - M Niinimäki
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Pohde, Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
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30
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Lukkarinen M, Kirjavainen PV, Backman K, Gonzales-Inca C, Hickman B, Kallio S, Karlsson H, Karlsson L, Keski-Nisula L, Korhonen LS, Korpela K, Kuitunen M, Kukkonen AK, Käyhkö N, Lagström H, Lukkarinen H, Peltola V, Pentti J, Salonen A, Savilahti E, Tuoresmäki P, Täubel M, Vahtera J, de Vos WM, Pekkanen J, Karvonen AM. Early-life environment and the risk of eczema at 2 years-Meta-analyses of six Finnish birth cohorts. Pediatr Allergy Immunol 2023; 34:e13945. [PMID: 37102387 DOI: 10.1111/pai.13945] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/28/2023] [Accepted: 03/07/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Urban-related nature exposures are suggested to contribute to the rising prevalence of allergic diseases despite little supporting evidence. Our aim was to evaluate the impact of 12 land cover classes and two greenness indices around homes at birth on the development of doctor-diagnosed eczema by the age of 2 years, and the influence of birth season. METHODS Data from 5085 children were obtained from six Finnish birth cohorts. Exposures were provided by the Coordination of Information on the Environment in three predefined grid sizes. Adjusted logistic regression was run in each cohort, and pooled effects across cohorts were estimated using fixed or random effect meta-analyses. RESULTS In meta-analyses, neither greenness indices (NDVI or VCDI, 250 m × 250 m grid size) nor residential or industrial/commercial areas were associated with eczema by age of 2 years. Coniferous forest (adjusted odds ratio 1.19; 95% confidence interval 1.01-1.39 for the middle and 1.16; 0.98-1.28 for the highest vs. lowest tertile) and mixed forest (1.21; 1.02-1.42 middle vs. lowest tertile) were associated with elevated eczema risk. Higher coverage with agricultural areas tended to associate with elevated eczema risk (1.20; 0.98-1.48 vs. none). In contrast, transport infrastructure was inversely associated with eczema (0.77; 0.65-0.91 highest vs. lowest tertile). CONCLUSION Greenness around the home during early childhood does not seem to protect from eczema. In contrast, nearby coniferous and mixed forests may increase eczema risk, as well as being born in spring close to forest or high-green areas.
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Affiliation(s)
- Minna Lukkarinen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Pirkka V Kirjavainen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Katri Backman
- Kuopio Birth Cohort (KuBiCo), University of Eastern Finland, Kuopio, Finland
- Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
| | | | - Brandon Hickman
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sampo Kallio
- FLORA: New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Leea Keski-Nisula
- Kuopio Birth Cohort (KuBiCo), University of Eastern Finland, Kuopio, Finland
- Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland
| | - Laura S Korhonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Katri Korpela
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Mikael Kuitunen
- FLORA: New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anna Kaarina Kukkonen
- FLORA: New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Niina Käyhkö
- Department of Geography and Geology, University of Turku, Turku, Finland
| | - Hanna Lagström
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Heikki Lukkarinen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Ville Peltola
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne Salonen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Erkki Savilahti
- FLORA: New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pauli Tuoresmäki
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Martin Täubel
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
| | - Willem M de Vos
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Juha Pekkanen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne M Karvonen
- Department of Health Security, Finnish Institute for Health and Welfare, Kuopio, Finland
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Rikkonen T, Sund R, Koivumaa-Honkanen H, Sirola J, Honkanen R, Kröger H. Effectiveness of exercise on fall prevention in community-dwelling older adults: a 2-year randomized controlled study of 914 women. Age Ageing 2023; 52:7136744. [PMID: 37097767 PMCID: PMC10128158 DOI: 10.1093/ageing/afad059] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Communal exercise interventions may help prevent falls and injuries. However, pragmatic trials demonstrating the effectiveness of such strategies are sparse. METHODS We determined whether a cost-free 12-month admission to the city's recreational sports facilities including initial 6 months of supervised weekly gym and Tai Chi sessions decreases the number of falls and related injuries. The mean (SD) follow-up time was 22·6 (4.8) months in 2016-19. A total of 914 women from a population-based sample with a mean age of 76.5 (SD 3.3, range 71.1-84.8) years were randomized into exercise intervention (n = 457) and control (n = 457) groups. Fall information was collected through biweekly short message (SMS) queries and fall diaries. Altogether 1,380 falls were recorded for the intention-to-treat analysis, with 1,281 (92.8%) being verified by telephone. RESULTS A 14.3% fall rate reduction was detected in the exercise group (Incidence rate ratio (IRR) = 0.86; CI 95% 0.77-0.95) compared with the control group. Approximately half of the falls caused moderate (n = 678, 52.8%) or severe (n = 61, 4.8%) injury. In total, 13.2% (n = 166) of falls (including 73 fractures) required medical consultation with a 38% lower fracture rate in the exercise group (IRR = 0.62; CI 95% 0.39-0.99). Overall, the greatest reduction of 41% (IRR = 0.59; CI 95% 0.36-0.99) was observed in falls with severe injury and pain. CONCLUSIONS A community-based approach for a 6-month exercise period combined with a 12-month free use of sports premises can reduce falls, fractures and other fall-related injuries in aging women.
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Affiliation(s)
- Toni Rikkonen
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland Kuopio, Finland
| | - Reijo Sund
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland Kuopio, Finland
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine (Psychiatry), University of Eastern Finland, Kuopio, Finland
- Mental Health and Wellbeing Center, Kuopio University Hospital, Kuopio, Finland
| | - Joonas Sirola
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland Kuopio, Finland
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Risto Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland Kuopio, Finland
| | - Heikki Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland Kuopio, Finland
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
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Koivuniemi E, Hart K, Mazanowska N, Ruggeri S, Egan B, Censi L, Roccaldo R, Mattila L, Buonocore P, Löyttyniemi E, Raats MM, Wielgos M, Laitinen K. Food Supplement Use Differs from the Recommendations in Pregnant Women: A Multinational Survey. Nutrients 2022; 14:2909. [PMID: 35889867 PMCID: PMC9322729 DOI: 10.3390/nu14142909] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/01/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
The aim was to investigate, among pregnant women, (1) the use of food supplements and (2) the awareness of food supplement recommendations and beliefs about food supplement use in four European countries: Finland, Italy, Poland, and the United Kingdom. The participants (n = 1804) completed an online questionnaire with predefined statements. Daily intakes of vitamins and minerals were calculated using uploaded pictures or weblinks of the supplement packages. Country differences were assessed. Most participants (91%) used at least one food supplement during pregnancy. A prenatal multivitamin was the most commonly used supplement type (84% of the users), and 75% of the participants thought consumption of multivitamin is recommended. Of the participants, 81% knew that folic acid is recommended during pregnancy while 58% knew the recommendation for vitamin D. In 19% of the supplement users, the daily safe upper intake limit of at least one nutrient was exceeded. Nevertheless, most participants agreed that they knew which supplements (91%) and doses of supplements (87%) needed to be used during pregnancy. To conclude, the majority of the participants used food supplements, but lower proportions knew and adhered to the recommended intakes. Between-country differences were observed in the use and knowledge of and beliefs regarding supplements. The results suggest a need for assessment and monitoring of supplement use in antenatal care to ensure appropriate use.
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Affiliation(s)
- Ella Koivuniemi
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
| | - Kathryn Hart
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK;
| | - Natalia Mazanowska
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.M.); (M.W.)
| | - Stefania Ruggeri
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Bernadette Egan
- Food, Consumer Behaviour and Health (FCBH) Research Centre, University of Surrey, Guildford GU2 7XH, UK; (B.E.); (M.M.R.)
| | - Laura Censi
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Romana Roccaldo
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Lilja Mattila
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
| | - Pasquale Buonocore
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Eliisa Löyttyniemi
- Biostatistics, Department of Clinical Medicine, University of Turku, 20014 Turku, Finland;
| | - Monique M. Raats
- Food, Consumer Behaviour and Health (FCBH) Research Centre, University of Surrey, Guildford GU2 7XH, UK; (B.E.); (M.M.R.)
| | - Miroslaw Wielgos
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.M.); (M.W.)
| | - Kirsi Laitinen
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
- Functional Foods Forum, University of Turku, 20014 Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, 20521 Turku, Finland
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Cheng Y, Li Y, Scherer N, Grundner-Culemann F, Lehtimäki T, Mishra BH, Raitakari OT, Nauck M, Eckardt KU, Sekula P, Schultheiss UT. Genetics of osteopontin in patients with chronic kidney disease: The German Chronic Kidney Disease study. PLoS Genet 2022; 18:e1010139. [PMID: 35385482 PMCID: PMC9015153 DOI: 10.1371/journal.pgen.1010139] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/18/2022] [Accepted: 03/09/2022] [Indexed: 11/18/2022] Open
Abstract
Osteopontin (OPN), encoded by SPP1, is a phosphorylated glycoprotein predominantly synthesized in kidney tissue. Increased OPN mRNA and protein expression correlates with proteinuria, reduced creatinine clearance, and kidney fibrosis in animal models of kidney disease. But its genetic underpinnings are incompletely understood. We therefore conducted a genome-wide association study (GWAS) of OPN in a European chronic kidney disease (CKD) population. Using data from participants of the German Chronic Kidney Disease (GCKD) study (N = 4,897), a GWAS (minor allele frequency [MAF]≥1%) and aggregated variant testing (AVT, MAF<1%) of ELISA-quantified serum OPN, adjusted for age, sex, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR) was conducted. In the project, GCKD participants had a mean age of 60 years (SD 12), median eGFR of 46 mL/min/1.73m2 (p25: 37, p75: 57) and median UACR of 50 mg/g (p25: 9, p75: 383). GWAS revealed 3 loci (p<5.0E-08), two of which replicated in the population-based Young Finns Study (YFS) cohort (p<1.67E-03): rs10011284, upstream of SPP1 encoding the OPN protein and related to OPN production, and rs4253311, mapping into KLKB1 encoding prekallikrein (PK), which is processed to kallikrein (KAL) implicated through the kinin-kallikrein system (KKS) in blood pressure control, inflammation, blood coagulation, cancer, and cardiovascular disease. The SPP1 gene was also identified by AVT (p = 2.5E-8), comprising 7 splice-site and missense variants. Among others, downstream analyses revealed colocalization of the OPN association signal at SPP1 with expression in pancreas tissue, and at KLKB1 with various plasma proteins in trans, and with phenotypes (bone disorder, deep venous thrombosis) in human tissue. In summary, this GWAS of OPN levels revealed two replicated associations. The KLKB1 locus connects the function of OPN with PK, suggestive of possible further post-translation processing of OPN. Further studies are needed to elucidate the complex role of OPN within human (patho)physiology.
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Affiliation(s)
- Yurong Cheng
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Yong Li
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
| | - Nora Scherer
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Freiburg, Germany
| | - Franziska Grundner-Culemann
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Binisha H. Mishra
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku Finland
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Nephrology and Medical Intensive Care, Charité, University-Medicine, Berlin, Germany
| | - Peggy Sekula
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
| | - Ulla T. Schultheiss
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
- Department of Medicine IV, Nephrology and Primary Care, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
- * E-mail:
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Suur-Uski J, Pietiläinen O, Rahkonen O, Lallukka T. Trajectories of working hours in later careers and their association with social and health-related factors: a follow-up study. Eur J Public Health 2022; 32:66-72. [PMID: 34608930 PMCID: PMC8807068 DOI: 10.1093/eurpub/ckab179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The aim was to identify working hours' trajectories in later work careers over a follow-up of 15-17 years and to examine their association with social factors and health. METHODS A subsample from the Helsinki Health Study was extracted comprising employees of the City of Helsinki, Finland. Growth mixture modelling was used to identify different working hour trajectories. Age, gender, occupational class, marital status, health behaviour, physical and mental functioning and current pain were associated with trajectory membership. Relative risks (RRs) and their 95% confidence intervals (CIs) were estimated. RESULTS A two-trajectory model was selected: 'Stable regular working hours' (90%) and 'Shorter and varying working hours' (10%). Women (RR 1.40, 95% CI 1.09-1.78), the oldest employees (RR 2.71, 95% CI 2.06-3.57), managers and professionals (RR 1.56, 95% CI 1.20-2.02), those reporting non-drinker (RR 1.66, 95% CI 1.32-2.10), those reporting sleeping more than 8 h per night (RR 1.74 95% CI 1.25-2.42) and those reporting poor mental functioning (RR 1.39 95% CI 1.15-1.68) had higher likelihood of belonging to the trajectory 'Shorter and varying working hours'. There were no differences between the trajectories in marital status, smoking, body mass index, current pain or physical functioning. However, routine non-manual workers (RR 0.74, 95% CI 0.55-0.98), and semi-professionals (RR 0.70, 95% CI 0.50-0.96) had lower likelihood of belonging to this trajectory. CONCLUSIONS Trajectories of working hours in later work career differ by age, gender and occupational class but also by health behaviours and mental health functioning.
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Affiliation(s)
- Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
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35
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Lehtisalo J, Rusanen M, Solomon A, Antikainen R, Laatikainen T, Peltonen M, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M, Ngandu T. Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial. Eur Heart J 2022; 43:2054-2061. [PMID: 35051281 PMCID: PMC9156384 DOI: 10.1093/eurheartj/ehab922] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 01/01/2023] Open
Abstract
AIMS Joint prevention of cardiovascular disease (CVD) and dementia could reduce the burden of both conditions. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated a beneficial effect on cognition (primary outcome) and we assessed the effect of this lifestyle intervention on incident CVD (pre-specified secondary outcome). METHODS AND RESULTS FINGER enrolled 1259 individuals aged 60-77 years (ClinicalTrials.gov NCT01041989). They were randomized (1:1) to a 2-year multi-domain intervention with diet, physical and cognitive activity, and vascular monitoring (n = 631), or general health advice (n = 628). National registries provided data on CVD including stroke, transient ischaemic attack (TIA), or coronary heart event. During an average of 7.4 years, 229 participants (18%) had at least one CVD diagnosis: 107 in the intervention group and 122 in the control group. The incidence of cerebrovascular events was lower in the intervention than the control group: hazard ratio (HR) for combined stroke/TIA was 0.71 [95% confidence interval (CI): 0.51-0.99] after adjusting for background characteristics. Hazard ratio for coronary events was 0.84 (CI: 0.56-1.26) and total CVD events 0.80 (95% CI: 0.61-1.04). Among those with history of CVD (n = 145), the incidence of both total CVD events (HR: 0.50, 95% CI: 0.28-0.90) and stroke/TIA (HR: 0.40, 95% CI: 0.20-0.81) was lower in the intervention than the control group. CONCLUSION A 2-year multi-domain lifestyle intervention among older adults was effective in preventing cerebrovascular events and also total CVD events among those who had history of CVD. KEY QUESTION Can a 2-year multi-domain lifestyle intervention, primarily designed for prevention of cognitive impairment, prevent new cardiovascular events among older adults over an extended follow-up? KEY FINDING Among the 1259 participants aged 60-77 years, the intervention resulted in 13-20% lower cardiovascular disease (CVD) event rates (unadjusted and adjusted analyses), but with large degree of uncertainty. Cerebrovascular event rates were lower but for total CVD only among those with earlier CVD events. TAKE-HOME MESSAGE A 2-year multi-domain lifestyle intervention among older adults was effective in preventing cerebrovascular events and also total CVD events among those with a history of CVD.
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Affiliation(s)
| | | | - Alina Solomon
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Riitta Antikainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint municipal authority for North Karelia Social and Health Services (Siun sote), Development Unit, Joensuu, Finland
| | - Markku Peltonen
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
- South Ostrobothnia Central Hospital, Seinäjoki, Finland
| | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, KYS Kuopio, Finland
| | - Miia Kivipelto
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Tiia Ngandu
- Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Richardson TG, Mykkänen J, Pahkala K, Ala-Korpela M, Bell JA, Taylor K, Viikari J, Lehtimäki T, Raitakari O, Davey Smith G. Evaluating the direct effects of childhood adiposity on adult systemic metabolism: a multivariable Mendelian randomization analysis. Int J Epidemiol 2021; 50:1580-1592. [PMID: 33783488 PMCID: PMC8580280 DOI: 10.1093/ije/dyab051] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals who are obese in childhood have an elevated risk of disease in adulthood. However, whether childhood adiposity directly impacts intermediate markers of this risk, independently of adult adiposity, is unclear. In this study, we have simultaneously evaluated the effects of childhood and adulthood body size on 123 systemic molecular biomarkers representing multiple metabolic pathways. METHODS Two-sample Mendelian randomization (MR) was conducted to estimate the causal effect of childhood body size on a total of 123 nuclear magnetic resonance-based metabolic markers using summary genome-wide association study (GWAS) data from up to 24 925 adults. Multivariable MR was then applied to evaluate the direct effects of childhood body size on these metabolic markers whilst accounting for adult body size. Further MR analyses were undertaken to estimate the potential mediating effects of these circulating metabolites on the risk of coronary artery disease (CAD) in adulthood using a sample of 60 801 cases and 123 504 controls. RESULTS Univariable analyses provided evidence that childhood body size has an effect on 42 of the 123 metabolic markers assessed (based on P < 4.07 × 10-4). However, the majority of these effects (35/42) substantially attenuated when accounting for adult body size using multivariable MR. We found little evidence that the biomarkers that were potentially influenced directly by childhood body size (leucine, isoleucine and tyrosine) mediate this effect onto adult disease risk. Very-low-density lipoprotein markers provided the strongest evidence of mediating the long-term effect of adiposity on CAD risk. CONCLUSIONS Our findings suggest that childhood adiposity predominantly exerts its detrimental effect on adult systemic metabolism along a pathway that involves adulthood body size.
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Affiliation(s)
- Tom G Richardson
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Juha Mykkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Mika Ala-Korpela
- Computational Medicine, Center for Life Course Health Research, Faculty of Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Joshua A Bell
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Kurt Taylor
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Jorma Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
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Kivelä J, Sormunen-Harju H, Girchenko PV, Huvinen E, Stach-Lempinen B, Kajantie E, Villa PM, Reynolds RM, Hämäläinen EK, Lahti-Pulkkinen M, Murtoniemi KK, Laivuori H, Eriksson JG, Räikkönen K, Koivusalo SB. Longitudinal Metabolic Profiling of Maternal Obesity, Gestational Diabetes, and Hypertensive Pregnancy Disorders. J Clin Endocrinol Metab 2021; 106:e4372-e4388. [PMID: 34185058 PMCID: PMC8530734 DOI: 10.1210/clinem/dgab475] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Indexed: 12/24/2022]
Abstract
CONTEXT Comprehensive assessment of metabolism in maternal obesity and pregnancy disorders can provide information about the shared maternal-fetal milieu and give insight into both maternal long-term health and intergenerational transmission of disease burden. OBJECTIVE To assess levels, profiles, and change in the levels of metabolic measures during pregnancies complicated by obesity, gestational diabetes (GDM), or hypertensive disorders. DESIGN, SETTING AND PARTICIPANTS A secondary analysis of 2 study cohorts, PREDO and RADIEL, including 741 pregnant women. MAIN OUTCOME MEASURES We assessed 225 metabolic measures by nuclear magnetic resonance in blood samples collected at median 13 [interquartile range (IQR) 12.4-13.7], 20 (IQR 19.3-23.0), and 28 (27.0-35.0) weeks of gestation. RESULTS Across all 3 time points women with obesity [body mass index (BMI) ≥ 30kg/m2] in comparison to normal weight (BMI 18.5-24.99 kg/m2) had significantly higher levels of most very-low-density lipoprotein-related measures, many fatty and most amino acids, and more adverse metabolic profiles. The change in the levels of most metabolic measures during pregnancy was smaller in obese than in normal weight women. GDM, preeclampsia, and chronic hypertension were associated with metabolic alterations similar to obesity. The associations of obesity held after adjustment for GDM and hypertensive disorders, but many of the associations with GDM and hypertensive disorders were rendered nonsignificant after adjustment for BMI and the other pregnancy disorders. CONCLUSIONS This study shows that the pregnancy-related metabolic change is smaller in women with obesity, who display metabolic perturbations already in early pregnancy. Metabolic alterations of obesity and pregnancy disorders resembled each other suggesting a shared metabolic origin.
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Affiliation(s)
- Jemina Kivelä
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Heidi Sormunen-Harju
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Polina V Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Emilia Huvinen
- Teratology Information Service, Emergency Medicine, Department of Prehospital Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Beata Stach-Lempinen
- Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland
| | - Eero Kajantie
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pia M Villa
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Hyvinkää Hospital at Helsinki and Uusimaa Hospital District, Hyvinkää, Finland
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Esa K Hämäläinen
- Department of Clinical Chemistry, University of Eastern Finland, Kuopio, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Katja K Murtoniemi
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, University of Turku and Turku University Hospital, Turku, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Saila B Koivusalo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Koljonen L, Enlund-Cerullo M, Hauta-alus H, Holmlund-Suila E, Valkama S, Rosendahl J, Andersson S, Pekkinen M, Mäkitie O. Phosphate Concentrations and Modifying Factors in Healthy Children From 12 to 24 Months of Age. J Clin Endocrinol Metab 2021; 106:2865-2875. [PMID: 34214153 PMCID: PMC8475199 DOI: 10.1210/clinem/dgab495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 12/12/2022]
Abstract
CONTEXT Phosphate homeostasis and its modifiers in early childhood are inadequately characterized. OBJECTIVE To determine physiological plasma phosphate concentration and modifying factors in healthy infants at 12 to 24 months of age. DESIGN This study included 525 healthy infants (53% girls), who participated in a randomized vitamin D intervention trial and received daily vitamin D3 supplementation of either 10 or 30 μg from age 2 weeks to 24 months. Biochemical parameters were measured at 12 and 24 months. Dietary phosphate intake was determined at 12 months. MAIN OUTCOME MEASURES Plasma phosphate concentrations at 12 and 24 months of age. RESULTS Mean (SD) phosphate concentration decreased from 12 months (1.9 ± 0.15 mmol/L) to 24 months (1.6 ± 0.17 mmol/L) of age (P < 0.001 for repeated measurements). When adjusted by covariates, such as body size, creatinine, serum 25-hydroxyvitamin D, intact and C-terminal fibroblast growth factor 23, mean plasma phosphate was higher in boys than girls during follow-up (P = 0.019). Phosphate concentrations were similar in the vitamin D intervention groups (P > 0.472 for all). Plasma iron was associated positively with plasma phosphate at both time points (B, 0.006 and 0.005; 95% CI, 0.004-0.009 and 0.002-0.008; P < 0.001 at both time points, respectively). At 24 months of age, the main modifier of phosphate concentration was plasma creatinine (B, 0.007; 95% CI 0.003-0.011, P < 0.001). CONCLUSION Plasma phosphate concentration decreased from age 12 to 24 months. In infants and toddlers, the strongest plasma phosphate modifiers were sex, iron, and creatinine, whereas vitamin D supplementation did not modify phosphate concentrations.
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Affiliation(s)
- Laura Koljonen
- Folkhälsan Research Center, 00290 Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Maria Enlund-Cerullo
- Folkhälsan Research Center, 00290 Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Helena Hauta-alus
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
- National Institute for Health and Welfare (THL), 00271 Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, 90014 Oulu,Finland
| | - Elisa Holmlund-Suila
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Saara Valkama
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Jenni Rosendahl
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Sture Andersson
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Minna Pekkinen
- Folkhälsan Research Center, 00290 Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Outi Mäkitie
- Folkhälsan Research Center, 00290 Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, 17176 Stockholm, Sweden
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Pasanen S, Halonen JI, Pulakka A, Kestens Y, Thierry B, Brondeel R, Pentti J, Vahtera J, Leskinen T, Stenholm S. Contexts of sedentary time and physical activity among ageing workers and recent retirees: cross-sectional GPS and accelerometer study. BMJ Open 2021; 11:e042600. [PMID: 34006539 PMCID: PMC8149443 DOI: 10.1136/bmjopen-2020-042600] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES We examined sedentary time and physical activity in different contexts among ageing workers, between their workdays and days off, and recent retirees, between their weekdays and weekend days. DESIGN Cross-sectional study. SETTING Finnish Retirement and Aging study and Enhancing physical activity and healthy ageing among recent retirees-Randomised controlled in-home physical activity trial. PARTICIPANTS 137 workers (544 measurement days) and 53 retirees (323 days), who provided data for at least 1 workday/weekday and 1 day off/weekend day. PRIMARY AND SECONDARY OUTCOME MEASURES Physical activity behaviour was measured with a combined Global Positioning System and accelerometer device (SenseDoc V.2.0), providing information on sedentary time, light physical activity and moderate-to-vigorous physical activity (MVPA) by locations (home or non-home) and trips (active travel, ie, speed <20 km/hour and passive travel, ie, speed ≥20 km/hour). RESULTS Workers accumulated more sedentary time and physical activity at non-home locations than at home on workdays, while the opposite was confirmed for days off (p<0.01). Workers accrued more MVPA on days off than on workdays (34 vs 28 min, p<0.05), of which 9 min on workdays and 14 min on days off was accrued during active travel. Retirees' physical activity behaviour did not differ between weekdays and weekend days (p>0.05). Regardless of the day, retirees accumulated 33 min of daily MVPA, of which 14 min was accrued during active travel. CONCLUSIONS Workers accumulated more MVPA on days off than on workdays, and their activity behaviour varied between workdays and days off at different locations. Our results showed that a large proportion of the MVPA was accumulated during travel at slower speeds, which suggests that active travel could be a feasible way to increase MVPA among older adults. TRIAL REGISTRATION NUMBER NCT03320746.
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Affiliation(s)
- Sanna Pasanen
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaana I Halonen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anna Pulakka
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Yan Kestens
- Department of Social and Preventive Medicine, École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, Quebec, Canada
- University of Montreal Hospital Research Centre (Centre de recherche du Centre Hospitalier de l'Université de Montréal, CRCHUM), Montreal, Quebec, Canada
| | - Benoit Thierry
- University of Montreal Hospital Research Centre (Centre de recherche du Centre Hospitalier de l'Université de Montréal, CRCHUM), Montreal, Quebec, Canada
| | - Ruben Brondeel
- Department of Movement and Sport Sciences, Ghent University, Gent, Belgium
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Saarinen A, Keltikangas-Järvinen L, Viding E, Dobewall H, Kaseva K, Lehtimäki T, Raitakari O, Hintsanen M. Compassion protects against vital exhaustion and negative emotionality. Motiv Emot 2021; 45:506-517. [PMID: 34720257 PMCID: PMC8550749 DOI: 10.1007/s11031-021-09878-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 11/25/2022]
Abstract
We investigated (i) the predictive relationships of compassion with negative emotionality (a marker of susceptibility to stress) and vital exhaustion (a marker of chronic stress response) and (ii) the effect of compassion on the developmental courses of negative emotionality and vital exhaustion over a follow-up from early adulthood to middle age. We used the prospective Young Finns data (n = 1031-1495, aged 20-50). Compassion was evaluated in 1997, 2001, and 2012; and vital exhaustion and negative emotionality in 2001, 2007, and 2012. The predictive paths from compassion to vital exhaustion and negative emotionality were stronger than vice versa: high compassion predicted lower vital exhaustion and lower negative emotionality. The effect of high compassion on lower vital exhaustion and lower negative emotionality was evident from early adulthood to middle age. Overall, high compassion appears to protect against dimensions of stress from early adulthood to middle age, whereas this study found no evidence that dimensions of stress could reduce disposition to feel compassion for others' distress over a long-term follow-up. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11031-021-09878-2.
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Affiliation(s)
- Aino Saarinen
- Research Unit of Psychology, University of Oulu, Oulu, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Henrik Dobewall
- Research Unit of Psychology, University of Oulu, Oulu, Finland
| | - Kaisa Kaseva
- Cicero Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Mirka Hintsanen
- Research Unit of Psychology, University of Oulu, Oulu, Finland
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Doku DT, Neupane S, Dobewall H, Rimpelä A. Alcohol-related mortality and all-cause mortality following bereavement in two successive generations. PLoS One 2020; 15:e0243290. [PMID: 33301516 PMCID: PMC7728282 DOI: 10.1371/journal.pone.0243290] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 11/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background and aim Bereavement affects the health of the bereaved both emotionally and physically. Bereavement resulting from alcohol-related death of the previous generation (parents-first generation) may increase the risk of alcohol abuse and consequently alcohol-related mortality as well as all-cause mortality in the next generation (offspring-second generation). Furthermore, these associations can be bi-directional. However, there is no conclusive evidence of these effects, and studies exploring these intergenerational effects are rare. This study investigates these associations. Methods A longitudinal data were constructed by linking participants from the Adolescent Health and Lifestyle Surveys (AHLS) from 1979 to 1997 with census and registry-based data from Statistics Finland containing the socioeconomic status of the survey participants and their parents (N = 78610) to investigate these associations. Multivariate Cox proportional hazards models were used to calculate hazard ratios with 95% confidence intervals to determine the effect of bereavement with alcohol-related mortality and all-cause mortality. Results The findings suggest that bereavement following the death of an offspring increases the risk of both alcohol-related and all-cause mortality among both parents. The magnitude of the risk of mortality following the death of an offspring is higher for mothers than for fathers. There were no clear associations of a parent’s death with an offspring’s alcohol-related or all-cause mortality. However, generally, a father’s death seems to be protective of the risk of mortality among the offspring while a mother’s alcohol-related death slightly increased the risk of alcohol-related mortality among their offspring. Conclusions These findings emphasise the role of bereavement, particularly resulting from the death of an offspring, on alcohol-related and all-cause mortality and therefore inequalities in mortality. Furthermore, the findings highlighting the need for alcohol abuse intervention and emotional support for bereaved persons following the death of an offspring.
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Affiliation(s)
- David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
- * E-mail:
| | - Subas Neupane
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
| | - Henrik Dobewall
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
| | - Arja Rimpelä
- Faculty of Social Sciences, Tampere University, Health Sciences, Tampere, Finland
- PERLA (Tampere Centre for Childhood, Youth and Family Research), Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Pitkäniemi, Finland
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42
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Liang Y, Ngandu T, Laatikainen T, Soininen H, Tuomilehto J, Kivipelto M, Qiu C. Cardiovascular health metrics from mid- to late-life and risk of dementia: A population-based cohort study in Finland. PLoS Med 2020; 17:e1003474. [PMID: 33320852 PMCID: PMC7737898 DOI: 10.1371/journal.pmed.1003474] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Very few studies have explored the patterns of cardiovascular health (CVH) metrics in midlife and late life in relation to risk of dementia. We examined the associations of composite CVH metrics from midlife to late life with risk of incident dementia. METHODS AND FINDINGS This cohort study included 1,449 participants from the Finnish Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study, who were followed from midlife (baseline from1972 to 1987; mean age 50.4 years; 62.1% female) to late life (1998), and then 744 dementia-free survivors were followed further into late life (2005 to 2008). We defined and scored global CVH metrics based on 6 of the 7 components (i.e., smoking, physical activity, and body mass index [BMI] as behavioral CVH metrics; fasting plasma glucose, total cholesterol, and blood pressure as biological CVH metrics) following the modified American Heart Association (AHA)'s recommendations. Then, the composite global, behavioral, and biological CVH metrics were categorized into poor, intermediate, and ideal levels. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Data were analyzed with Cox proportional hazards and the Fine and Gray competing risk regression models. During the follow-up examinations, dementia was diagnosed in 61 persons in 1998 and additional 47 persons in 2005 to 2008. The fully adjusted hazard ratio (HR) of dementia was 0.71 (95% confidence interval [CI]: 0.43, 1.16; p = 0.174) and 0.52 (0.29, 0.93; p = 0.027) for midlife intermediate and ideal levels (versus poor level) of global CVH metrics, respectively; the corresponding figures for late-life global CVH metrics were 0.60 (0.22, 1.69; p = 0.338) and 0.91 (0.34, 2.41; p = 0.850). Compared with poor global CVH metrics in both midlife and late life, the fully adjusted HR of dementia was 0.25 (95% CI: 0.08, 0.86; p = 0.028) for people with intermediate global CVH metrics in both midlife and late life and 0.14 (0.02, 0.76; p = 0.024) for those with midlife ideal and late-life intermediate global CVH metrics. Having an intermediate or ideal level of behavioral CVH in both midlife and late life (versus poor level in both midlife and late life) was significantly associated with a lower dementia risk (HR range: 0.03 to 0.26; p < 0.05), whereas people with midlife intermediate and late-life ideal biological CVH metrics had a significantly increased risk of dementia (p = 0.031). Major limitations of this study include the lack of data on diet and midlife plasma glucose, high rate of attrition, as well as the limited power for certain subgroup analyses. CONCLUSIONS In this study, we observed that having the ideal CVH metrics, and ideal behavioral CVH metrics in particular, from midlife onwards is associated with a reduced risk of dementia as compared with people having poor CVH metrics. Maintaining life-long health behaviors may be crucial to reduce late-life risk of dementia.
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Affiliation(s)
- Yajun Liang
- Aging Research Center & Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tiia Ngandu
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics & Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Tiina Laatikainen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland
| | - Hilkka Soininen
- Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia and Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Miia Kivipelto
- Division of Clinical Geriatrics & Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
- Stockholms Sjukhem, Research and Development Unit, Stockholm, Sweden
- * E-mail: (MK); (CQ)
| | - Chengxuan Qiu
- Aging Research Center & Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden
- * E-mail: (MK); (CQ)
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Suorsa K, Pulakka A, Leskinen T, Pentti J, Vahtera J, Stenholm S. Changes in prolonged sedentary behaviour across the transition to retirement. Occup Environ Med 2020; 78:oemed-2020-106532. [PMID: 33203649 PMCID: PMC8142433 DOI: 10.1136/oemed-2020-106532] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/10/2020] [Accepted: 09/24/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Prolonged sedentary behaviour is associated with a higher risk of cardiometabolic diseases. This longitudinal study examined changes in daily total, prolonged (≥30 min) and highly prolonged (≥60 min) sedentary time across the transition to retirement by gender and occupational status. METHODS We included 689 aging workers (mean (SD) age before retirement 63.2 (1.6) years, 85% women) from the Finnish Retirement and Aging Study (FIREA). Sedentary time was measured annually using a wrist-worn triaxial ActiGraph accelerometer before and after retirement with on average 3.4 (range 2-4) measurement points. RESULTS Women increased daily total sedentary time by 22 min (95% CI 13 to 31), prolonged sedentary time by 34 min (95% CI 27 to 42) and highly prolonged sedentary time by 15 min (95% CI 11 to 20) in the transition to retirement, and remained at the higher level of sedentary time years after retirement. The highest increase in total and prolonged sedentary time was observed among women retiring from manual occupations. Men had more total and prolonged sedentary time compared with women before and after retirement. Although no changes in men's sedentary time were observed during the retirement transition, there was a gradual increase of 33 min (95% CI 6 to 60) in prolonged sedentary time from pre-retirement years to post-retirement years. CONCLUSION The transition to retirement was accompanied by an abrupt increase in prolonged sedentary time in women but a more gradual increase in men. The retirement transition may be a suitable time period for interventions aiming to decrease sedentary behaviour.
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Affiliation(s)
- Kristin Suorsa
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Anna Pulakka
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
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Lakka TA, Lintu N, Väistö J, Viitasalo A, Sallinen T, Haapala EA, Tompuri TT, Soininen S, Karjalainen P, Schnurr TM, Mikkonen S, Atalay M, Kilpeläinen TO, Laitinen T, Laaksonen DE, Savonen K, Brage S, Schwab U, Jääskeläinen J, Lindi V, Eloranta AM. A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children: the PANIC study. Diabetologia 2020; 63:2270-2281. [PMID: 32816094 PMCID: PMC7527318 DOI: 10.1007/s00125-020-05250-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/02/2020] [Indexed: 12/12/2022]
Abstract
AIMS/HYPOTHESIS We studied for the first time the long-term effects of a combined physical activity and dietary intervention on insulin resistance and fasting plasma glucose in a general population of predominantly normal-weight children. METHODS We carried out a 2 year non-randomised controlled trial in a population sample of 504 children aged 6-9 years at baseline. The children were allocated to a combined physical activity and dietary intervention group (306 children at baseline, 261 children at 2-year follow-up) or a control group (198 children, 177 children) without blinding. We measured fasting insulin and fasting glucose, calculated HOMA-IR, assessed physical activity and sedentary time by combined heart rate and body movement monitoring, assessed dietary factors by a 4 day food record, used the Finnish Children Healthy Eating Index (FCHEI) as a measure of overall diet quality, and measured body fat percentage (BF%) and lean body mass by dual-energy x-ray absorptiometry. The intervention effects on insulin, glucose and HOMA-IR were analysed using the intention-to-treat principle and linear mixed-effects models after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The measures of physical activity, sedentary time, diet and body composition at baseline and 2 year follow-up were entered one-by-one as covariates into the models to study whether changes in these variables might partly explain the observed intervention effects. RESULTS Compared with the control group, fasting insulin increased 4.65 pmol/l less (absolute change +8.96 vs +13.61 pmol/l) and HOMA-IR increased 0.18 units less (+0.31 vs +0.49 units) over 2 years in the combined physical activity and dietary intervention group. The intervention effects on fasting insulin (regression coefficient β for intervention effect -0.33 [95% CI -0.62, -0.04], p = 0.026) and HOMA-IR (β for intervention effect -0.084 [95% CI -0.156, -0.012], p = 0.023) were statistically significant after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The intervention had no effect on fasting glucose, BF% or lean body mass. Changes in total physical activity energy expenditure, light physical activity, moderate-to-vigorous physical activity, total sedentary time, the reported consumption of high-fat (≥60%) vegetable oil-based spreads, and FCHEI, but not a change in BF% or lean body mass, partly explained the intervention effects on fasting insulin and HOMA-IR. CONCLUSIONS/INTERPRETATION The combined physical activity and dietary intervention attenuated the increase in insulin resistance over 2 years in a general population of predominantly normal-weight children. This beneficial effect was partly mediated by changes in physical activity, sedentary time and diet but not changes in body composition. TRIAL REGISTRATION ClinicalTrials.gov NCT01803776 Graphical abstract.
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Affiliation(s)
- Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland.
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Taisa Sallinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Eero A Haapala
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuomo T Tompuri
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Sonja Soininen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
- Social and Health Center, City of Varkaus, Finland
| | - Panu Karjalainen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Theresia M Schnurr
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - David E Laaksonen
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Kai Savonen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Institute of Clinical Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Virpi Lindi
- University of Eastern Finland Library Kuopio, Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Masip G, Silventoinen K, Keski-Rahkonen A, Palviainen T, Sipilä PN, Kaprio J, Bogl LH. The genetic architecture of the association between eating behaviors and obesity: combining genetic twin modeling and polygenic risk scores. Am J Clin Nutr 2020; 112:956-966. [PMID: 32685959 PMCID: PMC7528566 DOI: 10.1093/ajcn/nqaa181] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/12/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Obesity susceptibility genes are highly expressed in the brain suggesting that they might exert their influence on body weight through eating-related behaviors. OBJECTIVES To examine whether the genetic susceptibility to obesity is mediated by eating behavior patterns. METHODS Participants were 3977 twins (33% monozygotic, 56% females), aged 31-37 y, from wave 5 of the FinnTwin16 study. They self-reported their height and weight, eating behaviors (15 items), diet quality, and self-measured their waist circumference (WC). For 1055 twins with genome-wide data, we constructed a polygenic risk score for BMI (PRSBMI) using almost 1 million single nucleotide polymorphisms. We used principal component analyses to identify eating behavior patterns, twin modeling to decompose correlations into genetic and environmental components, and structural equation modeling to test mediation models between the PRSBMI, eating behavior patterns, and obesity measures. RESULTS We identified 4 moderately heritable (h2 = 36-48%) eating behavior patterns labeled "snacking," "infrequent and unhealthy eating," "avoidant eating," and "emotional and external eating." The highest phenotypic correlation with obesity measures was found for the snacking behavior pattern (r = 0.35 for BMI and r = 0.32 for WC; P < 0.001 for both), largely due to genetic factors in common (bivariate h2 > 70%). The snacking behavior pattern partially mediated the association between the PRSBMI and obesity measures (βindirect = 0.06; 95% CI: 0.02, 0.09; P = 0.002 for BMI; and βindirect = 0.05; 95% CI: 0.02, 0.08; P = 0.003 for WC). CONCLUSIONS Eating behavior patterns share a common genetic liability with obesity measures and are moderately heritable. Genetic susceptibility to obesity can be partly mediated by an eating pattern characterized by frequent snacking. Obesity prevention efforts might therefore benefit from focusing on eating behavior change, particularly in genetically susceptible individuals.
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Affiliation(s)
- Guiomar Masip
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Karri Silventoinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | | | - Teemu Palviainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Pyry N Sipilä
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Leonie H Bogl
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Puolitaival T, Sieppi M, Pyky R, Enwald H, Korpelainen R, Nurkkala M. Health behaviours associated with video gaming in adolescent men: a cross-sectional population-based MOPO study. BMC Public Health 2020; 20:415. [PMID: 32228539 PMCID: PMC7106563 DOI: 10.1186/s12889-020-08522-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 03/12/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Playing video games, a form of sedentary behaviour, is associated with poor well-being and increased risk of morbidity due to chronic disease. However, the association between health behaviours and video gaming is poorly understood. The purpose of this population-based study was to reveal the differences in dietary habits and physical activity for adolescent men with high amount of video games on weekdays, as compared to their peers who play less often. METHODS Seven hundred ninety-six adolescent men (age: mean = 17.8, SD = 0.6) attended compulsory conscription for military service in 2013 and completed a questionnaire regarding the amount and frequency of their video gaming. They also participated in a medical examination and underwent physiological measurements. The participants who played video games more than 3 h/d on weekdays were compared with those who played 3h/d or less. The association between health behaviours and the amount of playing video gaming was analysed using multivariable logistic regression analysis. RESULTS 24.1% (n = 192) of the participants reported video gaming in excess of 3 h/d. This group had higher incidence of having low physical fitness, having poor eating habits, and being obese. No differences were found in smoking or alcohol drinking habits. Other factors, including low leisure-time physical activity (OR = 1.94; 95% CI, 1.29-2.91), low consumption of vegetables and fruits (OR = 0.83; 95% CI, 0.72-0.97), high consumption of sweetened soft drinks (OR = 1.28; 95% CI, 1.06-1.55) and high amount of sitting time (OR = 1.40; 95% CI, 1.28-1.52), explained one-fourth of the difference. CONCLUSION In this population-based study, adolescent men who played video games a lot on weekdays had lower physical fitness, were more often obese, and had poorer dietary habits, as compared to their peers who played less often. Because playing video games typically adds to a person's total sedentary time, this activity may be associated with adverse health outcomes at a very young age- especially in combination with poor health behaviours. The results of this study can be utilized to promote health interventions targeted at adolescent men so as to raise their awareness of the disadvantages of excessive video gaming.
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Affiliation(s)
- Tuulia Puolitaival
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Albertinkatu 18A, P.O. Box 365, 90100 Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
| | - Mirjam Sieppi
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Albertinkatu 18A, P.O. Box 365, 90100 Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
| | - Riitta Pyky
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Albertinkatu 18A, P.O. Box 365, 90100 Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 8000, 90014 Oulu, Finland
| | - Heidi Enwald
- Medical Research Center, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
- Information Studies, Faculty of Humanities, University of Oulu, P.O. Box 8000, 90014 Oulu, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Albertinkatu 18A, P.O. Box 365, 90100 Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
| | - Marjukka Nurkkala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Albertinkatu 18A, P.O. Box 365, 90100 Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland
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Halonen JI, Mänty M, Pietiläinen O, Kujanpää T, Kanerva N, Lahti J, Lahelma E, Rahkonen O, Lallukka T. Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders? Soc Psychiatry Psychiatr Epidemiol 2020; 55:1021-1029. [PMID: 31893288 PMCID: PMC7395011 DOI: 10.1007/s00127-019-01823-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 12/24/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Physical work exposures and common mental disorders (CMD) have been linked to increased risk of work disability, but their joint associations with disability retirement due to any cause, mental disorders or musculoskeletal diseases have not been examined. METHODS The data for exposures and covariates were from the Finnish Helsinki Health Study occupational cohort surveys in 2000-2002, 2007 and 2012. We used 12,458 observations from 6159 employees, who were 40-60 years old at baseline. CMD were measured by the General Health Questionnaire (GHQ-12, cut-off point 3+). Four self-reported work exposures (hazardous exposures, physical workload, computer and shift work) were combined with CMD and categorized as "neither", "work exposure only", "CMD only", and "both". Associations with register-based disability retirement were assessed with Cox proportional hazards models for sample survey data adjusting for confounders over 5-year follow-up. Additionally, synergy indices were calculated for the combined effects. RESULTS Those reporting CMD and high physical workload had a greater risk of disability retirement due to any cause (HR 4.26, 95% CI 3.60-5.03), mental disorders (HR 5.41, 95% CI 3.87-7.56), and musculoskeletal diseases (HR 4.46, 95% CI 3.49-5.71) when compared to those with neither. Synergy indices indicated that these associations were synergistic. Similar associations were observed for CMD and hazardous exposures, but not for combined exposures to CMD and computer or shift work. CONCLUSIONS Identification of mental health problems among employees in physically demanding jobs is important to support work ability and reduce the risk of premature exit from work due to disability.
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Affiliation(s)
- Jaana I Halonen
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland.
- Finnish Institute of Occupational Health, Työterveyslaitos, 40, 00032, Helsinki, Finland.
- Finnish Institute for Health and Welfare, 30, 00271, Helsinki, Finland.
| | - Minna Mänty
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Tero Kujanpää
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, 8000, 90014, Oulu, Finland
| | - Noora Kanerva
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, 20, 00014, Helsinki, Finland
- Finnish Institute of Occupational Health, Työterveyslaitos, 40, 00032, Helsinki, Finland
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Abstract
As the number of obese people is globally increasing, reports about the putative protective effect of obesity in life-threatening diseases, such as subarachnoid hemorrhage (SAH), are gaining more interest. This theory-the obesity paradox-is challenging to study, and the impact of obesity has remained unclear in survival of several critical illnesses, including SAH. Thus, we performed a systematic review to clarify the relation of obesity and SAH mortality. Our study protocol included systematic literature search in PubMed, Scopus, and Cochrane library databases, whereas risk-of-bias estimation and quality of each selected study were evaluated by the Critical Appraisal Skills Program and Cochrane Collaboration guidelines. A directional power analysis was performed to estimate sufficient sample size for significant results. From 176 reviewed studies, six fulfilled our eligibility criteria for qualitative analysis. One study found paradoxical effect (odds ratio, OR = 0.83 (0.74-0.92)) between morbid obesity (body mass index (BMI) > 40) and in-hospital SAH mortality, and another study found the effect between continuously increasing BMI and both short-term (OR = 0.90 (0.82-0.99)) and long-term SAH mortalities (OR = 0.92 (0.85-0.98)). However, according to our quality assessment, methodological shortcomings expose all reviewed studies to a high-risk-of-bias. Even though two studies suggest that obesity may protect SAH patients from death in the acute phase, all reviewed studies suffered from methodological shortcomings that have been typical in the research field of obesity paradox. Therefore, no definite conclusions could be drawn.
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Affiliation(s)
- Ilari Rautalin
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, FI-00029, Helsinki, Finland.
- Department of Public Health, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland.
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
- Institute for Molecular Medicine FIMM, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Miikka Korja
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, FI-00029, Helsinki, Finland
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Liu RS, Dunn S, Grobler AC, Lange K, Becker D, Goldsmith G, Carlin JB, Juonala M, Wake M, Burgner DP. Carotid artery intima-media thickness, distensibility and elasticity: population epidemiology and concordance in Australian children aged 11-12 years old and their parents. BMJ Open 2019; 9:23-33. [PMID: 31273013 PMCID: PMC6624035 DOI: 10.1136/bmjopen-2017-020264] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To describe a well-established marker of cardiovascular risk, carotid intima-media thickness (IMT) and related measures (artery distensibility and elasticity) in children aged 11-12 years old and mid-life adults, and examine associations within parent-child dyads. DESIGN Cross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven Australian major cities and eight selected regional towns, February 2015 to March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1489 children (50.0% girls) and 1476 parents (86.8% mothers) with carotid IMT data were included. Survey weights and methods were applied to account for LSAC's complex sample design and clustering within postcodes and strata. OUTCOME MEASURES Ultrasound of the right carotid artery was performed using standardised protocols. Primary outcomes were mean and maximum far-wall carotid IMT, quantified using semiautomated edge detection software. Secondary outcomes were carotid artery distensibility and elasticity. Pearson's correlation coefficients and multivariable linear regression models were used to assess parent-child concordance. Random effects modelling on a subset of ultrasounds (with repeated measurements) was used to assess reliability of the child carotid IMT measure. RESULTS The average mean and maximum child carotid IMT were 0.50 mm (SD 0.06) and 0.58 mm (SD 0.05), respectively. In adults, average mean and maximum carotid IMT were 0.57 mm (SD 0.07) and 0.66 mm (SD 0.10), respectively. Mother-child correlations for mean and maximum carotid IMT were 0.12 (95% CI 0.05 to 0.23) and 0.10 (95% CI 0.03 to 0.21), respectively. For carotid artery distensibility and elasticity, mother-child correlations were 0.19 (95% CI 0.10 to 0.25) and 0.11 (95% CI 0.02 to 0.18), respectively. There was no strong evidence of father-child correlation in any measure. CONCLUSIONS We provide Australian values for carotid vascular measures and report a modest mother-child concordance. Both genetic and environmental exposures are likely to contribute to carotid IMT.
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Affiliation(s)
- Richard S Liu
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Sophie Dunn
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Emergency Department, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Katherine Lange
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Denise Becker
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Greta Goldsmith
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - John B Carlin
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - David P Burgner
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
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50
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Vilpunaho T, Kröger H, Honkanen R, Koivumaa-Honkanen H, Sirola J, Kuvaja-Köllner V, Sund R, Rikkonen T. Randomised controlled trial (RCT) study design for a large-scale municipal fall prevention exercise programme in community-living older women: study protocol for the Kuopio Fall Prevention Study (KFPS). BMJ Open 2019; 9:e028716. [PMID: 31230026 PMCID: PMC6596943 DOI: 10.1136/bmjopen-2018-028716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Falls are a substantial health problem in seniors, causing fractures and being the leading cause of fatal injuries. The benefits of physical activity in fall prevention have been shown in randomised controlled trials (RCTs) in small cohorts (eg, ≤200 persons), but there is a gap between the known health effects of exercise and the large-scale implementation of effective activity in communities. Mental health and subjective well-being (SWB) should also be studied since they are strongly related to healthy ageing. Thus far, the proven efficacy of communal strategies to reduce falls and improve healthy ageing is sparse. METHODS AND ANALYSIS In 2016, a 2-year RCT was launched in Kuopio, Finland to estimate the efficacy of a large, population-based, fall prevention exercise programme in community-living older women (born 1932-1945). Both the intervention and control group (n=457+457) receive health education. The intervention group is also offered free 6-month supervised training courses (weekly gym training and Taiji sessions), followed by a free 6-month unsupervised use of exercise facilities, as well as unsupervised low-cost exercise is also offered for another 12 months. During the whole 24-month follow-up, controls are free to pursue all their normal physical activities. Both study groups undergo the study measurements three times. Outcome measures include recording of falls, injuries, bone mineral density, changes in health and functional status and cognitive performance, deaths and SWB. Finally, the cost-effectiveness and cost-utility analysis will be conducted from the societal view. The main analyses comparing outcomes between study groups will be conducted using the intention to treat principle. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Research Ethics Committee of the Hospital District of North Savo. All regulations and measures of ethics and confidentiality are handled in accordance with the Declaration of Helsinki. TRIAL REGISTRATION NUMBER NCT02665169; Pre-results.
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Affiliation(s)
- Tommi Vilpunaho
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland - Kuopio Campus, Finland
| | - Heikki Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland - Kuopio Campus, Finland
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Finland
| | - Risto Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland - Kuopio Campus, Finland
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine (Psychiatry), University of Eastern Finland - Kuopio Campus, Finland
- Department of Psychiatry, Kuopio University Hospital, Finland
| | - Joonas Sirola
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland - Kuopio Campus, Finland
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Finland
| | - Virpi Kuvaja-Köllner
- Department of Health and Social Management, University of Eastern Finland - Kuopio Campus, Finland
| | - Reijo Sund
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland - Kuopio Campus, Finland
| | - Toni Rikkonen
- Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland - Kuopio Campus, Finland
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