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Larsson, K., Kallings, L., Ekblom, Ö., Blom, V., Andersson, E. & Ekblom, M. (2019). Criterion validity and test-retest reliability of SED-GIH, a single item question for assessment of daily sitting time.. BMC Public Health, 19(1), Article ID 19:17.
Open this publication in new window or tab >>Criterion validity and test-retest reliability of SED-GIH, a single item question for assessment of daily sitting time.
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, no 1, article id 19:17Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sedentary behaviour has been closely linked to metabolic and cardiovascular health and is therefore of importance in disease prevention. A user-friendly tool for assessment of sitting time is thus needed. Previous studies concluded that the present tools used to assess a number of sedentary behaviours are more likely to overestimate sitting than single-item questions which often underestimate sitting time, and that categorical answering options are recommended. In line with this, the single-item question with categorical answering options, SED-GIH, was developed. The aim of this study was to investigate the criterion validity of the SED-GIH question using activPAL3 micro as the criterion measure. The second aim was to evaluate the test-retest reliability of the SED-GIH questionnaire.

METHOD: In the validity section of this study, 284 middle-aged adults answered a web questionnaire, which included SED-GIH, wore activPAL and filled in a diary log for one week. Spearman's rho assessed the relationship between the SED-GIH answers and the daily average sitting time as monitored by the activPAL (activPAL-SIT), a Weighted Kappa assessed the agreement, ANOVA assessed differences in activPAL-SIT between the SED-GIH answer categories, and a Chi2 compared the proportions of hazardous sitters between the different SED-GIH answer categories. In the reliability section, 95 elderly participants answered the SED-GIH question twice, with a mean interval of 5.2 days. The reliability was assessed with ICC and a weighted Kappa.

RESULTS: The SED-GIH question correlated moderately with activPAL-SIT (rho = 0.31), with a poor agreement (weighted Kappa 0.12). In total, 40.8% underestimated and 22.2% overestimated their sitting time. The ANOVA showed significant differences in activPAL-SIT between the different SED-GIH answer categories (p < 0.001). The Chi2 showed a significant difference in proportion of individuals sitting more than 10 h per day within each SED-GIH answer category. ICC for the test-retest reliability of SED-GIH was excellent with ICC = 0.86, and the weighted Kappa showed an agreement of 0.77.

CONCLUSIONS: The unanchored single item SED-GIH question showed excellent reliability but poor validity in the investigated populations. Validity and reliability of SED-GIH is in line with other questionnaires that are commonly used when assessing sitting time.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Adults, Office-based work, Older adults, Reliability, Sedentary behaviour, Sitting, Validity, activPAL
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5520 (URN)10.1186/s12889-018-6329-1 (DOI)30611226 (PubMedID)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-08
Ekblom Bak, E., Ekblom, Ö., Andersson, G., Wallin, P., Söderling, J., Hemmingsson, E. & Ekblom, B. (2019). Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.. Scandinavian Journal of Medicine and Science in Sports, 29(2), 232-239
Open this publication in new window or tab >>Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.
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2019 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, no 2, p. 232-239Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Long-term trend analyses of cardiorespiratory fitness (VO2 max) in the general population are limited.

OBJECTIVES: To describe trends in VO2 max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions.

METHODS: 354.277 participants (44% women, 18-74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L·min-1 ) and relative (ml·min-1 ·kg-1 ) VO2 max, and the proportion with low (<32) relative VO2 max are reported. VO2 max was estimated using a submaximal cycle test.

RESULTS: Absolute VO2 max decreased by -6.7% (-0.19 L·min-1 ) in the total population. Relative VO2 max decreased by -10.8% (-4.2 ml·min-1 ·kg-1 ) with approximately one-third explained by a simultaneous increase in body mass. Decreases in absolute fitness were more pronounced in men vs. women (8.7% vs. 5.3%), in younger vs. older (6.5% vs 2.3%), in short (11.4%) vs. long (4.5%) education, and in rural vs. urban regions (6.5% vs 3.5%), all p<0.001. The proportions with low VO2 max increased from 27% to 46% (p<0.001).

CONCLUSION: Between 1995 and 2017, there was a steady and pronounced decline in mean cardiorespiratory fitness in Swedish adults. Male gender, young age, short education and living in a rural area were predictive of greater reductions. The proportion with low cardiorespiratory fitness almost doubled. Given the strong associations between cardiorespiratory fitness and multiple morbidities and mortality, preventing further decreases is a clear public health priority, especially for vulnerable groups. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Maximal oxygen consumption, VO2max, aerobic capacity, population, secular trend
National Category
Physiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5460 (URN)10.1111/sms.13328 (DOI)30351472 (PubMedID)
Projects
HPI-gruppen
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-01-18Bibliographically approved
Hallgren, M., Skott, M., Ekblom, Ö., Firth, J., Schembri, A. & Forsell, Y. (2019). Exercise effects on cognitive functioning in young adults with first-episode psychosis: FitForLife.. Psychological Medicine, 49(3), 431-439
Open this publication in new window or tab >>Exercise effects on cognitive functioning in young adults with first-episode psychosis: FitForLife.
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2019 (English)In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 49, no 3, p. 431-439Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Exercise has mood-enhancing effects and can improve cognitive functioning, but the effects in first-episode psychosis (FEP) remain understudied. We examined the feasibility and cognitive effects of exercise in FEP.

METHOD: Multi-center, open-label intervention study. Ninety-one outpatients with FEP (mean age = 30 years, 65% male) received usual care plus a 12-week supervised circuit-training program, consisting of high-volume resistance exercises, aerobic training, and stretching. Primary study outcome was cognitive functioning assessed by Cogstate Brief Battery (processing speed, attention, visual learning, working memory) and Trailmaking A and B tasks (visual attention and task shifting). Within-group changes in cognition were assessed using paired sample t tests with effect sizes (Hedges' g) reported for significant values. Relationships between exercise frequency and cognitive improvement were assessed using analysis of covariance. Moderating effects of gender were explored with stratified analyses.

RESULTS: Participants exercised on average 13.5 (s.d. = 11.7) times. Forty-eight percent completed 12 or more sessions. Significant post-intervention improvements were seen for processing speed, visual learning, and visual attention; all with moderate effect sizes (g = 0.47-0.49, p < 0.05). Exercise participation was also associated with a positive non-significant trend for working memory (p < 0.07). Stratified analyses indicated a moderating effect of gender. Positive changes were seen among females only for processing speed, visual learning, working memory, and visual attention (g = 0.43-0.69). A significant bivariate correlation was found between total training frequency and improvements in visual attention among males (r = 0.40, p < 0.05).

CONCLUSION: Supported physical exercise is a feasible and safe adjunct treatment for FEP with potential cognitive benefits, especially among females.

Place, publisher, year, edition, pages
Cambridge University Press, 2019
Keywords
Cognition, exercise, first-episode, physical activity, psychosis, schizophrenia
National Category
Applied Psychology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5276 (URN)10.1017/S0033291718001022 (DOI)29729687 (PubMedID)
Available from: 2018-05-31 Created: 2018-05-31 Last updated: 2019-01-16Bibliographically approved
Rahman, M. S., Helgadóttir, B., Hallgren, M., Forsell, Y., Stubbs, B., Vancampfort, D. & Ekblom, Ö. (2018). Cardiorespiratory fitness and response to exercise treatment in depression.. BJPsych open, 4(5), 346-351
Open this publication in new window or tab >>Cardiorespiratory fitness and response to exercise treatment in depression.
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2018 (English)In: BJPsych open, ISSN 2056-4724, Vol. 4, no 5, p. 346-351Article in journal (Refereed) Published
Abstract [en]

Background: Exercise improves cardiorespiratory fitness (CRF) and reduces depressive symptoms in people with depression. It is unclear if changes in CRF are a predictor of the antidepressant effect of exercise in people with depression.

Aims: To investigate whether an increase in CRF is a predictor of depression severity reduction after 12 weeks of exercise (trial registration: DRKS study ID, DRKS00008745).

Method: The present study includes participants who took part in vigorous (n = 33), moderate (n = 38) and light (n = 39) intensity exercise and had CRF information (as predicted maximal oxygen uptake, O2max) collected before and after the intervention. Depression severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS). O2max (L/min) was assessed with the Åstrand-Rhyming submaximal cycle ergometry test. The main analysis was conducted pooling all exercise intensity groups together.

Results: All exercise intensities improved O2max in people with depression. Regardless of frequency and intensity of exercise, an increase in post-treatment O2max was significantly associated with reduced depression severity at follow-up (B = -3.52, 95% CI -6.08 to -0.96); adjusting for intensity of exercise, age and body mass index made the association stronger (B = -3.89, 95% CI -6.53 to -1.26). Similarly, increased O2max was associated with higher odds (odds ratio = 3.73, 95% CI 1.22-11.43) of exercise treatment response (≥50% reduction in MADRS score) at follow-up.

Conclusions: Our data suggest that improvements in O2max predict a greater reduction in depression severity among individuals who were clinically depressed. This finding indicates that improvements in O2max may be a marker for the underpinning biological pathways for the antidepressant effect of exercise.

Declaration of interest: None.

Keywords
Depression, cardiorespiratory fitness, exercise
National Category
Psychiatry Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5391 (URN)10.1192/bjo.2018.45 (DOI)000451392100003 ()30140446 (PubMedID)
Available from: 2018-08-27 Created: 2018-08-27 Last updated: 2018-12-17
Nooijen, C. F., Kallings, L., Blom, V., Ekblom, Ö., Forsell, Y. & Ekblom, M. (2018). Common Perceived Barriers and Facilitators for Reducing Sedentary Behaviour among Office Workers.. International Journal of Environmental Research and Public Health, 15(4), Article ID E792.
Open this publication in new window or tab >>Common Perceived Barriers and Facilitators for Reducing Sedentary Behaviour among Office Workers.
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2018 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 4, article id E792Article in journal (Refereed) Published
Abstract [en]

Qualitative studies identified barriers and facilitators associated with work-related sedentary behaviour. The objective of this study was to determine common perceived barriers and facilitators among office workers, assess subgroup differences, and describe sedentary behaviour. From two Swedish companies, 547 office workers (41 years (IQR = 35–48), 65% women, 66% highly educated) completed questionnaires on perceived barriers and facilitators, for which subgroup differences in age, gender, education, and workplace sedentary behaviour were assessed. Sedentary behaviour was measured using inclinometers (n = 311). The most frequently reported barrier was sitting is a habit (67%), which was reported more among women than men (X2 = 5.14, p = 0.03) and more among highly sedentary office workers (X2 = 9.26, p < 0.01). The two other most reported barriers were that standing is uncomfortable (29%) and standing is tiring (24%). Facilitators with the most support were the introduction of either standing- or walking-meetings (respectively 33% and 29%) and more possibilities or reminders for breaks (31%). The proportion spent sedentary was 64% at the workplace, 61% on working days, and 57% on non-working days. This study provides a detailed understanding of office workers’ ideas about sitting and means to reduce sitting. We advise to include the supported facilitators and individualized support in interventions to work towards more effective strategies to reduce sedentary behaviour.

Keywords
barriers, facilitators, office workers, sedentary behaviour, workplace
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5262 (URN)10.3390/ijerph15040792 (DOI)000434868800231 ()29670047 (PubMedID)
Projects
Fysisk aktivitet och hälsosamma hjärnfunktioner: Delprojekt 1, Tvärsnittsstudie
Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2018-11-22
Nooijen, C. F., Kallings, L., Blom, V., Ekblom, Ö., Forsell, Y. & Ekblom, M. (2018). Common perceived barriers and facilitators for reducing sedentary behaviour among office-workers. In: Journal of Physical Activity & Health, Volume 15, Issue 10, Pages S94-S95 Supplement 1: . Paper presented at 7th International Society for Physical Activity and Health Congress, London, England, October 15 to October 17, 2018 (pp. S94-S95). Canadian Consortium on Human Security, 15(10)
Open this publication in new window or tab >>Common perceived barriers and facilitators for reducing sedentary behaviour among office-workers
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2018 (English)In: Journal of Physical Activity & Health, Volume 15, Issue 10, Pages S94-S95 Supplement 1, Canadian Consortium on Human Security, 2018, Vol. 15, no 10, p. S94-S95Conference paper, Oral presentation with published abstract (Other academic)
Place, publisher, year, edition, pages
Canadian Consortium on Human Security, 2018
National Category
Occupational Health and Environmental Health
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5513 (URN)000446516100316 ()
Conference
7th International Society for Physical Activity and Health Congress, London, England, October 15 to October 17, 2018
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2018-12-21Bibliographically approved
Gripeteg, L., Arvidsson, D., Johannesson, E., Larsson, C., Sjöberg, A., Angerås, O., . . . Börjesson, M. (2018). Concomitant Associations of Healthy Food Intake and Cardiorespiratory Fitness With Coronary Artery Calcium.. American Journal of Cardiology, 122(4), 560-564, Article ID S0002-9149(18)31060-9.
Open this publication in new window or tab >>Concomitant Associations of Healthy Food Intake and Cardiorespiratory Fitness With Coronary Artery Calcium.
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2018 (English)In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 122, no 4, p. 560-564, article id S0002-9149(18)31060-9Article in journal (Refereed) Published
Abstract [en]

Conflicting findings remain regarding associations between lifestyle behaviors and coronary artery calcium (CAC). We investigated concomitant associations of healthy food intake and cardiorespiratory fitness (CRF) with CAC. Data from 706 men and women 50 to 64 years old from the Swedish SCAPIS pilot trial were analyzed. A CAC score was calculated using the Agatston method. A Healthy Food Index (HFI) was established using data from a web-based food frequency questionnaire. CRF was assessed from a bike exercise test. Regression analyses were performed with occurrence of CAC (dichotomous) and level of CAC score in patients with CAC (continuous) as outcomes. 58% had 0 CAC score. HFI was significantly associated with having no CAC (standardized coefficient β = 0.18, p <0.001) but not with level of CAC score (β = -0.09, p = 0.34). CRF showed no significant association with having no CAC (β = -0.08, p = 0.12) or with the level of CAC score (β = -0.04, p = 0.64). However, there was an interaction between HFI and CRF (β = -0.23, p = 0.02); for increasing levels of CRF there was stronger negative association between HFI and level of CAC score, reaching β = -0.48, p = 0.045 for the highest CRF level. In conclusion, these results emphasize the importance of a healthy food intake in combination with higher CRF to counteract CAC development.

National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5377 (URN)10.1016/j.amjcard.2018.04.059 (DOI)000447683800006 ()29958710 (PubMedID)
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-11-12Bibliographically approved
Berg, U. & Ekblom, Ö. (2018). Fysisk aktivitet för barn och ungdomar - allmänna rekommendationer. In: Ing-Marie Dohrn (Ed.), Fysisk aktivitet som medicin: en praktisk handbok utifrån FYSS (pp. 31-41). Stockholm: SISU idrottsböcker
Open this publication in new window or tab >>Fysisk aktivitet för barn och ungdomar - allmänna rekommendationer
2018 (Swedish)In: Fysisk aktivitet som medicin: en praktisk handbok utifrån FYSS / [ed] Ing-Marie Dohrn, Stockholm: SISU idrottsböcker , 2018, p. 31-41Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Stockholm: SISU idrottsböcker, 2018
National Category
Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5580 (URN)
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-01-21Bibliographically approved
Ekblom, M., Blom, V., Ekblom, Ö., Kallings, L. & Nooijen, C. F. (2018). Fysisk aktivitet och hjärnhälsa. Fysioterapi (5), 32-35
Open this publication in new window or tab >>Fysisk aktivitet och hjärnhälsa
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2018 (Swedish)In: Fysioterapi, ISSN 1653-5804, no 5, p. 32-35Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Psykisk ohälsa är den vanligaste orsaken till sjukskrivning. Fysisk aktivitet kan förebygga många former av ohälsa, men vilka fysiska aktivitetsmönster som gynnar psykisk hälsa och kognitiva förmågor är fortfarande okänt. Denna typ av forskning är komplex och kräver samarbete med många olika aktörer i samhället.

National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5452 (URN)
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2018-11-22Bibliographically approved
Ekblom, Ö., Ek, A., Cider, Å., Hambraeus, K. & Börjesson, M. (2018). Increased Physical Activity Post-Myocardial Infarction Is Related to Reduced Mortality; Results From the SWEDEHEART Registry. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 7(24), Article ID e010108.
Open this publication in new window or tab >>Increased Physical Activity Post-Myocardial Infarction Is Related to Reduced Mortality; Results From the SWEDEHEART Registry
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2018 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 7, no 24, article id e010108Article in journal (Refereed) Published
Abstract [en]

Background

With increasing survival rates among patients with myocardial infarction (MI), more demands are placed on secondary prevention. While physical activity (PA) efforts to obtain a sufficient PA level are part of secondary preventive recommendations, it is still underutilized. Importantly, the effect of changes in PA after MI is largely unknown. Therefore, we sought to investigate the effect on survival from changes in PA level, post‐MI.

Methods and Results

Data from Swedish national registries were combined, totaling 22 227 patients with MI. PA level was self‐reported at 6 to 10 weeks post‐MI and 10 to 12 months post‐MI. Patients were classified as constantly inactive, increased activity, reduced activity, and constantly active. Proportional hazard ratios were calculated. During 100 502 person‐years of follow‐up (mean follow‐up time 4.2 years), a total of 1087 deaths were recorded. Controlling for important confounders (including left ventricular function, type of MI, medication, smoking, participation in cardiac rehabilitation program, quality of life, and estimated kidney function), we found lower mortality rates among constantly active (hazard ratio: 0.29, 95% confidence interval: 0.21–0.41), those with increased activity (0.41, 95% confidence interval: 0.31–0.55), and those with reduced activity (hazard ratio: 0.56, 95% confidence interval: 0.45–0.69) during the first year post‐MI, compared with those being constantly inactive. Stratified analyses indicated strong effect of PA level among both sexes, across age, MI type, kidney function, medication, and smoking status.

Conclusions

The present article shows that increasing the PA level, compared with staying inactive the first year post‐MI, was related to reduced mortality.

Place, publisher, year, edition, pages
American Heart Association, 2018
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5506 (URN)10.1161/JAHA.118.010108 (DOI)000455184800009 ()30561263 (PubMedID)
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2019-01-24
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6058-4982

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