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Salier Eriksson, J., Ekblom, B., Kallings, L., Hemmingsson, E., Andersson, G., Wallin, P., . . . Ekblom Bak, E. (2019). Active commuting in Swedish workers between 1998 and 2015 - trends, characteristics and cardiovascular disease risk.. Scandinavian Journal of Medicine and Science in Sports
Open this publication in new window or tab >>Active commuting in Swedish workers between 1998 and 2015 - trends, characteristics and cardiovascular disease risk.
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2019 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Trend analyses of active commuting and potential variations in trends and association with cardiovascular disease (CVD) risk within sub-groups are unknown.

OBJECTIVES: To a) describe trends in active commuting between 1998 to 2015 and b) to study the association between different amounts of active commuting and the incidence risk of CVD in a large sample of Swedish workers, and analyses of potential variations across sub-groups of socio-demographics, physical activity and BMI.

METHODS: A total of 318,309 participants (47% women, 18-74 years) who participated in a nationwide occupational health service screening between 1998 and 2015 were included. Commuting habits were self-reported, and data on first-time CVD events were derived from national registers.

RESULTS: Self-reported passive commuters decreased between 1998 and 2015 (64% to 56%), transferring to an increase in mainly moderate/high-dose active commuters (12% to 19%). Changes were seen in all subgroups. The characteristics and life-style habits of the typical passive and active commuter changed little over the study period. Low- and moderate/high-dose active commuters had significantly decreased risks for a first time CVD during follow-up. This was accentuated in men, middle-aged and in participants with light physical work situations, irregular exercise habits, being overweight/obese and with low fitness.

CONCLUSION: Increases in active commuting were observed between 1998 and 2015, however still leaving a majority who do not actively commute. As active commuting, regardless dose, is associated with a lower CVD risk, encouraging more people to actively commute may provide an easily accessible and time-efficient possibility to increase physical activity and health in the general population.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
active commuting, cardiovascular disease, cycling, physical activity, trends, walking, working population
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5889 (URN)10.1111/sms.13581 (DOI)31631386 (PubMedID)
Projects
HPI-gruppen
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-10-31Bibliographically approved
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
Nooijen, C. F., Blom, V., Ekblom, Ö., Ekblom, M. & Kallings, L. (2019). Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions. BMC Public Health, 19, Article ID 266.
Open this publication in new window or tab >>Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 266Article in journal (Refereed) Published
Abstract [en]

Background

Physically inactive and sedentary lifestyles are negatively related to both mental health and cognition. For office-workers, who spend two-thirds of their workday sitting, it is important to improve these lifestyles. The aim of this study is to assess the effectiveness of multi-component interventions, incorporating individual, environmental and organizational changes, to increase physical activity or reduce sedentary behavior among office-workers in order to improve mental health and cognition.

Methods

a 3-arm, clustered randomized controlled trial (RCT) with waiting list control group amongst adult office-workers of two large Swedish companies. Cluster teams will be randomized into 6-month interventions or to a passive waiting list control group which will receive the allocated intervention with a 6-month delay. Two multicomponent interventions will be studied of which one focuses on improving physical activity and the other on reducing sedentary behavior. Both interventions include 5 sessions of motivational counselling. In the physical activity intervention persons also get access to a gym and team leaders will organize lunch walks and encourage to exercise. In the sedentary behavior intervention standing- and walking meetings will be implemented and team leaders will encourage to reduce sitting. The recruitment target is 110 office-workers per arm (330 in total). Measurements will be repeated every 6months for a total intended duration of 24months. Proximal main outcomes are physical activity measured with accelerometers and sedentary behavior with inclinometers. Distal outcomes are self-reported mental health and a cognition test battery. Additional outcomes will include cardiovascular fitness, body composition, sleep, self-reported physical activity and sedentary behavior, other health habits, physical health, and working mechanisms from blood samples and questionnaires.

Discussion

This cluster RCT will contribute to the currently available evidence by comparing the effectiveness of multi-component interventions targeting physical activity or sedentary behavior with the end goal of improving mental health and cognition. This study is strong in its cluster randomized design, numerous objective outcome measures and long-term follow-up. The exact content of the interventions has been defined by combining theory with results from a larger research project as well as having a continuous dialogue with the involved companies.

Place, publisher, year, edition, pages
Springer, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5646 (URN)10.1186/s12889-019-6589-4 (DOI)000460405200003 ()30836957 (PubMedID)
Projects
Fysisk aktivitet och hälsosamma hjärnfunktioner bland kontorsarbetare: Delprojekt 3, Långsiktiga interventioner
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-08-06
Larsson, K., Ekblom, Ö., Kallings, L., Ekblom, M. & Blom, V. (2019). Job Demand-Control-Support Model as Related to Objectively Measured Physical Activity and Sedentary Time in Working Women and Men.. International Journal of Environmental Research and Public Health, 16(18), Article ID E3370.
Open this publication in new window or tab >>Job Demand-Control-Support Model as Related to Objectively Measured Physical Activity and Sedentary Time in Working Women and Men.
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2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 18, article id E3370Article in journal (Refereed) Published
Abstract [en]

A physically active lifestyle incurs health benefits and physically active individuals show reduced reactivity to psychosocial stressors. However, the findings are inconclusive and are based on self-reported physical activity and sedentary time. The present study aimed at studying the associations between psychological stressors (job demand, control, support, JD-C-S) and objectively measured physical activity (PA) on various intensities from sedentary (SED) to vigorous physical activity. The participants were 314 employees from a cross-sectional study. PA data were collected with the accelerometer ActiGraph GT3X (Pensacola, FL, USA), SED data with the inclinometer activPAL (PAL Technologies Ltd., Glasgow, Scotland, UK), and psychosocial stressors with a web questionnaire. Results showed that vigorous-intensity PA was negatively associated with demand (β -0.15, p < 0.05), even when adjusted for the covariates. SED was negatively associated to support (β -0.13, p < 0.05). Stress significantly moderated relations between support and sedentary time (β -0.12, p < 0.05). Moderate PA (MVPA) was negatively associated with demand, but only when controlling for overtime (β -0.13, p < 0.05). MVPA was also negatively associated with control (β -0.15, p < 0.05) but not when work engagement was included in the model. Being more physically active and spending less time sedentary may help to handle job situations with high demand and low support.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
ActiGraph, activPAL, job demand-control-support model, physical activity, questionnaire, sedentary time, workplace
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5858 (URN)10.3390/ijerph16183370 (DOI)000489178500144 ()31547253 (PubMedID)
Projects
Fysisk aktivitet och hälsosamma hjärnfunktioner bland kontorsarbetare: Delprojekt 1, Tvärsnittsstudie
Available from: 2019-09-26 Created: 2019-09-26 Last updated: 2019-10-29
Ek, A., Ekblom, Ö., Hambraeus, K., Cider, Å., Kallings, L. & Börjesson, M. (2019). Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.. Clinical Research in Cardiology, 108(3), 324-332
Open this publication in new window or tab >>Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.
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2019 (English)In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 108, no 3, p. 324-332Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Physical activity (PA) and smoking cessation are included in the secondary prevention guidelines after myocardial infarction (MI), but they are still underutilised. This study aims to explore how PA level and smoking status (6-10 weeks post-MI) were associated with 1-year readmission and mortality during full follow-up time, and with the cumulative 5-year mortality.

METHODS: A population-based cohort of all hospitals providing MI-care in Sweden (SWEDEHEART-registry) in 2004-2014. PA was expressed as the number of exercise sessions of ≥ 30 min in the last 7 days: 0-1 (low), 2-4 (medium) and 5-7 (high) sessions/week. Individuals were categorised as smokers, former smokers or never-smokers. The associations were analysed by unadjusted and adjusted logistic and Cox regressions.

RESULTS: During follow-up (M = 3.58 years), a total of 1702 deaths occurred among 30 644 individuals (14.1 cases per 1000 person-years). For medium and high PA, the hazard ratios (HRs) for mortality were 0.39 and 0.36, respectively, compared with low PA. For never-smokers, the HR was 0.45 and former smokers 0.56 compared with smokers. Compared with low PA, the odds ratios (ORs) for readmission in medium PA were 0.65 and 0.59 for CVD and non-CVD causes, respectively. For high PA, the corresponding ORs were 0.63 and 0.55. The association remained in adjusted models. There were no associations between smoking status and readmission.

CONCLUSIONS: The PA level and smoking status are strong predictors of mortality post-MI and the PA level also predicts readmission, highlighting the importance of adherence to the secondary prevention guidelines.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Hospitalisation, Myocardial ischaemia, Physical activity, Survival, Tobacco
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5405 (URN)10.1007/s00392-018-1360-x (DOI)000459158700012 ()30167806 (PubMedID)
Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2019-03-21
Ekblom Bak, E., Ekblom, B., Söderling, J., Börjesson, M., Blom, V., Kallings, L., . . . Ekblom, Ö. (2019). Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults.. Preventive Medicine, 127, Article ID 105799.
Open this publication in new window or tab >>Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults.
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2019 (English)In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 127, article id 105799Article in journal (Refereed) Published
Abstract [en]

The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO2max) using a submaximal cycle test. Incident cases of first-time CVD event and death from any cause were ascertained through national registers. There were 4244 CVD events and 2750 cases of all-cause mortality during mean 7.6 years follow-up. Male gender, higher age and lower estVO2max were associated with higher all-cause mortality and CVD morbidity incidence rates. Risk reductions with increasing estVO2max were present in all age-groups of men and women. No obvious levelling off in risk was identified in the total cohort. However, women and older age-groups showed no further reduction in higher aggregated estVO2max levels. CVD specific mortality was more associated with estVO2max compared to tumor specific mortality. The risk for all-cause mortality and CVD morbidity decreased by 2.3% and 2.6% per increase in 1 ml·min-1·kg-1 with no significant sex-differences but more pronounced in the three lower estVO2max categories for all-cause mortality (9.1%, 3.8% and 3.3%, respectively). High compared to lower levels of estVO2max was not related to a significantly elevated mortality or morbidity. In this large cohort study, CVD morbidity and all-cause mortality were inversely related to estVO2max in both men and women of all age-groups. Increasing cardiorespiratory fitness is a clear public health priority.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Aerobic capacity, Cancer, Cardiovascular disease, Population, Risk, VO(2)max
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5834 (URN)10.1016/j.ypmed.2019.105799 (DOI)000485788400010 ()31454664 (PubMedID)
Projects
HPI-gruppen
Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-10-11
Kallings, L., Olsson, S. J., Ekblom, Ö., Ekblom Bak, E. & Börjesson, M. (2019). The SED-GIH: A Single-Item Question for Assessment of Stationary Behavior-A Study of Concurrent and Convergent Validity.. International Journal of Environmental Research and Public Health, 16(23), Article ID E4766.
Open this publication in new window or tab >>The SED-GIH: A Single-Item Question for Assessment of Stationary Behavior-A Study of Concurrent and Convergent Validity.
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2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 23, article id E4766Article in journal (Refereed) Published
Abstract [en]

The unfavorable health consequences of prolonged time spent sedentary (stationary) make accurate assessment in the general population important. However, for many existing questionnaires, validity for identifying stationary time has not been shown or has shown low validity. This study aimed to assess the concurrent and convergent validity of the GIH stationary single-item question (SED-GIH). Data were obtained in 2013 and 2014 from two Swedish cohorts. A total of 711 men and women provided valid accelerometer data (Actigraph GT3X+) and were included for concurrent validity analyses. A total of 560 individuals answered three additional commonly used sedentary questions, and were included for convergent validity analysis. The SED-GIH displayed a significant correlation with total stationary time (rs = 0.48) and time in prolonged stationary time (rs = 0.44). The ROC analysis showed an AUC of 0.72 for identifying individuals with stationary time over 600 min/day. The SED-GIH correlated significantly with other previously used questions (r = 0.72-0.89). The SED-GIH single-item question showed a relatively high agreement with device-assessed stationary behavior and was able to identify individuals with high levels of stationary time. Thus, the SED-GIH may be used to assess total and prolonged stationary time. This has important implications, as simple assessment tools of this behavior are needed in public health practice and research.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
accelerometry, measurement, public health, sedentary behavior, surveys and questionnaires, validation studies
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5950 (URN)10.3390/ijerph16234766 (DOI)31795109 (PubMedID)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-09
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 bland kontorsarbetare: Delprojekt 1, Tvärsnittsstudie
Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2019-08-06
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
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
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3185-9702

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