Gymnastik- och idrottshögskolan, GIH

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Lönn, A., Börjesson, M., Hambraeus, K. & Ekblom, Ö. (2023). Changes in Physical Activity and Incidence of Nonfatal Cardiovascular Events in 47 153 Survivors of Myocardial Infarction.. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 12(20), Article ID e030583.
Open this publication in new window or tab >>Changes in Physical Activity and Incidence of Nonfatal Cardiovascular Events in 47 153 Survivors of Myocardial Infarction.
2023 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 12, no 20, article id e030583Article in journal (Refereed) Published
Abstract [en]

Background The majority of patients survive the acute phase of myocardial infarction (MI) but have an increased risk of recurrent cardiovascular disease (CVD) events. To be regularly physically active or change activity level is associated with a lower risk of all-cause mortality. The objective was to explore to what extent physical activity (PA) levels or change in PA levels during the first year post-MI was associated with any recurrent nonfatal CVD events and specific CVD events (eg, MI, ischemic stroke, and vascular dementia). Methods and Results This cohort study among MI survivors was based on Swedish national registries between 2005 and 2020. PA levels were self-rated at 2 and 12 months post-MI, and patients were classified into remaining physically inactive, increasing, decreasing, or remaining active. A total of 6534 nonfatal CVD events occurred during 6 years of follow-up among the 47 153 included patients. In fully adjusted analyses, the risk of any nonfatal CVD event was lower (P<0.05) among patients remaining active (37%), increasing (22%), or decreasing (18%) PA level compared with remaining inactive. Compared with remaining inactive, the risk of recurring MI and stroke was lower (P>0.05) among remaining active (41% versus 52%, respectively), increasing (20% versus 35%, respectively), or decreasing PA level (24% versus 34%, respectively). For vascular dementia, patients remaining physically active had an 80% lower risk compared with remaining inactive (P<0.05). Conclusions Remaining physically active or change in PA levels during the first year post-MI was associated with a lower risk of recurrent nonfatal CVD events. This emphasizes the importance of supporting patients to continue to be or become physically active.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2023
Keywords
coronary heart disease, exercise, stroke, vascular dementia
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology; Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7896 (URN)10.1161/JAHA.123.030583 (DOI)37804194 (PubMedID)
Funder
Swedish Heart Lung Foundation
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2023-10-26
Lönn, A., Kallings, L., Andersson, G., Paulsson, S., Wallin, P., Salier Eriksson, J. & Ekblom Bak, E. (2023). Lifestyle-related habits and factors before and after cardiovascular diagnosis: a case control study among 2,548 Swedish individuals.. International Journal of Behavioral Nutrition and Physical Activity, 20(1), Article ID 41.
Open this publication in new window or tab >>Lifestyle-related habits and factors before and after cardiovascular diagnosis: a case control study among 2,548 Swedish individuals.
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2023 (English)In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 20, no 1, article id 41Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Healthy lifestyle habits are recommended in prevention of cardiovascular disease (CVD). However, there is limited knowledge concerning the change in lifestyle-related factors from before to after a CVD event. Thus, this study aimed to explore if and how lifestyle habits and other lifestyle-related factors changed between two health assessments in individuals experiencing a CVD event between the assessments, and if changes varied between subgroups of sex, age, educational level, duration from CVD event to second assessment and type of CVD event.

METHODS: Among 115,504 Swedish employees with data from two assessments of occupational health screenings between 1992 and 2020, a total of 637 individuals (74% men, mean age 47 ± SD 9 years) were identified having had a CVD event (ischemic heart disease, cardiac arrythmia or stroke) between the assessments. Cases were matched with controls without an event between assessments from the same database (ratio 1:3, matching with replacement) by sex, age, and time between assessment (n = 1911 controls). Lifestyle habits included smoking, active commuting, exercise, diet, alcohol intake, and were self-rated. Lifestyle-related factors included overall stress, overall health (both self-rated), physical capacity (estimated by submaximal cycling), body mass index and resting blood pressure. Differences in lifestyle habits and lifestyle-related factors between cases and controls, and changes over time, were analysed with parametric and non-parametric tests. Multiple logistic regression, OR (95% CI) was used to analyse differences in change between subgroups.

RESULTS: Cases had, in general, a higher prevalence of unhealthy lifestyle habits as well as negative life-style related factors prior to the event compared to controls. Nevertheless, cases improved their lifestyle habits and lifestyle factors to a higher degree than controls, especially their amount of active commuting (p = 0.025), exercise (p = 0.009) and non-smoking (p < 0.001). However, BMI and overall health deteriorated to a greater extent (p < 0.001) among cases, while physical capacity (p < 0.001) decreased in both groups.

CONCLUSION: The results indicate that a CVD event may increase motivation to improve lifestyle habits. Nonetheless, the prevalence of unhealthy lifestyle habits was still high, emphasizing the need to improve implementation of primary and secondary CVD prevention.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Alcohol habits, Cardiovascular prevention, Diet habits, Lifestyle change, Physical activity, Physical capacity, Smoking, Stress
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7626 (URN)10.1186/s12966-023-01446-w (DOI)000963288200001 ()37020317 (PubMedID)
Projects
HPI-gruppen
Funder
Swedish Heart Lung Foundation
Available from: 2023-05-08 Created: 2023-05-08 Last updated: 2024-01-17
Lönn, A., Kallings, L., Börjesson, M., Ekblom, Ö. & Ekström, M. (2022). Convergent validity of commonly used questions assessing physical activity and sedentary time in Swedish patients after myocardial infarction.. BMC sports science, medicine & rehabilitation, 14(1), Article ID 117.
Open this publication in new window or tab >>Convergent validity of commonly used questions assessing physical activity and sedentary time in Swedish patients after myocardial infarction.
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2022 (English)In: BMC sports science, medicine & rehabilitation, ISSN 2052-1847, Vol. 14, no 1, article id 117Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Guidelines recommend regular physical activity (PA) and decreased sedentary time (SED) for patients after myocardial infarction (MI). Therefore, valid self-assessment of PA is vital in clinical practice. The purpose of this study was to assess the convergent validity of commonly used PA and SED questions recommended by the National Board of Health and welfare (NBHW) and national SWEDEHEART-registry using accelerometers as the reference method in patients after MI.

METHODS: Data were obtained 2017-2021 among Swedish men and women (180 assessments). Participants answered five commonly used PA and SED-questions (by NBHW and SWEDEHEART) and wore an accelerometer (Actigraph GT3X) for seven days. Convergent validity was assessed gradually by; Kruskall Wallis-, Sperman rho, Weighted Kappa- and ROC-analyses. Misclassification was explored by Chi-square analyses with Benjamini-Hochberg adjustment.

RESULTS: The strongest correlation (r = 0.37) was found for the SED-GIH question (NBHW). For PA, no specific question stood out, with correlations of r = 0.31 (NBWH), and r = 0.24-0.30 (SWEDEHEART). For all questions (NBHW and SWEDEHEART), there was a high degree of misclassification (congruency 12-30%) affecting the agreement (0.09-0.32) between self-report and accelerometer assessed time. The SED-GIH, PA-index and SWEDEHEART-VPA had the strongest sensitivity for identifying individuals with high SED (0.72) or low PA (0.77 and 0.75).

CONCLUSION: The studied PA and SED questions may provide an indication of PA and SED level among patients with MI in clinical practice and could be used to form a basis for further dialogue and assessment. Further development is needed, since practical assessment tools of PA and SED are desirable.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Accelerometer, Coronary heart disease, Physical activity, Questionnaire, Sedentary time, Validation
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7122 (URN)10.1186/s13102-022-00509-y (DOI)35751097 (PubMedID)
Available from: 2022-09-13 Created: 2022-09-13 Last updated: 2022-12-01
Ek, A., Kallings, L., Ekstrom, M., Börjesson, M. & Ekblom, Ö. (2022). P05-04 Physical activity level and sedentary time prior to cardiac ward admission among patients with cardiovascular disease and its association to all-cause mortality. In: EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 32, S2: . Paper presented at 11th Conference of HEPA Europe (Health Enhancing Physical Activity). 31 August - 2 September 2022, Nice, France. Oxford University Press, 32
Open this publication in new window or tab >>P05-04 Physical activity level and sedentary time prior to cardiac ward admission among patients with cardiovascular disease and its association to all-cause mortality
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2022 (English)In: EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 32, S2, Oxford University Press, 2022, Vol. 32Conference paper, Oral presentation with published abstract (Other academic)
Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
physical exercise, sedentary behaviour, heart diseases, survival
National Category
Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7413 (URN)10.1093/eurpub/ckac095.071 (DOI)000848627100245 ()
Conference
11th Conference of HEPA Europe (Health Enhancing Physical Activity). 31 August - 2 September 2022, Nice, France
Note

The abstract was not presented at the conference due to covid pandemic, but published in the meeting abstracts.

Available from: 2022-11-29 Created: 2022-11-29 Last updated: 2022-12-01
Ekblom, Ö., Cider, Å., Hambraeus, K., Bäck, M., Leosdottir, M., Lönn, A. & Börjesson, M. (2022). Participation in exercise-based cardiac rehabilitation is related to reduced total mortality in both men and women: results from the SWEDEHEART registry.. European Journal of Preventive Cardiology, 29(3), 485-492
Open this publication in new window or tab >>Participation in exercise-based cardiac rehabilitation is related to reduced total mortality in both men and women: results from the SWEDEHEART registry.
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2022 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 29, no 3, p. 485-492Article in journal (Refereed) Published
Abstract [en]

AIMS: Participation in exercise-based cardiac rehabilitation (exCR) increases aerobic capacity and improves outcomes in patients following myocardial infarction (MI) and is therefore universally recommended. While meta-analyses consistently report that participation in exCR reduces cardiovascular mortality, there are conflicting results regarding effects on total mortality. Presently, many eligible patients do not receive exCR in clinical practice. We aimed to investigate the relation between participation in exCR post-MI and total mortality in men and women in a nationwide real-world cohort from the SWEDEHEART registry.

DESIGN: Longitudinal, observational cohort study.

METHODS AND RESULTS: In total, 20 895 patients from the SWEDEHEART registry were included. Mortality data were obtained from the Swedish National Population Registry. During a mean of 4.55 (±2.33) years of follow-up, 1000 patients died. Using Cox regression for proportional odds and taking a wide range of potential confounders into consideration, participation in exCR was related to significantly lower total mortality [hazard ratio (HR) 0.72, 95% confidence interval 0.62-0.83]. Excluding patients with shorter follow-up than 2 years did not alter the results. Exercise-based CR participation was related to lowered total mortality in most of the investigated subgroups. The risk reduction was more pronounced in women than in men (HR 0.54 vs. 0.81, respectively).

CONCLUSION: Participation in exCR was associated with reduced total mortality, and more pronounced in women, compared with men. Our results further support the recommendations to participate in exCR, and hence we argue that exCR should be a mandatory part of comprehensive CR programmes, offered to all patients post-MI.

Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
Cardiac rehabilitation, Gender, Mortality exercise, Myocardial infarction, Registry
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6729 (URN)10.1093/eurjpc/zwab083 (DOI)000755871400001 ()34097031 (PubMedID)
Funder
Region Västra Götaland, ALFGBG-720691
Available from: 2021-06-21 Created: 2021-06-21 Last updated: 2022-12-01
Ekblom Bak, E., Väisänen, D., Ekblom, B., Blom, V., Kallings, L., Hemmingsson, E., . . . Lönn, A. (2021). Cardiorespiratory fitness and lifestyle on severe COVID-19 risk in 279,455 adults: a case control study.. International Journal of Behavioral Nutrition and Physical Activity, 18(1), Article ID 135.
Open this publication in new window or tab >>Cardiorespiratory fitness and lifestyle on severe COVID-19 risk in 279,455 adults: a case control study.
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2021 (English)In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 18, no 1, article id 135Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The impact of cardiorespiratory fitness (CRF) and other lifestyle-related factors on severe COVID-19 risk is understudied. The present study aims to investigate lifestyle-related and socioeconomic factors as possible predictors of COVID-19, with special focus on CRF, and to further study whether these factors may attenuate obesity- and hypertension-related risks, as well as mediate associations between socioeconomic factors and severe COVID-19 risk.

METHODS: Out of initially 407,131 participants who participated in nationwide occupational health service screening between 1992 and 2020, n = 857 cases (70% men, mean age 49.9 years) of severe COVID-19 were identified. CRF was estimated using a sub-maximum cycle test, and other lifestyle variables were self-reported. Analyses were performed including both unmatched, n = 278,598, and sex-and age-matched, n = 3426, controls. Severe COVID-19 included hospitalization, intensive care or death due to COVID-19.

RESULTS: Patients with more severe COVID-19 had significantly lower CRF, higher BMI, a greater presence of comorbidities and were more often daily smokers. In matched analyses, there was a graded decrease in odds for severe COVID-19 with each ml in CRF (OR = 0.98, 95% CI 0.970 to 0.998), and a two-fold increase in odds between the lowest and highest (< 32 vs. ≥ 46 ml·min-1·kg-1) CRF group. Higher BMI (per unit increase, OR = 1.09, 1.06 to 1.12), larger waist circumference (per cm, OR = 1.04, 1.02 to 1.06), daily smoking (OR = 0.60, 0.41 to 0.89) and high overall stress (OR = 1.36, 1.001 to 1.84) also remained significantly associated with severe COVID-19 risk. Obesity- and blood pressure-related risks were attenuated by adjustment for CRF and lifestyle variables. Mediation through CRF, BMI and smoking accounted for 9% to 54% of the associations between low education, low income and blue collar/low skilled occupations and severe COVID-19 risk. The results were consistent using either matched or unmatched controls.

CONCLUSIONS: Both lifestyle-related and socioeconomic factors were associated with risk of severe COVID-19. However, higher CRF attenuated the risk associated with obesity and high blood pressure, and mediated the risk associated with various socioeconomic factors. This emphasises the importance of interventions to maintain or increase CRF in the general population to strengthen the resilience to severe COVID-19, especially in high-risk individuals.

Place, publisher, year, edition, pages
BioMed Central, 2021
Keywords
Cardiorespiratory fitness, Lifestyle, Obesity, Severe acute respiratory syndrome coronavirus 2, Socioeconomics
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6827 (URN)10.1186/s12966-021-01198-5 (DOI)000708860700001 ()34666788 (PubMedID)
Projects
HPI-gruppen
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2024-01-17
Blom, V., Lönn, A., Ekblom, B., Kallings, L., Väisänen, D., Hemmingsson, E., . . . Ekblom Bak, E. (2021). Lifestyle Habits and Mental Health in Light of the Two COVID-19 Pandemic Waves in Sweden, 2020. International Journal of Environmental Research and Public Health, 18(6), Article ID 3313.
Open this publication in new window or tab >>Lifestyle Habits and Mental Health in Light of the Two COVID-19 Pandemic Waves in Sweden, 2020
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2021 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 6, article id 3313Article in journal (Refereed) Published
Abstract [en]

The COVID-19 pandemic has become a public health emergency of international concern, which may have affected lifestyle habits and mental health. Based on national health profile assessments, this study investigated perceived changes of lifestyle habits in response to the COVID-19 pandemic and associations between perceived lifestyle changes and mental health in Swedish working adults. Among 5599 individuals (50% women, 46.3 years), the majority reported no change (sitting 77%, daily physical activity 71%, exercise 69%, diet 87%, alcohol 90%, and smoking 97%) due to the pandemic. Changes were more pronounced during the first wave (April–June) compared to the second (October–December). Women, individuals &lt;60 years, those with a university degree, white-collar workers, and those with unhealthy lifestyle habits at baseline had higher odds of changing lifestyle habits compared to their counterparts. Negative changes in lifestyle habits and more time in a mentally passive state sitting at home were associated with higher odds of mental ill-health (including health anxiety regarding one’s own and relatives’ health, generalized anxiety and depression symptoms, and concerns regarding employment and economy). The results emphasize the need to support healthy lifestyle habits to strengthen the resilience in vulnerable groups of individuals to future viral pandemics and prevent health inequalities in society.

Keywords
physical activity, sitting, alcohol, diet, smoking, SARS-CoV-2, Sweden, mental health, health anxiety, depression
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6611 (URN)10.3390/ijerph18063313 (DOI)000639241400001 ()33806951 (PubMedID)
Projects
HPI-gruppen
Available from: 2021-03-23 Created: 2021-03-23 Last updated: 2022-12-01
Ek, A., Ekblom, Ö., Ekström, M., Börjesson, M. & Kallings, L. (2021). The gap between stated importance of and clinical work in promoting healthy lifestyle habits by healthcare professionals in a Swedish hospital setting: A cross-sectional survey.. Health & Social Care in the Community, 29, 385-394
Open this publication in new window or tab >>The gap between stated importance of and clinical work in promoting healthy lifestyle habits by healthcare professionals in a Swedish hospital setting: A cross-sectional survey.
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2021 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 29, p. 385-394Article in journal (Refereed) Published
Abstract [en]

The objective of this study was to explore the stated importance of promoting healthy lifestyle habits (alcohol, eating habits, physical activity and tobacco) by healthcare professionals, and to what extent these attitudes were translated into clinical work. In 2014, healthcare professionals (n = 251) from cardiology departments in two hospitals in Stockholm, Sweden, participated in a cross-sectional descriptive questionnaire-based survey. The questionnaire included topics regarding stated importance and clinical work undertaken to promote healthy lifestyle habits. Personal and organisational factors of potential importance, expectations and future work were also explored. To analyse differences in stated importance and clinical work within and between lifestyle factors, comparisons of proportions were performed with 99% confidence intervals (CI). Relationships between stated importance and clinical work were investigated using logistic regression. The majority of healthcare professionals stated that it was 'very important' to promote healthy lifestyle habits among patients in general (69%-94%) and in their own clinical work (63%-80%). Despite this, always asking questions (18%-41%) or providing counselling (11%-23%) regarding lifestyle habits was reported to be rare. Overall, tobacco cessation was considered the most important behavioural change and was more often included in clinical work compared to promoting physical activity, healthy eating habits and limiting alcohol use. Clinical work was mainly influenced by to what extent the healthcare professional perceived clear organisational routines and objectives. In conclusion, we observed a gap between stated importance and clinical work in the promotion of healthy lifestyle habits among healthcare professionals. There were differences between lifestyle factors, indicating that work with tobacco cessation is the most established. Our results suggest that in order to promote patients' lifestyle habits in line with evidence-based guidelines, healthcare management should focus on and improve organisational routines and objectives.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
alcohol, cardiology service, eating habits, guideline adherence, physical activity, tobacco cessation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6263 (URN)10.1111/hsc.13097 (DOI)000548538200001 ()32671934 (PubMedID)
Projects
Ischemisk hjärtsjukdom
Note

At the time of Amanda Ek's dissertation this article was a manuscript.

Available from: 2020-08-14 Created: 2020-08-14 Last updated: 2022-12-01
Lönn, A. (2020). Fysisk aktivitet är bra för personer med hjärtsjukdom. Svensk Idrottsmedicn, 20(3), 21-25
Open this publication in new window or tab >>Fysisk aktivitet är bra för personer med hjärtsjukdom
2020 (Swedish)In: Svensk Idrottsmedicn, ISSN 2001-3302, Vol. 20, no 3, p. 21-25Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Svensk förening för fysisk aktivitet och idrottsmedicin, 2020
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6378 (URN)
Available from: 2020-11-17 Created: 2020-11-17 Last updated: 2020-11-18Bibliographically approved
Ek, A. (2020). Physical activity among patients with cardiovascular disease: a predictor of hospital care utilisation and mortality in clinical work. (Doctoral dissertation). Stockholm: Gymnastik och Idrottshögskolan, GIH
Open this publication in new window or tab >>Physical activity among patients with cardiovascular disease: a predictor of hospital care utilisation and mortality in clinical work
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Guidelines highlight the importance of physical activity (PA) in secondary prevention of cardiovascular disease (CVD) within the healthcare sector. Previous studies have mainly focused on the effects of PA at moderate-vigorous intensity performed within exercise-based cardiac rehabilitation (CR). However, only a minority of patients with CVD participate in exercise-based CR, and it is not known to what extent the guidelines for PA are implemented in clinical work. This leads to a knowledge gap in PA levels among patients with CVD, and the potential association of PA with hospital care utilisation and all-cause mortality. The overall aim of this thesis was to investigate PA and its importance for patients with CVD, and to what extent it is promoted during clinical work. The associations between self-rated PA level, changes in self-rated PA level, and sedentary time (SED) with hospital care utilisation and all-cause mortality were explored in three cohort studies (Studies I-III). Data were collected via questionnaires, medical records and national registers. Study I explored everyday PA, physical exercise and SED among patients with CVD (n=1148) prior to admittance to a cardiac ward at two of the hospitals in Stockholm. Studies II and III explored PA (of at least moderate intensity) post hospitalisation, and included 30 644 and 22 227 patients with myocardial infarction (MI), respectively, from the national SWEDHEART registry. Finally, in Study IV, healthcare professionals’ (n=251) stated importance and clinical work to promote healthy lifestyle habits (alcohol consumption, eating habits, physical activity, and smoking) were explored in a cross-sectional study. All healthcare professionals working on cardiac departments in two hospitals in Stockholm were included.

The main findings were:

• PA level (everyday PA, physical exercise, total PA level) and SED pre and post hospitalisation for cardiac events were found to be significant predictors of hospital care duration, readmission and mortality. The effects of high PA level and low SED did not differ between CVD diagnosis, sex, age, or comorbid states such as individuals with and without diabetes mellitus type II, kidney dysfunction, hypertension or dyslipidaemia.

• There were no differences between individuals reporting a moderate or high level of PA or a medium or low level of SED, illustrating that “a little activity is better than nothing” and that the greatest health benefits would be achieved by increasing PA among the most inactive patients with CVD.

• Changes in PA level during the first year post MI are important. Increased PA lowered the risk of mortality, and decreased PA increased the risk of mortality in patients post MI.

• Healthcare professionals considered it important to promote lifestyle habits among patients within the healthcare sector in general, as well as in their own clinical work. However, there was a difference between stated importance and clinical practice as only a minority of healthcare professionals asked or provided counselling on healthy lifestyle habits. Our results indicated a relationship between promoting patients’ lifestyle habits in clinical work, and if they perceived clear organisational routines and objectives.

In conclusion, the results of this thesis have a clinical impact. Firstly, asking patients on a cardiac department about their PA level and SED may identify individuals in need of behavioural changes. By identifying and supporting individuals who need to increase their PA level, clinicians may potentially decrease the utilisation of inpatient care and also lower the risk of all-cause mortality among individuals with a CVD diagnosis. Secondly, this information is of great predictive value, and PA can be seen as an additional marker of disease severity.

Place, publisher, year, edition, pages
Stockholm: Gymnastik och Idrottshögskolan, GIH, 2020. p. 108
Series
Avhandlingsserie för Gymnastik- och idrottshögskolan ; 17
Keywords
Cardiovascular disease, Physical exercise, Sedentary behaviour, Physical activity, Survival, Mortality, Hospitalisation, Cardiology Service, Guideline adherence
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Care Service and Management, Health Policy and Services and Health Economy Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5970 (URN)978-91-983151-8-9 (ISBN)
Public defence
2020-02-07, Aulan, Lidingövägen 1, Box 5626, Stockholm, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2022-12-01Bibliographically approved
Projects
E-PABS - a centre of Excellence in Physical Activity, healthy Brain functions and Sustainability [20210002 01 H]; Swedish School of Sport and Health Sciences, GIH; Publications
Hoy, S., Larsson, H., Kjellenberg, K., Nyberg, G., Ekblom, Ö. & Helgadóttir, B. (2024). Gendered relations? Associations between Swedish parents, siblings, and adolescents' time spent sedentary and physically active. Frontiers in Sports and Active Living, 6, Article ID 1236848. Heiland, E. G., Kjellenberg, K., Tarassova, O., Nyberg, G., Ekblom, M., Ekblom, Ö. & Helgadóttir, B. (2023). Acute effects of nitrate and breakfast on working memory and cerebral blood flow in adolescents: a randomized crossover trial. In: : . Paper presented at The International Society of Behavioral Nutrition and Physical Activity (ISBNPA), Uppsala, Sweden, June 15-18, 2023. Regan, C., Heiland, E. G., Ekblom, Ö., Tarassova, O., Kjellenberg, K., Larsen, F. J., . . . Helgadóttir, B. (2023). Acute effects of nitrate and breakfast on working memory, cerebral blood flow, arterial stiffness, and psychological factors in adolescents: Study protocol for a randomised crossover trial.. PLOS ONE, 18(5), Article ID e0285581. Farias, L., Nyberg, G., Helgadóttir, B. & Andermo, S. (2023). Adolescents' experiences of a school-based health promotion intervention in socioeconomically advantaged and disadvantaged areas in Sweden: a qualitative process evaluation study.. BMC Public Health, 23(1), Article ID 1631. Larsson, L. E., Wang, R., Cederholm, T., Wiggenraad, F., Rydén, M., Hagman, G., . . . Thunborg, C. (2023). Association of Sarcopenia and Its Defining Components with the Degree of Cognitive Impairment in a Memory Clinic Population.. Journal of Alzheimer's Disease, 96(2), 777-788Yman, J., Helgadóttir, B., Kjellenberg, K. & Nyberg, G. (2023). Associations between organised sports participation, general health, stress, screen-time and sleep duration in adolescents.. Acta Paediatrica, 112(3), 452-459Wu, J., Xiong, Y., Xia, X., Orsini, N., Qiu, C., Kivipelto, M., . . . Wang, R. (2023). Can dementia risk be reduced by following the American Heart Association's Life's Simple 7?: A systematic review and dose-response meta-analysis.. Ageing Research Reviews, 83, Article ID 101788. Nyberg, G., Helgadóttir, B., Kjellenberg, K. & Ekblom, Ö. (2023). COVID-19 and unfavorable changes in mental health unrelated to changes in physical activity, sedentary time, and health behaviors among Swedish adolescents: A longitudinal study.. Frontiers In Public Health, 11, Article ID 1115789. Helgadóttir, B., Fröberg, A., Kjellenberg, K., Ekblom, Ö. & Nyberg, G. (2023). COVID-19 induced changes in physical activity patterns, screen time and sleep among Swedish adolescents - a cohort study.. BMC Public Health, 23(1), Article ID 380. Kjellenberg, K., Heiland, E. G., Tarassova, O., Fernström, M., Nyberg, G., Ekblom, M., . . . Ekblom, Ö. (2023). Effects of physical activity breaks on working memory and oxygenated hemoglobin in adolescents: Results from the AbbaH teen study. In: : . Paper presented at ArtScientific 2023, Frankfurt, Germany, May 5-6, 2023.
The twin project – Twin-based studies on the importance of genes and environment in associations between physical activity patterns and brain health in adolescents; Swedish School of Sport and Health Sciences, GIH; Publications
Ekblom, M., Ekblom, Ö., Wiklund, C. & Wang, R. (2023). Environmental and genetic contributions to device-based measures of physical activity in Swedish 9-year-olds.. In: : . Paper presented at ISBNPA, International Society of Behavioral Nutrition and Physical Activity annual meeting, June 14-17, 2023, Uppsala, Sweden.
Physiological and psychological effect of physical activity in patients with burnout; Swedish School of Sport and Health Sciences, GIHPhysical Activity and sedentary behavior post myocardial infarction, assessed with accelerometry [FA 2022/22]; Swedish School of Sport and Health Sciences, GIH
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ORCID iD: ORCID iD iconorcid.org/0000-0001-9833-8306

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