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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)000499749900001 ()31631386 (PubMedID)
Projects
HPI-gruppen
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-12-18Bibliographically approved
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
Dreber, H., Thorell, A., Reynisdottir, S. & Hemmingsson, E. (2019). Health-Related Quality of Life 5 Years After Roux-en-Y Gastric Bypass in Young (18-25 Years) Versus Older (≥ 26 Years) Adults: a Scandinavian Obesity Surgery Registry Study.. Obesity Surgery, 29(2), 434-443
Open this publication in new window or tab >>Health-Related Quality of Life 5 Years After Roux-en-Y Gastric Bypass in Young (18-25 Years) Versus Older (≥ 26 Years) Adults: a Scandinavian Obesity Surgery Registry Study.
2019 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 29, no 2, p. 434-443Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To compare changes in health-related quality of life (HRQoL) in young (18-25 years) versus older (≥ 26 years) adults up to 5 years after Roux-en-Y gastric bypass (RYGB).

METHODS: Data on Short Form-36 (SF-36) and obesity-related problems scale (OP) at baseline and 1, 2, and 5 years after RYGB were extracted from the Scandinavian Obesity Surgery Registry. Within-group changes and the effect of age group on 5-year changes in SF-36 and OP were analyzed. Effects sizes (ESs) were calculated.

RESULTS: A total of 2542 young and 12,425 older adults were included at baseline, and 138 young (20.7% of those eligible) and 1021 older (31.8%) adults were followed-up 5 years post-RYGB. At this time, average to large improvements (ES ≥ 0.5) were observed in physical functioning, physical component score and OP in young adults, and in physical functioning, role physical, general health, physical component score, and OP in older adults (all, p ≤ 0.001). Both age groups displayed negligible to weak (ES < 0.5) or no improvements in mental HRQoL (all, p < 0.55). Older adults displayed greater 5-year improvements than their young counterparts in role physical, general health, vitality, social functioning, physical component score, and obesity-related problems scale (all, p < 0.05).

CONCLUSIONS: Both young and older adults displayed improvements in OP and physical HRQoL 5 years post-RYGB compared to baseline, while mental HRQoL did not improve to the same extent. Greater HRQoL-improvements could be expected in older patients why future research on HRQoL post-RYGB should stratify data on age groups.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
HRQoL, RYGB, Young adult
National Category
Surgery
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5997 (URN)10.1007/s11695-018-3559-3 (DOI)30426351 (PubMedID)
Available from: 2020-01-20 Created: 2020-01-20 Last updated: 2020-01-20
Salier Eriksson, J., Ekblom Bak, E., Blom, V., Kallings, L., Ekblom, Ö., Hemmingsson, E., . . . Lindwall, M. (2019). Latent profiles of sedentary time, exercise and cardiorespiratory fitness in adults, and the associations with metabolic and percieved health. In: : . Paper presented at EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal.
Open this publication in new window or tab >>Latent profiles of sedentary time, exercise and cardiorespiratory fitness in adults, and the associations with metabolic and percieved health
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2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Health Sciences
Research subject
Medicine/Technology; Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6000 (URN)
Conference
EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal
Available from: 2020-01-21 Created: 2020-01-21 Last updated: 2020-01-21Bibliographically approved
Hemmingsson, E., Ekblom, Ö., Kallings, L., Andersson, G., Wallin, P., Söderling, J., . . . Ekblom Bak, E. (2019). Objectively measured prevalence and time trends of obesity and severe obesity in 447 925 Swedish adults, 1995-2017. In: : . Paper presented at EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal.
Open this publication in new window or tab >>Objectively measured prevalence and time trends of obesity and severe obesity in 447 925 Swedish adults, 1995-2017
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2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5998 (URN)
Conference
EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal
Available from: 2020-01-20 Created: 2020-01-20 Last updated: 2020-01-20Bibliographically approved
Christenson, A., Johansson, E., Reynisdottir, S., Torgerson, J. & Hemmingsson, E. (2019). “…or else I close my ears” How women with obesity want to be approached and treated regarding gestational weight management: A qualitative interview study.. PLoS ONE, 14(9), 1-17
Open this publication in new window or tab >>“…or else I close my ears” How women with obesity want to be approached and treated regarding gestational weight management: A qualitative interview study.
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 9, p. 1-17Article in journal (Refereed) Published
Abstract [en]

Introduction: The importance of helping pregnant women maintain a healthy lifestyle and prevent excessive gestational weight gain is well recognized, but pregnant women do not always perceive communication about body weight as respectful or helpful. Furthermore, fear of inducing shame or guilt can prohibit some midwives from talking about body weight, especially if the woman has obesity. We aimed to explore what women of reproductive age with obesity regard to be the most important and relevant aspects when discussing gestational weight management. Methods: Qualitative interview study using focus groups and individual semi-structured interviews with 17 women of reproductive age (19–39 y) with obesity. Thematic analysis was used to analyze the data. Results: We identified three themes: 1) Importance of obtaining vital medical information; 2) A wish to feel understood and treated with respect; 3) Midwives’ approach is crucial in sensitive key situations, which include bringing up the subject of body weight, weighing, providing weight-related information, coaching lifestyle modification, dealing with emotional reactions and ending a conversation. Conclusions: A majority of the interviewed women wished to receive information about risks about obesity and gestational weight gain, and recommendations on weight management. However, the risk of midwives offending someone by raising the topic may be increased if the pregnant woman believe that gestational weight gain is uncontrollable by the individual. Also, several situations during maternity care meetings can be stigmatizing and make women less receptive to advice or support. Women suggest that a good working alliance is likely to be achieved if midwives have knowledge about the causes of obesity, take interest in the patients’ background, have a non-judgmental approach and refrain from giving unsolicited advice. 

Place, publisher, year, edition, pages
Public Library of Science, 2019
Keywords
Biology and life sciences, Body mass index, Body weight, Emotions, Maternal health, Medical personnel, Medicine and health sciences, Midwives, Obesity, Obstetrics and gynecology, People and places, Physiological parameters, Physiology, Population groupings, Pregnancy, Professions, Psychology, Research, Article, Social sciences, Weight gain, Women's health
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5851 (URN)10.1371/journal.pone.0222543 (DOI)
Available from: 2019-09-24 Created: 2019-09-24 Last updated: 2019-09-24
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
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 316.137 Swedish adults. In: : . Paper presented at EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal.
Open this publication in new window or tab >>Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 316.137 Swedish adults
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2019 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6001 (URN)
Conference
EuroPrevent 2019. 11-13 April 2019, Lisbon, Portugal
Available from: 2020-01-21 Created: 2020-01-21 Last updated: 2020-01-21Bibliographically approved
Hemmingsson, E. (2018). Early Childhood Obesity Risk Factors: Socioeconomic Adversity, Family Dysfunction, Offspring Distress, and Junk Food Self-Medication.. Current Obesity Reports, 7(2), 204-209
Open this publication in new window or tab >>Early Childhood Obesity Risk Factors: Socioeconomic Adversity, Family Dysfunction, Offspring Distress, and Junk Food Self-Medication.
2018 (English)In: Current Obesity Reports, E-ISSN 2162-4968, Vol. 7, no 2, p. 204-209Article in journal (Refereed) Published
Abstract [en]

PURPOSE OF REVIEW: To explore the sequence and interaction of infancy and early childhood risk factors, particularly relating to disturbances in the social environment, and how the consequences of such exposures can promote weight gain and obesity.

RECENT FINDINGS: This review will argue that socioeconomic adversity is a key upstream catalyst that sets the stage for critical midstream risk factors such as family strain and dysfunction, offspring insecurity, stress, emotional turmoil, low self-esteem, and poor mental health. These midstream risk factors, particularly stress and emotional turmoil, create a more or less perfect foil for calorie-dense junk food self-medication and subtle addiction, to alleviate uncomfortable psychological and emotional states. Disturbances in the social environment during infancy and early childhood appear to play a critical role in weight gain and obesity, through such mechanisms as insecurity, stress, and emotional turmoil, eventually leading to junk food self-medication and subtle addiction.

Keywords
Affective states, Emotion regulation, Family environment, Food addiction, Infancy, Obesity etiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5264 (URN)10.1007/s13679-018-0310-2 (DOI)000432628100013 ()29704182 (PubMedID)
Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2018-06-07
Christenson, A., Johansson, E., Reynisdottir, S., Torgerson, J. & Hemmingsson, E. (2018). Shame and avoidance as barriers in midwives’ communication about body weight with pregnant women: A qualitative interview study. Midwifery, 63, 1-7
Open this publication in new window or tab >>Shame and avoidance as barriers in midwives’ communication about body weight with pregnant women: A qualitative interview study
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2018 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 63, p. 1-7Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION:

Excessive gestational weight gain, regardless of initial BMI, is associated with perinatal risks for both mother and offspring and contributes to obesity in women. Studies report that healthcare professionals find it difficult to communicate about weight and pregnant women perceive healthcare professionals as unconcerned, leaving many women uninformed about weight recommendations and risks. We aimed to explore how midwives approach communication about gestational weight gain recommendations, and to characterize communication barriers and facilitators.

METHODS:

Seventeen midwives from different areas in Sweden were interviewed by a therapist using semi-structured interviews. Interviews were transcribed verbatim and analysed by three researchers using latent content analysis. Recurrent themes were identified and formulated.

RESULTS:

The main theme identified in the latent part of the analysis was "midwives use avoidant behaviours to cope with fear of inflicting worries, shame or feelings of guilt in pregnant women". Avoidant behaviours include: adjusting weight recommendations, toning down risks and avoid talking about weight. Subthemes identified were (I) Conflicting responsibilities in midwives' professional identity (II) Perceived deficiencies in the working situation.

CONCLUSION:

Midwives' empathy and awareness of weight stigma strongly affects communication about weight with pregnant women, and midwives' use of avoidant behaviours constitutes salient information barriers. More research is needed on whether gestational weightguidelines and weighing routines for all women, resources for extra visits, training in specific communication skills and backup access to other professions can facilitate for midwives to initiate and communicate about healthy gestational weight development, enabling more pregnant women to make well-informed lifestyle choices.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5282 (URN)10.1016/j.midw.2018.04.020 (DOI)000436780500002 ()
Available from: 2018-06-04 Created: 2018-06-04 Last updated: 2018-08-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7335-3796

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