Gymnastik- och idrottshögskolan, GIH

OBJECTIVES: To examine the associations between changes in cardiorespiratory fitness (CRF) in adulthood and prostate cancer incidence and mortality.

METHODS: In this prospective study, men who completed an occupational health profile assessment including at least two valid submaximal CRF tests, performed on a cycle ergometer, were included in the study. Data on prostate cancer incidence and mortality were derived from national registers. HRs and CIs were calculated using Cox proportional hazard regression with inverse probability treatment weights of time-varying covariates.

RESULTS: During a mean follow-up time of 6.7 years (SD 4.9), 592 (1%) of the 57 652 men were diagnosed with prostate cancer, and 46 (0.08%) died with prostate cancer as the primary cause of death. An increase in absolute CRF (as % of L/min) was associated with a reduced risk of prostate cancer incidence (HR 0.98, 95% CI 0.96 to 0.99) but not mortality, in the fully adjusted model. When participants were grouped as having increased (+3%), stable (±3%) or decreased (-3%) CRF, those with increased fitness also had a reduced risk of prostate cancer incidence compared with those with decreased fitness (HR 0.65, 95% CI 0.49 to 0.86), in the fully adjusted model.

CONCLUSION: In this study of employed Swedish men, change in CRF was inversely associated with risk of prostate cancer incidence, but not mortality. Change in CRF appears to be important for reducing the risk of prostate cancer.

OBJECTIVE: Specific information for whom and when cardiorespiratory fitness (CRF) is associated with depression risk is lacking. We aimed to study the association between adulthood CRF and incident depression, long-term sickness absence, and disability pension due to depression, as well as examine moderation of sex, age, education, and occupation on associations.

METHODS: A large prospective cohort study follows participants over time with Swedish occupational health screenings data. The study includes 330,247 individuals (aged 16-79 years, 46% women) without a depression diagnosis at baseline. CRF was estimated from a submaximal cycle test.

RESULTS: CRF was associated beneficially from low to higher levels with incident depression and long-term sickness absence due to depression. Further, CRF at high levels (≥46 ml/min/kg) was associated with a decreased risk of receiving disability pension due to depression. The associations remained after adjustment for age and sex, but not lifestyle-related factors and co-morbidity. Participants with moderate and high CRF had 16% and 21%, respectively, lower risk for incident depression, and participants with high CRF had 11% lower risk for long-term sickness absence due to depression. Associations between higher CRF and the outcomes were mainly evident in men, younger participants, and individuals with low education.

CONCLUSION: In a large sample of adults without a depression diagnosis at baseline, higher CRF was shown to be beneficially related to the risk of incident depression and, to some extent, long-term sickness absence due to depression. If causal, targeted interventions focusing on increasing CRF in these sub-groups should be prioritized.

INTRODUCTION: High cardiorespiratory fitness (CRF) has been associated with a lower risk of depression, anxiety, and cerebrovascular disease. The aim was to explore CRF changes over-time associated with these outcomes.

METHODS: This large-scale prospective cohort study, using data from Swedish population-wide registries and databases (during 1972-2020), included men (n=131,431), with measures of estimated CRF (estCRF) in late adolescence (maximal cycle test) and adulthood (submaximal cycle test) (mean years between 24.6, SD 8.8). The study explored how change in estCRF was associated with incident depression, anxiety, and cerebrovascular disease using Cox proportional hazards models. Analyses were performed in 2023.

RESULTS: Higher estCRF in late adolescence and adulthood were associated with a lower risk of incident depression, anxiety, and cerebrovascular disease later in life. For all three outcomes, an increase in estCRF (mL/min/kg and z-score) between the two-time points was associated with a lower risk. Further, decreasing from moderate or high estCRF in adolescence to low estCRF in adulthood, compared to staying at a moderate or high level, was associated with a higher risk of depression and anxiety (HR: 1.24 95% CI 1.07-1.45 and 1.25 95% CI 1.06-1.49, respectively). Conversely, increasing from moderate to high estCRF was associated with a lower risk of incident anxiety (HR: 0.84 95% CI 0.71-0.99).

CONCLUSIONS: The findings indicate that there is a longitudinal association between negative change in estCRF and increased risk of depression, anxiety, and cerebrovascular disease later in life. Decreasing levels of estCRF could be a helpful indicator when identifying these disorders at a population level.

INTRODUCTION: The aim of this prospective cohort study was to investigate the associations between changes in cardiorespiratory fitness (CRF) and the risk of colorectal and prostate cancer in men.

METHODS: Data from men who completed a health assessment both in military conscription in youth and an occupational health profile assessment (HPA) later in life were used. CRF was assessed as estimated V̇O_2max, using a cycle ergometer fitness test at both time points. We linked the assessment data to national register data on colorectal and prostate cancer incidence, and hazard ratios and confidence intervals were estimated using Cox proportional hazard regression.

RESULTS: 139,764 men with a mean age of 18 (SD 0.6) at conscription and 43 (SD 8.9) at HPA were included. The average time between the two assessments was 25.9 (SD 9.0) years and mean follow-up time following HPA test was 10.0 (SD 5.6) years for prostate and colorectal cancer. Annual percentage change in relative and absolute V̇O_2max from conscription to HPA was inversely associated with the risk of colorectal cancer incidence, hazard ratio of 0.83 (95% CI [0.72-0.94]) and 0.88 (95% CI [0.79-0.99]), respectively. These associations were driven by data from individuals in the lowest and moderate level fitness tertials at conscription. Change in CRF was not associated with prostate cancer incidence risk.

CONCLUSIONS: Changes in, not only level of, CRF from youth to adulthood are related to colorectal cancer incidence risk and therefore, improving CRF should be considered as an important colorectal cancer risk reduction strategy.

OBJECTIVES: This study aimed to investigate the reach of a large-scale health assessment delivered by the occupational health service in Sweden for almost 30 years.

METHODS: A total of 418 286 individuals who participated in a health assessment (Health Profile Assessment, HPA) between 1995-2021 were included. A comparative sample was obtained from Statistics Sweden, comprising the entire working population for each year (4 962 127-6 011 829 unique individuals per time period). Sociodemographic and work organization characteristics were compared between the HPA and comparative population for six different periods. Under- and overrepresented groups in the private and public sectors were identified using the most recent data (2015-2021).

RESULTS: With negative per cent indicating underrepresentation, the most notable changes over time in representation in the HPA population compared to the comparative were observed for women (-1.2% to -12.8%), private sector employees (-9.4% to 14.9%), individuals with ≥3 years of employment (14.5% to 0.9%), in personal care (0.8% to -8.8%) and manufacturing (0.7% to 6.4%) occupations. Consistently overrepresented groups (median representation across periods) included individuals who had a single income source (6.3%) and were middle-aged (10.8%), born in Sweden (5.9%), associate professionals (8.7%), and employed in companies with high operating profit (17.9%) and low staff turnover (14.3%). Conversely, individuals with low income (-34.0%) and employed in small companies/organizations (-10.9%) were consistently underrepresented. Middle-aged women in education occupations were most underrepresented in the public sector, while in the private sector, it was young women in service and shop sales occupations.

CONCLUSIONS: This health assessment has reached many professionals, including hard-to-reach groups, but did not fully represents the Swedish workforce throughout the years.

En internationell studie visar att de flesta VM- och OS-medaljörer ­hållit på med flera sporter och valt sin huvudidrott relativt sent. AIK och ­andra klubbar gör fel när de sorterar bort 10-åringar och satsar på ­”akademier”. Prestationshetsen måste bort, för både folkhälsans och elit­idrottens skull, skriver 17 idrottsforskare.

IMPORTANCE: Cardiorespiratory fitness (CRF) levels appear to be an important risk factor for cancer incidence and death.

OBJECTIVES: To examine CRF and prostate, colon, and lung cancer incidence and mortality in Swedish men, and to assess whether age moderated any associations between CRF and cancer.

DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted in a population of men who completed an occupational health profile assessment between October 1982 and December 2019 in Sweden. Data analysis was performed from June 22, 2022, to May 11, 2023.

EXPOSURE: Cardiorespiratory fitness was assessed as maximal oxygen consumption, estimated using a submaximal cycle ergometer test.

MAIN OUTCOMES AND MEASURES: Data on prostate, colon, and lung cancer incidence and mortality were derived from national registers. Hazard ratios (HRs) and 95% CIs were calculated using Cox proportional hazards regression.

RESULTS: Data on 177 709 men (age range, 18-75 years; mean [SD] age, 42 [11] years; mean [SD] body mass index, 26 [3.8]) were analyzed. During a mean (SD) follow-up time of 9.6 (5.5) years, a total of 499 incident cases of colon, 283 of lung, and 1918 of prostate cancer occurred, as well as 152 deaths due to colon cancer, 207 due to lung cancer, and 141 deaths due to prostate cancer. Higher levels of CRF (maximal oxygen consumption as milliliters per minute per kilogram) were associated with a significantly lower risk of colon (HR, 0.98, 95% CI, 0.96-0.98) and lung cancer (HR, 0.98; 95% CI, 0.96-0.99) incidence, and a higher risk of prostate cancer incidence (HR, 1.01; 95% CI, 1.00-1.01). Higher CRF was associated with a lower risk of death due to colon (HR, 0.98; 95% CI, 0.96-1.00), lung (HR, 0.97; 95% CI, 0.95-0.99), and prostate (HR, 0.95; 95% CI, 0.93-0.97) cancer. After stratification into 4 groups and in fully adjusted models, the associations remained for moderate (>35-45 mL/min/kg), 0.72 (0.53-0.96) and high (>45 mL/min/kg), 0.63 (0.41-0.98) levels of CRF, compared with very low (<25 mL/min/kg) CRF for colon cancer incidence. For prostate cancer mortality, associations remained for low (HR, 0.67; 95% CI, 0.45-1.00), moderate (HR, 0.57; 95% CI, 0.34-0.97), and high (HR, 0.29; 95% CI, 0.10-0.86) CRF. For lung cancer mortality, only high CRF (HR, 0.41; 95% CI, 0.17-0.99) was significant. Age modified the associations for lung (HR, 0.99; 95% CI, 0.99-0.99) and prostate (HR, 1.00; 95% CI, 1.00-1.00; P < .001) cancer incidence, and for death due to lung cancer (HR, 0.99; 95% CI, 0.99-0.99; P = .04).

CONCLUSIONS AND RELEVANCE: In this cohort of Swedish men, moderate and high CRF were associated with a lower risk of colon cancer. Low, moderate, and high CRF were associated with lower risk of death due to prostate cancer, while only high CRF was associated with lower risk of death due to lung cancer. If evidence for causality is established, interventions to improve CRF in individuals with low CRF should be prioritized.

Previous studies suggest a preretirement disengagement process from work, which includes reduced work motivation. In this study, we investigated changes in autonomous and controlled work motivation over two years among participants of the Health, Aging and Retirement Transition in Sweden (HEARTS) study. We found stability in both types of motivation; however, those who retired after the study period showed more distinct declines in autonomous motivation. A stronger sense of community at work was related to level, but not change in autonomous motivation. Intra-individual fluctuations in the expected retirement age did not predict work motivation or vice versa. Future studies are needed to better understand the antecedents and consequences of preretirement declines in autonomous work motivation.

Retirement is a major life transition that involves changes to everyday routines, roles, and habits. Previous studies suggest that retirement may influence drinking habits. Many natural inhibitors of alcohol consumption disappear with the removal of work constraints. The potential impact depends on both individual and contextual factors. Women in the cohorts undergoing retirement now have been more active on the labor market, including the occupation of higher status jobs, which indicates more financial resources as well as a larger role loss after retirement. Also, the current cohorts who retire have had more liberal drinking habits throughout their lives compared to previous cohorts. We therefore examined changes in alcohol consumption surrounding retirement in different education groups among women and men undergoing retirement using annual data from the Health, Aging and Retirement Transitions in Sweden (HEARTS) study, a longitudinal national study of 60- to 66-year-olds (n = 5,913), from 2015 to 2018. Latent growth curve models were used to estimate trajectories of alcohol consumption. Results showed that those who retired during the follow-up increased their usual weekly alcohol consumption while those who worked or were retired throughout the period had stable drinking habits. Those who were retired reported the highest alcohol consumption. The increase surrounding retirement was driven by people with higher education. Women with tertiary education and men with intermediate or tertiary education increased their weekly alcohol intake after retirement, while those with low education had unchanged drinking habits. Mechanisms and motivations that may fuel increased alcohol intake among people with higher education should be further investigated.

Objectives: To examine bidirectional within- and between-person relations between physical activity and cognitive function across 15 years.

Methods: Participants (N = 1722, age range 40-85 years, 55% women) were drawn from the Betula prospective cohort study. We included four waves of data. Bivariate latent curve models with structured residuals were estimated to examine bidirectional within- and between-person relations between physical activity and cognitive function (episodic memory recall, verbal fluency, visuospatial ability).

Results: We observed no statistically significant bidirectional within-person relations over time. Higher levels of physical activity at baseline were related to less decline in episodic memory recall. Positive occasion-specific within- and between-person relations were observed, with the most consistent being between physical activity and episodic memory recall.

Discussion: The lack of bidirectional within-person relations indicate that shorter time lags may be needed to capture time-ordered within-person relations. The link between higher physical activity at baseline and less decline in episodic memory recall over time may indicate a protective effect of physical activity on episodic memory recall.