Gymnastik- och idrottshögskolan, GIH

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  • 1.
    Andersson, Helena
    et al.
    Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden..
    Caspers, Andreas
    Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden ; Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden..
    Godhe, Manne
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Helge, Torbjörn
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Eriksen, Julia
    Department of Medicine, Geriatrics and Acute Medicine, Östra Sjukhuset, Sahlgrenska University Hospital, Gothenburg, Sweden..
    Fransson, Dan
    Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden ; Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden..
    Börjesson, Mats
    Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Walking football for Health - physiological response to playing and characteristics of the players.2023In: Science and medicine in football, ISSN 2473-3938, E-ISSN 2473-4446, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p = .001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.

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  • 2.
    Arvidsson, Daniel
    et al.
    Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Fridolfsson, J
    Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bergström, G
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ; Department of Clinical Physiology, Region Västra Götaland, Gothenburg, Sweden..
    Börjesson, Mats
    Center for Health and Performance, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. ; Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden..
    Fundament for a methodological standard to process hip accelerometer data to a measure of physical activity intensity in middle-aged individuals.2024In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 34, no 1, article id e14541Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of a methodological standard to process accelerometer data to measures of physical activity, which impairs data quality and comparability. This study investigated the effect of different combinations of settings of multiple processing components, on the measure of physical activity and the association with measures of cardiometabolic health in an unselected population of middle-aged individuals.

    METHODS: Free-living hip accelerometer data, aerobic fitness, body mass index, HDL:total cholesterol ratio, blood glucose, and systolic blood pressure were achieved from 4391 participants 50-64 years old included in The Swedish CArdioPulmonary bioImage Study (SCAPIS) baseline measurement (cross-sectional). Lab data were also included for calibration of accelerometers to provide comparable measure of physical activity intensity and time spent in different intensity categories, as well as to enhance understanding. The accelerometer data processing components were hardware recalibration, frequency filtering, number of accelerometer axes, epoch length, wear time criterium, time composition (min/24 h vs. % of wear time). Partial least regression and ordinary least regression were used for the association analyses.

    RESULTS: The setting of frequency filter had the strongest effect on the physical activity intensity measure and time distribution in different intensity categories followed by epoch length and number of accelerometer axes. Wear time criterium and recalibration of accelerometer data were less important. The setting of frequency filter and epoch length also showed consistent important effect on the associations with the different measures of cardiometabolic health, while the effect of recalibration, number of accelerometer axes, wear time criterium and expression of time composition was less consistent and less important. There was a large range in explained variance of the measures of cardiometabolic health depending on the combination of processing settings, for example, 12.1%-20.8% for aerobic fitness and 5.8%-14.0% for body mass index.

    CONCLUSIONS: There was a large variation in the physical activity intensity measure and the association with different measures of cardiometabolic health depending on the combination of settings of accelerometer data processing components. The results provide a fundament for a standard to process hip accelerometer data to assess the physical activity in middle-aged populations.

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  • 3.
    Arvidsson, Daniel
    et al.
    University of Gothenburg, Sweden.
    Fridolfsson, Jonatan
    University of Gothenburg, Sweden.
    Buck, Christoph
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Lissner, Lauren
    University of Gothenburg, Sweden.
    Hunsberger, Monica
    University of Gothenburg, Sweden.
    Börjesson, Mats
    University of Gothenburg, Sweden.
    Reexamination of Accelerometer Calibration with Energy Expenditure as Criterion: VO2net Instead of MET for Age-Equivalent Physical Activity Intensity.2019In: Sensors, E-ISSN 1424-8220, Vol. 19, no 15, article id E3377Article in journal (Refereed)
    Abstract [en]

    Accelerometer calibration for physical activity (PA) intensity is commonly performed using Metabolic Equivalent of Task (MET) as criterion. However, MET is not an age-equivalent measure of PA intensity, which limits the use of MET-calibrated accelerometers for age-related PA investigations. We investigated calibration using VO2net (VO2gross - VO2stand; mL⋅min-1⋅kg-1) as criterion compared to MET (VO2gross/VO2rest) and the effect on assessment of free-living PA in children, adolescents and adults. Oxygen consumption and hip/thigh accelerometer data were collected during rest, stand and treadmill walk and run. Equivalent speed (Speedeq) was used as indicator of the absolute speed (Speedabs) performed with the same effort in individuals of different body size/age. The results showed that VO2net was higher in younger age-groups for Speedabs, but was similar in the three age-groups for Speedeq. MET was lower in younger age-groups for both Speedabs and Speedeq. The same VO2net-values respective MET-values were applied to all age-groups to develop accelerometer PA intensity cut-points. Free-living moderate-and-vigorous PA was 216, 115, 74 and 71 min/d in children, adolescents, younger and older adults with VO2net-calibration, but 140, 83, 74 and 41 min/d with MET-calibration, respectively. In conclusion, VO2net calibration of accelerometers may provide age-equivalent measures of PA intensity/effort for more accurate age-related investigations of PA in epidemiological research.

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  • 4.
    Baldanzi, Gabriel
    et al.
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Sayols-Baixeras, Sergi
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; CIBER Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain..
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Dekkers, Koen F
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Hammar, Ulf
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Nguyen, Diem
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Ahmad, Shafqat
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Preventive Medicine Division, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States.
    Ericson, Ulrika
    Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden..
    Arvidsson, Daniel
    Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden..
    Börjesson, Mats
    Center for Lifestyle Intervention, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Geriatric and Acute Medicine Östra, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Johanson, Peter J
    Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden..
    Smith, J Gustav
    The Wallenberg Laboratory/Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University and the Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden; Wallenberg Center for Molecular Medicine and Lund University Diabetes Center, Lund University, Lund, Sweden..
    Bergström, Göran
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Physiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden..
    Lind, Lars
    Clinical Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Gunnar
    Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden..
    Ärnlöv, Johan
    Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden..
    Kennedy, Beatrice
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Orho-Melander, Marju
    Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden..
    Fall, Tove
    Molecular Epidemiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS.2024In: EBioMedicine, E-ISSN 2352-3964, Vol. 100, article id 104989Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous population-based studies investigating the relationship between physical activity and the gut microbiota have relied on self-reported activity, prone to reporting bias. Here, we investigated the associations of accelerometer-based sedentary (SED), moderate-intensity (MPA), and vigorous-intensity (VPA) physical activity with the gut microbiota using cross-sectional data from the Swedish CArdioPulmonary bioImage Study.

    METHODS: In 8416 participants aged 50-65, time in SED, MPA, and VPA were estimated with hip-worn accelerometer. Gut microbiota was profiled using shotgun metagenomics of faecal samples. We applied multivariable regression models, adjusting for sociodemographic, lifestyle, and technical covariates, and accounted for multiple testing.

    FINDINGS: Overall, associations between time in SED and microbiota species abundance were in opposite direction to those for MPA or VPA. For example, MPA was associated with lower, while SED with higher abundance of Escherichia coli. MPA and VPA were associated with higher abundance of the butyrate-producers Faecalibacterium prausnitzii and Roseburia spp. We observed discrepancies between specific VPA and MPA associations, such as a positive association between MPA and Prevotella copri, while no association was detected for VPA. Additionally, SED, MPA and VPA were associated with the functional potential of the microbiome. For instance, MPA was associated with higher capacity for acetate synthesis and SED with lower carbohydrate degradation capacity.

    INTERPRETATION: Our findings suggest that sedentary and physical activity are associated with a similar set of gut microbiota species but in opposite directions. Furthermore, the intensity of physical activity may have specific effects on certain gut microbiota species.

    FUNDING: European Research Council, Swedish Heart-Lung Foundation, Swedish Research Council, Knut and Alice Wallenberg Foundation.

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  • 5. Berglund, B
    et al.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Ekblom, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Berglund, L
    Kallner, A
    Reinebo, P
    Lindeberg, S
    The Swedish Blood Pass project.2007In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 17, no 3, p. 292-7Article in journal (Refereed)
    Abstract [en]

    Manipulation of the blood's oxygen carrying capacity (CaO(2)) through reinfusion of red blood cells, injections of recombinant erythropoietin or by other means results in an increased maximal oxygen uptake and concomitantly enhanced endurance performance. Therefore, there is a need to establish a system--"A Blood Pass"--through which such illegal and unethical methods can be detected. Venous blood samples were taken under standardized conditions from 47 male and female Swedish national and international elite endurance athletes four times during the athletic year of the individual sport (beginning and end of the preparation period and at the beginning and during peak performance in the competition period). In these samples, different hematological values were determined. ON(hes) and OFF(hre) values were calculated according to the formula of Gore et al. A questionnaire regarding training at altitude, alcohol use and other important factors for hematological status was answered by the athletes. There were some individual variations comparing hematological values obtained at different times of the athletic year or at the same time in the athletic year but in different years. However, the median values of all individual hematological, ON(hes) and OFF(hre), values taken at the beginning and the end of the preparation or at the beginning and the end of the competition period, respectively, as well as median values for the preparation and competition periods in the respective sport, were all within the 95% confidence limit (CI) of each comparison. It must be mentioned that there was no gender difference in this respect. This study shows that even if there are some individual variations in different hematological values between different sampling times in the athletic year, median values of important hematological factors are stable over time. It must be emphasized that for each blood sample, the 95% CI in each athlete will be increasingly narrower. The conclusion is that there is a physiological basis for establishing an individual-based "Blood Pass" system, mainly for athletes competing at the international level. On indications of manipulations of hemoglobin concentration and red cell mass by deviations from established "Blood Pass" data, more specific methods can be applied.

  • 6.
    Björkman, Frida
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. School of Health and Welfare, Dalarna University, Falun, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bohman, Tony
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. School of Health and Welfare, Dalarna University, Falun, Sweden.
    The ability of a submaximal cycle ergometer test to detect longitudinal changes in VO2max.2021In: BMC sports science, medicine & rehabilitation, ISSN 2052-1847, Vol. 13, no 1, article id 156Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of the present study was to examine the ability of a submaximal cycling test to detect longitudinal changes in maximal oxygen uptake (VO2max) and examine the conformity between changes in measured and estimated VO2max over a time span of 5-8 years.

    METHODS: A total of 35 participants (21 men and 14 women), aged 29 to 63 years, performed the Ekblom-Bak (EB) submaximal cycle test for estimation of VO2max and a maximal treadmill running test for direct measurement of VO2max. The baseline tests were conducted between 2009 and 2012, and the follow-up tests were completed 5 to 8 years later. Pearson's coefficient of correlation (r) and paired sample t-test were used to analyse the association between change in measured and estimated VO2max. Random and systematic errors between the measured and estimated VO2max were evaluated using Bland-Altman plots. Repeated measures ANOVA were used to test differences between changes over time.

    RESULTS: There was no significant change in mean measured VO2max between baseline and follow-up (p = 0.91), however large individual variations were noted (- 0.78 to 0.61 L/min). The correlation between individual change in measured and estimated VO2max was r = 0.75 (p < 0.05), and the unstandardised B-coefficient from linear regression modelling was 0.88 (95% CI 0.61 to 1.15), i.e., for each litre of change in estimated VO2max, the measured value had changed 0.88 L. The correlation between baseline and follow-up errors (the difference between estimated-measured VO2max at each occasion) was r = 0.84 (p < 0.05). With regard to the testing procedure, repeated measures ANOVA revealed that there was no significant difference between the group who exercised at the same work rates at baseline and follow-up (n = 25), and those who required a change in work rate (n = 10).

    CONCLUSIONS: The EB test detected a change in VO2max with reasonably good precision over a time span of 5-8 years. Further studies are needed to evaluate if the test can be used in clinical populations and in subjects with different medications.

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  • 7.
    Björkman, Frida
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom-Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Validity of the revised Ekblom Bak cycle ergometer test in adults.2016In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 116, no 9, p. 1627-1638Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To further develop the Ekblom Bak-test prediction equation for estimation of VO2max from submaximal cycle ergometry.

    METHODS: The model group (117 men and 100 women, aged 48.3 ± 15.7 and 46.1 ± 16.8 years, VO2max 46.6 ± 11.1 and 40.4 ± 9.6 mL kg(-1) min(-1), respectively) and the cross-validation group (60 men and 55 women, aged 40.6 ± 17.1 and 41.6 ± 16.7 years, VO2max 49.0 ± 12.1 and 43.2 ± 8.9 mL min(-1) kg(-1), respectively) performed 4 min of cycling on a standard work rate (30 W) directly followed by 4 min on a higher work rate. Heart rate (HR) at each work rate was recorded. Thereafter, participants completed a graded maximal treadmill test for direct measurement of oxygen uptake. The new prediction equation was cross-validated and accuracy compared with the original Ekblom Bak equation as well as by the Åstrand test method.

    RESULTS: The final sex-specific regression models included age, change in HR per-unit change in power (ΔHR/ΔPO), the difference in work rates (ΔPO), and HR at standard work rate as independent variables. The adjusted R (2) for the final models were 0.86 in men and 0.83 in women. The coefficient of variation (CV) was 8.7 % and SEE 0.28 L min(-1). The corresponding CV and SEE values for the EB-test2012 and the Åstrand tests were 10.9 and 18.1 % and 0.35 and 0.48 L min(-1), respectively.

    CONCLUSION: The new EB-test prediction equation provides an easy administered and valid estimation of VO2max for a wide variety of ages (20-86 years) and fitness levels (19-76 mL kg(-1) min(-1)).

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  • 8.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska institutet.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Wallin, Peter
    HPI Health Profile Institute AB, Stockholm, Sweden.
    Andersson, Gunnar
    HPI Health Profile Institute AB, Stockholm, Sweden.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Söderling, Jonas
    Karolinska institutet.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Self-Reported General Health, Overall and Work-Related Stress, Loneliness, and Sleeping Problems in 335,625 Swedish Adults from 2000 to 2016.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 2, article id E511Article in journal (Refereed)
    Abstract [en]

    The prevalence of poor health, in particular stress-related mental ill-health, is increasing over time and birth cohorts. As rapid societal changes have occurred in the last decade and still are occurring, there is an interest in investigating the trends in health-related factors. The aim of the present study was to investigate trends in self-reported general health, overall stress, work-related stress, feelings of loneliness, and sleeping problems in 335,625 Swedish adults across categories of gender, geographic regions, length of education, and age from 2000 to 2016. On population level, sleeping problems and poor general health have increased markedly and significantly, while experiences of work stress decreased between 2000 and 2016 (p < 0.05). Overall stress and level of loneliness were unchanged (p > 0.05). The risk of having ≥3 symptoms (any of poor or very poor general health, often or very often perceived overall stress, loneliness, or sleeping problems) has increased significantly from 2000 to 2016 (ß = 1034 (1027-1040)). This increase was significantly higher in young (ß = 1052 (1038-1065)) and individuals with lower education (ß = 1056 (1037-1076)) compared to older and high length of education.

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  • 9.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Lönn, Amanda
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska University Hospital, Solna, Sweden.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Väisänen, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd, Sweden.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd, Sweden.
    Stenling, Andreas
    Umeå University, Umeå, Sweden; University of Agder, Kristiansand, Norway.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Lindwall, Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. University of Gothenburg, Gothenburg, Sweden.
    Salier Eriksson, Jane
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Holmlund, Tobias
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institute, Stockholm, Sweden.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Lifestyle Habits and Mental Health in Light of the Two COVID-19 Pandemic Waves in Sweden, 20202021In: 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)
    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.

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  • 10.
    Bolam, Kate
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Wallin, Peter
    Research Department, HPI Health Profile Institute, Stockholm, Sweden..
    Paulsson, Sofia
    Research Department, HPI Health Profile Institute, Stockholm, Sweden..
    Lindwall, Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Psychology, University of Gothenburg, Goteborg, Sweden..
    Rundqvist, Helene
    Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden..
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Association between change in cardiorespiratory fitness and prostate cancer incidence and mortality in 57 652 Swedish men.2024In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480Article in journal (Refereed)
    Abstract [en]

    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.

  • 11.
    Börjesson, Mats
    et al.
    Center for Health and Performance, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Geraiatric and Acute Medicine Östra, Sahlgrenska University Hospital, Goteborg, Sweden..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Arvidsson, Daniel
    Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden..
    Heiland, Emerald G
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden..
    Väisänen, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bergström, Göran
    Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden.; Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden..
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Correlates of cardiorespiratory fitness in a population-based sample of middle-aged adults: cross-sectional analyses in the SCAPIS study2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 12, article id e066336Article in journal (Refereed)
    Abstract [en]

    Objectives: This study aimed to identify main sex-specific correlates of cardiorespiratory fitness (CRF) in a population-based, urban sample of Swedish adults.

    Design: Cross-sectional.

    Setting: Multi-site study at university hospitals, data from the Gothenburg site.

    Participants: A total of 5308 participants (51% women, aged 50-64 years) with a valid estimated VO2max, from submaximal cycle test, in the Swedish CArdioPulmonary bioImage Study (SCAPIS), were included.

    Primary and secondary outcomes: A wide range of correlates were examined including (a) sociodemographic and lifestyle behaviours, (b) perceived health, anthropometrics and chronic conditions and (c) self-reported as well as accelerometer-derived physical activity and sedentary behaviours. Both continuous levels of estimated VO2max as well as odds ratios (OR) and confidence intervals (CI)s of low VO2max (lowest sex-specific tertile) were reported.

    Results: In multivariable regression analyses, higher age, being born abroad, short education, high waist circumference, poor perceived health, high accelerometer-derived time in sedentary and low in vigorous physical activity, as well as being passive commuter, correlated independently and significantly with low VO2max in both men and women (OR range 1.31-9.58). Additionally in men, financial strain and being an ex-smoker are associated with higher odds for low VO2max (OR 2.15; 95% CI 1.33 to 3.48 and OR 1.40; 95% CI 1.09 to 1.80), while constant stress with lower odds (OR 0.61; 95% CI 0.43 to 0.85). Additionally in women, being a regular smoker is associated with lower odds for low VO2max (OR 0.64; 95% CI 0.45 to 0.92).

    Conclusions: The present study provides important reference material on CRF and correlates of CRF in a general middle-aged population, which can be valuable for future research, clinical practice and public health work. If relations are causal, increased knowledge about specific subgroups will aid in the development of appropriate, targeted interventions.

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  • 12.
    Cardinale, Daniele
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Research group for Mitokondriell funktion och metabolisk kontroll.
    Boushel, Robert
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Research group for Mitokondriell funktion och metabolisk kontroll.
    Ekblom-Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, The Research Unit for Movement, Health and Environment.
    Is the Ekblom-Bak Test a valid screening tool for Vo2peak in highly active individuals?2015Conference paper (Refereed)
    Abstract [en]

    Introduction

    Maximal oxygen consumption testing is suggested to be regularly included between training blocks of athletes in order to monitor changes in fitness throughout the season. However, despite the good reliability and validity of this physiological test, an expensive metabolic chart, and expert personnel are needed. Further, the maximal effort needed by the athlete makes this test difficult to be performed routinely. Therefore, it is important to develop valid tools that are also feasible for the estimation of the maximal oxygen consumption. The aim of this study was to validate the Ekblom-Bak test (EBT) (Ekblom-Bak et al., 2014) against an incremental test measuring peak VO2 by gas exchange on a cycle ergometer in well-trained individuals.

    Methods

    33 highly active individuals aged 34.5±6.6yrs (mean ± standard deviation (SD)) body mass 74.5±12kg, and height; 178± 9.3m) participated in the study. The EBT test was performed prior to the incremental exercise test to peak effort on a cycle ergometer for VO2peak assessment. Oxygen uptake was determined by an automated measuring system for oxygen uptake with a mixing chamber (OxygenPro, Jaeger GmbH, Germany) validated against the Douglas bag method resulting in a typical error of 2%. The mean difference and standard deviation of the differences between the EBT and measured VO2peak was calculated with Bland-Altman analysis.

    Results

    The measured mean and SD VO2peak was 4.1±0.8 L•min-1 for the whole group (male 4.4±0.6 L•min-1 and female 2.9±0.5 L•min-1). The mean differences between measured and estimated (EBT) VO2peak was 0.05 L•min-1 (95% CI; -0.15 to 0.25). CV was 13.2% in the whole group with no significant differences between sexes. For individuals with a VO2peak within the valid range of the EBT (VO2max 1.56 to 4.49 L•min-1, n=23), the mean differences between measured and estimate VO2peak was -0.22 L•min-1 (95% CI; -0.36 to -0.08), resulting in a CV of 8.2%. For individuals above the valid limit (n=10), the mean difference was 0.68L•min-1(95% CI; 0.47 to 0.98) with a CV of 6.9%. Discussion The Ekblom-Bak test is an easily applied and inexpensive screening tool for a population of highly active individuals within the current validity range, and may be used routinely in monitoring fitness.

    References

    Ekblom-Bak E, Björkman F, Hellenius ML, Ekblom B (2014). Scand J Med Sci Sports, 24(2), 319-326

  • 13.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    All aktivitet är bra aktivitet2014In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 23, no 1, p. 16-19Article in journal (Other academic)
    Abstract [sv]

    Alla vet att motion är bra för hälsan. Men en aktiv vardag är lika viktig, inte minst för äldre vuxna som inte kan röra sig lika lätt. Mindre stillasittande skulle ha stor betydelse för hjärt-kärlhälsan hos enskilda individer och för samhället i stort. Det visar en ny avhandling.

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  • 14.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Att mäta stillasittande2013In: Långvarigt stillasittande: en hälsofara i tiden / [ed] Elin Ekblom Bak, Studentlitteratur, 2013, p. 79-102Chapter in book (Other academic)
  • 15.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Det farliga midjemåttet: ny avhandling: Physical activity, cardiorespiratory fitness, and abdominal obesity in relation to cardiovascular disease risk: epidemiological studies2014In: Svensk idrottsmedicin, ISSN 1103-7652, Vol. 33, no 2, p. 20-23Article in journal (Other academic)
    Abstract [sv]

    Olika aspekter av fysisk aktivitet, alltifrån lågintensiv vardaglig aktivitet, till motion och en god kondition, är var och en viktiga för vår hjärt-kärlhälsa, till och med för hur länge vi lever. Detta visar en nyligen framlagd doktorsavhandling vid Karolinska institutet/Gymnastik- och idrottshögskolan. Dessutom presenteras i avhandlingen ett nytt submaximalt konditionstest på cykel.

  • 16.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Det riskfyllda stillasittandet2017In: Blå boken: årsbok, ISSN 2000-7272, Vol. 110, p. 224-235Article in journal (Other (popular science, discussion, etc.))
  • 17.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Inledning2021In: Långvarigt stillasittande: en hälsofara i tiden? / [ed] Elin Ekblom Bak, Studentlitteratur AB, 2021, 2, p. 21-33Chapter in book (Other (popular science, discussion, etc.))
  • 18.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Långvarigt stillasittande: En hälsofara i tiden2013Collection (editor) (Other academic)
    Abstract [sv]

    Vetenskaplig evidens visar att långvarigt dagligt stillasittande, oberoende av övrig fysisk aktivitet och motion, innebär en ökad risk för flertalet av de stora folksjukdomarna samt förtida död. Stillasittande är således inte samma sak som brist på motion, utan de bör ses som två separata beteenden med delvis oberoende betydelse för utfallet hälsa och sjukdom.

    Stillasittande innebär frånvaro av muskelkontraktioner, muskulär inaktivitet, i de större muskelgrupperna i kroppen och karaktäriseras av en mycket låg energiomsättning. Långvarigt stillasittande ersätter framför allt den lågintensiva vardagliga aktiviteten, och genom att öka denna kan ett stillasittande beteende motverkas. I dag finns stora möjligheter, men också krav, på att vara stilla­sittande stora delar av den vakna tiden. Att arbeta med det stillasittande beteendet är således relevant för många olika professioner och yrkeskategorier; alltifrån den som möter individen i det enskilda samtalet, till samhällsplaneraren och beslutsfattaren.

    I denna bok beskrivs för första gången det stillasittande beteendet och bl.a. berörs den epidemiologiska forskningsgrunden hos såväl vuxna som barn, föreslagna mekanismer samt metoder för att mäta och motverka stillasittande. Dessutom ger fyra olika professioner sin syn på saken och hur dom har arbetat med det i sin yrkesroll.

    Innehåll

    • Epidemiologi och mekanismer
    • Stillasittande och psykisk ohälsa
    • Stillasittande hos barn och ungdomar
    • Att mäta stillasittande
    • Sambands- och bestämningsfaktorer för stillasittande
    • Metoder för att reducera ett stillasittande beteende
    • Allmänläkarens perspektiv på stillasittande
    • Sjuksköterskans perspektiv på stillasittande
    • Sjukgymnastens perspektiv på stillasittande
    • Hälsopedagogens perspektiv på stillasittande
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  • 19.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Långvarigt stillasittande: en hälsofara i tiden?2021Collection (editor) (Other academic)
    Abstract [sv]

    Den stora mängd vetenskapliga studier som tillkommit de senaste åren pekar på att långvarigt dagligt stillasittande samvarierar med såväl ohälsa i olika aspekter som ökad risk för flertalet av de stora folksjukdomarna. Detta varierar dock med hur fysiskt aktiv man i övrigt är, om man är frisk och fri från andra metabola riskfaktorer, hur de andra levnadsvanorna ser ut, om man är ung eller gammal och en mängd andra faktorer. Men stillasittande är inte samma sak som brist på motion eller träning. De två ska snarare ses som separata beteenden med delvis olika betydelse för hälsa och sjukdom och som skiljer sig gällande flertalet olika aspekter, bland annat i vilken kontext, i vilket syfte och med vilket mål de utförs.

    I denna nya upplaga har kapitlen uppdaterats med relevant vetenskaplig litteratur som tillkommit under de senaste åren. Ett nytt kapitel har tillkommit kring stillasittande och äldre, även reflektionsfrågor har lagts till efter varje kapitel. Därtill har några nya kapitelförfattare tillkommit.

    I dag finns stora möjligheter, men också krav på, att vara stillasittande stora delar av den vakna tiden. Att arbeta med det stillasittande beteendet är således relevant för många olika professioner och yrkeskategorier; alltifrån den som möter individen i det enskilda samtalet, till samhällsplaneraren och beslutsfattaren.

    Innehåll

     1. Inledning  / Elin Ekblom Bak

     2. Epidemiologi och mekanismer  / Mai-Lis Hellénius & Björn Ekblom

     3. Stillasittande och psykisk ohälsa  / Jill Taube & Eva Andersson

     4. Stillasittande hos barn och ungdomar  / Gisela Nyberg & Örjan Ekblom

    5. Stillasittande och äldre  / Ing-Mari Dohrn

    6. Att mäta stillasittande / Elin Ekblom Bak & Örjan Ekblom

    7. Bestämningsfaktorer för stillasittande  / Elin Ekblom Bak,Björn Ekblom & Lars-Magnus Engström

    8. Metoder för att minska ett stillasittande beteende  / Lena Kallings

    9. Allmänläkarens perspektiv på stillasittande  / Patrik Wennberg & Maria Brännholm Syrjälä

    10. Sjuksköterskans perspektiv på stillasittande  / Matthias Lidin & Sofia Trygg Lycke

    11. Fysioterapeutens perspektiv på stillasittande  / Ing-Mari Dohrn & Elin Vidlund

    12. Hälsopedagogens perspektiv på stillasittande  / Cassandra Spoonberg & Sara Petersson

    [Förlagets text]

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  • 20.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Medverkan i skolidrotten ger bättre vanor och hälsa2018In: Idrott & hälsa, ISSN 1653-1124, no 4, p. 6-9Article in journal (Other (popular science, discussion, etc.))
  • 21.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Physical activity, cardiorespiratory fitness, and abdominal obesity in relation to cardiovascular disease risk: epidemiological studies2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Although Sweden saw a decline in death rates related to cardiovascular disease (CVD) between 1987 and 2011, it is still the most common cause of death for both women and men. Lifestyle-related factors such as inadequate physical activity (PA), poor cardiorespiratory fitness (CF), and excess body fat are all recognised as important predictors of CVD morbidity and mortality. More recently, studies have highlighted the possible detrimental effects of prolonged sitting, which mainly substitutes for daily non-exercise PA (NEPA). Conversely, more preferable levels of these lifestyle factors are associated with lower CVD risk and increased life expectancy. Despite the extensive research performed within this field, there is still no consensus.

    The main objective of this thesis was therefore to examine the interrelationship between different levels of PA, CF, and abdominal adiposity and their association with CVD risk factors, CVD morbidity, and longevity in population-based samples of Swedish men and women of different ages. A second objective was to develop a new and more precise method for estimation of CF in a mixed, healthy, population.

    The main findings were

    - In a cross-sectional population based random sample of Swedish men (n=781) and women (n=890) aged 20 to 65 years were CF and abdominal obesity each independently and strongly beneficially associated with individual CVD risk factors, as well as to a clustered CVD risk factor profile. For the clustered risk, each unit of fitness (ml·kg-1·min-1) was associated with a 5% decrease in risk and each unit of waist circumference (cm) with a 5% increase in risk. This was seen in women as well as men, younger as well as older people, and daily smokers as well as non-smokers; however, there were some differences within the subgroups.

    - In the same population, higher levels of self-reported PA and CF, but mainly the latter, were independently associated in a beneficial way with both individual and clustered CVD risk factors. Furthermore, a notable interaction of excess clustered CVD risk was shown for being insufficiently physical active according to general guidelines in combination with not being fit.

    - In a representative cohort of 60-year-old men (n=2039) and women (n=2193) in Stockholm County, a generally active daily life was associated with beneficial metabolic health at baseline and an approximately 30% lower risk for a first-time cardiovascular event and all-cause mortality, respectively, after 12.5 years. These relationships were independent of regular exercise.

    - A new submaximal cycle ergometer test for estimation of maximal oxygen uptake was developed. The test is simple, low-risk, and easily administered, and does not require laboratory equipment or expertise. In a mixed population (in terms of age, activity status, and gender), the test showed a significantly increased precision compared with one of the most commonly used submaximal exercise tests today.

    In conclusion, these results indicate that in clinical practice it is important to evaluate both PA and CF as well as abdominal obesity status. Regarding PA, it is important to highlight the separate beneficial associations of a daily active life including NEPA on the one hand, and intentional regular exercise on the other.

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  • 22.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Stor försämring av svenskars kondition2018In: Idrottsforskning.se, article id 20 novemberArticle in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    En ny studie visar alarmerande resultat om folkhälsan. Närmare hälften av 350 000 undersökta svenskar har så dålig kondition att sjukdomsrisken är kraftigt ökad.

  • 23.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Wallin, Peter
    Research Department, HPI Health Profile Institute, Stockholm, Sweden.
    Paulsson, Sofia
    Research Department, HPI Health Profile Institute, Stockholm, Sweden.
    Lindwall, Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Psychology, University of Gothenburg, Stockholm, Sweden.
    Rundqvist, Helene
    Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bolam, Kate
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden..
    Association Between Cardiorespiratory Fitness and Cancer Incidence and Cancer-Specific Mortality of Colon, Lung, and Prostate Cancer Among Swedish Men.2023In: JAMA Network Open, E-ISSN 2574-3805, Vol. 6, no 6, article id e2321102Article in journal (Refereed)
    Abstract [en]

    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.

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  • 24.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Börjesson, Mats
    Center for Health and Performance Department of Molecular and Clinical Medicine Sahlgrenska Academy Gothenburg University Sweden;Dept MGA Sahlgrenska University Hospital Region Västra Götaland Gothenburg Sweden.
    Bergman, Frida
    Department of Public Health and Clinical Medicine Umeå University Umeå Sweden.
    Bergström, Göran
    Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg;Clinical Physiology Sahlgrenska University Hospital Gothenburg Sweden.
    Dahlin‐Almevall, Albin
    Department of Health, Learning and Technology Luleå University of Technology Luleå Sweden.
    Drake, Isabel
    Department of Clinical Sciences in Malmö Lund University Malmö Sweden.
    Engström, Gunnar
    Department of Clinical Sciences in Malmö Lund University Malmö Sweden.
    Engvall, Jan E
    CMIV Centre of Medical Image Science and Visualization Linkoping University Linkoping Sweden;Department of Clinical Physiology and Department of Medical and Health Sciences Linköping University Linköping Sweden.
    Gummesson, Anders
    Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg;Clinical Genetics and Genomics Sahlgrenska University Hospital Gothenburg Sweden.
    Hagström, Emil
    Department of Medical Sciences Cardiology, Uppsala University Sweden;Uppsala Clinical Research Center Uppsala University Uppsala Sweden.
    Hjelmgren, Ola
    Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg;Clinical Physiology Sahlgrenska University Hospital Gothenburg Sweden.
    Jernberg, Tomas
    Department of Clinical Sciences Danderyd University Hospital Karolinska Institutet Stockholm Sweden.
    Johansson, Peter J
    Department of Medical Sciences, Occupational and Environmental Medicine Uppsala University Uppsala University Hospital Uppsala Sweden.
    Lind, Lars
    Department of Medical Sciences Clinical Epidemiology Uppsala University Uppsala Sweden.
    Mannila, Maria
    Heart and Vascular Theme Karolinska University Hospital Stockholm Sweden.
    Nyberg, André
    Department of Community Medicine and Rehabilitation Umeå University Umeå Sweden.
    Persson, Margaretha
    Department of Clinical Sciences in Malmö Lund University Malmö Sweden.
    Reitan, Christian
    Department of Clinical Sciences Danderyd University Hospital Karolinska Institutet Stockholm Sweden.
    Rosengren, Annika
    Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg;Clinical Physiology Sahlgrenska University Hospital Gothenburg Sweden.
    Rådholm, Karin
    Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden.
    Schmidt, Caroline
    Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg.
    Sköld, Magnus C
    Department of Respiratory Medicine and Allergy Karolinska University Hospital Solna Stockholm Sweden;Respiratory Medicine Unit Department of Medicine Solna and Center for Molecular Medicine Karolinska Institutet Stockholm Sweden.
    Sonestedt, Emily
    Department of Clinical Sciences in Malmö Lund University Malmö Sweden.
    Sundström, Johan
    Department of Medical Sciences Clinical Epidemiology Uppsala University Uppsala Sweden;The George Institute for Global Health University of New South Wales Sydney Australia.
    Swahn, Eva
    Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden;Department of Cardiology Linköping University Linköping Sweden.
    Öhlin, Jerry
    Department of Community Medicine and Rehabilitation Umeå University Umeå Sweden.
    Östgren, Carl Johan
    Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Physical Activity and Health The Swedish School of Sport and Health Sciences Stockholm Sweden.
    Accelerometer derived physical activity patterns in 27.890 middle‐aged adults – the SCAPIS cohort study2022In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 32, no 5, p. 866-880Article in journal (Refereed)
    Abstract [en]

    The present study aims to describe accelerometer-assessed physical activity (PA) patterns and fulfilment of PA recommendations in a large sample of middle-aged men and women, and to study differences between sub-groups of socio-demographic, socio-economic and lifestyle-related variables. A total of 27,890 (92.5% of total participants, 52% women, aged 50-64 years) middle-aged men and women with at least four days of valid hip-worn accelerometer data (Actigraph GT3X+, wGT3X+ and wGT3X-BT) from the Swedish CArdioPulmonary bioImage Study, SCAPIS, were included. In total, 54.5% of daily wear time was spent sedentary, 39.1% in low, 5.4% in moderate, and only 0.1% in vigorous PA. Male sex, higher education, low financial strain, born in Sweden and sedentary/light working situation were related to higher sedentary time, but also higher levels of vigorous PA. High BMI and having multiple chronic diseases associated strongly with higher sedentary time and less time in all three PA intensities. All-year physically active commuters had an overall more active PA pattern. The proportion fulfilling current PA recommendations varied substantially (1.4% to 92.2%) depending on data handling procedures and definition used. Twenty-eight percent was defined as having an "at risk" behaviour, which included both high sedentary time and low vigorous PA. In this large population-based sample, a majority of time was spent sedentary and only a fraction in vigorous PA, with clinically important variations between subgroups. This study provides important reference material and emphasizes the importance of a comprehensive assessment of all aspects of the individual PA pattern in future research and clinical practice.

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  • 25.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Börjesson, Mats
    Center for Health and Performance, University of Gothenburg, Goteborg, Sweden. ; Institute of Medicine, University of Gothenburg, Goteborg, Sweden..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Angerås, Oskar
    Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden. ; Department of Molecular and Clinical Medicine, University of Gothenburg, Göteborg, Sweden.
    Bergman, Frida
    Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden..
    Berntsson, Caroline
    Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden. ; Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Göteborg, Sweden.
    Carlhäll, Carl-Johan
    Department of Health, Medicine and Caring Sciences and Department of Clinical Physiology, Linköping University, Linköping, Sweden. ; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden..
    Engström, Gunnar
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Engvall, Jan
    Department of Health, Medicine and Caring Sciences and Department of Clinical Physiology, Linköping University, Linköping, Sweden. ; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden..
    Fagman, Erika
    Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden. ; Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Göteborg, Sweden.
    Flinck, Agneta
    Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden. ; Department of Radiology, Institute of Clinical Sciences, University of Gothenburg, Göteborg, Sweden.
    Johansson, Peter
    Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden..
    Jujic, Amra
    Department of Clinical Sciences, Lund University, Malmö, Sweden. ; Department of Cardiology, Skåne University Hospital Malmö, Malmö, Sweden..
    Kero, Tanja
    Medical Image Centre, Uppsala University Hospital, Uppsala, Sweden. ; Department of Surgical Sciences and Radiology, Uppsala University, Uppsala, Sweden..
    Lind, Lars
    Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden..
    Mannila, Maria
    Department of Cardiology and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden..
    Ostenfeld, Ellen
    Department of Clinical Sciences, Lund University, Lund, Sweden. ; Department of Clinical Physiology, Skåne University Hospital, Lund, Sweden..
    Persson, Anders
    Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden.; Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden. ; Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden..
    Persson, Jonas
    Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden.Department of Clinical Sciences, Lund University, Malmö, Sweden..
    Persson, Margaretha
    Department of Clinical Sciences, Lund University, Malmö, Sweden. ; Department of Internal Medicine, University Hospital, Malmö, Sweden..
    Redfors, Björn
    Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden..
    Sandberg, Camilla
    Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden. ; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umea, Sweden..
    Wennberg, Patrik
    Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden..
    Öhlin, Jerry
    Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden..
    Östgren, Carl Johan
    Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden. ; Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden..
    Jernberg, Tomas
    Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden..
    Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis: cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study.2023In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 11, article id e073380Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours.

    DESIGN: Cross-sectional.

    SETTING: Multisite study at university hospitals.

    PARTICIPANTS: A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer.

    PRIMARY AND SECONDARY OUTCOMES: Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound.

    RESULTS: High daily SED (>70% ≈10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% ≈8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% ≈20 min/day, associated with lower OR for significant CA (OR range 0.61-0.67), CACS (OR range 0.71-0.75) and CarA (OR range 0.72-0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73).

    CONCLUSIONS: MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.

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  • 26.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Större studier vid GIH2013In: Idrottsmedicin, ISSN 2001-3302, no 2, p. 5-10Article in journal (Other academic)
    Abstract [sv]

    På Åstrandslaboratoriet vid Gymnastik- och idrotthögskolan i Stockholm finns tradition och erfarenhet av att göra populationsundersökningar. För närvarande finns tre pågående projekt av populationskaraktär; Skola-Idrott-Hälsa (SIH), SCAPIS-undersökningen samt LIV-studierna.

  • 27.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Olsson, Gustav
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Bolan, Kate
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Svenskar rör sig för lite2015In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 24, no 2, p. 30-31Article in journal (Other academic)
    Abstract [sv]

    För den som betraktar svenskarna som ett aktivt folk är det dags att tänka om. Bara sju procent av 50-65 åringarna är tillräckligt fysiskt aktiva, visar  resultat från den stora SCAPIS-studien.

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  • 28.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Långvarigt stillasittande - ett riskbeteende2013In: Idrottsmedicin, ISSN 2001-3302, no 2, p. 14-17Article in journal (Other academic)
    Abstract [sv]

    Stillasittande innebär en hälsorisk som är skiljd från den risk som otillräcklig fysisk aktivitet utgör. Långvarig inaktivitet är alltså ett eget område med tidigare endast delvis kända riskfaktorer som kräver egna insatser för att motverka ohälsa.

  • 29.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH.
    Negativ hälsoutveckling kräver nationell strategi2020In: Idrottsforskning.se, article id 2 decemberArticle in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    En stor grupp av arbetsföra svenskar har haft en negativ utveckling av såväl kondition, förekomst av övervikt och fetma samt mående och upplevd hälsa under de senaste 30 åren. Det visar flera studier som baserats på en unik databas med hälsoprofiler.

  • 30.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Nytt submaximalt test för beräkning av maximal syreupptagning.2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, no 6, p. 271-Article in journal (Other academic)
  • 31.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Engström, Lars-Magnus
    Bestämningsfaktorer för stillasittande2021In: Långvarigt stillasittande: en hälsofara i tiden? / [ed] Elin Ekblom Bak, Studentlitteratur AB, 2021, 2, p. 151-160Chapter in book (Other academic)
  • 32.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Engström, Lars-Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Forskningsgruppen för pedagogik, idrott och fritidskultur.
    Sambands- och bestämningsfaktorer för stillasittande2013In: Långvarigt stillasittande: en hälsofara i tiden / [ed] Elin Ekblom Bak, Studentlitteratur, 2013, p. 103-111Chapter in book (Other academic)
  • 33.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Söderling, J
    Börjesson, M
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Andersson, G
    Wallin, P
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 316.137 Swedish adults2019Conference paper (Other academic)
  • 34.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Söderling, Jonas
    Karolinska institutet.
    Börjesson, Mats
    University of Gothenburg.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults.2019In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 127, article id 105799Article in journal (Refereed)
    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.

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  • 35.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Att mäta stillasittande2021In: Långvarigt stillasittande: en hälsofara i tiden? / [ed] Elin Ekblom Bak, Studentlitteratur AB, 2021, 2, p. 123-150Chapter in book (Other academic)
  • 36.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Stillasittandets effekter på barns hälsa är underbeforskat: Svårt att definiera säker gräns för ökad risk för ohälsa2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 25-26Article in journal (Other academic)
    Abstract [sv]

    Sammanfattat:

    De få studier som gjorts om stillasittande hos barn har fokuserat på övervikt och metabola risker.

    Den svaga kopplingen mellan stillasittande och metabola effekter kan bero på att dessa tillstånd inte har hunnit manifesteras hos barn.

    Fler longitudinella studier med upprepade mätpunkter och objektiv mätmetodik behövs.

    Andra utfall, t ex kognition, bör studeras.

  • 37.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Andersson, Gunnar
    HPI Health Profile Institute AB.
    Wallin, Peter
    HPI Health Profile Institute AB.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Physical Education and Leisure-Time Physical Activity in Youth Are Both Important for Adulthood Activity, Physical Performance, and Health.2018In: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 15, no 9, p. 661-670Article in journal (Refereed)
    Abstract [en]

    Background: The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated. Methods: A total of 258,146 participants (49% women), aged 19–70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VO2max) were obtained. Results: Women participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81–0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17–1.23) for exercising regularly and a normal/high VO2max in adulthood. For men, the ORs were significantly lower (range: 0.66–0.86) for poor perceived overall health, general, and abdominal obesity. These associations were seen for participants up to 70 years. Increased PA outside school hours revealed even stronger beneficial associations. In joint analyses, both youth and current PA were important for lower OR of poor health and being obese in adulthood. Conclusions: Physical education class participation and additional PA after school hours were both important for perceived health, PA, VO2max, and metabolic health in adulthood up to 70 years.

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  • 38.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Andersson, Gunnar
    HPI Health Profile Institute.
    Wallin, Peter
    HPI Health Profile Institute.
    Söderling, Jonas
    Karolinska Institutet.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Karolinska Institutet.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.2019In: 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)
    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.

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  • 39.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Halldin, Mats
    Sophiahemmet Hospital, Sweden..
    Vikström, Max
    Karolinska Institutet, Sweden..
    Stenling, Andreas
    Umeå University, Sweden.
    Gigante, Bruna
    Karolinska Institutet, Sweden..
    de Faire, Ulf
    Umeå University, Sweden ; Karolinska Institutet, Sweden..
    Leander, Karin
    Karolinska Institutet, Sweden..
    Hellénius, Mai-Lis
    Karolinska Institutet, Sweden..
    Physical activity attenuates cardiovascular risk and mortality in men and women with and without the metabolic syndrome - a 20-year follow-up of a population-based cohort of 60-year-olds.2021In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 8, no 12, p. 1376-1385Article in journal (Refereed)
    Abstract [en]

    Aims

    The purpose of this study was to analyse the association of leisure-time physical activity of different intensities at baseline, and cardiovascular disease incidence, cardiovascular disease mortality and all-cause mortality in a population-based sample of 60-year-old men and women with and without established metabolic syndrome, for more than 20 years of follow-up. A secondary aim was to study which cardiometabolic factors may mediate the association between physical activity and long-term outcomes.

    Methods

    A total of 3693 participants (53% women) underwent physical examination and laboratory tests, completed an extensive questionnaire at baseline 1997–1999 and were followed until their death or until 31 December 2017. First-time cardiovascular disease events and death from any cause were ascertained through regular examinations of national registers.

    Results

    Metabolic syndrome prevalence was 23.0%. In metabolic syndrome participants, light physical activity attenuated cardiovascular disease incidence (hazard ratio = 0.71; 95% confidence interval 0.50–1.00) compared to sedentary (reference) after multi-adjustment. Moderate/high physical activity was inversely associated with both cardiovascular disease and all-cause mortality, but became non-significant after multi-adjustment. Sedentary non-metabolic syndrome participants had lower cardiovascular disease incidence (0.47; 0.31–0.72) but not significantly different cardiovascular disease (0.61; 0.31–1.19) and all-cause mortality (0.92; 0.64–1.34) compared to sedentary metabolic syndrome participants. Both light and moderate/high physical activity were inversely associated with cardiovascular disease and all-cause mortality in non-metabolic syndrome participants (p<0.05). There were significant variations in several central cardiometabolic risk factors with physical activity level in non-metabolic syndrome participants. Fibrinogen mediated the protective effects of physical activity in non-metabolic syndrome participants.

    Conclusion

    Physical activity of different intensities attenuated cardiovascular risk and mortality in 60-year old men and women with metabolic syndrome during a 20-year follow-up.

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  • 40.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Pettersson, Tobbe
    Lunds universitet.
    Flockhart, Mikael
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Mattsson, Mikael C
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    F17 – Flygvapenövning 20142015Report (Other academic)
    Abstract [sv]

    På uppdrag av Försvarsmakten genomförde Militärmedicinska forskningsgruppen vid Åstandlaboratoriet vid Gymnastik- och idrottshögskolan Stockholm (GIH), en observationsstudie gällande fysiologisk/medicinsk belastning på 14 flygplatsjägare under en fältövning med beteckningen "F 17 - Flygvapenövning 2014".

    Övningen var indelad i tre etapper, varav den första (c:a 42 tim) och sista (c:a 59 tim) planerades vara mer fysiskt och psykiskt krävande än den mellersta (c:a 114 tim). Registrering av hjärtfrekvens gjordes under hela övningen. Fysiologiska mätningar samt blodprov togs före och efter varje etapp samt efter c:a 12 timmars vila med sedvanliga kost efter övningens avslutande.

    Beräkningar av energiomsättningen för de tre etapperna inklusive viloperioder var c:a 308, 185 respektive 369 kcal/tim, resulterande i totalt c:a 13 000, 21 100 respektive 21 600 kcal per etapp eller totalt c:a 55 700 kcal för hela övningen. De höga fysiska belastningarna i etapp ett och tre är klart högre än tidigare uppmätta data i svenska och utländska militära operationer. Vissa delar av etapp tre resulterade i fysiska belastningar som var på ungefär samma nivå som vid tävlingar i längre uthållighetsidrotter.

    Den höga belastningen resulterade i stora förändringar i fysiologiska parametrar och medicinska markörer. Vissa mätningar av muskelstyrka i armar och ben liksom maximal syreupptagning försämrades. Testosteron sjönk under hela övningen kraftigt. Dessa och andra uppmätta data talar för att fysiska arbetsförmågan – i förlängningen "stridsvärdet" – blev klart försämrat under övningen.

    Mätningen 12 timmar efter övningens avslut visade oväntade resultat. Den subjektiva ansträngningskänslan under standardiserat cykelarbete var klart förbättrat av 12-timmarsvilan efter övningen. Däremot var flertalet medicinska och fysiologiska värden oförändrade jämfört med värden vid testerna 12 timmar tidigare och därmed var de klart lägre än vid testet innan övningens start. Det är uppenbart att återhämtning av stridsvärdet inte kan bedömas subjektivt utan måste avgöras genom reliabla psykologiska och fysiologiska mätningar.

    Undersökningen har gett underlag för fortsatta studier rörande bland annat typer av energitillskott under övning, olika strategier för snabb återhämtning samt försök att finna markörer för individuella reaktionsmönster på "stridsvärde" under långvariga militära operationer.

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  • 41.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Stenling, Andreas
    Umeå University, Umeå, Sweden.
    Salier Eriksson, Jane
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, The Research Unit for Movement, Health and Environment.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd, Sweden.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Lindwall, Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Latent profile analysis patterns of exercise, sitting and fitness in adults - Associations with metabolic risk factors, perceived health, and perceived symptoms.2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 4, article id e0232210Article in journal (Refereed)
    Abstract [en]

    AIM: To identify and describe the characteristics of naturally occurring patterns of exercise, sitting in leisure time and at work and cardiorespiratory fitness, and the association of such profiles with metabolic risk factors, perceived health, and perceived symptoms.

    METHODS: 64,970 participants (42% women, 18-75 years) participating in an occupational health service screening in 2014-2018 were included. Exercise and sitting were self-reported. Cardiorespiratory fitness was estimated using a submaximal cycle test. Latent profile analysis was used to identify profiles. BMI and blood pressure were assessed through physical examination. Perceived back/neck pain, overall stress, global health, and sleeping problems were self-reported.

    RESULTS: Six profiles based on exercise, sitting in leisure time and at work and cardiorespiratory fitness were identified and labelled; Profile 1 "Inactive, low fit and average sitting in leisure, with less sitting at work"; Profile 2 "Inactive, low fit and sedentary"; Profile 3 "Active and average fit, with less sitting at work"; Profile 4 "Active, average fit and sedentary in leisure, with a sedentary work" (the most common profile, 35% of the population); Profile 5 "Active and fit, with a sedentary work"; Profile 6 "Active and fit, with less sitting at work". Some pairwise similarities were found between profiles (1 and 2, 3 and 4, 5 and 6), mainly based on similar levels of exercise, leisure time sitting and fitness, which translated into similar dose-response associations with the outcomes. In general, profile 1 and 2 demonstrated most adverse metabolic and perceived health, profile 4 had a more beneficial health than profile 3, as did profile 6 compared to profile 5.

    CONCLUSIONS: The present results implies a large variation in exercise, sitting, and fitness when studying naturally occurring patterns, and emphasize the possibility to target exercise, sitting time, and/or fitness in health enhancing promotion intervention and strategies.

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  • 42.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Väisänen, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Andersson, Gunnar
    HPI Health Profile Institute, Sweden.
    Wallin, Peter
    HPI Health Profile Institute, Sweden.
    Salier Eriksson, Jane
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Holmlund, Tobias
    Karolinska Institute, Stockholm, Sweden.
    Lindwall, Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. University of Gothenburg, Sweden.
    Stenling, Andreas
    Umeå University, Sweden; University of Agder, Kristiansand, Norway.
    Lönn, Amanda
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Women's Health and Allied Health Professionals Theme Medical Unit Occupational Therapy and Physiotherapy, Stockholm, Sweden.
    Cardiorespiratory fitness and lifestyle on severe COVID-19 risk in 279,455 adults: a case control study.2021In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 18, no 1, article id 135Article in journal (Refereed)
    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.

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  • 43.
    Ekblom, Björn
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom-Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Långvarigt stillasittande är en metabol riskfaktor2012In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, no 34-35, p. 1467-1470Article in journal (Other academic)
    Abstract [sv]

    Längre stunder av stillasittande, oberoende av övrig medel- och högintensiv fysisk aktivitet, ökar risken för flertalet av de stora folksjukdomarna och förtida död.

    Stillasittande innebär frånvaro av kontraktioner i de stora muskelgrupperna, dvs muskulär inaktivitet.

    Bakomliggande patogena mekanismer som kopplar långvarigt stillasittande till negativa hälsoeffekter har föreslagits vara låg energiomsättning, vilket leder till ansamling av visceralt fett och låggradig systemisk inflammation; uteblivna endokrina svar från den inaktiva skelettmuskulaturen med påföljande försämrad effekt i flera organ och vävnader samt låg s k skjuvspänning.

    Minskad tid i stillasittande och ökad lågintensiv vardaglig aktivitet är faktorer som kan motverka framtida ohälsa.

  • 44.
    Ekblom, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ståhlberg, Linda
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hur förhåller sig Fysisk aktivitet och Vo2max till riskfaktorer för hjärt- kärlsjukdomar?2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte och frågeställning

    Syftet med denna studie var att studera hur olika nivåer av fysisk aktivitet och maximal syreupptagning (VO2max) förhåller sig till olika riskfaktorer för förtida död i hjärt-kärlsjukdom (CVD). Därutöver var syftet att, om möjligt, utifrån erhållna resultat sammanställa rekommendationer för fysisk aktivitet och VO2max för att erhålla reducerad risk för de studerade riskfaktorerna för CVD.

    Är det VO2max-värdet i sig, som både kan vara genetiskt-, tränings- och sjukdomsbetingat, eller är det den fysiska aktiviteten bakom ett visst VO2max-värde som är av större betydelse för olika riskfaktorer för CVD?

    Metod

    Studien baserades på 1851 svenska kvinnor och män i åldrarna 20-65 år utvalda från ett redan insamlat datamaterial från tre tidigare vetenskapliga studier; LIV90, LIV2000 och Vasaloppsstudien. Den fysiska aktiviteten bestämdes genom en enkätfråga i respektive studie och delades in i tre nivåer. VO2max beräknades via ett submaximalt cykeltest eller mättes via ett maximalt löptest. Tolv välkända riskfaktorer för CVD erhölls utifrån enkätsvar eller medicinska testresultat. För analys av den fysiska aktivitetens och VO2max betydelse för varje riskfaktor, gjordes en binär regressionsanalys med kontroll för fysisk aktivitetsgrad, VO2max samt olika kontrollvariabler. Vid varje analys erhölls en oddskvot med 95 % konfidensintervall som beskrev hur risken att erhålla respektive riskfaktor varierade mellan de olika fysiska aktivitetsgrupperna då VO2max hölls konstant.

    Resultat

    Huvudresultaten i denna studie visade att VO2max hade ett starkare samband än fysisk aktivitet med minskad risk för utfall av enskilda riskfaktorer för CVD. Däremot hade en hög fysisk aktivitetsgrad, motsvarande en belastning som bibehöll/ökade VO2max, liknande betydelse som VO2max för reducering av den generella risken för riskfaktorer för CVD. Fysisk aktivitet på lägre belastningsnivåer uppvisade inte samma signifikanta resultat.

    Slutsats

    Både högre nivåer av fysisk aktivitet och ett högre värde på VO2max har betydelse för reducerad risk för de studerade riskfaktorerna för CVD och i förlängningen utfall av sjukdom i främst CVD. Därför bör hänsyn tas till båda variablerna då hälsopreventiva och hälsopromotiva rekommendationer utformas.

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  • 45.
    Ekblom, Örjan B
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Bak, Elin A M Ekblom
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Björn T
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Cross-sectional trends in cardiovascular fitness in Swedish 16-year-olds between 1987 and 2007.2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 4, p. 565-9Article in journal (Refereed)
    Abstract [en]

    AIM: We sought to investigate the temporal trends in estimated maximal aerobic capacity in adolescents (mean age 16.1).

    METHODS: Analyses were based on data from three population-based samples, collected in 1987 (n=221), 2001 (n=537) and 2007 (n=265). Subjects underwent sub-maximal ergometer testing. Absolute and relative aerobic capacities were estimated using the Åstrand-Ryhming nomogram.

    RESULTS: Compared to 1987, values for estimated relative and absolute maximal aerobic capacities were lower in 2001 and 2007, and values in 2007 were lower compared to 2001, in both boys and girls, except for absolute capacity between 1987 and 2001 in girls. The differences over time did not differ between genders. Absolute values changed from 3.0 and 2.5 L/min in 1987 to 2.5 and 2.2 L/min in 2007, for boys and girls, respectively. Relative values changed from 46.5 and 45.9 mL/min/kg in 1987 to 35.0 and 36.6 mL/min/kg, in 2007, for boys and girls, respectively.

    CONCLUSION: Based on earlier reports on the relationship between aerobic capacity and metabolic risk, the results from the present study provide argument that future public health will be affected negatively.

  • 46.
    Ekblom, Örjan
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's and Mats Börjesson's research group.
    Temporal Trends In Cardiovascular Fitness Among Swedish Adolescents In Ninth Grade Between 1987 And 20072012In: Journal of General Internal Medicine, 2012, Vol. 27, p. 390-390Conference paper (Refereed)
  • 47.
    Ekblom, Örjan
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Björn T
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Trends in body mass in Swedish adolescents between 2001 and 2007.2009In: Acta paediatrica (Oslo, Norway : 1992), ISSN 1651-2227, Vol. 98, no 3, p. 519-22Article in journal (Refereed)
    Abstract [en]

    AIM: (1) Compare BMI standard deviation scores (BMIsds) in 16-year olds in 2001 and 2007 to assess trends. (2) Describe tracking of BMIsds between ages 10 and 16 years, in a longitudinal 6-year follow-up. (3) Identify possible predictors in 2001 for high BMIsds in 2007 and increase in BMIsds between 2001 and 2007. METHODS: A six-year follow-up study on 296 subjects, aged 10 years at baseline and a panel study among 16-year olds. BMIsds was used as the main outcome. RESULTS. No difference in BMIsds in 16-year-old adolescents was found between 2001 and 2007. Strong tracking (r = 0.80, 95% CI: 0.75-0.84) was found for BMIsds between ages 10 and 16 years. Low aerobic capacity and high BMIsds at age 10 years predicted overweight at age 16 years. High BMIsds in 2001 predicted a decline in BMIsds (OR: 0.58, 95% CI: 0.43-0.76) and high level of self-reported moderate-to-vigorous physical activity predicted an increased BMIsds (OR: 1.38, 95% CI: 1.13-1.67). CONCLUSION: There was no difference in prevalence of overweight plus obesity between the 2001 and 2007 samples. Normal weight and good aerobic fitness in 10-year-old children seems to decrease the risk of elevated relative BMI in 16-year olds.

  • 48.
    Ekblom, Örjan
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Rosengren, Annika
    Hallsten, Mattias
    Bergström, Göran
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Cardiorespiratory Fitness, Sedentary Behaviour and Physical Activity Are Independently Associated with the Metabolic Syndrome, Results from the SCAPIS Pilot Study.2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 6, article id e0131586Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: 

    Previous studies on the relation between lifestyle and the metabolic syndrome lack one or several aspects of the physical activity pattern in the analyses or cardiorespiratory fitness. Likewise, both uni- and triaxial accelerometry have been used, though, the predictive validity of these two modes has not been compared.

    OBJECTIVES: 

    The aims of the present study were firstly to investigate the independent relation between cardiorespiratory fitness and physical activity pattern to the metabolic syndrome (MetS) and secondly to examine the predictive validity of uni- and triaxial accelerometry, respectively.

    METHODS: 

    Data was extracted from the SCAPIS pilot study (n=930, mean age 57.7 yrs). Physical activity pattern was assessed by accelerometry. Cardiorespiratory fitness was estimated using cycle ergometry. MetS was defined per the Adult Treatment Panel III from the National Cholesterol Education Program definition.

    RESULTS: 

    Time spent sedentary (OR: 2.38, 95% CI: 1.54-4.24 for T3 vs T1), in light intensity (OR: 0.50, 95% CI: 0.28-0.90) and in moderate-to-vigorous activity (OR: 0.33, 95% CI: 0.18-0.61), as well as cardiorespiratory fitness (OR: 0.24, 95% CI:0.12-0.48), were all independently related to the prevalence of MetS after adjustment for potential confounders, fitness and/or the other aspects of the physical activity pattern. In addition, we found that triaxial analyses were more discriminant, with ORs farther away from the reference group and additional significant ORs.

    CONCLUSION: 

    The finding that several aspects of the physical activity pattern reveal independent relations to the MetS makes new possible targets for behaviour change of interest, focusing on both exercise and everyday life. When assessing the risk status of a patient, it is advised that triaxial accelerometry is used.

  • 49.
    Ekblom, Örjan
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom-Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Bolam, Kate A
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Schmidt, Caroline
    Söderberg, Caroline
    Bergström, Göran
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Concurrent and predictive validity of physical activity measurement items commonly used in clinical settings- data from SCAPIS pilot study.2015In: BMC Public Health, E-ISSN 1471-2458, Vol. 15, article id 978Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    As the understanding of how different aspects of the physical activity (PA) pattern relate to health and disease, proper assessment is increasingly important. In clinical care, self-reports are the most commonly used assessment technique. However, systematic comparisons between questions regarding concurrent or criterion validity are rare, as are measures of predictive validity. The aim of the study was to examine the concurrent (using accelerometry as reference) and predictive validity (for metabolic syndrome) of five PA questions.

    METHODS:

    A sample of 948 middle-aged Swedish men and women reported their PA patterns via five different questions and wore an accelerometer (Actigraph GT3X) for a minimum of 4 days. Concurrent validity was assessed as correlations and ROC-analyses. Predictive validity was assessed using logistic regression, controlling for potential confounders.

    RESULTS:

    Concurrent validity was low-to-moderate (r <0.35 and ROC AUC <0.7) with large misclassifications regarding time spent sitting/sedentary and in moderate-to vigorous PA. The predictive validity of the questions was good, and one question (PHAS) showed an 80 % decreased odds-ratio of having metabolic syndrome, after taking potential confounders into consideration.

    DISCUSSION:

    In this mixed sample of adults, both concurrent and predictive validity vaired between items and between measures of the physical activity pattern. The PHAS and WALK items are proposed for assessment of adherence to PA recommendations.

    CONCLUSION:

    Assessing PA patterns using self-report measures results in methodological problems when trying to predict individual risk for the metabolic syndrome, as the concurrent validity generally was low. However, several of the investigated questions may be useful for assessing risk at a group level, showing better predictive validity.

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  • 50.
    Ekblom, Örjan
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Nyberg, Gisela
    Karolinska Institutet.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekelund, Ulf
    Cambridge University.
    Marcus, Claude
    Karolinska Institutet.
    Validity and comparability of a wrist-worn accelerometer in children.2012In: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 9, no 3, p. 389-393Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Wrist-worn accelerometers may provide an alternative to hip-worn monitors for assessing physical activity as they are easier to wear and may thus facilitate long-term recordings. The current study aimed at a) assessing the validity of the Actiwatch (wrist-worn) for estimating energy expenditure, b) determining cut-off values for light, moderate, and vigorous activities, c) studying the comparability between the Actiwatch and the Actigraph (hip-worn), and d) assessing reliability.

    METHODS:

    For validity, indirect calorimetry was used as criterion measure. ROC-analyses were applied to identify cut-off values. Comparability was tested by simultaneously wearing of the 2 accelerometers during free-living condition. Reliability was tested in a mechanical shaker.

    RESULTS:

    All-over correlation between accelerometer output and energy expenditure were found to be 0.80 (P < .001).Based on ROC-analysis, cut-off values for 1.5, 3, and 6 METs were found to be 80, 262, and 406 counts per 15 s, respectively. Energy expenditure estimates differed between the Actiwatch and the Actigraph (P < .05). The intra- and interinstrument coefficient of variation of the Actiwatch ranged between 0.72% and 8.4%.

    CONCLUSION:

    The wrist-worn Actiwatch appears to be valid and reliable for estimating energy expenditure and physical activity intensity in children aged 8 to 10 years.

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