Gymnastik- och idrottshögskolan, GIH

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  • 1.
    Andermo, Susanne
    et al.
    Karolinska institutet.
    Helgadóttir, Björg
    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.
    Kjellenberg, Karin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nyberg, Gisela
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Extra schemalagd fysisk aktivitet i högstadiet: en väg framåt?2021In: Svensk idrottsmedicin 2021:3, 2021Conference paper (Other academic)
  • 2.
    Andersson, Eva A.
    et al.
    Department of Neuroscience, Karolinska Institutet.
    Defaire, Gi
    Swedish School of Sport and Health Sciences, GIH.
    Hultgren, Staffan
    Swedish School of Sport and Health Sciences, GIH.
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH.
    Oddsson, Kristjan
    Swedish School of Sport and Health Sciences, GIH.
    Olin, Hedvig
    Swedish School of Sport and Health Sciences, GIH.
    Strand, Leif
    Swedish School of Sport and Health Sciences, GIH.
    Wahlgren, Lina
    Swedish School of Sport and Health Sciences, GIH.
    Wedman, Ingemar
    Swedish School of Sport and Health Sciences, GIH.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH.
    Physical activity for persons with obesity—a health project reported2008In: Forum on Public Policy Online, ISSN 1938-9809, Vol. 4, no SpringArticle in journal (Refereed)
    Abstract [en]

    In public health contexts, increased physical activity habits and fitness (aerobic and strength capacities) are positively related for promoting health and preventing  and treating common diseases/problems, including obesity and overweight. A strongly graded inverse association between physical activity and obesity has been shown both for adults and children. However, a lower mortality risk has been shown for those with greater weight but good aerobic capacity than for those of recommended weight but less fit. On the basis of a health project with physical activity for persons with or without obesity, the paper discusses evidence-based methods for promoting physical activity. General guidelines for the amount of physical activity for persons are described, as are the numerous physiological and medical advantages of physical activity. The economic benefits are also illustrated. The paper exemplifies methods of measuring physical activity habits and physical fitness. These two factors must be observed when showing improvements in public-health contexts, including groups with obesity.

     

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  • 3.
    Andersson, Eva A.
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Rönquist, Gustaf
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Oddsson, Kristjan
    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, Björn Ekblom's research group.
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Äldre blir starkare av Hälsoprojektet2013In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 22, no 1, p. 25-27Article in journal (Other academic)
    Abstract [sv]

    En god kondition och styrka har samband med förbättrad hälsa, minskad förekomst av flera folksjukdomar samt ökad livslängd. Fysiologiska tester kan vara stimulerande för äldre att följa utvecklingen av sin fysiska kapacitet och för olika aktörer som vill göra hälsoutvärderingar.

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  • 4.
    Andersson, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Oddsson, Kristjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Wahlgren, Lina
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Research Unit for Movement, Health and Environment.
    Kjellman, Bengt
    Jonsson, Bo
    Taube, Jill
    Improved Physical Capacity in a Project with Guided Physical Activity for Persons with Depression or Anxiety.2010Conference paper (Refereed)
    Abstract [en]

    Background: Higher physical capacity is correlated with increased health. Knowledge in this area regarding psychiatric diseases is sparse. 

    Purpose: The aim was to study aerobic and several strength capacities in a physical activity project for persons with depression or anxiety.

    Methods: Eighty-four persons (56 women and 28 men) with depression or anxiety were recruited from psychiatric out-patient clinics in Stockholm. Their mean age and BMI was 46 (21-80) years and 26 (17-41) kg/m2, respectively. 50% were sick-listed. 50% had BMI>25. Aerobic and strength tests were chosen by each subgroup´s project leaders. Directed physical activity was given, in groups 10-15, 1 hour twice/week during 8-12 weeks.

    Results: Significant changes (p<0.05, of all n=84) between pre- and post tests were seen in submaximal cycle test (11% enhanced values, n=56) and distance of 6 minutes walk test (16%, n=15) as well as in strength tests for the back for the back (i.e. time in static horizontal belly-back, 40%, n=44), abdominal and hip flexors (i.e. number of hip flexion sit-ups, 45%, n=38), leg (i.e. standing with 90O in hips and knees, 48%, n=56) and arm with shoulder muscles (i.e. number of raising weights alternately with the arms, 46%, n=32). Hand grip tests, BMI or blood pressure values did not change significantly.

    Conclusions: Directed 8-12 weeks physical activity programs can improve physical fitness in individuals with depression or anxiety.

  • 5.
    Arvidsson, Daniel
    et al.
    Lund University, Sweden.
    Berglind, Daniel
    Karolinska Institutet, Stockholm, Sweden.
    Bergman, Patrick
    Linneaus University, Kalmar, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Fröberg, Andreas
    University of Gothenburg, Sweden.
    Hagströmer, Maria
    Löf, Marie
    Karolinska Institutet, Stockholm, Sweden.
    Nyberg, Gisela
    Karolinska Institutet, Stockholm, Sweden.
    Med accelerometrar kan fysisk aktivitet mätas objektivt: [Physical activity measured with accelerometers].2019In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, article id FPZWArticle in journal (Refereed)
    Abstract [sv]

    The development of accelerometers has revolutionized measurement of physical activity, and they are used to a large extent in research and have started to be implemented into clinical settings. However, achievement of reliable outcomes requires good methodological knowledge and skills by the user. Otherwise, significant measurement errors may occur, interfering with assessment of the physical activity level in the population, group differences, associations with health parameters or effect of treatments. This paper by the Swedish Network for Objective Measurement of Movement (NORM) provides an overview of physical activity measurement including sections of data collection, processing of raw data into useful metrics and statistical analysis. It targets users of accelerometer in research, health care and national surveys.

  • 6.
    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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  • 7.
    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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  • 8.
    Arvidsson, Daniel
    et al.
    University of Gothenburg.
    Fridolfsson, Jonatan
    University of Gothenburg.
    Börjesson, Mats
    University of Gothenburg.
    Andersen, Lars Bo
    Western Norway University of Applied Sciences, Campus Sogndal, Norway..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Dencker, Magnus
    Lund University.
    Brønd, Jan Christian
    University of Southern Denmark, Odense, Denmark.
    Re-examination of accelerometer data processing and calibration for the assessment of physical activity intensity.2019In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, no 10, p. 1442-1452Article in journal (Refereed)
    Abstract [en]

    This review reexamines use of accelerometer and oxygen uptake data for assessment of activity intensity. Accelerometers capture mechanical work, while oxygen uptake captures the energy cost of this work. Frequency filtering needs to be considered when processing acceleration data. A too restrictive filter attenuates the acceleration signal for walking and, to a higher degree, for running. This measurement error affects shorter (children) more than taller (adults) individuals due to their higher movement frequency. Less restrictive filtering includes more movement related signals and provide measures that better capture mechanical work, but may include more noise. An optimal filter cut-point is determined where most relevant acceleration signals are included. Further, accelerometer placement affects what part of mechanical work being captured. While the waist placement captures total mechanical work and therefore contributes to measures of activity intensity equivalent by age and stature, the thigh and wrist placements capture more internal work and do not provide equivalent measures. Value calibration of accelerometer measures is usually performed using measured oxygen uptake with the metabolic equivalent of task (MET) as reference measure of activity intensity. However, the use of MET is not stringent and is not a measure of activity intensity equivalent by age and stature. A candidate measure is the mass-specific net oxygen uptake, VO2 net (VO2 tot - VO2 stand). To improve measurement of physical activity intensity using accelerometers, research developments are suggested concerning processing of accelerometer data, use of energy expenditure as reference for activity intensity, and calibration procedure with absolute versus relative intensity. This article is protected by copyright. All rights reserved.

  • 9.
    Bakkman, Linda
    et al.
    Sveriges olympiska kommitté.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nutley, Sissela
    Karolinska institutet.
    Hälsosegrar: Den vetenskapliga vägen till ett friskare liv2021Book (Other (popular science, discussion, etc.))
    Abstract [sv]

    Forskning visar att det vi aktivt ägnar oss åt - våra medvetna livsstilsval - kan påverka så mycket som 40 % av vårt välbefinnande. Vi har med andra ord stora möjligheter att själva göra en skillnad i hur vi mår. Hälsosegrarna är inom räckhåll!

    Här presenteras den allra senaste forskningen om hur rörelse, mat och återhämtning påverkar vår hälsa. Vi får veta vad som händer i kroppen och i hjärnan när vi till exempel stressar för mycket, sover dåligt, sitter för länge eller inte får i oss tillräckligt med näring. Men också hur vi faktiskt kan omsätta den kunskapen i praktiken och ändra våra beteenden. Hur vilar man hjärnan? Vad är egentligen "nyttig" mat? Och vilken funktion fyller vardagsmotionen? Fokus ligger på de vardagliga utmaningarna och de små men hållbara förändringar som kan göra stor skillnad.

    Med gedigen kunskap och ett motiverande tilltal varvar de tre författarna vetenskapliga fakta och studier med konkreta tips. Sammantaget blir det ett inspirerande smörgåsbord av fullt genomförbara livsstilsförändringar som kan göra stor skillnad för hur vi mår.

    [Text från förlaget]

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  • 10.
    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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  • 11. Berg, Ulrika
    et al.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Fysisk aktivitet för barn och ungdomar - allmänna rekommendationer2018In: Fysisk aktivitet som medicin: en praktisk handbok utifrån FYSS / [ed] Ing-Marie Dohrn, Stockholm: SISU idrottsböcker , 2018, p. 31-41Chapter in book (Other (popular science, discussion, etc.))
  • 12.
    Berg, Ulrika
    et al.
    Astrid Lindgrens barnsjukhus.
    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.
    Rekommendationer om fysisk aktivitet för barn och ungdomar2015In: FYSS 2015, Stockholm: Yrkesföreningar för Fysisk Aktivitet (YFA) , 2015Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    En rimlig fråga är varför barn och unga är speciella när det gäller hälsoeffekter av fysisk aktivitet. Många av de påvisade och kända effekterna av fysisk aktivitet är likartade oavsett ålder, men i vissa fall finns det anledning att lyfta fram vad som är specifikt för barn och unga.

    Mognads- och tillväxtprocesserna, som i princip pågår fram till cirka 18–20 års ålder, är ofta orsaken till de skillnader som finns. En rad kapaciteter och förmågor, till exempel syreupptagningsförmåga, muskelstyrka, koordination och motorik samt mentala aspekter utvecklas över tid. En konsekvens av detta är att det är svårt att med precision utvärdera effekter av träning hos en ung individ, och att på ett korrekt och meningsfullt sätt särskilja dessa från mognad och tillväxt. En annan faktor är ökande kroppsstorlek, vilken medför att gränser för övervikt och fetma varierar mellan könen och med ålder upp till cirka 18 år. Att på ett korrekt sätt värdera effekter av insatser mot övervikt hos en växande individ kräver särskilda överväganden.

  • 13.
    Berg, Ulrika
    et al.
    Astrid Lindgrens barnsjukhus.
    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.
    Rekommendationer om fysisk aktivitet för barn och ungdomar2016In: FYSS 2017: fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling, Läkartidningen förlag , 2016, p. 98-113Chapter in book (Other academic)
    Abstract [sv]

    Sammanfattning

    Fysisk aktivitet ger fysiska och mentala hälsovinster hos barn och ungdomar.

    Mognads- och tillväxtprocesserna hos barn och ungdomar påverkar en rad fysiska, mentala och sociala kapaciteter och förmågor. Vid rekommendation av fysisk aktivitet bör hänsyn tas till detta och individuella intressen.

    Alla barn och ungdomar mellan 6 och 17 år rekommenderas minst 60 minuters daglig fysisk aktivitet av främst aerob karaktär. Muskelstärkande och skelettstärkande aktiviteter bör ingå tre gånger i veckan. Hos barn från 0–5 år ska daglig fysisk aktivitet uppmuntras och underlättas.

    Barn och ungdomar som inte kan nå upp till rekommendationerna på grund av sjukdom eller funktionsnedsättning bör vara så aktiva som tillståndet medger.

    Individuella råd för anpassad regelbunden fysisk aktivitet bör ges.

    Barn och ungdomar med övervikt och fetma kan uppnå positiva hälsoeffekter av fysisk aktivitet avseende till exempel blodfetter och insulinkänslighet även om vikten är oförändrad. Konditionshöjande fysisk aktivitet har tydligast effekt, och i kombination med kostförändringar är effekterna större.

    Hos barn och ungdomar med astma bör en noggrann analys av ansträngningsutlösta besvär göras. Astman ska vara välreglerad och anpassad information och kunskap ska ges för att trygga den unge och främja fysisk aktivitet.

    Fysisk aktivitet utgör en del av behandlingen vid depression hos barn och ungdomar.

    Barn och ungdomars hälsa tycks kunna påverkas negativt av långvarigt stillasittande. För närvarande finns dock inte tillräckligt med vetenskapligt stöd för att ge en evidensbaserad rekommendation angående begränsning av stillasittande i den här åldersgruppen.

  • 14.
    Berg, Ulrika
    et al.
    Astrid Lindgrens barnsjukhus, Karolinska universitetssjukhuset, Stockholm.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Onerup, Aron
    Drottning Silvias barn- och ungdomssjukhus, Göteborg.
    Rekommendationer om fysisk aktivitet och stillasittande för barn och ungdomar2021In: FYSS 2021: fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling, Läkartidningens förlag , 2021, 4, p. 105-118Chapter in book (Other academic)
  • 15.
    Berg, Ulrika
    et al.
    Astrid Lindgrens barnsjukhus, Stockholm.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Onerup, Aron
    Drottning Silvias barn- och ungdomssjukhus, Göteborg.
    Skärmtiden ett hinder för tillräcklig aktivitet: FYSS rekommendationer för barn och ungdomar2021In: Svensk idrottsmedicin, ISSN 1103-7652, Vol. 40, no 2, p. 17-21Article in journal (Other academic)
  • 16.
    Berg, Ulrika
    et al.
    Astrid Lindgrens barnsjukhus, Karolinska universitetssjukhuset, Stockholm.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Onerup, Aron
    Drottning Silvias barn- och ungdomssjukhus, Göteborg.
    Villard, Li
    Astrid Lindgrens barnsjukhus, Karolinska universitetssjukhuset, Stockholm.
    Fysisk aktivitet för barn och ungdomar med sjukdomstillstånd2021In: FYSS 2021: fysisk aktivitet i sjukdomsprevention och sjukdomsbehandling, Läkartidningens förlag , 2021, p. 119-141Chapter in book (Other academic)
  • 17.
    Bergström, Göran
    et al.
    Department of Molecular and Clinical Medicine (G. Bergström, E.B., O.A., B.F., O.H., A.R.), University of Gothenburg, Sweden.;Departments of Clinical Physiology (G. Bergström, O.H.), Region Västra Götaland, Gothenburg, Sweden..
    Persson, Margaretha
    Department of Clinical Sciences (M.P., G. Berglund, G.E., M. Magnusson), Lund University, Malmö, Sweden.;Departments of Internal Medicine (M.P.), Skåne University Hospital, Malmö, Sweden..
    Adiels, Martin
    Sahlgrenska Academy, and School of Public Health and Community Medicine, Institute of Medicine (M.A., C.B.), University of Gothenburg, Sweden..
    Björnson, Elias
    Department of Molecular and Clinical Medicine (G. Bergström, E.B., O.A., B.F., O.H., A.R.), University of Gothenburg, Sweden..
    Bonander, Carl
    Sahlgrenska Academy, and School of Public Health and Community Medicine, Institute of Medicine (M.A., C.B.), University of Gothenburg, Sweden..
    Ahlström, Håkan
    Section of Radiology, Department of Surgical Sciences (H.A., O.D.), Uppsala University, Sweden..
    Alfredsson, Joakim
    Departments of Cardiology (J.A., E.S.), Linköping University, Sweden.;Health, Medicine and Caring Sciences (J.A., E.S., J.E.E., F.H.N., C.J.Ö., A.P.), Linköping University, Sweden..
    Angerås, Oskar
    Department of Molecular and Clinical Medicine (G. Bergström, E.B., O.A., B.F., O.H., A.R.), University of Gothenburg, Sweden.;Cardiology (O.A.), Region Västra Götaland, Gothenburg, Sweden..
    Berglund, Göran
    Department of Clinical Sciences (M.P., G. Berglund, G.E., M. Magnusson), Lund University, Malmö, Sweden..
    Blomberg, Anders
    Department of Public Health and Clinical Medicine, Medicine and Heart Centre (A.B., J.L., A. Sandström, A. Själander, S.S.), Umeå University, Sweden..
    Brandberg, John
    Department of Radiology, Institute of Clinical Sciences (J.B., E.F., A.F.), University of Gothenburg, Sweden.;Radiology (J.B., E.F., A.F.), Region Västra Götaland, Gothenburg, Sweden..
    Börjesson, Mats
    Institute of Medicine (M.B.), University of Gothenburg, Sweden.;Center for Health and Performance (M.B.), University of Gothenburg, Sweden.;Sahlgrenska University Hospital (M.B., B.F., A.R., K.T.), Region Västra Götaland, Gothenburg, Sweden..
    Cederlund, Kerstin
    Department of Clinical Science, Intervention and Technology (K.C.), Karolinska Institutet, Stockholm, Sweden..
    de Faire, Ulf
    Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine (U.d.F.), Karolinska Institutet, Stockholm, Sweden..
    Duvernoy, Olov
    Section of Radiology, Department of Surgical Sciences (H.A., O.D.), Uppsala University, Sweden..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Engström, Gunnar
    Department of Clinical Sciences (M.P., G. Berglund, G.E., M. Magnusson), Lund University, Malmö, Sweden..
    Engvall, Jan E.
    Health, Medicine and Caring Sciences (J.A., E.S., J.E.E., F.H.N., C.J.Ö., A.P.), Linköping University, Sweden.;Clinical Physiology (J.E.E.), Linköping University, Sweden.;CMIV, Centre of Medical Image Science and Visualization (J.E.E., A.P., C.J.Ö.), Linköping University, Sweden..
    Fagman, Erika
    Department of Radiology, Institute of Clinical Sciences (J.B., E.F., A.F.), University of Gothenburg, Sweden.;Radiology (J.B., E.F., A.F.), Region Västra Götaland, Gothenburg, Sweden..
    Eriksson, Mats
    Department of Endocrinology, Metabolism &amp; Diabetes and Clinical Research Center, Karolinska University Hospital Huddinge, Stockholm, Sweden (M.E.)..
    Erlinge, David
    Department of Clinical Sciences Lund, Cardiology, Lund University and Skåne University Hospital, Lund, Sweden (D.E., M.A.M.)..
    Fagerberg, Björn
    Department of Molecular and Clinical Medicine (G. Bergström, E.B., O.A., B.F., O.H., A.R.), University of Gothenburg, Sweden.;Sahlgrenska University Hospital (M.B., B.F., A.R., K.T.), Region Västra Götaland, Gothenburg, Sweden..
    Flinck, Agneta
    Department of Radiology, Institute of Clinical Sciences (J.B., E.F., A.F.), University of Gothenburg, Sweden.;Radiology (J.B., E.F., A.F.), Region Västra Götaland, Gothenburg, Sweden..
    Gonçalves, Isabel
    Department of Clinical Sciences Malmö (I.G.), Lund University and Skåne University Hospital, Lund, Sweden..
    Hagström, Emil
    Cardiology (E.H.), Uppsala University, Sweden.;Department of Medical Sciences, and Uppsala Clinical Research Center (E.H.), Uppsala University, Sweden..
    Hjelmgren, Ola
    Department of Molecular and Clinical Medicine (G. Bergström, E.B., O.A., B.F., O.H., A.R.), University of Gothenburg, Sweden.;Departments of Clinical Physiology (G. Bergström, O.H.), Region Västra Götaland, Gothenburg, Sweden..
    Lind, Lars
    Clinical Epidemiology (L.L., J.S.), Uppsala University, Sweden..
    Lindberg, Eva
    Respiratory, Allergy and Sleep Research (E.L.), Uppsala University, Sweden..
    Lindqvist, Per
    Department of Surgical and Perioperative Sciences (P.L.), Umeå University, Sweden..
    Ljungberg, Johan
    Department of Public Health and Clinical Medicine, Medicine and Heart Centre (A.B., J.L., A. Sandström, A. Själander, S.S.), Umeå University, Sweden..
    Magnusson, Martin
    Department of Clinical Sciences (M.P., G. Berglund, G.E., M. Magnusson), Lund University, Malmö, Sweden.;Cardiology (M. Magnusson), Skåne University Hospital, Malmö, Sweden.;Wallenberg Center for Molecular Medicine, Lund University, Sweden (M. Magnusson).;North-West University, Hypertension in Africa Research Team (HART), Potchefstroom, South Africa (M. Magnusson)..
    Mannila, Maria
    Heart and Vascular Theme, Department of Cardiology, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden (M. Mannila)..
    Markstad, Hanna
    Experimental Cardiovascular Research, Clinical Research Center, Clinical Sciences Malmö (H.M.), Lund University, Malmö, Sweden.;Center for Medical Imaging and Physiology (H.M.), Lund University and Skåne University Hospital, Lund, Sweden..
    Mohammad, Moman A.
    Department of Clinical Sciences Lund, Cardiology, Lund University and Skåne University Hospital, Lund, Sweden (D.E., M.A.M.)..
    Nystrom, Fredrik H.
    Health, Medicine and Caring Sciences (J.A., E.S., J.E.E., F.H.N., C.J.Ö., A.P.), Linköping University, Sweden..
    Ostenfeld, Ellen
    Department of Clinical Sciences Lund, Clinical Physiology (E.O.), Lund University and Skåne University Hospital, Lund, Sweden..
    Persson, Anders
    Health, Medicine and Caring Sciences (J.A., E.S., J.E.E., F.H.N., C.J.Ö., A.P.), Linköping University, Sweden.;Radiology (A.P.), Linköping University, Sweden.;CMIV, Centre of Medical Image Science and Visualization (J.E.E., A.P., C.J.Ö.), Linköping University, Sweden..
    Rosengren, Annika
    Department of Molecular and Clinical Medicine (G. Bergström, E.B., O.A., B.F., O.H., A.R.), University of Gothenburg, Sweden.;Sahlgrenska University Hospital (M.B., B.F., A.R., K.T.), Region Västra Götaland, Gothenburg, Sweden..
    Sandström, Anette
    Department of Public Health and Clinical Medicine, Medicine and Heart Centre (A.B., J.L., A. Sandström, A. Själander, S.S.), Umeå University, Sweden..
    Själander, Anders
    Department of Public Health and Clinical Medicine, Medicine and Heart Centre (A.B., J.L., A. Sandström, A. Själander, S.S.), Umeå University, Sweden..
    Sköld, Magnus C.
    Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine (M.C.S.), Karolinska Institutet, Stockholm, Sweden.;Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden (M.C.S.)..
    Sundström, Johan
    Clinical Epidemiology (L.L., J.S.), Uppsala University, Sweden.;The George Institute for Global Health, University of New South Wales, Sydney, Australia (J.S.)..
    Swahn, Eva
    Departments of Cardiology (J.A., E.S.), Linköping University, Sweden.;Health, Medicine and Caring Sciences (J.A., E.S., J.E.E., F.H.N., C.J.Ö., A.P.), Linköping University, Sweden..
    Söderberg, Stefan
    Department of Public Health and Clinical Medicine, Medicine and Heart Centre (A.B., J.L., A. Sandström, A. Själander, S.S.), Umeå University, Sweden..
    Torén, Kjell
    Occupational and Environmental Medicine/School of Public Health and Community Medicine (K.T.), University of Gothenburg, Sweden.;Sahlgrenska University Hospital (M.B., B.F., A.R., K.T.), Region Västra Götaland, Gothenburg, Sweden..
    Östgren, Carl Johan
    Health, Medicine and Caring Sciences (J.A., E.S., J.E.E., F.H.N., C.J.Ö., A.P.), Linköping University, Sweden.;CMIV, Centre of Medical Image Science and Visualization (J.E.E., A.P., C.J.Ö.), Linköping University, Sweden..
    Jernberg, Tomas
    Department of Clinical Sciences, Danderyd University Hospital (T.J.), Karolinska Institutet, Stockholm, Sweden..
    Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population2021In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 144, no 12, p. 916-929Article in journal (Refereed)
    Abstract [en]

    Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.

    Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.

    Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.

    Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.

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  • 18.
    Björkman, Frida
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Eggers, Andrea
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Stenman, Adam
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Bohman, Tony
    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.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Sex and maturity status affected the validity of a submaximal cycle test in adolescents.2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 1, p. 126-133Article in journal (Refereed)
    Abstract [en]

    AIM: This study assessed the validity and reliability of the Ekblom-Bak (EB) submaximal cycle test in adolescents and identified any sex- or maturity-related factors for prediction errors.

    METHODS: We recruited 50 healthy subjects through a public announcement in Stockholm, Sweden, in 2016. The 27 boys and 23 girls were aged 10-15 years and in Tanner stages I-IV. They performed an EB test and incremental treadmill running test for direct measurement of maximal oxygen uptake (VO2 max).

    RESULTS: The estimation error of VO2 max was 0.09 L/min. The correlation (r) was 0.86, and the standard error of the estimate (SEE) was 0.29 L/min. The largest overestimation was seen in prepubertal boys (0.49 L/min). The best precision of the EB test was achieved when boys in Tanner stages I and II were re-calculated using the prediction equation developed for adult women. This yielded a mean difference of -0.05 L/min, r = 0.92 and SEE 0.23 L/min, in the entire sample. The prediction error was lowered in boys, but not girls, with increasing pubertal maturity.

    CONCLUSION: The EB test was reasonably valid in adolescents, seemed to be related to sex and maturity status, and our findings support its use.

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  • 19.
    Björkman, Frida
    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.
    Physical Exercise as Treatment for PTSD: A Systematic Review and Meta-Analysis.2022In: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 187, no 9-10, p. 1103-e1113Article, review/survey (Refereed)
    Abstract [en]

    INTRODUCTION: Post-traumatic stress disorder (PTSD) is a cluster of physical and psychiatric symptoms following military or civilian trauma. The effect of exercise on PTSD symptoms has previously been investigated in several studies. However, it has not been fully determined what type of exercise most impacts PTSD symptoms. The aim of the present study was to systematically review the effects of different types of exercise on PTSD symptom severity and symptoms of coexisting conditions in adults.

    MATERIALS AND METHODS: Electronic searches were conducted in the databases PubMed, APA PsycInfo, and SportDiscus, from database inception up until February 1, 2021. Inclusion criteria were randomized controlled trials published in English, participants having a PTSD diagnosis or clinically relevant symptoms, and participants randomly allocated to either a non-exercising control group or an exercise group. Data concerning the number of participants, age, exercise type and duration, PTSD symptom severity (primary outcome), and symptoms of coexisting conditions (secondary outcomes) were extracted. The subgroup analysis included high or low training dose, military trauma versus non-military trauma, the type of intervention (yoga versus other exercise), active or passive control condition, group training versus individual exercise, and study quality. The study quality and risk of bias were assessed using grading of recommendation assessment, development and evaluation (GRADE) guidelines. A meta-analysis was performed with a mixed-effects model and restricted maximum likelihood as model estimator, and effect size was calculated as the standardized difference in mean and 95% CI.

    RESULTS: Eleven studies were included in the present review. Results showed a main random effect of exercise intervention (0.46; 95% CI: 0.18 to 0.74) and a borderline significant interaction between more voluminous (>20 hours in total) and less voluminous (≤20 hours in total) exercise interventions (P = .07). No significant findings from the subgroup analysis were reported. The secondary outcome analysis showed a small but significant effect of exercise on depressive symptoms (0.20, 95% CI: 0.01 to 0.38), and a larger effect on sleep (0.51, 95% CI: 0.29 to 0.73). For substance use (alcohol and drugs combined) and quality of life, we found significant effects of 0.52 (95% CI: 0.06 to 0.98) and 0.51 (95% CI: 0.34 to 0.69), respectively. No significant effect was found for anxiety (0.18, 95% CI: -0.15 to 0.51), and no sign of publication bias was found.

    CONCLUSIONS: Exercise can be an effective addition to PTSD treatment, and greater amounts of exercise may provide more benefits. However, as there were no differences found between exercise type, possibly due to the inclusion of a low number of studies using different methodologies, further research should aim to investigate the optimal type, dose, and duration of activity that are most beneficial to persons with PTSD.

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  • 20.
    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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  • 21.
    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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  • 22.
    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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  • 23.
    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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  • 24.
    Bojsen-Møller, Emil
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Boraxbekk, Carl-Johan
    Copenhagen University Hospital, Hvidovre, Denmark.
    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.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Karolinska institutet.
    Relationships between Physical Activity, Sedentary Behaviour and Cognitive Functions in Office Workers.2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 23, article id E4721Article in journal (Refereed)
    Abstract [en]

    Increasing evidence from animal experiments suggests that physical activity (PA) promotes neuroplasticity and learning. For humans, most research on the relationship between PA, sedentary behaviour (SB), and cognitive function has relied on self-reported measures of behaviour. Office work is characterised by high durations of SB combined with high work demands. While previous studies have shown that fitter office workers outperform their less fit colleagues in cognitive tests, the importance of PA and SB remains unknown. This study investigated associations between objectively measured PA and SB, using hip-worn accelerometers, and cognitive functions in 334 office workers. Time spent in moderate-to-vigorous PA (MVPA) was not associated with any cognitive outcome. However, time spent in SB tended to be positively associated with words recalled in free recall (β = 0.125). For the least fit participants, the average length of MVPA bouts was favourably related to Stroop performance (β = -0.211), while for the fitter individuals, a longer average length of MVPA bouts was related to worse recognition (β = -0.216). While our findings indicate that the length of MVPA bouts was associated with better Stroop performance in the least fit participants, our findings do not support the notion that more time spent in MVPA or less time in SB is associated with better cognitive function.

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  • 25.
    Bojsen-Møller, Emil
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Dunstan, D W
    Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    The effect of breaking up prolonged sitting on paired associative stimulation-induced plasticity.2020In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 238, p. 2497-2506Article in journal (Refereed)
    Abstract [en]

    Paired associative stimulation (PAS) can induce plasticity in the motor cortex, as measured by changes in corticospinal excitability (CSE). This effect is attenuated in older and less active individuals. Although a single bout of exercise enhances PAS-induced plasticity in young, physically inactive adults, it is not yet known if physical activity interventions affect PAS-induced neuroplasticity in middle-aged inactive individuals. Sixteen inactive middle-aged office workers participated in a randomized cross-over design investigating how CSE and short-interval intracortical inhibition (SICI) were affected by PAS preceded by 3 h of sitting (SIT), 3 h of sitting interrupted every 30 min by 3 min of frequent short bouts of physical activity (FPA) and 2.5 h of sitting followed by 25 min of moderate-intensity exercise (EXE). Transcranial magnetic stimulation was applied over the primary motor cortex (M1) of the dominant abductor pollicis brevis to induce recruitment curves before and 5 min and 30 min post-PAS. Linear mixed models were used to compare changes in CSE using time and condition as fixed effects and subjects as random effects. There was a main effect of time on CSE and planned within-condition comparisons showed that CSE was significantly increased from baseline to 5 min and 30 min post-PAS, in the FPA condition, with no significant changes in the SIT or EXE conditions. SICI decreased from baseline to 5 min post-PAS, but this was not related to changes in CSE. Our findings suggest that in middle-aged inactive adults, FPAs may promote corticospinal neuroplasticity. Possible mechanisms are discussed.

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  • 26.
    Bojsen-Møller, Emil
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Activity breaks during prolonged sitting enhance responses to paired associative stimulation2019In: Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, Volume 12, Issue 2, 466, Elsevier, 2019, Vol. 12, no 2Conference paper (Refereed)
  • 27.
    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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  • 28.
    Dahlstrand, Johan
    et al.
    University of Gothenburg, Gothenburg, Sweden. ; The Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Stockholm, Sweden..
    Friberg, Peter
    University of Gothenburg, Gothenburg, Sweden. ; The Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Stockholm, Sweden..
    Fridolfsson, Jonatan
    University of Gothenburg, Gothenburg, Sweden.
    Börjesson, Mats
    University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
    Arvidsson, Daniel
    University of Gothenburg, Gothenburg, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Chen, Yun
    University of Gothenburg, Gothenburg, Sweden.
    The use of coping strategies "shift-persist" mediates associations between physical activity and mental health problems in adolescents: a cross-sectional study.2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 1104Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Self-perceived mental health problems among adolescents has had an upward trend. Concurrently, adolescents' physical activity (PA) has been falling whilst sedentary time (SED) has increased. There is a lack of research using accelerometer measured PA and SED to study their relationships to perceived stress and psychosomatic symptoms, both frequently observed mental health problems among adolescents. Whether coping strategies is one of the mechanisms underlying such relationship is less clear.

    METHODS: A total of 2283 13-year olds were enrolled in the baseline examination of the STARS (STudy of Adolescence Resilience and Stress) study in Western Sweden. Light-, moderate-, vigorous-intensity PA (LPA, MPA and VPA) and SED were measured using hip-worn ActiGraph GT3X+ accelerometer. A total of 1284 adolescents provided valid accelerometer data (at least 4 days with ≥10 h per day). PA and SED during school-time and leisure-time were analysed separately. Surveys were utilized to monitor perceived stress, psychosomatic symptoms and the use of coping strategies "shift-persist". Logistic regression and mediation analyses were performed adjusting for gender, ethnicity, socioeconomic status and puberty development.

    RESULTS: We observed that more time spent in PA was associated with less stress in adolescents. The associations were observed for LPA (Odds ratio for LPA per 60 min: 0.557 (95% CI 0.399-0.776), VPA (Odds ratio for VPA per 15 min: 0.688 (95% CI 0.588-0.806) and MVPA (Odds ratio for MVPA per 15 min: 0.795 (95%CI 0.718-0.879) during leisure time, but not during school time. Similar associations were observed between leisure time PA and psychosomatic symptoms. The associations remained statistically significant even after adjusting for the confounders. Further, our data showed that adolescents who engaged more time in PA during leisure time were more likely to adopt the coping strategies of "shift-persist". Mediation analysis showed that the use of "shift-persist" mediated the associations between leisure time PA and stress/psychosomatic symptoms.

    CONCLUSIONS: Leisure time physical activity, irrespective of intensity, may facilitate successful coping with stress and stress-related mental health problems in adolescents.

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  • 29. Danielsson, Evelina
    et al.
    Oddsson, Kristjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Fredriksson, Mårten
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ovendal, Alexander
    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.
    Wahlgren, Lina
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hultgren, Staffan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Andersson, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hälsoprojekt med ledarledd fysisk aktivitet för äldre2012Conference paper (Other academic)
    Abstract [sv]

    Bakgrund och syfte. Syftet med hälsoprojektet under 8-12 veckor för äldre är att ge ledarledd fysisk aktivitet 2 gånger/vecka samt att utvärdera upplevd hälsa, förändring av livsstilssvanor samt fysisk kapacitet. Hälsoprojektet är ett fortlöpande samarbete mellan Solna stad och Gymnastik- och idrottshögskolan (GIH) och utförs under vårterminerna sedan ett flertal år.

    Metod. Individerna anmäler sitt deltagande själva. Det kostnadsfria hälsoprojektet utförs inom undervisningen i Folkhälsa i regi av GIH-studenter under handledning av verksamhetschefen i Solna stad och lärare/läkare på GIH. Den ledarledda fysiska aktiviteten utgörs primärt av stavgång, motionsgymnastik, vattengymnastik samt styrketräning. Initialt och i slutet av perioden besvarar deltagarna en hälsoenkät angående upplevd hälsa och livsstilsvanor om fysisk aktivitet, kost, sömn, rökning och alkohol samt utför några olika fysiologiska tester i samband med ett hälsosamtal.

    Resultat. Exempel på sammanställda resultat ges här för de 117 äldre som fullföljde hela projektet under en vårtermin (för kvinnorna var antalet samt medelvärden för ålder och BMI 99, 74år och 26 respektive för männen 18, 73år och 25). Efter avslutat projekt sågs för gruppen som helhet generellt en signifikant förbättrad upplevd fysisk och mental hälsa, kondition och styrka i buk-, ben- och armmuskulatur. För kvinnorna observerades även en ökad balansförmåga och uthållighet i ryggmusklerna. Enkätfrågorna angående fysiska aktivitetsvanor och stillasittande visade på, efter avslutat projekt, en förändring till en mer aktiv livsstil.

    Slutsats/Diskussion. Således kan utvärderade 8-12 veckors hälsoprojekt med ledarledd fysisk aktivitet för äldre bidra till förbättrad upplevd hälsa, ökade fysiska aktivitetsvanor, minskat stillasittande och bättre fysiska kapaciteter såsom kondition, styrka och balans som är positivt korrelerade till ökad livslängd och minskad förekomst av en mängd olika folksjukdomar och skador. Fler projekt och studier behövs framöver med ytterligare uppföljningar, jämförelser och för att vidareutveckla olika fysiologiska tester och andra hälsoparametrar som kan ha positiva samband med ökad hälsa.

  • 30. Danielsson, Pernilla
    et al.
    Kowalski, Jan
    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.
    Marcus, Claude
    Response of severely obese children and adolescents to behavioral treatment.2012In: Archives of Pediatrics & Adolescent Medicine, ISSN 1072-4710, E-ISSN 1538-3628, Vol. 166, no 12, p. 1103-1108Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    To investigate whether the degree of obesity predicts the efficacy of long-term behavioral treatment and to explore any interaction with age.

    DESIGN:

    A 3-year longitudinal observational study. Obese children were divided into 3 age groups (6-9, 10-13, and 14-16 years) and also into 2 groups (moderately obese, with a body mass index [BMI]-standard deviation [SD] score [or z score] of 1.6 to <3.5, and severely obese, with a BMI-SD score of ≥3.5).

    SETTING:

    National Childhood Obesity Center, Stockholm, Sweden.

    PARTICIPANTS:

    Children 6 to 16 years of age who started treatment between 1998 and 2006.

    INTERVENTION:

    Behavioral treatment of obesity.

    MAIN OUTCOME MEASURE:

    Change in BMI-SD score during 3 years of treatment; a reduction in BMI-SD score of 0.5 units or more was defined as clinically significant.

    RESULTS:

    A total of 643 children (49% female children) met the inclusion criteria. Among the youngest moderately obese children, 44% had a clinically significant reduction in BMI-SD score (mean reduction, -0.4 [95% CI, -0.55 to -0.32]). Treatment was less effective for the older moderately obese children. Twenty percent of children who were 10 to 13 years of age and 8% of children who were 14 to 16 years of age had a reduction in BMI-SD score of 0.5 units or more; 58% of the severely obese young children showed a clinically significant reduction in BMI-SD score (mean reduction, -0.7 [95% CI, -0.80 to -0.54]). The severely obese adolescents showed no change in mean BMI-SD score after 3 years, and 2% experienced clinically significant weight loss. Age was found to be a predictor of a reduction in BMI-SD score (odds ratio, 0.68 units per year [95% CI, 0.60-0.77 units per year]).

    CONCLUSIONS:

    Behavioral treatment was successful for severely obese children but had almost no effect on severely obese adolescents.

  • 31.
    Danielsson, Pernilla
    et al.
    Karolinska Institutet.
    Svensson, Viktoria
    Karolinska Institutet.
    Kowalski, Jan
    Karolinska Institutet.
    Nyberg, Gisela
    Karolinska Institutet.
    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.
    Marcus, Claude
    Karolinska Institutet.
    Importance of age for 3-year continuous behavioral obesity treatment success and dropout rate.2012In: Obesity Facts, ISSN 1662-4025, E-ISSN 1662-4033, Vol. 5, no 1, p. 34-44Article in journal (Refereed)
    Abstract [en]

    Abstract

    Objective: To assess whether first year weight loss, age, and socioeconomic background correlate with the success rate of continuous long-term behavioral obesity treatment. Methods: In a 3-year longitudinal study, obese children (n = 684) were divided into three groups based on age at the start of treatment, age 6-9 years, 10-13 years, and 14-16 years. Results: The mean BMI standard deviation score (BMI-SDS) decline was age-dependent (p = 0.001), independently of adjustment for missing data: -1.8 BMI-SDS units in the youngest, -1.3 in the middle age group, and -0.5 in the oldest age group. SES and parental BMI status did not affect the results. 30% of the adolescents remained in treatment at year 3. There was only a weak correlation between BMI-SDS change after 1 and 3 years: r = 0.51 (p < 0.001). Among children with no BMI-SDS reduction during year 1 (n = 46), 40% had a clinically significantly reduced BMI-SDS after year 3. Conclusion: Behavioral treatment should be initiated at an early age to increase the chance for good results. Childhood obesity treatment should be continued for at least 3 years, regardless of the initial change in BMI-SDS. Copyright © 2012 S. Karger GmbH, Freiburg.

  • 32.
    Drake, Emma
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Ekblom, Örjan
    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.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Cardiorespiratory Fitness and Device-Measured Sedentary Behaviour are Associated with Sickness Absence in Office Workers.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 2, article id E628Article in journal (Refereed)
    Abstract [en]

    Physical activity reduces the risk of several noncommunicable diseases, and a number of studies have found self-reported physical activity to be associated with sickness absence. The aim of this study was to examine if cardiorespiratory fitness, device-measured physical activity, and sedentary behaviour were associated with sickness absence among office workers. Participants were recruited from two Swedish companies. Data on sickness absence (frequency and duration) and covariates were collected via questionnaires. Physical activity pattern was assessed using ActiGraph and activPAL, and fitness was estimated from submaximal cycle ergometry. The sample consisted of 159 office workers (67% women, aged 43 ± 8 years). Higher cardiorespiratory fitness was significantly associated with a lower odds ratio (OR) for both sickness absence duration (OR = 0.92, 95% confidence interval (CI) 0.87-0.96) and frequency (OR = 0.93, 95% CI 0.90-0.97). Sedentary time was positively associated with higher odds of sickness absence frequency (OR = 1.03, 95% CI 0.99-1.08). No associations were found for physical activity at any intensity level and sickness absence. Higher sickness absence was found among office workers with low cardiorespiratory fitness and more daily time spent sedentary. In contrast to reports using self-reported physical activity, device-measured physical activity was not associated with sickness absence.

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  • 33.
    Ek, Amanda
    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, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekström, Mattias
    Danderyd Hospital, Stockholm, Sweden.
    Börjesson, Mats
    Sahlgrenska Academy & Sahlgrenska University Hospital, Gothenburg, Sweden..
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    The gap between stated importance of and clinical work in promoting healthy lifestyle habits by healthcare professionals in a Swedish hospital setting: A cross-sectional survey.2021In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 29, p. 385-394Article in journal (Refereed)
    Abstract [en]

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

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  • 34.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Karolinska University Hospital.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hambraeus, Kristina
    Falun Hospital.
    Cider, Åsa
    Gothenburg University and Sahlgrenska University Hospital.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Uppsala University.
    Börjesson, Mats
    Gothenburg University and Sahlgrenska University Hospital.
    Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.2019In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 108, no 3, p. 324-332Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 35.
    Ek, Amanda
    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, 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.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Hambraeus, Kristina
    Cardiologkliniken, Falu lasarett.
    Börjesson, Mats
    Göteborgs Universitet.
    Association between physical activity level and risk of all-cause mortality after myocardial infarction2017In: European Journal of Preventive Cardiology, Vol 24, Issue 1 Suppl, April 2017: Abstract Book EuroPrevent 2017 Malaga, Spain, 2017, Vol. 24, article id 45Conference paper (Refereed)
    Abstract [en]

    Background/Introduction: There is little knowledge of the association between physical activity (PA) level and the mortality risk post myocardial infarction (MI). Steffen/Batey et al (2000), concluded in a smaller study, that individuals who remained active or increased their level of PA after MI had a lower risk of death. However, in order to confirm this and adjust for confounders larger studies are needed.

    Purpose: Explore any association between PA level after MI and all-cause mortality during follow-up in a large MI-cohort.

    Methods: A national cohort study including all patients <75 years of age, with a diagnosis of MI between 1991-2014 (Swedish MI register SWEDEHEART). From the register self-reported PA, 6-10 weeks post MI, (i.e. number of sessions during the past seven days with moderate and/or vigorous PA lasting ≥30 minutes) was obtained. The answers were grouped into 0-1 sessions (inactive), 2-4 sessions (moderately active) and 5-7 sessions (regularly active). Associations were first assessed unadjusted, stratified by potential confounders (sex, age, smoking status, ejection fraction, ST-elevation and quality of life). Thereafter, a multiple logistic regression was performed to control for possible confounders.

    Results: Complete data was obtained from 37 655 individuals (median 63 years, 74 % men). A total of 2512 deaths occurred during a mean of 4.1 years of follow-up. The mortality rate was 17.0 cases/1000 person-years. Moderate and regular activity, was associated with a lower risk of all-cause mortality (OR 0,356 95 %, CI 0,320-0,396 and OR 0,334, 95 % CI 0,305-0,366) compared to being physically inactive. The OR´s remained largely unchanged when stratifying for age, sex, NSTEM/STEMI and ejection fraction. However, active smokers had a lower OR, for subsequent death, as had patients with a low EQ5D. The associations persisted in the multiple logistic regression, after adjustment for confounders (Figure 1).

    Conclusion(s): A higher level of physical activity seems to be associated with a lower risk of all-cause mortality. These results suggest that physical activity assessment is important post MI, not least as an important predictor.

     

  • 36.
    Ek, Amanda
    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, 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.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Hambraeus, Kristina
    Cardiologkliniken, Falu lasarett.
    Börjesson, Mats
    Göteborgs Universitet.
    Samband mellan fysisk aktivitetsnivå efter hjärtinfarkt och risken för mortalitet: Association between physical activity level and risk of all-cause mortality after myocardial infarction2017In: Fria föredrag, nr 025, 2017, article id 025Conference paper (Refereed)
    Abstract [en]

    Background: There is little knowledge of the association between physical activity (PA) level and the mortality risk post myocardial infarction (MI)Steffen/Batey et al (2000), concluded in a smaller study, that individuals who remained active or increased their level of PA post-MI had a lower risk of death. This study aimed to explore any association between PA level post-MI and all-cause mortality during follow-up in a large MI-cohort.

    Methods: A national cohort study including patients <75 years of age, with a diagnosis of MI between 2005-2014 (SWEDEHEART, SEPHIA-register). Self-reported PA, 6-10 weeks post-MI, (i.e. number of sessions during the past seven days with moderate and/or vigorous PA lasting ≥30 minutes) was obtained. The answers were grouped into 0-1 sessions (inactive), 2-4 sessions (moderately active) and 5-7 sessions (regularly active). First, stratified unadjusted associations were investigated. Thereafter, a multiple logistic regression was performed to control for possible confounders.

    Results: Complete data was obtained from 37 655 individuals (median age 63 years, 74 % men). A total of 2512 deaths occurred during a mean of 4.1 years of follow-up. The mortality rate was 17.0 cases/1000 person-years. Moderate and regular activity, was associated with a lower risk of all-cause mortality (OR 0.36, 95 % CI: 0.32-0.40 and OR 0.33, 95 % CI: 0.31-0.37) compared to being physically inactive. The OR´s remained largely unchanged when stratifying for age, gender, NSTEM/STEMI and ejection fraction. However, compared to inactive patients, physically active smokers and patients with ≤ 0.85 Eq5D had a higher OR, for subsequent death. The associations persisted in the multiple logistic regression, after adjustment for confounders (Figure 1).

    Conclusions: A higher level of PA, post-MI was associated with a lower risk of all-cause mortality. These results suggest that PA assessment is important post-MI, not least as an important predictor for risk of death.

  • 37.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Swedish Sch sport & Hlth Sci, Stockholm, Sweden..
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekstrom, Mattias
    Danderyd Hosp, Div Cardiovasc Med, Dept Clin Sci, Stockholm, Sweden..
    Börjesson, Mats
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Gothenburg, Sweden..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    P05-04 Physical activity level and sedentary time prior to cardiac ward admission among patients with cardiovascular disease and its association to all-cause mortality2022In: EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 32, S2, Oxford University Press, 2022, Vol. 32Conference paper (Other academic)
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  • 38.
    Ek, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Karolinska University Hospital, Sweden.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Uppsala University, Sweden.
    Ekström, Mattias
    Danderyd Hospital, Sweden ; Karolinska Institutet, Sweden.
    Börjesson, Mats
    Sahlgrenska Academy & Sahlgrenska University Hospital/Ostra, Sweden ; University of Gothenburg, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Subjective reports of physical activity levels and sedentary time prior to hospital admission can predict utilization of hospital care and all-cause mortality among patients with cardiovascular disease.2020In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 19, no 8, p. 691-701Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In prevention, sedentary behaviour and physical activity have been associated with risk of cardiovascular disease and mortality. Less is known about associations with utilization of hospital care.

    AIM: To investigate whether physical activity level and sedentary behaviour prior to cardiac ward admission can predict utilization of hospital care and mortality among patients with cardiovascular disease.

    METHODS: Longitudinal observational study including 1148 patients admitted and treated in cardiac wards in two hospitals. Subjective reports of physical activity levels and sedentary time prior to admission were collected during inpatient care and categorized as low, medium or high. The associations between physical activity level and sedentary time with hospital stay, readmission and mortality were analysed using linear, logistic and Cox regressions.

    RESULTS: Median hospital stay was 2.1 days. One higher step in the physical activity level, or lower sedentary time, was related to an approximately 0.9 days shorter hospital stay. Sixty per cent of patients were readmitted to hospital. The risk of being readmitted was lower for individuals reporting high physical activity and low sedentary time (odds ratios ranging between 0.44 and 0.91). A total of 200 deaths occurred during the study. Mortality was lower among those with high and medium physical activity levels and low sedentary time (hazard ratios ranging between 0.36 and 0.90).

    CONCLUSION: Both physical activity level and sedentary time during the period preceding hospitalization for cardiac events were predictors of hospital utilization and mortality. This highlights the prognostic value of assessing patients' physical activity and sedentary behaviour.

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  • 39.
    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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  • 40.
    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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  • 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, 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.

  • 42.
    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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  • 43.
    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)
  • 44.
    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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  • 45.
    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)
  • 46.
    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.

  • 47.
    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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  • 48.
    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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  • 49.
    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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  • 50.
    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, 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.
    Stroke volume and the endurance athlete.2006In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 16, no 1, p. 70-1Article in journal (Refereed)
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