Gymnastik- och idrottshögskolan, GIH

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

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

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

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

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

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  • 2.
    Ekstedt, Mirjam
    et al.
    KTH.
    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.
    Ingre, Mikael
    Stockholms Universitet.
    Marcus, Claude
    Karolinska Insitutete.
    Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study.2013In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 22, no 10, p. 82-89Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The aim of this study is to describe the relationship between objective measures of sleep, physical activity and BMI in Swedish pre-adolescents. The day-to-day association between physical activity and sleep quality as well as week-day and weekend pattern of sleep is also described.

    METHOD:

    We conducted a cross sectional study consisted of a cohort of 1.231 children aged six to ten years within the Stockholm county area. Sleep and physical activity were measured by accelerometry during seven consecutive days. Outcome measures are total sleep time, sleep efficiency, sleep start and sleep end; physical activity intensity divided into: sedentary (<1.5 METS), light (1.5 to 3 METS) and moderate-to-vigorous (> 3 METS); and Body Mass Index standard deviations score, BMIsds.

    RESULTS:

    Total sleep time decreased with increasing age, and was shorter in boys than girls on both weekdays and weekends. Late bedtime but consistent wake-up time during weekends made total sleep time shorter on weekends than on weekdays. Day-to-day within-subject analysis revealed that moderate-to-vigorous intense physical activity promoted an increased sleep efficiency the following night (CI < 0.001 to 0.047), while total sleep time was not affected (CI -0.003 to 0.043). Neither sleep duration (CI -0.024 to 0.022) nor sleep efficiency (CI -0.019 to 0.028) affected mean physical activity level the subsequent day. The between-subject analysis indicates that the sleep of children characterized by high moderate-to-vigorous physical activity during the day was frequently interrupted (SE = -.23, P < .01). A negative association between BMIsds and sleep duration was found (-.10, p < .01).

    CONCLUSIONS:

    Short sleep duration was associated with high BMI in six to ten year old children. This study underscores the importance of consistent bedtimes throughout the week for promoting sleep duration in preadolescents. Furthermore, this study suggests that a large proportion of intensive physical activity during the day might promote good sleep quality.

  • 3.
    Lönn, Amanda
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Women's Health and Allied Health Professionals Theme Medical Unit Occupational Therapy and Physiotherapy, Stockholm, Sweden..
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd, Sweden.
    Paulsson, Sofia
    HPI Health Profile Institute, Danderyd, Sweden.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd, Sweden.
    Salier Eriksson, Jane
    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.
    Lifestyle-related habits and factors before and after cardiovascular diagnosis: a case control study among 2,548 Swedish individuals.2023In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 20, no 1, article id 41Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 4.
    Nyberg, Gisela
    et al.
    Karolinska Institutet, Stockholm, Sweden and Centre for Epidemiology and Community Medicine, Stockholm County Council.
    Norman, Åsa
    Sundblom, Elinor
    Zeebari, Zangin
    Elinder, Liselotte Schäfer
    Effectiveness of a universal parental support programme to promote health behaviours and prevent overweight and obesity in 6-year-old children in disadvantaged areas, the Healthy School Start Study II, a cluster-randomised controlled trial.2016In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 13, article id 4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is increasing evidence for the effectiveness of parental support programmes to promote healthy behaviours and prevent obesity in children, but only few studies have been conducted among groups with low socio-economic status. The aim of this study was to develop and evaluate the effectiveness of a parental support programme to promote healthy dietary and physical activity habits and to prevent overweight and obesity in six-year-old children in disadvantaged areas.

    METHODS: A cluster-randomised controlled trial was carried out in disadvantaged areas in Stockholm. Participants were six-year-old children (n = 378) and their parents. Thirty-one school classes from 13 schools were randomly assigned to intervention (n = 16) and control groups (n = 15). The intervention lasted for 6 months and included: 1) Health information for parents, 2) Motivational Interviewing with parents and 3) Teacher-led classroom activities with children. Physical activity was measured by accelerometry, dietary intake and screen time with a questionnaire, body weight and height were measured and BMI standard deviation score was calculated. Measurements were conducted at baseline, post-intervention and at 5months follow-up. Group effects were examined using Mixed-effect Regression analyses adjusted for sex, parental education and baseline values.

    RESULTS: Fidelity to all three intervention components was satisfactory. Significant intervention effects were found regarding consumption of unhealthy foods (p = 0.01) and unhealthy drinks (p = 0.01). At follow-up, the effect on intake of unhealthy foods was sustained for boys (p = 0.03). There was no intervention effect on physical activity. Further, the intervention had no apparent effect on BMI sds for the whole sample, but a significant difference between groups was detected among children who were obese at baseline (p = 0.03) which was not sustained at follow-up.

    CONCLUSIONS: The Healthy School Start study shows that it is possible to influence intake of unhealthy foods and drinks and weight development in obese children by providing individual parental support in a school context. However, the effects were short-lived. Therefore, the programme needs to be prolonged and/or intensified in order to obtain stronger and sustainable effects. This study is an important contribution to the further development of evidence-based parental support programmes to prevent overweight and obesity in children in disadvantaged areas.

  • 5.
    Wahlgren, Lina
    et al.
    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.
    Stigell, Erik
    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.
    Schantz, Peter
    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.
    The Active Commuting Route Environment Scale (ACRES): Development and Evaluation2010In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 7, no 58Article in journal (Refereed)
    Abstract [en]

    Background

    Route environments can be a potentially important factor in influencing people’s behaviours in relation to active commuting. To better understand these possiblerelationships, assessments of route environments are needed. We therefore developed a scale; the Active Commuting Route Environment Scale (ACRES), for the assessment of bicyclists’ and pedestrians’ perceptions of their commuting route environments. Here we will report on the development and the results of validity and reliability assessments thereof.

    Methods

    Active commuters (n = 54) were recruited when they bicycled in Stockholm, Sweden. Traffic planning and environmental experts from the Municipality of Stockholm were assembled to form an expert panel (n = 24). The active commuters responded to the scale on two occasions, and the expert panel responded to it once. To test criterion-related validity, differences in ratings of the inner urban and suburban environments of Greater Stockholm were compared between the experts and the commuters. Furthermore, four items were compared with existing objective measures. Test-retest reproducibility was assessed with three types of analysis: order effect, typical error and intraclass correlation.

    Results

    There was a concordance in sizes and directions of differences in ratings of inner urban and suburban environments between the experts and the commuters. Furthermore, both groups’ ratings were in line with existing objectively measured differences between the two environmental settings. Order effects between test and retest were observed in 6 of 36 items. The typical errors ranged from 0.93 to 2.54, and the intraclass correlation coefficients ranged from ‘moderate’ (0.42) to ‘almost perfect’ (0.87).

    Conclusions

    The ACRES was characterized by considerable criterion-related validity and reasonable test-retest reproducibility.

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