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  • 101.
    Cardinale, Daniele A.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Exercise training strategies to optimize muscle oxygen uptake, muscle oxidative capacity and performance in humans2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    My research area focuses on studying the entire O2 cascade in humans from lungs to mitochondria with an integrative approach.

    The overall aim of the PhD project is to examine in detail 1) the differences in convective O2 delivery (Fick method) and mitochondrial function (high resolution respirometry technique) between individuals with low and high VO2 max, 2) to quantify the effect of aerobic interval training with elevated O2 delivery on circulatory, muscle mitochondrial components on VO2 max in highly trained individuals, as well as, 3) to quantify the effect of elevated O2 delivery on circulatory and metabolic responses (blood flow and muscle VO2) to exercise engaging small and large muscle groups. A specific focus of the PhD project is to examine and quantify how differences in a) mitochondrial OXPHOS capacity and b) mitochondrial O2 affinity (p50) define differences in muscle O2 extraction and muscle VO2 between individuals of low fitness and those with high aerobic endurance capacity. Although a vast body of literature supports a strong link between muscle oxidative capacity and peak VO2 during exercise, almost all studies are correlative, and the dependence and contribution of mitochondrial capacity to muscle VO2 has yet to be quantified. To this end, experiments are designed to control for O2 transport during exercise as the independent variable between groups with high and low aerobic capacities. The effect of aerobic interval training with elevated O2 delivery on central (circulatory) and peripheral (muscle oxidative) mechanisms for elevating peak VO2 and endurance performance are explored in endurance-trained individuals. Hyperoxic air increases O2 dissolved in the blood, elevates arterial O2 saturation, and increases arterial O2 concentration, resulting in a higher O2 delivery to the working muscle independently from blood flow. Since mitochondria have an excess oxidative capacity in relation to O2 delivery during whole body exercise in normoxia, we hypothesize that mitochondrial volume, function and O2 affinity as well as endurance performance are largely improved following endurance interval training with elevated O2 delivery compared to normoxia.

    Our preliminary data show that OXPHOS and performance are significantly enhanced following six weeks of periodized aerobic interval training. Significantly differences in performance but not in OXPHOS are found when training is conducted in hyperoxia compared to normoxia.

  • 102.
    Cardinale, Daniele A.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Skeletal muscle V̇O2max and mitochondrial p50 measured in-vivo and ex-vivo: effect of hyperoxia in exercise with small and large muscle mass in well-trained individuals2016Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    In healthy individuals maximal oxygen uptake is limited by cardiac output when exercising with large musclemass, e.g. 2-legged cycling (BIKE), whereas during one-leg knee extension (KE) exercise there is a closermatch between the amounts of O2 delivered to O2 demand. However hyperoxia has been shown to increaseO2 uptake in both work modalities. This study examined the extent to which hyperoxia affects leg oxygentransport, muscle diffusion capacity, mitochondrial oxygen affinity (p50mito) in vivo and ex vivo, and muscleO2 uptake during exercise engaging a large and small muscle mass in well-trained individuals. In this studywe show that light hyperoxia increases O2 uptake at peak incremental exercise (~10%, p< 0.05) in bothBIKE and KE due to an increased O2 delivery (~ 10%, p< 0.05), which in turn is mainly caused by anincreased arterial O2 content (~5%, p< 0.05), and a non-significant increased leg blood flow (~ 5%). Hencehyperoxia decreases mitochondrial O2 affinity as indicated by the higher calculated in vivo mitochondrialp50. Inspired O2 enhanced maximal work rate in BIKE (~6.5%) and in KE (~4.5%).Our data show that in vivo mitop50 is lower than the ex vivo measure in BIKE, whereas in vivo mitop50 issimilar to ex vivo measure in KE. These indicates that mitochondrial OXPHOS capacity was in excess inBIKE, whereas in KE was almost fully utilized in vivo. This study indicated that both during whole body peakexercise as well as during exercise with smaller muscle mass, V̇O2 may not limit O2 diffusion capacity.

  • 103.
    Cardinale, Daniele A.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Syrgas – så påverkas prestationen2016Ingår i: Idrottsforskning, ISSN 2002-3944, artikel-id 31 marsArtikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Vältränade idrottare som andas syrgas ökar omedelbart prestationen. Trots det är metoden inte dopningsklassad. En genomgång av aktuell forskning visar att syrgasandning skulle ha en signifikant effekt under tävlingar, men hur det fungerar som träningsmetod är mer osäkert. Vanlig luft kan vara minst lika bra.

  • 104.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Cardinale, Marco
    Aspire Academy, Doha, Qatar.
    Nilsson, Johnny E.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för tillämpad idrottsvetenskap (LTIV). University of Dalarna, Falun.
    Comparison between single and combined data collection methods in loaded squat jump power output2017Ingår i: Gazzetta Medica Italiana, ISSN 0393-3660, E-ISSN 1827-1812, Vol. 176, nr 6, s. 315-321Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The aim of this study was to compare linear position transducer force plate-based methods and more complex combinations of those for calculation of power output in loaded squat jump.

    METHODS: Eight methods were used simultaneously in data collection: vertical ground reaction force (VGRF), ground reaction forces (GRF), 1 linear position transducer (1LPT), 1LPT and VGRF (1LPT+VGRF), 2 linear position transducers (2LPTs), 2LPTs and VGRF (2LPTs+VGRF), 5 linear position transducers (5LPTs), 5LPTs and GRF (5LPTs+GRF). Power output was calculated for each lift according to the sensor or sensors used and the results were compared.

    RESULTS: Power output calculated separately with LPTs and GRF method did not differ significantly from combined methods such as 1LPT+VGRF, 2LPTs+VGRF. No significant differences were found when comparing power output between 5LPTs+GRF and combined methods such as 2LPTs+VGRF.

    CONCLUSIONS: This study indicates that test methodology with a simple single linear position transducer setup and or force platform suffice when recording vertical jump such as loaded squat jump.

  • 105.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Hyperoxia for performance and training.2018Ingår i: Journal of Sports Sciences, ISSN 0264-0414, E-ISSN 1466-447X, nr 13, s. 1515-1522Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Recent technological developments have made it possible to use hyperoxia as an enhancement aid during training. Athletes wearing a mask can breathe a higher fraction of oxygen from a stationary or portable apparatus while exercising. A large body of evidence indicates that the oxygen transport capacity, lactate metabolism, power output and work tolerance (endurance) are improved when breathing hyperoxia. The physiological mechanisms underlying these performance improvements, although still not fully elucidated, are based on higher oxygen delivery and reduced central fatigue. Although much is known about the acute effects of hyperoxia, the effect of hyperoxic-supplemented endurance training on performance and the mechanisms beneath training adaptations are not very well understood, especially in well-trained endurance athletes. The few studies on the physiological effects of hyperoxia training have been conducted with conflicting results, discussed in this paper. Potential detrimental effects have not yet been shown experimentally and warrant further investigation.

  • 106.
    Cardinale, Daniele A
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll. Elite Performance Centre, Bosön.
    Gejl, Kasper D
    University of Southern Denmark.
    Ørtenblad, Niels
    University of Southern Denmark.
    Ekblom, Bjorn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Blomstrand, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Eva Blomstrands forskningsgrupp.
    Larsen, Filip J
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Reliability of maximal mitochondrial oxidative phosphorylation in permeabilized fibers from the vastus lateralis employing high-resolution respirometry.2018Ingår i: Physiological Reports, E-ISSN 2051-817X, Vol. 6, nr 4, artikel-id e13611Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose was to assess the impact of various factors on methodological errors associated with measurement of maximal oxidative phosphorylation (OXPHOS) in human skeletal muscle determined by high-resolution respirometry in saponin-permeabilized fibers. Biopsies were collected from 25 men to assess differences in OXPHOS between two muscle bundles and to assess the correlation between OXPHOS and the wet weight of the muscle bundle. Biopsies from left and right thighs of another five subjects were collected on two occasions to compare limbs and time-points. A single muscle specimen was used to assess effects of the anesthetic carbocaine and the influence of technician. The difference in OXPHOS between two fiber-bundles from the same biopsy exhibited a standard error of measurement (SEM) of 10.5 pmol · s-1  · mg-1 and a coefficient of variation (CV) of 15.2%. The differences between left and right thighs and between two different time-points had SEMs of 9.4 and 15.2 pmol · s-1  · mg-1 and CVs of 23.9% and 33.1%, respectively. The average (±SD) values obtained by two technicians monitoring different bundles of fibers from the same biopsy were 31.3 ± 7.1 and 26.3 ± 8.1 pmol · s-1  · mg-1 . The time that elapsed after collection of the biopsy (up to a least 5 h in preservation medium), wet weight of the bundle (from 0.5 to 4.5 mg) and presence of an anesthetic did not influence OXPHOS. The major source of variation in OXPHOS measurements is the sample preparation. The thigh involved, time-point of collection, size of fiber bundles, and time that elapsed after biopsy had minor or no effect.

  • 107.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Larsen, Filip J
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Jensen-Urstad, M
    Karolinska institutet.
    Rullman, E
    Karolinska institutet.
    Søndergaard, H
    Rigshospitalet, Köpenhamn, Danmark.
    Morales-Alamo, D
    University of Las Palmas de Gran Canaria, Spanien.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Calbet, J A L
    University of Las Palmas de Gran Canaria, Spanien.
    Boushel, Robert
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet. University of British Columbia, Vancouver, British Columbia, Canada.
    Muscle mass and inspired oxygen influence oxygen extraction at maximal exercise: role of mitochondrial oxygen affinity.2019Ingår i: Acta Physiologica, ISSN 1748-1708, E-ISSN 1748-1716, Vol. 225, nr 1, artikel-id e13110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:We examined the Fick components together with mitochondrial O2 affinity (p50mito ) in defining O2 extraction and O2 uptake during exercise with large and small muscle mass during normoxia (NORM) and hyperoxia (HYPER).

    METHODS:Seven individuals performed two incremental exercise tests to exhaustion on a bicycle ergometer (BIKE) and two on a one-legged knee extension ergometer (KE) in NORM or HYPER. Leg blood flow and VO2 were determined by thermodilution and the Fick method. Maximal ADP-stimulated mitochondrial respiration (OXPHOS) and p50mito were measured ex vivo in isolated mitochondria. Mitochondrial excess capacity in the leg was determined from OXPHOS in permeabilized fibers and muscle mass measured with magnetic resonance imaging in relation to peak leg O2 delivery.

    RESULTS:The ex vivo p50mito increased from 0.06±0.02 to 0.17±0.04 kPa with varying substrate supply and O2 flux rates from 9.84±2.91 to 16.34±4.07 pmol O2 ·s-1 ·μg-1 respectively. O2 extraction decreased from 83% in BIKE to 67% in KE as a function of a higher O2 delivery, and lower mitochondrial excess capacity. There was a significant relationship between O2 extraction and mitochondrial excess capacity and p50mito that was unrelated to blood flow and mean transit time.

    CONCLUSION:O2 extraction varies with mitochondrial respiration rate, p50mito and O2 delivery. Mitochondrial excess capacity maintains a low p50mito which enhances O2 diffusion from microvessels to mitochondria during exercise. This article is protected by copyright. All rights reserved.

  • 108.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Larsen, Filip J
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Lindholm, Peter
    Karolinska Institutet, Stockholm, Sweden..
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Boushel, Robert
    Univ British Columbia, Vancouver, BC, Canada..
    Effects Of Hyperoxic-Supplemented High Intensity Interval Training On Endurance Performance, Maximal Oxygen Consumption And Mitochondrial Function In Trained Cyclists2019Ingår i: MEDICINE AND SCIENCE IN SPORTS AND EXERCISE Vol 51(2019):6. Supplement: S, Meeting Abstract: 1753, Lippincott Williams & Wilkins, 2019, Vol. 51, nr 6, s. 463-464Konferensbidrag (Övrigt vetenskapligt)
  • 109.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Larsen, Filip J
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Lännerström, Johan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Manselin, Tom
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Södergård, Olof
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Mijwel, Sara
    Karolinska institutet, Sweden.
    Lindholm, P
    Karolinska institutet, Sweden.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Boushel, Robert
    University of British Columbia, Vancouver, BC, Canada..
    Influence of Hyperoxic-Supplemented High-Intensity Interval Training on Hemotological and Muscle Mitochondrial Adaptations in Trained Cyclists.2019Ingår i: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 10, artikel-id 730Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Hyperoxia (HYPER) increases O2 carrying capacity resulting in a higher O2 delivery to the working muscles during exercise. Several lines of evidence indicate that lactate metabolism, power output, and endurance are improved by HYPER compared to normoxia (NORM). Since HYPER enables a higher exercise power output compared to NORM and considering the O2 delivery limitation at exercise intensities near to maximum, we hypothesized that hyperoxic-supplemented high-intensity interval training (HIIT) would upregulate muscle mitochondrial oxidative capacity and enhance endurance cycling performance compared to training in normoxia. Methods: 23 trained cyclists, age 35.3 ± 6.4 years, body mass 75.2 ± 9.6 kg, height 179.8 ± 7.9 m, and VO2max 4.5 ± 0.7 L min-1 performed 6 weeks polarized and periodized endurance training on a cycle ergometer consisting of supervised HIIT sessions 3 days/week and additional low-intensity training 2 days/week. Participants were randomly assigned to either HYPER (FIO2 0.30; n = 12) or NORM (FIO2 0.21; n = 11) breathing condition during HIIT. Mitochondrial respiration in permeabilized fibers and isolated mitochondria together with maximal and submaximal VO2, hematological parameters, and self-paced endurance cycling performance were tested pre- and posttraining intervention. Results: Hyperoxic training led to a small, non-significant change in performance compared to normoxic training (HYPER 6.0 ± 3.7%, NORM 2.4 ± 5.0%; p = 0.073, ES = 0.32). This small, beneficial effect on the self-paced endurance cycling performance was not explained by the change in VO2max (HYPER 1.1 ± 3.8%, NORM 0.0 ± 3.7%; p = 0.55, ES = 0.08), blood volume and hemoglobin mass, mitochondrial oxidative phosphorylation capacity (permeabilized fibers: HYPER 27.3 ± 46.0%, NORM 16.5 ± 49.1%; p = 0.37, ES = 3.24 and in isolated mitochondria: HYPER 26.1 ± 80.1%, NORM 15.9 ± 73.3%; p = 0.66, ES = 0.51), or markers of mitochondrial content which were similar between groups post intervention. Conclusions: This study showed that 6 weeks hyperoxic-supplemented HIIT led to marginal gain in cycle performance in already trained cyclists without change in VO2max, blood volume, hemoglobin mass, mitochondrial oxidative phosphorylation capacity, or exercise efficiency. The underlying mechanisms for the potentially meaningful performance effects of hyperoxia training remain unexplained and may raise ethical questions for elite sport.

  • 110.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Larsen, Filip J
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Schiffer, Tomas A
    Karolinska Institute.
    Morales-Alamo, David
    University of Las Palmas de Gran Canaria.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Calbet, Jose A L
    University of Las Palmas de Gran Canaria.
    Holmberg, Hans-Christer
    Mid Sweden University, Östersund, The University of British Columbia, Vancouver, BC, Canada..
    Boushel, Robert
    The University of British Columbia, Vancouver, BC, Canada..
    Superior Intrinsic Mitochondrial Respiration in Women Than in Men.2018Ingår i: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 9, artikel-id 1133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sexual dimorphism is apparent in humans, however, to date no studies have investigated mitochondrial function focusing on intrinsic mitochondrial respiration (i.e., mitochondrial respiration for a given amount of mitochondrial protein) and mitochondrial oxygen affinity (p50mito) in relation to biological sex in human. A skeletal muscle biopsy was donated by nine active women, and ten men matched for maximal oxygen consumption (VO2max) and by nine endurance trained men. Intrinsic mitochondrial respiration, assessed in isolated mitochondria, was higher in women compared to men when activating complex I (CIP) and complex I+II (CI+IIP) (p < 0.05), and was similar to trained men (CIP, p = 0.053; CI+IIP, p = 0.066). Proton leak and p50mito were higher in women compared to men independent of VO2max. In conclusion, significant novel differences in mitochondrial oxidative function, intrinsic mitochondrial respiration and p50mito exist between women and men. These findings may represent an adaptation in the oxygen cascade in women to optimize muscle oxygen uptake to compensate for a lower oxygen delivery during exercise.

  • 111.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll. Elite Performance Centre, Bosön.
    Lilja, Mats
    Karolinska institutet.
    Mandic, Mirko
    Karolinska institutet.
    Gustafsson, Thomas
    Karolinska institutet.
    Larsen, Filip J.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Lundberg, Tommy R.
    Karolinska institutet.
    Resistance Training with Co-ingestion of Anti-inflammatory Drugs Attenuates Mitochondrial Function2017Ingår i: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 8, artikel-id 1074Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The current study aimed to examine the effects of resistance exercise with concomitant consumption of high versus low daily doses of non-steroidal anti-inflammatory drugs (NSAIDs) on mitochondrial oxidative phosphorylation in skeletal muscle. As a secondary aim, we compared the effects of eccentric-overload with conventional training. Methods: Twenty participants were randomized to either a group taking high doses (3 x 400 mg/day) of ibuprofen (IBU; 27±5 yr; n=11) or a group ingesting a low dose (1 x 75 mg/day) of acetylsalicylic acid (ASA; 26±4 yr; n=9) during 8 weeks of supervised knee extensor resistance training. Each of the subject’s legs were randomized to complete the training program using either a flywheel (FW) device emphasizing eccentric-overload, or a traditional weight stack machine (WS). Maximal mitochondrial oxidative phosphorylation (CI+IIP) from permeabilized skeletal muscle bundles was assessed using high-resolution respirometry. Citrate synthase (CS) activity was assessed using spectrophotometric techniques and mitochondrial protein content using western blotting. Results: After training, CI+IIP decreased (P<0.05) in both IBU (23%) and ASA (29%) with no difference across medical treatments. Although CI+IIP decreased in both legs, the decrease was greater (interaction p = 0.015) in WS (33%, p = 0.001) compared with FW (19%, p = 0.078). CS activity increased (p = 0.027) with resistance training, with no interactions with medical treatment or training modality. Protein expression of ULK1 increased with training in both groups (p < 0.001). The increase in quadriceps muscle volume was not correlated with changes in CI+IIP (R=0.16). Conclusion: These results suggest that 8 weeks of resistance training with co-ingestion of anti-inflammatory drugs reduces mitochondrial function but increases mitochondrial content. The observed changes were not affected by higher doses of NSAIDs consumption, suggesting that the resistance training intervention was the prime mediator of the decreased mitochondrial phosphorylation. Finally, we noted that flywheel resistance training, emphasizing eccentric overload, rescued some of the reduction in mitochondrial function seen with conventional resistance training.

  • 112.
    Cardinale, Daniele A.
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC). Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Cardinale, Marco
    Comparative multiple sensor approach for power calculation in loaded squat jump and power clean2013Ingår i: Comparative multiple sensor approach for power calculation in loaded squat jump and power clean, 2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

    Power output is a critical component of athletic performance (McGuigan et al., 2012); therefore, strength and conditioning specialists are nowadays employed to help athletes increase the power-generating capacity in specific motor tasks. Due to the widespread need to assess power output in common strength training exercises, the development and validation of various assessment approaches has led to studies aimed at identifying the external optimal load (OL) to maximize power output (Cormie et al., 2007). The aim of this study was to compare conventionally used linear position transducer and force plate based methods with a new methodology for calculation of peak power (PP) and average power (AP) output in conjunction with the load-power relationship.

    Methods

    Nineteen male elite athletes performed loaded squat jump (LSJ) and power clean (PC) with different external loads to determine the load/power relationship. Nine methods were used simultaneously in data collection: vertical ground reaction force (VGRF), ground reaction force (GRF) i.e. vertical, anterio-posterior and medio-lateral reaction force components, 1 linear encoder (1Encoder), 1 linear position transducer (1LPT), 1LPT and VGRF (1LPT+VGRF), 2 linear position transducers (2LPTs), 2LPTs and VGRF (2LPTs+VGRF), 5 linear position transducers (5LPTs), 5LPTs and GRF (5LPTs+GRF; novel method). Power output was calculated for each lift according to the sensor or sensors simultaneously used and the results were compared.

    Results

    Power output calculated separately with LPTs and GRF method differed significantly from combined methods such as 1LPT+VGRF, 2LPTs+VGRF, and 5LPTs+GRF (novel method). The optimal load in LSJ and PC with respect to PP output was identified at loads between 30 and 50% of their body mass (bm), respectively; and with respect to AP output equal to loads between 85 and 75% of bm, respectively.

    Discussion

    This study indicates that test methodology influences the results of the power output and the load–power relationship in LSJ and PC exercises. The results of this study suggest the possibility that the combined methods provide a better representation of muscle power generation during dynamic movements involving the non-linear trajectories of the barbell than kinematic or kinetic methods alone.

    References

    Cormie, P., McBride, J. M., & McCaulley, G. O. (2007). J Appl Biomech, 23(2), 103-118. McGuigan. (2012). Strength and Power Assessment Protocols. Physiological Tests for Elite Athletes (2nd ed., pp. 207-230). Stanningley Leeds, United Kingdom: Human Kinetics.

  • 113.
    Cardinale, Daniele
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Boushel, Robert
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Ekblom-Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Is the Ekblom-Bak Test a valid screening tool for Vo2peak in highly active individuals?2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

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

    Methods

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

    Results

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

    References

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

  • 114.
    Cardinale, Daniele
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Lilja, Mats
    Karolinska Institutet, Stockholm, Sweden..
    Mandic, Mirko
    Karolinska Institutet, Stockholm, Sweden..
    Gustafsson, Thomas
    Karolinska Institutet, Stockholm, Sweden..
    Larsen, Filip J.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Forskningsgruppen Mitokondriell funktion och metabolisk kontroll.
    Lundberg, Tommy R.
    Karolinska Institutet Stockholm, Sweden..
    Resistance Exercise Attenuates Mitochondrial Function: Effects Of NSAID Intake And Eccentric-Overload Training2017Ingår i: Medicine & Science in Sports & Exercise. 49(5S):329, MAY 2017, 2017, Vol. 49, nr 5, s. 329-329Konferensbidrag (Refereegranskat)
    Abstract [en]

    Although nonsteroidal antiinflammatorydrugs (NSAIDs) have been shown to modulate skeletal muscle adaptations and protein metabolism in response toresistance exercise, little is known about the effects of NSAIDs on mitochondrial function. Thus, the current study aimed to examine the effects of resistanceexercise with concomitant NSAID consumption on mitochondrial oxidative phosphorylation in skeletal muscle. Twenty participants were randomized in asingleblindedfashion to either an experimental group receiving ibuprofen (IBU: 27±5 yr; n=11; 1200 mg/d) or a control group receiving a lowdoseacetylsalicylic acid (CON: 26±4 yr; n=9; 75 mg/d) During this period, subjects performed 8 weeks of supervised resistance exercise involving the kneeextensors muscles. Each of the subject’s legs were randomized to complete the training program using either a flywheel (FW) device emphasizing eccentricoverload,or a traditional weight stack machine (WS). Maximal mitochondrial oxidative phosphorylation (OXPHOS) from permeabilized skeletal muscle bundleswas assessed using high resolution respirometry before and after the training intervention. Citrate synthase activity was assessed using spectrophotometrictechniques. After training, OXPHOS decreased (P<0.05) in both IBU (23%) and CON (29%) with no difference across medical treatments. Although OXPHOSdecreased in both legs, the decrease was greater (interaction P= 0.015) in WS (33%, P= 0.015) than in FW (19%, P= 0.078). Citrate synthase (CS) did notchange after the intervention. The increase in quadriceps muscle volume was not significantly correlated with the change in OXPHOS (R=0.15). These resultssuggest that 1) eight weeks of resistance training reduces mitochondrial function but not mitochondrial content, 2) The decreased mitochondrial function withresistance exercise was not affected by ibuprofen consumption, 3) flywheel resistance training, emphasizing eccentric overload, rescues some of thereduction in mitochondrial function seen with conventional resistance training.

  • 115.
    Carlström, P.A.
    et al.
    Idrottsmedicin Umeå Universitet.
    Boman, N
    Idrottsmedicin Umeå Universitet.
    Söderlund, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Isaksson, A
    Idrottsmedicin umeå Universitet.
    Johansson, J
    Idrottsmedicin Umeå universitet.
    Burén, J
    Idrottsmedicin Umeå Universitet.
    Svensson, M.B.
    Idrottsmedicin Umeå Universitet.
    Adaptations in peak oxygen consumption and fat oxidation following hypertrophy-induced heavy resistance training2012Konferensbidrag (Övrigt vetenskapligt)
  • 116. Celsing, F
    et al.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Sylvén, C
    Everett, J
    Åstrand, PO
    Effects of chronic iron deficiency anaemia on myoglobin content, enzyme activity, and capillary density in the human skeletal muscle.1988Ingår i: Acta medica Scandinavica, ISSN 0001-6101, Vol. 223, nr 5, s. 451-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The influence of chronic iron deficiency anaemia on myoglobin content, maximal enzyme activities and capillarization in the human skeletal muscle was investigated. Muscle samples from musculus vastus lateralis were screened in an Indonesian population. The causes of iron deficiency were chronic intestinal bleeding or repeated pregnancy combined with low iron intake. The maximal activities of iron-dependent and non-iron-dependent glycolytic and oxidative enzymes as well as myoglobin showed similar values in the iron-deficient group and the matched control group. The activities of the oxidative enzymes in both the iron-deficient group and the controls were lower, however, compared even to untrained Swedish subjects. The capillary density was essentially within a normal range in both groups. It is concluded that chronic iron deficiency anaemia of a moderate or severe degree, with Hb concentrations of about 80-100 g.1(-1), does not cause an impaired biochemical function of the human skeletal muscle.

  • 117.
    Christenson, Anne
    et al.
    Obesity Center, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
    Johansson, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Reynisdottir, Signy
    Obesity Center, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.
    Torgerson, Jarl
    Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Hemmingsson, Erik
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    “…or else I close my ears” How women with obesity want to be approached and treated regarding gestational weight management: A qualitative interview study.2019Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 9, s. 1-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 118.
    Dang, Phung
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, FoU-gruppen för rörelse, hälsa och miljö.
    Lundvall, Suzanne
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Engström, Lars-Magnus
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Schantz, Peter
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, FoU-gruppen för rörelse, hälsa och miljö.
    Tiden talar för fysiskt aktiv skolpendling2006Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, nr 3, s. 14-15Artikel i tidskrift (Övrigt vetenskapligt)
  • 119.
    Danielsen, Yngvild
    et al.
    University of Bergen, Norway.
    Júlíusson, Pétur
    University of Bergen, Norway.
    Nordhus, Inger Hilde
    Haukeland University Hospital, Bergen, Hordaland, Norway.
    Kleiven, M
    University of Bergen, Norway.
    Meltzer, H M
    Norwegian Institute of Public Health, Kristiania (historical), Oslo County, Norway.
    Olsson, Sven Johan Gustav
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Pallesen, S.
    The relationship between life-style and cardio-metabolic risk indicators in children: the importance of screen time2011Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 2, s. 253-259Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS:

    To examine differences between children with obesity and normal weight children (aged 7-13 years) in terms of physical activity, screen time, food intake and blood parameters indicative of cardio-metabolic risk. Further, to explore the relationship between physical activity, screen time and food intake with cardio-metabolic parameters.

    METHODS:

    Forty-three children with obesity were compared with 43 normal weight peers. Physical activity was monitored by accelerometers and screen time and food intake by diaries. Blood parameters indicative of cardio-metabolic risk were analysed.

    RESULTS:

    The group of children with obesity had significantly less vigorous activity (p = 0.013), more daily screen time (p = 0.004) and consumed more fat (p = 0.04) than the group of normal weight children. The former group also demonstrated higher values of triglycerides (p = 0.001), HbA1c (p = 0.009), C-peptide (p = 0.001), had a higher HOMA-R score (p = 0.001), and lower levels of HDL (p = 0.001). After controlling for weight category, regression analyses revealed that screen time was significantly and positively related to the HOMA-R score and C-peptide levels independent of physical activity and intake of fat and sugar.

    CONCLUSIONS:

    The results indicate that screen time is an important behavioural factor related to obesity and cardio-metabolic risk indicators in children.

  • 120. Danielsson, Pernilla
    et al.
    Kowalski, Jan
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Marcus, Claude
    Response of severely obese children and adolescents to behavioral treatment.2012Ingår i: Archives of Pediatrics & Adolescent Medicine, ISSN 1072-4710, E-ISSN 1538-3628, Vol. 166, nr 12, s. 1103-1108Artikel i tidskrift (Refereegranskat)
    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.

  • 121.
    Danielsson, Pernilla
    et al.
    Karolinska Institutet.
    Svensson, Viktoria
    Karolinska Institutet.
    Kowalski, Jan
    Karolinska Institutet.
    Nyberg, Gisela
    Karolinska Institutet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Marcus, Claude
    Karolinska Institutet.
    Importance of age for 3-year continuous behavioral obesity treatment success and dropout rate.2012Ingår i: Obesity Facts, ISSN 1662-4025, E-ISSN 1662-4033, Vol. 5, nr 1, s. 34-44Artikel i tidskrift (Refereegranskat)
    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.

  • 122. De Vries, Sjerp
    et al.
    Claßen, Thomas
    Eigenheer-Hug, Stella-Maria
    Korpela, Kalevi
    Maas, Jolanda
    Mitchell, Richard
    Schantz, Peter
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Contributions of Natural Environments to Physical Activity: Theory and Evidence Base2011Ingår i: Forests, Trees and Human Health / [ed] Nilsson, K., Sangster, M., Gallis, C., Hartig, T., de Vries, S., Seeland, K.. & Schipperijn, J., Heidelberg: Springer Verlag , 2011, 1, s. 205-243Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    The link between modern lifestyles and increasing levels of chronic heart disease, obesity, stress and poor mental health is a concern across the world. The cost of dealing with these conditions places a large burden on national public health budgets so that policymakers are increasingly looking at prevention as a cost-effective alternative to medical treatment. Attention is turning towards interactions between the environment and lifestyles. Exploring the relationships between health, natural environments in general, and forests in particular, this groundbreaking book is the outcome of the European Union’s COST Action E39 ‘Forests, Trees and Human Health and Wellbeing’, and draws together work carried out over four years by scientists from 25 countries working in the fields of forestry, health, environment and social sciences. While the focus is primarily on health priorities defined within Europe, this volume explicitly draws also on research from North America and elsewhere and will have relevance worldwide. A state-of-the-art analysis of the global research on the topic of forests and human health, a key contribution of the book is its synthesis of material across both disciplines and nations, providing a vital reference for researchers in forestry, health, natural resource management and environmental policy. Currently the only unified body of work on this topic, the book will also be an important tool for those working in both health and environment policy and practice.

  • 123.
    Devin, James L
    et al.
    School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
    Bolam, Kate A
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp. School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
    Jenkins, David G
    School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
    Skinner, Tina L
    School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
    The influence of exercise on the insulin-like growth factor axis in oncology: physiological basis, current and future perspectives.2016Ingår i: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 25, nr 2, s. 239-249Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Exercise and physical activity have been shown to reduce the risk of many common cancers and strongly influence tumour biology. A cause-effect mechanism explaining this relationship is dependent on cellular pathways that can influence tumour growth and are exercise-responsive. The insulin-like growth factor (IGF) axis is reported to promote the development and progression of carcinomas through cellular signalling in cancerous tissues. This review summarises the physiological basis of the role of the IGF axis in oncology and the influence of exercise on this process. We examined the effects of exercise prescription on the IGF axis in cancer survivors by evaluating the current scope of the literature. The current research demonstrates a remarkable heterogeneity and inconsistency in the responses of the IGF axis to exercise in breast, prostate and colorectal cancer survivors. Finally, this review presents an in-depth exploration of the physiological basis and mechanistic underpinnings of the seemingly disparate relationship between exercise and the IGF axis in oncology. Whilst there is currently insufficient evidence to categorise the effects of exercise prescription on the IGF axis in cancer survivors, the inconsistency of results suggests a multifaceted relationship, the complexities of which are considered in this review.

  • 124.
    Devin, James L.
    et al.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Jenkins, David G.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Sax, Andrew T.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Hughes, Gareth I.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Aitken, Joanne F.
    Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia..
    Chambers, Suzanne K.
    Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia.;Prostate Canc Fdn Australia, Sydney, NSW, Australia.;Edith Cowan Univ, Hlth & Wellness Inst, Perth, WA, Australia.;Univ Queensland, Clin Res Ctr, Brisbane, Qld, Australia..
    Dunn, Jeffrey C.
    Canc Council Queensland, Canc Res Ctr, Brisbane, Qld, Australia.;Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld, Australia.;Univ Queensland, Sch Social Sci, Brisbane, Qld, Australia..
    Bolam, Kate A.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet. Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    Skinner, Tina L.
    Univ Queensland, Sch Human Movement & Nutr Sci, Brisbane, Qld, Australia..
    THE INFLUENCE OF EXERCISE INTENSITY AND FREQUENCY ON CARDIORESPIRATORY FITNESS AND BODY COMPOSITION IN COLORECTAL CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL2016Ingår i: Asia-Pacific Journal of Clinical Oncology, ISSN 1743-7563, E-ISSN 1743-7563, Vol. 12, nr S5, s. 109-109, artikel-id 191Artikel i tidskrift (Övrigt vetenskapligt)
  • 125. Devin, James L
    et al.
    Sax, Andrew T
    Hughes, Gareth I
    Jenkins, David G
    Aitken, Joanne F
    Chambers, Suzanne K
    Dunn, Jeffrey C
    Bolam, Kate A
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Skinner, Tina L
    The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial.2016Ingår i: Journal of cancer survivorship, ISSN 1932-2259, E-ISSN 1932-2267, Vol. 10, nr 3, s. 467-479Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Following colorectal cancer diagnosis and anti-cancer therapy, declines in cardiorespiratory fitness and body composition lead to significant increases in morbidity and mortality. There is increasing interest within the field of exercise oncology surrounding potential strategies to remediate these adverse outcomes. This study compared 4 weeks of moderate-intensity exercise (MIE) and high-intensity exercise (HIE) training on peak oxygen consumption (V̇O2peak) and body composition in colorectal cancer survivors.

    METHODS: Forty seven post-treatment colorectal cancer survivors (HIE = 27 months post-treatment; MIE = 38 months post-treatment) were randomised to either HIE [85-95 % peak heart rate (HRpeak)] or MIE (70 % HRpeak) in equivalence with current physical activity guidelines and completed 12 training sessions over 4 weeks.

    RESULTS: HIE was superior to MIE in improving absolute (p = 0.016) and relative (p = 0.021) V̇O2peak. Absolute (+0.28 L.min(-1), p < 0.001) and relative (+3.5 ml.kg(-1).min(-1), p < 0.001) V̇O2 peak were increased in the HIE group but not the MIE group following training. HIE led to significant increases in lean mass (+0.72 kg, p = 0.002) and decreases in fat mass (-0.74 kg, p < 0.001) and fat percentage (-1.0 %, p < 0.001), whereas no changes were observed for the MIE group. There were no severe adverse events.

    CONCLUSIONS: In response to short-term training, HIE is a safe, feasible and efficacious intervention that offers clinically meaningful improvements in cardiorespiratory fitness and body composition for colorectal cancer survivors.

    IMPLICATIONS FOR CANCER SURVIVORS: HIE appears to offer superior improvements in cardiorespiratory fitness and body composition in comparison to current physical activity recommendations for colorectal cancer survivors and therefore may be an effective clinical utility following treatment.

  • 126. Devin, James
    et al.
    Sax, Andrew
    Hughes, Gareth
    Jenkins, David
    Aitken, Joanne F.
    Chambers, Suzanne K.
    Dunn, Jeffrey C.
    Bolam, Kate A.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Skinner, Tina
    The temporal response of cardiorespiratory fitness to high-intensity or moderate-intensity exercise training and detraining in colorectal cancer survivors2016Ingår i: Research to Practice 2016: Conference Proceedings, Exercise & Sports Science Australia, , 2016, s. 74-Konferensbidrag (Övrigt vetenskapligt)
  • 127. Duttaroy, Smita
    et al.
    Nilsson, Jonas
    Hammarsten, Ola
    Cider, Asa
    Bäck, Maria
    Karlsson, Thomas
    Wennerblom, Bertil
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    High frequency home-based exercise decreases levels of vascular endothelial growth factor in patients with stable angina pectoris.2015Ingår i: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, nr 5, s. 575-581Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In coronary artery disease (CAD), circulating angiogenic factors have been seen to increase, possibly as a response to ischaemia. Regular physical activity (PA) is recommended for prevention and treatment of CAD, but more research is needed to optimise PA regimes. We investigated the effect of home-based high frequency exercise (HFE) on angiogenic cytokines and cardiac markers in patients with stable CAD.

    DESIGN: This was a randomised case-control study METHODS: Sixty-two patients, with stable CAD, were randomised to HFE (n = 33), (aerobic exercise 70% of max, 30 min, five times/week and resistance exercise three times/week), performed at home, or usual lifestyle (control, n = 29). After eight weeks, percutaneous coronary intervention (PCI) was performed in both groups, and the HFE group continued another six months of exercise. Serum vascular endothelial growth factor (VEGF) and stromal derived factor-1 (SDF-1), plasma N-terminal-brain natriuretic peptide (NT-proBNP), high-sensitive troponin T (TnT) and copeptin were analysed.

    RESULTS: Data are presented as median (25(th), 75(th) percentile) of relative changes (%) from baseline. Values of p are given for the difference between the HFE and controls. HFE decreased circulating VEGF levels, before PCI (-5% (-15%, -2%)), while VEGF levels increased in the control group (5% (-3%, 20%) p = 0.004). A significant difference in VEGF remained at three months post-PCI (HFE (-1%(-12%, 5%), control (7% (0%, 14%), p = 0.04), but not at six months after PCI. SDF-1, NT-proBNP, TnT and copeptin levels did not differ significantly. In addition, VEGF levels were positively correlated to NT pro-BNP.

    CONCLUSIONS: Home-based HFE decreased circulating VEGF in patients with stable CAD, suggesting a reduced ischaemic burden. HFE does not increase markers of cardiac dysfunction, suggesting that it is a safe therapeutic intervention in these patients.

  • 128.
    Edman, Sebastian
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Söderlund, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Blomstrand, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Eva Blomstrands forskningsgrupp.
    Anabolic signalling in individual muscle fibres following resistance exercise in combination with amino acid intake: PO-2602018Ingår i: Exercise Biochemistry Review: Vol 1 No 5 (2018): Proceedings of IBEC 2018, Beijing, China (PO-201 -> PO-308), 2018Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Objective Human muscle consists of a mixture of fibres with different contractile and metabolic properties, type I (slow-twitch) and type II (fast-twitch) fibres. Little is known about the effect of anabolic stimuli, in particular nutrition, on the molecular response in the different fibre types. Here, we examine the effect of resistance exercise and essential amino acid (EAA) supplementation on mTOR signalling in individual type I and type II human muscle fibres.

    Methods Five strength-trained male subjects performed two sessions of leg press exercise (10 x 10 repetition at 62-85 % of 1RM). During exercise and recovery, the subjects ingested an aqueous solution with EAA (290 mg/kg) or flavoured water (placebo). Muscle biopsies were taken from the vastus lateralis before and 90 min after exercise. The biopsies were freeze-dried and single fibres dissected out and weighed (range 0.9 – 8 ug). The fibres were individually homogenized and analysed for proteins in the mTOR pathway using Western blot. Membranes were repeatedly stripped and fibres were identified as type I or type II following incubation with antibodies against the different myosin isoforms.

    Results Exercise led to a significant increase in mTOR and p70S6k1 phosphorylation and a fall in eEF2 phosphorylation, similar in both fibre types. There was a large variation between individual fibres; some fibres were highly activated whereas others were not activated at all despite the heavy exercise performed. Intake of EAA caused a 2- to 6-fold higher increase in mTOR and p70S6k1 phosphorylation in both type I and type II fibres as compared to intake of placebo, with no difference between the fibre types. The phosphorylation of eEF2 was not affected by intake of EAA. The total expression of p70S6k1 and eEF2 was 145% and 155% higher in type II than in type I fibres (P<0.05), respectively, whereas no difference between the fibre types was observed for mTOR protein.

    Conclusions The response to heavy resistance exercise regarding mTOR signalling was similar in type I and type II fibres in trained subjects, but with a large variation between single fibres of both types. Furthermore, ingestion of EAA enhanced the effect of resistance exercise on phosphorylation of mTOR and p70S6k1 in both fibre types.

  • 129.
    Edman, Sebastian
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Eva Blomstrands forskningsgrupp.
    Söderlund, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Eva Blomstrands forskningsgrupp.
    Moberg, Marcus
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Apro, William
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Blomstrand, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Eva Blomstrands forskningsgrupp.
    mTORC1 Signaling in Individual Human Muscle Fibers Following Resistance Exercise in Combination With Intake of Essential Amino Acids2019Ingår i: Frontiers in nutrition, ISSN 2296-861X, Vol. 6, artikel-id 96Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Human muscles contain a mixture of type I and type II fibers with different contractile and metabolic properties. Little is presently known about the effect of anabolic stimuli, in particular nutrition, on the molecular responses of these different fiber types. Here, we examine the effect of resistance exercise in combination with intake of essential amino acids (EAA) on mTORC1 signaling in individual type I and type II human muscle fibers. Five strength-trained men performed two sessions of heavy leg press exercise. During exercise and recovery, the subjects ingested an aqueous solution of EAA (290 mg/kg) or flavored water (placebo). Muscle biopsies were taken from the vastus lateralis before and 90 min after exercise. The biopsies were freeze-dried and single fibers dissected out and weighed (range 0.95-8.1 mu g). The fibers were homogenized individually and identified as type I or II by incubation with antibodies against the different isoforms of myosin. They were also analyzed for both the levels of protein as well as phosphorylation of proteins in the mTORC1 pathway using Western blotting. The levels of the S6K1 and eEF2 proteins were similar to 50% higher in type II than in type I fibers (P < 0.05), but no difference was found between fiber types with respect to the level of mTOR protein. Resistance exercise led to non-significant increases (2-3-fold) in mTOR and S6K1 phosphorylation as well as a 50% decrease (P < 0.05) in eEF2 phosphorylation in both fiber types. Intake of EAA caused a 2 and 6-fold higher (P < 0.05) elevation of mTOR and S6K1 phosphorylation, respectively, in both type I and type II fibers compared to placebo, with no effect on phosphorylation of eEF2. In conclusion, protein levels of S6K1 and eEF2 were significantly higher in type II than type I fibers suggesting higher capacity of the mTOR pathway in type II fibers. Ingestion of EAA enhanced the effect of resistance exercise on phosphorylation of mTOR and S6K1 in both fiber types, but with considerable variation between single fibers of both types.

  • 130.
    Ek, Amanda
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet. Karolinska University Hospital.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Hambraeus, Kristina
    Falun Hospital.
    Cider, Åsa
    Gothenburg University and Sahlgrenska University Hospital.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet. 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.2019Ingår i: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 108, nr 3, s. 324-332Artikel i tidskrift (Refereegranskat)
    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.

  • 131.
    Ek, Amanda
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Hambraeus, Kristina
    Cardiologkliniken, Falu lasarett.
    Börjesson, Mats
    Göteborgs Universitet.
    Association between physical activity level and risk of all-cause mortality after myocardial infarction2017Ingår i: European Journal of Preventive Cardiology, Vol 24, Issue 1 Suppl, April 2017: Abstract Book EuroPrevent 2017 Malaga, Spain, 2017, Vol. 24, artikel-id 45Konferensbidrag (Refereegranskat)
    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.

     

  • 132.
    Ek, Amanda
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    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 infarction2017Ingår i: Fria föredrag, nr 025, 2017, artikel-id 025Konferensbidrag (Refereegranskat)
    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.

  • 133.
    Ek, Amanda
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Promoting physical activity - an established part of the clinical practice?2015Ingår i: 23rd International Conference on Health Promoting Hospitals and Health Services: "Person-oriented health promotion in a rapidly changing world:Co-production – continuity – new media & technologies", 2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

    Insufficient physical activity is a considerable risk factor for mortality and premature death. The healthcare has a unique role in health promotion as they reach a large part of the population. The evidence based recommendation is that the healthcare sector should offer “counseling with the adjunct of exercise on prescription or a pedometer, as well as special follow-up” to promote patients physical activity. Despite this, physical activity is underutilized in prevention and treatment of disease, for reasons not fully known.

     

     

    Purpose/Method

    We aimed to study the attitudes of different healthcare professionals in the hospital setting, towards the importance of physical activity and its clinical use at different levels.

    The study comprised 264 (78% women) health care professionals at the cardiac department/outpatient cardiac center in Stockholm (response rate 91%). Data was obtained in 2013, by questionnaire. Containing 28 multiple choice questions on participants attitudes towards physical activity behavior change, the perceived importance of such measures, practical implementation and possible barriers for implementation.

     

    Results

    All participants stated importance of physical activity promotion within healthcare. Forty-seven percent reported that they promoted physical activity in clinical practice, however only a minority fulfilled the evidence based recommendations (n=65), as brief advice (n=165) or counseling (n=111) were most common. Sixty-one percent aimed to improve the use of physical activity promotion, factors hampering were inadequate knowledge, follow-up possibilities and length of patient visits. Less than half group reported insufficient routines (46%), goals (37%) and lack of management support (42%).

     

    Conclusion         

    Although health professionals generally are positive towards promoting physical activity, just a small proportion actually use the evidence based methods in clinical practice. To improve the promotion of physical activity in patients there is need for further implementation strategies at all levels to create a well-functioning structure, clear goals and routines. Our study suggests, that implementation should focus at education, logistics for follow-up and increased amount of time with direct patient care. 

     

  • 134.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    All aktivitet är bra aktivitet2014Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 23, nr 1, s. 16-19Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

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

  • 135.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Att mäta stillasittande2013Ingår i: Långvarigt stillasittande: en hälsofara i tiden / [ed] Elin Ekblom Bak, Studentlitteratur, 2013, s. 79-102Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 136.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Det farliga midjemåttet: ny avhandling: Physical activity, cardiorespiratory fitness, and abdominal obesity in relation to cardiovascular disease risk: epidemiological studies2014Ingår i: Svensk idrottsmedicin, ISSN 1103-7652, Vol. 33, nr 2, s. 20-23Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

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

  • 137.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Det riskfyllda stillasittandet2017Ingår i: Blå boken: årsbok, ISSN 2000-7272, Vol. 110, s. 224-235Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 138.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Långvarigt stillasittande: En hälsofara i tiden2013Samlingsverk (redaktörskap) (Övrigt vetenskapligt)
    Abstract [sv]

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

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

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

    Innehåll

    • Epidemiologi och mekanismer
    • Stillasittande och psykisk ohälsa
    • Stillasittande hos barn och ungdomar
    • Att mäta stillasittande
    • Sambands- och bestämningsfaktorer för stillasittande
    • Metoder för att reducera ett stillasittande beteende
    • Allmänläkarens perspektiv på stillasittande
    • Sjuksköterskans perspektiv på stillasittande
    • Sjukgymnastens perspektiv på stillasittande
    • Hälsopedagogens perspektiv på stillasittande
  • 139.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Medverkan i skolidrotten ger bättre vanor och hälsa2018Ingår i: Idrott & hälsa, ISSN 1653-1124, nr 4, s. 6-9Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 140.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Physical activity, cardiorespiratory fitness, and abdominal obesity in relation to cardiovascular disease risk: epidemiological studies2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

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

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

    The main findings were

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

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

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

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

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

  • 141.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Stor försämring av svenskars kondition2018Ingår i: Idrottsforskning.se, artikel-id 20 novemberArtikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

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

  • 142.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Större studier vid GIH2013Ingår i: Idrottsmedicin, ISSN 2001-3302, nr 2, s. 5-10Artikel i tidskrift (Övrigt vetenskapligt)
    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.

  • 143.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Olsson, Gustav
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Bolan, Kate
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Svenskar rör sig för lite2015Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 24, nr 2, s. 30-31Artikel i tidskrift (Övrigt vetenskapligt)
    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.

  • 144.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Långvarigt stillasittande - ett riskbeteende2013Ingår i: Idrottsmedicin, ISSN 2001-3302, nr 2, s. 14-17Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

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

  • 145.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Nytt submaximalt test för beräkning av maximal syreupptagning.2013Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, nr 6, s. 271-Artikel i tidskrift (Övrigt vetenskapligt)
  • 146.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Björn Ekbloms forskningsgrupp.
    Engström, Lars-Magnus
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Forskningsgruppen för pedagogik, idrott och fritidskultur.
    Sambands- och bestämningsfaktorer för stillasittande2013Ingår i: Långvarigt stillasittande: en hälsofara i tiden / [ed] Elin Ekblom Bak, Studentlitteratur, 2013, s. 103-111Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 147.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Söderling, Jonas
    Karolinska institutet.
    Börjesson, Mats
    University of Gothenburg.
    Blom, Victoria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Forskningsgruppen för idrottspsykologi.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Hemmingsson, Erik
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults.2019Ingår i: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 127, artikel-id 105799Artikel i tidskrift (Refereegranskat)
    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.

  • 148.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Stillasittandets effekter på barns hälsa är underbeforskat: Svårt att definiera säker gräns för ökad risk för ohälsa2015Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, nr 25-26Artikel i tidskrift (Övrigt vetenskapligt)
    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.

  • 149.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Andersson, Gunnar
    HPI Health Profile Institute AB.
    Wallin, Peter
    HPI Health Profile Institute AB.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Physical Education and Leisure-Time Physical Activity in Youth Are Both Important for Adulthood Activity, Physical Performance, and Health.2018Ingår i: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 15, nr 9, s. 661-670Artikel i tidskrift (Refereegranskat)
    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.

  • 150.
    Ekblom Bak, Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Andersson, Gunnar
    HPI Health Profile Institute.
    Wallin, Peter
    HPI Health Profile Institute.
    Söderling, Jonas
    Karolinska Institutet.
    Hemmingsson, Erik
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap. Karolinska Institutet.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Decline in cardiorespiratory fitness in the Swedish working force between 1995 and 2017.2019Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, nr 2, s. 232-239Artikel i tidskrift (Refereegranskat)
    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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