Gymnastik- och idrottshögskolan, GIH

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  • 1.
    Bojsen-Møller, Emil
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden..
    Nilsson, Jonna
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Heiland, Emerald G
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Surgical Sciences, Medical Epidemiology, University of Uppsala, Uppsala, Sweden..
    Boraxbekk, Carl-Johan
    Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.; Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.; Institute of Sports Medicine Copenhagen (ISMC) and Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark..
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    The effect of two multi-component behavior change interventions on cognitive functions.2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1082Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We previously reported the effects of two cluster-randomized 6-month multi-component workplace interventions, targeting reducing sedentary behavior or increasing physical activity among office workers, on movement behaviors and cardiorespiratory fitness. The primary aim of this study was to investigate the effects of these interventions on cognitive functions compared to a wait-list control group. The secondary aims were to examine if changes in cognition were related to change in cardiorespiratory fitness or movement behaviors and if age, sex, or cardiorespiratory fitness moderated these associations.

    METHODS: Both interventions encompassed multi-components acting on the individual, environmental, and organizational levels and aimed to change physical activity patterns to improve mental health and cognitive function. Out of 263 included participants, 139 (mean age 43 years, 76% females) completed a neuropsychological test battery and wore accelerometers at baseline and 6-month follow-up. The intervention effect (aim 1) on cognitive composite scores (i.e., Executive Functions, Episodic Memory, Processing Speed, and Global Cognition) was investigated. Additionally, associations between changes in movement behaviors and cardiorespiratory fitness, and changes in cognition were examined (aim 2). Moreover, age, sex, and cardiorespiratory fitness level were investigated as possible moderators of change associations (aim 3).

    RESULTS: Overall, cognitive performance improved from baseline to follow-up, but the change did not differ between the intervention groups and the control group. Changes in cardiorespiratory fitness or any movement behavior category did not predict changes in cognitive functions. The association between changes in time in bed and changes in both Executive Function and Global Cognition were moderated by age, such that a more positive relation was seen with increasing age. A less positive association was seen between changes in sedentary behavior and Processing Speed for men vs. women, whereas higher cardiorespiratory fitness was related to a more positive association between changes in moderate-intensity physical activity and Global Cognition.

    CONCLUSION: The lack of an intervention effect on cognitive functions was expected since the intervention did not change movement behavior or fitness. Age, sex, and cardiorespiratory fitness level might moderate the relationships between movement behaviors and cognitive functions changes.

    TRIAL REGISTRATION: ISRCTN92968402 . Registered 09/04/2018.

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  • 2.
    Börjesson, Mats
    et al.
    Center for Health and Performance, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Geraiatric and Acute Medicine Östra, Sahlgrenska University Hospital, Goteborg, Sweden..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Arvidsson, Daniel
    Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden..
    Heiland, Emerald G
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden..
    Väisänen, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bergström, Göran
    Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden.; Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden..
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Correlates of cardiorespiratory fitness in a population-based sample of middle-aged adults: cross-sectional analyses in the SCAPIS study2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 12, article id e066336Article in journal (Refereed)
    Abstract [en]

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

    Design: Cross-sectional.

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

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

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

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

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

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  • 3.
    Ekström, Lena
    et al.
    Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden..
    Mous, Dinah
    Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden..
    Heiland, Vincent
    Heiland, Emerald G.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Surgical Sciences, Medical Epidemiology, Uppsala University, Uppsala, Sweden..
    Schulze, Jenny
    Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden..
    Intra-individual stability of longitudinal urinary steroid profiles in Swedish athletes.2023In: Drug Testing and Analysis, ISSN 1942-7603, E-ISSN 1942-7611, Vol. 15, no 7, p. 769-778Article in journal (Refereed)
    Abstract [en]

    The steroid module of the athlete biological passport (ABP) aims to detect doping with endogenous steroids by longitudinally monitoring epitestosterone (E), testosterone (T), and four metabolically related steroids and their ratios. There are large variations in the urinary levels of the androgen metabolites due to genetic polymorphisms, drug use, menstrual cycle, and other factors. In this study, we aimed to increase our understanding of the natural, within-individual variations of the established ABP markers in males and females over time, looking at samples collected both in and out-of-competition (IC/OOC). Urinary steroid profiles from 323 Swedish athletes, with at least five samples per athlete, were extracted from ADAMS together with information on type of sport, IC/OOC, and time of day. Data were analyzed using coefficient of variation (CV%) to examine within-subject variability and linear mixed effects models to estimate within-subject change in the metabolites over time. The metabolites and ratios expressed higher individual CV% in females (23-56) than in males (18-39). Samples taken OOC showed larger intra-individual variations than samples collected IC for most of the ABP metabolites in both sexes. The median concentrations were higher IC for some metabolites, particularly testosterone being 52% higher among females. Time of day influenced the intra-individual variation of the urinary steroid profile with decreases in androgen metabolites over time, if measured in evening versus daytime. These findings can aid in the testing strategies and interpretation of the steroidal module of ABP.

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  • 4.
    Fernström, Maria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Heiland, Emerald G
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Surgical Sciences, Medical Epidemiology, Uppsala University Uppsala Sweden.
    Kjellenberg, Karin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Pontén, Marjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Nyberg, Gisela
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
    Helgadóttir, Björg
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Effects of prolonged sitting and physical activity breaks on measures of arterial stiffness and cortisol in adolescents2023In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 112, no 5, p. 1011-1018Article in journal (Refereed)
    Abstract [en]

    Aim

    In adults, prolonged periods of sitting have been linked to acute negative effects on vascular structure and function. The aim of this study was to evaluate the acute effects of physical activity (PA) breaks during prolonged sitting on arterial stiffness, cortisol and psychological factors in adolescents.

    Methods

    Adolescents underwent different short (3-min) breaks starting every 20 min, during 80 min of sitting on three separate days. Breaks were (A) social seated breaks (SOC), (B) low-intensity simple resistance activity PA breaks (SRA) and (C) moderate-intensity step-up PA breaks (STEP). The arterial stiffness measures were augmentation index (AIx), AIx@75 and pulse wave velocity (PWV). Cortisol was measured from saliva. Psychological factors were self-reported.

    Results

    Eleven girls and six boys (average age 13.6 ± 0.7 years) participated, with average baseline heart rates of 72 ± 11 bpm, systolic/diastolic blood pressure 111 ± 7/64 ± 6 mmHg and cortisol 10.9 ± 5.8 nmoL/L. PWV, cortisol and psychological factors did not change after any of the conditions. AIx@75 increased significantly (4.9 ± 8.7–9.2 ± 13.2) after the STEP intervention compared with SOC and SRA (time × condition p < 0.05).

    Conclusion

    Arterial stiffness increased after prolonged sitting with frequent, short step-up activity breaks. The results indicate potential important intensity-dependent effects of physical activity on vascular regulation in youth.

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  • 5.
    Heiland, Emerald G
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Larisch, Lisa-Marie
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bi-Directional, Day-to-Day Associations between Objectively-Measured Physical Activity, Sedentary Behavior, and Sleep among Office Workers.2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 15, article id 7999Article in journal (Refereed)
    Abstract [en]

    The bi-directional, day-to-day associations between daytime physical activity and sedentary behavior, and nocturnal sleep, in office workers are unknown. This study investigated these associations and whether they varied by weekday or weekend day. Among 324 Swedish office workers (mean age 42.4 years; 33.3% men), moderate-to-vigorous physical activity (MVPA), and sedentary behaviors and sleep (total sleep time (TST) and sleep efficiency (SE)) were ascertained by using accelerometers (Actigraph GT3X) over 8 days. Multilevel linear mixed models were used to assess the bi-directional, day-to-day, within-person associations. Additional analyses stratified by weekend/weekday were performed. On average, participants spent 6% (57 min) of their day in MVPA and 59% (9.5 h) sedentary, and during the night, TST was 7 h, and SE was 91%. More daytime sedentary behavior was associated with less TST that night, and reciprocally, more TST at night was associated with less sedentary behavior on the following weekday. Greater TST during the night was also associated with less MVPA the next day, only on weekdays. However, daytime MVPA was not associated with TST that night. Higher nighttime SE was associated with greater time spent sedentary and in MVPA on the following day, regardless if weekday or weekend day. Sleep may be more crucial for being physically active the following day than vice versa, especially on weekdays. Nevertheless, sedentary behavior's relation with sleep time may be bi-directional. Office workers may struggle with balancing sleep and physical activity time.

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  • 6.
    Heiland, Emerald G
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    English, Coralie
    University of Newcastle, NSW, Australia..
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    ABBaH: Activity Breaks for Brain Health: A Protocol for a Randomized Crossover Trial2020In: Frontiers in Human Neuroscience, E-ISSN 1662-5161, Vol. 14, article id 273Article in journal (Refereed)
    Abstract [en]

    Introduction: Extended periods of sitting may have detrimental effects on brain health. However, the effects of breaking up prolonged sedentary periods with frequent, short physical activity bouts on mechanisms to improve brain health remain unclear. Therefore, this study aims to investigate the immediate effects of uninterrupted sitting and frequent, short bouts of physical activity on cerebral blood flow and cognitive function in the prefrontal cortex in middle-aged adults. Methods: This is a protocol article to describe a randomized crossover study. We will collect data from 13 healthy adults, aged between 40 and 60 years old, with a body mass index <35 kg/m(2). Participants will be required to come into the laboratory on three occasions, sit for 3 h, and perform a different type of break for 3 min every 30 min at each visit in a random order, being either: (1) a social break; (2) brisk walk on a treadmill; or (3) simple resistance activities. Before and after each experimental condition, cerebral blood flow (primary outcome) will be measured using functional near-infrared spectroscopy (fNIRS), with short-separation channels, and working memory (1-, 2-, and 3-back on the computer) will be assessed. The following additional secondary outcomes will be collected: psychological factors (questionnaires); arterial stiffness; salivary cortisol levels; and blood glucose levels. Conclusion: The results from this randomized crossover study will determine the effects of uninterrupted sitting and frequent, short bouts of physical activity on cerebral blood flow and cognitive performance. Publication of this study protocol emphasizes the importance of registration and publication of protocols in the field of sedentary behavior research.

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  • 7.
    Heiland, Emerald G
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University, Sweden.
    Kjellenberg, Karin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nyberg, Gisela
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska institutet, Stockholm, Sweden.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska institutet, Stockholm, Sweden.
    Helgadóttir, Björg
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    ABBaH teens: Activity Breaks for Brain Health in adolescents2022In: Trials, E-ISSN 1745-6215, Vol. 23, no 1, article id 22Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity breaks are widely being implemented in school settings as a solution to increase academic performance and reduce sitting time. However, the underlying physiological mechanisms suggested to improve cognitive function from physical activity and the frequency, intensity, and duration of the breaks remain unknown. This study will investigate the effects of frequent, short physical activity breaks during prolonged sitting on task-related prefrontal cerebral blood flow, cognitive performance, and psychological factors. Additionally, the moderating and mediating effects of arterial stiffness on changes in cerebral blood flow will be tested.

    METHODS: This is a protocol for a randomized crossover study that will recruit 16 adolescents (13-14 years old). Participants will undergo three different conditions in a randomized order, on three separate days, involving sitting 80 min with a different type of break every 17 min for 3 min. The breaks will consist of (1) seated social breaks, (2) simple resistance activities, and (3) step-up activities. Before and after the 80-min conditions, prefrontal cerebral blood flow changes will be measured using functional near-infrared spectroscopy (primary outcome), while performing working memory tasks (1-, 2-, and 3-back tests). Arterial stiffness (augmentation index and pulse wave velocity) and psychological factors will also be assessed pre and post the 80-min interventions.

    DISCUSSION: Publication of this protocol will help to increase rigor in science. The results will inform regarding the underlying mechanisms driving the association between physical activity breaks and cognitive performance. This information can be used for designing effective and feasible interventions to be implemented in schools.

    TRIAL REGISTRATION: www.ClinicalTrials.gov , NCT04552626 . Retrospectively registered on September 21, 2020.

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  • 8.
    Heiland, Emerald G.
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Kjellenberg, Karin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Nyberg, Gisela
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Helgadóttir, Björg
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Acute effects of nitrate and breakfast on working memory and cerebral blood flow in adolescents: a randomized crossover trial2023Conference paper (Other academic)
    Abstract [en]

    Purpose: Beneficial acute effects of dietary nitrate have been demonstrated on working memory in adults, with changes in cerebral blood flow (CBF) being a potential mechanism. However, these effects have not been studied in adolescents. Moreover, having breakfast compared to skipping may also exhibit positive effects on working memory. Therefore, this randomized crossover trial investigated the acute effects of nitrate and breakfast on working memory and changes in task-related CBF in adolescents.  Methods: This trial will recruit at least 43 adolescents (13–15 years old). There were three experimental breakfast conditions: (1) none, (2) regular, and (3) regular breakfast with high nitrate in the form of concentrated beetroot juice. Working memory (1-, 2-, 3-back tests) and task-related CBF (prefrontal cortex oxygenated and deoxygenated-hemoglobin changes estimated using functional near-infrared spectroscopy) were measured immediately after breakfast and 130 min later. The data collection for this study is ongoing, thus results for 35 adolescents are presented here and due to blinding of the researcher we are unable to report at this time in which condition these effects occurred, but will be revealed by the time of the conference, as well as for the results on changes in CBF.  Results: Preliminary results from the ongoing study showed that from pretest to posttest there was a statistically significant improvement in reaction time in all three conditions for all three n-back tests, but no intervention effects. Accuracy, however, improved from pretest to posttest in only one condition, for all three nback tests (β [95% confidence interval] from linear mixed-effects models with subject as random effect: 1-back 2.8[1.2-4.3], 2-back 2.6[0.9-4.2], 3-back 3.6[2.2-5.0]), and there was a tendency towards an intervention effect between this breakfast condition and another on the accuracy of the 3-back test (P for time-by-condition interaction 0.07).   Conclusions: The results from this study will increase our understanding into the effects of breakfast and its composition (i.e., nitrate-rich) on acutely improving working memory in adolescents and the potential mechanisms. In turn, the results will inform on whether policies on providing breakfast in schools should be considered to improve students' cognitive performance.

  • 9.
    Heiland, Emerald G
    et al.
    Karolinska Institutet.
    Qiu, Chengxuan
    Wang, Rui
    Santoni, Giola
    Liang, Yajun
    Fratiglioni, Laura
    Welmer, Anna-Karin
    Cardiovascular Risk Burden and Future Risk of Walking Speed Limitation in Older Adults.2017In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 65, no 11, p. 2418-2424Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To explore the association between cardiovascular risk factor (CRF) burden and limitation in walking speed, balance, and chair stand and to verify whether these associations vary according to age and cognitive status.

    DESIGN: Longitudinal population-based study.

    SETTING: Urban area of Stockholm, Sweden.

    PARTICIPANTS: Individuals aged 60 and older who participated in the Swedish National Study on Aging and Care in Kungsholmen and were free of limitations in walking speed (n = 1,441), balance (n = 1,154), or chair stands (n = 1,496) at baseline (2001-04).

    MEASUREMENTS: At baseline, data on demographic characteristics, CRFs, other lifestyle factors, C-reactive protein, and cognitive function were collected. CRF burden was measured using the Framingham general cardiovascular risk score (FRS). Limitations in walking speed (<0.8 m/s), balance (<5 seconds), and chair stand (inability to rise 5 times) were determined at 3-, 6-, and 9-year follow-up. Data were analyzed using Cox proportional hazards models stratified according to age (<78, ≥78).

    RESULTS: During follow-up, 326 persons developed limitations in walking speed, 303 in balance, and 374 in chair stands. An association between the FRS and walking speed limitation was evident only in adults younger than 78 (for each 1-point increase in FRS: hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.02-1.17) after controlling for potential confounders including cognitive function (correspondingly, in adults aged ≥78: HR = 0.98, 95% CI = 0.92-1.03). Also, higher FRS was significantly associated with faster decline in walking speed (P < .001).

    CONCLUSION: A higher FRS is associated with greater risk of subsequent development of walking speed limitation in adults younger than 78, independent of cognitive function. Interventions targeting multiple CRFs in younger-old people may help in maintaining mobility function.

  • 10.
    Heiland, Emerald G
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    English, Coralie
    School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, NSW, Australia.; Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience and Hunter Medical Research Institute, Callaghan, NSW, Australia..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neuroscience, Karolinska Institutet, Solna, Sweden..
    Frequent, Short Physical Activity Breaks Reduce Prefrontal Cortex Activation but Preserve Working Memory in Middle-Aged Adults: ABBaH Study.2021In: Frontiers in Human Neuroscience, E-ISSN 1662-5161, Vol. 15, article id 719509Article in journal (Refereed)
    Abstract [en]

    Prolonged sitting is increasingly common and may possibly be unfavorable for cognitive function and mood. In this randomized crossover study, the effects of frequent, short physical activity breaks during prolonged sitting on cognitive task-related activation of the prefrontal cortex were investigated. The effects on working memory, psychological factors, and blood glucose were also examined, and whether arterial stiffness moderated prefrontal cortex activation. Thirteen subjects (mean age 50.5 years; eight men) underwent three 3-h sitting conditions, interrupted every 30-min by a different 3-min break on separate, randomized-ordered days: seated social interactions (SOCIAL), walking (WALK), or simple resistance activities (SRA). Arterial stiffness was assessed at baseline. Before and after each 3-h condition, psychological factors (stress, mood, sleepiness, and alertness) were assessed through questionnaires and functional near-infrared spectroscopy (fNIRS) was used to measure changes in prefrontal oxygenated hemoglobin (Oxy-Hb), indicative of cortical activation, while performing working memory tasks [1- (baseline), 2-, and 3-back]. Blood glucose levels were continuously measured throughout the conditions. Results revealed no significant changes in Oxy-Hb during the 2-back compared with the 1-back test in any condition, and no time-by-condition interactions. During the 3-back test, there was a significant decrease in Oxy-Hb compared with the 1-back after the WALK condition in the right prefrontal cortex, but there were no time-by-condition interactions, although 3-back reaction time improved only in the WALK condition. Mood and alertness improved after the WALK condition, which was significantly different from the SOCIAL condition. Arterial stiffness moderated the effects, such that changes in Oxy-Hb were significantly different between WALK and SOCIAL conditions only among those with low arterial stiffness. Blood glucose during the interventions did not differ between conditions. Thus, breaking up prolonged sitting with frequent, short physical activity breaks may reduce right prefrontal cortex activation, with improvements in some aspects of working memory, mood, and alertness. Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT04137211.

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  • 11.
    Heiland, Emerald G
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University, Sweden; Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Welmer, Anna-Karin
    Aging Research Center, Karolinska Institutet-Stockholm University, Sweden; Stockholm Gerontology Research Center, Sweden; Karolinska University Hospital, Stockholm, Sweden; Karolinska Institutet, Huddinge, Sweden.
    Kalpouzos, Grégoria
    Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Laveskog, Anna
    Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Qiu, Chengxuan
    Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Cerebral small vessel disease, cardiovascular risk factors, and future walking speed in old age: a population-based cohort study.2021In: BMC Neurology, E-ISSN 1471-2377, Vol. 21, no 1, article id 496Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of this study was to examine the associations between combined and individual cerebral small vessel disease (cSVD) markers on future walking speed over 9 years; and to explore whether these associations varied by the presence of cardiovascular risk factors (CRFs).

    METHODS: This population-based cohort study included 331 adults, aged ≥60 years, without limitation in walking speed (≥0.8 m/s). At baseline, cSVD markers, including white matter hyperintensities (WMH), lacunes, and perivascular spaces (PVS), were assessed on magnetic resonance imaging. The modifiable CRFs (physical inactivity, heavy alcohol consumption, smoking, hypertension, high total cholesterol, diabetes, and overweight/obese) were combined into a score. The association between baseline cSVD markers and the decline in walking speed was examined using linear mixed-effects models, whereas Cox proportional hazards models were used to estimate the association with walking speed limitation (defined as < 0.8 m/s) over the follow-up.

    RESULTS: Over the follow-up period, 76 (23.0%) persons developed walking speed limitation. Participants in the highest tertile of the combined cSVD marker score had a hazard ratio (HR) of 3.78 (95% confidence interval [CI] 1.70-8.45) for walking speed limitation compared with people in the lowest score tertile, even after adjusting for socio-demographics, CRFs, cognitive function, and chronic conditions. When investigating the cSVD markers individually, having the highest burden of WMH was associated with a significantly faster decline in walking speed (β coefficient - 0.020; 95% CI -0.035-0.004) and a greater HR of walking speed limitation (HR 2.78; 95% CI 1.31-5.89) compared with having the lowest WMH burden. Similar results were obtained for the highest tertile of PVS (HR 2.13; 95% CI 1.04-4.36). Lacunes were associated with walking speed limitation, but only in men. Having ≥4 CRFs and high WMH volume simultaneously, showed a greater risk of walking speed limitation compared with having ≥4 CRFs and low WMH burden. CRFs did not modify the associations between lacunes or PVS and walking speed.

    CONCLUSIONS: Combined cSVD markers strongly predict walking speed limitation in healthy older adults, independent of cognitive function, with WMH and PVS being the strongest contributors. Improving cardiovascular health may help to mitigate the negative effects of WMH on future walking speed.

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  • 12.
    Heiland, Emerald G
    et al.
    Karolinska Institutet.
    Welmer, Anna-Karin
    Wang, Rui
    Santoni, Giola
    Angleman, Sara
    Fratiglioni, Laura
    Qiu, Chengxuan
    Association of mobility limitations with incident disability among older adults: a population-based study.2016In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 45, no 6, p. 812-819Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: mobility-related limitations predict future disability; however, the extent to which individual and combined mobility tests may predict disability remains unclear.

    OBJECTIVES: to estimate the odds of developing disability in activities of daily living (ADL) according to limitations in walking speed, balance or both; and explore the role of chronic diseases and cognitive function.

    DESIGN: a prospective cohort study.

    SETTING: urban area of Stockholm, Sweden.

    SUBJECTS: one thousand nine hundred and seventy-one disability-free persons (age ≥60 years, 63% women) from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K), who underwent baseline examination in 2001-04 and follow-up assessments for 6 years.

    MEASUREMENTS: mobility limitation was defined as a one-leg balance stand <5 s or walking speed <0.8 m/s. ADL disability was defined as the inability to complete one or more ADL: bathing, dressing, using the toilet, transferring and eating.

    RESULTS: during a total of 11,404 person-years (mean per person 5.8 years, SD 0.30) of follow-up, 119 (incidence 1.5/100 person-years) participants developed ADL disability. The demographic adjusted odds ratios (OR) (95% confidence intervals, CI) of incident ADL disability related to balance stand and walking speed limitations were 3.8 (2.3-6.3) and 8.4 (5.2-13.3), respectively. The associations remained statistically significant after controlling for number of chronic diseases and cognitive status. People with limitations in both balance and walking speed had an OR of 12.9 (95% CI 7.0-23.7) for incident disability compared with no limitation.

    CONCLUSION: balance and walking speed tests are simple clinical procedures that can indicate hierarchical risk of ADL dependence in older adults.

  • 13.
    Heiland, Emerald G
    et al.
    Karolinska Institutet.
    Welmer, Anna-Karin
    Wang, Rui
    Santoni, Giola
    Fratiglioni, Laura
    Qiu, Chengxuan
    Cardiovascular Risk Factors and the Risk of Disability in Older Adults: Variation by Age and Functional Status.2019In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 2, p. 208-212.e3, article id S1525-8610(18)30285-8Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: We aimed to quantify the increased risk of disability associated with cardiovascular risk factors among older adults, and to verify whether this risk may vary by age and functional status.

    DESIGN: Longitudinal population-based cohort study.

    SETTING: Urban area of Stockholm, Sweden.

    PARTICIPANTS: Community-dwelling and institutionalized adults ≥60 years in the Swedish National study on Aging and Care in Kungsholmen free of cardiovascular diseases and disability (n = 1756) at baseline (2001-2004).

    MEASURES: Incident disability in activities of daily living (ADL) was ascertained over 9 years. Cardiovascular risk factors (physical inactivity, alcohol consumption, smoking, high blood pressure, diabetes, high body mass index, high levels of total cholesterol, and high C-reactive protein) and walking speed were assessed at baseline. Data were analyzed using Cox proportional hazards models, stratifying by younger-old (age 60-72 years) and older-old (≥78 years).

    RESULTS: During the follow-up, 23 and 148 persons developed ADL-disability among the younger- and older-old, respectively. In the younger-old, the adjusted hazard ratio (HR) of developing ADL-disability was 4.10 (95% confidence interval [CI] 1.22-13.76) for physical inactivity and 5.61 (95% CI 1.17-26.82) for diabetes. In the older-old, physical inactivity was associated with incident ADL-disability (HR 1.99, 95% CI 1.36-2.93), and there was a significant interaction between physical inactivity and walking speed limitation (<0.8 m/s), showing a 6-fold higher risk of ADL-disability in those who were both physically inactive and had walking speed limitation than being active with no limitation, accounting for a population-attributable risk of 42.7%.

    CONCLUSIONS/IMPLICATIONS: Interventions targeting cardiovascular risk factors may be more important for the younger-old in decreasing the risk of disability, whereas improving physical function and maintaining physical activity may be more beneficial for the older-old.

  • 14.
    Kjellenberg, Karin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Heiland, Emerald G.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nyberg, Gisela
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Helgadóttir, Björg
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Effects of physical activity breaks on working memory and oxygenated hemoglobin in adolescents: Results from the AbbaH teen study2023Conference paper (Other academic)
  • 15.
    Kjellenberg, Karin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Heiland, Emerald G.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nyberg, Gisela
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Helgadóttir, Björg
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Short, frequent physical activity breaks improve working memory in adolescents during prolonged sitting (AbbaH teen study)2023Conference paper (Other academic)
    Abstract [en]

    Purpose: Physical activity breaks in schools have been suggested as a promising strategy to acutely improve cognitive performance in children and adolescents. Most previous studies have explored the effects of single physical activity bouts, but they are infeasible in a school setting (e.g. long duration/high-intensity or requiring equipment/space). Further, studies investigating the underlying physiological mechanisms in adolescents arel acking. Therefore, the aim of this study was to investigate the effects of short, frequent physical activity breaks of different intensities on adolescents’ working memory (WM) and cerebral blood flow (CBF) during prolonged sitting.

    Methods: This randomized crossover study was performed in adolescents (13-15 years of age). In 80-minute sessions, one of the following types of breaks was performed four times in three minutes durations on three different days: simple resistance training (SRA), step-up at a pre-determined pace (STEP), or remaining seated (SOCIAL). Before and after each session, WM (accuracy and reaction time during the 1,2,3-back test) were measured, with simultaneous measurement of task-related CBF (assessed by prefrontal oxygenation using functional near-infrared spectroscopy). Analysis of CBF is ongoing and will be presented at the conference.

    Results: A total of 17 students participated (mean age 13.6 years, 11 girls). In the most demanding task (3-back) the following results were seen: improvement in reaction time following SRA (-30.1, p=0.04) and STEP (-34.3 ms, p=0.05) and no improvement following prolonged sitting. We also found a moderating effect (p <0.01) of WM performance at baseline (using a mean split), such that students with poor WM significantly improved their accuracy and reaction time following the higher-intensity breaks (STEP) while students with high performance did not.

    Conclusion: We found that implementing physical activity breaks of both moderate and high intensities was beneficial for WM performance. For students with low WM performance, high-intensity breaks were more beneficial. Implementing physical activity breaks during periods of prolonged sitting, such as long school classes could improve the students’ cognitive performance. However, future studies should investigate if these breaks are feasible, acceptable, and beneficial to implement in the school setting.

  • 16.
    Ma, Chuanwei
    et al.
    Shandong University, Jinan, China.
    Heiland, Emerald G
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Li, Zilin
    Shandong University, Jinan, China.
    Zhao, Min
    Shandong University, Jinan, China.
    Liang, Yajun
    Karolinska institutet, Stockholm, Sweden.
    Xi, Bo
    Shandong University, Jinan, China.
    Global trends in the prevalence of secondhand smoke exposure among adolescents aged 12-16 years from 1999 to 2018: an analysis of repeated cross-sectional surveys.2021In: The Lancet Global Health, E-ISSN 2214-109X, Vol. 9, no 12, p. E1667-E1678Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Secondhand smoke exposure can cause morbidity and premature mortality. However, the global prevalence of, and trends in, secondhand smoke exposure among adolescents are poorly documented. We aimed to assess the prevalence of, and trends in, secondhand smoke exposure among adolescents from 1999 to 2018.

    METHODS: We did an analysis of the most recent data from the Global Youth Tobacco Survey (GYTS), a nationally representative, self-administered, school-based cross-sectional survey of tobacco use and related factors among adolescents aged 12-16 years worldwide. Data from 142 countries and territories that had done a GYTS between 2010 and 2018, comprising 711 366 participants, were used to assess the prevalence of secondhand smoke exposure. Data from 131 countries and territories that had done two or more surveys between 1999 and 2018, comprising 1 405 458 participants, were used to assess trends in secondhand smoke exposure. The frequency of secondhand smoke exposure at home, in public places, or in any place was defined as follows, based on students' responses: 1 or more days, 3 or more days, 5 or more days, or daily during the past 7 days.

    FINDINGS: Based on the most recent surveys done in 142 countries between Jan 1, 2010, and Dec 31, 2018, the global prevalence of secondhand smoke exposure in any place was 62·9% (95% CI 61·7-64·1) on 1 or more days, 51·0% (49·8-52·1) on 3 or more days, 40·1% (38·9-41·2) on 5 or more days, and 32·5% (31·5-33·6) daily during the past 7 days. The prevalence of secondhand smoke exposure at home was 33·1% (95% CI 32·1-34·1) on 1 or more days, 20·1% (19·3-20·9) on 3 or more days, 14·9% (14·2-15·7) on 5 or more days, and 12·3% (11·7-13·0) daily during the past 7 days; and in public places the prevalence of secondhand smoke exposure was 57·6% (56·4-58·8) on 1 or more days, 43·4% (42·2-44·6) on 3 or more days, 30·3% (29·2-31·5) on 5 or more days, and 23·5% (22·5-24·5) daily during the past 7 days. Between Jan 1, 1999, and Dec 31, 2018, the prevalence of secondhand smoke exposure (on ≥1 day during the past 7 days) in any place decreased in 57 (43·5%) of 131 countries, increased in 27 (20·6%), and remained unchanged in 47 (35·9%). Although the prevalence of secondhand smoke exposure at home decreased in 86 (65·6%) countries, the prevalence in public places did not change in 46 (35·1%) countries and increased in 40 (30·5%).

    INTERPRETATION: Secondhand smoke exposure among adolescents remains a serious public health challenge worldwide. Although the prevalence of secondhand smoke exposure at home decreased in most countries, the prevalence in public places increased or remained unchanged in most countries between 1999 and 2018. These findings emphasise the need to strengthen smoke-free policies, especially in public places.

    FUNDING: Youth Team of Humanistic and Social Science of Shandong University, Jinan, China.

    TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

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  • 17.
    Nooijen, Carla F J
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Heiland, Emerald G
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Larisch, Lisa-Marie
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Karolinska Institutet, Stockholm, Sweden.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Uppsala University, Sweden.
    The effectiveness of multi-component interventions targeting physical activity or sedentary behaviour amongst office workers: a three-arm cluster randomised controlled trial.2020In: BMC Public Health, E-ISSN 1471-2458, Vol. 20, no 1, article id 1329Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Interventions to increase physical activity or reduce sedentary behaviour within the workplace setting have shown mixed effects. This cluster randomised controlled trial assessed whether multi-component interventions, focusing on changes at the individual, environmental, and organisational levels, either increased physical activity or reduced sedentary behaviour, compared to a passive control group.

    METHODS: Teams of office-workers from two companies participated in one of two interventions (iPA: targeting physical activity; or iSED: targeting sedentary behaviour), or wait-list control group (C). Exclusion criterion was very high physical activity level (MVPA ≥30 min/day in ≥10 min bouts every day). Randomisation occurred at the level of workplace cluster, and groups were randomly allocated (1:1) with stratification for company and cluster size. Personnel involved in data collection and processing were blinded to group allocation. Both interventions included five sessions of cognitive behavioural therapy counselling for 6 months. iPA included counselling focused on physical activity, access to a gym, and encouragement to exercise, and go for lunch walks. iSED included counselling on sedentary behaviour and encouragement to reduce sitting and increase engagement in standing- and walking-meetings. At baseline and the 6-month mark accelerometers were worn on the hip and thigh for 7 days. The primary outcomes were group differences in time spent in moderate-to-vigorous intensity physical activity (%MVPA) and in sedentary behaviour (%), analysed using Bayesian multilevel modelling for those with complete data.

    RESULTS: Two-hundred and sixty three office workers (73% women, mean age 42 ± 9 years, education 15 ± 2 years) were randomised into 23 cluster teams (iPA n = 84, 8 clusters; iSED n = 87, 7 clusters; C n = 92, 7 clusters). No significant group differences (posterior mean ratios: 95% credible interval) were found after the intervention for %MVPA or for %Sedentary. %MVPA: iPA vs C (0·04: - 0·80-0·82); iSED vs C (0·47: - 0·41-1·32); iPA vs iSED (0·43: - 0·42-1·27). %Sedentary: iPA vs C (1·16: - 1·66-4·02); iSED vs C (- 0·44: - 3·50-2·64); iPA vs iSED (- 1·60: - 4·72-1·47).

    CONCLUSIONS: The multi-component interventions focusing on either physical activity or sedentary behaviour were unsuccessful at increasing device-measured physical activity or reducing sedentary behaviour compared to a control group.

    TRIAL REGISTRATION: ISRCTN, ISRCTN92968402 . Registered 27/2/2018, recruitment started 15/03/2018.

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  • 18.
    Regan, Callum
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet, Huddinge, Sweden..
    Heiland, Emerald G.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University, Uppsala, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Kjellenberg, Karin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Larsen, Filip J
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Walltott, Hedda
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Fernström, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nyberg, Gisela
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet, Solna, Sweden.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet, Solna, Sweden.
    Helgadóttir, Björg
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet, Solna, Sweden.
    Acute effects of nitrate and breakfast on working memory, cerebral blood flow, arterial stiffness, and psychological factors in adolescents: Study protocol for a randomised crossover trial.2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 5, article id e0285581Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Inorganic nitrate has been shown to acutely improve working memory in adults, potentially by altering cerebral and peripheral vasculature. However, this remains unknown in adolescents. Furthermore, breakfast is important for overall health and psychological well-being. Therefore, this study will investigate the acute effects of nitrate and breakfast on working memory performance, task-related cerebral blood flow (CBF), arterial stiffness, and psychological outcomes in Swedish adolescents.

    METHODS: This randomised crossover trial will recruit at least 43 adolescents (13-15 years old). There will be three experimental breakfast conditions: (1) none, (2) low-nitrate (normal breakfast), and (3) high-nitrate (concentrated beetroot juice with normal breakfast). Working memory (n-back tests), CBF (task-related changes in oxygenated and deoxygenated haemoglobin in the prefrontal cortex), and arterial stiffness (pulse wave velocity and augmentation index) will be measured twice, immediately after breakfast and 130 min later. Measures of psychological factors and salivary nitrate/nitrite will be assessed once before the conditions and at two-time points after the conditions.

    DISCUSSION: This study will provide insight into the acute effects of nitrate and breakfast on working memory in adolescents and to what extent any such effects can be explained by changes in CBF. This study will also shed light upon whether oral intake of nitrate may acutely improve arterial stiffness and psychological well-being, in adolescents. Consequently, results will indicate if nitrate intake from beetroot juice or if breakfast itself could acutely improve cognitive, vascular, and psychological health in adolescents, which can affect academic performance and have implications for policies regarding school meals.

    TRIAL REGISTRATION: The trial has been prospectively registered on 21/02/2022 at https://doi.org/10.1186/ISRCTN16596056. Trial number: ISRCTN16596056.

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  • 19. Santoni, Giola
    et al.
    Angleman, Sara B
    Ek, Stina
    Heiland, Emerald G
    Karolinska institutet.
    Lagergren, Mårten
    Fratiglioni, Laura
    Welmer, Anna-Karin
    Temporal trends in impairments of physical function among older adults during 2001-16 in Sweden: towards a healthier ageing.2018In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 47, no 5, p. 698-704Article in journal (Refereed)
    Abstract [en]

    Background: a trend towards decline in disability has been reported in older adults, but less is known about corresponding temporal trends in measured physical functions.

    Objective: to verify these trends during 2001-16 in an older Swedish population.

    Methods: functional status was assessed at three occasions: 2001-04 (n = 2,266), 2007-10 (n = 2,033) and 2013-16 (n = 1,476), using objectively measured balance, chair stands and walking speed. Point prevalence was calculated and trajectories of change in impairment/vital status were assessed and were sex-adjusted and age-stratified: 66; 72; 78; 81 and 84; 87 and 90.

    Results: point prevalence of impairment was significantly lower at the 2013-16 assessment than the 2001-04 in chair stand amongst age cohorts 78-90 years, and in walking speed amongst age cohorts 72-84 years (P < 0.05), but not significantly different for balance. The prevalence remained stable between 2001-04 and 2007-10, while the decrease in chair stands and walking speed primarily occurred between 2007-10 and 2013-16. Among persons unimpaired in 2007-10, the proportion of persons who remained unimpaired in 2013-16 tended to be higher, and both the proportion of persons who became impaired and the proportion of persons who died within 6 years tended to be lower, relative to corresponding proportions for persons unimpaired in 2001-04. Overall, there were no corresponding changes for those starting with impairment.

    Conclusions: our results suggest a trend towards less functional impairment in older adults in recent years. The improvements appear to be driven by improved prognosis amongst those without impairments rather than substantial changes in prognosis for those with impairments.

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