1
|
Sander SE, Johansen RF, Caunt S, Søndergaard E, Rolver MG, Sandbæk A, Heller S, Kristensen PL, Molsted S. A Cross-sectional Study on the Impact of Educational Status on Physical Activity Level in Danish and English Adults With Type 1 Diabetes. Can J Diabetes 2024; 48:204-210.e1. [PMID: 38218396 DOI: 10.1016/j.jcjd.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/06/2023] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVES Physical activity is associated with improved health in people with type 1 diabetes. However, physical activity level may be associated with socioeconomic status. The primary aim of this study was to investigate the association between education level and physical activity level among people with type 1 diabetes. METHODS In this cross-sectional study, data on physical activity level (high or low) was measured using the Saltin-Grimby Physical Activity Level Scale, and education level (low, medium, or high) was self-reported. RESULTS Respondents were recruited from outpatient clinics (Steno Diabetes Centre Aarhus, Denmark; Nordsjællands Hospital, Denmark; or Sheffield Diabetes and Endocrine Centre, United Kingdom), by health-care personnel from September 2019 to July 2021. A total of 324 people with type 1 diabetes were included (54% male, median age 50 years [interquartile range 30-60 years]). Education level was low in 10%, medium in 33%, and high in 57%. A logistic regression analysis, adjusted for age, sex, cohabitation status and nationality, found that a medium vs. high education level was associated with lower odds of a high physical activity level (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.32-0.94, p=0.029), while no association was found for low vs. high education level with high physical activity level (OR 0.56, 95% CI 0.25-1.29, p=0.173). CONCLUSIONS Medium education level compared with a high education level was associated with a lower level of physical activity in people with type 1 diabetes. Health-care professionals are advised to be attentive of physical activity levels among people with type 1 diabetes.
Collapse
Affiliation(s)
- Sarah Elton Sander
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark.
| | | | - Sharon Caunt
- Academic Directorate of Diabetes and Endocrinology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Esben Søndergaard
- Steno Diabetes Centre Aarhus, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Monica Gylling Rolver
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark; Department of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark
| | - Anni Sandbæk
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
| | - Simon Heller
- Academic Directorate of Diabetes and Endocrinology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom
| | - Peter Lommer Kristensen
- Department of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Årnes AP, Fjeld MK, Stigum H, Nielsen CS, Stubhaug A, Johansen A, Hopstock LA, Morseth B, Wilsgaard T, Steingrímsdóttir ÓA. Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study. Pain 2024:00006396-990000000-00543. [PMID: 38442413 DOI: 10.1097/j.pain.0000000000003209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/28/2024] [Indexed: 03/07/2024]
Abstract
ABSTRACT Knowledge is needed regarding mechanisms acting between physical activity (PA) and chronic pain. We investigated whether cold pain tolerance mediates an effect of leisure-time physical activity on the risk of chronic pain 7 to 8 years later using consecutive surveys of the population-based Tromsø Study. We included participants with information on baseline leisure-time PA (LTPA) and the level of cold pressor-assessed cold pain tolerance, who reported chronic pain status at follow-up as any of the following: chronic pain for ≥3 months, widespread chronic pain, moderate-to-severe chronic pain, or widespread moderate-to-severe chronic pain. We included 6834 participants (52% women; mean age, 55 years) in counterfactual mediation analyses. Prevalence decreased with severity, for example, 60% for chronic pain vs 5% for widespread moderate-to-severe chronic pain. People with one level higher LTPA rating (light to moderate or moderate to vigorous) at baseline had lower relative risk (RR) of 4 chronic pain states 7 to 8 years later. Total RR effect of a 1-level LTPA increase was 0.95 (0.91-1.00), that is, -5% decreased risk. Total effect RR for widespread chronic pain was 0.84 (0.73-0.97). Indirect effect for moderate-to-severe chronic pain was statistically significant at RR 0.993 (0.988-0.999); total effect RR was 0.91 (0.83-0.98). Statistically significantly mediated RR for widespread moderate-to-severe chronic pain was 0.988 (0.977-0.999); total effect RR was 0.77 (0.64-0.94). This shows small mediation of the effect of LTPA through pain tolerance on 2 moderate-to-severe chronic pain types. This suggests pain tolerance to be one possible mechanism through which PA modifies the risk of moderate-to-severe chronic pain types with and without widespread pain.
Collapse
Affiliation(s)
- Anders Pedersen Årnes
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Mats Kirkeby Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hein Stigum
- Institute of Health and Society, University of Oslo, Norway
| | - Christopher Sivert Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Aslak Johansen
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | |
Collapse
|
3
|
Sagelv EH, Dalene KE, Eggen AE, Ekelund U, Fimland MS, Heitmann KA, Holtermann A, Johansen KR, Løchen ML, Morseth B, Wilsgaard T. Occupational physical activity and risk of mortality in women and men: the Tromsø Study 1986-2021. Br J Sports Med 2024; 58:81-88. [PMID: 37914386 DOI: 10.1136/bjsports-2023-107282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Associations between occupational physical activity (OPA) and mortality risks are inconclusive. We aimed to examine associations between (1) OPA separately and (2) jointly with leisure time physical activity (LTPA), and risk of all-cause, cardiovascular disease (CVD) and cancer mortality, over four decades with updated exposure and covariates every 6-8 years. METHODS Adults aged 20-65 years from the Tromsø Study surveys Tromsø3-Tromsø7 (1986-2016) were included. We categorised OPA as low (sedentary), moderate (walking work), high (walking+lifting work) or very high (heavy manual labour) and LTPA as inactive, moderate and vigorous. We used Cox/Fine and Gray regressions to examine associations, adjusted for age, body mass index, smoking, education, diet, alcohol and LTPA (aim 1 only). RESULTS Of 29 605 participants with 44 140 total observations, 4131 (14.0%) died, 1057 (25.6%) from CVD and 1660 (40.4%) from cancer, during follow-up (median: 29.1 years, 25th-75th: 16.5.1-35.3). In men, compared with low OPA, high OPA was associated with lower all-cause (HR 0.83, 95% CI 0.74 to 0.92) and CVD (subdistributed HR (SHR) 0.68, 95% CI 0.54 to 0.84) but not cancer mortality (SHR 0.99, 95% CI 0.84 to 1.19), while no association was observed for moderate or very high OPA. In joint analyses using inactive LTPA and low OPA as reference, vigorous LTPA was associated with lower all-cause mortality combined with low (HR 0.75, 95% CI 0.64 to 0.89), high (HR 0.67, 95% CI 0.54 to 0.82) and very high OPA (HR 0.74, 95% CI 0.58 to 0.94), but not with moderate OPA. In women, there were no associations between OPA, or combined OPA and LTPA, with mortality. CONCLUSION High OPA, but not moderate and very high OPA, was associated with lower all-cause and CVD mortality risk in men but not in women. Vigorous LTPA was associated with lower mortality risk in men with low, high and very high OPA, but not moderate OPA.
Collapse
Affiliation(s)
- Edvard H Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ulf Ekelund
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Kim Arne Heitmann
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sport Science and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kristoffer Robin Johansen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
4
|
Mo Y, Zhou Y, Chan H, Evans C, Maddocks M. The association between sedentary behaviour and sarcopenia in older adults: a systematic review and meta-analysis. BMC Geriatr 2023; 23:877. [PMID: 38124026 PMCID: PMC10734096 DOI: 10.1186/s12877-023-04489-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Sedentary behaviour is considered to contribute to sarcopenia when combined with physical inactivity. Whether sedentary behaviour is independently associated with sarcopenia remains controversial. The aim of this study is to explore the association between sedentary behaviour and sarcopenia in older adults in community and long-term care facility settings. METHODS Eight electronic databases including MEDLINE, PsycINFO, Wanfang were searched from inception until August 2023. The review included cross-sectional and longitudinal studies concerning the association between sedentary behaviour and sarcopenia among participants over 60 years old. Evidence was pooled by both random-effects meta-analysis and narrative synthesis. Subgroup analyses explored variation according to adjustment of physical activity, settings, and measurements of sedentary behaviour and sarcopenia. Quality assessment for individual studies was performed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. RESULTS Seventeen articles (16 cross-sectional studies and 1 longitudinal study) of 25,788 participants from community or long-term care facility settings were included. The overall quality of the included studies was rated high. Meta-analysis of 14 cross-sectional studies showed that sedentary behaviour was independently positively associated with sarcopenia: pooled odd ratio 1.36 (95% confidence interval, 1.18-1.58). The independent positive association remained in subgroup analyses by adjustment of physical activity, settings, and measurements of sedentary behaviour and sarcopenia. The narrative analysis corroborated the findings of the meta-analysis and provided additional evidence suggesting that interruptions in sedentary periods were linked to a decreased likelihood of developing sarcopenia. CONCLUSIONS The findings support the hypothesis that sedentary behaviour is independently positively associated with sarcopenia in older adults, providing vital indications for the development of strategies to prevent sarcopenia. SYSTEMATIC REVIEW REGISTRATION The systematic review protocol has been registered with the PROSPERO database (CRD42022311399).
Collapse
Affiliation(s)
- Yihan Mo
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
| | - Yuxin Zhou
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Helen Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Catherine Evans
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| |
Collapse
|
5
|
Parma JO, Bacelar MFB, Cabral DAR, Recker RS, Orsholits D, Renaud O, Sander D, Krigolson OE, Miller MW, Cheval B, Boisgontier MP. Relationship between reward-related brain activity and opportunities to sit. Cortex 2023; 167:197-217. [PMID: 37572531 DOI: 10.1016/j.cortex.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 08/14/2023]
Abstract
The present study tested whether energy-minimizing behaviors evoke reward-related brain activity that promotes the repetition of these behaviors via reinforcement learning processes. Fifty-eight healthy young adults in a standing position performed a task where they could earn a reward either by sitting down or squatting while undergoing electroencephalographic (EEG) recording. Reward-prediction errors were quantified as the amplitude of the EEG-derived reward positivity. Results showed that reward positivity was larger on reward versus no reward trials, confirming the validity of our paradigm to measure evoked reward-related brain activity. However, results showed no evidence that sitting (versus standing and squatting) trials led to larger reward positivity. Moreover, we found no evidence suggesting that this effect was moderated by typical physical activity, physical activity on the day of the study, or energy expenditure during the experiment. However, at the behavioral level, results showed that the probability of choosing the stimulus more likely to lead to sitting than standing increased as the number of trials increased. In addition, results revealed that the probability of changing the selected stimulus was higher when the previous trial was a stand trial relative to a sit trial. In sum, neural results showed no evidence supporting the theory that opportunities to minimize energy expenditure are rewarding. However, behavioral findings suggested participants tend to choose the less effortful behavioral alternative and were therefore consistent with the theory of effort minimization (TEMPA).
Collapse
Affiliation(s)
| | | | | | | | - Dan Orsholits
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland; Swiss National Centre of Competence in Research LIVES-Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
| | - Olivier Renaud
- Methodology and Data Analysis, Department of Psychology, University of Geneva, Switzerland
| | - David Sander
- Swiss Center for Affective Sciences, University of Geneva, Switzerland; Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | | | - Matthew W Miller
- School of Kinesiology, Auburn University, AL, USA; Center for Neuroscience, Auburn University, USA.
| | - Boris Cheval
- Department of Sport Sciences and Physical Education, Ecole Normale Supérieure Rennes, Bruz, France; Laboratory VIPS2, University of Rennes, Rennes, France.
| | - Matthieu P Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Bruyère Research Institute, Ottawa, Canada.
| |
Collapse
|
6
|
Hussenoeder FS, Conrad I, Pabst A, Engel C, Zachariae S, Zeynalova S, Glaesmer H, Hinz A, Witte V, Schomerus G, Löffler M, Villringer A, Sander C, Riedel-Heller SG. Physical activity and mental health: the connection between step count and depression, anxiety and quality of sleep. PSYCHOL HEALTH MED 2023; 28:2419-2429. [PMID: 36529963 DOI: 10.1080/13548506.2022.2159453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
While there are studies connecting everyday physical activity (PA) to mental health, they mostly use self-report measures for PA which are biased in multiple ways. Nevertheless, a realistic assessment of everyday PA is important for the development and implementation of low-threshold public health interventions. Therefore, we want to analyze the relationship between objectively measured daily steps and mental health. We included 1451 subjects from a subsample of the population-based LIFE-Adult-Study (2011-2014) with an average age of 55.0 years, 52.1% were female. We analyzed the effects of PA (step count measured via SenseWear Pro 3) on depression (CES-D), anxiety (GAD-7), and quality of sleep (PSQI). The regression analysis showed a significant negative association between low to moderate PA [Incidence rate ratio: 0.87 (0.77; 0.98)] as well as high to very high PA [0.84 (0.74; 0.95)] and depression and no significant associations between PA and anxiety [l-m: 0.98 (0.81; 1.18)/h-vh: 1.00 (0.82; 1.21)] or quality of sleep [l-m: 0.94 (0.84, 1.06)/h-vh: 0.92 (0.82, 1.03)], controlling for sociodemographic variables and personality. Low-threshold interventions that increase daily step count could be a useful approach for the prevention of depression. The use of objective PA measurement for research is highly encouraged.
Collapse
Affiliation(s)
- Felix S Hussenoeder
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Faculty of Medicine, Leipzig University, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Silke Zachariae
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Samira Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Veronica Witte
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, Leipzig University, Leipzig, Germany
| |
Collapse
|
7
|
Mikkelsen M, Wilsgaard T, Grimsgaard S, Hopstock LA, Hansson P. Associations between postprandial triglyceride concentrations and sex, age, and body mass index: cross-sectional analyses from the Tromsø study 2015-2016. Front Nutr 2023; 10:1158383. [PMID: 37396133 PMCID: PMC10308115 DOI: 10.3389/fnut.2023.1158383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Elevated serum triglyceride concentrations increase the risk of developing atherosclerosis, the leading cause of cardiovascular disease. Postprandial triglyceride concentrations have shown to be a stronger predictor of cardiovascular disease compared to fasting triglycerides. It is therefore clinically relevant to study patterns of postprandial triglyceride concentrations in a general adult population. Aims The aim of this cross-sectional analysis was to examine postprandial triglyceride concentrations in women and men, and the association with age, body mass index and menopausal status. Methods Non-fasting blood samples from 20,963 women and men aged 40 years and older, attending the seventh survey of the Tromsø Study (2015-2016), were analyzed for postprandial triglyceride concentrations using descriptive statistics and linear regression models. Self-reported time since last meal before blood sampling was categorized into 1-h intervals with 7+ hours considered fasting. Results Men had higher triglyceride concentrations compared to women. The pattern of postprandial triglyceride concentrations differed between the sexes. In women, the highest triglyceride concentration (19% higher compared to fasting level, p < 0.001) was found 3-4 h postprandially compared to 1-3 h in men (30% higher compared to fasting level, p < 0.001). In women, all subgroups of age and BMI had higher triglyceride concentrations than the reference group (age 40-49 years and BMI < 25 kg/m2), but no linear trend for age was observed. In men, triglyceride concentrations were inversely associated with age. Body mass index was positively associated with triglyceride concentration in both women (p < 0.001) and men (p < 0.001), although this association was somewhat modified by age in women. Postmenopausal women had significantly higher triglyceride concentrations compared to premenopausal women (p < 0.05). Conclusion Postprandial triglyceride concentrations differed in groups of sex, age, body mass index, and menopausal status.
Collapse
Affiliation(s)
- Mari Mikkelsen
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A. Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Patrik Hansson
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| |
Collapse
|
8
|
Myrstad M, Johansen KR, Sørensen E, Ranhoff AH. Rationale and design of the Birkebeiner Ageing Study - a prospective cohort study of older endurance athletes. BMC Geriatr 2023; 23:365. [PMID: 37308811 DOI: 10.1186/s12877-023-04099-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 06/08/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND While regular physical activity is associated with reduced mortality and morbidity in general populations, health outcomes and functional capacity related to upholding strenuous endurance exercise beyond the age of 65 years are only sparsely studied. The aim of this study is to assess associations of prolonged strenuous endurance sport practice with ageing, functional decline, morbidity and longevity among older recreational endurance athletes, during long-term follow-up. METHODS Prospective cohort study of older recreational endurance athletes in Norway. All skiers aged 65 years and older who participated in a long-distance endurance competition, the annual 54-km Birkebeiner cross-country ski race in 2009 or 2010, were invited. The participants answered an extensive baseline questionnaire about lifestyle habits, including leisure-time physical activity and endurance sport participation, diseases, medication use and physical and mental health, with follow-up questionnaires planned every fifth year until 2029. New participants may be invited with the aim to increase the study size. Endpoints such as all-cause and disease-specific mortality, incidence and cumulative prevalence of diseases, use of medication, physical and mental health and functional decline will be assessed subsequently. Out of 658 invited skiers (51 women), 551(84%) completed the baseline questionnaire and were included in the study. The mean age was 68.8 years (median 68, range 65- 90). At baseline, the participants had completed the Birkebeiner race for an average of 16.6 years and reported an average of 33.4 years of regular endurance exercise, with one out of five reporting at least 50 years of exercise. In all, 479 (90%) reported that they were still practicing leisure-time physical activity of moderate or vigorous intensity at least twice weekly. The prevalence of cardiovascular risk factors and diseases was low. DISCUSSION This prospective study of a cohort of recreational athletes exposed to prolonged and strenuous endurance exercise, could complement population-based studies by providing data on associations between life-long endurance sport participation, aging, functional decline and health outcomes during long-term follow-up.
Collapse
Affiliation(s)
- Marius Myrstad
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, N-1346, Gjettum, Norway.
- Department of Internal Medicine, Bærum Hospital, Vestre Viken Hospital Trust, N-1346, Gjettum, Norway.
| | - Kristoffer Robin Johansen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Eivind Sørensen
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, N-1346, Gjettum, Norway
- Department of Internal Medicine, Diakonhjemmet Hospital, N-0370, Oslo, Norway
| | - Anette Hylen Ranhoff
- Department of Internal Medicine, Diakonhjemmet Hospital, N-0370, Oslo, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
9
|
Årnes AP, Nielsen CS, Stubhaug A, Fjeld MK, Johansen A, Morseth B, Strand BH, Wilsgaard T, Steingrímsdóttir ÓA. Longitudinal relationships between habitual physical activity and pain tolerance in the general population. PLoS One 2023; 18:e0285041. [PMID: 37224163 DOI: 10.1371/journal.pone.0285041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/13/2023] [Indexed: 05/26/2023] Open
Abstract
Physical activity (PA) might influence the risk or progression of chronic pain through pain tolerance. Hence, we aimed to assess whether habitual leisure-time PA level and PA change affects pain tolerance longitudinally in the population. Our sample (n = 10,732; 51% women) was gathered from the sixth (Tromsø6, 2007-08) and seventh (Tromsø7, 2015-16) waves of the prospective population-based Tromsø Study, Norway. Level of leisure-time PA (sedentary, light, moderate, or vigorous) was derived from questionnaires; experimental pain tolerance was measured by the cold-pressor test (CPT). We used ordinary, and multiple-adjusted mixed, Tobit regression to assess 1) the effect of longitudinal PA change on CPT tolerance at follow-up, and 2) whether a change in pain tolerance over time varied with level of LTPA. We found that participants with high consistent PA levels over the two surveys (Tromsø6 and Tromsø7) had significantly higher tolerance than those staying sedentary (20.4 s. (95% CI: 13.7, 27.1)). Repeated measurements show that light (6.7 s. (CI 3.4, 10.0)), moderate (CI 14.1 s. (9.9, 18.3)), and vigorous (16.3 s. (CI 6.0, 26.5)) PA groups had higher pain tolerance than sedentary, with non-significant interaction showed slightly falling effects of PA over time. In conclusion, being physically active at either of two time points measured 7-8 years apart was associated with higher pain tolerance compared to being sedentary at both time-points. Pain tolerance increased with higher total activity levels, and more for those who increased their activity level during follow-up. This indicates that not only total PA amount matters but also the direction of change. PA did not significantly moderate pain tolerance change over time, though estimates suggested a slightly falling effect possibly due to ageing. These results support increased PA levels as a possible non-pharmacological pathway towards reducing or preventing chronic pain.
Collapse
Affiliation(s)
| | - Christopher Sievert Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mats Kirkeby Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Aslak Johansen
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn Heine Strand
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust Norway, Tønsberg, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | |
Collapse
|
10
|
Fjeld MK, Årnes AP, Engdahl B, Morseth B, Hopstock LA, Horsch A, Stubhaug A, Strand BH, Nielsen CS, Steingrímsdóttir ÓA. Consistent pattern between physical activity measures and chronic pain levels: the Tromsø Study 2015 to 2016. Pain 2023; 164:838-847. [PMID: 36083173 PMCID: PMC10026831 DOI: 10.1097/j.pain.0000000000002773] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 01/13/2023]
Abstract
ABSTRACT Epidemiological literature on the relationship between physical activity and chronic pain is scarce and inconsistent. Hence, our aim was to assess the relationship applying comprehensive methodology, including self-reported and accelerometer measures of physical activity and different severity levels of chronic pain. We used data from the Tromsø Study (2015-2016). All residents in the municipality, aged 40 years and older were invited to participate (n = 32,591, 51% women). A total of 21,083 (53%) women reported on questionnaires. Additionally, 6778 participants (54% women) were invited to wear accelerometers (6125 with complete measurements). Our exposure measures were self-reported leisure time physical activity, exercise frequency, duration, and intensity and 2 accelerometer measures (steps per day and minutes of moderate to vigorous physical activity per day). Outcome measurements were chronic pain and moderate-to-severe chronic pain. We used Poisson regression to estimate chronic pain prevalence and prevalence ratios for each physical activity measure, with adjustments for sex, age, education level, smoking history, and occupational physical activity. Our main analyses showed an inverse dose-response relationship between all physical activity measures and both severity measures of chronic pain, except that the dose-response relationship with exercise duration was only found for moderate-to-severe pain. All findings were stronger for the moderate-to-severe pain outcomes than for chronic pain. Robustness analyses gave similar results as the main analyses. We conclude that an inverse dose-response association between physical activity and chronic pain is consistent across measures. To summarize, higher levels of physical activity is associated with less chronic pain and moderate-to-severe chronic pain.
Collapse
Affiliation(s)
- Mats Kirkeby Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Bo Engdahl
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila Arnesdatter Hopstock
- Departments of Department of Health and Care Sciences, UiT The Artic University of Norway, Tromsø, Norway
| | - Alexander Horsch
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Bjørn Heine Strand
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Christopher Sivert Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Ólöf Anna Steingrímsdóttir
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
11
|
Landgraff IK, Meyer HE, Ranhoff AH, Holvik K, Talsnes O, Myrstad M. Resting heart rate, self-reported physical activity in middle age, and long-term risk of hip fracture. A NOREPOS cohort study of 367,386 men and women. Bone 2023; 167:116620. [PMID: 36427775 DOI: 10.1016/j.bone.2022.116620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 10/18/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Abstract
Enhanced knowledge regarding modifiable risk factors for hip fractures are warranted. We aimed to study the associations between two indicators of physical fitness (resting heart rate and level of physical activity) in middle-aged individuals, and the risk of hip fractures during the subsequent three decades. Data on objectively measured resting heart rate and self-reported leisure time physical activity from a national health survey (1985-1999) was linked to a database including all hip fractures treated in Norwegian hospitals from 1994 through 2018. We calculated hazard ratios (HR) with 95 % confidence intervals (95 % CI) for hip fractures according to categories of resting heart rate (mean of two repeated measures), and leisure time physical activity level in adjusted Cox proportional hazard models. In total, 367,386 persons (52 % women) aged 40 to 45 years were included, of whom 5482 persons sustained a hip fracture during a mean follow-up of 24.8 years. Higher resting heart rate was associated with higher hip fracture risk. Men with a resting heart rate above 80 bpm, who also reported low levels of physical activity, had a HR of 1.82 (95 % CI 1.49-2.22) for hip fracture compared to men with a resting heart rate below 70 bpm who reported high levels of physical activity. The same measure of association for women was 1.62 (95 % CI 1.28-2.06). Physical fitness measured by low resting heart rate in middle age, and a high physical activity level were associated with a lower long-term risk of hip fractures in both men and women.
Collapse
Affiliation(s)
- Ida Kalstad Landgraff
- Department of Internal Medicine, Bœrum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway.
| | - Haakon E Meyer
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Anette Hylen Ranhoff
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Kristin Holvik
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ove Talsnes
- Department of Orthopedics, Innlandet Hospital Trust, Elverum, Norway
| | - Marius Myrstad
- Department of Internal Medicine, Bœrum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway; Department of Medical Research, Bœrum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| |
Collapse
|
12
|
Smith MT, Kishman EE, Weaver RG, O'Neill JR, Wang X. Measurement of Physical Activity with Wrist-Worn ActiGraph GT3X+ in Older Women. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:1538-1553. [PMID: 36618018 PMCID: PMC9797004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
UNLABELLED Higher wear compliance has been seen with wrist placed accelerometers versus hip placed. Performance of wrist placed ActiGraph GT3X+ accelerometer (GT3X+, ActiGraph LLC, Pensacola, FL) in assessing physical activity (PA) remains unclear. PURPOSE This study examined GT3X+'s performance in measuring PA energy expenditure (PAEE) and classifying PA intensity in older women. METHODS Women [n = 89, age = 65.6 (4.3)] wore GT3X+ and SenseWear Armband Mini (SWAM, BodyMedia Inc. Pittsburgh, PA) for 2 weeks. Concurrently, doubly labeled water (DLW) determined total daily energy expenditure (TDEE). Resting energy expenditure (REE) was determined by Indirect Calorimetry. Data was processed using manufacturer-provided software. Bivariate correlations, Intra Class Correlations, and Bland-Altman plots were performed to evaluate agreement between GT3X+ and criterion measures for sedentary time, light and moderate-to-vigorous PA (determined by SWAM) and PAEE (determined by SWAM and by DLW and REE). Epoch-by-epoch analysis evaluated discrepancy and agreement of PA intensity classification between GT3X+ and SWAM. RESULTS For PAEE, GT3X+ showed moderate correlations with criterion measures (r = 0.413, 0.400 with SWAM; r = 0.564, 0.501 with DLW and REE), but Bland-Altman plots showed large variability. When estimating time spent in PA intensity, GT3X+ underestimated sedentary time and overestimated PA intensity compared to SWAM. During epoch-by-epoch analysis, GT3X+ misclassified light intensity PA as moderate-to-vigorous PA 72% of the time. Counts per minute showed strong correlations with criterion measures (r = 0.68, 0.625 for SWAM and DLW and REE respectively). CONCLUSION Current equations and cut points do not provide accurate measures of PA with wrist-worn GT3X+ in older women.
Collapse
Affiliation(s)
- Michal T Smith
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Erin E Kishman
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Jennifer R O'Neill
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xuewen Wang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
13
|
Johansen KR, Ranhoff AH, Sørensen E, Nes BM, Heitmann KA, Apelland T, Bucher Sandbakk S, Wilsgaard T, Løchen ML, Thelle DS, Morseth B, Myrstad M. Risk of atrial fibrillation and stroke among older men exposed to prolonged endurance sport practice: a 10-year follow-up. The Birkebeiner Ageing Study and the Tromsø Study. Open Heart 2022; 9:openhrt-2022-002154. [DOI: 10.1136/openhrt-2022-002154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022] Open
Abstract
AimsEndurance sport practice is associated with a high prevalence of atrial fibrillation (AF), which increases the risk of stroke in the general population. However, stroke risk in endurance athletes with AF is sparsely investigated. Most studies have been limited by design and are largely restricted to younger and middle-aged populations. Thus, we aimed to investigate AF and stroke risk in older athletes exposed to prolonged endurance training.MethodDuring a 10-year period, 505 male athletes aged ≥65 years frequently participating in a long-distance ski race were compared with 1867 men of the same age from the general population. The main exposure was endurance sport practice with self-reported AF and stroke as outcomes. Stroke risk was further examined by joint modelling of AF and endurance practice. Statistical analysis was conducted with a modified Poisson model.ResultsAthletes (median age: 68, range: 65–90) participated in a long-distance ski race over a median of 14 years (range: 1–53). Prevalence (28.5% vs 17.8%) and adjusted risk of AF (risk ratio (RR): 1.88, 95% CI: 1.49 to 2.37) were higher in athletes compared with non-athletes, whereas the prevalence (5.4% vs 9.7%) and risk of stroke were lower (RR: 0.60, 95% CI: 0.37 to 0.95). Compared with athletes without AF, risk of stroke was twofold in athletes (RR: 2.38, 95% CI: 1.08 to 5.24) and nearly fourfold in non-athletes (RR: 3.87, 95% CI: 1.98 to 7.57) with AF.ConclusionAlthough older male endurance athletes experienced an increased risk of AF, the long-term risk of stroke was substantially reduced compared with non-athletes.
Collapse
|
14
|
Brørs G, Dalen H, Allore H, Deaton C, Fridlund B, Osborne RH, Palm P, Wentzel-Larsen T, Norekvål TM. Health Literacy and Risk Factors for Coronary Artery Disease (From the CONCARD PCI Study). Am J Cardiol 2022; 179:22-30. [PMID: 35853782 DOI: 10.1016/j.amjcard.2022.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 11/01/2022]
Abstract
In the setting of established coronary artery disease (CAD), lower health literacy is associated with poor outcomes. The aim of this study was to determine whether health literacy at the index admission was associated with established CAD risk factors and with changes in CAD risk factors from baseline until 6 months after percutaneous coronary intervention (PCI). A multicenter cohort study recruited 3,417 patients aged ≥18 years who were treated with PCI. Assessments were made at the index admission for PCI and at 6-month follow-up, including 4 of the 9 scales from the Health Literacy Questionnaire, an assessment of behavioral risk factors and psychologic risk factors for CAD. In this large study, key aspects of health literacy were associated with behavioral and psychologic risk factors for CAD. For each 1-unit higher score on the health literacy scales, weekly physical activity was 12 to 20 intensity-adjusted minutes higher, and the odds of being a nonsmoker were 24% to 72% higher. The risk factors for CAD improved from baseline to 6-month follow-up, although most were not significantly associated with health literacy. Still, patients with lower health literacy scores were more likely to report a greater reduction in depression symptoms from baseline to 6-month follow-up. In conclusion, the study provides evidence that several aspects of health literacy are associated with risk factors for CAD. These results serve as a reminder to healthcare teams to consider health literacy challenges in connection with secondary prevention care.
Collapse
Affiliation(s)
- Gunhild Brørs
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Håvard Dalen
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Heather Allore
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Christi Deaton
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Bengt Fridlund
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Richard H Osborne
- Center for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Pernille Palm
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Tore Wentzel-Larsen
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway; Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway; Center for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
| | | |
Collapse
|
15
|
Luo M, Gupta N, Holtermann A, Stamatakis E, Ding D. Revisiting the 'physical activity paradox' in a Chinese context: Occupational physical activity and mortality in 142,302 urban working adults from the China Kadoorie Biobank study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 23:100457. [PMID: 35602414 PMCID: PMC9120052 DOI: 10.1016/j.lanwpc.2022.100457] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Previous research suggests that while leisure-time physical activity (LTPA) is beneficial, occupational physical activity (OPA) may be detrimental to health, known as the 'physical activity paradox'. However, the current evidence is primarily based on data from Western countries. We examined the association of OPA with all-cause and cardiovascular disease mortality in working adults in urban China. METHODS This prospective longitudinal study was based on a sample of 142,302 urban working adults aged 30-79 years from the China Kadoorie Biobank study. Self-reported OPA (mainly sedentary, standing occupation, and manual work) was collected at baseline (year 2004-2008) and linked to death registries until 31st December 2016. Multivariable Cox proportional hazards models were used to examine the relationship between OPA and mortality outcomes, with further tests for effect modification by sex, educational attainment and LTPA. FINDINGS During a median follow-up of 10·2 years, 4,077 deaths occurred, of which cardiovascular disease was the primary cause for 727 deaths. Crude modelling showed that compared with the sedentary workers, manual work was associated with increased risk of all-cause mortality. However, after adjusting for socio-demographic and lifestyle variables, the association was attenuated to null (HR=1·00, 95%CI: 0·93-1·08). In subgroup analysis, higher OPA was associated with lower risk of all-cause mortality in the least educated group (HR=0·84, 95%CI: 0·75-0·95 for manual work, and HR=0·86, 95%CI: 0·75-0·99 for standing occupation), but harmful in the most educated group (HR=1·17, 95%CI: 1·01-1·36) and in those who reported regular LTPA (HR=1·20, 95%CI: 1·01-1·43). INTERPRETATION OPA was not associated with mortality risk in the overall sample. However, findings support the 'physical activity paradox' within better educated Chinese workers. FUNDING None.
Collapse
Key Words
- BMI, Body mass index
- CI, Confidence interval
- CNY, Chinese Yuan
- CVD, Cardiocascular disease
- China
- DSP, Disease Surveillance Points
- Epidemiology
- HR, Hazard ratio
- ICD, International Statistical Classification of Diseases
- IQR, Interquartile range
- LMIC
- LMICs, Low-to-middle income countries
- LTPA, Leisure-time physical activity
- Low and middle income countries
- Mortality
- OPA, Occupational physical activity
- Physical activity
- SGPALS, Saltin-Grimby Physical Activity Level Scale
- UK, United Kingdom
- USD, United States Dollars
Collapse
Affiliation(s)
- Mengyun Luo
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Nidhi Gupta
- Department of Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Emmanuel Stamatakis
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Ding Ding
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
16
|
Criterion validity of a research-based application for tracking screen time on android and iOS smartphones and tablets. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2022. [DOI: 10.1016/j.chbr.2021.100164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
17
|
Mikkilä S, Johansson J, Nordström A, Nordström P, Emaus N, Handegård BH, Morseth B, Welde B. A 15-year follow-up study of hip bone mineral density and associations with leisure time physical activity. The Tromsø Study 2001–2016. PLoS One 2022; 17:e0262228. [PMID: 35081131 PMCID: PMC8791505 DOI: 10.1371/journal.pone.0262228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/19/2021] [Indexed: 11/18/2022] Open
Abstract
Aims
The aim was to investigate the long-term association between leisure time physical activity and hip areal bone mineral density (aBMD), in addition to change in hip aBMD over time, in 32–86 years old women and men.
Methods
Data were retrieved from the 2001, 2007–2008, and 2015–2016 surveys of the Tromsø Study, a longitudinal population study in Norway. Leisure time physical activity was assessed by the four-level Saltin-Grimby Physical Activity Level Scale which refers to physical exertion in the past twelve months. Hip aBMD was assessed by Dual-Energy X-ray Absorptiometry. Linear Mixed Model analysis was used to examine long-term associations between physical activity and hip aBMD (n = 6324). In addition, the annual change in hip aBMD was analyzed in a subsample of 3199 participants.
Results
Physical activity was significantly and positively associated with total hip aBMD in the overall cohort (p<0.005). Participants who reported vigorous activity had 28.20 mg/cm2 higher aBMD than those who were inactive (95% CI 14.71; 41.69, controlled for confounders), and even light physical activity was associated with higher aBMD than inactivity (8.32 mg/cm2, 95% CI 4.89; 11.76). Associations between physical activity and femoral neck aBMD yielded similar results. Hip aBMD decreased with age in both sexes, although more prominently in women. From 2001 to 2007–2008, aBMD changed by –5.76 mg/cm2 per year (95% CI –6.08; –5.44) in women, and –2.31 mg/cm2 (95% CI –2.69; –1.93), in men. From 2007–2008 to 2015–2016, the change was –4.45 mg/cm2 per year (95% CI –4.84; –4.06) in women, and –1.45 mg/cm2 (95% CI –1.92; –0.98) in men.
Conclusions
In this cohort of adult men and women, physical activity levels were positively associated with hip aBMD in a dose-response relationship. Hip aBMD decreased with age, although more pronounced in women than men.
Collapse
Affiliation(s)
- Saija Mikkilä
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anna Nordström
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Public Health and Clinical Medicine, Section for Sustainable Health, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn Helge Handegård
- The Regional Centre for Child and Adolescent Mental Health–North, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Boye Welde
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
18
|
Hauger AV, Holvik K, Bergland A, Ståhle A, Emaus N, Morseth B, Strand BH. Physical capability, physical activity, and their association with femoral bone mineral density in adults aged 40 years and older: The Tromsø study 2015-2016. Osteoporos Int 2021; 32:2083-2094. [PMID: 33864108 PMCID: PMC8510966 DOI: 10.1007/s00198-021-05949-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/01/2021] [Indexed: 11/28/2022]
Abstract
UNLABELLED Since muscles can influence bone growth and vice versa, we examined if level of physical activity and physical capability tests can predict areal bone mineral density (aBMD). Both high activity level and good test performance were associated with higher aBMD, especially in women. INTRODUCTION Muscle influences bone formation and vice versa. Tests of physical capability and level of physical activity reflect various muscle qualities. We assessed the associations between total hip aBMD and physical activity as well as a range of standardized physical capability tests in an adult general population. METHODS A total of 3 533 women and men aged 40-84 years, participating in the population-based cross-sectional Tromsø study in Norway in 2015-2016, were included. Linear regression was used to assess associations between aBMD and physical activity and the physical capability tests grip strength, Timed Up and Go (TUG), Short Physical Performance Battery (SPPB), and standing balance. Non-linear associations were examined in cubic spline models. Standardized regression coefficients were calculated to compare effect sizes across physical capability measures. RESULTS In fully adjusted models, higher physical activity was positively associated with total hip aBMD in both sexes compared to a sedentary lifestyle. All tests of physical capability were associated with aBMD in women, SPPB showing the strongest association although effect sizes were too small to indicate clinically significant differences (1 point increase corresponded to an aBMD increase of 0.009 g/cm2, CI = 0.005 to 0.012). In men, SPPB and its subtests were associated with aBMD with chair rises showing the strongest association (1 s increase in execution time corresponded to an aBMD decrease of 0.005 g/cm2, CI = 0.008 to 0.002). CONCLUSION Physical activity was associated with aBMD, and tests of physical capability can account for some of the aBMD variations in adults aged 40 years and older, especially in women.
Collapse
Affiliation(s)
- A V Hauger
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Postboks 4, St. Olavs plass, 0130, Oslo, Norway.
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473, Oslo, Norway.
| | - K Holvik
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473, Oslo, Norway
| | - A Bergland
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Postboks 4, St. Olavs plass, 0130, Oslo, Norway
| | - A Ståhle
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, 14183, Huddinge, Sweden
| | - N Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - B Morseth
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Department of Clinical Therapeutic Services, University Hospital of Northern Norway, Tromsø, Norway
| | - B H Strand
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473, Oslo, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
19
|
Kieffer SK, Nauman J, Syverud K, Selboskar H, Lydersen S, Ekelund U, Wisløff U. Association between Personal Activity Intelligence (PAI) and body weight in a population free from cardiovascular disease - The HUNT study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 5:100091. [PMID: 34557819 PMCID: PMC8454800 DOI: 10.1016/j.lanepe.2021.100091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Personal Activity Intelligence (PAI) is a new metric for physical activity tracking, and is associated with reduced risk of all-cause and cardiovascular mortality. We prospectively investigated whether PAI is associated with lower body weight gain in a healthy population. METHODS We included 85,243 participants (40,037 men and 45,206 women) who participated in at least one of three waves of the Trøndelag Health Study (HUNT1: 1984-86, HUNT2: 1995-97, and HUNT3: 2006-08). We used questionnaires to estimate PAI, and linear mixed models to examine body weight according to PAI levels at three study waves. We also conducted regression analyses to assess separate relationships between change in PAI and the combined changes in PAI and physical activity recommendations, according to body weight from HUNT1 to HUNT3. FINDINGS Compared with HUNT1, body weight was 8.6 and 6.7 kg higher at HUNT3 for men and women, respectively, but was lower among those with ≥200 PAI at HUNT3. For both sexes, a change from inactive (0 PAI) at HUNT1 to ≥100 weekly PAI-score at HUNT2 and HUNT3, and a ≥100 PAI-score at all three occasions were associated with lower body weight gain, compared with the reference group (0 PAI at all three waves). Importantly, among both sexes, obtaining ≥100 weekly PAI at HUNT1 and HUNT3 was associated with lower body weight gain regardless of adhering to physical activity guidelines. INTERPRETATION Adhering to a high PAI over time may be a useful tool to attenuate excessive body weight gain in a population free from cardiovascular disease. FUNDING Norwegian Research Council and the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and technology.
Collapse
Affiliation(s)
- Sophie K. Kieffer
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
| | - Javaid Nauman
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
| | - Kari Syverud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
| | - Hege Selboskar
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| |
Collapse
|
20
|
Dalene KE, Tarp J, Selmer RM, Ariansen IKH, Nystad W, Coenen P, Anderssen SA, Steene-Johannessen J, Ekelund U. Occupational physical activity and longevity in working men and women in Norway: a prospective cohort study. LANCET PUBLIC HEALTH 2021; 6:e386-e395. [PMID: 33932334 DOI: 10.1016/s2468-2667(21)00032-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/03/2021] [Accepted: 02/12/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Studies suggest that high occupational physical activity increases mortality risk. However, it is unclear whether this association is causal or can be explained by a complex network of socioeconomic and behavioural factors. We aimed to examine the association between occupational physical activity and longevity, taking a complex network of confounding variables into account. METHODS In this prospective cohort study, we linked data from Norwegian population-based health examination surveys, covering all parts of Norway with data from the National Population and Housing Censuses and the Norwegian Cause of Death Registry. 437 378 participants (aged 18-65 years; 48·7% men) self-reported occupational physical activity (mutually exclusive groups: sedentary, walking, walking and lifting, and heavy labour) and were followed up from study entry (between February, 1974, and November, 2002) to death or end of follow-up on Dec 31, 2018, whichever came first. We estimated differences in survival time (death from all causes, cardiovascular disease, and cancer) between occupational physical activity categories using flexible parametric survival models adjusted for confounding factors. FINDINGS During a median of 28 years (IQR 25-31) from study entry to the end of follow-up, 74 203 (17·0%) of the participants died (all-cause mortality), of which 20 111 (27·1%) of the deaths were due to cardiovascular disease and 29 886 (40·3%) were due to cancer. Crude modelling indicated shorter mean survival times among men in physically active occupations than in those with sedentary occupations. However, this finding was reversed following adjustment for confounding factors (birth cohort, education, income, ethnicity, prevalent cardiovascular disease, smoking, leisure-time physical activity, body-mass index), with estimates suggesting that men in occupations characterised by walking, walking and lifting, and heavy labour had life expectancies equivalent to 0·4 (95% CI -0·1 to 1·0), 0·8 (0·3 to 1·3), and 1·7 (1·2 to 2·3) years longer, respectively, than men in the sedentary referent category. Results for mortality from cardiovascular disease and cancer showed a similar pattern. No clear differences in survival times were observed between occupational physical activity groups in women. INTERPRETATION Our results suggest that moderate to high occupational physical activity contributes to longevity in men. However, occupational physical activity does not seem to affect longevity in women. These results might inform future physical activity guidelines for public health. FUNDING The Norwegian Research Council (grant number 249932/F20).
Collapse
Affiliation(s)
- Knut Eirik Dalene
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Randi Marie Selmer
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Wenche Nystad
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.
| |
Collapse
|
21
|
Ács P, Veress R, Rocha P, Dóczi T, Raposa BL, Baumann P, Ostojic S, Pérmusz V, Makai A. Criterion validity and reliability of the International Physical Activity Questionnaire - Hungarian short form against the RM42 accelerometer. BMC Public Health 2021; 21:381. [PMID: 33892658 PMCID: PMC8062944 DOI: 10.1186/s12889-021-10372-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Physical inactivity is a global phenomenon in European welfare countries. Proper monitoring is essential to measure the physical activity level of the population. METHODS In the Hungarian cohort of the European Physical Activity and Sport Monitoring System (EUPASMOS) project, our participants (N = 598) completed sociodemographic questions and the International Physical Activity Questionnaire - short form (IPAQ-SF) survey. The validity and reliability of the subjective measurement tool were examined, IPAQ-SF outcomes were contrasted against triaxial RM42 accelerometer wore for 7 consecutive days. RESULTS The IPAQ-SF showed moderate internal consistency (Cronbach Alpha = 0.647). The concurrent validity of the IPAQ-SF to triaxial accelerometer indicated a significant weak-to-moderate correlation (R = 0.111-0.338, p = 0.042; p < 0.001). The test-retest reliability showed a significant correlation between two measurements (R = 0.788-0.981, p < 0.001). CONCLUSION The Hungarian version of the IPAQ-SF had excellent test-retest reliability, but low-to-fair concurrent validity for moderate and vigorous physical activity, walking and sitting time, as compared to the objective criterion measure among Hungarian adults.
Collapse
Affiliation(s)
- Pongrác Ács
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621 Hungary
| | - Réka Veress
- Hungarian Leisure Sport Association, Istvánmezei út 1-3, Budapest, H-1146 Hungary
| | - Paulo Rocha
- Instituto Português do Desporto e Juventud, 1990-100 Lisbon, Portugal
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1649-004 Lisbon, Portugal
| | - Tamás Dóczi
- University of Physical Education, Budapest, Hungary
| | - Bence László Raposa
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621 Hungary
| | - Petra Baumann
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621 Hungary
| | - Sergej Ostojic
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621 Hungary
| | - Viktória Pérmusz
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621 Hungary
| | - Alexandra Makai
- Faculty of Health Sciences, University of Pécs, Vörösmarty u. 4, Pécs, H-7621 Hungary
| |
Collapse
|
22
|
Allesøe K, Lau CJ, Buhelt LP, Aadahl M. Physical activity, self-rated fitness and stress among 55,185 men and women in the Danish Capital Region Health survey 2017. Prev Med Rep 2021; 22:101373. [PMID: 33868905 PMCID: PMC8044425 DOI: 10.1016/j.pmedr.2021.101373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/27/2021] [Accepted: 03/28/2021] [Indexed: 11/25/2022] Open
Abstract
Previous studies have indicated that both low physical activity and low physical fitness are associated with a higher level of stress but the influence of age and health status on the associations is unknown. This was examined in a cross-sectional study based on data from the Danish Capital Region Health Survey 2017. Among all adults ≥ 16 years residing in the largest of five regions in Denmark 1. January 2017 a random sample of 104,950 was invited to participate. Hereof, 55.185 responded (52,6%). Physical activity during leisure time, fitness, self-rated health and stress (Cohens Perceived Stress Scale) was self-reported by questionnaire. Logistic regression weighted for size of municipality and non-response was used. Age modified the associations. In all age-groups odds ratio (OR) for a high level of stress was increasingly higher the lower the level of physical activity. The association was strongest among the 16-24-year-olds and persisted after adjustment for self-rated health, that otherwise attenuated the associations to an increasing extent the older the age-group. Similar models investigating the modifying effect of age on the association between self-rated fitness and stress showed the same patterns and tendencies. This study showed that physical activity and self-rated fitness were both associated with stress. The OR for a high level of stress was increasingly higher the lower the level of physical activity or self-rated fitness. This was found in all age-groups, but most pronounced among the 16-24-year-olds. Furthermore, findings suggest that health condition explains the associations to an increasing extent with increasing age.
Collapse
Affiliation(s)
- Karen Allesøe
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.,Department of Occupational and Social Medicine, Holbæk Hospital, part of Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Lone Prip Buhelt
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1014 København K, Denmark
| |
Collapse
|
23
|
Hopstock LA, Morseth B, Cook S, Eggen AE, Grimsgaard S, Lundblad MW, Løchen ML, Mathiesen E, Nilsen A, Njølstad I. Treatment target achievement after myocardial infarction and ischaemic stroke: cardiovascular risk factors, medication use, and lifestyle: the Tromsø Study 2015-16. Eur J Prev Cardiol 2021; 29:362-370. [PMID: 33778888 DOI: 10.1093/eurjpc/zwab050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/03/2021] [Accepted: 03/12/2021] [Indexed: 12/29/2022]
Abstract
AIMS To investigate European guideline treatment target achievement in cardiovascular risk factors, medication use, and lifestyle, after myocardial infarction (MI) or ischaemic stroke, in women and men living in Norway. METHODS AND RESULTS In the population-based Tromsø Study 2015-16 (attendance 65%), 904 participants had previous validated MI and/or stroke. Cross-sectionally, we investigated target achievement for blood pressure (<140/90 mmHg, <130/80 mmHg if diabetes), LDL cholesterol (<1.8 mmol/L), HbA1c (<7.0% if diabetes), overweight (body mass index (BMI) <25 kg/m2, waist circumference women <80 cm, men <94 cm), smoking (non-smoking), physical activity (self-reported >sedentary, accelerometer-measured moderate-to-vigorous ≥150 min/week), diet (intake of fruits ≥200 g/day, vegetables ≥200 g/day, fish ≥200 g/week, saturated fat <10E%, fibre ≥30 g/day, alcohol women ≤10 g/day, men ≤20 g/day), and medication use (antihypertensives, lipid-lowering drugs, antithrombotics, and antidiabetics), using regression models. Proportion of target achievement was for blood pressure 55.2%, LDL cholesterol 9.0%, HbA1c 42.5%, BMI 21.1%, waist circumference 15.7%, non-smoking 86.7%, self-reported physical activity 79%, objectively measured physical activity 11.8%, intake of fruit 64.4%, vegetables 40.7%, fish 96.7%, saturated fat 24.3%, fibre 29.9%, and alcohol 78.5%, use of antidiabetics 83.6%, lipid-lowering drugs 81.0%, antihypertensives 75.9%, and antithrombotics 74.6%. Only 0.7% achieved all cardiovascular risk factor targets combined. Largely, there was little difference between the sexes, and in characteristics, medication use, and lifestyle among target achievers compared to non-achievers. CONCLUSION Secondary prevention of cardiovascular disease was suboptimal. A negligible proportion achieved the treatment target for all risk factors. Improvement in follow-up care and treatment after MI and stroke is needed.
Collapse
Affiliation(s)
- Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway.,Pandemic Unit, Tromsø Municipality, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sarah Cook
- Faculty of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Marie W Lundblad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Ellisiv Mathiesen
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Amalie Nilsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway.,Department of Medicine, Nordland Hospital, Bodø, Norway
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| |
Collapse
|
24
|
Jacobs CA, Mace RA, Greenberg J, Popok PJ, Reichman M, Lattermann C, Burris JL, Macklin EA, Vranceanu AM. Development of a mind body program for obese knee osteoarthritis patients with comorbid depression. Contemp Clin Trials Commun 2021; 21:100720. [PMID: 33553798 PMCID: PMC7859301 DOI: 10.1016/j.conctc.2021.100720] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/29/2020] [Accepted: 01/11/2021] [Indexed: 01/11/2023] Open
Abstract
Knee osteoarthritis (OA) is the most common joint disorder in the U.S. and a leading cause of disability. Depression and obesity are highly comorbid among knee OA patients, and the combination of obesity and depression is associated with decreased physical activity, higher pain and disability, and more rapid cartilage degradation. Depression, obesity and OA exacerbate one another and share a common pathophysiology involving systemic inflammation and pro-inflammatory cytokines, reflecting a complex mind-body interaction. Current treatments for knee OA offer little to no benefit over placebo, and do not emphasize mind-body practices or physical activity to target the underlying pathophysiology. Mind-body interventions to lessen depressive symptoms and increase physical activity offer the ability to target biological, mechanical and psychological mechanisms of OA progression. Our long-term goals are to evaluate the mechanisms by which the Relaxation Response Resiliency Program (3RP) delivered via secure telehealth, and adapted for patients with depression, obesity and knee OA (GetActive-OA) promotes increases in physical activity and improved knee health. We hypothesize that the synergistic interaction between mindfulness, adaptive thinking, positive psychology and healthy living skills of the GetActive-OA will slow the progression of symptomatic knee OA by reducing pro-inflammatory cytokine expression and promoting optimal mechanical loading of the cartilage. Here we present the protocol for a mixed methods study that will adapt the 3RP for the needs of knee OA patients with depression and obesity with a focus on increasing physical activity (GetActive-OA), and iteratively maximize the feasibility, credibility and acceptability of the programs and research procedures.
Collapse
Affiliation(s)
- Cale A. Jacobs
- Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, 740 S. Limestone, Suite K401, Lexington, 40536-0284, KY, USA
| | - Ryan A. Mace
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, 02114, MA, USA
| | - Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, 02114, MA, USA
| | - Paula J. Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, 02114, MA, USA
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, 02114, MA, USA
| | - Christian Lattermann
- Department of Orthopedic Surgery, Brigham and Women's Hospital, 850 Boylston Street, Chestnut Hill, 02467, MA, USA
| | - Jessica L. Burris
- Department of Psychology, University of Kentucky, 207K Kastle Hall, Lexington, 40506, KY, USA
| | - Eric A. Macklin
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, 02114, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 1st Floor, Suite 100, Boston, 02114, MA, USA
| |
Collapse
|
25
|
Aadahl M, Andreasen AH, Petersen CB, Gupta N, Holtermann A, Lau CJ. Should leisure-time sedentary behavior be replaced with sleep or physical activity for prevention of diabetes? Scand J Med Sci Sports 2021; 31:1105-1114. [PMID: 33462843 DOI: 10.1111/sms.13924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 12/25/2022]
Abstract
The aim was to examine the effects of replacing self-reported leisure-time sedentary behavior with sleep, light-to-moderate physical activity, or vigorous physical activity on incident diabetes among Danish adults using isotemporal substitution modeling. Participants ≥25 years from the Danish Capital Region Health Survey 2007 (N = 69 800, response rate 52.3%), 2010 (N = 95 150, response rate 52.3%), and 2013 (N = 95 150, response rate 43.5%) were included. Information on daily sleep duration, leisure-time sedentary behavior, and movement behaviors was collected by questionnaire. Information on incident diabetes was obtained from National registers. Analyses included Cox proportional hazards regression models and isotemporal substitution analyses, with time (in years) from baseline to incident diabetes or censoring December 31, 2017. Potential confounders, sex, age, BMI, ethnicity, education, smoking, inflammatory joint disease, perceived stress, physical and mental component scale and work status, were included. Out of N = 87 339 in the final study sample, n = 3007 had incident diabetes during a mean follow-up time of 7.4 years. Adults with incident diabetes included more men, higher mean age, and higher BMI, compared to respondents without incident diabetes. Theoretically substituting 30 minutes of leisure-time sedentary behavior with light-to-moderate PA (HR: 0.96; 95% CI: 0.94; 0.98) or with vigorous PA (HR: 0.82; 95% CI: 0.72; 0.94) decreased the risk of incident diabetes. We found no change in incident diabetes risk of substituting sedentary time with sleep (HR: 1.00; 95% CI: 0.97; 1.02). Substituting 30 minutes per day of leisure-time sedentary behavior with light-to-moderate or vigorous PA may significantly reduce the risk of incident diabetes among adults.
Collapse
Affiliation(s)
- Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne H Andreasen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Christina B Petersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.,National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Copenhagen, Denmark
| | - Cathrine J Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| |
Collapse
|
26
|
Concurrent Validity Between Electronically Administered Physical Activity Questionnaires and Objectively Measured Physical Activity in Danish Community-Dwelling Older Adults. J Aging Phys Act 2020; 29:595-603. [PMID: 33310928 DOI: 10.1123/japa.2020-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 11/18/2022]
Abstract
AIM To investigate the concurrent validity of the International Physical Activity Questionnaire-short form (IPAQ-SF) and the Nordic Physical Activity Questionnaire-short (NPAQ-short) when compared with objectively measured daily steps among older adults. METHODS Spearman's ρ between IPAQ-SF and NPAQ-short and objectively measured steps using Garmin Vivofit 3 physical activity monitors. RESULTS A total of 54 participants were included. The IPAQ-SF subscales' moderate physical activity (PA), moderate to vigorous PA (MVPA), and sedentary time showed little or no correlation with daily steps. The NPAQ-short subscales' vigorous PA, moderate PA, and MVPA showed little or no correlation. The IPAQ-SF subscales' vigorous PA and walking showed fair correlation. Only the IPAQ-SF metabolic equivalent of task minutes showed moderate to good correlation with daily steps. The IPAQ-SF categories and NPAQ-short categorization of World Health Organization compliance were significantly different, but the magnitudes were small and distributions indicated problems with the categorization. CONCLUSION The concurrent validity is low, as the scores did not reflect objectively measured daily steps.
Collapse
|
27
|
Årnes AP, Nielsen CS, Stubhaug A, Fjeld MK, Hopstock LA, Horsch A, Johansen A, Morseth B, Wilsgaard T, Steingrímsdóttir ÓA. Physical activity and cold pain tolerance in the general population. Eur J Pain 2020; 25:637-650. [PMID: 33165994 DOI: 10.1002/ejp.1699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The relationship between habitual physical activity (PA) and experimental pain tolerance has been investigated in small samples of young, healthy and/or single-sex volunteers. We used a large, population-based sample to assess this relationship in men and women with and without chronic pain. METHODS We used data from the sixth and seventh Tromsø Study surveys (2007-2008; 2015-2016), with assessed pain tolerance of participants with the cold pressor test (CPT: dominant hand in circulating cold water at 3°C, maximum test time 106 s), and self-reported total amount of habitual PA in leisure time (n = 19,087), exercise frequency (n = 19,388), exercise intensity (n = 18,393) and exercise duration (n = 18,343). A sub-sample had PA measured by accelerometers (n = 4,922). We used Cox regression to compare CPT tolerance times between self-reported PA levels. For accelerometer-measured PA, we estimated hazard ratios for average daily activity counts, and for average daily minutes of moderate-to-vigorous PA done in bouts lasting 10 min or more. Models were tested for PA-sex, and PA-chronic pain and PA-moderate-to-severe chronic pain interactions. RESULTS Leisure-time PA, exercise intensity and exercise duration were positively associated with CPT tolerance (p < .001; p = .011; p < .001). More PA was associated with higher CPT tolerance. At high levels of leisure-time PA and exercise intensity, men had a significantly higher CPT tolerance than women. Accelerometer-measured PA was not associated with CPT tolerance. CONCLUSIONS This study is one of the first to show that higher self-reported habitual PA was connected to higher experimental pain tolerance in a population-based sample, especially for men. This was not found for accelerometer-measured PA. SIGNIFICANCE This study finds that higher level of self-reported leisure-time physical activity is associated with increased cold pressor pain tolerance in a large population-based sample. Though present in both sexes, the association is strongest among men. Despite the robust dose-response relationship between pain tolerance and self-reported activity level, no such relationship was found for accelerometer-measured activity, reflecting a possible discrepancy in the aspect of physical activity measured. Though the study design does not permit causal conclusions, the findings suggest that increasing physical activity may increase pain tolerance in the general population.
Collapse
Affiliation(s)
- Anders P Årnes
- Department of Pain, Department of Community Medicine, University Hospital of North Norway, Tromsø, Norway.,Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christopher S Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mats K Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Alexander Horsch
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Aslak Johansen
- Department of Pain, Department of Community Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | |
Collapse
|