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Haapala EA, Leppänen MH, Lee E, Savonen K, Laukkanen JA, Kähönen M, Brage S, Lakka TA. Accumulating Sedentary Time and Physical Activity From Childhood to Adolescence and Cardiac Function in Adolescence. J Am Heart Assoc 2024; 13:e031837. [PMID: 38497441 PMCID: PMC11010014 DOI: 10.1161/jaha.123.031837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Increased physical activity (PA) may mitigate the negative cardiovascular health effects of sedentary behavior in adolescents. However, the relationship of PA and sedentary time from childhood with cardiac function in adolescence remains underexplored. Therefore, we investigated the associations of cumulative sedentary time and PA from childhood to adolescence with cardiac function in adolescence. METHODS AND RESULTS Participants were 153 adolescents (69 girls) who were aged 6 to 8 years at baseline, 8 to 10 years at 2-year follow-up, and 15 to 17 years at 8-year follow-up. Cumulative sedentary time and PA exposure between baseline and 2-year follow-up and between baseline and 8-year follow-up were measured using a combined accelerometer and heart rate monitor. Cardiac function was assessed using impedance cardiography at 8-year follow-up. The data were analyzed using linear regression analyses adjusted for age and sex. Cumulative moderate to vigorous PA (standardized regression coefficient [β]=-0.323 [95% CI, -0.527 to -0.119]) and vigorous PA (β=-0.295 [95% CI, -0.508 to -0.083]) from baseline to 8-year follow-up were inversely associated with cardiac work at 8-year follow-up. Conversely, cumulative sedentary time had a positive association (β=0.245 [95% CI, 0.092-0.398]). Cumulative vigorous PA from baseline to 8-year follow-up was inversely associated with cardiac work index at 8-year follow-up (β=-0.218 [95% CI, -0.436 to 0.000]). CONCLUSIONS Higher levels of sedentary time and lower levels of PA during childhood were associated with higher cardiac work in adolescence, highlighting the importance of increasing PA and reducing sedentary time from childhood.
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Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Marja H. Leppänen
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
- Faculty of MedicineUniversity of HelsinkiFinland
| | - Earric Lee
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Kai Savonen
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
- Department of MedicineWellbeing Services County of Central FinlandJyväskyläFinland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Soren Brage
- MRC Epidemiology UnitUniversity of Cambridge School of Clinical MedicineCambridgeUnited Kingdom
| | - Timo A. Lakka
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
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Vepsäläinen H, Korkalo L, Skaffari E, Abdollahi AM, Pajulahti R, Lehto R, Engberg E, Leppänen MH, Lehto E, Ray C, Roos E, Erkkola M. How energy balance-related behaviours, temperament, stress and overweight associate: a cross-sectional study of Finnish preschoolers. Public Health Nutr 2024; 27:e93. [PMID: 38433593 DOI: 10.1017/s1368980024000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This study aimed to (1) examine the clustering of energy balance-related behaviours (EBRB) and (2) investigate whether EBRB clusters, temperament and hair cortisol concentration (HCC) associate with overweight. DESIGN We assessed food consumption using food records, screen time (ST) using sedentary behaviour diaries, sleep consistency and temperament (negative affectivity, surgency, effortful control) using questionnaires and HCC using hair samples. Accelerometers were used to assess physical activity (PA) intensities, sleep duration and sleep efficiency. Researchers measured each child's weight and height. We used finite mixture models to identify EBRB clusters and multilevel logistic regression models to examine the associations between EBRB clusters, temperament, HCC and overweight. SETTING The cross-sectional DAGIS survey, data collected in 2015-2016. PARTICIPANTS Finnish 3-6-year-olds (n 864) recruited through preschools. RESULTS One-third of the participants were categorised into the cluster labelled 'Unhealthy diet, excessive screen time', characterised by unhealthy dietary choices (e.g. greater consumption of high-fat, high-sugar dairy products) and longer ST. Two-thirds were categorised into the second cluster, labelled 'Healthy diet, moderate screen time'. PA and sleep were irrelevant for clustering. Higher negative affectivity and lower effortful control associated with the 'Unhealthy diet, excessive screen time' cluster. EBRB clusters and HCC did not associate with overweight, but surgency was positively associated with overweight (OR = 1·63, 95 % CI 1·17, 2·25). CONCLUSIONS Of the EBRB, food consumption and ST seem to associate. As temperament associates with EBRB clusters and overweight, tailored support acknowledging the child's temperament could be profitable in maintaining a healthy weight.
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Affiliation(s)
- Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Liisa Korkalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Essi Skaffari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Riikka Pajulahti
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Elviira Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Carola Ray
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, University of Uppsala, Uppsala, Sweden
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Toivonen E, Lee E, Leppänen MH, Laitinen T, Kähönen M, Lakka TA, Haapala EA. The associations of depressive symptoms and perceived stress with arterial health in adolescents. Physiol Rep 2024; 12:e15986. [PMID: 38519264 PMCID: PMC10959692 DOI: 10.14814/phy2.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024] Open
Abstract
Cardiovascular and mental diseases are among the most important global health problems, but little is known on the associations between mental and arterial health in adolescents. Therefore, we investigated the associations of arterial health with depressive symptoms and perceived stress in adolescents. A total of 277 adolescents, 151 boys, 126 girls, aged 15-17 years participated in the study. Depressive symptoms were assessed using the Beck Depression Inventory and perceived stress by the Cohen Perceived Stress Scale. Arterial health was assessed by measures from carotid ultrasonography (carotid intima-media thickness, Young's Elastic Modulus, carotid artery distensibility, stiffness index), impedance cardiography (pulse wave velocity, cardio-ankle vascular index), and pulse contour analysis (reflection index, stiffness index). The data were analyzed using linear regression models adjusted for age and sex. Depressive symptoms or perceived stress were not associated with indices of arterial health in the whole study group (β = -0.08 to 0.09, p > 0.05), in boys (β = -0.13 to 0.10, p > 0.05) or in girls (standardized regression coefficient β = -0.16 to 0.08, p > 0.05). We found no associations of depressive symptoms and perceived stress with arterial health in adolescents. These observations suggest that the association between mental and arterial health problems develop in later life.
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Affiliation(s)
- Emmi Toivonen
- Faculty of Sports and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Earric Lee
- Faculty of Sports and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institut de Cardiologie de MontréalMontréalQCCanada
- École de kinésiologie et des sciences de l’activité physiqueUniversité de MontréalMontréalQCCanada
| | - Marja H. Leppänen
- Institute of Biomedicine, University of Eastern FinlandKuopio CampusKuopioFinland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Timo A. Lakka
- Institute of Biomedicine, University of Eastern FinlandKuopio CampusKuopioFinland
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
| | - Eero A. Haapala
- Faculty of Sports and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institute of Biomedicine, University of Eastern FinlandKuopio CampusKuopioFinland
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Abdollahi AM, Li X, Merikanto I, Leppänen MH, Vepsäläinen H, Lehto R, Ray C, Erkkola M, Roos E. Comparison of actigraphy-measured and parent-reported sleep in association with weight status among preschool children. J Sleep Res 2024; 33:e13960. [PMID: 37282765 DOI: 10.1111/jsr.13960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 04/07/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023]
Abstract
This study compared weekday and weekend actigraphy-measured and parent-reported sleep in relation to weight status among preschool-aged children. Participants were 3-6 years old preschoolers from the cross-sectional DAGIS-study with sleep data for ≥2 weekday and ≥2 weekend nights. Parents-reported sleep onset and wake-up times were gathered alongside 24 h hip-worn actigraphy. An unsupervised Hidden-Markov Model algorithm provided actigraphy-measured night time sleep without the guidance of reported sleep times. Waist-to-height ratio and age-and-sex-specific body mass index characterised weight status. Comparison of methods were assessed with consistency in quintile divisions and Spearman correlations. Associations between sleep and weight status were assessed with adjusted regression models. Participants included 638 children (49% girls) with a mean ± SD age of 4.76 ± 0.89. On weekdays, 98%-99% of actigraphy-measured and parent-reported sleep estimates were classified in the same or adjacent quintile and were strongly correlated (rs = 0.79-0.85, p < 0.001). On weekends, 84%-98% of actigraphy-measured and parent-reported sleep estimates were respectively classified and correlations were moderate to strong (rs = 0.62-0.86, p < 0.001). Compared with actigraphy-measured sleep, parent-reported sleep had consistently earlier onset, later wake-up, and greater duration. Earlier actigraphy-measured weekday sleep onset and midpoint were associated with a higher body mass index (respective β-estimates: -0.63, p < 0.01 and -0.75, p < 0.01) and waist-to-height ratio (-0.004, p = 0.03 and -0.01, p = 0.02). Though the sleep estimation methods were consistent and correlated, actigraphy measures should be favoured as they are more objective and sensitive to identifying associations between sleep timing and weight status compared with parent reports.
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Affiliation(s)
- Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China
| | - Ilona Merikanto
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Marja H Leppänen
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Reetta Lehto
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Carola Ray
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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Peltonen H, Erkkola M, Abdollahi AM, Leppänen MH, Roos E, Sajaniemi N, Pajari AM, Vepsäläinen H. Associations of dietary patterns with common infections and antibiotic use among Finnish preschoolers. Food Nutr Res 2023; 67:8997. [PMID: 37351020 PMCID: PMC10284098 DOI: 10.29219/fnr.v67.8997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/20/2023] [Accepted: 05/08/2023] [Indexed: 06/24/2023] Open
Abstract
Background Preschoolers suffer frequently from infections. Although nutrition plays a key role in immune function, very little is known about the impact of overall diet on preschoolers' infections. Objective To assess the associations between dietary patterns, common infections and antibiotic use among Finnish preschoolers. Design The study included 721 3-6-year-old preschoolers participating in the cross-sectional DAGIS survey. Parents retrospectively reported the number of common colds, gastroenteritis episodes and antibiotic courses their children had acquired during the past year. Food consumption outside preschool hours was recorded using a food frequency questionnaire. Dietary patterns were derived from the consumption frequencies using principal component analysis. Associations between the thirds of the dietary pattern scores and the outcomes were analysed using logistic and negative binomial regression models. Results Prevalence of common colds was lower in moderate and high adherence to the sweets-and-treats pattern than in low adherence (prevalence ratio [PR]: 0.89, 95% confidence interval [CI]: 0.80-1.00, and PR: 0.88, 95% CI: 0.79-0.99, respectively) and higher in high adherence to the health-conscious pattern than in low adherence (PR: 1.13, 95% CI: 1.01-1.27) after adjusting for age, sex, number of children living in the same household, frequency of preschool attendance, family's highest education and probiotic use. The risk of ≥1 gastroenteritis episode and the prevalence of antibiotic courses were lower in moderate adherence to the sweets-and-treats pattern than in low adherence (odds ratio [OR]: 0.63, 95% CI: 0.44-0.92 and PR: 0.77, 95% CI: 0.59-1.00, respectively). Conclusions The results were unexpected. Parents who were most health-conscious of their children's diet might also have been more aware of their children's illness.
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Affiliation(s)
- Henna Peltonen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anna M. Abdollahi
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Marja H. Leppänen
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Nina Sajaniemi
- Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Anne-Maria Pajari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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6
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Burnett AJ, Ray C, Lehto R, Leppänen MH, Sajaniemi N, Erkkola M, Roos E. The role of parental congruence in pre-school children's screen time, moderated by parental education. Acta Paediatr 2023. [PMID: 37002868 DOI: 10.1111/apa.16782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/11/2023]
Abstract
AIM This study investigated whether parental congruency regarding screen time (ST) is associated with ST in pre-school children. In addition, we investigated whether parental education levels moderated this relationship. METHODS A cross-sectional study was conducted in 2015-2016 in Finland (N = 688). Parents completed a questionnaire reporting their children's sedentary behaviour, their parental congruency regarding ST rules, and their educational level. Associations were examined using linear regression. RESULTS Children of parents with higher congruence regarding ST rules engaged in less ST, this was moderated by parental education levels. Children whose parents had a high level of education and parents' who strongly agree or somewhat agree on ST rules was negatively associated with ST. Furthermore, children whose parents had a medium level of education and parents' who strongly agree on ST rules was negatively associated with ST. CONCLUSION Children of parents who agree on ST rules engaged in less ST compared with children of parents who do not agree on ST rules. Providing advice to parents regarding parental congruency could be the focus of future interventions.
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Affiliation(s)
- Alissa J Burnett
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Carola Ray
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Reetta Lehto
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | - Nina Sajaniemi
- Department of Teacher Education, University of Helsinki, Helsinki, Finland
- Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, Kuopio, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
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Haapala EA, Kuronen E, Ihalainen JK, Lintu N, Leppänen MH, Tompuri T, Atalay M, Schwab U, Lakka TA. Cross-sectional associations between physical fitness and biomarkers of inflammation in children-The PANIC study. Scand J Med Sci Sports 2023; 33:1000-1009. [PMID: 36779507 DOI: 10.1111/sms.14337] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND Systemic low-grade inflammation has been proposed as an underlying pathophysiological mechanism for cardiometabolic diseases. We investigated the associations of physical fitness with a systemic low-grade inflammatory state in a population sample of children. METHODS Altogether 391 children aged 6-9 years were examined. Cardiorespiratory fitness (maximal power output, Wmax ) was assessed by a maximal cycle ergometer test and neuromuscular fitness by hand grip strength, sit-up, standing long jump, 50-meter shuttle run, static balance, sit-and-reach, and box and block tests. Body fat percentage (BF%) and lean mass (LM) were assessed by dual-energy X-ray absorptiometry (DXA). High sensitivity C-reactive protein (hs-CRP), leptin, leptin receptor, high molecular weight adiponectin (HMW-adiponectin), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and glycoprotein acetyls (GlycA) were assessed from fasting blood samples. The modified inflammatory score (IS) was calculated using the population-specific z-scores and formula (z hs-CRP + z leptin + z IL-6 + z TNF-α + z GlycA)-z leptin receptor-z HMW-adiponectin. The data were analyzed using linear regression analyses. RESULTS Higher Wmax /kg of body mass (β = -0.416, 95% CI = -0.514 to -0.318), higher number of completed sit-ups (β = -0.147, 95% CI = -0.244 to -0.049), a longer distance jumped in the standing long jump test (β = -0.270, 95% CI = -0.371 to -0.169), and a shorter time in the 50-meter shuttle run test (β = 0.123, 95% CI = 0.022 to 0.223) were associated with lower IS. None of these associations remained statistically significant after adjustment for BF%. CONCLUSIONS Higher physical fitness is associated with a more favorable inflammatory biomarker profile in children. However, the associations were explained by BF%.
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Affiliation(s)
- Eero A Haapala
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Emmi Kuronen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Johanna K Ihalainen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Marja H Leppänen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Tuomo Tompuri
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Migueles JH, Delisle Nyström C, Dumuid D, Leppänen MH, Henriksson P, Löf M. Longitudinal associations of movement behaviours with body composition and physical fitness from 4 to 9 years of age: structural equation and mediation analysis with compositional data. Int J Behav Nutr Phys Act 2023; 20:11. [PMID: 36750838 PMCID: PMC9903529 DOI: 10.1186/s12966-023-01417-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/27/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The associations of movement behaviours (physical activity [PA], sedentary behaviour [SB], and sleep) with body composition and physical fitness from pre-school to childhood, as well as the direction of the associations, could provide important information for healthy lifestyle promotion in children. This study investigated the longitudinal and bidirectional associations of movement behaviours with body composition and physical fitness measured at 4 and 9 years of age. METHODS This longitudinal study included baseline (n = 315, 4.5 [SD = 0.1] years) and follow-up data (n = 231, 9.6 [SD = 0.1] years) from the MINISTOP study. Movement behaviours were measured for 7 days using wrist-worn accelerometers, body composition with air-displacement plethysmography, and physical fitness with the ALPHA health-related fitness test battery. Cross-lagged panel models and mediation analyses were performed in combination with compositional data analysis. RESULTS We did not observe direct associations of the movement behaviours at 4 years with either body composition or physical fitness at 9 years (all P > 0.05). However, fat mass index at 4 years was negatively associated with vigorous PA (VPA), relative to remaining behaviours (VPA, β = - 0.22, P = 0.002) and light PA (LPA), relative to SB and sleep (β = - 0.19, P = 0.016) at 9 years. VPA (relative to remaining), moderate PA (MPA) (relative to LPA, SB, and sleep), and SB (relative to sleep) tracked from 4 to 9 years (all β ≥ 0.17, all P < 0.002), and these behaviours shared variance with fat mass index (all|β| ≥ 0.19, all P < 0.019), and aerobic, motor, and muscular fitness (all|β| ≥ 0.19, all P < 0.014) at 9 years. Mediation analysis suggested that the tracking of VPA (relative to remaining behaviours) from 4 to 9 years was negatively associated with fat mass index (β ≥ - 0.45, P = 0.012), and positively with aerobic fitness at 9 years (β ≥ 1.64, P = 0.016). CONCLUSION PA and SB tracked from the pre-school years into childhood. Fat mass index at 4 years of age was negatively associated with VPA (relative to remaining behaviours) and LPA (relative to SB and sleep) at 9 years of age. The tracking of VPA was associated with lower fat mass index and higher aerobic fitness at 9 years of age. These findings suggest that higher levels of VPA in pre-school age, if maintained throughout childhood, may support the development of healthy body composition and aerobic fitness levels in later childhood.
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Affiliation(s)
- Jairo H. Migueles
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden ,grid.4489.10000000121678994PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Christine Delisle Nyström
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden
| | - Dorothea Dumuid
- grid.1026.50000 0000 8994 5086Alliance for Research in Exercise, Nutrition and Activity, Allied Health & Human Performance, University of South Australia, Adelaide, SA Australia ,grid.1026.50000 0000 8994 5086University of South Australia, Adelaide, SA Australia
| | - Marja H. Leppänen
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Pontus Henriksson
- grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Marie Löf
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden ,grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
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9
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Lehto R, Vepsäläinen H, Lehtimäki AV, Lehto E, Leppänen MH, Skaffari E, Abdollahi AM, Roos E, Erkkola M, Ray C. Effects of the DAGIS randomized controlled trial on home environment and children's food consumption according to the degree of implementation. BMC Public Health 2022; 22:2268. [PMID: 36471322 PMCID: PMC9720976 DOI: 10.1186/s12889-022-14639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/05/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Combining process evaluation data with effectiveness data and examining the possible mediators of intervention effects elicits valuable knowledge about how and for whom these interventions are effective. The aim of this study was to examine whether the parental degree of implementation (DOI) of a home-involving preschool intervention affected children's food consumption via home mediators. METHODS The five-month Increased Health and Wellbeing in Preschools (DAGIS) intervention involved 476 participating children aged 3-6 years and was conducted in 2017-2018. Parents reported children's food consumption (g/day) outside childcare hours, the availability of foods at home, role modelling of food consumption, and the norms related to food consumption. In addition, parents reported the extent to which they had implemented the intervention program at home. Mediation analyses were conducted to examine the effect of low and high DOI compared to control group on the change in children's consumption of fruit and vegetables (FV), sugary everyday foods, sugary treats, and sugar-sweetened beverages (SSB) via food availability in the home, parental role modelling and parental norms. RESULTS Compared to the control group, there was a direct effect of a high DOI on diminishing consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No indirect effects were detected. In the high DOI group, a change in parental norm was associated with increased FV consumption showing an indirect effect (B 4.31, 95% CI 0.23, 10.59). In the low DOI group, there was an indirect effect via decreased food availability leading to decreased sugary everyday food consumption (B -2.17, 95% CI -5.09, -0.09). CONCLUSIONS Combining process evaluation and effectiveness data revealed a decrease in children's SSB consumption only in the high DOI group, as well as indirect effects on children's consumption of FV and sugary everyday foods. In order to gain more intervention effects, further studies are required in order to examine parental facilitators and barriers to the implementation of interventions and how to impact effectively the determinants of the targeted behavior. TRIAL REGISTRATION ISRCTN57165350 (8 January, 2015).
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Affiliation(s)
- Reetta Lehto
- grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
| | - Henna Vepsäläinen
- grid.7737.40000 0004 0410 2071Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
| | - Aku-Ville Lehtimäki
- grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland
| | - Elviira Lehto
- grid.7737.40000 0004 0410 2071Faculty of Social Sciences, Department of Sociology, University of Helsinki, P.O. Box, 00014 Helsinki, Finland ,grid.7737.40000 0004 0410 2071Faculty of Educational Sciences, Department of Teacher Education, University of Helsinki, P.O. Box 9, 00014 Helsinki, Finland
| | - Marja H. Leppänen
- grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland ,grid.7737.40000 0004 0410 2071Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Essi Skaffari
- grid.7737.40000 0004 0410 2071Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
| | - Anna M. Abdollahi
- grid.7737.40000 0004 0410 2071Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
| | - Eva Roos
- grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland ,grid.7737.40000 0004 0410 2071Faculty of Medicine, University of Helsinki, Helsinki, Finland ,grid.8993.b0000 0004 1936 9457Department of food studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Maijaliisa Erkkola
- grid.7737.40000 0004 0410 2071Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
| | - Carola Ray
- grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Food and Nutrition, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
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10
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Lehto R, Vepsäläinen H, Lehtimäki AV, Lehto E, Leppänen MH, Skaffari E, Abdollahi A, Roos E, Erkkola M, Ray C. Implementation, home mediators and children’s sugary drink consumption - results from DAGIS study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and objectives
The effectiveness of a health behavior intervention can depend on the extent to which the intervention is implemented; higher degree of implementation (DOI) might associate with larger intervention effects. This study examined whether the parental DOI of an health behavior intervention had an effect on children's consumption of sugar-sweetened beverages (SSB) and was the effect mediated by home factors.
Methods
the DAGIS preschool intervention was conducted in 2017-2018 in Finland among 3-6-year-olds with valid data from 476 children. At baseline and follow-up parents reported 1) children's SSB consumption in a semi-quantified food frequency questionnaire, 2) availability of SSB at home, parental role modelling of drinking SSB, and norm (parental view on the suitable amount of SSB for children), and 3) DOI: a dichotomized sum variable on several aspects of parental program implementation. In the analyses, high and low DOI were compared to control group. Mediation analysis of the effect of DOI on the change in children's SSB consumption via change in availability, role modelling and norm was conducted with R statistical software.
Results
High DOI was associated with reduced consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No mediated effects were found. All studied mediators impacted the change in SSB consumption, but the DOI had no effect on the change in mediators.
Conclusions
Intervention effect on the consumption of SSB was only found in the high DOI group, which supports the importance of assessing intervention implementation. Since the found effect was not mediated by the studied mediators, other possible mediators should be examined, as understanding intervention mediators is crucial in developing successful interventions.
Key messages
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Affiliation(s)
- R Lehto
- Folkhälsan Research Center , Helsinki, Finland
| | - H Vepsäläinen
- Department of Food and Nutrition, University of Helsinki , Helsinki, Finland
| | | | - E Lehto
- Department of Sociology, University of Helsinki , Helsinki, Finland
| | - MH Leppänen
- Folkhälsan Research Center , Helsinki, Finland
- Faculty of Medicine, University of Helsinki , Helsinki, Finland
| | - E Skaffari
- Department of Food and Nutrition, University of Helsinki , Helsinki, Finland
| | - A Abdollahi
- Department of Food and Nutrition, University of Helsinki , Helsinki, Finland
| | - E Roos
- Department of Food Studies, Nutrition and Dietetics, Uppsala University , Uppsala, Sweden
- Folkhälsan Research Center , Helsinki, Finland
| | - M Erkkola
- Department of Food and Nutrition, University of Helsinki , Helsinki, Finland
| | - C Ray
- Folkhälsan Research Center , Helsinki, Finland
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11
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Migueles JH, Delisle Nyström C, Leppänen MH, Henriksson P, Löf M. Revisiting the cross-sectional and prospective association of physical activity with body composition and physical fitness in preschoolers: A compositional data approach. Pediatr Obes 2022; 17:e12909. [PMID: 35212168 PMCID: PMC9539596 DOI: 10.1111/ijpo.12909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/18/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Information is limited for the benefits of physical activity (PA) in preschoolers. Previous research using accelerometer-assessed PA may be affected for multicollinearity issues. OBJECTIVES This study investigated the cross-sectional and prospective associations of sedentary behaviour (SB) and PA with body composition and physical fitness using compositional data analysis. METHODS Baseline PA and SB were collected in 4-year-old (n = 315) using wrist-worn GT3X+ during seven 24 h-periods. Body composition (air-displacement plethysmography) and physical fitness (PREFIT test battery) were assessed at baseline and at the 12-month follow-up. RESULTS Increasing vigorous PA at expenses of lower-intensity behaviours for 4-year-old was associated with body composition and physical fitness at cross-sectional and longitudinal levels. For example, reallocating 15 min/day from lower intensities to vigorous PA at baseline was associated with higher fat-free mass index (+0.45 kg/m2 , 95% confidence intervals [CI]: 0.18-0.72 kg/m2 ), higher upper-body strength (+0.6 kg, 95% CI: 0.1-1.19 kg), higher lower-body strength (+8 cm, 95% CI: 3-13 cm), and shorter time in completing the motor fitness test (-0.4 s, 95% CI: -0.82 to [-0.01] s) at the 12-month follow-up. Pairwise reallocations of time indicated that the behaviour replaced was not relevant, as long as vigorous PA was increased. CONCLUSIONS More time in vigorous PA may imply short- and long-term benefits on body composition and physical fitness in preschoolers. These findings using compositional data analysis corroborate our previously published results using isotemporal substitution models.
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Affiliation(s)
- Jairo H. Migueles
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden,PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport SciencesUniversity of GranadaGranadaSpain,Department of Biosciences and NutritionKarolinska InstitutetHuddingeSweden
| | | | - Marja H. Leppänen
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland,Folkhälsan Research CenterHelsinkiFinland
| | - Pontus Henriksson
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Marie Löf
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden,Department of Biosciences and NutritionKarolinska InstitutetHuddingeSweden
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12
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Leppänen MH, Migueles JH, Abdollahi AM, Engberg E, Ortega FB, Roos E. Comparing estimates of physical activity in children across different cut-points and the associations with weight status. Scand J Med Sci Sports 2022; 32:971-983. [PMID: 35253276 PMCID: PMC9311199 DOI: 10.1111/sms.14147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to compare sedentary time (SED) and intensity-specific physical activity (PA) estimates and the associations of SED and PA with body mass index (BMI) and waist circumference (WC) using three different sets of cut-points in preschool-aged children. A total of 751 children (4.7 ± 0.9 years, boys 52.7%) wore an ActiGraph GT3X+BT accelerometer on their hip for 7 days (24 h). Euclidean norm -1 G with negative values rounded to zero (ENMO) and activity counts from vertical axis (VACounts) and vector magnitude (VMCounts) were derived. Estimates of SED and light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were calculated for commonly used cut-points by Hildebrand et al., Butte et al., and Evenson et al. Furthermore, the prevalence of meeting the PA recommendation, 180 min/day of which at least 60 min/day being MVPA, were assessed for the cut-points. Multilevel mixed analysis was used to examine associations of SED and PA with BMI and WC. In accordance with the results, SED and PA intensity estimates differed largely across cut-points (i.e., SED = 22-341 min/day; light PA = 52-257 min/day; moderate PA = 5-18 min/day; vigorous PA = 7-17 min/day; MVPA = 13-35 min/day), and the prevalence of children meeting the PA recommendation varied from 4% to 70%. Associations of SED and PA with BMI or WC varied between the cut-points. Our results indicate that SED and PA estimates in preschool-aged children between studies using these cut-points are poorly comparable. Methods facilitating accelerometer-derived PA estimate comparison between studies are highly warranted.
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Affiliation(s)
- Marja H Leppänen
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jairo H Migueles
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Anna M Abdollahi
- Folkhälsan Research Center, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Huddinge, Sweden
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland.,Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.,Department of Public Health, University of Helsinki, Helsinki, Finland
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Haapala EA, Väistö J, Ihalainen JK, González CT, Leppänen MH, Veijalainen A, Sallinen T, Eloranta AM, Ekelund U, Schwab U, Brage S, Atalay M, Lakka TA. Associations of physical activity, sedentary time, and diet quality with biomarkers of inflammation in children. Eur J Sport Sci 2022; 22:906-915. [PMID: 33599556 DOI: 10.1080/17461391.2021.1892830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We investigated the associations of physical activity (PA), sedentary time (ST), and diet quality with biomarkers of inflammation in 390 children (192 girls, 198 boys) aged 6-8 years. PA energy expenditure (PAEE), light PA, moderate PA (MPA), vigorous PA (VPA), moderate-to-vigorous PA (MVPA), and ST were assessed by combined movement and heart rate sensor. Finnish Children Healthy Eating Index was calculated using data from 4 d food records. Body fat percentage (BF%) was measured by dual-energy X-ray absorptiometry. High-sensitivity C-reactive protein (Hs-CRP), leptin, interleukin-6 (IL-6), adiponectin, tumour necrosis factor-α, and glycoprotein acetyls were measured from fasting blood samples. PAEE, MPA, VPA, and MVPA were inversely associated with hs-CRP (β=-191 to -139, 95% CI=-0.294 to -0.024), leptin (β=-0.409 to -0.301, 95% CI=-0.499 to -0.107), IL-6 (β=-0.136 to -0.104, 95% CI=-0.240 to -0.001) and PAEE, MPA, and MVPA were inversely associated with glycoprotein acetyls (β=-0.117 to -0.103, 95% CI=-0.213 to -0.001). ST was directly associated with hs-CRP (β=0.170, 95% CI=0.070-0.269), leptin (β=0.355, 95% CI=0.265-0.445), and IL-6 (β=0.105, 95% CI=0.005-0.205). VPA was inversely associated with hs-CRP, leptin, and IL-6 in children with higher BF% (β=-0.344 to -0.181, 95% CI=-0.477 to -0.033) but not among children with lower BF% (β=-0.007-0.033, 95% CI=-0.183-0.184). In conclusion, PA was inversely and ST directly associated with circulating levels of biomarkers of inflammation among children. Furthermore, we observed that PA was inversely associated with these biomarkers for inflammation in children with a higher BF%. HighlightsSystemic inflammation, as indicated by increased circulating concentrations of biomarkers for inflammation, may be important in causal pathways leading to insulin resistance, sub-clinical atherosclerosis, and eventually clinical manifestations of cardiovascular diseases.Higher levels of physical activity and lower levels of sedentary time were associated with more favourable inflammatory profile.Body fat percentage modified these associations and especially vigorous intensity physical activity was inversely associated with biomarkers of inflammation on children with higher body fat percentage but not in children with lower body fat percentage.
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Affiliation(s)
- Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Johanna K Ihalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Swedish Winter Sports Research Centre, Mid Sweden University, Sweden
| | | | - Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Aapo Veijalainen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Taisa Sallinen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aino-Maija Eloranta
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ulf Ekelund
- Norwegian School of Sports Science, Oslo, Norway
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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14
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Haapala EA, Leppänen MH, Lehti M, Lintu N, Tompuri T, Viitasalo A, Schwab U, Lakka TA. Cross-sectional associations between cardiorespiratory fitness and NMR-derived metabolic biomarkers in children - the PANIC study. Front Endocrinol (Lausanne) 2022; 13:954418. [PMID: 36213296 PMCID: PMC9538338 DOI: 10.3389/fendo.2022.954418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Cardiorespiratory fitness has been inversely associated with cardiovascular risk across the lifespan. Some studies in adults suggest that higher cardiorespiratory fitness is associated with cardioprotective metabolite profile, but the evidence in children is lacking. Therefore, we investigated the cross-sectional association of cardiorespiratory fitness with serum nuclear magnetic resonance derived metabolic biomarkers in children. METHODS A population sample of 450 children aged 6-8 years was examined. Cardiorespiratory fitness was assessed by a maximal exercise test on a cycle ergometer and quantified as maximal power output normalised for lean body mass assessed by dual-energy X-ray absorbtiometry. Serum metabolites were assessed using a high throughput nuclear magnetic resonance platform. The data were analysed using linear regression analyses adjusted for age and sex and subsequently for body fat percentage (BF%) assessed by DXA. RESULTS Cardiorespiratory fitness was directly associated with high density lipoprotein (HDL) cholesterol (β=0.138, 95% CI=0.042 to 0.135, p=0.005), average HDL particle diameter (β=0.102, 95% CI=0.004 to 0.199, p=0.041), and the concentrations of extra-large HDL particles (β=0.103, 95% CI=0.006 to 0.201, p=0.038), large HDL particles (β=0.122, 95% CI=0.025 to 0.220, p=0.014), and medium HDL particles (β=0.143, 95% CI=0.047 to 0.239, p=0.004) after adjustment for age and sex. Higher cardiorespiratory fitness was also associated with higher concentrations of ApoA1 (β=0.145, 95% CI=0.047 to 0.242, p=0.003), glutamine (β=0.161, 95% CI=0.064 to 0.257, p=0.001), and phenylalanine (β=0.187, 95% CI=0.091 to 0.283, p<0.001). However, only the direct associations of cardiorespiratory fitness with the concentrations of HDL cholesterol (β=0.114, 95% CI=0.018 to 0.210, p=0.021), medium HDL particles (β=0.126, 95% CI=0.030 to 0.223, p=0.010), ApoA1 (β=0.126, 95% CI=0.030 to 0.223, p=0.011), glutamine (β=0.147, 95% CI=0.050 to 0.224, p=0.003), and phenylalanine (β=0.217, 95% CI=0.122 to 0.311, p<0.001) remained statistically significant after further adjustment for BF%. CONCLUSIONS Higher cardiorespiratory fitness was associated with a cardioprotective biomarker profile in children. Most associations were independent of BF% suggesting that the differences in serum metabolites between children are driven by cardiorespiratory fitness and not adiposity.
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Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- *Correspondence: Eero A. Haapala,
| | - Marja H. Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Maarit Lehti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tuomo Tompuri
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Timo A. Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Leppänen MH, Haapala EA, Väistö J, Ekelund U, Brage S, Kilpeläinen TO, Lakka TA. Longitudinal and cross-sectional associations of adherence to 24-hour movement guidelines with cardiometabolic risk. Scand J Med Sci Sports 2021; 32:255-266. [PMID: 34644434 DOI: 10.1111/sms.14081] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 12/11/2022]
Abstract
This study aimed to examine (1) adherence to 24 h movement guidelines over a 2 years follow-up in children aged 6-8 years and (2) association of this adherence with cardiometabolic risk factors. Physical activity and sleep were assessed by a monitor combining heart rate and accelerometry measurements. Screen time was reported by the parents. Body fat percentage, waist circumference, blood glucose, serum insulin, plasma lipids, and blood pressure were assessed, and a cardiometabolic risk score was calculated using z-scores. Children were classified as meeting the guidelines if they had on average ≥60 min/day of moderate-to-vigorous physical activity during the valid days; ≤120 min/day of screen time; and 9-11 h/day of sleep. In total, 485 children had valid data at baseline or at 2 years follow-up. Analyses were conducted using adjusted logistic and linear regression models. Most children adhered to the 24 h movement guidelines at baseline, but the adherence decreased over the 2 years follow-up. Meeting physical activity guidelines individually, or in combination with screen time and/or sleep, was longitudinally associated with a lower cardiometabolic risk score, insulin and waist circumference, and cross-sectionally additionally with lower diastolic blood pressure and higher high-density lipoprotein cholesterol. However, these associations became statistically non-significant after adjustment for body fat. In conclusion, meeting 24 h movement guidelines at baseline increases the odds of meeting them at 2 years follow-up in school-aged children. Furthermore, meeting 24 h movement guidelines is associated with lower levels of cardiometabolic risk factors, but these associations are partly explained by lower body fat. Thus, promoting movement behaviors, especially physical activity, and healthy weight in early childhood is important in supporting cardiometabolic health in children.
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Affiliation(s)
- Marja H Leppänen
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ulf Ekelund
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.,Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Tuomas O Kilpeläinen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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16
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Henriksson P, Sandborg J, Söderström E, Leppänen MH, Snekkenes V, Blomberg M, Ortega FB, Löf M. Associations of body composition and physical fitness with gestational diabetes and cardiovascular health in pregnancy: Results from the HealthyMoms trial. Nutr Diabetes 2021; 11:16. [PMID: 34099629 PMCID: PMC8184768 DOI: 10.1038/s41387-021-00158-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to examine associations of body composition (fat mass index, % fat mass, fat-free mass index, body mass index) and physical fitness (cardiorespiratory fitness and handgrip strength) with gestational diabetes and cardiovascular health in early pregnancy. This cross-sectional study utilized baseline data (n = 303) collected in early pregnancy from the HealthyMoms trial. Body composition was measured using air-displacement plethysmography, cardiorespiratory fitness was assessed by means of the 6-min walk test and handgrip strength using a dynamometer. Logistic regression was used to estimate odds ratios (ORs) for gestational diabetes as well as high (defined as 1 SD above the mean) blood pressure, homeostatic model assessment for insulin resistance (HOMA-IR), and metabolic syndrome score (MetS score) per 1 SD increase in body composition and fitness variables. Fat mass index, % fat mass and body mass index were all strongly associated with gestational diabetes (ORs: 1.72–2.14, P ≤ 0.003), HOMA-IR (ORs: 3.01–3.80, P < 0.001), blood pressure (ORs: 1.81–2.05, P < 0.001) and MetS score (ORs: 3.29–3.71, P < 0.001). Associations with fat-free mass index were considerably weaker (ORs: 1.26–1.82, P = 0.001–0.15) and were strongly attenuated after adjustments for fat mass index (ORs: 0.88–1.54, P = 0.039–0.68). Finally, greater cardiorespiratory fitness was associated with lower risk of high HOMA-IR and MetS score (ORs: 0.57–0.63, P ≤ 0.004) although these associations were attenuated when accounting for fat mass index (ORs: 1.08-1.11, P ≥ 0.61). In conclusion, accurately measured fat mass index or % fat mass were strongly associated with gestational diabetes risk and markers of cardiovascular health although associations were not stronger than the corresponding ones for body mass index. Fat-free mass index had only weak associations with gestational diabetes and cardiovascular health which support that the focus during clinical care would be on excess fat mass and not fat-free mass.
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Affiliation(s)
- Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Johanna Sandborg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marja H Leppänen
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Victoria Snekkenes
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Francisco B Ortega
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden.,PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health, University of Granada, Granada, Spain
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
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Leppänen MH, Kaseva K, Pajulahti R, Sääksjärvi K, Mäkynen E, Engberg E, Ray C, Erkkola M, Sajaniemi N, Roos E. Temperament, physical activity and sedentary time in preschoolers - the DAGIS study. BMC Pediatr 2021; 21:129. [PMID: 33726712 PMCID: PMC7962366 DOI: 10.1186/s12887-021-02593-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Identifying individual characteristics linked with physical activity (PA) and sedentary time (SED) can assist in designing health-enhancing interventions for children. We examined cross-sectional associations of temperament characteristics with 1) PA and SED and 2) meeting the PA recommendation in Finnish children. Methods Altogether, 697 children (age: 4.7 ± 0.9 years, 51.6% boys) within the Increased Health and Wellbeing in Preschools (DAGIS) study were included. Parents responded to the Very Short Form of the Children’s Behavior Questionnaire consisting of three temperament dimensions: surgency, negative affectivity, and effortful control. PA and SED were assessed for 7 days (24 h per day) using a hip-worn ActiGraph accelerometer, and the daily minutes spent in light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and SED were calculated. The PA recommendation was defined as having PA at least 180 min/day, of which at least 60 min/day was in moderate-to-vigorous PA. Adjusted linear and logistic regression analyses were applied. Results Surgency was associated with LPA (B = 3.80, p = 0.004), MPA (B = 4.87, p < 0.001), VPA (B = 2.91, p < 0.001), SED (B = − 11.45, p < 0.001), and higher odds of meeting the PA recommendation (OR = 1.56, p < 0.001). Effortful control was associated with MPA (B = − 3.63, p < 0.001), VPA (B = − 2.50, p < 0.001), SED (B = 8.66, p < 0.001), and lower odds of meeting the PA recommendation (OR = 0.61, p = 0.004). Negative affectivity was not associated with PA, SED, or meeting the PA recommendation. Conclusion Children’s temperament should be considered when promoting PA in preschoolers. Special attention should be paid to children scoring high in the temperament dimension effortful control.
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Affiliation(s)
- Marja H Leppänen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland. .,Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Kaisa Kaseva
- Cicero Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland.,Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland
| | - Riikka Pajulahti
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Katri Sääksjärvi
- Cicero Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland.,Department of Education, University of Helsinki, Helsinki, Finland
| | - Ella Mäkynen
- Cicero Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland.,Department of Education, University of Helsinki, Helsinki, Finland
| | - Elina Engberg
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Education, University of Helsinki, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Nina Sajaniemi
- Cicero Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland.,Department of Education, University of Helsinki, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.,Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland.,Department of Public Health Clinicum, University of Helsinki, Helsinki, Finland
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18
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Sandborg J, Söderström E, Henriksson P, Bendtsen M, Henström M, Leppänen MH, Maddison R, Migueles JH, Blomberg M, Löf M. Effectiveness of a Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e26091. [PMID: 33704075 PMCID: PMC7995071 DOI: 10.2196/26091] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/19/2021] [Accepted: 02/04/2021] [Indexed: 02/06/2023] Open
Abstract
Background Excessive gestational weight gain (GWG) during pregnancy is a major public health concern associated with negative health outcomes for both mother and child. Scalable interventions are needed, and digital interventions have the potential to reach many women and promote healthy GWG. Most previous studies of digital interventions have been small pilot studies or have not included women from all BMI categories. We therefore examined the effectiveness of a smartphone app in a large sample (n=305) covering all BMI categories. Objective To investigate the effectiveness of a 6-month intervention (the HealthyMoms app) on GWG, body fatness, dietary habits, moderate-to-vigorous physical activity (MVPA), glycemia, and insulin resistance in comparison to standard maternity care. Methods A 2-arm parallel randomized controlled trial was conducted. Women in early pregnancy at maternity clinics in Östergötland, Sweden, were recruited. Eligible women who provided written informed consent completed baseline measures, before being randomized in a 1:1 ratio to either an intervention (n=152) or control group (n=153). The control group received standard maternity care while the intervention group received the HealthyMoms smartphone app for 6 months (which includes multiple features, eg, information; push notifications; self-monitoring; and feedback features for GWG, diet, and physical activity) in addition to standard care. Outcome measures were assessed at Linköping University Hospital at baseline (mean 13.9 [SD 0.7] gestational weeks) and follow-up (mean 36.4 [SD 0.4] gestational weeks). The primary outcome was GWG and secondary outcomes were body fatness (Bod Pod), dietary habits (Swedish Healthy Eating Index) using the web-based 3-day dietary record Riksmaten FLEX, MVPA using the ActiGraph wGT3x-BT accelerometer, glycemia, and insulin resistance. Results Overall, we found no statistically significant effect on GWG (P=.62); however, the data indicate that the effect of the intervention differed by pre-pregnancy BMI, as women with overweight and obesity before pregnancy gained less weight in the intervention group as compared with the control group in the imputed analyses (–1.33 kg; 95% CI –2.92 to 0.26; P=.10) and completers-only analyses (–1.67 kg; 95% CI –3.26 to –0.09; P=.031]). Bayesian analyses showed that there was a 99% probability of any intervention effect on GWG among women with overweight and obesity, and an 81% probability that this effect was over 1 kg. The intervention group had higher scores for the Swedish Healthy Eating Index at follow-up than the control group (0.27; 95% CI 0.05-0.50; P=.017). We observed no statistically significant differences in body fatness, MVPA, glycemia, and insulin resistance between the intervention and control group at follow up (P≥.21). Conclusions Although we found no overall effect on GWG, our results demonstrate the potential of a smartphone app (HealthyMoms) to promote healthy dietary behaviors as well as to decrease weight gain during pregnancy in women with overweight and obesity. Trial Registration ClinicalTrials.gov NCT03298555; https://clinicaltrials.gov/ct2/show/NCT03298555 International Registered Report Identifier (IRRID) RR2-10.2196/13011
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Affiliation(s)
- Johanna Sandborg
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Maria Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Marja H Leppänen
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Jairo H Migueles
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health, University of Granada, Granada, Spain
| | - Marie Blomberg
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
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19
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Hiltunen P, Leppänen MH, Ray C, Määttä S, Vepsäläinen H, Koivusilta L, Sajaniemi N, Erkkola M, Roos E. Relationship between screen time and sleep among Finnish preschool children: results from the DAGIS study. Sleep Med 2020; 77:75-81. [PMID: 33338700 DOI: 10.1016/j.sleep.2020.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES To examine the associations between screen time, the time spent on different screen devices, and sleep in a sample of Finnish preschool children. METHODS The current study analyzed cross-sectional data from the DAGIS study carried out in Finland in 2015-2016 on 736 children aged 3-6 years. Parents reported in a 7-day diary the durations the child used screen devices daily, with separate details about watching TV or DVDs, using tablets or smartphones, and using computers. In addition, parents reported children's bedtimes and wake-up times, which were further used in calculating sleep duration. Parents answered questions regarding their child's sleep consistency. Statistical analyses included adjusted general linear modeling. RESULTS An hourly increase in total screen time was associated with 11 min later bedtime (p < 0.001) and 10 min shorter sleep duration (p < 0.001). More TV/DVD watching was associated with later bedtimes (p = 0.016) and a shorter sleep duration (p = 0.001). More smartphone/tablet use was associated with later bedtimes (p = 0.005), later wake-up times (p = 0.038), and weaker sleep consistency (p = 0.024). More computer use was associated with later bedtimes (p = 0.046). Results did not differ between genders. CONCLUSIONS Increased screen time was associated with later bedtimes and shorter sleep duration among preschool children. Adverse associations with sleep outcomes were found for each screen device. Attention should be paid to promoting balanced use of screens and regular sleep habits in young children.
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Affiliation(s)
- Pauliina Hiltunen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland.
| | - Marja H Leppänen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Public Health, Faculty of Medicine, P.O. Box 63, 00014 University of Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Suvi Määttä
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Faculty of Social Sciences, University of Helsinki, Unioninkatu 37, P.O. Box 54, 00014 University of Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Leena Koivusilta
- Department of Social Research, University of Turku, FI-20014, Turku, Finland
| | - Nina Sajaniemi
- Faculty of Educational Sciences, University of Helsinki, Siltavuorenpenger 1-5, 10, P.O. Box 9, 00014 University of Helsinki, Finland; Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, P.O. Box 111, FI-8010, Joensuu, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, P.O. Box 66, 00014 University of Helsinki, Finland; Department of Public Health, Faculty of Medicine, P.O. Box 63, 00014 University of Helsinki, Finland.
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20
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Vepsäläinen H, Hautaniemi H, Sääksjärvi K, Leppänen MH, Nissinen K, Suhonen E, Saha M, Lehto E, Ray C, Sajaniemi N, Erkkola M. Do stressed children have a lot on their plates? A cross-sectional study of long-term stress and diet among Finnish preschoolers. Appetite 2020; 157:104993. [PMID: 33065192 DOI: 10.1016/j.appet.2020.104993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/25/2020] [Accepted: 09/30/2020] [Indexed: 11/18/2022]
Abstract
We examined the association between hair cortisol concentration (HCC) - an indicator of long-term stress - and diet among preschoolers in a cross-sectional design. The participants were 597 Finnish 3-6-year-olds, and the data were collected in 2015-16. We used 4-cm hair samples to analyze HCC during the past four months. Food consumption was assessed using a food frequency questionnaire, and we used consumption frequencies of selected food groups as well as data-driven dietary pattern scores in the analyses. The parents of the participating children reported their educational level and family income. The researchers measured the children's weight and height. We examined the associations between HCC and diet using multilevel linear mixed models adjusted for age, gender, the highest education in the family, household relative income, and child BMI. Higher HCCs were associated with less frequent consumption of fruit and berries (B estimate -1.17, 95% CI -2.29, -0.05) and lower scores in a health-conscious dietary pattern (B estimate -0.38, 95% CI -0.61, -0,14). Higher HCCs were also associated with more frequent consumption of sugary beverages (B estimate 1.30, 95% CI 0.06, 2.54) in a model adjusted for age, gender and highest education in the family, but the association attenuated after further adjustments. Our results are parallel with previous studies that show a link between stress and unhealthy diet. In the future, longitudinal studies are needed to establish a causal relationship between stress and diet among children.
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Affiliation(s)
- Henna Vepsäläinen
- University of Helsinki, Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, Helsinki, Finland.
| | - Hannele Hautaniemi
- University of Helsinki, Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, Helsinki, Finland.
| | - Katri Sääksjärvi
- University of Helsinki, Department of Teacher Education, P.O. Box 9, 00014 University of Helsinki, Helsinki, Finland.
| | - Marja H Leppänen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; University of Helsinki, Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, Helsinki, Finland.
| | - Kaija Nissinen
- Seinäjoki University of Applied Sciences, Kampusranta 11, 60101, Seinäjoki, Finland; University of Helsinki, Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, Helsinki, Finland.
| | - Eira Suhonen
- University of Helsinki, Department of Teacher Education, P.O. Box 9, 00014 University of Helsinki, Helsinki, Finland.
| | - Mari Saha
- Tampere University, Faculty of Education and Culture, P.O. Box 700, 33014, Tampere University, Tampere, Finland.
| | - Elviira Lehto
- University of Helsinki, Department of Teacher Education, P.O. Box 9, 00014 University of Helsinki, Helsinki, Finland; Tampere University, Faculty of Social Sciences, Arvo Ylpön Katu 34, 33014, Tampere University, Tampere, Finland.
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250, Helsinki, Finland; University of Helsinki, Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, Helsinki, Finland.
| | - Nina Sajaniemi
- University of Helsinki, Department of Teacher Education, P.O. Box 9, 00014 University of Helsinki, Helsinki, Finland; University of Eastern Finland, School of Applied Sciences and Teacher Education, P.O. Box 111, 80101, Joensuu, Finland.
| | - Maijaliisa Erkkola
- University of Helsinki, Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, Helsinki, Finland.
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21
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Leppänen MH, Migueles JH, Cadenas‐Sanchez C, Henriksson P, Mora‐Gonzalez J, Henriksson H, Labayen I, Löf M, Esteban‐Cornejo I, Ortega FB. Hip and wrist accelerometers showed consistent associations with fitness and fatness in children aged 8-12 years. Acta Paediatr 2020; 109:995-1003. [PMID: 31583747 DOI: 10.1111/apa.15043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/14/2019] [Accepted: 10/01/2019] [Indexed: 12/23/2022]
Abstract
AIM Physical activity (PA) has traditionally been measured wearing accelerometers on the hip, but they are increasingly being worn on the wrist. We compared hip and wrist accelerometers with regard to their acceptability and any associations between PA and fatness and fitness. METHODS This cross-sectional study comprised 103 children aged 8-12 years (62% boys) who participated in the ActiveBrains trial by the University of Granada, Spain, in 2014-2016. The children wore both ActiGraph GT3X+ hip and wrist accelerometers round the clock for 7 days. The acceptability of both placements was evaluated by a questionnaire, while the children's fat mass index, waist circumference and cardiorespiratory fitness (CRF) were assessed. RESULTS Wearing wrist accelerometers caused less disturbance, mainly because hip accelerometers caused more issues during the night. The measurements from both placements showed that lower PA levels were associated with fatness and that higher PA levels were associated with better CRF. CONCLUSION Both placements showed consistent results with regard to measuring associations between PA levels and fatness and fitness. However, wearing them on the wrist caused less discomfort at night. Future studies are needed to confirm the best placement for accelerometers during PA studies.
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Affiliation(s)
- Marja H. Leppänen
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Department of Biosciences and Nutrition Karolinska Institutet Huddinge Sweden
| | - Jairo H. Migueles
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH) Department of Physical and Sports Education Faculty of Sport Sciences University of Granada Granada Spain
| | - Cristina Cadenas‐Sanchez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH) Department of Physical and Sports Education Faculty of Sport Sciences University of Granada Granada Spain
| | - Pontus Henriksson
- Department of Biosciences and Nutrition Karolinska Institutet Huddinge Sweden
- Department of Medicine and Health Linköping University Linköping Sweden
| | - Jose Mora‐Gonzalez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH) Department of Physical and Sports Education Faculty of Sport Sciences University of Granada Granada Spain
| | - Hanna Henriksson
- Department of Medicine and Health Linköping University Linköping Sweden
| | - Idoia Labayen
- Institute for Innovation and Sustainable Development in Food Chain (IS‐FOOD) Public University of Navarra Pamplona Navarra Spain
| | - Marie Löf
- Department of Biosciences and Nutrition Karolinska Institutet Huddinge Sweden
- Department of Medicine and Health Linköping University Linköping Sweden
| | - Irene Esteban‐Cornejo
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH) Department of Physical and Sports Education Faculty of Sport Sciences University of Granada Granada Spain
- Center for Cognitive and Brain Health Department of Psychology Northeastern University Boston MA USA
| | - Francisco B. Ortega
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH) Department of Physical and Sports Education Faculty of Sport Sciences University of Granada Granada Spain
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22
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Leppänen MH, Haapala EA, Veijalainen A, Seppälä S, Oliveira RS, Lintu N, Laitinen T, Tarvainen MP, Lakka TA. Associations of cardiometabolic risk factors with heart rate variability in 6- to 8-year-old children: The PANIC Study. Pediatr Diabetes 2020; 21:251-258. [PMID: 31855297 DOI: 10.1111/pedi.12967] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 11/15/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Associations of cardiometabolic risk factors with heart rate variability (HRV) in children are unclear. We examined associations of cardiometabolic risk score (CRS) and individual cardiometabolic risk factors with HRV variables in 6- to 8-year-olds. METHODS The participants were a population-based sample of 443 children participating in baseline measurements of the Physical Activity and Nutrition in Children trial. Cardiometabolic risk factors included waist circumference (WC), insulin, glucose, triglycerides, HDL cholesterol, systolic blood pressure (SBP), and diastolic blood pressure (DBP). CRS was calculated as WC + insulin + glucose + triglycerides - HDL cholesterol + the mean of SBP and DBP. HRV variables (SDNN, RMSSD, HF, LF, LF/HF, Mean RR) were measured using 5-minute electrocardiography at rest and analyzed using the Kubios HRV software. In this cross-sectional study, associations of CRS and individual cardiometabolic risk factors with HRV were investigated using linear regression analyses adjusted for sex and peak height velocity. RESULTS CRS was negatively associated with RMSSD, HF, Mean RR (P value < .05) and positively with LF/HF (P value = .005). Insulin was negatively associated with SDNN, RMSSD, HF, LF, and Mean RR (P value < .05) and positively with LF/HF (P value = .008). SBP was negatively associated with SDNN, RMSSD, HF, LF, and Mean RR (P value < .05). DBP was negatively associated with SDNN, RMSSD, and Mean RR (P value < .05). WC, glucose, triglycerides, or HDL cholesterol were not associated with HRV variables. CONCLUSIONS Higher CRS, insulin, and blood pressure were associated with smaller HRV, mainly indicating lower parasympathetic activity, in young children. This knowledge may help improving the clinical management of metabolic syndrome and cardiovascular diseases since childhood.
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Affiliation(s)
- Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aapo Veijalainen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Santeri Seppälä
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ricardo S Oliveira
- Departamento de Educação Física, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Mika P Tarvainen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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23
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Leppänen MH, Ray C, Wennman H, Alexandrou C, Sääksjärvi K, Koivusilta L, Erkkola M, Roos E. Compliance with the 24-h movement guidelines and the relationship with anthropometry in Finnish preschoolers: the DAGIS study. BMC Public Health 2019; 19:1618. [PMID: 31796014 PMCID: PMC6889540 DOI: 10.1186/s12889-019-7967-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background Recent 24-h movement guidelines for the early years established recommendations for physical activity (PA), screen time (ST), and sleep. To date, few studies have focused on compliance with meeting the guidelines and their associations with health outcomes. Thus, we aimed to investigate: 1) compliance with the 24-h movement guidelines, and 2) associations between compliance and anthropometry in Finnish preschoolers. Methods We utilized DAGIS survey data that were collected in 2015–2016 (N = 864). PA was assessed 24 h/day over 7 days using a waist-worn ActiGraph wGT3X-BT accelerometer. ST and sleep were reported by the parents during the same 7 days. Anthropometry was assessed using body mass index (BMI, kg/m2) and waist circumference (WC, cm). Children were classified as meeting the guidelines if they averaged ≥180 min/day of PA, which consisted of ≥60 min of moderate-to-vigorous intensity; ≤60 min/day of ST; and 10–13 h/day of sleep. In total, 778 children (51% boys, mean age: 4.7 ± 0.9 years) were included in the study. The compliance with meeting the 24-h movement guidelines was calculated for each behavior separately and in combinations. Adjusted linear regression analyses were applied to examine associations of compliance with BMI and WC. Results Children were physically active on average 390 (±46.2) min/day and spent 86 (±25.5) min/day in moderate-to-vigorous PA. They spent 76 (±37.4) min/day on ST and had on average 10:21 (±0:33) h:min/day of sleep. The compliance rate in meeting all three movement guidelines overall was 24%. The highest compliance rate was found for PA (85%), followed by sleep (76%) and ST (35%). Meeting guidelines separately for PA or sleep, or for both, were associated with lower WC (PA: B = -1.37, p < 0.001; Sleep: B = -0.72, p = 0.009; PA + Sleep: B = -1.03, p < 0.001). In addition, meeting guidelines for sleep or for both PA and sleep were associated with lower BMI (Sleep: B = -0.26, p = 0.027; PA + Sleep: B = -0.30, p = 0.007). There were no significant associations found regarding ST. Conclusions Meeting recommendations for PA and sleep may have an important role in supporting a healthy weight status in young children. However, there is still a need to improve compliance with the 24-h movement guidelines, especially for ST.
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Affiliation(s)
- Marja H Leppänen
- Folkhälsan Research Center, Helsinki, Finland. .,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - Carola Ray
- Folkhälsan Research Center, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Heini Wennman
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Christina Alexandrou
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Katri Sääksjärvi
- Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Leena Koivusilta
- Department of Social Research, University of Turku, Turku, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland.,Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.,Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
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24
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Leppänen MH, Raitanen J, Husu P, Kujala UM, Tuominen PP, Vähä-Ypyä H, Luoto R. Physical Activity and Body Composition in Children and Their Mothers According to Mother's Gestational Diabetes Risk: A Seven-Year Follow-Up Study. ACTA ACUST UNITED AC 2019; 55:medicina55100635. [PMID: 31557895 PMCID: PMC6843146 DOI: 10.3390/medicina55100635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 08/15/2019] [Accepted: 09/17/2019] [Indexed: 12/16/2022]
Abstract
Background and Objectives: There is lack of knowledge on whether mothers' gestational diabetes (GDM) risk is related to their physical activity (PA) or their children's PA and body composition. We aimed to examine the difference in (1) change in self-reported PA from pre-pregnancy to seven-year follow-up and (2) accelerometer-based PA at seven years after delivery between the mothers having GDM risk (GDMRyes-mothers) and not having GDM risk (GDMRno-mothers). Furthermore, we examined the difference in children's PA and/or body composition at six years of age according to their mothers' GDM risk. Materials and Methods: The study included 199 Finnish women. GDM risk factors were screened at the beginning of pregnancy, and the women were classified as GDMRyes-mothers if they had at least one GDM risk factor (body mass index ≥25 kg/m2; age ≥40 years; family history of diabetes; GDM, signs of glucose intolerance, or newborn's macrosomia (≥4500 g) in earlier pregnancy) or as GDMRno-mothers if they had no risk factors. Mothers' PA was assessed by self-reporting at 8-12 gestational weeks concerning pre-pregnancy PA and at a follow-up seven years after the delivery. Moreover, mothers' and their children's PA was measured using a triaxial Hookie AM20-accelerometer at seven years after delivery. Children's body composition was assessed using a TANITA bioelectrical impedance device. Adjusted linear regression analyses were applied. Results: GDMRno-mothers increased their self-reported PA more than GDMRyes-mothers from pre-pregnancy to the seven-year follow-up. Concerning women's measured PA as well as children's PA and body composition at seven years after delivery, the differences were non-significant between GDMRyes-mothers and GDMRno-mothers. However, of the GDM risk factors, mothers' pre-pregnancy body mass index was positively related to unhealthier body composition in boys at six years of age. Conclusion: Health promotion should be targeted at women with GDM risk factors, in particular overweight women, in enhancing women's PA in the long term and their children's healthy body composition.
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Affiliation(s)
- Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40100 Jyväskylä, Finland.
| | - Jani Raitanen
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland.
- Faculty of Social Sciences (Health Sciences), Tampere University, 33014 Tampere, Finland.
| | - Pauliina Husu
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland.
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40100 Jyväskylä, Finland.
| | - Pipsa Pa Tuominen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40100 Jyväskylä, Finland
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland.
| | - Riitta Luoto
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere Finland.
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25
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Henriksson P, Sandborg J, Blomberg M, Alexandrou C, Maddison R, Silfvernagel K, Henriksson H, Leppänen MH, Migueles JH, Widman L, Thomas K, Trolle Lagerros Y, Löf M. A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13011. [PMID: 30821695 PMCID: PMC6418485 DOI: 10.2196/13011] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 01/20/2023] Open
Abstract
Background Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. Objective The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. Methods HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. Results Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. Conclusions This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy. International Registered Report Identifier (IRRID) DERR1-10.2196/13011
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Affiliation(s)
- Pontus Henriksson
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Johanna Sandborg
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Christina Alexandrou
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Kristin Silfvernagel
- Division of Psychology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Hanna Henriksson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marja H Leppänen
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Jairo H Migueles
- Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Linnea Widman
- Department of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kristin Thomas
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden.,Obesity Center, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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26
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Henriksson P, Leppänen MH, Henriksson H, Delisle Nyström C, Cadenas-Sanchez C, Ek A, Ruiz JR, Ortega FB, Löf M. Physical fitness in relation to later body composition in pre-school children. J Sci Med Sport 2018; 22:574-579. [PMID: 30573178 DOI: 10.1016/j.jsams.2018.11.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 11/14/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Although physical fitness is considered a marker of health in youth, little is known whether physical fitness in pre-school age is related to later body composition. Thus, this study investigated (i) associations of physical fitness at 4.5years of age with body composition 12months later and (ii) whether improvements in physical fitness during the 12-month follow-up were associated with changes in body composition. DESIGN This study included 142 children, measured at 4.5 and 5.5years, from the control group of the MINISTOP trial. METHODS Physical fitness (cardiorespiratory fitness, lower- and upper-body muscular strength and motor fitness) was measured using the PREFIT test battery. Body composition was assessed using air-displacement plethysmography. RESULTS In adjusted regression analyses, greater cardiorespiratory fitness, lower-body muscular strength and motor fitness at 4.5years were associated with a lower fat mass index at 5.5years (standardized β=-0.182 to -0.229, p≤0.028). Conversely, greater cardiorespiratory fitness, lower- and upper-body muscular strength as well as motor fitness at 4.5years of age were associated with a higher fat-free mass index (standardized β=0.255-0.447, p≤0.001). Furthermore, improvements in cardiorespiratory fitness, lower-body muscular strength and motor fitness during the 12-month follow-up period were associated with decreases in fat mass index and/or % fat mass. CONCLUSIONS In conclusion, the results of this study provide evidence of the importance of physical fitness early in life. Nevertheless, further studies are needed in order to clarify the influence of physical fitness in the pre-school age with later health outcomes.
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Affiliation(s)
- Pontus Henriksson
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden; Department of Medical and Health Sciences, Linköping University, Sweden; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain.
| | - Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Finland
| | - Hanna Henriksson
- Department of Medical and Health Sciences, Linköping University, Sweden; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Christine Delisle Nyström
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden; Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Canada
| | - Cristina Cadenas-Sanchez
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Anna Ek
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden; Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden
| | - Jonatan R Ruiz
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Francisco B Ortega
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden; Department of Medical and Health Sciences, Linköping University, Sweden
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27
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Leppänen MH, Henriksson P, Delisle Nyström C, Henriksson H, Ortega FB, Pomeroy J, Ruiz JR, Cadenas-Sanchez C, Löf M. Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers. Med Sci Sports Exerc 2018; 49:2078-2085. [PMID: 28538260 DOI: 10.1249/mss.0000000000001313] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate longitudinal associations of objectively measured physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness at a 12-month follow-up in healthy Swedish 4-yr-old children. METHODS The data from the population-based MINISTOP trial were collected between 2014 and 2016, and this study included the 138 children who were in the control group. PA and SB were assessed using the wrist-worn ActiGraph (wGT3x-BT) accelerometer during seven 24-h periods and, subsequently, defined as SB, light-intensity PA, moderate-intensity PA, vigorous-intensity PA (VPA), and moderate-to-vigorous PA (MVPA). Body composition was measured using air-displacement plethysmography and physical fitness (cardiorespiratory fitness, lower and upper muscular strength as well as motor fitness) by the PREFIT fitness battery. Linear regression and isotemporal substitution models were applied. RESULTS Greater VPA and MVPA at the age of 4.5 yr were associated with higher fat-free mass index (FFMI) at 5.5 yr (P < 0.001 and P = 0.044, respectively). Furthermore, greater VPA and MVPA at the age of 4.5 yr were associated with higher scores for cardiorespiratory fitness, lower body muscular strength, and motor fitness at 12-month follow-up (P = 0.001 to P = 0.031). Substituting 5 min·d of SB, light-intensity PA, or moderate-intensity PA for VPA at the age of 4.5 yr were associated with higher FFMI, and with greater upper and lower muscular strength at 12-month follow-up (P < 0.001 to P = 0.046). CONCLUSION Higher VPA and MVPA at the age of 4.5 yr were significantly associated with higher FFMI and better physical fitness at 12-month follow-up. Our results indicate that promoting high-intensity PA at young ages may have long-term beneficial effects on childhood body composition and physical fitness, in particular muscular strength.
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Affiliation(s)
- Marja H Leppänen
- 1Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, FINLAND; 2Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linkoping, SWEDEN; 3Promoting Fitness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, SPAIN; 4Department of Biosciences and Nutrition, Karolinska Institutet, NOVUM, Huddinge, SWEDEN; and 5Marshfield Clinic Research Foundation, Marshfield, WI
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28
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Henriksson P, Cadenas-Sanchez C, Leppänen MH, Delisle Nyström C, Ortega FB, Pomeroy J, Ruiz JR, Löf M. Associations of Fat Mass and Fat-Free Mass with Physical Fitness in 4-Year-Old Children: Results from the MINISTOP Trial. Nutrients 2016; 8:nu8080473. [PMID: 27483320 PMCID: PMC4997386 DOI: 10.3390/nu8080473] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/20/2016] [Accepted: 07/27/2016] [Indexed: 11/28/2022] Open
Abstract
Physical fitness is a powerful marker of health in youth. Studies in adolescents and adults suggest that higher fat mass is related to worse physical fitness. However, there is limited knowledge whether fat mass and fat-free mass are associated with physical fitness already in preschoolers. Baseline data from the MINISTOP (Mobile-based INtervention Intended to STop Obesity in Preschoolers) trial was utilized for this cross-sectional analysis. Body composition was assessed using air-displacement plethysmography. Fat mass index [fat mass (kg)/height2 (m)] and fat-free mass index [fat-free mass (kg)/height2 (m)] were used to provide height-adjusted measures of body composition. Physical fitness was measured using the PREFIT (FITness testing in PREschool children) battery, which assesses cardiorespiratory fitness, upper-body and lower-body muscular strength as well as motor fitness. In total, this study included 303 children (168 boys and 135 girls), who were on average 4.48 ± 0.15 years old. Higher fat mass index was associated with worse cardiorespiratory fitness (standardized β = −0.17, p = 0.002), lower-body muscular strength (β = −0.17, p = 0.003) and motor fitness (β = −0.21, p < 0.001) in regression analyses adjusted for age, sex and mutually adjusted for fat-mass index and fat-free mass index. Conversely, higher fat-free mass index was associated with better cardiorespiratory fitness (β = 0.18, p = 0.002), upper-body muscular strength (β = 0.39, p < 0.001), lower-body muscular strength (β = 0.22, p < 0.001) and motor fitness (β = 0.17, p = 0.004). Thus, fat mass and fat-free mass in preschoolers appear to have joint but opposite associations with physical fitness, an important marker for current and future health.
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Affiliation(s)
- Pontus Henriksson
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
- Department of Clinical and Experimental Medicine, Faculty of Health Science, Linköping University, 581 53 Linköping, Sweden.
| | - Cristina Cadenas-Sanchez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| | - Marja H Leppänen
- Department of Health Sciences, University of Jyvaskyla, 40014 Jyvaskyla, Finland.
| | | | - Francisco B Ortega
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden.
| | - Jeremy Pomeroy
- Marshfield Clinic Research Foundation, Marshfield, WI 54449, USA.
| | - Jonatan R Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden.
| | - Marie Löf
- Department of Clinical and Experimental Medicine, Faculty of Health Science, Linköping University, 581 53 Linköping, Sweden.
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden.
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