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  • 1.
    Ek, Anna
    et al.
    Karolinska Inst, Sweden.
    Nystrom, Christine Delisle
    Karolinska Inst, Sweden.
    Chirita-Emandi, Adela
    Univ Med and Farm Timisoara, Romania; Louis Turcanu Clin Emergency Hosp Children, Romania.
    Tur, Josep A.
    Univ Balearic Isl, Spain; Inst Carlos III, Spain.
    Nordin, Karin
    Karolinska Inst, Sweden.
    Bouzas, Cristina
    Univ Balearic Isl, Spain; Inst Carlos III, Spain.
    Argelich, Emma
    Univ Balearic Isl, Spain; Inst Carlos III, Spain.
    Alfredo Martinez, J.
    Inst Carlos III, Spain; Univ Navarra, Spain; IMDEA Food Precis Nutr, Spain.
    Frost, Gary
    Imperial Coll London, England.
    Garcia-Perez, Isabel
    Imperial Coll London, England.
    Saez, Marc
    Univ Girona, Spain; Inst Carlos III, Spain.
    Paul, Corina
    Univ Med and Farm Timisoara, Romania; Clin Emergency Cty Hosp Timisoara, Romania.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Nowicka, Paulina
    Karolinska Inst, Sweden; Uppsala Univ, Sweden.
    A randomized controlled trial for overweight and obesity in preschoolers: the More and Less Europe study- an intervention within the STOP project2019Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikel-id 945Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundChildhood overweight and obesity is a serious public health issue with an increase being observed in preschool-aged children. Treating childhood obesity is difficult and few countries use standardized treatments. Therefore, there is a need to find effective approaches that are feasible for both health care providers and families. Thus, the overall aim of this study is to assess the acceptance and effectiveness of a parent support program (the More and Less, ML) for the management of overweight and obesity followed by a mobile health (mHealth) program (the MINISTOP application) in a socially diverse population of families.Methods/designA two-arm, parallel design randomized controlled trial in 300 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden (n=100 from each). Following baseline assessments children are randomized into the intervention or control group in a 1:1 ratio. The intervention, the ML program, consists of 10-weekly group sessions which focus on evidence-based parenting practices, followed by the previously validated MINISTOP application for 6-months to support healthy eating and physical activity behaviors. The primary outcome is change in body mass index (BMI) z-score after 9-months and secondary outcomes include: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire), physical activity (ActiGraph wGT3x-BT), dietary patterns (based onmetabolic markers from urine and 24h dietary recalls), epigenetic and gut hormones (fasting blood samples), and the overall acceptance of the overweight and obesity management in young children (semi-structured interviews). Outcomes are measured at baseline and after: 10-weeks (only BMI z-score, waist circumference), 9-months (all outcomes), 15- and 21-months (all outcomes except physical activity, dietary patterns, epigenetics and gut hormones) post-baseline.DiscussionThis study will evaluate a parent support program for weight management in young children in three European countries. To boost the effect of the ML program the families will be supported by an app for 6-months. If the program is found to be effective, it has the potential to be implemented into routine care to reduce overweight and obesity in young children and the app could prove to be a viable option for sustained effects of the care provided.Trial registrationClinicalTrials.gov NCT03800823; 11 Jan 2019.

  • 2.
    Migueles, Jairo H.
    et al.
    Univ Granada, Spain.
    Nystrom, Christine Delisle
    Karolinska Inst, Sweden; Childrens Hosp Eastern Ontario, Canada.
    Henriksson, Pontus
    PROFITH, Univ Granada, Spain; Karolinska Inst, Sweden.
    Cadenas-Sanchez, Cristina
    Univ Granada, Spain.
    Ortega, Francisco B.
    Univ Granada, Spain; Karolinska Inst, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Accelerometer Data Processing and Energy Expenditure Estimation in Preschoolers2019Ingår i: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 51, nr 3, s. 590-598Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose To assess the capacity of different acceleration metrics from wrist accelerations to estimate total energy expenditure (TEE) and activity energy expenditure (AEE) using doubly labeled water in preschool children. Methods Thirty-nine preschoolers (5.5 0.1 yr) were included. Total energy expenditure was measured using doubly labeled water during 14 d, and AEE was then calculated using a predicted basal metabolic rate. Participants wore a wGT3X-BT accelerometer on their nondominant wrist for 5 d. We derived the following metrics from raw accelerations: raw ActiGraph activity counts using the normal filter and the low-frequency extension; and alternate summary metrics, such as the Euclidian norm minus 1g (ENMO), Euclidian norm of the high-pass-filtered accelerations (HFEN), the bandpass-filtered accelerations, the HFEN plus Euclidean norm of low-pass filtered accelerations minus 1g (HFEN+) and the mean amplitude deviation. Results Alternate summary metrics explained a larger proportion of the variance in TEE and AEE than ActiGraphs activity counts (counts, 7-8 and 25% of TEE and AEE; alternate summary metrics, 13%-16% and 35%-39% of TEE and AEE). Adjustments for body weight and height resulted in an explanation of 51% of AEE by ENMO. All of the metrics adjusted for fat mass and fat-free mass explained up to 84% and 67% of TEE and AEE, respectively. Conclusions ENMO and the other alternate summary metrics explained more of the variance in TEE and AEE than the ActiGraphs activity counts in 5-yr-old children, suggesting further exploration of these variables in studies on physical activity and energy expenditure in preschoolers. Our results need confirmation in other populations with wider age groups and varying body compositions.

  • 3.
    Lindqvist, Anna-Karin
    et al.
    Lulea Univ Technol, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Ek, Anna
    Karolinska Inst, Sweden.
    Rutberg, Stina
    Lulea Univ Technol, Sweden.
    Active School Transportation in Winter Conditions: Biking Together Is Warmer2019Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, nr 2, artikel-id 234Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There has been a decline in childrens use of active school transportation (AST) while there is also limited research concerning AST in winter conditions. This study aimed to explore the prerequisites and experiences of schoolchildren and parents participating in an empowerment- and gamification-inspired intervention to promote students AST in winter conditions. Methods: Thirty-five students, who were aged 12-13 years, and 34 parents from the north of Sweden participated in the study. Data were collected using photovoice and open questions in a questionnaire and analyzed using qualitative content analysis. Results: The results show that involvement and togetherness motivated the students to use AST. In addition, during the project, the parents changed to have more positive attitudes towards their childrens use of AST. The students reported that using AST during wintertime is strenuous but rewarding and imparts a sense of pride. Conclusion: Interventions for increasing students AST in winter conditions should focus on the motivational aspects for both children and parents. For overcoming parental hesitation with regards to AST during winter, addressing their concerns and empowering the students are key factors. To increase the use of AST all year around, targeting the challenges perceived during the winter is especially beneficial.

  • 4.
    Bonn, Stephanie E.
    et al.
    Karolinska Inst, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Ostenson, Claes-Goeran
    Karolinska Inst, Sweden.
    Lagerros, Ylva Trolle
    Karolinska Inst, Sweden; Karolinska Univ Hosp Huddinge, Sweden.
    App-technology to improve lifestyle behaviors among working adults - the Health Integrator study, a randomized controlled trial2019Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikel-id 273Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundMobile health, mHealth is recognized as a strategy to improve lifestyle behaviors. Research targeting specific lifestyle behaviors has shown that interventions using smartphones can be effective. However, few studies have evaluated solutions with multicomponent interventions, tailoring the intervention to the specific needs of the participant using a combination of mHealth and conventional treatment. To accomplish this, we developed Health Integrator, an mHealth platform with services and offers in the areas of diet, physical activity, sleeping habits, stress, alcohol and tobacco use. In the system, the user selects an area of intervention together with a health coach and set weekly goals. This study protocol presents the design and methodology of the Health Integrator Study, a randomized controlled trial to promote improved lifestyle behaviors.MethodsA three-arm parallel randomized controlled trial (1:1:1) is conducted in the Stockholm County, Sweden. In total, 209 employees at a four different companies representing both white and blue collar workers, have been recruited.Participants are randomized to either a control group or to one of two intervention groups receiving a 3-month lifestyle behavior change program including either 1) use of Health Integrator and monthly health coaching sessions or 2) only Health Integrator.At baseline and follow-up after 3- and 6-months, all participants answer questionnaires assessing lifestyle behaviors and quality of life. At baseline and the 3-month follow-up (end of intervention period), weight, height, waist circumference and blood pressure are measured, and all participants wear an Actigraph accelerometer for 7days to assess physical activity. Blood lipid profile and HbA1c are measured among all participants at baseline. If baseline measures fall outside the normal range, a second measurement is done after 3months.DiscussionThe Health Integrator Intervention Study will evaluate if a personalized intervention combining mHealth and conventional programs for lifestyle change, with or without additional health coach sessions, can improve lifestyle behaviors and quality of life. Based on the results from this trial, Health Integrator can easily be implemented within a broad public.Trial registrationClinicalTrials.gov Identifier: NCT03579342. Retrospectively registered, first submitted May 8, 2018.

  • 5.
    Migueles, Jairo H.
    et al.
    Univ Granada, Spain.
    Cadenas-Sanchez, Cristina
    Univ Granada, Spain.
    Tudor-Locke, Catrine
    Univ Massachusetts, MA 01003 USA.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Esteban-Cornejo, Irene
    Univ Granada, Spain; Northeastern Univ, MA 02115 USA.
    Molina-Garcia, Pablo
    Univ Granada, Spain; Univ Leuven, Belgium.
    Mora-Gonzalez, Jose
    Univ Granada, Spain.
    Rodriguez-Ayllon, Maria
    Univ Granada, Spain.
    Garcia-Marmol, Eduardo
    Univ Granada, Spain.
    Ekelund, Ulf
    Norwegian Sch Sport Sci, Norway.
    Ortega, Francisco B.
    Univ Granada, Spain; Karolinska Inst, Sweden.
    Comparability of published cut-points for the assessment of physical activity: Implications for data harmonization2019Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 29, nr 4, s. 566-574Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to compare estimations of sedentary time (SED) and time spent in physical activity (PA) intensities in children with overweight/obesity across different age-appropriate cut-points based on different body-worn attachment sites and acceleration metrics. A total of 104 overweight/obese children (10.1 +/- 1.1 years old, 43 girls) concurrently wore ActiGraph GT3X+ accelerometers on their right hip and non-dominant wrist for 7 days (24 hours). Euclidean norm -1 g (ENMO) and activity counts from both vertical axis (VACounts) and vector magnitude (VMCounts) were derived. We calculated estimates of SED and light, moderate, vigorous, and moderate-to-vigorous (MVPA) intensity PA using different published cut-points for children. The prevalence of children meeting the recommended 60 min/d of MVPA was calculated. The time spent in SED and the different PA intensities largely differed across cut-points based on different attachment sites and acceleration metrics (ie, SED = 11-252 min/d; light PA = 10-217 min/d; moderate PA = 1-48 min/d; vigorous PA = 1-35 min/d; MVPA = 4-66 min/d). Consequently, the prevalence of children meeting the recommended 60 min/d of MVPA varied from 8% to 96% of the study sample. The present study provides a comprehensive comparison between available cut-points for different attachment and acceleration metrics in children. Furthermore, our data clearly show that it is not possible (and probably will never be) to know the prevalence of meeting the PA guidelines based on accelerometer data since apparent differences range from almost zero to nearly everyone meeting the guidelines.

  • 6.
    Forsum, Elisabet
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Eriksson, Britt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Flinke Carlsson, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Fat and fat-free mass of healthy Swedish children show tracking during early life, but there are differences2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 9, s. 1704-1708Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim Obesity may start early in life. We investigated relationships between size and body composition variables in infancy and at 4 years of age using valid estimates of body composition. The results were compared to those obtained when body mass index (BMI) was used to estimate body fatness at 4 years. Methods Using air displacement plethysmography, size, fat mass and fat-free mass were studied, between 2007 and 2015, in 253 full-term healthy Swedish children at 1 week, 12 weeks and 4 years of age. Results Positive associations between variables in infancy and at 4 years were found at 1 and 12 weeks for weight, height, BMI, fat-free mass and fat-free mass index (p amp;lt;= 0.002) and for fat mass, per cent body fat and fat mass index (p amp;lt;= 0.04) at 12 weeks. Fat mass gained during infancy correlated positively (p amp;lt;= 0.031) with per cent fat mass, fat mass index and BMI, all at 4 years. In girls, gains in fat-free mass during infancy correlated with BMI (p = 0.0005) at 4 years. Conclusion The results provide information regarding body composition trajectories during early life and demonstrate limitations of BMI as a proxy for body fatness when relating early weight gain to variables, relevant for later obesity risk.

  • 7.
    Henriksson, Pontus
    et al.
    Karolinska Inst, Sweden; Univ Granada, Spain; Karolinska Inst, Sweden.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Univ Granada, Spain.
    Tynelius, Per
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden; Karolinska Inst, Sweden.
    Berglind, Daniel
    Karolinska Inst, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Lee, I-Min
    Harvard Med Sch, MA 02115 USA; Harvard TH Chan Sch Publ Hlth, MA USA.
    Shiroma, Eric J.
    NIA, MD 20892 USA.
    Ortega, Francisco B.
    Karolinska Inst, Sweden; Univ Granada, Spain.
    Fitness and Body Mass Index During Adolescence and Disability Later in Life A Cohort Study2019Ingår i: Annals of Internal Medicine, ISSN 0003-4819, E-ISSN 1539-3704, Vol. 170, nr 4, s. 230-+Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Low physical fitness, obesity, and the combination of the two in adolescence may be related to risk for disability in adulthood, but this has rarely been studied. Objective: To examine individual and combined associations of cardiorespiratory fitness and obesity in male adolescents with later receipt of a disability pension due to all and specific causes. Design: Population-based cohort study. Setting: Sweden. Participants: 1 079 128 Swedish adolescents aged 16 to 19 years who were conscripted into the military between 1972 and 1994. Measurements: Cardiorespiratory fitness and body mass index (BMI) were measured at conscription and were related to information on later receipt of a disability pension obtained from the Social Insurance Agency. Results: Over a median follow-up of 28.3 years, 54 304 men were granted a disability pension. Low cardiorespiratory fitness was strongly associated with later receipt of a disability pension due to all causes (hazard ratio, 3.74 [95% CI, 3.55 to 3.95] for lowest vs. highest fitness decile) and specific causes (psychiatric, musculoskeletal, injuries, nervous system, circulatory, and tumors). Obesity was associated with greater risk for receipt of a disability pension due to all and specific causes, with the greatest risks observed for class II and III obesity. Compared with being unfit, being moderately or highly fit was associated with attenuated risk for receipt of a disability pension across BMI categories. Limitation: The cohort did not include women, had data on smoking and alcohol intake only in a subsample, and lacked repeated measures of exposures and covariates. Conclusion: Low cardiorespiratory fitness, obesity, and the combination of the two were strongly associated with later chronic disability due to a wide range of diseases and causes. Although additional well-designed studies are required, these findings support the importance of high cardiorespiratory fitness and healthy body weight during adolescence to prevent later chronic disease.

  • 8.
    Ek, Anna
    et al.
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Sandborg, Johanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Delisle Nystrom, Christine
    Karolinska Inst, Sweden.
    Lindqvist, Anna-Karin
    Lulea Univ Technol, Sweden.
    Rutberg, Stina
    Lulea Univ Technol, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Physical Activity and Mobile Phone Apps in the Preschool Age: Perceptions of Teachers and Parents2019Ingår i: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 7, nr 4, artikel-id e12512Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Physical activity (PA) is already beneficial at the preschool age. In many countries, young children spend most of their days in the preschool setting, making it a common arena for PA interventions. Mobile health tools are becoming increasingly popular to promote PA in different populations; however, little is known about the interest for and how the preschool setting could incorporate such a tool. Objective: This study aimed to examine how teachers and parents perceive PA in preschool-aged children in general and their perceptions of how a mobile phone app could be used to promote PA in the preschool setting. Methods: Semistructured interviews were conducted with 15 teachers (93%, [14/15] women, mean age 43.5 years, 47%, [7/15] with a university degree and 10 parents [91%, 9/10] women, mean age 38.9 years, all with a university degree) recruited from 2 urban preschools in central Sweden. The interviews were recorded, fully transcribed, coded, and analyzed using thematic analysis by means of an inductive approach. Results: The analysis revealed 4 themes: (1) children are physically active by nature, (2) the environment as a facilitator or a barrier, (3) prerequisites of the adult world, and (4) an app in the preschool setting-challenges and possibilities. Parents and teachers perceived preschoolers as being spontaneously physically active; however, high-intensity PA was perceived as low. The PA was specifically performed during the day in the preschool. Identified facilitators of PA were access to safe and engaging outdoor environments such as forests, spacious indoor areas, and adult involvement. Adult involvement was considered especially important for children preferring sedentary activities. Identified barriers for PA were restricted indoor and outdoor space, rules for indoor activities, and lack of adult involvement because of time constraints. The teachers perceived that they had limited skills and experiences using apps in general, although they also acknowledged the increasing role of technological tools in the curriculum. Thus, the teachers expressed an interest for an app designed as a support tool for them, especially for situations when PA was limited because of perceived barriers. They suggested the app to include accessible information regarding the health benefits of PA in children linked to a library of activities for different settings and seasons. Parents suggested interactive app features including problem-solving tasks and music and dance, but not video clips as they made children passive. Conclusions: Vigorous PA was perceived as low in preschool-aged children. Future tailoring of interventions in the preschool setting should work around barriers and support facilitators to PA, especially PA of high intensity. In such work, an app could serve as a source of inspiration for PA in different ages, settings, and seasons and thus reduce environmental and structural inequalities in the preschool setting.

  • 9.
    Leppanen, Marja H.
    et al.
    Univ Jyvaskyla, Finland; Karolinska Inst, Sweden.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Nystrom, Christine Delisle
    Karolinska Inst, Sweden; Eastern Ontario Res Inst, Canada.
    Llorente-Cantarero, Francisco Jesus
    Univ Seville, Spain; Univ Cordoba, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Physical Activity Level Using Doubly-Labeled Water in Relation to Body Composition and Physical Fitness in Preschoolers2019Ingår i: Medicina (Kaunas), ISSN 1010-660X, E-ISSN 1648-9144, Vol. 55, nr 1, artikel-id UNSP 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and objectives: There is a lack of studies investigating associations of physical activity level (PAL) and activity energy expenditure (AEE) using the doubly-labeled water (DLW) method with body composition and physical fitness in young children. Thus, we aimed to examine cross-sectional associations of PAL and AEE with body composition indices and physical fitness components in Swedish preschool children. Materials and methods: PAL was calculated as total energy expenditure measured using DLW divided by the predicted basal metabolic rate in 40 children aged 5.5 (standard deviation 0.2) years. AEE was calculated as total energy expenditure minus basal metabolic rate and the thermic effect of food, and divided by fat-free mass. Body composition was assessed using the 3-component model by combining measurements based on isotope dilution and air-displacement plethysmography. Physical fitness (muscular strength, motor fitness, and cardiorespiratory fitness) was evaluated using the PREFIT test battery. Multiple linear regression models were conducted. Results: PAL and AEE were negatively associated with body mass index, percent body fat, and fat mass index (PAL: standardized beta -0.35, -0.41, and -0.45, all p amp;lt; 0.036; AEE: standardized beta -0.44, -0.44, and -0.47, all p amp;lt; 0.006, respectively). Furthermore, PAL and AEE were positively associated with the standing long jump test (PAL: standardized beta 0.37, p = 0.017; AEE: standardized beta 0.38, p = 0.014). There were no statistically significant associations found regarding PAL or AEE with fat-free mass index or any other physical fitness test. Conclusions: Greater PAL and AEE at the age 5.5 were significantly associated with body fatness and improved lower-body muscular strength. Therefore, increasing physical activity, and thus energy expenditure, at young ages may be beneficial for preventing overweight/obesity. However, further studies with larger sample sizes are needed to confirm the results.

  • 10.
    Henriksson, Pontus
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden; Univ Granada, Spain.
    Leppanen, Marja H.
    Univ Jyvaskyla, Finland.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Univ Granada, Spain.
    Nystrom, Christine Delisle
    Karolinska Inst, Sweden; Childrens Hosp Eastern Ontario, Canada.
    Cadenas-Sanchez, Cristina
    Univ Granada, Spain.
    Ek, Anna
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Ruiz, Jonatan R.
    Karolinska Inst, Sweden; Univ Granada, Spain.
    Ortega, Francisco B.
    Karolinska Inst, Sweden; Univ Granada, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Physical fitness in relation to later body composition in pre-school children2019Ingår i: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 22, nr 5, s. 574-579Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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 4.5 years of age with body composition 12 months 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 5.5 years, 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 4.5 years were associated with a lower fat mass index at 5.5 years (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 4.5 years 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.

  • 11.
    Cadenas-Sanchez, Cristina
    et al.
    PROFITH, University of Granada, Spain; Novum, Karolinska Institutet, Sweden.
    Intemann, Timm
    University of Bremen, Germany; Novum, Karolinska Institutet, Sweden.
    Labayen, Idoia
    Public University of Navarra, Spain.
    Peinado, Ana B
    Universidad Politécnica de Madrid, Spain.
    Vidal-Conti, Josep
    University of the Balearic Islands, Spain.
    Sanchis-Moysi, Joaquin
    University of Las Palmas de Gran Canaria, Spain.
    Moliner-Urdiales, Diego
    LIFE reserach group, University Jaume I, Spain.
    Rodriguez Perez, Manuel A
    University of Almeria, Spain.
    Cañete Garcia-Prieto, Jorge
    Universidad de Castilla-La Mancha, Health and Social Research Center, Spain.
    Fernández-Santos, Jorge Del Rosario
    School of Education, University of Cádiz, Spain.
    Martinez-Tellez, Borja
    PROFITH, University of Granada, Spain.
    Vicente-Rodríguez, Germán
    University of Zaragoza, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Ruiz, Jonatan R
    PROFITH, University of Granada, Spain; Novum, Karolinska Institutet, Sweden.
    Ortega, Francisco B
    PROFITH, University of Granada, Spain; Novum, Karolinska Institutet, Sweden.
    Physical fitness reference standards for preschool children: The PREFIT project.2019Ingår i: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 22, nr 4, s. 430-437, artikel-id S1440-2440(18)30911-3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Reference values are necessary for classifying children, for health screening, and for early prevention as many non-communicable diseases aggravate during growth and development. While physical fitness reference standards are available in children aged 6 and older, such information is lacking in preschool children. Therefore, the purposes of this study were (1) to provide sex-and age-specific physical fitness reference standards for Spanish preschool children; and (2) to study sex differences across this age period and to characterise fitness performance throughout the preschool period.

    DESIGN: Cross-sectional.

    METHODS: A total of 3179 preschool children (1678 boys) aged 2.8-6.4 years old from Spain were included in the present study. Physical fitness was measured using the PREFIT battery.

    RESULTS: Age- and sex-specific percentiles for the physical fitness components are provided. Boys performed better than girls in the cardiorespiratory fitness, muscular strength, and speed-agility tests over the whole preschool period studied and for the different percentiles. In contrast, girls performed slightly better than boys in the balance test. Older children had better performance in all fitness tests than their younger counterparts.

    CONCLUSIONS: Our study provides age- and sex-specific physical fitness reference standards in preschool children allowing interpretation of fitness assessment. Sexual dimorphism in fitness tests exists already at preschool age, and these differences become larger with age. These findings will help health, sport, and school professionals to identify preschool children with a high/very low fitness level, to examine changes in fitness over time, and to analyse those changes obtained due to intervention effects.

  • 12.
    Rodriguez-Ayllon, Maria
    et al.
    Univ Granada, Spain.
    Cadenas-Sanchez, Cristina
    Univ Granada, Spain.
    Estevez-Lopez, Fernando
    Univ Granada, Spain; Ulster Univ, North Ireland.
    Munoz, Nicolas E.
    Univ Granada, Spain.
    Mora-Gonzalez, Jose
    Univ Granada, Spain.
    Migueles, Jairo H.
    Univ Granada, Spain.
    Molina-Garcia, Pablo
    Univ Granada, Spain; KU Leuven Univ Leuven, Belgium.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Univ Granada, Spain.
    Mena-Molina, Alejandra
    Univ Granada, Spain.
    Martinez-Vizcaino, Vicente
    Univ Castilla La Mancha, Spain; Univ Autonoma Chile, Chile.
    Catena, Andres
    Univ Granada, Spain; Univ Granada, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Erickson, Kirk I.
    Univ Pittsburgh, PA 15260 USA.
    Lubans, David R.
    Univ Newcastle, Australia.
    Ortega, Francisco B.
    Univ Granada, Spain; Karolinska Inst, Sweden.
    Esteban-Cornejo, Irene
    Univ Granada, Spain; Northeastern Univ, MA 02115 USA.
    Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis2019Ingår i: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 49, nr 9, s. 1383-1410Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background Evidence suggests that participation in physical activity may support young peoples current and future mental health. Although previous reviews have examined the relationship between physical activity and a range of mental health outcomes in children and adolescents, due to the large increase in published studies there is a need for an update and quantitative synthesis of effects. Objectives The objectives of this study were to determine the effect of physical activity interventions on mental health outcomes by conducting a systematic review and meta-analysis, and to systematically synthesize the observational evidence (both longitudinal and cross-sectional studies) regarding the associations between physical activity and sedentary behavior and mental health in preschoolers (2-5 years of age), children (6-11 years of age) and adolescents (12-18 years of age). Methods A systematic search of the PubMed and Web of Science electronic databases was performed from January 2013 to April 2018, by two independent researchers. Meta-analyses were performed to examine the effect of physical activity on mental health outcomes in randomized controlled trials (RCTs) and non-RCTs (i.e. quasi-experimental studies). A narrative synthesis of observational studies was conducted. Studies were included if they included physical activity or sedentary behavior data and at least one psychological ill-being (i.e. depression, anxiety, stress or negative affect) or psychological well-being (i.e. self-esteem, self-concept, self-efficacy, self-image, positive affect, optimism, happiness and satisfaction with life) outcome in preschoolers, children or adolescents. Results A total of 114 original articles met all the eligibility criteria and were included in the review (4 RCTs, 14 non-RCTs, 28 prospective longitudinal studies and 68 cross-sectional studies). Of the 18 intervention studies, 12 (3 RCTs and 9 non-RCTs) were included in the meta-analysis. There was a small but significant overall effect of physical activity on mental health in children and adolescents aged 6-18 years (effect size 0.173, 95% confidence interval 0.106-0.239, p amp;lt; 0.001, percentage of total variability attributed to between-study heterogeneity [I-2] = 11.3%). When the analyses were performed separately for children and adolescents, the results were significant for adolescents but not for children. Longitudinal and cross-sectional studies demonstrated significant associations between physical activity and lower levels of psychological ill-being (i.e. depression, stress, negative affect, and total psychological distress) and greater psychological well-being (i.e. self-image, satisfaction with life and happiness, and psychological well-being). Furthermore, significant associations were found between greater amounts of sedentary behavior and both increased psychological ill-being (i.e. depression) and lower psychological well-being (i.e. satisfaction with life and happiness) in children and adolescents. Evidence on preschoolers was nearly non-existent. Conclusions Findings from the meta-analysis suggest that physical activity interventions can improve adolescents mental health, but additional studies are needed to confirm the effects of physical activity on childrens mental health. Findings from observational studies suggest that promoting physical activity and decreasing sedentary behavior might protect mental health in children and adolescents. PROSPERO Registration Number: CRD42017060373.

  • 13.
    Nyström, Christine Delisle
    et al.
    Novum, Sweden; Childrens Hosp, Canada.
    Sandin, Sven
    Karolinska Inst, Sweden; Icahn Sch Med Mt Sinai, NY 10029 USA; Seaver Autism Ctr Res and Treatment Mt Sinai, NY 10029 USA.
    Henriksson, Pontus
    Novum, Karolinska Institutet, Sweden; PROFITH, University Granada, Spain.
    Henriksson, Hanna
    Univ Granada, Spain.
    Maddison, Ralph
    Deakin Univ, Australia.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Novum, Karolinska Institutet, Sweden.
    A 12-month follow-up of a mobile-based (mHealth) obesity prevention intervention in pre-school children: the MINISTOP randomized controlled trial2018Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, artikel-id 658Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To date, few mobile health (mHealth) interventions aimed at changing lifestyle behaviors have measured long term effectiveness. At the 6-month follow-up the MINISTOP trial found a statistically significant intervention effect for a composite score comprised of fat mass index (FMI) as well as dietary and physical activity variables; however, no intervention effect was observed for FMI. Therefore, the aim of this study was to investigate if the MINISTOP intervention 12-months after baseline measurements: (i) improved FMI and (ii) had a maintained effect on a composite score comprised of FMI and dietary and physical activity variables. Methods: A two-arm parallel randomized controlled trial was conducted in 315 healthy 4.5 year old children between January 2014 and October 2015. Parents of the participating children either received the MINISTOP intervention or a basic pamphlet on dietary and physical activity behaviors (control group). After 6 months, participants did not have access to the intervention content and were measured again 6 months later (i.e. the 12-month follow-up). The Wilcoxon rank-sum test was then used to examine differences between the groups. Results: At the 12-month follow-up, no statistically significant difference was observed between the intervention and control groups for FMI (p = 0.57) and no maintained effect for the change in composite score was observed (mean +/- standard deviation for the intervention and control group: + 0.53 +/- 1.49 units and + 0.35 +/- 1.27 units respectively, p = 0.25 between groups). Conclusions: The intervention effect observed at the 6-month follow-up on the composite score was not maintained at the 12-month follow-up, with no effect on FMI being observed at either follow-up. Future studies using mHealth are needed to investigate how changes in obesity related markers in young children can be maintained over longer time periods.

  • 14.
    Parekh, Niyati
    et al.
    NYU, NY USA.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Univ Granada, Spain.
    Nyström, Christine Delisle
    Karolinska Inst, Sweden.
    Silfvernagel, Kristin
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Ruiz, Jonatan R.
    Univ Granada, Spain.
    Ortega, Francisco B.
    Univ Granada, Spain.
    Pomeroy, Jeremy
    Marshfield Clin Hlth Syst, WI USA.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Associations of Parental Self-Efficacy With Diet, Physical Activity, Body Composition, and Cardiorespiratory Fitness in Swedish Preschoolers: Results From the MINISTOP Trial2018Ingår i: Health Education & Behavior, ISSN 1090-1981, E-ISSN 1552-6127, Vol. 45, nr 2, s. 238-246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. High parental self-efficacy (PSE) has been associated with healthy diets and higher levels of physical activity (PA) in children; however, data on PSE in relation to body weight and body composition are scarce. The objective of this study was to investigate associations of PSE with measures of diet, PA, body composition, and physical fitness in early childhood. Method. We used baseline data from the MINISTOP trial in healthy Swedish children (n = 301; 4.5 +/- 0.15 years). PSE was assessed using a questionnaire, dietary data were collected using a mobile technology-assisted methodology, and PA was obtained (sedentary behavior and moderate-to-vigorous) by accelerometry. Body composition was measured using the pediatric option for BodPod and cardiorespiratory fitness by the 20 m shuttle run. Linear regression was conducted to evaluate cross-sectional associations of the outcomes in relation to total PSE and scores computed for the individual PSE factors: (1) diet, (2) limit setting of unhealthful behaviors, and (3) PA. Results. Higher scores of total PSE and the diet factor were associated with higher fruit intake ( = 0.82 g/point and 1.99 g/point; p = .014 and .009, respectively) and lower consumption of unhealthy snacks ( = -0.42 g/point and -0.89 g/point; p = .012 and .020, respectively) after adjustment for parental body mass index and education, respondent, and childs sex and age. No associations were observed between PSE and PA, body composition, or cardiorespiratory fitness. Conclusions. Our study noted that PSE should be considered in conjunction with other strategies for a sustainable impact on childhood obesity.

  • 15.
    Sanchez-Delgado, Guillermo
    et al.
    PROFITH, University of Granada, Spain.
    Alcantara, Juan M A
    PROFITH, University of Granada, Spain.
    Acosta, Francisco M
    PROFITH, University of Granada, Spain.
    Martinez-Tellez, Borja
    PROFITH, University of Granada, Spain.
    Amaro-Gahete, Francisco J
    PROFITH, University of Granada, Spain.
    Ortiz-Alvarez, Lourdes
    PROFITH, University of Granada, Spain.
    Löf, Marie
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. NOVUM, Karolinska Institutet, Sweden.
    Labayen, Idoia
    Public University of Navarra, Spain.
    Ruiz, Jonatan R
    PROFITH, University of Granada, Spain.
    Estimation of non-shivering thermogenesis and cold-induced nutrient oxidation rates: Impact of method for data selection and analysis.2018Ingår i: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, artikel-id S0261-5614(18)32445-2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND & AIMS: Since the discovery of active brown adipose tissue in human adults, non-shivering cold-induced thermogenesis (CIT) has been regarded as a promising tool to combat obesity. However, there is a lack of consensus regarding the method of choice to analyze indirect calorimetry data from a CIT study. We analyzed the impact of methods for data selection and methods for data analysis on measures of cold-induced energy expenditure (EE) and nutrient oxidation rates.

    METHODS: Forty-four young healthy adults (22.1 ± 2.1 years old, 25.6 ± 5.2 kg/m2, 29 women) participated in the study. Resting metabolic rate (RMR), cold-induced thermogenesis (CIT), and cold-induced nutrient oxidation rates were estimated by indirect calorimetry under fasting conditions during 1 h of cold exposure combining air conditioning (19.5-20 °C) and a water perfused cooling vest set at a temperature of 4 °C above the individual shivering threshold. We applied three methods for data selection: (i) time intervals every 5 min (5min-TI), (ii) the most stable 5-min period of every forth part of the cold exposure (5min-SS-4P), and (iii) the most stable 5-min period of every half part of the cold exposure (5min-SS-2P). Lately we applied two methods for data analysis: (i) area under the curve as a percentage of the baseline RMR (AUC) and; (ii) the difference between EE at the end of the cold exposure and baseline RMR (Last-RMR).

    RESULTS: Mean overall CIT estimation ranged from 11.6 ± 10.0 to 20.1 ± 17.2 %RMR depending on the methods for data selection and analysis used. Regarding methods for data selection, 5min-SS-2P did not allow to observe physiologically relevant phenomena (e.g. metabolic shift in fuel oxidation; P = 0.547) due to a lack of resolution. The 5min-TI and 5min-SS-4P methods for data selection seemed to be accurate enough to observe physiologically relevant phenomena (all P < 0.014), but not comparable for estimating over-all CIT and cold-induced nutrient oxidation rates (P < 0.01). Regarding methods for data analysis, the AUC seemed to be less affected for data artefacts and to be more representative in participants with a non-stable energy expenditure during cold exposure.

    CONCLUSIONS: The methods for data selection and analysis can have a profound impact on CIT and cold-induced nutrient oxidation rates estimations, and therefore, it is mandatory to unify it across scientific community to allow inter-study comparisons. Based on our findings, 5min-TI should be considered the method of choice to study dynamics (i.e. changes across time) of CIT and cold-induced nutrient oxidation rates, while 5min-SS-4P and AUC should be the method of choice when computing CIT and cold-induced nutrient oxidation rates as a single value.

  • 16.
    Aubert, Salome
    et al.
    CHEO Res Inst, Canada.
    Barnes, Joel D.
    CHEO Res Inst, Canada.
    Abdeta, Chalchisa
    Haramaya Univ, Ethiopia.
    Nader, Patrick Abi
    Univ Moncton, Canada; CHU Montreal, Canada.
    Adeniyi, Ade F.
    Univ Ibadan, Nigeria; Nigerian Heart Fdn, Nigeria.
    Aguilar-Farias, Nicolas
    Univ La Frontera, Chile; Univ La Frontera, Chile.
    Andrade Tenesaca, Dolores S.
    Univ Cuenca, Ecuador.
    Bhawra, Jasmin
    Univ Waterloo, Canada.
    Brazo-Sayavera, Javier
    Univ Republ, Uruguay; Univ Republ, Uruguay.
    Cardon, Greet
    Univ Ghent, Belgium.
    Chang, Chen-Kang
    Natl Taiwan Univ Sport, Taiwan.
    Nystrom, Christine Delisle
    CHEO Res Inst, Canada; Karolinska Inst, Sweden.
    Demetriou, Yolanda
    Tech Univ Munich, Germany.
    Draper, Catherine E.
    Univ Witwatersrand, South Africa; Univ Cape Town, South Africa.
    Edwards, Lowri
    Swansea Univ, Wales.
    Emeljanovas, Arunas
    Lithuanian Sports Univ, Lithuania.
    Gaba, Ales
    Palacky Univ Olomouc, Czech Republic.
    Galaviz, Karla I.
    Emory Univ, GA 30322 USA.
    Gonzalez, Silvia A.
    CHEO Res Inst, Canada; Univ Los Andes, Colombia.
    Herrera-Cuenca, Marianella
    Univ Cent Venezuela, Venezuela; Fdn Bengoa Alimentac and Nutr, Venezuela; Observ Venezolano Salud, Venezuela.
    Huang, Wendy Y.
    Hong Kong Baptist Univ, Peoples R China.
    Ibrahim, Izzeldin A. E.
    Aspetar Orthoped and Sports Med Hosp, Qatar.
    Jurimae, Jaak
    Univ Tartu, Estonia.
    Kamppi, Katariina
    LIKES Res Ctr Phys Activ and Hlth, Finland.
    Katapally, Tarun R.
    Univ Regina, Canada.
    Katewongsa, Piyawat
    Mahidol Univ, Thailand.
    Katzmarzyk, Peter T.
    Pennington Biomed Res Ctr, LA 70808 USA.
    Khan, Asaduzzaman
    Univ Queensland, Australia.
    Korcz, Agata
    Poznan Univ Phys Educ, Poland.
    Kim, Yeon Soo
    Seoul Natl Univ, South Korea.
    Lambert, Estelle
    Univ Cape Town, South Africa.
    Lee, Eun-Young
    Queens Univ, Canada.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Loney, Tom
    Mohammed Bin Rashid Univ Med and Hlth Sci, U Arab Emirates.
    Lopez-Taylor, Juan
    Univ Guadalajara, Mexico.
    Liu, Yang
    Shanghai Univ Sport, Peoples R China.
    Makaza, Daga
    Natl Univ Sci and Technol, Zimbabwe.
    Manyanga, Taru
    CHEO Res Inst, Canada.
    Mileva, Bilyana
    BG Act Assoc, Bulgaria.
    Morrison, Shawnda A.
    Univ Primorska, Slovenia.
    Mota, Jorge
    Univ Porto, Portugal.
    Nyawornota, Vida K.
    Univ Ghana, Ghana.
    Ocansey, Reginald
    Univ Ghana, Ghana.
    Reilly, John J.
    Univ Strathclyde, Scotland.
    Roman-Vinas, Blanca
    Nutr Res Fdn, Spain; Univ Girona, Spain; Inst Salud Carlos III, Spain.
    Santos Silva, Diego Augusto
    Univ Fed Santa Catarina, Brazil.
    Saonuam, Pairoj
    Thai Hlth Promot Fdn ThaiHlth, Thailand.
    Scriven, John
    Jersey Sport Fdn, England.
    Seghers, Jan
    Katholieke Univ Leuven, Belgium.
    Schranz, Natasha
    Univ South Australia, Australia.
    Skovgaard, Thomas
    Univ Southern Denmark, Denmark.
    Smith, Melody
    Univ Auckland, New Zealand.
    Standage, Martyn
    Univ Bath, England.
    Starc, Gregor
    Univ Ljubljana, Slovenia.
    Stratton, Gareth
    Swansea Univ, Wales.
    Subedi, Narayan
    Tribhuvan Univ, Nepal.
    Takken, Tim
    Univ Med Ctr Utrecht, Netherlands.
    Tammelin, Tuija
    LIKES Res Ctr Phys Activ and Hlth, Finland.
    Tanaka, Chiaki
    JF Oberlin Univ, Japan.
    Thivel, David
    Univ Clermont Ferrand, France.
    Tladi, Dawn
    Univ Botswana, Botswana.
    Tyler, Richard
    Swansea Univ, Wales.
    Uddin, Riaz
    Univ Queensland, Australia; Stamford Univ Bangladesh, Bangladesh.
    Williams, Alun
    Sir Charles Froissard House, England.
    Wong, Stephen H. S.
    Chinese Univ Hong Kong, Peoples R China.
    Wu, Ching-Lin
    Natl Chung Hsing Univ, Taiwan.
    Zembura, Pawel
    Univ Warsaw, Poland.
    Tremblay, Mark S.
    CHEO Res Inst, Canada.
    Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries2018Ingår i: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 15, s. S251-S273Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5-17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of "C-," "D+," and "C-" was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

  • 17.
    Forsum, Elisabet
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Janerot Sjöberg, Birgitta
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    MET-values of standardised activities in relation to body fat: studies in pregnant and non-pregnant women2018Ingår i: Nutrition & Metabolism, ISSN 1743-7075, E-ISSN 1743-7075, Vol. 15, artikel-id 45Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Physical activity is associated with health in women. Published MET-values (MET: metabolic equivalent of task) may assess physical activity and energy expenditure but tend to be too low for subjects with a high total body fat (TBF) content and therefore inappropriate for many contemporary women. The MET-value for an activity is the energy expenditure of a subject performing this activity divided by his/her resting energy expenditure, often assumed to be 4.2 kJ/kg/h. Relationships between TBF and MET have been little studied although overweight and obesity is common in women. Available data indicate that MET-values decrease during pregnancy but more studies in pregnant contemporary women are needed. Subjects and methods: Using indirect calorimetry we measured energy expenditure and assessed MET-values in women, 22 non-pregnant (BMI: 18-34) and 22 in gestational week 32 (non-pregnant BMI: 18-32) when resting, sitting, cycling (30 and 60 watts), walking (3.2 and 5.6 km/h) and running (8 km/h). Relationships between TBF and MET-values were investigated and used to predict modified MET-values. The potential of such values to improve calculations of total energy expenditure of women was investigated. Results: The resting energy expenditure was below 4.2 kJ/kg/h in both groups of women. Women in gestational week 32 had a higher resting energy metabolism (p amp;lt; 0.001) and 7-15% lower MET-values (p amp;lt; 0.05) than non-pregnant women. MET-values of all activities were correlated with TBF (p amp;lt; 0.05) in non-pregnant women and modified MET-values improved estimates of total energy expenditure in such women. In pregnant women, correlations (p amp;lt;= 0.03) between TBF and MET were found for running (8 km/h) and for walking at 5.6 km/h. Conclusions: Our results are relevant when attempts are made to modify the MET-system in contemporary pregnant and non-pregnant women. MET-values were decreased in gestational week 32, mainly due to an increased resting energy metabolism and studies describing how body composition affects the one MET-value (i.e. the resting energy metabolism in kJ/kg/h) during pregnancy are warranted. Studies of how pregnancy and TBF affect MET-values of high intensity activities are also needed. Corrections based on TBF may have a potential to improve the MET-system in non-pregnant women.

  • 18.
    Aubert, Salome
    et al.
    CHEO Res Inst, Canada.
    Barnes, Joel D.
    CHEO Research Institute, Ottawa, Ontario, Canada..
    Aguilar-Farias, Nicolas
    Univ La Frontera, Chile.
    Cardon, Greet
    Univ Ghent, Belgium.
    Chang, Chen-Kang
    Natl Taiwan Univ Sport, Taiwan.
    Nystrom, Christine Delisle
    Karolinska Inst, Sweden.
    Demetriou, Yolanda
    Tech Univ Munich, Germany.
    Edwards, Lowri
    Swansea Univ, Wales.
    Emeljanovas, Arunas
    Lithuanian Sports Univ, Lithuania.
    Gaba, Ales
    Palacky Univ Olomouc, Czech Republic.
    Huang, Wendy Y.
    Hong Kong Baptist Univ, Peoples R China.
    Ibrahim, Izzeldin A. E.
    Aspetar Orthoped and Sports Med Hosp, Qatar.
    Jurimae, Jaak
    Univ Tartu, Estonia.
    Katzmarzyk, Peter T.
    Pennington Biomed Res Ctr, LA 70808 USA.
    Korcz, Agata
    Poznan Univ Phys Educ, Poland.
    Kim, Yeon Soo
    Seoul Natl Univ, South Korea.
    Lee, Eun-Young
    Queens Univ, Canada.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Loney, Tom
    Mohammed Bin Rashid Univ Med and Hlth Sci, U Arab Emirates.
    Morrison, Shawnda A.
    Univ Primorska, Slovenia.
    Mota, Jorge
    Univ Porto, Portugal.
    Reilly, John J.
    Univ Strathclyde, Scotland.
    Roman-Vinas, Blanca
    Nutr Res Fdn, Spain; Univ Girona, Spain; Inst Salud Carlos III, Spain.
    Schranz, Natasha
    Univ South Australia, Australia.
    Scriven, John
    Jersey Sport Fdn, England.
    Seghers, Jan
    Katholieke Univ Leuven, Belgium.
    Skovgaard, Thomas
    Univ Southern Denmark, Denmark.
    Smith, Melody
    Univ Auckland, New Zealand.
    Standage, Martyn
    Univ Bath, England.
    Starc, Gregor
    Univ Ljubljana, Slovenia.
    Stratton, Gareth
    Swansea Univ, Wales.
    Takken, Tim
    Univ Med Ctr Utrecht, Netherlands.
    Tammelin, Tuija
    LIKES Res Ctr Phys Act and Hlth, Finland.
    Tanaka, Chiaki
    JF Oberlin Univ, Japan.
    Thivel, David
    Clermont Auvergne Univ, France.
    Tyler, Richard
    Swansea Univ, Wales.
    Williams, Alun
    Guernsey Educ Serv, England.
    Wong, Stephen H. S.
    Chinese Univ Hong Kong, Peoples R China.
    Zembura, Pawel
    Univ Warsaw, Poland.
    Tremblay, Mark S.
    CHEO Res Inst, Canada.
    Report Card Grades on the Physical Activity of Children and Youth Comparing 30 Very High Human Development Index Countries2018Ingår i: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 15, s. S298-S314Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To better understand the childhood physical inactivity crisis, Report Cards on physical activity of children and youth were prepared concurrently in 30 very high Human Development Index countries. The aim of this article was to present, describe, and compare the findings from these Report Cards. Methods: The Report Cards were developed using a harmonized process for data gathering, assessing, and assigning grades to 10 common physical activity indicators. Descriptive statistics were calculated after converting letter grades to interval variables, and correlational analyses between the 10 common indicators were performed using Spearmans rank correlation coefficients. Results: A matrix of 300 grades was obtained with substantial variations within and between countries. Low grades were observed for behavioral indicators, and higher grades were observed for sources of influence indicators, indicating a disconnect between supports and desired behaviors. Conclusion: This analysis summarizes the level and context of the physical activity of children and youth among very high Human Development Index countries, and provides additional evidence that the situation regarding physical activity in children and youth is very concerning. Unless a major shift to a more active lifestyle happens soon, a high rate of noncommunicable diseases can be anticipated when this generation of children reaches adulthood.

  • 19.
    Nystrom, Christine Delisle
    et al.
    Karolinska Inst, Sweden; Childrens Hosp Eastern Ontario, Canada.
    Larsson, Christel
    Univ Gothenburg, Sweden.
    Alexandrou, Christina
    Karolinska Inst, Sweden.
    Ehrenblad, Bettina
    Karolinska Inst, Sweden.
    Eriksson, Ulf
    Kosterhavets Ekobod AB, Sweden.
    Friberg, Marita
    Publ Hlth Agcy, Sweden.
    Hagstromer, Maria
    Karolinska Inst, Sweden.
    Lindroos, Anna Karin
    Natl Food Agcy, Sweden.
    Nyberg, Gisela
    Karolinska Inst, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Results from Swedens 2018 Report Card on Physical Activity for Children and Youth2018Ingår i: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 15, s. S413-S414Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    n/a

  • 20.
    Delisle Nyström, Christine
    et al.
    Karolinska Inst, Sweden; Eastern Ontario Res Inst, Canada.
    Soderstrom, Emmie
    Karolinska Inst, Sweden.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. PROFITH, Univ Granada, Spain.
    Poortvliet, Eric
    Karolinska Inst, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    The paediatric option for BodPod to assess body composition in preschool children: what fat-free mass density values should be used?2018Ingår i: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 120, nr 7, s. 797-802Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Air displacement plethysmography utilises a two-component model to assess body composition, which relies on assumptions regarding the density of fat-free mass (FFM). To date, there is no evidence as to whether Lohmans or Wells et al.s FFM density values are more accurate in young children. Therefore, the aims of this study were to compare total body fat percentage (TBF%) assessed using the BodPod with both Lohmans and Wells et al.s FFM density values with TBF% from the three-component (3C) model in forty healthy Swedish children aged 5.5 years. Average TBF% calculated using Lohmans FFM density values underestimated TBF% in comparison with the corresponding value assessed using the 3C model (22.2 (SD 5.7) and 25.1 (SD 5.5)%, respectively; P amp;lt;0.001). No statistically significant difference was observed between TBF% assessed using Wells et al.s FFM density values and the 3C model (24.9 (so 5.5) and 251 (so 5.5)%, respectively; P= 0.614). The Bland and Altman plots for TBF% using both Lohmans and Wells et al.s FFM density values did not show any bias across the range of body fatness (Lohman: r0.056, P= 0.733 and Wells el al.: r-0.006, P= 0.970). These results indicate that Wells Cl al.s FFM density values should be used when assessing body composition with the paediatric option for BodPod in 5-year-old children. However, future studies are needed to confirm these results in other populations, including a wider age range of children.

  • 21.
    Migueles, Jairo H.
    et al.
    University of Granada, Spain.
    Cadenas-Sanchez, Cristina
    University of Granada, Spain.
    Ekelund, Ulf
    Norwegian School Sport Science, Norway; University of Cambridge, England.
    Delisle Nystrom, Christine
    Karolinska Institute, Sweden.
    Mora-Gonzalez, Jose
    University of Granada, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Labayen, Idoia
    University of Basque Country, Spain.
    Ruiz, Jonatan R.
    University of Granada, Spain; Karolinska Institute, Sweden.
    Ortega, Francisco B.
    University of Granada, Spain; Karolinska Institute, Sweden.
    Accelerometer Data Collection and Processing Criteria to Assess Physical Activity and Other Outcomes: A Systematic Review and Practical Considerations2017Ingår i: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 47, nr 9, s. 1821-1845Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background Accelerometers are widely used to measure sedentary time, physical activity, physical activity energy expenditure (PAEE), and sleep-related behaviors, with the ActiGraph being the most frequently used brand by researchers. However, data collection and processing criteria have evolved in a myriad of ways out of the need to answer unique research questions; as a result there is no consensus. Objectives The purpose of this review was to: (1) compile and classify existing studies assessing sedentary time, physical activity, energy expenditure, or sleep using the ActiGraph GT3X/+ through data collection and processing criteria to improve data comparability and (2) review data collection and processing criteria when using GT3X/+ and provide age-specific practical considerations based on the validation/calibration studies identified. Methods Two independent researchers conducted the search in PubMed and Web of Science. We included all original studies in which the GT3X/+ was used in laboratory, controlled, or free-living conditions published from 1 January 2010 to the 31 December 2015. Results The present systematic review provides key information about the following data collection and processing criteria: placement, sampling frequency, filter, epoch length, non-wear-time, what constitutes a valid day and a valid week, cut-points for sedentary time and physical activity intensity classification, and algorithms to estimate PAEE and sleep-related behaviors. The information is organized by age group, since criteria are usually age-specific. Conclusion This review will help researchers and practitioners to make better decisions before (i.e., device placement and sampling frequency) and after (i.e., data processing criteria) data collection using the GT3X/? accelerometer, in order to obtain more valid and comparable data.

  • 22.
    Henriksson, Hanna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden; University of Granada, Spain.
    Eriksson, Britt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Flinke Carlsson, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. University of Granada, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Longitudinal assessment of body composition in healthy Swedish children from 1 week until 4 years of age2017Ingår i: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 71, nr 11, s. 1345-1352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Knowledge of longitudinal body composition development is required to identify the mechanisms behind childhood overweight and obesity and to prevent these conditions. However, accurate data on this development in early childhood are lacking. Our aim was to describe the longitudinal body composition development in healthy young Swedish children. SUBJECTS/METHODS: Body size and composition were assessed in 26 children using air-displacement plethysmography (1 and 12 weeks and 4.4 years of age) and isotope dilution (1.5 and 3 years of age) and compared with available reference data. RESULTS: Body fat (%) for boys (n = 16) was 12.8 +/- 3.9 (1 week), 25.6 +/- 4.8 (12 weeks), 28.2 +/- 3.8 (1.5 years), 27.3 +/- 5.1 (3 years) and 26.1 +/- 3.5 (4.4 years). For girls (n = 10) these values were 15.3 +/- 2.9, 25.7 +/- 3.9, 27.9 +/- 3.3, 26.3 +/- 7.2 and 26.0 +/- 5.3, respectively. These values were above the Fomon reference values at 1.5 years of age and later and higher than the Butte reference (Po0.05) for boys at 1.5 years of age. At all ages the coefficients of variation were higher for body fat (%) (12-30%) than for BMI (4-11%). CONCLUSIONS: At 4 years of age our children had more body fat than indicated by reference data. This high level may have already been established at 1.5 years of age but our small sample and the lack of appropriate reference data limit the possibility of drawing firm conclusions. Our results demonstrate the limitations of BMI when investigating overweight and obesity in early life and highlight the need for appropriate reference body composition data in infants and young children.

  • 23.
    Leppänen, Marja H.
    et al.
    University of Jyvaskyla, Finland.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. University of Granada, Spain; Karolinska Institute, Sweden.
    Delisle Nyström, Christine
    Karolinska Institute, Sweden.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. University of Granada, Spain.
    Ortega, Francisco B.
    University of Granada, Spain.
    Pomeroy, Jeremy
    Marshfield Clin Research Fdn, WI USA.
    Ruiz, Jonatan R.
    University of Granada, Spain.
    Cadenas-Sanchez, Cristina
    University of Granada, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers2017Ingår i: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 49, nr 10, s. 2078-2085Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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 amp;lt; 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(-1) 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 amp;lt; 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.

  • 24.
    Delisle Nystrom, Christine
    et al.
    Novum, Sweden.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Trolle-Lagerros, Ylva
    Karolinska Institute, Sweden.
    Larsson, Christel
    University of Gothenburg, Sweden.
    Maddison, Ralph
    University of Auckland, New Zealand.
    Timpka, Toomas
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för hälso- och vårdutveckling, Folkhälsocentrum.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Novum, Sweden.
    A Mobile Phone Based Method to Assess Energy and Food Intake in Young Children: A Validation Study against the Doubly Labelled Water Method and 24 h Dietary Recalls2016Ingår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, nr 1, s. 50-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured via doubly labelled water (DLW); and (b) to compare intakes of fruits, vegetables, fruit juice, sweetened beverages, candy, ice cream, and bakery products using TECH with intakes acquired by 24 h dietary recalls. Participants were 39 healthy, Swedish children (5.5 +/- 0.5 years) within the ongoing Mobile-based Intervention Intended to Stop Obesity in Preschoolers (MINISTOP) obesity prevention trial. Energy and food intakes were assessed during four days using TECH and 24 h telephone dietary recalls. Mean EI (TECH) was not statistically different from TEE (DLW) (5820 +/- 820 kJ/24 h and 6040 +/- 680kJ/24 h, respectively). No significant differences in the average food intakes using TECH and 24 h dietary recalls were found. All food intakes were correlated between TECH and the 24 h dietary recalls (r = 0.665-0.896, p &lt; 0.001). In conclusion, TECH accurately estimated the average intakes of energy and selected foods and thus has the potential to be a useful tool for dietary studies in pre-school children, for example obesity prevention trials.

  • 25.
    Jung, Seungyoun
    et al.
    Harvard TH Chan School Public Heatlh, MA USA; University of Maryland, MD 21201 USA.
    Wang, Molin
    Harvard TH Chan School Public Heatlh, MA USA; Harvard TH Chan School Public Heatlh, MA USA.
    Anderson, Kristin
    University of Minnesota, MN USA; University of Minnesota, MN USA.
    Baglietto, Laura
    Cancer Council Victoria, Australia; University of Melbourne, Australia.
    Bergkvist, Leif
    Central Hospital Vasteras, Sweden; Central Hospital Vasteras, Sweden.
    Bernstein, Leslie
    Beckman Research Institute, CA USA; City Hope National Medical Centre, CA 91010 USA.
    van den Brandt, Piet A.
    Maastricht University, Netherlands.
    Brinton, Louise
    NCI, MD 20892 USA.
    Buring, Julie E.
    Harvard TH Chan School Public Heatlh, MA USA; Harvard Medical Sch, MA USA.
    Eliassen, A. Heather
    Harvard TH Chan School Public Heatlh, MA USA; Brigham and Womens Hospital, MA USA; Harvard Medical Sch, MA USA.
    Falk, Roni
    NCI, MD 20892 USA.
    Gapstur, Susan M.
    Amer Cancer Soc, GA 30329 USA.
    Giles, Graham G.
    Cancer Council Victoria, Australia; University of Melbourne, Australia.
    Goodman, Gary
    Fred Hutchinson Cancer Research Centre, WA 98104 USA.
    Hoffman-Bolton, Judith
    Johns Hopkins Bloomberg School Public Heatlh, MD USA.
    Horn-Ross, Pamela L.
    Cancer Prevent Institute Calif, CA USA.
    Inoue, Manami
    National Cancer Centre, Japan; University of Tokyo, Japan.
    Kolonel, Laurence N.
    University of Hawaii, HI 96822 USA.
    Krogh, Vittorio
    Fdn IRCCS Ist Nazl Tumori, Italy.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Maas, Paige
    NCI, MD 20892 USA.
    Miller, Anthony B.
    University of Toronto, Canada.
    Neuhouser, Marian L.
    Fred Hutchinson Cancer Research Centre, WA 98104 USA.
    Park, Yikyung
    Washington University, MO 63110 USA.
    Robien, Kim
    George Washington University, DC USA.
    Rohan, Thomas E.
    Albert Einstein Coll Med, NY 10467 USA.
    Scarmo, Stephanie
    NYU, NY USA.
    Schouten, Leo J.
    Maastricht University, Netherlands.
    Sieri, Sabina
    Fdn IRCCS Ist Nazl Tumori, Italy.
    Stevens, Victoria L.
    Amer Cancer Soc, GA 30329 USA.
    Tsugane, Schoichiro
    National Cancer Centre, Japan.
    Visvanathan, Kala
    Johns Hopkins Bloomberg School Public Heatlh, MD USA.
    Wilkens, Lynne R.
    University of Hawaii, HI 96822 USA.
    Wolk, Alicja
    Karolinska Institute, Sweden.
    Weiderpass, Elisabete
    Karolinska Institute, Sweden; University of Tromso, Norway; Cancer Registry Norway, Norway; Folkhalsan Research Centre, Finland.
    Willett, Walter C.
    Harvard TH Chan School Public Heatlh, MA USA; Harvard TH Chan School Public Heatlh, MA USA; Brigham and Womens Hospital, MA USA; Harvard Medical Sch, MA USA.
    Zeleniuch-Jacquotte, Anne
    NYU, NY USA.
    Zhang, Shumin M.
    Harvard Medical Sch, MA USA.
    Zhang, Xuehong
    Brigham and Womens Hospital, MA USA; Harvard Medical Sch, MA USA.
    Ziegler, Regina G.
    NCI, MD 20892 USA.
    Smith-Warner, Stephanie A.
    Harvard TH Chan School Public Heatlh, MA USA.
    Alcohol consumption and breast cancer risk by estrogen receptor status: in a pooled analysis of 20 studies2016Ingår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 45, nr 3, s. 916-928Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Breast cancer aetiology may differ by estrogen receptor (ER) status. Associations of alcohol and folate intakes with risk of breast cancer defined by ER status were examined in pooled analyses of the primary data from 20 cohorts. Methods: During a maximum of 6-18 years of follow-up of 1 089 273 women, 21 624 ER+ and 5113 ER- breast cancers were identified. Study-specific multivariable relative risks (RRs) were calculated using Cox proportional hazards regression models and then combined using a random-effects model. Results: Alcohol consumption was positively associated with risk of ER+ and ER- breast cancer. The pooled multivariable RRs (95% confidence intervals) comparing amp;gt;= 30 g/d with 0 g/day of alcohol consumption were 1.35 (1.23-1.48) for ER+ and 1.28 (1.10-1.49) for ER+ breast cancer (P-trend amp;lt;= 0.001; Pcommon-effects by ER status: 0.57). Associations were similar for alcohol intake from beer, wine and liquor. The associations with alcohol intake did not vary significantly by total (from foods and supplements) folate intake (P-interaction amp;gt;= 0.26). Dietary (from foods only) and total folate intakes were not associated with risk of overall, ER+ and ER- breast cancer; pooled multivariable RRs ranged from 0.98 to 1.02 comparing extreme quintiles. Following-up US studies through only the period before mandatory folic acid fortification did not change the results. The alcohol and folate associations did not vary by tumour subtypes defined by progesterone receptor status. Conclusions: Alcohol consumption was positively associated with risk of both ER+ and ER- breast cancer, even among women with high folate intake. Folate intake was not associated with breast cancer risk.

  • 26.
    Henriksson, Pontus
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. University of Granada, Spain.
    Cadenas-Sanchez, Cristina
    University of Granada, Spain.
    Leppanen, Marja H.
    University of Jyvaskyla, Finland.
    Delisle Nystrom, Christine
    Karolinska Institute, Sweden.
    Ortega, Francisco B.
    University of Granada, Spain; Karolinska Institute, Sweden.
    Pomeroy, Jeremy
    Marshfield Clin Research Fdn, WI 54449 USA.
    Ruiz, Jonatan R.
    University of Granada, Spain; Karolinska Institute, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Associations of Fat Mass and Fat-Free Mass with Physical Fitness in 4-Year-Old Children: Results from the MINISTOP Trial2016Ingår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, nr 8, s. 473-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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)/height(2) (m)] and fat-free mass index [fat-free mass (kg)/height(2) (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 beta = -0.17, p = 0.002), lower-body muscular strength (beta = -0.17, p = 0.003) and motor fitness (beta = -0.21, p amp;lt; 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 (beta = 0.18, p = 0.002), upper-body muscular strength (beta = 0.39, p amp;lt; 0.001), lower-body muscular strength (beta = 0.22, p amp;lt; 0.001) and motor fitness (beta = 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.

  • 27.
    Leppänen, M. H.
    et al.
    University of Jyvaskyla, Finland.
    Delisle Nyström, C.
    Karolinska Institute, Sweden.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. University of Granada, Spain.
    Pomeroy, J.
    Marshfield Clin Research Fdn, WI USA.
    Ruiz, J. R.
    University of Granada, Spain.
    Ortega, F. B.
    University of Granada, Spain.
    Cadenas-Sanchez, C.
    University of Granada, Spain.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Physical activity intensity, sedentary behavior, body composition and physical fitness in 4-year-old children: results from the ministop trial2016Ingår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 40, nr 7, s. 1126-1133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Existing knowledge on associations of physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness in preschoolers is limited. OBJECTIVE: To examine associations of PA and SB with body composition and physical fitness in healthy Swedish 4-year-old children. METHODS: We utilized baseline data collected in 2014 for the population-based MINISTOP trial (n = 307). Light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA), moderate-to-vigorous PA (MVPA) and SB were measured using accelerometry (ActiGraph-wGT3x-BT). Body composition was measured using air-displacement plethysmography, and physical fitness (that is, cardiorespiratory fitness, lower and upper body muscular strength and motor fitness) was measured using the PREFIT fitness test battery. Multiple linear regression models adjusted for relevant confounders, and in addition, isotemporal substitution models were applied. RESULTS: Greater MVPA was associated with lower fat mass percent (%FM, P = 0.015), and greater VPA and MVPA were associated with higher fat-free mass index (FFMI, P = 0.002 and P = 0.011). In addition, greater VPA and MVPA were associated with higher scores for all physical fitness tests (P = 0.042 to Pamp;lt;0.001). The results for MVPA were primarily due to VPA. SB was associated with weaker handgrip strength (P = 0.031) when PA was not adjusted, but after adjusting also for VPA, the significant association disappeared (P = 0.25). Substituting 5 min per day of SB, LPA or MPA with 5 min per day of VPA was associated with higher FFMI and better scores for cardiorespiratory fitness and motor fitness. Correspondingly, substituting 5 min per day of VPA with SB or LPA was associated with weaker performance for lower muscular strength. CONCLUSIONS: Time spent on VPA was associated with higher FFMI and better physical fitness. The results suggest that promoting VPA may be important to improve childhood body composition and physical fitness already at an early age.

  • 28.
    Hedelin, Maria
    et al.
    University of Gothenburg, Sweden; Karolinska Institute, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Sandin, Sven
    Karolinska Institute, Sweden.
    Adami, Hans-Olov
    Karolinska Institute, Sweden; Harvard University, MA 02115 USA.
    Weiderpass, Elisabete
    Karolinska Institute, Sweden; Cancer Registry Norway, Norway; Arctic University of Norway, Norway; Folkhalsan Research Centre, Finland.
    Prospective Study of Dietary Phytoestrogen Intake and the Risk of Colorectal Cancer2016Ingår i: Nutrition and Cancer, ISSN 0163-5581, E-ISSN 1532-7914, Vol. 68, nr 3, s. 388-395Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dietary phytoestrogen intake has been inversely associated with the risk of prostate and breast cancer and might also affect the risk of colorectal cancer. We evaluated the associations between dietary lignan intake, dietary isoflavonoid intake, dietary coumestrol intake, and dietary enterolignans and equol intake, and risk of colorectal cancer. Data from the Womens Lifestyle and Health (WLH) Cohort study was used. The WLH study is a prospective population-based cohort study including 48,268 Swedish women aged 30-49years at the time of enrolment in 1991-92. Follow-up for colorectal cancer incidence, death, and emigration until the end of 2010 was performed through record linkage to the Swedish Cancer Registry and Total Population Register. During follow-up 206 incident colorectal cancer cases were identified. Cox proportional hazards models were fitted to estimate adjusted risk ratios with 95% confidence intervals. We found no statistically significant association between the intake of dietary lignans, dietary isoflavonoids, coumestrol, or enterolignans and equol, and risk of colorectal cancer. We found no association between dietary phytoestrogen intake and the risk of colorectal cancer. However, since the number of cancer cases was small, our results need to be confirmed. Future studies should investigate colon and rectal cancer separately.

  • 29.
    Delisle Nystrom, Christine
    et al.
    Karolinska Institute, Sweden.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. PROmoting FITness and Health Phys Actv Research Grp PROFIT, Spain.
    Alexandrou, Christina
    Karolinska Institute, Sweden.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    The Tanita SC-240 to Assess Body Composition in Pre-School Children: An Evaluation against the Three Component Model2016Ingår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, nr 6, s. 371-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Quick, easy-to-use, and valid body composition measurement options for young children are needed. Therefore, we evaluated the ability of the bioelectrical impedance (BIA) device, Tanita SC-240, to measure fat mass (FM), fat free mass (FFM) and body fatness (BF%) in 40 healthy, Swedish 5.5 years old children against the three component model (3C model). Average BF%, FM, and FFM for BIA were: 19.4% +/- 3.9%, 4.1 +/- 1.9 kg, and 16.4 +/- 2.4 kg and were all significantly different (p amp;lt; 0.001) from corresponding values for the 3C model (25.1% +/- 5.5%, 5.3 +/- 2.5 kg, and 15.2 +/- 2.0 kg). Bland and Altman plots had wide limits of agreement for all body composition variables. Significant correlations ranging from 0.81 to 0.96 (p amp;lt; 0.001) were found for BF%, FM, and FFM between BIA and the 3C model. When dividing the children into tertiles for BF%, 60% of children were classified correctly by means of BIA. In conclusion, the Tanita SC-240 underestimated BF% in comparison to the 3C model and had wide limits of agreement. Further work is needed in order to find accurate and easy-to-use methods for assessing body composition in pre-school children.

  • 30.
    Henriksson, Hanna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Bonn, E. Stephanie
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Bergström, Anna
    Karolinska Institutet, Institute of Enviromental Medicine, Stockholm, Sweden.
    Bälter, Katarina
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Bälter, Olle
    Royal Institute of Technology, School of Computer Science and Communication, Stockholm, Sweden.
    Delisle, Christine
    Karolinska Institutet, Department of Biosciences and Nutrition, Huddinge, Sweden.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Karolinska Institutet, Department of Biosciences and Nutrition, Huddinge, Sweden.
    A New Mobile Phone-Based Tool for Assessing Energy and Certain Food Intakes in Young Children: A Validation Study2015Ingår i: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 3, nr 2, artikel-id e38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Childhood obesity is an increasing health problem globally. Obesity may be established already at pre-school age. Further research in this area requires accurate and easy-to-use methods for assessing the intake of energy and foods. Traditional methods have limited accuracy, and place large demands on the study participants and researchers. Mobile phones offer possibilities for methodological advancements in this area since they are readily available, enable instant digitalization of collected data, and also contain a camera to photograph pre- and post-meal food items. We have recently developed a new tool for assessing energy and food intake in children using mobile phones called the Tool for Energy Balance in Children (TECH). Objective: The main aims of our study are to (1) compare energy intake by means of TECH with total energy expenditure (TEE) measured using a criterion method, the doubly labeled water (DLW) method, and (2) to compare intakes of fruits and berries, vegetables, juice, and sweetened beverages assessed by means of TECH with intakes obtained using a Web-based food frequency questionnaire (KidMeal-Q) in 3 year olds. Methods: In this study, 30 Swedish 3 year olds were included. Energy intake using TECH was compared to TEE measured using the DLW method. Intakes of vegetables, fruits and berries, juice, as well as sweetened beverages were assessed using TECH and compared to the corresponding intakes assessed using KidMeal-Q. Wilcoxon matched pairs test, Spearman rank order correlations, and the Bland-Altman procedure were applied. Results: The mean energy intake, assessed by TECH, was 5400 kJ/24h (SD 1500). This value was not significantly different (P=.23) from TEE (5070 kJ/24h, SD 600). However, the limits of agreement (2 standard deviations) in the Bland-Altman plot for energy intake estimated using TECH compared to TEE were wide (2990 kJ/24h), and TECH overestimated high and underestimated low energy intakes. The Bland-Altman plots for foods showed similar patterns. The mean intakes of vegetables, fruits and berries, juice, and sweetened beverages estimated using TECH were not significantly different from the corresponding intakes estimated using KidMeal-Q. Moderate but statistically significant correlations (ρ=.42-.46, P=.01-.02) between TECH and KidMeal-Q were observed for intakes of vegetables, fruits and berries, and juice, but not for sweetened beverages. Conclusion: We found that one day of recordings using TECH was not able to accurately estimate intakes of energy or certain foods in 3 year old children.

  • 31.
    Delisle, Christine
    et al.
    Karolinska Institute, Sweden.
    Sandin, Sven
    Karolinska Institute, Sweden.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Trolle-Lagerros, Ylva
    Karolinska Institute, Sweden.
    Larsson, Christel
    University of Gothenburg, Sweden.
    Maddison, Ralph
    University of Auckland, New Zealand.
    Ortega, Francisco B.
    University of Granada, Spain.
    Ruiz, Jonatan R.
    University of Granada, Spain.
    Silfvernagel, Kristin
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Timpka, Toomas
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för hälso- och vårdutveckling, Folkhälsocentrum.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Karolinska Institute, Sweden.
    A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial2015Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, nr 95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Childhood obesity is an increasing health problem globally. Overweight and obesity may be established as early as 2-5 years of age, highlighting the need for evidence-based effective prevention and treatment programs early in life. In adults, mobile phone based interventions for weight management (mHealth) have demonstrated positive effects on body mass, however, their use in child populations has yet to be examined. The aim of this paper is to report the study design and methodology of the MINSTOP (Mobile-based Intervention Intended to Stop Obesity in Preschoolers) trial. Methods/Design: A two-arm, parallel design randomized controlled trial in 300 healthy Swedish 4-year-olds is conducted. After baseline measures, parents are allocated to either an intervention-or control group. The 6-month mHealth intervention consists of a web-based application (the MINSTOP app) to help parents promote healthy eating and physical activity in children. MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive, personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children. Parents also register physical activity and intakes of candy, soft drinks, vegetables as well as fruits of their child and receive feedback through the application. Primary outcomes include body fatness and energy intake, while secondary outcomes are time spent in sedentary, moderate, and vigorous physical activity, physical fitness and intakes of fruits and vegetables, snacks, soft drinks and candy. Food and energy intake (Tool for Energy balance in Children, TECH), body fatness (pediatric option for BodPod), physical activity (Actigraph wGT3x-BT) and physical fitness (the PREFIT battery of five fitness tests) are measured at baseline, after the intervention (six months after baseline) and at follow-up (12 months after baseline). Discussion: This novel study will evaluate the effectiveness of a mHealth program for mitigating gain in body fatness among 4-year-old children. If the intervention proves effective it has great potential to be implemented in child-health care to counteract childhood overweight and obesity.

  • 32.
    Henriksson, Hanna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Britt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Flinke Carlsson, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Development of body composition and its relationship with physical activity: A longitudinal study of Swedish children until 4·5 years of age2015Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    In order to develop strategies to prevent early childhood obesity more knowledge about longitudinal body composition development is needed. Previous studies have shown that there is a negative relationship between the physical activity level (PAL) and total body fat (TBF) in children. The aims of this study were: 1) To describe the longitudinal development of body composition from 1 week to 4·5 years of age. 2) To study the relationships between measures of body composition and PAL at 3 years of age. 3) To compare the relationships between body composition measures and PAL at 3 years of age to the corresponding relationships at 1·5 years of age. Body composition was measured using air-displacement plethysmography at 1 week, 12 weeks and at 4·5 years of age. At 1·5 and 3 years body composition and PAL were assessed using the doubly labelled water method and indirect calorimetry. The results showed that TBF% and fat mass index (FMI) were higher than corresponding reference values, during infancy and childhood. We found a relationship between TBF% and PAL at 3 years of age but this was explained by a relationship between PAL and fat-free mass index (FFMI). The corresponding relationship at 1·5 years of age could not be explained by a relationship between PAL and FFMI. In conclusion, the children in this study had higher body fatness compared to the corresponding reference values. This may indicate an identification of a secular trend in body composition development which is characterized by a high body fatness. Our findings also suggest that body fatness might counteract physical activity at 1·5 years of age when the capacity to perform physical activity is limited, however this result was not observed at 3 years of age when such a capacity has been developed.

  • 33.
    Henriksson, Pontus
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Eriksson, B
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Gestational weight gain according to Institute of Medicine recommendations in relation to infant size and body composition.2015Ingår i: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 10, nr 5, s. 388-394Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Intrauterine life may be a critical period for programming childhood obesity; however, there is insufficient knowledge concerning how gestational weight gain (GWG) affects infant fat mass (FM) and fat-free mass (FFM).

    OBJECTIVES: The aim of this study was to investigate relationships between GWG according to Institute of Medicine (IOM) recommendations and infant size, FM and FFM. We also investigated if the associations were different for normal-weight and overweight/obese women.

    METHODS: This study included 312 healthy Swedish mother-infant pairs. Infant body composition at 1 week of age was assessed using air-displacement plethysmography. Maternal GWG was defined as below, within or above the 2009 IOM recommendations. Multiple regression analyses were used.

    RESULTS: Compared with women whose weight gain was within IOM recommendations, women with weight gain below the recommendations had infants that were shorter (-0.7 cm, P = 0.008) when adjusting for confounders. Normal-weight women exceeding IOM recommendations had infants with higher FM (+58 g, P = 0.008) compared with normal-weight women who gained within the recommendations. No corresponding association was observed for overweight/obese women.

    CONCLUSIONS: Inadequate GWG was associated with shorter infants, while excessive GWG was associated with greater infant FM for women who were of normal weight before pregnancy.

  • 34.
    Henriksson, Hanna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Karolinska Institute, Sweden .
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Evaluation of Actiheart and a 7d activity diary for estimating free-living total and activity energy expenditure using criterion methods in 1 center dot 5- and 3-year-old children2014Ingår i: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 111, nr 10, s. 1830-1840Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Accurate and easy-to-use methods to assess free-living energy expenditure in response to physical activity in young children are scarce. In the present study, we evaluated the capacity of (1) 4d recordings obtained using the Actiheart (mean heart rate (mHR) and mean activity counts (mAC)) to provide assessments of total energy expenditure (TEE) and activity energy expenditure (AEE) and (2) a 7d activity diary to provide assessments of physical activity levels (PAL) using three sets of metabolic equivalent (MET) values (PAL(Torun), PAL(Adolph) and PAL(Ainsworth)) in forty-four and thirty-one healthy Swedish children aged 1 center dot 5 and 3 years, respectively. Reference TEE, PAL(ref) and AEE were measured using criterion methods, i.e. the doubly labelled water method and indirect calorimetry. At 1 center dot 5 years of age, mHR explained 8% (P=0 center dot 006) of the variation in TEE above that explained by fat mass and fat-free mass. At 3 years of age, mHR and mAC explained 8 (P=0 center dot 004) and 6 (P=0 center dot 03)% of the variation in TEE and AEE, respectively, above that explained by fat mass and fat-free mass. At 1 center dot 5 and 3 years of age, average PAL(Ainsworth) values were 1 center dot 44 and 1 center dot 59, respectively, and not significantly different from PAL(ref) values (1 center dot 39 and 1 center dot 61, respectively). By contrast, average PAL(Torun) (1 center dot 5 and 3 years) and PAL(Adolph) (3 years) values were lower (Pless than0 center dot 05) than the corresponding PAL(ref) values. In conclusion, at both ages, Actiheart recordings explained a small but significant fraction of free-living energy expenditure above that explained by body composition variables, and our activity diary produced mean PAL values in agreement with reference values when using MET values published by Ainsworth.

  • 35.
    Forsum, Elisabet
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Karolinska Institute, Novum, Sweden.
    The Two-Component Model for Calculating Total Body Fat from Body Density: An Evaluation in Healthy Women before, during and after Pregnancy2014Ingår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 6, nr 12, s. 5888-5899Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A possibility to assess body composition during pregnancy is often important. Estimating body density (D-B) and use the two-component model (2CM) to calculate total body fat (TBF) represents an option. However, this approach has been insufficiently evaluated during pregnancy. We evaluated the 2CM, and estimated fat-free mass (FFM) density and variability in 17 healthy women before pregnancy, in gestational weeks 14 and 32, and 2 weeks postpartum based on D-B (underwater weighing), total body water (deuterium dilution) and body weight, assessed on these four occasions. TBF, calculated using the 2CM and published FFM density (TBF2CM), was compared to reference estimates obtained using the three-component model (TBF3CM). TBF2CM minus TBF3CM (mean +/- 2SD) was -1.63 +/- 5.67 (p = 0.031), -1.39 +/- 7.75 (p = 0.16), -0.38 +/- 4.44 (p = 0.49) and -1.39 +/- 5.22 (p = 0.043) % before pregnancy, in gestational weeks 14 and 32 and 2 weeks postpartum, respectively. The effect of pregnancy on the variability of FFM density was larger in gestational week 14 than in gestational week 32. The 2CM, based on D-B and published FFM density, assessed body composition as accurately in gestational week 32 as in non-pregnant adults. Corresponding values in gestational week 14 were slightly less accurate than those obtained before pregnancy.

  • 36.
    Henriksson, Pontus
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Assessment and prediction of thoracic gas volume in pregnant women: an evaluation in relation to body composition assessment using air displacement plethysmography2013Ingår i: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, nr 1, s. 111-117Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Assessment of body fat (BF) in pregnant women is important when investigating the relationship between maternal nutrition and offspring health. Convenient and accurate body composition methods applicable during pregnancy are therefore needed. Air displacement plethysmography, as applied in Bod Pod, represents such a method since it can assess body volume (BV) which, in combination with body weight, can be used to calculate body density and body composition. However, BV must be corrected for the thoracic gas volume (TGV) of the subject. In non-pregnant women, TGV may be predicted using equations, based on height and age. It is unknown, however, whether these equations are valid during pregnancy. Thus, we measured the TGV of women in gestational week 32 (n 27) by means of plethysmography and predicted their TGV using equations established for non-pregnant women. Body weight and BV of the women was measured using Bod Pod. Predicted TGV was significantly (P = 0.033) higher than measured TGV by 6% on average. Calculations in hypothetical women showed that this overestimation tended to be more pronounced in women with small TGV than in women with large TGV. The overestimation of TGV resulted in a small but significant (P = 0.043) overestimation of BF, equivalent to only 0.5% BF, on average. A Bland-Altman analysis showed that the limits of agreement were narrow (from -1.9 to 2.9% BF). Thus, although predicted TGV was biased and too high, the effect on BF was marginal and probably unimportant in many situations.

  • 37.
    Forsum, Elisabet
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Flinke Carlsson, Eva
    Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Karolinska Institutet, Stockholm, Sweden .
    BMI kan inte säkert identifiera 4-åringar med hög kroppsfetthalt2013Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, nr 36Artikel i tidskrift (Övrigt vetenskapligt)
  • 38.
    Forsum, Elisabet
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Karolinska Institutet, Stockholm, Sweden .
    Henriksson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Evaluations of Actiheart, IDEEA and RT3 monitors for estimating activity energy expenditure in  free-living women2013Ingår i: Journal of Nutritional Science, ISSN 2048-6790, E-ISSN 2048-6790, Vol. 2, nr e31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Activity energy expenditure (AEE) during free-living conditions can be assessed using devices based on different principles. To make proper comparisons of different devices' capacities to assess AEE, they should be evaluated in the same population. Thus, in the present study we evaluated, in the same group of subjects, the ability of three devices to assess AEE in groups and individuals during free-living conditions. In twenty women, AEE was assessed using RT3 (three-axial accelerometry) (AEERT3), Actiheart (a combination of heart rate and accelerometry) (AEEActi) and IDEEA (a multi-accelerometer system) (AEEIDEEA). Reference AEE (AEEref) was assessed using the doubly labelled water method and indirect calorimetry. Average AEEActi was 5760 kJ per 24 h and not significantly different from AEEref (5020 kJ per 24 h). On average, AEERT3 and AEEIDEEA were 2010 and 1750 kJ per 24 h lower than AEEref, respectively (P < 0·001). The limits of agreement (± 2 sd) were 2940 (Actiheart), 1820 (RT3) and 2650 (IDEEA) kJ per 24 h. The variance for AEERT3 was lower than for AEEActi (P = 0·006). The RT3 classified 60 % of the women in the correct activity category while the corresponding value for IDEEA and Actiheart was 30 %. In conclusion, the Actiheart may be useful for groups and the RT3 for individuals while the IDEEA requires further development. The results are likely to be relevant for a large proportion of Western women of reproductive age and demonstrate that the procedure selected to assess physical activity can greatly influence the possibilities to uncover important aspects regarding interactions between physical activity, diet and health.

  • 39.
    Jung, Seungyoun
    et al.
    Harvard University, MA USA .
    Spiegelman, Donna
    Harvard University, MA USA .
    Baglietto, Laura
    Cancer Council Victoria, Australia .
    Bernstein, Leslie
    City Hope National Medical Centre, CA USA .
    Boggs, Deborah A.
    Boston University, MA USA .
    van den Brandt, Piet A.
    Maastricht University, Netherlands .
    Buring, Julie E.
    Harvard University, MA USA .
    Cerhan, James R.
    Mayo Clin, MN USA .
    Gaudet, Mia M.
    Amer Cancer Soc, GA USA .
    Giles, Graham G.
    Cancer Council Victoria, Australia .
    Goodman, Gary
    Fred Hutchinson Cancer Research Centre, WA USA .
    Hakansson, Niclas
    Karolinska Institute, Sweden .
    Hankinson, Susan E.
    Harvard University, MA USA .
    Helzlsouer, Kathy
    St Johns Mercy Medical Centre, MD USA .
    Horn-Ross, Pamela L.
    Cancer Prevent Institute Calif, CA USA .
    Inoue, Manami
    National Cancer Centre, Japan .
    Krogh, Vittorio
    Fdn IRCCS Ist Nazl Tumori Milano, Italy .
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    McCullough, Marjorie L.
    Amer Cancer Soc, GA USA .
    Miller, Anthony B.
    University of Toronto, Canada .
    Neuhouser, Marian L.
    Fred Hutchinson Cancer Research Centre, WA USA .
    Palmer, Julie R.
    Boston University, MA USA .
    Park, Yikyung
    NCI, MD USA .
    Robien, Kim
    University of Minnesota, MN USA .
    Rohan, Thomas E.
    Albert Einstein Coll Med, NY USA .
    Scarmo, Stephanie
    NYU, NY 10016 USA .
    Schairer, Catherine
    NCI, MD USA .
    Schouten, Leo J.
    Maastricht University, Netherlands .
    Shikany, James M.
    University of Alabama Birmingham, AL USA .
    Sieri, Sabina
    Fdn IRCCS Ist Nazl Tumori Milano, Italy .
    Tsugane, Schoichiro
    National Cancer Centre, Japan .
    Visvanathan, Kala
    Johns Hopkins Bloomberg School Public Heatlh, MD USA .
    Weiderpass, Elisabete
    Karolinska Institute, Sweden .
    Willett, Walter C.
    Harvard University, MA USA .
    Wolk, Alicja
    Karolinska Institute, Sweden .
    Zeleniuch-Jacquotte, Anne
    NYU, NY USA .
    Zhang, Shumin M.
    Brigham and Womens Hospital, MA USA .
    Zhang, Xuehong
    Brigham and Womens Hospital, MA USA .
    Ziegler, Regina G.
    NCI, MD USA .
    Smith-Warner, Stephanie A:
    Harvard University, MA USA .
    Fruit and Vegetable Intake and Risk of Breast Cancer by Hormone Receptor Status2013Ingår i: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 105, nr 3, s. 219-236Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Estrogen receptornegative (ER) breast cancer has few known or modifiable risk factors. Because ER tumors account for only 15% to 20% of breast cancers, large pooled analyses are necessary to evaluate precisely the suspected inverse association between fruit and vegetable intake and risk of ER breast cancer. less thanbrgreater than less thanbrgreater thanAmong 993 466 women followed for 11 to 20 years in 20 cohort studies, we documented 19 869 estrogen receptor positive (ER) and 4821 ER breast cancers. We calculated study-specific multivariable relative risks (RRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression analyses and then combined them using a random-effects model. All statistical tests were two-sided. less thanbrgreater than less thanbrgreater thanTotal fruit and vegetable intake was statistically significantly inversely associated with risk of ER breast cancer but not with risk of breast cancer overall or of ER tumors. The inverse association for ER tumors was observed primarily for vegetable consumption. The pooled relative risks comparing the highest vs lowest quintile of total vegetable consumption were 0.82 (95% CI 0.74 to 0.90) for ER breast cancer and 1.04 (95% CI 0.97 to 1.11) for ER breast cancer (Pcommon-effects by ER status andlt; .001). Total fruit consumption was non-statistically significantly associated with risk of ER breast cancer (pooled multivariable RR comparing the highest vs lowest quintile 0.94, 95% CI 0.85 to 1.04). less thanbrgreater than less thanbrgreater thanWe observed no association between total fruit and vegetable intake and risk of overall breast cancer. However, vegetable consumption was inversely associated with risk of ER breast cancer in our large pooled analyses.

  • 40.
    Couto, Elisabeth
    et al.
    Karolinska Institute, Sweden .
    Sandin, Sven
    Karolinska Institute, Sweden .
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Ursin, Giske
    Cancer Registry Norway, Norway .
    Adami, Hans-Olov
    Karolinska Institute, Sweden .
    Weiderpass, Elisabete
    Karolinska Institute, Sweden .
    Mediterranean Dietary Pattern and Risk of Breast Cancer2013Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, nr 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    A Mediterranean diet has a recognized beneficial effect on health and longevity, with a protective influence on several cancers. However, its association with breast cancer risk remains unclear.

    Objective

    We aimed to investigate whether adherence to a Mediterranean dietary pattern influences breast cancer risk.

    Design

    The Swedish Women’s Lifestyle and Health cohort study includes 49,258 women aged 30 to 49 years at recruitment in 1991–1992. Consumption of foods and beverages was measured at enrollment using a food frequency questionnaire. A Mediterranean diet score was constructed based on the consumption of alcohol, vegetables, fruits, legumes, cereals, fish, the ratio of unsaturated to saturated fat, and dairy and meat products. Relative risks (RR) for breast cancer and specific tumor characteristics (invasiveness, histological type, estrogen/progesterone receptor status, malignancy grade and stage) associated with this score were estimated using Cox regression controlling for potential confounders.

    Results

    1,278 incident breast cancers were diagnosed. Adherence to a Mediterranean dietary pattern was not statistically significantly associated with reduced risk of breast cancer overall, or with specific breast tumor characteristics. A RR (95% confidence interval) for breast cancer associated with a two-point increment in the Mediterranean diet score was 1.08 (1.00–1.15) in all women, and 1.10 (1.01–1.21) and 1.02 (0.91–1.15) in premenopausal and postmenopausal women, respectively. When alcohol was excluded from the Mediterranean diet score, results became not statistically significant.

    Conclusions

    Adherence to a Mediterranean dietary pattern did not decrease breast cancer risk in this cohort of relatively young women.

  • 41.
    Forsum, Elisabet
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Flinke Carlsson, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.
    Total body fat content versus BMI in 4-year-old healthy Swedish children.2013Ingår i: Journal of Obesity, ISSN 2090-0708, E-ISSN 2090-0716, Vol. 2013, artikel-id 206715Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Childhood overweight and obesity, a worldwide problem, is generally identified using BMI (body mass index). However, this application of BMI has been little investigated in children below 5 years of age due to a lack of appropriate methods to assess body composition. Therefore, we used air displacement plethysmography (ADP) to study 4.4-year old boys and girls since this method is accurate in young children if they accept the requirements of the measurement. The purpose was to analyze the relationship between BMI and body fat in these children. Body composition was assessed in 76 (43 boys, 33 girls) of the 84 children brought to the measurement session. Boys and girls contained 25.2 ± 4.7 and 26.8 ± 4.0% body fat, respectively. BMI-based cut-offs for overweight could not effectively identify children with a high body fat content. There was a significant (P < 0.001) but weak (r = 0.39) correlation between BMI and body fat (%). In conclusion, requirements associated with a successful assessment of body composition by means of ADP were accepted by most 4-year-olds. Furthermore, BMI-based cut-offs for overweight did not effectively identify children with a high body fatness and BMI explained only a small proportion of the variation in body fat (%) in this age group.

  • 42.
    Eriksson, Britt
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Henriksson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Hannestad, Ulf
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Body-composition development during early childhood and energy expenditure in response to physical activity in 1.5-y-old children2012Ingår i: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 96, nr 3, s. 567-573Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The prevalence of childhood overweight and obesity has increased recently, but the mechanisms involved are incompletely known. Previous research has shown a correlation between the percentage of total body fat (TBF) and physical activity level (PAL). However, the PAL values used may involve a risk of spurious correlations because they are often based on predicted rather than measured estimates of resting energy metabolism. less thanbrgreater than less thanbrgreater thanObjectives: We studied the development of body composition during early childhood and the relation between the percentage of TBF and PAL on the basis of the measured resting energy metabolism. less thanbrgreater than less thanbrgreater thanDesign: Body composition was previously measured in 108 children when they were 1 and 12 wk old. When 44 of these children (21 girls and 23 boys) were 1.5 y old, their total energy expenditure and TBF were assessed by using the doubly labeled water method. Resting energy metabolism, which was assessed by using indirect calorimetry, was used to calculate PAL. less thanbrgreater than less thanbrgreater thanResults: Significant correlations were shown for TBF (r = 0.32, P = 0.035) and fat-free mass (r = 0.34, P = 0.025) between values (kg) assessed at 12 wk and 1.5 y of age. For TBF (kg) a significant interaction (P = 0.035) indicated a possible sex difference. PAL at 1.5 y was negatively correlated with the percentage of TBF (r = -0.40, P = 0.0076) and the increase in the percentage of TBF between 12 wk and 1.5 y (r = 0.38, P = 0.0105). less thanbrgreater than less thanbrgreater thanConclusions: The results indicate that body fatness and physical activity interact during early childhood and thereby influence obesity risk. Our results are based on a small sample, but nevertheless, they motivate additional studies in boys compared with girls regarding the development of body composition during early life.

  • 43.
    Trolle Lagerros, Ylva
    et al.
    Karolinska Institute, Sweden .
    Sandin, Sven
    Karolinska Institute, Sweden .
    Bexelius, Christin
    Karolinska Institute, Sweden .
    Litton, Jan-Eric
    Karolinska Institute, Sweden .
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Estimating physical activity using a cell phone questionnaire sent by means of short message service (SMS): a randomized population-based study2012Ingår i: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, nr 7, s. 561-566Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An investigation in a randomized population-based Swedish study with 564 participants aged 18-80 years showed that mean physical activity levels obtained using short message service (SMS) by means of cell phones (n = 171) were equal to corresponding levels obtained when sending identical questions by web (n = 182) or paper (n = 211). The response rates were similar for the SMS, web and paper groups.

  • 44.
    Lagiou, Pagona
    et al.
    University of Athens, Greece Harvard University, MA 02115 USA .
    Sandin, Sven
    Karolinska Institute, Sweden .
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Trichopoulos, Dimitrios
    Harvard University, USA Academic Athens, Greece .
    Adami, Hans-Olov
    Harvard University, USA Karolinska Institute, Sweden .
    Weiderpass, Elisabete
    Karolinska Institute, Sweden Cancer Registry Norway, Norway Samfundet Folkhalsan, Finland .
    Letter: Research authors reply to Campillo-Soto and Freedhoff2012Ingår i: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 345, nr e5112Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 45.
    Lagiou, Pagona
    et al.
    University of Athens, Greece Harvard University, MA 02115 USA .
    Sandin, Sven
    Karolinska Institute, Sweden .
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Näringslära. Linköpings universitet, Hälsouniversitetet.
    Trichopoulos, Dimitrios
    Harvard University, MA 02115 USA Academic Athens, Greece .
    Adami, Hans-Olov
    Harvard University, MA 02115 USA Karolinska Institute, Sweden .
    Weiderpass, Elisabete
    Karolinska Institute, Sweden Cancer Registry Norway, Norway University of Tromso, Norway Samfundet Folkhalsan, Finland .
    Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study2012Ingår i: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 344Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To study the long term consequences of low carbohydrate diets, generally characterised by concomitant increases in protein intake, on cardiovascular health. Design Prospective cohort study. Setting Uppsala, Sweden. Participants From a random population sample, 43 396 Swedish women, aged 30-49 years at baseline, completed an extensive dietary questionnaire and were followed-up for an average of 15.7 years. Main outcome measures Association of incident cardiovascular diseases (ascertained by linkage with nationwide registries), overall and by diagnostic category, with decreasing carbohydrate intake (in tenths), increasing protein intake (in tenths), and an additive combination of these variables (low carbohydrate-high protein score, from 2 to 20), adjusted for intake of energy, intake of saturated and unsaturated fat, and several non-dietary variables. Results A one tenth decrease in carbohydrate intake or increase in protein intake or a 2 unit increase in the low carbohydrate-high protein score were all statistically significantly associated with increasing incidence of cardiovascular disease overall (n=1270)-incidence rate ratio estimates 1.04 (95% confidence interval 1.00 to 1.08), 1.04 (1.02 to 1.06), and 1.05 (1.02 to 1.08). No heterogeneity existed in the association of any of these scores with the five studied cardiovascular outcomes: ischaemic heart disease (n=703), ischaemic stroke (n=294), haemorrhagic stroke (n=70), subarachnoid haemorrhage (n=121), and peripheral arterial disease (n=82). Conclusions Low carbohydrate-high protein diets, used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins, are associated with increased risk of cardiovascular disease.

  • 46.
    Hedelin, Maria
    et al.
    Folkhalsan Research Centre.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Nutrition. Linköpings universitet, Hälsouniversitetet.
    Andersson, Therese M -L
    Karolinska Institute.
    Adlercreutz, Herman
    University of Helsinki.
    Weiderpass, Elisabete
    Karolinska Institute.
    Dietary Phytoestrogens and the Risk of Ovarian Cancer in the Womens Lifestyle and Health Cohort Study2011Ingår i: CANCER EPIDEMIOLOGY BIOMARKERS and PREVENTION, ISSN 1055-9965, Vol. 20, nr 2, s. 308-317Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Dietary intake of phytoestrogens has been inversely associated to hormone-dependent cancers, such as prostate and breast cancers. Few studies have investigated the association between ovarian cancer and intake of phytoestrogens. We evaluated the associations between intake of phytoestrogens (isoflavonoids/lignans/coumestrol) and fiber (vegetable/cereal) and risk of ovarian cancer. Methods: In 1991-1992 a prospective population-based cohort study among Swedish women was conducted, including 47,140 women with complete dietary questionnaire data. During follow-up until December 2007, 163 women developed invasive (n = 117) and borderline (n = 46) ovarian cancers. The median follow-up time was 16 years and total person year was 747,178. Cox proportional hazards models were conducted to estimate multivariate risk ratios, 95% CI for associations with risk of ovarian cancer. Results: We found no association between intake of phytoestrogens or fiber and overall ovarian cancer risk. In addition, we found no statistically significant association between intake of specific food items rich in phytoestrogens (berries, nuts, beans/soy, and crisp or whole-grain bread) and ovarian cancer risk overall. Fiber and coumestrol was inversely associated with borderline ovarian cancer, but not with invasive ovarian cancer. Conclusions: We found no association between intake of phytoestrogens or fiber and overall ovarian cancer risk. Impact: Phytoestrogens do not play a major etiologic role in ovarian cancer, at least among women in this Swedish cohort with low bean/soy intake. However, our results of a difference in the effect of fiber or coumestrol between invasive and borderline ovarian cancer need to be evaluated in larger studies.

  • 47.
    van Hees, Vincent T
    et al.
    Institute Metab Science.
    Renstrom, Frida
    Umea University Hospital.
    Wright, Antony
    Med Research Council Human Nutr Research.
    Gradmark, Anna
    Umea University Hospital.
    Catt, Michael
    Newcastle University.
    Chen, Kong Y
    NIDDK.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Nutrition. Linköpings universitet, Hälsouniversitetet.
    Bluck, Les
    Med Research Council Human Nutr Research.
    Pomeroy, Jeremy
    NIDDK.
    Wareham, Nicholas J
    Institute Metab Science.
    Ekelund, Ulf
    Institute Metab Science.
    Brage, Soren
    Institute Metab Science.
    W Franks, Paul
    Umea University Hospital.
    Estimation of Daily Energy Expenditure in Pregnant and Non-Pregnant Women Using a Wrist-Worn Tri-Axial Accelerometer2011Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 6, nr 7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ackground: Few studies have compared the validity of objective measures of physical activity energy expenditure (PAEE) in pregnant and non-pregnant women. PAEE is commonly estimated with accelerometers attached to the hip or waist, but little is known about the validity and participant acceptability of wrist attachment. The objectives of the current study were to assess the validity of a simple summary measure derived from a wrist-worn accelerometer (GENEA, Unilever Discover, UK) to estimate PAEE in pregnant and non-pregnant women, and to evaluate participant acceptability. less thanbrgreater than less thanbrgreater thanMethods: Non-pregnant (N = 73) and pregnant (N = 35) Swedish women (aged 20-35 yrs) wore the accelerometer on their wrist for 10 days during which total energy expenditure (TEE) was assessed using doubly-labelled water. PAEE was calculated as 0.96TEE-REE. British participants (N = 99; aged 22-65 yrs) wore accelerometers on their non-dominant wrist and hip for seven days and were asked to score the acceptability of monitor placement (scored 1 [least] through 10 [most] acceptable). less thanbrgreater than less thanbrgreater thanResults: There was no significant correlation between body weight and PAEE. In non-pregnant women, acceleration explained 24% of the variation in PAEE, which decreased to 19% in leave-one-out cross-validation. In pregnant women, acceleration explained 11% of the variation in PAEE, which was not significant in leave-one-out cross-validation. Median (IQR) acceptability of wrist and hip placement was 9(8-10) and 9(7-10), respectively; there was a within-individual difference of 0.47 (p andlt; .001). less thanbrgreater than less thanbrgreater thanConclusions: A simple summary measure derived from a wrist-worn tri-axial accelerometer adds significantly to the prediction of energy expenditure in non-pregnant women and is scored acceptable by participants.

  • 48.
    Bexelius, Christin
    et al.
    Karolinska Institutet.
    Sandin, Sven
    Karolinska Institutet.
    Trolle Lagerros, Ylva
    Karolinska Institutet.
    Litton, Jan-Eric
    Karolinska Institutet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Nutrition. Linköpings universitet, Hälsouniversitetet.
    Estimation of Physical Activity Levels Using Cell Phone Questionnaires: A Comparison With Accelerometry for Evaluation of Between-Subject and Within-Subject Variations2011Ingår i: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 13, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Physical activity promotes health and longevity. Further elaboration of the role of physical activity for human health in epidemiological studies on large samples requires accurate methods that are easy to use, cheap, and possible to repeat. The use of telecommunication technologies such as cell phones is highly interesting in this respect. In an earlier report, we showed that physical activity level (PAL) assessed using a cell phone procedure agreed well with corresponding estimates obtained using the doubly labeled water method. However, our earlier study indicated high within-subject variation in relation to between-subject variations in PAL using cell phones, but we could not assess if this was a true variation of PAL or an artifact of the cell phone technique. less thanbrgreater than less thanbrgreater thanObjective: Our objective was to compare within-and between-subject variations in PAL by means of cell phones with corresponding estimates using an accelerometer. In addition, we compared the agreement of daily PAL values obtained using the cell phone questionnaire with corresponding data obtained using an accelerometer. less thanbrgreater than less thanbrgreater thanMethods: PAL was measured both with the cell phone questionnaire and with a triaxial accelerometer daily during a 2-week study period in 21 healthy Swedish women (20 to 45 years of age and BMI from 17.7 kg/m(2) to 33.6 kg/m(2)). The results were evaluated by fitting linear mixed effect models and descriptive statistics and graphs. less thanbrgreater than less thanbrgreater thanResults: With the accelerometer, 57% (95% confidence interval [CI] 40%-66%) of the variation was within subjects, while with the cell phone, within-subject variation was 76% (95% CI 59%-83%). The day-to-day variations in PAL observed using the cell phone questions agreed well with the corresponding accelerometer results. less thanbrgreater than less thanbrgreater thanConclusions: Both the cell phone questionnaire and the accelerometer showed high within-subject variations. Furthermore, day-to-day variations in PAL within subjects assessed using the cell phone agreed well with corresponding accelerometer values. Consequently, our cell phone questionnaire is a promising tool for assessing levels of physical activity. The tool may be useful for large-scale prospective studies.

  • 49.
    Eriksson, Britt
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Nutrition. Linköpings universitet, Hälsouniversitetet.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Nutrition. Linköpings universitet, Hälsouniversitetet.
    Hannestad, Ulf
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Forsum, Elisabet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Nutrition. Linköpings universitet, Hälsouniversitetet.
    Fat-free mass hydration in newborns: assessment and implications for body composition studies2011Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 5, s. 680-686Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Equipment (Pea Pod) for assessing infant body density accurately and conveniently has recently become available. This density can be converted to body composition using the “Fomon” or the “Butte” model. These models differ regarding the water content in fat-free mass (hydration factor, HF). We assessed HF and its biological variability in newborns and compared results calculated using the two models at one and 12 weeks. Body volume and body weight were measured in 12 infants less than 10 days old using Pea Pod. Their total body water was assessed using isotope dilution. Their HF was found to be 80.9% with low biological variability (0.81% of average HF). Further, Pea Pod was used to assess body density of 108 infants at one and 12 weeks of age. Values for body fat (%) calculated using the “Butte” model were significantly lower than when using the “Fomon” model at one week (p<0.05) and 12 weeks (p<0.01). The difference between the two models was particularly large at one week, probably due to their different HF-values. Our HF-value is in agreement with that in the “Fomon” model and our results support the conclusion that this model is preferable when calculating body composition in infants.

  • 50.
    Löf, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Nutrition. Linköpings universitet, Hälsouniversitetet.
    Physical activity pattern and activity energy expenditure in healthy pregnant and non-pregnant Swedish women2011Ingår i: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 65, nr 12, s. 1295-1301Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Objectives: Energy costs of pregnancy approximate 320 MJ in well-nourished women, but whether or not these costs may be partly covered by modifications in activity behavior is incompletely known. In healthy Swedish women: (1) to evaluate the potential of the Intelligent Device for Energy Expenditure and Physical Activity (IDEEA) to assess energy expenditure during free-living conditions, (2) to assess activity pattern, walking pace and energy metabolism in pregnant women and non-pregnant controls, and (3) to assess the effect on energy expenditure caused by changes in physical activity induced by pregnancy. less thanbrgreater than less thanbrgreater thanSubjects/Methods: Activity pattern was assessed using the IDEEA in 18 women in gestational week 32 and in 21 non-pregnant women. Activity energy expenditure (AEE) was assessed using IDEEA, as well as using the doubly labelled water method and indirect calorimetry. less thanbrgreater than less thanbrgreater thanResults: AEE using the IDEEA was correlated with reference estimates in both groups (r = 0.4-0.5; Pandlt;0.05). Reference AEE was 0.9 MJ/24 h lower in pregnant than in non-pregnant women. Pregnant women spent 92 min/24 h more on sitting, lying, reclining and sleeping (P = 0.020), 73 min/24 h less on standing (P = 0.037) and 21 min/24 h less on walking and using stairs (P = 0.049), and walked at a slower pace (1.1 +/- 0.1 m/s versus 1.2 +/- 0.1 m/s; P = 0.014) than did non-pregnant controls. The selection of less demanding activities and slower walking pace decreased energy costs by 720 kJ/24 h and 80 kJ/24 h, respectively. less thanbrgreater than less thanbrgreater thanConclusion: Healthy moderately active Swedish women compensated for the increased energy costs of pregnancy by 0.9 MJ/24 h. The compensation was mainly achieved by selecting less demanding activities.

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