Browsing by Subject "Overweight"

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  • Viukari, Marianna; Schalin-Jäntti, Camilla (2021)
    Endokriinisista sairauksista etenkin diabetes, lihavuus ja APECED-oireyhtymä altistavat vaikealle COVID-19:lle. Hyperglykemia on haitallista myös ilman edeltävää diabetesdiagnoosia, ja sen hyvä hoito parantaa ennustetta. Vaikeaa koronaviruskeuhkoinfektiota sairastavilla on todettu pieniä veren D-vitamiinipitoisuuksia, mutta D-vitamiinilisien merkityksestä vaikean COVID-19:n ehkäisyssä odotetaan vielä lisätietoa. Koronavirusinfektioiden yhteydessä on kuvattu myös kilpirauhastulehduksia. Lisämunuaiskuoren vajaatoimintaan liittyy akuuttien sairauksien yhteydessä lisämunuaiskriisin riski. Toistaiseksi ei kuitenkaan ole näyttöä, että lisämunuaiskuoren vajaatoimintaa sairastavien COVID-19:n ennuste olisi huonompi kuin muiden. Myöskään neuroendokriiniset kasvaintaudit eivät tiettävästi huononna ennustetta, joskin solunsalpaajahoito voi lisätä COVID-19-potilaiden vaikean taudin riskiä. Diabetesta sairastavien, glukokortikoidihoitoa saavien ja ylipainoisten potilaiden osalta on erityisen tärkeää huolehtia laskimotukosten ehkäisystä.
  • Uusitupa, Matti; Mustajoki, Pertti; Pietiläinen, Kirsi (2020)
  • Tan, Xiao; Alen, Markku; Wiklund, Petri; Partinen, Markku; Cheng, Sulin (2016)
    Objective: To determine the effect of a six-month aerobic exercise program on home-based sleep quality among overweight and obese men with chronic insomnia symptoms. Methods: Participants were 45 Finnish men (93% had body mass index >= 25) aged 30-65 years, with chronic months) insomnia symptoms as classified by the DSM-IV criteria. Participants were randomized into an exercise (n = 24) or control group (n = 21). The exercise group received six-month aerobic exercise intervention with one to five sessions per week of 30-60 minutes duration. The control group was instructed to maintain habitual lifestyle behaviors during the study period. Seven-night home sleep was measured with a piezoelectric bed sensor and sleep diary. Other assessments included the modified Basic Nordic Sleep Questionnaire, a health and behavior questionnaire, physical activity and diet diaries, anthropometry, fat mass, and physical fitness. Analysis of covariance controlling for baseline values, and repeated-measures analysis of variance were implemented for time-by-group comparisons and within group comparisons, respectively. Results: At six months, the exercise group showed reduced objective sleep onset latency (p = 0.010) and lowered frequency of difficulty initiating sleep (p = 0.021) than controls. Although a time-by-group difference was not significant, exercisers showed shorter objective wake after sleep onset (p = 0.004), reduced subjective nocturnal awakenings (p = 0.010), improved objective sleep efficiency (p <0.001), and improved morning-rated subjective sleep quality (p = 0.042) at six months than baseline. Conclusions: A six-month aerobic exercise can improve sleep, mainly by mitigating difficulty of initiating sleep among overweight and obese men with chronic insomnia symptoms. (C) 2016 Elsevier B.V. All rights reserved.
  • Liimatta, Jani; Utriainen, Pauliina; Voutilainen, Raimo; Jääskeläinen, Jarmo (2020)
  • Kivelä, Antti; Naukkarinen, Jussi (2018)
  • Shiri, Rahman; Lallukka, Tea; Rahkonen, Ossi; Leino-Arjas, Päivi (2020)
    Objective. To estimate the effects of excess body mass and leisure time physical activity on the incidence and persistence of chronic pain. Design. A prospective cohort study. Methods. As a part of the Finnish Helsinki Health Study, we included three cohorts of employees of the City of Helsinki (18,562 observations) and defined incident chronic pain as having pain in any part of the body for more than three months at follow-up in participants without chronic pain at baseline (N = 13,029 observations). Persistent chronic pain was defined as having pain for more than three months at both baseline and follow-up (N = 5,533 observations). Results. Overweight (adjusted odds ratio [OR] = 1.18, 95% confidence interval [CI] = 1.06-1.31) and obesity (OR = 1.65, 95% CI = 1.45-1.88) increased the incidence of chronic pain. Moreover, overweight (OR = 1.16, 95% CI = 1.02-1.32) and obesity (OR = 1.48, 95% CI = 1.26-1.74) increased the risk of persistent chronic pain. Vigorous leisure time physical activity reduced the incidence of chronic pain (OR = 0.85, 95% CI = 0.75-0.96). Physical activity did not influence the risk of persistent chronic pain. Furthermore, overweight/obesity modified the effect of leisure time physical activity on incident chronic pain. Inactive overweight or obese participants were at the highest risk of chronic pain (OR = 1.71, 95% CI = 1.40-2.09), while the OR dropped to 1.44 (95% CI = 1.19-1.75) in moderately active overweight or obese participants and to 1.20 (95% CI = 0.97-1.47) in highly active overweight or obese participants. Conclusions. Obesity not only increases the risk of developing chronic pain, but also increases the risk of persistent pain, while leisure time physical activity reduces the risk of developing chronic pain.
  • Laine, Merja K; Kautiainen, Hannu; Gissler, Mika; Pennanen, Pirjo; Eriksson, Johan G. (BioMed Central, 2021)
    Abstract Background The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding. Methods The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa. Results No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed < 6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p <  0.001 for linearity). Conclusions In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.
  • Laine, Merja K.; Kautiainen, Hannu; Gissler, Mika; Pennanen, Pirjo; Eriksson, Johan G. (2021)
    Background The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding. Methods The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa. Results No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed <6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p <0.001 for linearity). Conclusions In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.
  • Mokkala, Kati; Pellonpera, Outi; Roytio, Henna; Pussinen, Pirkko; Ronnemaa, Tapani; Laitinen, Kirsi (2017)
    Background. Increased intestinal permeability with subsequent metabolic endotoxemia, i.e., elevated circulating levels of bacterial lipopolysaccharide, LPS, has been introduced as a novel initiator of obesity related metabolic disturbances in non-pregnant individuals. The objective was to investigate the extent to which intestinal permeability, measured by serum zonulin concentration, is related to metabolic endotoxemia and metabolic risk markers in overweight pregnant women. Methods. This was a cross-sectional study including 100 pregnant overweight women in early pregnancy. Serum zonulin was analyzed using ELISA, and markers for metabolic endotoxemia (LPS), inflammation (high-sensitive C-reactive protein and glycoprotein acetylation GIyA), glucose metabolism (fasting glucose and insulin), and lipid metabolism were measured. Results. Higher serum zonulin concentration associated positively with LPS (P = 0.02), inflammatory markers (P <0.001), insulin (P <0.001), insulin resistance (P <0.001), and triglycerides (P = 0.001), and negatively with insulin sensitivity (P = 0.001) (ANOVA with Tukey's corrections or Kruskal-Wallis nonparametric test with Bonferroni correction for zonulin quartiles). All the observed associations were confirmed (P <0.015) in a linear regression model adjusted with potential confounding factors. Both LPS and GlycA showed positive relationship with insulin resistance, serum insulin, triglycerides, total and LDL-cholesterol and negative relationship with insulin sensitivity (P Conclusions. Our findings suggest that increased serum zonulin concentration, i.e., increased intestinal permeability, contributes to metabolic endotoxemia, systemic inflammation, and insulin resistance in overweight pregnant women. By reinforcingintestinal barrier, it may be possible to manipulate maternal metabolism during pregnancy with subsequent health benefits. (C) 2017 Elsevier Inc. All rights reserved.
  • Matikainen, Niina; Gordin, Daniel; Laine, Merja K. (2018)
  • Laatikainen, Tiina; Liira, Helena (2021)
  • Lehtimäki, Mari; Äärelä, Linnea; Hiltunen, Pauliina; Lassila, Arja; Vuorela, Nina; Merras-Salmio, Laura; Kurppa, Kalle (2021)
    Rasvamaksatauti on nykyisin lapsuusiän yleisin maksasairaus, joka hoitamattomana voi edetä kirroosiin saakka. Sekä kliininen kokemus että tutkimusnäyttö viittaavat sairauden merkittävään lisääntymiseen. Lapsilla esiintyy harvoin oireita. Tavallisin löydös ylipainon ohella on plasman suurentunut alaniiniaminotransferaasi (ALAT) -pitoisuus, jonka yleisesti käytetyn viiterajan 40 U/l tilalle on esitetty selvästi pienempiä seulontaraja-arvoja. Tilan seulonta ja alkuvaiheen tutkimukset voidaan yleensä toteuttaa perusterveydenhuollossa. Olennaista on varhainen epäily ja tilanteen kokonaisarvio sekä muiden sairauksien sulkeminen pois esitietojen, statuksen ja suunnattujen lisätutkimusten avulla. Erikoissairaanhoidossa tehdään mahdolliset jatkotutkimukset ja hoidetaan komplisoituneet tapaukset. Maksabiopsia on harvoin aiheellinen. Lasten rasvamaksataudin hoidossa korostuvat elintapamuutokset.
  • Vesikansa, Aino; Jokelainen, Jari; Mehtälä, Juha; Mutanen, Katja; Lundqvist, Annamari; Laatikainen, Tiina; Yli-Saukko-oja; Saukkonen, Tero; Pietiläinen, Kirsi H. (2020)
    Lähtökohdat : Tämän poikkileikkaustutkimuksen tavoitteena oli selvittää lihavuuden yhteyksiä elämänlaatuun ja työkykyyn suomalaisessa aikuisväestössä. Menetelmät : Aineistoon kuului 4 956 FinTerveys 2017 -tutkimuksen terveystarkastukseen satunnaisesti valittua täysi-ikäistä henkilöä. Elämänlaatua eri painoindeksiryhmissä selvitettiin EUROHIS-QOL 8 -¬elämänlaatumittarilla. Koettua psyykkistä ja fyysistä työkykyä sekä työstä poissaolojen määrää kartoitettiin kyselylomakkeella. Tulokset : Ylipainoisten ja lihavien elämänlaatu oli merkitsevästi heikompi kuin normaalipainoisten. Lihavat kokivat fyysisen ja psyykkisen työkykynsä heikommaksi kuin normaalipainoiset ja heillä oli enemmän itse raportoituja poissaoloja työstä. Päätelmät : Lihavuus on yhteydessä yksilön kokemukseen terveydestä sekä hyvinvoinnista ja heikentää työkykyä. Lihavuuden tehokkaalla hoidolla voidaan liitännäissairauksien ehkäisyn lisäksi parantaa väestön työ- ja toimintakykyä sekä elämänlaatua.
  • Koskela-Koivisto, Tiina (2018)
    Lihavuuteen liittyvät hormonaaliset muutokset, erityisesti insuliiniresistenssi, vaikuttavat sekä naisten että miesten lisääntymisterveyteen. Jo 5 %:n painonpudotus voi parantaa merkittävästi hedelmällisyyttä ja pienentää raskaudenaikaisia riskejä. Pysyvät elämäntapamuutokset näyttävät vaikuttavan merkittävästi myös tulevien jälkeläisten terveyteen epigeneettisten mekanismien ja ympäristövaikutusten kautta. Perusterveydenhuolto on keskeisessä asemassa lihavuuden ehkäisyssä ja varhaisessa hoidossa.Tarvitaan moniammatillista yhteistyötä ja toimivia hoitoketjuja.
  • Figueiredo, Rejane Augusta De Oliveira; Roos, Eva; Eriksson, Johan G.; Simola-Strom, Sabina; Weiderpass, Elisabete (2017)
    Aims: Little is known about impact of maternal alcohol and tobacco consumption on adolescents' body size. The purpose of this study was to evaluate whether maternal alcohol or tobacco consumption is associated with their children's body size in adolescence, assessed by Body Mass Index (BMI). Methods: This study was conduct in subjects recruited into the Finnish Health in Teens cohort (Fin-HIT) between 2011 and 2014. A total of 4525 subjects aged between 9 and 14 years and their mothers or female adults responsible for the children were analysed. Relative risks (RR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression. Results: Most children were normal weight (74.5%), 10.6% were underweight and 14.9% were overweight or obese. Among mothers, 50.6% were never smokers, 35.7% were former smokers, and 13.7% were current smokers. Alcohol consumption was classified by Alcohol Use Disorders Identification Test (AUDIT), 12.7% were abstainers (score=0), 65.0% were low-moderate drinkers (scores 1-4) and 22.3% were harmful drinkers (scores. 5). There were statistically significant associations between currently smoking mothers and children's overweight (RR=1.36; 95% CI: 1.05-1.76). There was an inverse association between maternal former smoking and children's underweight (RR=0.70; CI: 0.56-0.87) compared with never smoker mothers. Among children in puberty, abstainer mothers were more likely to have underweight children compared with low-moderate mothers (RR=1.57; 95% CI: 1.03-2.41). Conclusions: Current smoker mothers were associated with children's overweight and former-smoker mothers were inversely associated with the children's underweight. Being an abstainer mother was associated with the children's underweight in puberty stage. If other studies confirm these results, public health interventions aiming at healthy weight of adolescents should target the whole family, not only the adolescents themselves.
  • Kalso, Eija (2018)
    • Krooninen kipu on yleistä. Se heikentää elämänlaatua ja työkykyä ja tulee yhteiskunnalle kalliiksi. • Taustalla on perimään, inflammaatioon ja aivojen plastisuuteen liittyviä sekä psykososiaalisia tekijöitä. • Kivun pitkittymistä voi estää puuttumalla varhain paikallisiin kiputiloihin. Akuutti kipu ja taustasairaudet tulee hoitaa tehokkaasti. • Tärkeää on myös poistaa psykososiaaliset paranemisen esteet. • Elintavat vaikuttavat kivun taustasairauksien syntyyn ja herkistävät kivulle. Terveellisiä elintapoja tulisi tukea lapsuudesta lähtien.
  • Piltonen, Terhi T.; Morin-Papunen, Laure; Tapanainen, Juha S.; Purho, Elina; Uljas-Bärman, Riikka; Arffman, Riikka K. (2020)
    Munasarjojen monirakkulaoireyhtymään liittyy muutakin ¬sairastavuutta kuin ovulaatiohäiriöitä. Se on terveysriski, joka lääkärin tulisi tunnistaa.
  • Rautava, Samuli; Turta, Olli; Vahtera, Jussi; Pentti, Jaana; Kivimäki, Mika; Pearce, Jamie; Kawachi, Ichiro; Rautava, Paivi; Lagström, Hanna (2022)
    Background: The epidemic of increasing childhood overweight and obesity is a major global health concern, with local contextual factors identified as possible contributors. Robust research is needed to establish an evidence base supporting health policy decisions to reverse the trend. We aimed to examine the association between neighborhood socioeconomic disadvantage and trajectories of body mass index (BMI) from birth to age 7. Methods: The present study included 11,023 children born within the Southwest Finland Birth Cohort who were free of severe conditions affecting growth with adequate exposure and growth data. We obtained child growth data until school age from municipal follow-up clinics. We based cumulative childhood neighborhood socioeconomic disadvantage on the average annual income, unemployment, and level of education in a residential area defined using a geographic grid at a spatial resolution of 250 m by 250 m. Results: Cumulative neighborhood socioeconomic disadvantage was associated with distinct childhood BMI z score trajectories from birth to age 7. Despite being born in the lowest BMI z scores, children growing up in disadvantaged neighborhoods subsequently exhibited a trajectory of increasing BMI z scores starting at 4 years of age, ending up with a higher risk of overweight at the end of the follow-up (30%) as compared with children living in more affluent neighborhoods (22%). The corresponding risk of obesity was 5 % for those in affluent neighborhoods and 9 % and those in disadvantaged neighborhoods. Conclusion: Cumulative exposure to neighborhood socioeconomic disadvantage is independently associated with unfavorable BMI development and obesity in childhood.
  • Svärd, Anna; Lahti, Jouni; Rahkonen, Ossi; Lahelma, Eero; Lallukka, Tea (2016)
    Background: Both obesity and mental health are major public health issues. This study aimed to examine whether overweight and obesity among midlife employees are associated with subsequent psychotropic medication. A further aim was to examine the potential effect of key covariates on the association. Methods: The Helsinki Health Study baseline survey was conducted in 2000-2002 among 40-60-year-old employees of the City of Helsinki, Finland (n = 8960). The participants were classified as of normal weight (18.5-24. 9 kg/m(2)), overweight (25-29.9 kg/m(2)), obese (30-34.9 kg/m(2)) or severely obese (>= 35 kg/m(2)) based on self-reported body mass index. Data on psychotropic medication purchases from baseline to 2009 were derived from registers of the Social Insurance Institution of Finland. The final analysis included 4760 women and 1338 men. Antidepressants and sedatives were examined separately. Covariates included socio-demographic factors, workload, health behaviours, physical functioning, somatic ill-health and psychotropic medication prior to baseline. Hazard ratios (HR) for the first psychotropic medication purchase were calculated using Cox regression analysis. Results: Third of women and quarter of men made at least one psychotropic medication purchase during the follow-up. Adjusting for age, obese (HR = 1.57; 95 % CI = 1.10-2.24) and severely obese (HR = 2.15; 95 % CI = 1.29-3. 56) men were at risk of having psychotropic medication compared to men of normal weight. These associations disappeared after further adjustment. Severe obesity remained associated with subsequent sedative medication among the men even after full adjustment (HR = 2.12; 95 % CI = 1.17-3.84). No associations were found among the women. Conclusions: Obese and severely obese men, but not women, were at risk of psychotropic medication. Further studies are needed to deepen understanding of the relationship between obesity and mental ill-health, and the possible protecting effects of age, employment, and living environment.
  • Bachour, Adel; Avellan-Hietanen, Heidi (2021)
    • Obstruktiivinen uniapnea yleistyy kaikkialla maailmassa. Suomessa 1,46 miljoonan henkilön arvioidaan ¬sairastavan vähintään lievää uniapneaa. • Uniapnean vuoksi kirjoitetut lähetteet käsittävät noin puolet kaikista keuhkosairauksien alan lähetteistä. • Konservatiivinen hoito ja ylipainehoito (CPAP) ovat edelleen uniapnean hoidon kulmakiviä. • Perusterveydenhuollon tulisi saada suurempi rooli uniapnean hoidossa ja seurannassa. Tulevaisuudessa erikoissairaanhoidossa keskitytään ainoastaan erityistapauksiin.