Browsing by Subject "physical activity"

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  • Reinman, Roosaliina (Helsingin yliopisto, 2018)
    Purpose. According to previous research there are many factors, for example physical environment, family and friends, that affect being physically active and forming a physically active lifestyle during childhood and adolescence. The purpose of this study was to demonstrate the physical activity path of three young adults and research, which factors have affected to its forming. This study shows how physical activity has formed and struck root in the participants’ lives. Methods. The study involved three young adults who have a physically active lifestyle. The data were collected during the spring of the year 2017 by the giving participants a task in which they needed to draw a graph depicting physical activity during their lifetimes and by interviewing them. The interviews were supplemented afterwards via email. Everyone’s personal narrative, physical activity path, was formed from the interview data. The data was analyzed with a plot analysis, which is typical for narrative research, and by comparing it to previous research. Results and conclusion. Every participant has an own physical acitivity path. However, the backgrounds of two participants are quite similar compared to the third one. These two have been physically very active during their whole lives and they had been supported and guided to be physically active in many ways. They have also had plenty of positive experiences and experiences of success in physical activities. The third participant wasn’t physically active during her childhood and her family didn’t exercise. However, in the fifth grade she started to take dance lessons and in secondary school she had an encouraging PE teacher and she started to enjoy physical activity. Her physical self-esteem also rose. The joy and sociality of physical activity were repeated in every three stories. Other factors that are associated to physical activity and formation of physically active lifestyle are also realized in participants’ lives. This study shows that many kinds of physical activity paths can lead to the formation of a physically active lifestyle.
  • Acosta, Tania; Barengo, Noel C.; Arrieta, Astrid; Ricaurte, Carlos; Tuomilehto, Jaakko O. (2018)
    Type 2 diabetes (T2D) imposes a heavy public health burden in both developed and developing countries. It is necessary to understand the effect of T2D in different settings and population groups. This report aimed to present baseline characteristics of study participants in the demonstration area for the Type 2 Diabetes Prevention in Barranquilla and Juan Mina (DEMOJUAN) project after randomization and to compare their fasting and 2-hour glucose levels according to lifestyle and T2D risk factor levels. The DEMOJUAN project is a randomized controlled field trial. Study participants were recruited from study sites using population-wide screening using the Finnish Diabetes Risk Score (FINDRISC) questionnaire. All volunteers with FINDRISC of >= 13 points were invited to undergo an oral glucose tolerance test (OGTT). Participant inclusion criteria for the upcoming field trial were either FINDRISC of >= 13 points and 2-hour post-challenge glucose level of 7.0 to 11.0mmol/L or FINDRISC of >= 13 points and fasting plasma glucose level of 6.1 to 6.9mmol/L. Lifestyle habits and risk factors for T2D were assessed by trained interviewers using a validated questionnaire. Among the 14,193 participants who completed the FINDRISC questionnaire, 35% (n=4915) had a FINDRISC score of >= 13 points and 47% (n=2306) agreed to undergo the OGTT. Approximately, 33% (n=772) of participants underwent the OGTT and met the entry criteria; these participants were randomized into 3 groups. There were no statistically significant differences found in anthropometric or lifestyle risk factors, distribution of the glucose metabolism categories, or other diabetes risk factors between the 3 groups (P>.05). Women with a past history of hyperglycaemia had significantly higher fasting glucose levels than those without previous hyperglycaemia (103 vs 99mg/dL; P Lifestyle habits and risk factors were evenly distributed among the 3 study groups. No differences were found in fasting or 2-hour glucose levels among different lifestyle or risk factor categories with the exception of body mass index, past history of hyperglycaemia, and age of 64 years in women.
  • Lehtonen, Pyry (Helsingin yliopisto, 2021)
    Geographical accessibility to sports facilities plays an important role when choosing a sports facility. The aim of my thesis is to examine geographical accessibility for sports facilities in Helsinki and Jyväskylä. The data of my study consists of the facilities of three different types of sports in Helsinki, Jyväskylä. The chosen types of facilities are ball parks, disc golf courses and fitness centers. I also use demographic data that cover the age groups of 7-12, 20-24 and 60-64. Mapple Analytics Ltd has produced geographical accessibility data covering whole of Finland which I also use as my data. In my thesis I analyzed geographical accessibility of sports facilities and compare the results to demographic data. Both the geographical accessibility data and demographic data is in 250 x 250 m grid level. the methods I used were Local Moran’s I and Bivariate Local Moran’s I. I applied the methods so that I combined the travel-time data and demographic data. The travel-times are from Mapple Insights API. The travel modes I have used are cycling and driving because people travel to sports facilities mostly by driving or by active methods, especially cycling. The travel-times to ball parks and fitness centers are overall good in both study regions. The good geographical accessibility is caused by that the service pattern is so dense for ball parks and fitness centers. The service pattern covers almost all of the inhabited area in both study regions. However, for some postal areas seem to have not so good geographical accessibility to ball parks. In some areas in Helsinki the geographical accessibility to disc golf course can be considered to be somewhat bad. For the chosen age groups only 20-24-year-olds have unsatisfactory travel-times to disc golf course either by cycling or driving. Other age groups do not show a similar pattern because of the different service pattern of ball parks and fitness centers. Demographic variables do not explain the travel times in this context. It is important to see which postal areas have good or bad geographical accessibility to sports facilities. This helps the future planning of sports facilities. In the future it is also possible to apply non spatial methods to the data I have collected or a similar dataset. It would also be possible to which demographic variable best explains travel-times. Because of Mapple Insighs API data is in 250 x 250 m grid level many applications can be developed using the data.
  • Chaput, Jean-Philippe; Weippert, Madyson; LeBlanc, Allana G.; Hjorth, Mads F.; Michaelsen, Kim F.; Katzmarzyk, Peter T.; Tremblay, Mark S.; Barreira, Tiago V.; Broyles, Stephanie T.; Fogelholm, Mikael; Hu, Gang; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V.; Maher, Carol; Maia, Jose; Matsudo, Victor; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L.; Standage, Martyn; Tudor-Locke, Catrine; Zhao, Pei; Sjodin, Anders M.; ISCOLE Res Grp (2016)
    In order to verify if the full moon is associated with sleep and activity behaviors, we used a 12-country study providing 33,710 24-h accelerometer recordings of sleep and activity. The present observational, cross-sectional study included 5812 children ages 9-11 years from study sites that represented all inhabited continents and wide ranges of human development (Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, United Kingdom, and United States). Three moon phases were used in this analysis: full moon (4 days; reference), half moon (5-9 days), and new moon (+10-14 days) from nearest full moon. Nocturnal sleep duration, moderate -to vigorous physical activity (MVPA), light-intensity physical activity (LPA), and total sedentary time (SED) were monitored over seven consecutive days using a waist -worn accelerometer worn 24 h a day. Only sleep duration was found to significantly differ between moon phases (-5 min/night shorter during full moon compared to new moon). Differences in MVPA, LPA, and SED between moon phases were negligible and non-significant (
  • Lahelma, Mari; Luukkonen, Panu K.; Qadri, Sami; Ahlholm, Noora; Lallukka-Brück, Susanna; Porthan, Kimmo; Juuti, Anne; Sammalkorpi, Henna; Penttilä, Anne K.; Arola, Johanna; Orho-Melander, Marju; Yki-Järvinen, Hannele (2021)
    Only some individuals with obesity develop liver fibrosis due to non-alcoholic fatty liver disease (NAFLD-fibrosis). We determined whether detailed assessment of lifestyle factors in addition to physical, biochemical and genetic factors helps in identification of these patients. A total of 100 patients with obesity (mean BMI 40.0 +/- 0.6 kg/m(2)) referred for bariatric surgery at the Helsinki University Hospital underwent a liver biopsy to evaluate liver histology. Physical activity was determined by accelerometer recordings and by the Modifiable Activity Questionnaire, diet by the FINRISK Food Frequency Questionnaire, and other lifestyle factors, such as sleep patterns and smoking, by face-to-face interviews. Physical and biochemical parameters and genetic risk score (GRS based on variants in PNPLA3, TM6SF2, MBOAT7 and HSD17B13) were measured. Of all participants 49% had NAFLD-fibrosis. Independent predictors of NAFLD-fibrosis were low moderate-to-vigorous physical activity, high red meat intake, low carbohydrate intake, smoking, HbA(1c), triglycerides and GRS. A model including these factors (areas under the receiver operating characteristics curve (AUROC) 0.90 (95% CI 0.84-0.96)) identified NAFLD-fibrosis significantly more accurately than a model including all but lifestyle factors (AUROC 0.82 (95% CI 0.73-0.91)) or models including lifestyle, physical and biochemical, or genetic factors alone. Assessment of lifestyle parameters in addition to physical, biochemical and genetic factors helps to identify obese patients with NAFLD-fibrosis.
  • Palsola, Minttu (Helsingin yliopisto, 2020)
    Adolescents continue to be affected by behavior-related health risk factors such as low levels of physical activity. They can be motivated to be more physically active in various ways, but they can also take agency in their own behavior change and use different behavior change techniques to manage and maintain their behavior. According to self-determination theory, the quality of motivation is key in behavior change, as fostering autonomous motivation should lead to long-lasting wellbeing-enhancing changes, whereas controlled motivation might have adverse effects. There is some evidence of the positive effects of the use of individual behavior change techniques on physical activity, but the effects of their use on motivational constructs is less studied. The aim of this thesis is to map the effects of (1) the use of individual self-motivating behavior change techniques on changes in physical activity-related autonomous and controlled motivation, (2) the total use of self-motivating behavior change techniques on changes in physical activity-related autonomous and controlled motivation, and (3) the total use of self-motivational behavior change techniques, and controlled and autonomous motivation on changes in moderate-to-vigorous physical activity. This thesis utilizes data from Let’s Move It, a cluster-randomized controlled trial of a school-based physical activity intervention (baseline N=767, post-intervention N=687). At both time points, participants self-reported use of three self-motivational techniques (reflecting on identity congruence, life values congruence and thinking about personal motives) on a scale from 1 to 6, and their autonomous and controlled motivation on a scale from 1 to 5. Moderate-to-vigorous physical activity was assessed with 7-day accelerometry. Their associations are analyzed with multivariate regression models corrected for age, gender and baseline levels of motivation or physical activity. The findings show that reflecting on life identity congruence (autonomous motivation; AM β=0.202, p<.001; controlled motivation; CM β=0.132, p<.001), life values congruence (AM β=0.184, p<.001; CM β=0.112, p<.001), and thinking about personal motives (AM β=0.246, p<.001; CM β=0.175, p<.001), as well as their total use (AM β=0.260, p<.001; CM β=0.157, p<.001), were all associated with both autonomous and controlled motivation. Total self-motivational behavior change technique use (β= -0.026, p=.617) and controlled motivation (β= -0.037, p=.373) had no detectable effects on moderate-to-vigorous physical activity, but autonomous motivation (β=0.135, p<0.05) did. This thesis sheds light on the actions that individuals can take themselves to foster their motivation. Understanding how adolescents can self-motivate themselves can give insight into how to sustain a sense of autonomy while navigating through different life situations, and thus help to achieve long-lasting and wellbeing enhancing behaviors.
  • Lounassalo, Irinja; Hirvensalo, Mirja; Kankaanpaeae, Anna; Tolvanen, Asko; Palomäki, Sanna; Salin, Kasper; Fogelholm, Mikael; Yang, Xiaolin; Pahkala, Katja; Rovio, Suvi; Hutri-Kähönen, Nina; Raitakari, Olli; Tammelin, Tuija H. (2019)
    A physically active lifestyle and a diet rich in vegetables and fruits have a central role in promoting health. This study examined the associations between leisure-time physical activity (LTPA) trajectories and fruit and vegetable consumption (FVC) from childhood to middle age. The data were drawn from the Cardiovascular Risk in Young Finns Study with six age cohorts. Participants were 9 to 18 years (n = 3536; 51% females) at baseline in 1980 and 33 to 48 years at the last follow-up in 2011. LTPA and FVC were self-reported. LTPA trajectories were identified using latent profile analyses, after which the mean differences in FVC across the trajectories were studied. Active, low-active, decreasingly and increasingly active trajectories were identified for both genders. An additional trajectory describing inactivity was identified for females. Those who were persistently active or increased their LTPA had higher FVC at many ages when compared to their inactive or low-active counterparts (p <0.05). In females prior to age 42 and in males prior to age 24, FVC was higher at many ages in those with decreasing activity than in their inactive or low-active counterparts (p <0.05). The development of LTPA and FVC from childhood to middle age seem to occur in tandem.
  • Kujala, Urho M.; Hautasaari, Pekka; Vähä-Ypyä, Henri; Waller, Katja; Lindgren, Noora; Iso-Markku, Paula; Heikkilä, Kauko; Rinne, Juha; Kaprio, Jaakko; Sievänen, Harri (2019)
    Introduction: High physical activity (PA) at old age indicates good functional capacity enabling independent living. We investigated how different disease conditions are associated with measured PA indicators in old women and men, and whether they recognize this association. Materials and methods: This cross-sectional twin cohort study in Finland comprised 779 individuals (276 complete twin pairs, including 117 monozygotic pairs), who participated in hip-worn accelerometer monitoring of PA and responded to questions on diseases and mobility limitations at mean age of 73 (range 71-75). Results: Of the participants, 23.2% reported having a disease restricting mobility. With sex and age in the regression model, the reported disease restricting mobility explained 11.8% of the variation in moderate-to-vigorous PA (MVPA) and 10.4% of the variation in daily steps. Adding stepwise other self-reported diseases and body mass index to the model increased the explanatory power for MVPA up to 18.5% and 25.5%, and for daily steps up to 16.0% and 20.7%, respectively. In the co-twin control analysis the PA differences were smaller in disease-discordant monozygotic than dizygotic pairs. Conclusions: Chronic disease conditions are associated with low PA, which individuals may not always recognize. Shared genetic factors may explain part of the associations.Key messages Among community-dwelling older men and women one-fourth of the variation in objectively measured moderate-to-vigorous physical activity is accounted for by age, sex, body mass index and self-reported diseases. Occurrence of chronic diseases is associated with low physical activity and individuals do not always recognize this. Healthcare professionals should pay attention to the low physical activity and mobility of individuals with chronic disease conditions before these result in limitations in independent living.
  • Honkanen, Tuomas; Mäntysaari, M.; Leino, Tuomo; Avela, J.; Kerttula, L.; Haapamäki, V.; Kyröläinen, Heikki (2019)
    Background: A small cross sectional area (CSA) of the paraspinal muscles may be related to low back pain among military aviators but previous studies have mainly concentrated on spinal disc degeneration. Therefore, the primary aim of the study was to investigate the changes in muscle CSA and composition of the psoas and paraspinal muscles during a 5-year follow up among Finnish Air Force (FINAF) fighter pilots. Methods: Study population consisted of 26 volunteered FINAF male fighter pilots (age: 20.6 (±0.6) at the baseline). The magnetic resonance imaging (MRI) examinations were collected at baseline and after 5 years of follow-up. CSA and composition of the paraspinal and psoas muscles were obtained at the levels of 3-4 and 4-5 lumbar spine. Maximal isometric strength tests were only performed on one occasion at baseline. Results: The follow-up comparisons indicated that the mean CSA of the paraspinal muscles increased (p <0.01) by 8% at L3-4 level and 7% at L4-5 level during the 5-year period. There was no change in muscle composition during the follow-up period. The paraspinal and psoas muscles' CSA was positively related to overall maximal isometric strength at the baseline. However, there was no association between LBP and muscle composition or CSA. Conclusions: The paraspinal muscles' CSA increased among FINAF fighter pilots during the first 5 years of service. This might be explained by physically demanding work and regular physical activity. However, no associations between muscle composition or CSA and low back pain (LBP) experienced were observed after the five-year follow-up. © 2019 The Author(s).
  • Kaartinen, Sara; Korhonen, Tellervo; Rottensteiner, Mirva; Kujala, Urho M.; Kaprio, Jaakko; Aaltonen, Sari (2020)
    Leisure-time physical activity has a complex relationship with low back pain (LBP). Thus, we aimed to investigate whether the diversity of sport activities is associated with the type of LBP. In the FinnTwin16 study, 4246 (55% females) Finnish twins at mean age 34.1 years replied to a health behaviour survey in 2010-2012. Based on the participation in different sport activities, we created two measures of diversity: quantity (i.e. the number of sport activities: 1, 2, 3, 4 and >= 5) and quality (i.e. the type of sport activity: endurance, strength, body care, etc.). Based on the frequency, duration and type of LBP, we created three groups: no history of LBP lasting more than one day, radiating LBP and non-radiating LBP. The associations between the quantity and quality of sport activities and the type of LBP were investigated with logistic regression analyses. Participation in >= 5 sport activities associated with less radiating and non-radiating LBP in analyses pooled across sex (odds ratio 0.46, 95% CI 0.30-0.69 and 0.66, 0.44-0.99, respectively). However, the associations attenuated after adjusting for several confounders. Participation in endurance sports was associated with less radiating (0.58, 0.43-0.76) and non-radiating (0.60, 0.44-0.81) LBP, whereas strength sports and body care only with less radiating LBP (0.76, 0.58-1.00 and 0.26, 0.09-0.74, respectively) adjusted for all sport types. On a sport-specific level, running and cycling were associated with less radiating and non-radiating LBP. In adulthood, the diversity of sport activities, particularly participation in endurance sports, may be associated with less radiating and non-radiating LBP.
  • Vaara, Jani P.; Vasankari, Tommi; Fogelholm, Mikael; Koski, Harri; Kyrolainen, Heikki (2020)
    IntroductionActive commuting is an inexpensive and accessible form of physical activity and may be beneficial to health. The aim of this study was to investigate the association of active commuting and its subcomponents, cycling and walking, with cardiometabolic risk factors, physical fitness and body composition in young men.MethodsParticipants were 776 Finnish young (267 years), healthy adult men. Active commuting was measured with self-report. Waist circumference was measured and body mass index (BMI) calculated. Aerobic fitness was measured with bicycle ergometer and muscular fitness with maximal leg and bench press, sit-ups, push-ups and standing long jump. Cardiometabolic risk factors were analysed from blood samples and selected variables (glucose, insulin, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, as well as systolic and diastolic blood pressure) were further converted to z-score to form clustered cardiometabolic risk.ResultsA total of 24% used active commuting consisting of 10% of walkers and 14% of cyclists. After adjustments for age, smoking, time of year, leisure-time and occupational physical activities, cycling was inversely associated with the clustered cardiometabolic risk (beta=-0.11, 95% CI -0.22 to -0.01), while walking was not (beta=-0.04, 95% CI -0.16 to 0.08). However, further adjustment for waist circumference attenuated the associations to non-significant. Moreover, cycling but not walking was inversely associated with BMI, waist circumference and maximal strength, while a positive association was observed with aerobic fitness (p
  • Rinne, Tiina; Kajosaari, Anna; Söderholm, Maria; Berg, Päivi; Pesola, Arto J.; Smith, Melody; Kyttä, Marketta (Pergamon, 2022)
    Health and place
    Background The social ecological approach suggests that the spatial context among other factors influence physical activity behavior. Ample research documents physical environmental effects on physical activity. Yet, to date inconsistent associations remain, which might be explained by conceptual and methodological challenges in measuring the spatial dimensions of health behavior. We review methods applied to measure the spatial contexts in the social ecological physical activity literature. Methods Online databases and selected reviews were used to identify papers published between 1990 and 2020. A total of 2167 records were retrieved, from which 412 studies that used physical activity as a primary outcome variable, included measures of the physical environment and applied the main principles of the social ecological approach, were included. Results Subjective approaches were the dominant method to capture the spatial context of physical activities. These approaches were applied in 67% (n=279) of the studies. From the objective approaches an administrative unit was most prevalent and was applied in 29% (n=118) of the studies. The most comprehensive objective spatial methods that capture the true environmental exposure, were used only in 2% (n=10) of the studies. Conclusions Current social ecological physical activity research applies simple conceptualizations and methods of the spatial context. While conceptual and methodological concerns have been repeatedly expressed, no substantive progress has been made in the use of spatial approaches. To further our understanding on place effects on health, future studies should carefully consider the choice of spatial approaches, and their effect on study results.
  • Wackström, Nanna; Koponen, Anne M.; Suominen, Sakari; Tarkka, Ina M.; Simonsen, Nina (2020)
    ABSTRACT Background: Physical activity (PA) is a key component in management of type 2 diabetes (T2D). Pain might be a barrier to PA especially among older adults with T2D, but surprisingly few studies have investigated the association between chronic pain and PA. Our aim was to evaluate the prevalence of chronic pain among older adults with T2D and to examine the association between chronic pain and PA while taking important life-contextual factors into account. Methods: Data of this register-based, cross-sectional study were collected in a survey among adults with T2D (n=2866). In the current study, only respondents aged 65?75 years were included (response rate 63%, n=1386). Data were analysed by means of descriptive statistics and multivariate logistic regression analysis. Results: In total, 64% reported chronic pain. In specific groups, e.g. women and those who were obese, the prevalence was even higher. Among respondents experiencing chronic pain, frequent pain among women and severe pain among both genders were independently associated with decreased likelihood of being physically active. Moreover, the likelihood of being physically active decreased with higher age and BMI, whereas it increased with higher autonomous motivation and feelings of energy. Among physically active respondents suffering from chronic pain, neither intensity nor frequency of pain explained engagement in exercise (as compared with incidental PA). Instead, men were more likely to exercise regularly as were those with good perceived health and higher autonomous motivation. Conclusions: The prevalence of chronic pain is high among older adults with T2D. This study shows that among those suffering from chronic pain, severe pain is independently and inversely associated with being physically active, as is frequent pain, but only among women. Moreover, the findings show the importance of autonomous motivation and health variables for both incidental PA and exercise among older adults with T2D experiencing chronic pain.
  • Andersen, Heidi; Ilmarinen, Pinja; Honkamäki, Jasmin; Tuomisto, Leena E.; Piirilä, Päivi; Hisinger-Mölkänen, Hanna; Sovijärvi, Anssi; Backman, Helena; Lundback, Bo; Rönmark, Eva; Lehtimäki, Lauri; Kankaanranta, Hannu (2021)
    Background Difference in dyspnea mMRC >= 2 between Finnish speaking and Swedish-speaking populations in Finland has not been previously studied. Methods In February 2016, a respiratory questionnaire was sent to 8000 randomly selected subjects aged 20-69 years in western Finland with a response rate of 52.3%. The registered native language of each subject determined whether questionnaire in Finnish or Swedish was applied. Multiple logistic regression was performed to calculate Odds Ratios (OR) with 95% CI for the simultaneous effects of independent variables on dyspnea mMRC >= 2. Results Of all participants, 2780 (71.9%) were Finnish speakers and 1084 (28.1%) were Swedish speakers. Finnish speakers had a higher prevalence of dyspnea mMRC >= 2 (11.1% vs 6.5% p <0.001) when compared to Swedish speakers. Finnish speakers smoked more often, had higher BMI, spent less time moving during the day, had more often occupational exposure to vapours, gases, dusts or fumes (VGDF), and had lower socioeconomic status based on occupation. Significant risk factors for dyspnea mMRC >= 2 were COPD (OR = 10.94), BMI >35 (OR = 9.74), asthma (OR = 4.78), female gender (OR = 2.38), older age (OR = 2.20), current smoking (OR = 1.59), and occupational exposure to VGDF (OR = 1.47). Conclusions Swedish speakers had less dyspnea mMRC >= 2 which is explained by a healthier lifestyle. Smoking, obesity, and occupational exposures should be in focus to improve respiratory health.
  • Komulainen, K; Pulkki-Raback, L; Jokela, M; Lyytikäinen, LP; Pitkänen, N; Laitinen, T; Hintsanen, M; Elovainio, M; Hintsa, T; Jula, A (2018)
    Objectives:The life-course development of body mass index (BMI) may be driven by interactions between genes and obesity-inducing social environments. We examined whether lower parental or own education accentuates the genetic risk for higher BMI over the life course, and whether diet and physical activity account for the educational differences in genetic associations with BMI.Subjects/Methods:The study comprised 2441 participants (1319 women, 3-18 years at baseline) from the prospective, population-based Cardiovascular Risk in Young Finns Study. BMI (kg/m 2) trajectories were calculated from 18 to 49 years, using data from six time points spanning 31 years. A polygenic risk score for BMI was calculated as a weighted sum of risk alleles in 97 single-nucleotide polymorphisms. Education was assessed via self-reports, measured prospectively from participants in adulthood and from parents when participants were children. Diet and physical activity were self-reported in adulthood.Results:Mean BMI increased from 22.6 to 26.6 kg/m 2 during the follow-up. In growth curve analyses, the genetic risk score was associated with faster BMI increase over time (b=0.02, (95% CI, 0.01-0.02, P
  • Dorenbos, Elke; Drummen, Mathijs; Adam, Tanja; Rijks, Jesse; Winkens, Bjorn; Alfredo Martinez, J.; Navas-Carretero, Santiago; Stratton, Gareth; Swindell, Nils; Stouthart, Pauline; Mackintosh, Kelly; Mcnarry, Melitta; Tremblay, Angelo; Fogelholm, Mikael; Raben, Anne; Westerterp-Plantenga, Margriet; Vreugdenhil, Anita (2021)
    Background Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity. Objectives The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA-IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity. Methods Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI >= 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA-IR were analyzed. Results 126 adolescents were included in this study (13.6 +/- 2.2 years, BMI z-score 3.04 +/- 0.66, HOMA-IR 3.48 +/- 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed. Conclusions The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.
  • Sandborg, Johanna; Söderström, Emmie; Henriksson, Pontus; Bendtsen, Marcus; Henström, Maria; Leppänen, Marja H.; Maddison, Ralph; Migueles, Jairo H.; Blomberg, Marie; Löf, Marie (2021)
    Background: Excessive gestational weight gain (GWG) during pregnancy is a major public health concern associated with negative health outcomes for both mother and child. Scalable interventions are needed, and digital interventions have the potential to reach many women and promote healthy GWG. Most previous studies of digital interventions have been small pilot studies or have not included women from all BMI categories. We therefore examined the effectiveness of a smartphone app in a large sample (n=305) covering all BMI categories. Objective: To investigate the effectiveness of a 6-month intervention (the HealthyMoms app) on GWG, body fatness, dietary habits, moderate-to-vigorous physical activity (MVPA), glycemia, and insulin resistance in comparison to standard maternity care. Methods: A 2-arm parallel randomized controlled trial was conducted. Women in early pregnancy at maternity clinics in Östergötland, Sweden, were recruited. Eligible women who provided written informed consent completed baseline measures, before being randomized in a 1:1 ratio to either an intervention (n=152) or control group (n=153). The control group received standard maternity care while the intervention group received the HealthyMoms smartphone app for 6 months (which includes multiple features, eg, information; push notifications; self-monitoring; and feedback features for GWG, diet, and physical activity) in addition to standard care. Outcome measures were assessed at Linköping University Hospital at baseline (mean 13.9 [SD 0.7] gestational weeks) and follow-up (mean 36.4 [SD 0.4] gestational weeks). The primary outcome was GWG and secondary outcomes were body fatness (Bod Pod), dietary habits (Swedish Healthy Eating Index) using the web-based 3-day dietary record Riksmaten FLEX, MVPA using the ActiGraph wGT3x-BT accelerometer, glycemia, and insulin resistance. Results: Overall, we found no statistically significant effect on GWG (P=.62); however, the data indicate that the effect of the intervention differed by pre-pregnancy BMI, as women with overweight and obesity before pregnancy gained less weight in the intervention group as compared with the control group in the imputed analyses (-1.33 kg; 95% CI -2.92 to 0.26; P=.10) and completers-only analyses (-1.67 kg; 95% CI -3.26 to -0.09; P=.031]). Bayesian analyses showed that there was a 99% probability of any intervention effect on GWG among women with overweight and obesity, and an 81% probability that this effect was over 1 kg. The intervention group had higher scores for the Swedish Healthy Eating Index at follow-up than the control group (0.27; 95% CI 0.05-0.50; P=.017). We observed no statistically significant differences in body fatness, MVPA, glycemia, and insulin resistance between the intervention and control group at follow up (P≥.21). Conclusions: Although we found no overall effect on GWG, our results demonstrate the potential of a smartphone app (HealthyMoms) to promote healthy dietary behaviors as well as to decrease weight gain during pregnancy in women with overweight and obesity.
  • Räsänen, Sari (Helsingfors universitet, 2013)
    Maternity and child health clinics have a central role in preventing childhood obesity and providing the entire family with lifestyle counselling. The Pilot Intervention Study on Diet of Toddlers in Finland aims at evaluating the feasibility of a nutrition intervention in child health clinics. The Resourceful Family counselling method developed by the Finnish Heart Association is a family-centred and empowerment-based method employed in child health clinics that are part of the nutrition intervention group in the Pilot Intervention Study on Diet of Toddlers in Finland. The aim of this thesis was to describe the discussions about lifestyle issues in child health clinic. Another aim was to evaluate the translation of the principles and objectives of the Resourceful Family method into practice. Ten child’s one-year visits to child health clinic recorded in the Pilot Intervention Study on Diet of Toddlers in Finland were analyzed in this study. The check-up visits had been recorded in three child health clinics where the nutrition intervention was carried out. The research method was content analysis. The most frequent themes in discussions about lifestyle during the child’s one-year visit to child health clinic were: adjusting of the child to the family diet, milk or milk products in the child’s diet and vitamin D supplementation of the child (discussed during 8/10 child health clinic appointments). Salt in food preparation was also a common theme (6/10). In nearly all of the appointments (9/10) one or more theme related to the lifestyle of parents and/or the entire family was discussed. The nurse mostly controlled the counselling situation by bringing up new topics. The nurses invited families to participate in the discussions in more than half of the appointments in accordance with a specific guidance practice part of the Resourceful Family counselling method. The nurses linked the invitation to the Resourceful Family card. They provided families with information in a neutral manner. Some of the information provided was client-centred. Discussions related to changing habits were evident in more than half of the appointments. These discussions did not lead to setting specific goals or creating plans due to the lack of guidance practices aimed at helping the family proceed in the change process. Family-centred and resource-based lifestyle counselling should be developed especially regarding motivating the family and supporting the family members in the change process. Thus the importance of these two areas of counselling should be emphasized in the education of nurses.
  • Nurmi, Johanna; Knittle, Keegan; Ginchev, Todor; Khattak, Fida; Helf, Christopher; Zwickl, Patrick; Castellano-Tejedor, Carmina; Lusilla-Palacios, Pilar; Costa-Requena, Jose; Ravaja, Niklas; Haukkala, Ari (2020)
    Background: Most adults do not engage in sufficient physical activity to maintain good health. Smartphone apps are increasingly used to support physical activity but typically focus on tracking behaviors with no support for the complex process of behavior change. Tracking features do not engage all users, and apps could better reach their targets by engaging users in reflecting their reasons, capabilities, and opportunities to change. Motivational interviewing supports this active engagement in self-reflection and self-regulation by fostering psychological needs proposed by the self-determination theory (ie, autonomy, competence, and relatedness). However, it is unknown whether digitalized motivational interviewing in a smartphone app engages users in this process. Objective: This study aimed to describe the theory- and evidence-based development of the Precious app and to examine how digitalized motivational interviewing using a smartphone app engages users in the behavior change process. Specifically, we aimed to determine if use of the Precious app elicits change talk in participants and how they perceive autonomy support in the app. Methods: A multidisciplinary team built the Precious app to support engagement in the behavior change process. The Precious app targets reflective processes with motivational interviewing and spontaneous processes with gamified tools, and builds on the principles of self-determination theory and control theory by using 7 relational techniques and 12 behavior change techniques. The feasibility of the app was tested among 12 adults, who were asked to interact with the prototype and think aloud. Semistructured interviews allowed participants to extend their statements. Participants’ interactions with the app were video recorded, transcribed, and analyzed with deductive thematic analysis to identify the theoretical themes related to autonomy support and change talk. Results: Participants valued the autonomy supportive features in the Precious app (eg, freedom to pursue personally relevant goals and receive tailored feedback). We identified the following five themes based on the theory-based theme autonomy support: valuing the chance to choose, concern about lack of autonomy, expecting controlling features, autonomous goals, and autonomy supportive feedback. The motivational interviewing features actively engaged participants in reflecting their outcome goals and reasons for activity, producing several types of change talk and very little sustain talk. The types of change talk identified were desire, need, reasons, ability, commitment, and taking steps toward change. Conclusions: The Precious app takes a unique approach to engage users in the behavior change process by targeting both reflective and spontaneous processes. It allows motivational interviewing in a mobile form, supports psychological needs with relational techniques, and targets intrinsic motivation with gamified elements. The motivational interviewing approach shows promise, but the impact of its interactive features and tailored feedback needs to be studied over time. The Precious app is undergoing testing in a series of n-of-1 randomized controlled trials. KEYWORDS health app; mHealth; human-computer interaction; prevention; service design; usability design; intrinsic motivation; reflective processes; spontaneous processes; engagement; self-determination theory; autonomous motivation; gamification; physical activity
  • Acosta, Tania; Tuesca, Rafael; Florez, Karen; Barengo, Noel C.; Anillo, Luis; Florez-Garcia, Victor; Acosta, Jorge; Carvajal, Liliana; de la Rosa, Sandra; Pachon, Maria Julieta; Aschner, Pablo (2021)
    Low level of physical activity is a risk factor for chronic non-communicable diseases. Specifically, people at risk of Type 2 Diabetes (T2D) have shown to benefit from being physically active. The objective of this study was to explore what factors were associated with low physical activity in people at high risk of T2D living in Bogota and Barranquilla, Colombia. Methodology: Cross-sectional study using baseline data from a quasi-experimental clinical trial (PREDICOL Project). The study included 1,135 participants of Bogota and Barranquilla that presented a high risk of developing T2D according to the Finnish Diabetes Risk Score (>12 points) and who underwent an oral glucose tolerance test. The main outcome variable was the level of physical activity assessed by the International Physical Activity Questionnaire. Unadjusted and adjusted logistic regression analysis were used to calculate odds ratios (OR) and the corresponding 95% confidence intervals (CI). Results: In total, 72.5% of the study participants had low level of physical activity. Participants in the age group between 45 and 54 years showed 74% greater odds of having low physical activity compared with the youngest age group (OR 1.74, 95% CI 1.1 -2.8). People living in Barranquilla were eight times more likely to have low physical activity compared with those in Bogota D.C. (OR 8.1, 95% CI 5.7 to 11.4). Conclusion: A large proportion of the population at risk of developing D2T in two large cities of Colombia have a sedentary lifestyle. Interventions should be designed and implemented in order to increase physical activity in these populations.