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  • 1.
    Agahi, Neda
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Shaw, Benjamin A.
    Smoking trajectories from midlife to old age and the development of non-life-threatening health problems: A 34-year prospective cohort study2013In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 57, no 2, p. 107-112Article in journal (Refereed)
    Abstract [en]

    Objective. To examine how trajectories of smoking observed over a 34-year period, were associated with the progression of mobility impairment, musculoskeletal pain, and symptoms of psychological distress from midlife to old age. Method. The Swedish Level of Living Survey (LNU) and the Swedish Panel Study of the Oldest Old (SWEOLD) were merged to create a nationally representative longitudinal sample of Swedish adults (aged 30-50 at baseline; n = 1060), with four observation periods, from 1968 through 2002. Five discrete smoking trajectory groups were treated as predictors of variation in health trajectories using multilevel regression. Results. At baseline, there were no differences in mobility impairment between smoking trajectory groups. Over time all smokers, particularly persistent and former heavy smokers, exhibited faster increases in mobility problems compared with persistent non-smokers. Additionally, all smoking groups reported more pain symptoms than the non-smokers, at baseline and over time, but most of these differences did not reach statistical significance. Persistent heavy smokers reported elevated levels of psychological distress at baseline and over time. Conclusion. Smokers, and even some former smokers, who survive into old age appear to be at increased risk for non-life-threatening conditions that can diminish quality of life and increase demands for services.

  • 2.
    Ahacic, Kozma
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Kennison, Robert
    Thorslund, Mats
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Trends in smoking in Sweden from 1968 to 2002: Age, period, and cohort patterns2008In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 46, no 6, p. 558-564Article in journal (Refereed)
    Abstract [en]

    Objective. Smoking is related to many later life health outcomes. We examined age, period, and cohort patterns in smoking between 1968 and 2002. Methods. A nationally representative panel study allowed repeated cross-sectional comparisons of ages 18-75 (5 waves n approximate to 5000), and ages 77+ at later waves (2 waves n approximate to 500). Cross-sectional 10-year age group differences in 5 waves, time-lag differences between waves for age groups, and within-cohort differences between waves for 10-year birth cohorts were evaluated using graphs and ordered logistic regressions. Results. Age-period-cohort models suggested that period and age effects dominated smoking patterns, showing decreases over time and age. The 1935-44 and 1945-54 cohorts, however, showed lesser period decline. Moreover, men showed a period reduction of smoking rates but no age related decrease, while women showed an age related decrease but no period effect. The genders' cohort patterns were similar, with higher smoking rates in the last waves for some cohorts, for men the 1945-54 cohort and women the 1935-44 cohort. Conclusions. Cross-sectional studies of cohorts must be aware of age effects. Due to the coming of age of the 1940s' cohorts smoking may increase among women in the oldest age groups.

  • 3. Carlsson, Axel C
    et al.
    Wändell, Per
    Riserus, Ulf
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Borné, Yan
    Engström, Gunnar
    Leander, Karin
    Gigante, Bruna
    Hellénius, Mai-Lis
    de Faire, Ulf
    Differences in anthropometric measures in immigrants and Swedish-born individuals: results from two community-based cohort studies2014In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 69, p. 151-156Article in journal (Refereed)
    Abstract [en]

    AIM: To study differences in body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), sagittal abdominal diameter (SAD), waist-hip-height ratio (WHHR) and percent body fat in immigrants and Swedish-born men and women in two large population-based samples.

    METHODS: A cross-sectional analysis of 60-year-old individuals, n=4 232. To replicate the results, we also assessed another large independent cohort cross-sectionally, the Malmö Diet and Cancer Study (MDC, n=26 777). The data from both cohorts were collected in the 1990s in Sweden.

    RESULTS: Significant differences between Finnish-born, Middle Eastern and women from the rest of the world were seen for all anthropometric measures, using Swedish-born women as referent. However, WHHR was the only anthropometric measure that identified all these three groups of immigrant women as different from Swedish-born women with high statistical certainty (p<0.001). Apart from WHHR that identified differences in anthropometry in all immigrant groups of men using Swedish-born men as referent, few significant differences were seen in anthropometry among groups of immigrant men. These finding were observed in both cohorts, and remained after adjustments for smoking, physical activity and educational level.

    CONCLUSION: The present study confirms previous findings of more obesity among immigrants and is the first to report that WHHR measurements may detect anthropometric differences between different ethnic groups better than other anthropometrical measures.

  • 4.
    Carlsson, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Wändell, Per
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Borné, Yan
    Engström, Gunnar
    Leander, Karin
    Gigante, Bruna
    Hellenius, Mai-Lis
    de Faire, Ulf
    Differences inanthropometric measures in immigrants and Swedish-born individuals: Results from two community based cohort studies2014In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 69, p. 151-156Article in journal (Refereed)
    Abstract [en]

    Aim

    To study differences in body mass index (BMI), waist–hip ratio (WHR), waist circumference (WC), sagittal abdominal diameter (SAD), waist–hip–height ratio (WHHR) and percent body fat in immigrants and Swedish-born men and women in two large population-based samples.

    Methods

    A cross-sectional analysis of 60-year-old individuals, n = 4 232. To replicate the results, we also assessed another large independent cohort cross-sectionally, the Malmö Diet and Cancer Study (MDC, n = 26 777). The data from both cohorts were collected in the 1990s in Sweden.

    Results

    Significant differences between Finnish-born, Middle Eastern and women from the rest of the world were seen for all anthropometric measures, using Swedish-born women as referent. However, WHHR was the only anthropometric measure that identified all these three groups of immigrant women as different from Swedish-born women with high statistical certainty (p < 0.001). Apart from WHHR that identified differences in anthropometry in all immigrant groups of men using Swedish-born men as referent, few significant differences were seen in anthropometry among groups of immigrant men. These finding were observed in both cohorts, and remained after adjustments for smoking, physical activity and educational level.

    Conclusion

    The present study confirms previous findings of more obesity among immigrants and is the first to report that WHHR measurements may detect anthropometric differences between different ethnic groups better than other anthropometrical measures.

  • 5.
    Chillón, Palma
    et al.
    Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain.
    Ortega, Francisco B
    Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain; Department of Biosciences and Nutrition, Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden; Department of Physiology, School of Medicine, University of Granada, Granada, Spain.
    Ruiz, Jonatan R
    Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain; Department of Biosciences and Nutrition, Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Evenson, Kelly R
    Department of Epidemiology, Gillings School of Global Public Health, University of North Carolinat, Chapel Hill NC, United States; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill NC, United States.
    Labayen, Idoia
    Department of Biosciences and Nutrition, Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Food Sciences, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.
    Martínez-Vizcaino, Vicente
    Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain.
    Hurtig-Wennlöf, Anita
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Veidebaum, Toomas
    National Institute for Heath Development, Centre of Behavioral and Health Sciences, Tallinn, Estonia.
    Sjöström, Michael
    Department of Biosciences and Nutrition, Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Bicycling to school is associated with improvements in physical fitness over a 6-year follow-up period in Swedish children2012In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 55, no 2, p. 108-112Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine whether modes of commuting to school at baseline and changes in commuting were related to 6-year changes in cardiorespiratory fitness in youth.

    METHODS: A total of 262 (142 girls) Swedish children (9 years at entry) were measured at baseline (1998/9) and follow-up (2004/5). Mode of commuting to school was assessed by questionnaire and fitness by a maximal bicycle test.

    RESULTS: At baseline, 34% of children used passive modes of commuting (e.g., car, motorcycle, bus, train), 54% walked, and 12% bicycled to school. Six years later the percentage of bicyclists increased 19% and the percentage of walkers decreased 19%. On average, children who bicycled to school increased their fitness 13% (p=0.03) more than those who used passive modes and 20% (p=0.002) more than those who walked. Children who used passive modes or walked at baseline and bicycled to school at 6 years later increased their fitness 14% (p=0.001) more than those who remained using passive modes or walking at follow-up.

    CONCLUSIONS: Implementing initiatives that encourage bicycling to school may be a useful strategy to increase cardiorespiratory fitness of children.

  • 6.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Söderling, Jonas
    Karolinska institutet.
    Börjesson, Mats
    University of Gothenburg.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults.2019In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 127, article id 105799Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO2max) using a submaximal cycle test. Incident cases of first-time CVD event and death from any cause were ascertained through national registers. There were 4244 CVD events and 2750 cases of all-cause mortality during mean 7.6 years follow-up. Male gender, higher age and lower estVO2max were associated with higher all-cause mortality and CVD morbidity incidence rates. Risk reductions with increasing estVO2max were present in all age-groups of men and women. No obvious levelling off in risk was identified in the total cohort. However, women and older age-groups showed no further reduction in higher aggregated estVO2max levels. CVD specific mortality was more associated with estVO2max compared to tumor specific mortality. The risk for all-cause mortality and CVD morbidity decreased by 2.3% and 2.6% per increase in 1 ml·min-1·kg-1 with no significant sex-differences but more pronounced in the three lower estVO2max categories for all-cause mortality (9.1%, 3.8% and 3.3%, respectively). High compared to lower levels of estVO2max was not related to a significantly elevated mortality or morbidity. In this large cohort study, CVD morbidity and all-cause mortality were inversely related to estVO2max in both men and women of all age-groups. Increasing cardiorespiratory fitness is a clear public health priority.

  • 7.
    Falkstedt, Daniel
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Möller, Jette
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Zeebari, Zangin
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Engström, Karin
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Prevalence, co-occurrence, and clustering of health-risk behaviors among people with different socio-economic trajectories: A population-based study2016In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 93, p. 64-69Article in journal (Refereed)
    Abstract [en]

    Only a few previously published studies have investigated the co-occurrence and clustering of health-risk behaviors in people with different socio-economic trajectories from childhood to adulthood. This study was based on data collected through the Stockholm County Council's public health surveys. We selected the 24,241 participants aged 30 to 65 years, who responded to a postal questionnaire in 2010. Information on parents' and participants' educational levels was used for classification of four socio-economic trajectories, from childhood to adulthood: the ‘stable high’, the ‘upwardly mobile’, the ‘downwardly mobile’, and the ‘stable low’. Information on daily smoking, risky drinking, physical inactivity, and poor diet was used for assessment of health-risk behaviors: their prevalence, co-occurrence, and clustering. We found all health-risk behaviors to be more prevalent among women and men with a downwardly mobile or stable low socio-economic trajectory. Accordingly, having three or four co-occurring health-risk behaviors were much more likely (up to 4 times, in terms of odds ratios) in these groups as compared to the women and men with an upwardly mobile or a stable high socio-economic trajectory. However, clustering of the health-risk behaviors was not found to be stronger in those with a downwardly mobile or stable low socio-economic trajectory. Thus, the fact that women and men with a disadvantageous socio-economic career were found to have co-occurring health-risk behaviors more often than people with an advantageous socio-economic career seemed to be generated by differences in prevalence of the health-risk behaviors, not by differences in clustering of the behaviors.

  • 8.
    Fossum, Bjöörn
    et al.
    Red Cross University College of Nursing. Karolinska Institutet.
    Arborelius, E.
    Karolinska Institutet.
    Bremberg, S.
    National Institute of Public Health, Stockholm.
    Evaluation of a counseling method for the prevention of child exposure to tobacco smoke: An example of client-centered communication2004In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 38, no 3, p. 295-301Article in journal (Refereed)
  • 9.
    Fossum, Bjöörn
    et al.
    Sophiahemmet University.
    Arborelius, Elisabeth
    Bremberg, Sven
    Evaluation of a counseling method for the prevention of child exposure to tobacco smoke: an example of client-centered communication2004In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 38, no 3, p. 295-301Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Environmental tobacco smoke (ETS) is an important risk factor. The aim of this study is to evaluate effects of the counseling method "Smoke-free children" that focuses on protection of infants. METHODS: The counseling method, "Smoke-free children", has been developed and implemented at Swedish child health centers. The counseling method's point of departure is based upon a client-centered approach. Saliva cotinine samples from the mothers were collected when the child was 1-4 weeks and 3 months of age. Interviews regarding mothers' smoking habits and self-reported maternal smoking were also carried out. RESULTS: Forty-one mothers participated in the study, 26 in the intervention group and 15 in the control group. Cotinine was collected from 22 subjects in the intervention and 8 in the control group. Before the intervention, the mean cotinine level was 185 ng/mL in the intervention group and 245 ng/mL in the control group. After the intervention, cotinine levels were reduced in the intervention group (165 ng/mL) and increased in the control group (346 ng/mL). Yet, after the intervention, the mothers themselves reported more smoking in the intervention group than in the control group. Only weak correlations were found between self-reported smoking and cotinine. CONCLUSIONS: The statistical analysis supports the view that a client-centered intervention, aimed at increasing self-efficacy, exerts a positive effect on maternal smoking in the prevention of infant exposure to ETS, when applied in a routine clinical setting.

  • 10.
    Fraga, S
    et al.
    Institute of Public Health, University of Porto, Porto, Portugal.
    Lindert, J
    Department of Public Health Science, Protestant University of Applied Sciences, Ludwigsburg, Germany.
    Barros, H
    Institute of Public Health, University of Porto, Porto, Portugal.
    Torres-Gonzalez, F
    CIBERSAM, University of Granada, Granada, Spain.
    Ioannidi-Kapolou, E
    Department of Sociology, National School of Public Health, Athens, Greece.
    Melchiorre, MG
    I.N.R.C.A., Ancona, Italy.
    Stankunas, M
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Elder abuse and socioeconomic inequalities: A multilevel study in 7 European countries2014In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 61, p. 42-47Article in journal (Refereed)
    Abstract [en]

    Objectives To compare the prevalence of elder abuse using a multilevel approach that takes into account the characteristics of participants as well as socioeconomic indicators at city and country level.

    Methods In 2009, the project on abuse of elderly in Europe (ABUEL) was conducted in seven cities (Stuttgart, Germany; Ancona, Italy; Kaunas, Lithuania, Stockholm, Sweden; Porto, Portugal; Granada, Spain; Athens, Greece) comprising 4467 individuals aged 60–84 years. We used a 3-level hierarchical structure of data: 1) characteristics of participants; 2) mean of tertiary education of each city; and 3) country inequality indicator (Gini coefficient). Multilevel logistic regression was used and proportional changes in Intraclass Correlation Coefficient (ICC) were inspected to assert explained variance between models.

    Results The prevalence of elder abuse showed large variations across sites. Adding tertiary education to the regression model reduced the country level variance for psychological abuse (ICC = 3.4%), with no significant decrease in the explained variance for the other types of abuse. When the Gini coefficient was considered, the highest drop in ICC was observed for financial abuse (from 9.5% to 4.3%).

    Conclusion There is a societal and community level dimension that adds information to individual variability in explaining country differences in elder abuse, highlighting underlying socioeconomic inequalities leading to such behavior.

  • 11.
    Galanti, Maria R.
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Solna, Stockholm, Sweden.
    Virtanen, Suvi E.
    Department of Public Health Sciences, Karolinska Institutet, Solna, Stockholm, Sweden.
    Zeebari, Zangin
    Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Solna, Sweden.
    Rohyo, Izla
    Dentistry Clinic Solvändan, Sörmland Health Care Region, Folktandvården Sörmland AB, Folktandvården, Mariefred, Sweden.
    Reply to Ms. PM-14-1161: Brief counseling for tobacco cessation in dental clinics: A toothless intervention?2015In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 76, p. 124-125Article in journal (Other (popular science, discussion, etc.))
  • 12. Hallgren, Mats
    et al.
    Nakitanda, Olivia Aya
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Herring, Matthew P
    Owen, Neville
    Dunstan, David W
    Helgadottir, Björg
    Forsell, Yvonne
    Habitual physical activity levels predict treatment outcomes in depressed adults: A prospective cohort study.2016In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 88, p. 53-58Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Exercise is an efficacious stand-alone therapy for mild-to-moderate depression, but little is known about the influence of physical activity levels on responses to depression treatment. This study aimed to prospectively assess the association between self-reported habitual physical activity levels and depression severity following a 12-week intervention.

    METHOD: 629 adults (75% women; aged 18-71years) with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12weeks. The interventions included internet-based cognitive behavioural therapy (ICBT) and 'usual care' (CBT or supportive counselling). One third of all participants were taking anti-depressant medication. The primary outcome was the change in depression severity assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS). Habitual physical activity levels were self-rated and based on the estimated frequency, duration and intensity of total physical activity, including planned exercise, 'during a typical week'. Prospective associations were explored using linear regression models (percentage change) with 95% confidence intervals (CI's).

    RESULTS: Following adjustment for relevant covariates, high levels of habitual physical activity were associated with larger relative reductions in depression severity compared to low physical activity (β=-9.19, 95% CI=-18.46, -0.09, p=0.052) and moderate physical activity (β=-10.81, 95% CI=-21.09, -0.53, p<0.05), respectively.

    CONCLUSION: Adults who routinely engage in high levels of physical activity respond more favourably to CBT-focused depression treatments than adults who engage in low-to-moderate levels of activity. The optimal level of physical activity associated with reductions in depression severity corresponds to consensus recommendations for maximizing general health. One limitation is the use of self-reported physical activity data.

  • 13.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Jahncke, Helena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Sitting patterns after relocation to activity-based offices: a controlled study of a natural intervention2018In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 111, p. 384-390Article in journal (Refereed)
    Abstract [en]

    This study determined the effect of relocating workers from traditional to activity-based offices on objectively measured sitting patterns. Office workers (n=493) from five office-sites within a large Swedish government agency were included in a controlled study of a natural intervention (2015-2017). At four sites, traditional offices were replaced by activity-based offices, while workers at one site with no relocation acted as controls. Sitting, standing and walking were measured objectively for 5-8days in a sub-sample (n=110) using accelerometry (Actigraph). Total sitting time (% of working time) and time spent in short (<5min), moderate (5-30min) and prolonged (>30min) uninterrupted periods in sitting were determined. Intervention effects were determined at 3- and 12-month follow-ups using linear mixed models adjusted for baseline age, gender and office type, and stratified by office-site (referencing controls). The relocation to activity-based offices did not result in an overall effect (across sites) on occupational sitting time (all p>0.05), while walking time had increased significantly by 1.4% of the working time at 12months compared with controls. Heterogeneous results were found across offices after 12months on total sitting time compared with controls (estimated change -18.3% time-1.4% time), prolonged sitting (change -18.3% to -3.8%), walking (change 0.5%-3.5%) and standing (change -1.4%-13.9%). In conclusion, relocation to activity-based offices had a limited overall effect on occupational sitting patterns in the studied organization, but differed considerably between office sites. Site-specific determinants of sitting behavior in activity-based offices need be identified.

  • 14.
    Helgadóttir, Björg
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Forsell, Yvonne
    Karolinska Institutet, Stockholm, Sweden.
    Hallgren, Mats
    Karolinska Institutet, Stockholm, Sweden.
    Möller, Jette
    Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Long-term effects of exercise at different intensity levels on depression: A randomized controlled trial.2017In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 105, p. 37-46, article id S0091-7435(17)30294-3Article in journal (Refereed)
    Abstract [en]

    Previous research has shown positive effects of exercise on depression but studies have mainly focused on the short-term effects; few have examined the long-term effect, especially with regard to differences in intensity. The aim of this study was to examine the long-term effects of prescribed exercise on depression, performed at three intensity levels. People aged 18-67years with mild to moderate depression (Patient Health Questionnaire-9 score of ≥10) participated in a single-blind, parallel randomized control trial lasting 12weeks (Sweden 2011-2013). Four arms were included: Treatment as usual (TAU, n=310), light (n=106), moderate (n=105) and vigorous exercise (n=99). Severity of depression was measured at baseline, post-treatment and 12-month follow-up using the Montgomery-Åsberg Depression Rating Scale (MADRS). Coefficients (β) and odds ratios were estimated using linear mixed models with time×group interactions. The results showed that at the 12month follow-up the light exercise group had significantly lower depression severity scores than the TAU (-1.9, 95% CI: -3.7, -0.04) and the moderate exercise group (-2.94 95% CI: -5.2, -0.7). The vigorous exercise group had significantly lower scores than the moderate exercise group only (-2.7, 95% CI: -4.9, -0.4). In conclusion, compared to usual care for depression, only light exercise resulted in significantly lower depression severity at 12-month follow-up. Both light and vigorous exercise was more effective than moderate exercise.

    TRIAL REGISTRATION: The study was registered with the German Clinical Trial Register (DRKS study ID: DRKS00008745).

  • 15.
    Helgadóttir, Björg
    et al.
    Karolinska Institutet.
    Hallgren, Mats
    Karolinska Institutet.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Forsell, Yvonne
    Karolinska Institutet.
    Training fast or slow? Exercise for depression: A randomized controlled trial2016In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 91, p. 123-131Article in journal (Refereed)
    Abstract [en]

    Exercise can be used to treat depression but there is a lack of evidence regarding the optimal intensity and mode. Our aim was to compare the effects of different exercise intensities on post-treatment depression severity. People aged 18–67years with mild-to-moderate depression (Patient Health Questionnaire-9 score of ≥10) participated in a single-blind, parallel randomized control trial lasting 12-weeks (Sweden 2011–2013). Four treatment arms were included: treatment as usual (TAU) (n=310), light exercise (yoga or similar n=106), moderate exercise (aerobic conditioning, n=105) and vigorous exercise (aerobic conditioning, n=99). Depression severity was measured at baseline and post-treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS). Differences between the groups in depression severity at post-treatment were analysed using linear regression. Differences in exercise intensity were confirmed by heart rate monitoring. At post-treatment, the light (−4.05 Confidence Interval (CI)=−5.94, −2.17), moderate (−2.08 CI=−3.98, −0.18) and vigorous exercise groups (−3.13 CI=−5.07, −1.19) had reduced their MADRS scores significantly more than TAU. No significant differences were found between the exercise groups, and no significant interaction effect was observed between group and gender. In conclusion, exercise, whether performed at a low (yoga or similar), moderate or vigorous intensity (aerobic training) is effective in treating mild-to-moderate depression and is at least as effective as treatment as usual by a physician.

  • 16.
    Hollman, Gunilla
    et al.
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Olsson, Anders
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Familial hypercholesterolaemia and quality of life in family members2003In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 36, no 5, p. 569-574Article in journal (Refereed)
    Abstract [en]

    Background

    Awareness of genetic disease in the family may influence quality of life. The purpose of this study was to describe quality of life among nonaffected members of families with familial hypercholesterolaemia. All were aware of the risk for coronary heart disease. Their quality of life was compared with a reference group and with the patients with familial hypercholesterolesterolaemia themselves.

    Methods

    Names of family members (n = 129) were given by the patients with familial hypercholesterolaemia. A randomly selected reference group (n = 1485) and patients with familial hypercholesterolaemia (n = 185) were included for comparison. They all completed the questionnaire Quality of Life Index, the Hospital Anxiety and Depression Scale, and the Mastery Scale measuring coping. Family members and patients with familial hypercholesterolaemia also completed a questionnaire on health and lipids.

    Results

    Family members were more satisfied with family life, mean 22.1 ± 3.5 (SD), and psychological/spiritual life, 22.9 ± 4.0, than the reference group, 21.4 ± 4.3 and 21.1 ± 4.8, respectively; this was particularly expressed among partners, P < 0.05. Of family members, 91% were anxious about the patient with familial hypercholesterolaemia developing coronary heart disease.

    Conclusions

    Family members have as good a quality of life as members of the reference group, but they were anxious about the patient with familial hypercholesterolaemia developing coronary heart disease.

  • 17.
    Krachler, Benno
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Reality-check in physical activity promotion: self-report-based guidelines vs. measurement-based estimates2016In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 91, p. 395-396Article in journal (Refereed)
  • 18. Lagerlund, M
    et al.
    Hedin, A
    Sparén, Pär
    Södertörn University, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition). Karolinska Institute.
    Thurfjell, E
    Lambe, M
    Attitudes, beliefs, and knowledge as predictors of nonattendance in a Swedish population-based mammography screening program2000In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 31, no 4, p. 417-428Article in journal (Refereed)
    Abstract [en]

    Background. The effectiveness of mammography screening could be improved if factors that influence nonattendance were better understood. Methods. We examined attitudes, beliefs, and knowledge in relation to nonattendance in a population-based mammography screening program, using a case-control design. Data were collected from November 1997 to March 1998 through telephone interviews with 434 nonattenders and 515 attenders identified in a population-based mammography register in central Sweden. The questions asked drew primarily upon the components constituting the Health Belief Model. Results. Multivariate analysis showed that nonattendance was most common among women within the highest quartile of perceived emotional barriers, compared to women within the lowest quartile (OR = 4.81; 95% CI 2.96-7.82). Women who worried most about breast cancer were more likely to attend than those who worried least (OR = 0.09; 95% CI 0.02-0.31). Women with the highest scores of perceived benefits were more likely to attend than women with the lowest ones (OR = 0.35; 95% CI 0.08-0.75). Other factors associated with nonattendance were less knowledge about mammography and breast cancer, lack of advice from a health professional to participate, and very poor trust in health care. Conclusions, Our findings suggest that increased participation in outreach mammography screening programs can be achieved through enhancement of breast cancer awareness and possibly by reducing some of the modifiable barriers.

  • 19. Long, G H
    et al.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Fhärm, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Griffin, S J
    Simmons, R K
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Healthy behaviours and 10-year incidence of diabetes: a population cohort study2015In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 71, p. 121-127Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine the association between meeting behavioural goals and diabetes incidence over 10years in a large, representative Swedish population.

    METHODS: Population-based prospective cohort study of 32,120 individuals aged 35 to 55years participating in a health promotion intervention in Västerbotten County, Sweden (1990 to 2013). Participants underwent an oral glucose tolerance test, clinical measures, and completed diet and activity questionnaires. Poisson regression quantified the association between achieving six behavioural goals at baseline - body mass index (BMI) <25kg/m(2), moderate physical activity, non-smoker, fat intake <30% of energy, fibre intake ≥15g/4184kJ and alcohol intake ≤20g/day - and diabetes incidence over 10years.

    RESULTS: Median interquartile range (IQR) follow-up time was 9.9 (0.3) years; 2211 individuals (7%) developed diabetes. Only 4.4% of participants met all 6 goals (n=1245) and compared to these individuals, participants meeting 0/1 goals had a 3.74 times higher diabetes incidence (95% confidence interval (CI)=2.50 to 5.59), adjusting for sex, age, calendar period, education, family history of diabetes, history of myocardial infarction and long-term illness. If everyone achieved at least four behavioural goals, 14.1% (95% CI: 11.7 to 16.5%) of incident diabetes cases might be avoided.

    CONCLUSION: Interventions promoting the achievement of behavioural goals in the general population could significantly reduce diabetes incidence.

  • 20.
    Magnusson, Maria B.
    et al.
    Sahlgrenska Akademien, Göteborgs Universitet.
    Sjöberg, Agneta
    Sahlgrenska Akademien, Göteborgs Universitet.
    Kjellgren, Karin I.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lissner, Lauren
    Sahlgrenska Akademien, Göteborgs Universitet.
    Childhood obesity and prevention in different socio-economic contexts2011In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 53, no 6, p. 402-407Article in journal (Refereed)
    Abstract [en]

    Objective

    To assess recent trends in obesity, health beliefs, and lifestyles in Swedish schoolchildren, with focus on socioeconomic disparities.

    Method

    The study was conducted in two areas with high and low socioeconomic status (SES). 340 11–12 year olds participated in three cross-sectional surveys assessing food-related behaviours, physical activity and health beliefs, together with anthropometric examinations. Comparisons were made before and after a community-based intervention (2003 versus 2008) within the low-SES school, and between the low and high-SES school (2008 only).

    Results

    In the low-SES school BMI z-score decreased over 5 years (0.80 vs 0.46) as did the percentage of children frequently consuming sweet drinks (43.5 vs 26.8%), statistically significant in girls only (p < 0.05). Children increasingly perceived benefits of healthy life-styles (37 vs 55%). In 2008, consumption of breakfast, vegetables, sweets and sweet drinks differed between schools, as did screen-time and physical activity, all in favour of the high SES-school where the obesity-prevalence was significantly lower (0.8 vs 6.7%).

    Conclusion

    Positive changes in diet and weight status were observed, especially in girls, within a low-income multi-ethnic community undergoing a health promotion intervention. Our results underscore the multifactorial etiology of childhood obesity and the importance of continuing tailored, gender-sensitive prevention efforts.

  • 21.
    Mood, Carina
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Life-style and self-rated global health in Sweden: A prospective analysis spanning three decades2013In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 57, no 6, p. 802-806Article in journal (Refereed)
    Abstract [en]

    Objective. To study the relations between lifestyle factors (smoking, drinking, exercise, vegetable consumption, social relations) and global self-rated health in the adult Swedish population. Method. The data come from the Swedish Level of Living Survey, a face-to-face panel study. The analysis follows the respondents with good health in 1991 (N = 4035) and uses multivariate logistic regression to assess the relations between lifestyle factors in 1991 and health in 2000 and 2010. Results. Baseline (1991) exercise, social support, smoking and vegetable consumption are associated with health in 2000 and/or 2010.2000: Weekly exercise in 1991 increases the probability of good health by 6 percentage points [95% CI: 1-10] compared to no exercise, and smoking 10 or more cigarettes a day decreases the probability of good health by 5 percentage points [95% CI 1-8]. Lacking social support decreases the probability of good health by 17 percentage points (95% CI: 9-25). 2010: Smoking 10 or more cigarettes a day decreases the probability of good health by 10 percentage points [95% CI 5-15], and eating vegetables every day increases the probability of good health by 4 percentage points [95% CI 0.2-7]. Conclusions. Exercise, smoking, social support and vegetable consumption are related to self-rated health 2000 and/or 2010.

  • 22.
    Nooijen, Carla F J
    et al.
    Department of Public Health Sciences, Karolinska Institutet.
    Möller, Jette
    Department of Public Health Sciences, Karolinska Institutet.
    Forsell, Yvonne
    Department of Public Health Sciences, Karolinska Institutet.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Galanti, Maria R
    Department of Public Health Sciences, Karolinska Institutet.
    Engström, Karin
    Department of Public Health Sciences, Karolinska Institutet.
    Do unfavourable alcohol, smoking, nutrition and physical activity predict sustained leisure time sedentary behaviour? A population-based cohort study.2017In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 101, p. 23-27, article id S0091-7435(17)30182-2Article in journal (Refereed)
    Abstract [en]

    Comparing lifestyle of people remaining sedentary during longer periods of their life with those favourably changing their behaviour can provide cues to optimize interventions targeting sedentary behaviour. The objective of this study was to determine lifestyle predictors of sustained leisure time sedentary behaviour and assess whether these predictors were dependent on gender, age, socioeconomic position and occupational sedentary behaviour. Data from a large longitudinal population-based cohort of adults (aged 18-97years) in Stockholm responding to public health surveys in 2010 and 2014 were analysed (n=49,133). Leisure time sedentary behaviour was defined as >3h per day of leisure sitting time e.g. watching TV, reading or using tablet. Individuals classified as sedentary at baseline (n=9562) were subsequently categorized as remaining sedentary (n=6357) or reduced sedentary behaviour (n=3205) at follow-up. Lifestyle predictors were unfavourable alcohol consumption, smoking, nutrition, and physical activity. Odds ratios (OR) and corresponding 95% Confidence Intervals (CI) were calculated, adjusting for potential confounders. Unfavourable alcohol consumption (OR=1.22, CI:1.11-1.34), unfavourable candy- or cake consumption (OR=1.15, CI:1.05-1.25), and unfavourable physical activity in different contexts were found to predict sustained sedentary behaviour, with negligible differences according to gender, age, socioeconomic position and occupational sedentary behaviour. People with unfavourable lifestyle profiles regarding alcohol, sweets, or physical activity are more likely to remain sedentary compared to sedentary persons with healthier lifestyle. The impact of combining interventions to reduce leisure time sedentary behaviour with reducing alcohol drinking, sweet consumption and increasing physical activity should be tested as a promising strategy for behavioural modification.

  • 23.
    Ssegonja, Richard
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Nystrand, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Langenskiöld, Sophie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Economics. Karolinska Inst, Dept Learning Informat Management & Eth LIME, Stockholm, Sweden.
    Jonsson, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Karolinska Inst, Ctr Neurodev Disorders KIND, Div Neuropsychiat, Dept Womens & Childrens Hlth, Stockholm, Sweden;Stockholm Cty Council, Ctr Psychiat Res, Child & Adolescent Psychiat, BUP KIND, Stockholm, Sweden.
    Indicated preventive interventions for depression in children and adolescents: A meta-analysis and meta-regression2019In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 118, p. 7-15Article, review/survey (Refereed)
    Abstract [en]

    Depression contributes about 2% to the global burden of disease. A first onset of depressive disorder or subsyndromal depressive symptoms is common in adolescence, indicating that early prevention is a priority. However, trials of preventive interventions for depression in youths show conflicting results. This systematic review and meta-analysis investigated the effectiveness of group-based cognitive behavioral therapy (GB-CBT) as a preventive intervention targeting subsyndromal depression in children and adolescents. In addition, the impact of different covariates (type of comparator and use of booster sessions) was assessed. Relevant articles were identified from previous systematic reviews, and supplemented with an electronic search spanning from 01/09/2014 to 28/02/2018. The retrieved articles were assessed for eligibility and risk of bias. Relevant data were extracted. Intervention effectiveness was pooled using a random-effects model and the impact of covariates assessed using meta-regression. 38 eligible articles (34 trials) were obtained. The analysis showed GB-CBT to significantly reduce the incidence (relative risk 0.43, 95% CI 0.21-0.87) and symptoms (Cohen's d -0.22, 95% CI -0.32 to -0.11) of depression at post-test compared to all controls. Comparisons with passive comparators suggested that the effect decayed over time. However, compared to active controls, a significant intervention effect was evident only after 12 month or more. Our results suggest that the preventive effect of GB-CBT wears off, but still lasts longer than the effect of active comparators. Only a few studies included booster sessions, precluding firm conclusions. Future studies should clarify to what extent maintenance strategies can prolong the preventive effect of GB-CBT.

  • 24. Travier, Noemie
    et al.
    Agudo, Antonio
    May, Anne M.
    Gonzalez, Carlos
    Luan, Jian'an
    Wareham, Nick J.
    Bueno-de-Mesquita, H. Bas
    van den Berg, Saskia W.
    Slimani, Nadia
    Rinaldi, Sabina
    Clavel-Chapelon, Francoise
    Boutron-Ruault, Marie-Christine
    Palli, Domenico
    Sieri, Sabina
    Mattiello, Amalia
    Tumino, Rosario
    Vineis, Paolo
    Norat, Teresa
    Romaguera, Dora
    Rodriguez, Laudina
    Sanchez, Maria-Jose
    Dorronsoro, Miren
    Barricarte, Aurelio
    Huerta, Jose M.
    Key, Tim J.
    Orfanos, Philippos
    Naska, Androniki
    Trichopoulou, Antonia
    Rohrmann, Sabina
    Kaaks, Rudolf
    Bergmann, Manuela M.
    Boeing, Heiner
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Manjer, Jonas
    Lindkvist, Bjorn
    Jakobsen, Mariane U.
    Overvad, Kim
    Tjonneland, Anne
    Halkjaer, Jytte
    Lund, Eiliv
    Braaten, Toni
    Odysseos, Andreani
    Riboli, Elio
    Peeters, Petra H.
    Longitudinal changes in weight in relation to smoking cessation in participants of the EPIC-PANACEA study2012In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 54, no 3-4, p. 183-192Article in journal (Refereed)
    Abstract [en]

    Purpose. We assessed the association between smoking cessation and prospective weight change in the European population of the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol, Cessation of smoking. Eating out of home And obesity (EPIC-PANACEA) project. Methods. The study involved more than 300,000 healthy volunteers, recruited between 1992 and 2000 in 9 European countries, who provided data on anthropometry and smoking habits at baseline and after a follow-up of 5 years on average. Adjusted mixed-effects linear regression models were used to obtain sex-specific summary estimates of the association between the change in smoking status and the annual change in weight. Results. Smoking cessation tends to be followed by weight gain; when compared to stable smokers, annual weight gain was higher in men (0.44 kg (95%CI: 0.36; 0.52)) and women (0.46 kg (95%CI: 0.41; 0.52)) who stopped smoking during follow-up. When smokers who stopped smoking at least 1 year before recruitment were compared to never smokers, no major differences in annual weight gain were observed. The excess weight gain following smoking cessation appears to mainly occur in the first years following the cessation. Conclusions. When considering the benefits of smoking cessation, such findings strengthen the need for promoting cessation offering information on weight gain control and support to weight-concerned smokers in order to remove a barrier to quitting. (C) 2011 Elsevier Inc. All rights reserved.

  • 25. Travier, Noémie
    et al.
    Agudo, Antonio
    May, Anne M
    Gonzalez, Carlos
    Luan, Jian'an
    Besson, Hervé
    Wareham, Nick J
    Slimani, Nadia
    Rinaldi, Sabina
    Clavel-Chapelon, Françoise
    Boutron-Ruault, Marie-Christine
    Palli, Domenico
    Agnoli, Claudia
    Mattiello, Amalia
    Tumino, Rosario
    Vineis, Paolo
    Rodriguez, Laudina
    Sanchez, Maria-José
    Dorronsoro, Miren
    Barricarte, Aurelio
    Tormo, Maria-José
    Norat, Teresa
    Mouw, Traci
    Key, Tim J
    Spencer, Elizabeth A
    Bueno-de-Mesquita, H Bas
    Vrieling, Alina
    Orfanos, Philippos
    Naska, Ada
    Trichopoulou, Antonia
    Rohrmann, Sabina
    Kaaks, Rudolf
    M Bergmann, Manuela
    Boeing, Heiner
    Hallmans, Goran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Manjer, Jonas
    Lindkvist, Björn
    Jakobsen, Mariane Uhre
    Overvad, Kim
    Tjonneland, Anne
    Halkjaer, Jytte
    Lund, Eiliv
    Braaten, Toni
    Odysseos, Andreani
    Riboli, Elio
    Peeters, Petra H
    Smoking and body fatness measurements: a cross-sectional analysis in the EPIC-PANACEA study2009In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 49, no 5, p. 365-373Article in journal (Refereed)
    Abstract [en]

    Objective: The present study investigates the cross-sectional relationship between tobacco smoking and body fatness.

    Methods: This cross-sectional study consisted of 469,543 men and women who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) study between 1992 and 2000 providing anthropometric measurements and information on smoking. Adjusted multilevel mixed-effects linear regression models were used to assess the association between smoking and body fat mass.

    Results: The analyses showed that BMI and WC were positively associated with smoking intensity in current smokers but negatively associated with time since quitting in former smokers. When compared to never smokers, average current smokers (17 and 13 cig/day for men and women, respectively) showed a lower BMI. When average former smokers (men and women who had stopped smoking for 16 and 15 years, respectively) were compared to never smokers, higher BMI and WC were observed in men, whereas no significant associations were observed in women.

    Conclusions: This cross-sectional study suggests that smoking may be associated with body fatness and fat distribution. Although our findings cannot establish cause and effect, they suggest that providing information and support to those who want to stop may help in preventing weight gain and therefore weaken a barrier against stopping smoking.

  • 26.
    Virtanen, Suvi E.
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Zeebari, Zangin
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Rohyo, Izla
    Dentistry Clinic Solvändan, Sörmland Health Care Region, Mariefred, Sweden.
    Galanti, Maria R.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Evaluation of a brief counseling for tobacco cessation in dental clinics among Swedish smokers and snus users: A cluster randomized controlled trial (the FRITT study)2015In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 70, p. 26-32Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study is to assess the effectiveness of a very brief structured counseling for tobacco cessation in dentistry clinics.

    Method: A cluster randomized trial was conducted in Sweden in 2012-2013.

    Twenty-seven dentistry clinics in two Swedish counties were randomized to provide either a structured brief advice based on the 5 A's model or usual care. Participants were 467 patients currently using tobacco daily (225 in the intervention group and 242 in usual care), of which 97% were retained at follow-up, six months after enrolment. Study outcomes were: 7-day abstinence (primary outcome); 3-month sustained abstinence; 50% reduction of the amount tobacco used; quit attempts lasting at least 24 h.

    Results: Compared to usual care, brief counseling was not associated to statistically significant increase in the proportion abstinent from tobacco use after 6. months. However, there was a statistically significant association with reduction of tobacco consumption (OR = 2.07 95% CI 1.28-3.35). Changes in the expected direction for all outcomes were more frequent in the intervention than in the usual care group, and larger among exclusive snus users than among smokers.

    Conclusions: Very brief and structured counseling in dentistry may achieve positive behavioral modifications among tobacco users, with significant reduction of tobacco consumption, particularly among smokeless tobacco users.

  • 27.
    Waller, John
    et al.
    Linköping University, Department of Department of Health and Society, General Practice. Linköping University, Faculty of Health Sciences.
    Eriksson, Olle
    Linköping University, Department of Mathematics. Linköping University, The Institute of Technology.
    Foldevi, Mats
    Linköping University, Department of Department of Health and Society, General Practice. Linköping University, Faculty of Health Sciences.
    Grahn Kronhed, Ann-Charlotte
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Larsson, Lasse
    Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences.
    Löfman, Owe
    Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences. Linköping University, Faculty of Health Sciences.
    Toss, Göran
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Möller, Margareta
    Linköping University, Department of Neuroscience and Locomotion. Linköping University, Faculty of Health Sciences.
    Knowledge of osteoporosis in a Swedish municipality: a prospective study2002In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 34, no 4, p. 485-491Article in journal (Refereed)
    Abstract [en]

    Background. As a part of the Vadstena Osteoporosis Prevention Project, the knowledge of osteoporosis was examined before the intervention program started, after 5 and 10 years.

    Methods. At baseline (in 1989) 15% of the population in two Swedish municipalities was randomly invited to the study. The participants in the study group were invited for examination by forearm bone densitometry and a questionnaire concerning lifestyle and risk factors for osteoporosis and also knowledge of osteoporosis, while the subjects in the control group were examined only by questionnaire. Follow-ups were made in 1994 and in 1999. Meanwhile education about osteoporosis was given to the study group, to the public, and to various professionals in the study community.

    Results. There was a difference in the level of knowledge between the groups prior to the intervention. The rate of increment did not differ significantly between the groups for the study period. Previous participants had 0.58 higher score than new participants in the study group in 1994 (P = 0.031) and 0.76 higher score in 1999 (P < 0.001) regarding the total number of correct answers. The women in the study group had 0.63 higher score than the men in 1994 (P = 0.016) and 1.03 higher score in 1999 (P < 0.001) regarding the total number of correct answers.

    Conclusion. There was no significant effect of a general intervention program concerning the knowledge of osteoporosis in participants in the intervention area compared to the control area.

  • 28.
    Wandell, Per
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, S-14183 Huddinge, Sweden.;Stockholm Cty Council, Acad Primary Healthcare Ctr, Huddinge, Sweden..
    Carlsson, Axel C.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, S-14183 Huddinge, Sweden..
    Ljunggren, Gunnar
    Stockholm Cty Council, Publ Healthcare Serv Comm Adm, SE-10239 Stockholm, Sweden.;Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, SE-17177 Stockholm, Sweden..
    Gout and its comorbidities in the total population of Stockholm2015In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 81, p. 387-391Article in journal (Refereed)
    Abstract [en]

    Objective. Study of prevalence of gout with concomitant diseases. Methods. Study population included all living persons in Stockholm County, Sweden, on January 1st 2013 (N = 2,124,959). A diagnosis of gout was identified during 2013-2014, with information of diabetes mellitus and insulin resistance, hypertension, chronic heart failure, chronic kidney disease, alcohol abuse, and malignancies. Age-adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for women and men with gout, using individuals without gout as referents, were calculated. Results. Age-adjusted odds of co-morbidities among individuals with gout vs. those without goutwere: diabetes mellitus and insulin resistance 3.97 (95% CI 3.65-4.31) in women and 1.88 (95% CI 1.78-1.99) in men; hypertension 4.02 (95% CI 3.69-4.37) inwomen and 3.21 (95% CI 3.06-3.37) in men; chronic heart failure 4.72 (95% CI 4.31-5.19) in women and 2.84 (95% CI 2.66-3.04) inmen; chronic kidney disease 2.08 (95% CI 1.50-2.87) in women and 2.39 (95% CI 2.15-2.66) in men; alcohol abuse 8.98 (95% CI 8.15-9.80) in women and 4.38 (95% CI 4.10-4.69) in men; and malignancies 1.32 (95% CI 1.17-1.48) in women and 1.13 (95% CI 1.06-1.21) men. Conclusion. Gout is a warning sign for concomitant diseases, e.g. alcoholism, diabetes, cardiovascular diseases, and cancer. Key messages. 1. A diagnosis of gout was present in 0.3% among women and 0.8% among men in Stockholm County. 2. Among individuals with gout, hypertension, being the most common concomitant disease, was present in 68% among women and 54% among men. 3. Alcohol abuse was the most overrepresented disorder compared to individuals without gout, with odds ratio of 9 among women and 5 among men.

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