Elin Kolle

• Säfvenbom, Reidar; Agans, Jennifer P.; Kolle, Elin & Haugen, Tommy (2026). Reaching hard to reach youth: Who are the inactive youth? Journal of Health Psychology. ISSN 1359-1053. p. 1–17. doi: 10.1177/13591053261430656. Full text in Research Archive Show summary

  Despite growing knowledge emphasizing benefits of physical activity, the inactivity rate in youth seems to remain. The present study suggests that one reason for this is lack of knowledge about the inactive and that exploration of differences in every daily life-challenges of inactive and active youth are needed. Applying multivariate analysis of variance and classification and regression tree analysis, differences between the two groups were seen. Results show associations between demographic variables and inactivity, yet when adding psycho-social variables, the accuracy improved significantly. The results suggest that inactive youth seem to live more challenging lives compared to their active peers. When we feed statistical analyses with only demographic data such as age, gender, social class and ethnicity, we may fail to examine the role of important psycho-social variables and thus miss beneficial knowledge about inactive youth and a pedagogical potential for developing appropriate interventions.

• Husøy, Anders; Kolle, Elin; Steene-Johannessen, Jostein; Andersen, Lars Bo; Ekelund, Ulf & Anderssen, Sigmund Alfred (2025). Tracking of device-measured sedentary time, cardiorespiratory fitness, and cardiometabolic risk factors from childhood to young adulthood. American Journal of Preventive Cardiology. 24. doi: 10.1016/j.ajpc.2025.101313. Full text in Research Archive Show summary

  Background The tracking of clustered cardiometabolic risk from childhood to young adulthood, i.e., whether an unfavourable cardiometabolic risk profile persists from childhood into young adulthood, remain uncertain and has previously not included factors like sedentary time and cardiorespiratory fitness. Methods We used longitudinal data from the Physical Activity among Norwegian Children Studies (PANCS), where 731 participants participated at age 9 (2005–2006) and 258 of these again at age 24 (2019–2021). Multiple imputation was performed for all eligible participants at age 24 (n = 708). The cardiometabolic risk factors comprised body mass index (BMI), waist circumference, device-measured sedentary time, directly measured peak oxygen uptake (VO2peak), systolic blood pressure, LDL-cholesterol, insulin, high-sensitivity CRP, and a clustered risk Z-score. Tracking was analysed using regression models. Results Waist circumference and BMI demonstrated strong tracking, whereas moderate tracking was observed for VO2peak, LDL-cholesterol, systolic blood pressure, and clustered cardiometabolic risk. Insulin, high-sensitivity CRP, and sedentary time exhibited no tracking. Unfavourable childhood levels of risk factors demonstrating moderate to strong tracking were highly predictive, with those in the least favourable quartile of clustered risk at age 9 almost six times more likely than their peers to be in the least favourable quartile at age 24 years. Tracking was generally similar between sexes, but waist circumference tracked somewhat stronger among females while VO2peak tracked stronger among males. Conclusions Several cardiometabolic risk factors demonstrated moderate to strong tracking from childhood to young adulthood, supporting early intervention. However, sedentary behaviour may be less stable and easier to modify compared with more stable cardiometabolic risk factors.

• Husøy, Anders; Kolle, Elin; Steene-Johannessen, Jostein; Andersen, Lars Bo; Anderssen, Sigmund Alfred & Ekelund, Ulf (2025). Prospective Associatons of Physical Activity and Sedentary Time in Adolescence with Cardiometabolic Risk in Young Adulthood. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 57(3), p. 535–543. doi: 10.1249/MSS.0000000000003595. Full text in Research Archive Show summary

  Purpose The relationship between sedentary time, physical activity, and cardiometabolic risk factors during the transition from adolescence to adulthood remains uncertain. We examined the prospective associations of sedentary time and physical activity at age 15 yr with cardiometabolic risk markers at age 24 yr. Methods We used data from the Physical Activity among Norwegian Children Studies. Sedentary time, moderate-to-vigorous physical activity (MVPA), and vigorous physical activity (VPA) were measured by accelerometry. Outcomes included body mass index (BMI), waist circumference, visceral fat, maximal oxygen uptake (V̇O2max), systolic blood pressure, LDL-cholesterol, insulin, high-sensitivity C-reactive protein, and a clustered risk Z-score. The prospective associations were modeled through regression. Results A total of 731 boys and girls participated at ages 9 yr (2005–2006) and 15 yr (2011–2012), and 258 of these participated again at age 24 yr (2019–2021). Multiple imputation was performed for all eligible individuals (n = 708). Each standard deviation increase (minutes per day) in sedentary time at age 15 yr was associated with lower V̇O2max at age 24 yr (β = −1.6 mL·kg−1·min−1; 95% confidence interval (CI), −2.8 to −0.5). Each standard deviation increase (minutes per day) in MVPA (β = 1.6 mL·kg−1·min−1; 95% CI, 0.8 to 2.4) and VPA (β = 1.6 mL·kg−1·min−1; 95% CI, 0.8 to 2.4) at age 15 yr were associated with higher V̇O2max at age 24 yr. VPA in adolescence was further inversely associated with visceral fat mass (β = −41 g; 95% CI, −78 to −3), insulin level (β = −4.3 pmol·L−1; 95% CI, −8.2 to −0.4), and the clustered risk Z-score (β = −0.09; 95% CI, −0.18 to −0.01) in young adulthood. Childhood BMI modified the association of both MVPA and VPA with clustered risk, with the greatest magnitude of association observed in the highest BMI tertile. Conclusions Physical activity, especially of vigorous intensity, during adolescence appears to beneficially affect cardiometabolic health in young adulthood. These health benefits may be most pronounced among overweight/obese youth.

• Malnes, Lena; Haugen, Tommy; Nordbø, Emma Charlott Andersson; Ivarsson, Andreas; Kolle, Elin & Resaland, Geir Kåre [Show all 9 contributors for this article] (2025). Objectively measured environmental factors in relation to school travel mode among adolescents: a decision tree analysis. International Journal of Behavioral Nutrition and Physical Activity. 22. doi: 10.1186/s12966-025-01727-6. Full text in Research Archive Show summary

  Background Understanding the factors that influence school travel mode choice is essential for promoting active travel among adolescents. Currently, there is a lack of research that effectively investigates the interactions between demographic and environmental factors on travel behavior. We aimed to investigate the associations between various demographic and environmental characteristics and the choice of school travel modes—walking, cycling, or motorized transport—among adolescents, across the winter and summer seasons. Methods Data from 1409 Norwegian adolescents, aged 14–15 years, who participated in the School In Motion project were analyzed. Self-reported travel modes and demographic characteristics were collected via questionnaires, while environmental characteristics were determined using Geographic Information Systems (GIS). A decision tree analysis was conducted utilizing the chi-squared automatic interaction detection algorithm to discern patterns in the data. The present study has a cross-sectional design. Results During summer, the predominant travel modes were cycling (39%), walking (37%), and motorized transport (24%). Gender was associated with travel mode choices over short distances (< 1.6 km), with girls favoring walking and boys favoring cycling. For longer commutes, steep inclines were associated with reduced walking and cycling, while higher traffic exposure was associated with increased cycling. During winter, walking (50%) was the most common mode, followed by motorized travel (36%) and cycling (14%). Living near peers was associated with increased walking and cycling among girls. For commutes exceeding 2 km, factors such as available bus transit, more streetlights, the absence of steep hills, and higher urban centrality were linked to increased walking and cycling. Conclusions The findings indicated a complex pattern of demographic and environmental factors influencing active travel, with environmental factors becoming increasingly important as commuting distances increased. These findings highlight the importance of considering the interactions of various factors to effectively promote active travel, especially for adolescents undertaking longer commutes. Trial registration Clinicaltrials.gov ID no: NCT03817047. Registered on: January 25, 2019 (retrospectively registered).

• Zhou, Bin; Cesare, Mariachiara Di; Aguilar-Salinas, Carlos A; Ahmad, Nor Ani; Bovet, Pascal & Chen, Zhengming [Show all 51 contributors for this article] (2024). General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants. The Lancet. ISSN 0140-6736. 404(10455), p. 851–863. doi: 10.1016/S0140-6736(24)01405-3. Full text in Research Archive Show summary

  Background: Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. Methods: We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). Findings: The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m2 (95% CI 2·31–3·28) lower for women and 1·28 kg/m2 (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. Interpretation: BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions. Funding: UK Medical Research Council and UK Research and Innovation (Innovate UK).

• Andersen, Oddbjørn Klomsten; Gebremariam, Mekdes; Kaupang, Oda Bjørge; Lien, Nanna & Kolle, Elin (2024). Built for movement: Neighborhoods and adolescent physical activity behaviors, and the moderating role of socioeconomic position and gender. Health and Place. ISSN 1353-8292. 89. doi: 10.1016/j.healthplace.2024.103313. Full text in Research Archive Show summary

  This study examined whether the built environment was associated with physical activity among adolescents in Oslo, Norway, and the role of socioeconomic position and gender as potential moderators of this association. We used data from 897 adolescents who participated in the TACKLE cross-sectional study conducted in 2020. Built environment features (recreational facilities, parks, forest, public transport, traffic calming devices, and schools) were assessed objectively using Geographical Information Systems. Physical activity data included device-measured moderate-to-vigorous physical activity, total physical activity, and self-reported active transportation to school. Using general linear models and logistic regression, we found that most built environment features were unrelated to the participants’ device-measured physical activity. Longer distances to school and to traffic calming devices were associated with decreased likelihood of participants reporting active transportation to school. Our moderated regression analysis showed that adolescents with low socioeconomic backgrounds seemed less affected by longer distances to school compared with their high socioeconomic counterparts. Furthermore, boys appeared to be more sensitive to traffic safety relative to girls. Implementing traffic calming devices may enhance active transportation to school and improve traffic safety for Norwegian adolescents.

• Ostojic, Sergej; Phelps, Nowell H.; Singleton, Rosie K.; Zhou, Bin; Heap, Rachel & Mishra, Anu [Show all 54 contributors for this article] (2024). Worldwide trends in the underweight and obesity from 1990 to 2022: a pooled analysis of 3,633 population-representative studies with 222 million school-aged children, adolescents, and adults. The Lancet. ISSN 0140-6736. 403(10431), p. 1027–1050. doi: 10.1016/S0140-6736(23)02750-2. Full text in Research Archive Show summary

  Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.

• Husøy, Anders; Kolle, Elin; Steene-Johannessen, Jostein; Dalene, Knut Eirik; Andersen, Lars Bo & Ekelund, Ulf [Show all 7 contributors for this article] (2024). Longitudinal changes in device-measured physical activity from childhood to young adulthood: the PANCS follow-up study. International Journal of Behavioral Nutrition and Physical Activity. 21(1). doi: 10.1186/s12966-024-01578-7. Full text in Research Archive Show summary

  Background There is a lack of longitudinal studies examining changes in device-measured physical activity and sedentary time from childhood to young adulthood. We aimed to assess changes in device-measured physical activity and sedentary time from childhood, through adolescence, into young adulthood in a Norwegian sample of ostensibly healthy men and women. Methods A longitudinal cohort of 731 Norwegian boys and girls (49% girls) participated at age 9 years (2005–2006) and 15 years (2011–2012), and 258 of these participated again at age 24 years (2019–2021; including the COVID-19 pandemic period). Physical activity and sedentary time were measured using ActiGraph accelerometers. Linear mixed models were used to analyse changes in physical activity and sedentary time and whether low levels of childhood physical activity track, i.e., persist into young adulthood (nchange=721; ntracking=640). Results The most prominent change occurred between the ages of 9 to 15 years, with an increase in sedentary time (150 min/day) and less time spent in light (125 min/day), moderate (16 min/day), and vigorous physical activity (8 min/day). Only smaller changes were observed between the ages of 15 and 24 years. Changes in moderate-to-vigorous physical activity from childhood to young adulthood differed between subgroups of sex, tertiles of body mass index at baseline and tertiles of peak oxygen uptake at baseline. While the tracking models indicated low absolute stability of physical activity from childhood to young adulthood, children in the lowest quartiles of moderate-to-vigorous (OR:1.88; 95%CI: 1.23, 2.86) and total physical activity (OR: 1.87; 95%CI: 1.21, 2.87) at age 9 years were almost 90% more likely to be in these quartiles at age 24 years compared to those belonging to the upper three quartiles at baseline. Conclusions We found a substantial reduction in physical activity and increase in time spent sedentary between age 9 and 15 years. Contrary to previous studies, using mainly self-reported physical activity, little change was observed between adolescence and young adulthood. The least active children were more likely to remain the least active adults and could be targeted for early intervention.

• Mishra, Anu; Zhou, Bin; Rodriguez-Martinez, Andrea; Bixby, Honor; Singleton, Rosie K. & Carrillo-Larco, Rodrigo M. [Show all 1,626 contributors for this article] (2023). Diminishing benefits of urban living for children and adolescents’ growth and development. Nature. ISSN 0028-0836. 615(7954), p. 874–883. doi: 10.1038/s41586-023-05772-8. Full text in Research Archive Show summary

  Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1,2,3,4,5,6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

• Malnes, Lena; Berntsen, Sveinung; Kolle, Elin; Ivarsson, Andreas; Dyrstad, Sindre Mikal & Resaland, Geir Kåre [Show all 8 contributors for this article] (2023). School-based physical activity in relation to active travel – a cluster randomized controlled trial among adolescents enrolled in the school in motion study in Norway. International Journal of Behavioral Nutrition and Physical Activity. 20(1). doi: 10.1186/s12966-023-01534-x. Full text in Research Archive Show summary

  Background Active travel and school settings are considered ideal for promoting physical activity. However, previous research suggests limited effect of school-based interventions on overall physical activity levels among adolescents. The relationship between physical activity in different domains remains inconclusive. In this study, we examined the effects of adding two weekly hours of school-based physical activity on active travel rates. Method We analyzed data from 1370 pupils in the 9th-grade participating in the cluster RCT; the School In Motion (ScIM) project. Intervention schools (n = 19) implemented 120 min of class-scheduled physical activity and physical education, in addition to the normal 2 hours of weekly physical education in the control schools (n = 9), for 9 months. Active travel was defined as pupils who reported walking or cycling to school, while motorized travel was defined as pupils who commuted by bus or car, during the spring/summer half of the year (April–September), or autumn/winter (October–February). The participants were categorized based on their travel mode from pretest to posttest as; maintained active or motorized travel (“No change”), changing to active travel (motorized-active), or changing to motorized travel (active-motorized). Multilevel logistic regression was used to analyze the intervention effect on travel mode. Results During the intervention period, most participants maintained their travel habits. In total, 91% of pupils maintained their travel mode to school. Only 6% of pupils switched to motorized travel and 3% switched to active travel, with small variations according to season and trip direction. The intervention did not seem to influence the likelihood of changing travel mode. The odds ratios for changing travel habits in spring/summer season were from active to motorized travel 1.19 [95%CI: 0.53–2.15] and changing from motorized to active travel 1.18 [0.30–2.62], compared to the “No change” group. These findings were consistent to and from school, and for the autumn/winter season. Conclusion The extra school-based physical activity does not seem to affect rates of active travel among adolescents in the ScIM project.

• Dalene, Knut Eirik; Kolle, Elin; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Ekelund, Ulf & Grydeland, May [Show all 8 contributors for this article] (2022). Device-measured sedentary time in Norwegian children and adolescents in the era of ubiquitous internet access: secular changes between 2005, 2011 and 2018. International Journal of Epidemiology. ISSN 0300-5771. 51(5), p. 1556–1567. doi: 10.1093/ije/dyac063. Full text in Research Archive Show summary

  Background: Access to screen-based media has been revolutionized during the past two decades. How this has affected sedentary time (ST) accumulation in children is poorly understood. Methods: This study, based on the Physical Activity among Norwegian Children Study (PANCS), uses accelerometer data from population-based samples of 9- and 15‐year-olds, collected in 2005 (n = 1722), 2011 (n = 1587) and 2018 (n = 1859). Secular changes between surveys were analysed using random-effects linear regression models adjusted for survey-specific factors. Data on ST were collected using hip-worn ActiGraphs and ST was defined using a threshold equivalent to <100 counts/min. Sedentary bouts were grouped by duration: <1, 1–5, 5–15, 15–30 and ≥30 min. Results: Between 2005 and 2018, ST increased by 29 min/day in 9-year-old boys (95% CI: 19, 39; P <0.001), by 21 min/day in 15-year-old boys (95% CI: 8, 34; P = 0.002) and by 22 min/day in 15-year-old girls (95% CI: 10, 35; P <0.001), but not in 9-year-old girls at 6 min/day (95% CI: -3, 16; P = 0.191). All age-sex groups accumulated less ST in bouts lasting <5 min and more ST in longer bouts, particularly in 5–15-min bouts. Adolescent girls also increased ST accumulation in 15–30-min and ≥30-min bouts. Changes were largely mirrored before, during and after school on weekdays and during weekend days. Conclusions: Coinciding with the introduction of smartphones, tablets and near-universal internet access, total daily ST and ST accumulated in prolonged sedentary bouts increased between 2005 and 2018 in children and adolescents.

• Leibinger, Eva; Åvitsland, Andreas; Resaland, Geir Kåre; Solberg, Runar Barstad; Kolle, Elin & Dyrstad, Sindre Mikal (2022). Relationship between health-related quality of life and physical fitness in Norwegian adolescents. Quality of Life Research. ISSN 0962-9343. doi: 10.1007/s11136-022-03309-6. Full text in Research Archive
• Malnes, Lena Hansen; Haugen, Tommy; Hansen, Bjørge Hermann; Kolle, Elin & Berntsen, Sveinung (2022). Establishing the Convergent Validity of the Travel Habit Questions in the Health Behavior in School-Aged Children Questionnaire by Quantifying Active Travel in Norwegian Adolescents. Frontiers in Sports and Active Living. 4. doi: 10.3389/fspor.2022.761723. Full text in Research Archive Show summary

  Background: Active travel (cycling or walking to school) can be a substantial part of adolescents' daily physical activity. Research on transport activities primarily relies on self-reported indices of travel mode and travel time. However, many researchers do not report the psychometric properties of their instruments. The Health Behavior in School-aged Children (HBSC) questionnaire is a commonly used instrument, but the items in this questionnaire on travel habits have not yet been validated. The present study was conducted to investigate the convergent validity and agreement between the HBSC items and a travel diary on (1) transport mode to and from school and (2) travel time to school. Methods: The study sample consisted of 50 participants in the 9th grade (15 ± 0.3 years, 62% girls) from seven Norwegian schools. Outcome variables included transport mode and travel time derived from the HBSC items and a five-day travel diary. Convergent validity was assessed by evaluating Cohen's kappa for travel mode and the correlation coefficient (Spearman Rho) for travel time. Simple agreement calculations between the two measurement methods were also conducted. Results: The association between the HBSC questionnaire and the diary for travel mode to and from school was κ = 0.63 (P < 0.001) and κ = 0.77 (P < 0.001), respectively. The total agreement between the HBSC questionnaire and the diary for was 78%. However, the agreement was higher for walking (88%) and cycling (91%) than for motorized transport (67%). For travel time, the Spearman correlation coefficient was ρ = 0.60 (P < 0.001) between the HBSC questionnaire and the diary. The total agreement on travel time was 67%; however, active commuters (86%) seemed to more accurately estimated travel time than motorized commuters (55%). Conclusion: Although the overall agreement between the HBSC questionnaire and the diary for mode of transport was 78%, the HBSC questionnaire may underestimate the prevalence of motorized transport compared to walking and cycling.

• Andersen, Oddbjørn Klomsten; Gebremariam, Mekdes; Kolle, Elin & Tarp, Jakob (2022). Socioeconomic position, built environment and physical activity among children and adolescents: a systematic review of mediating and moderating effects. International Journal of Behavioral Nutrition and Physical Activity. 19. doi: 10.1186/s12966-022-01385-y. Full text in Research Archive Show summary

  Background: Physical activity behaviors among children and adolescents are socioeconomically patterned. Understanding if, and how, the built environment contributes to socioeconomic inequalities in physical activity and for whom built environments are most important, can lead to the identification of intervention entry points to reduce inequalities in physical activity. Objective: To summarize the existing evidence among children and adolescents on (a) whether the built environment mediates the association between socioeconomic position and physical activity and (b) whether socioeconomic position moderates the association between the built environment and physical activity. Methods: A systematic literature search was conducted using PubMed, Embase, PsycINFO and Web of Science. Two independent reviewers screened articles for eligibility, extracted information from included studies and assessed risk of bias with the Quality Assessment Tool for Observational Cohort and Cross-Sectional studies. We performed a narrative evidence synthesis considering the totality of the evidence and by study characteristics such as geographic region, age group, and exposure-outcome assessment methodology. The reporting was conducted in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results: A total of 28 papers were included. In general, the studies were of low methodological quality. There was no evidence to support that the built environment functions as a mediator in the relationship between socioeconomic position and physical activity. We observed inconclusive moderation patterns with five studies reporting stronger associations between features of the built environment and physical activity among high socioeconomic positioned youths. Seven studies reported stronger associations among low socioeconomic positioned youth and fourteen studies reported no difference in associations. We observed different moderation patterns across geographical regions (Europe vs. US) indicating that, in Europe, having a walkable neighborhood is important for low socioeconomic positioned youth only. No differences in moderation patterns were observed for younger vs. older children or activity domains. Conclusion: Current evidence does not support a strong interplay between built environment and socioeconomic position on physical activity in youth. However, given the low quality of the evidence, firm conclusions cannot be made, and additional high-quality research is likely to have substantial impact on the evidence base.

• Iurilli, Maria Laura Caminia; Zhou, Bin; Bennett, James E.; Carrillo-Larco, Rodrigo M.; Sophiea, Marisa K. & Rodriguez-Martinez, Andrea [Show all 77 contributors for this article] (2021). Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight. eLIFE. 10. doi: 10.7554/eLife.60060. Full text in Research Archive Show summary

  From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

• Solberg, Runar Barstad; Steene-Johannessen, Jostein; Fagerland, Morten; Anderssen, Sigmund Alfred; Berntsen, Sveinung & Resaland, Geir Kåre [Show all 9 contributors for this article] (2021). Aerobic fitness mediates the intervention effects of a school-based physical activity intervention on academic performance. The school in Motion study – A cluster randomized controlled trial. Preventive Medicine Reports. 24. doi: 10.1016/j.pmedr.2021.101648. Full text in Research Archive Show summary

  Little information exists on the mechanism of how physical activity interventions effects academic performance. We examined whether the effects of a school-based physical activity intervention on academic performance were mediated by aerobic fitness. The School in Motion study was a nine-month cluster randomized controlled trial between September 2017 and June 2018. Students from 30 Norwegian lower secondary schools (N = 2,084, mean age [SD] = 14 [0.3] years) were randomly assigned into three groups: the Physically Active Learning (PAL) intervention (n = 10), the Don’t Worry—Be Happy (DWBH) intervention (n = 10), or control (n = 10). Aerobic fitness was assessed by the Andersen test and academic performance by national tests in reading and numeracy. Mediation was assessed according to the causal steps approach using linear mixed models. In the PAL intervention, aerobic fitness partially mediated the intervention effect on numeracy by 28% from a total effect of 1.73 points (95% CI: 1.13 to 2.33) to a natural direct effect of 1.24 points (95% CI: 0.58 to 1.91), and fully mediated the intervention effect on reading, with the total effect of 0.89 points (95% CI: 0.15 to 1.62) reduced to the natural direct effect of 0.40 points (95% CI: −0.48 to 1.28). Aerobic fitness did not mediate the effects on academic performance in the DWBH intervention. As aerobic fitness mediated the intervention effect on academic performance in one intervention, physical activity of an intensity that increases aerobic fitness is one strategy to improve academic performance among adolescents.

• Sundgot-Borgen, Christine; Sundgot-Borgen, Jorunn; Bratland-Sanda, Solfrid; Kolle, Elin; Torstveit, Monica Klungland & Svantorp-Tveiten, Kethe Marie Engen [Show all 7 contributors for this article] (2021). Body appreciation and body appearance pressure in Norwegian university students comparing exercise science students and other students. BMC Public Health. 21. doi: 10.1186/s12889-021-10550-0. Full text in Research Archive Show summary

  Body image is considered a core issue for public health and associates with university students’ overall health. Due to positive associations between exercise and body image, it has been suggested that students within an exercise science program might be more body appreciative compared to other students. On the other hand, the strong societal idealization of the athletic body may expose them to a pressure of having a specific body appearance, which may result in unfavorable health consequences. Nevertheless, studies investigating these hypotheses are lacking. We therefore aimed to explore the level and associations of body appreciation, body appearance pressure, body image related mental health constructs, physical activity, and exercise, in Norwegian university exercise science and non-health reference students.

• Andersen, Oddbjørn Klomsten; O'Halloran, Siobhan Anne; Kolle, Elin; Lien, Nanna; Lakerveld, Jeroen & Arah, Onyebuchi A. [Show all 7 contributors for this article] (2021). Adapting the SPOTLIGHT Virtual Audit Tool to assess food and activity environments relevant for adolescents: a validity and reliability study. International Journal of Health Geographics. 20:4, p. 1–14. doi: 10.1186/s12942-021-00258-0. Full text in Research Archive Show summary

  Background: Physical inactivity and unhealthy diet are key behavioral determinants underlying obesity. The neighborhood environment represents an important arena for modifying these behaviors, and hence reliable and valid tools to measure it are needed. Most existing virtual audit tools have been designed to assess either food or activity environments deemed relevant for adults. Thus, there is a need for a tool that combines the assessment of food and activity environments, and which focuses on aspects of the environment relevant for youth. Objective: The aims of the present study were: (a) to adapt the SPOTLIGHT Virtual Audit Tool (S-VAT) developed to assess characteristics of the built environment deemed relevant for adults for use in an adolescent population, (b) to assess the tool’s inter- and intra-rater reliability, and (c) to assess its criterion validity by comparing the virtual audit to a field audit. Methods: The tool adaptation was based on literature review and on results of a qualitative survey investigating how adolescents perceived the influence of the environment on dietary and physical activity behaviors. Sixty streets (148 street segments) in six neighborhoods were randomly selected as the study sample. Two raters assessed the inter- and intra-rater reliability and criterion validity, comparing the virtual audit tool to a field audit. The results were presented as percentage agreement and Cohen’s kappa (κ). Results: Intra-rater agreement was found to be moderate to almost perfect (κ = 0.44–0.96) in all categories, except in the category aesthetics (κ = 0.40). Inter-rater agreement between auditors ranged from fair to substantial for all categories (κ = 0.24–0.80). Criterion validity was found to be moderate to almost perfect (κ = 0.56–0.82) for most categories, except aesthetics and grocery stores (κ = 0.26–0.35). Conclusion: The adapted version of the S-VAT can be used to provide reliable and valid data on built environment characteristics deemed relevant for physical activity and dietary behavior among adolescents.

• Åvitsland, Andreas; Leibinger, Eva; Kolle, Elin; Haugen, Tommy & Dyrstad, Sindre Mikal (2021). Associations between changes in physical fitness and psychological difficulties status among Norwegian adolescents. Mental Health and Physical Activity. ISSN 1755-2966. 21. doi: 10.1016/j.mhpa.2021.100411. Full text in Research Archive Show summary

  Objectives To investigate the associations for one-year changes in cardiorespiratory fitness, muscular strength and body mass index, with psychological difficulties status in adolescents. Methods Norwegian 14-15-year-olds (n = 925) participated in data collection at two time points separated by one year. Psychological difficulties were assessed via the Strengths and Difficulties questionnaire and data from follow-up serve as the dependent variable. Cardiorespiratory fitness (the Andersen-test), muscular strength (Eurofit) and body mass index were measured. Change scores were calculated from the physical fitness variables and serve as independent variables in linear mixed effects models. Results There was no association between change in body mass index and psychological difficulties. Sex and socioeconomic status moderated the association between cardiorespiratory fitness and psychological difficulties. Immigrant status moderated the association between muscular strength and psychological difficulties. Subgroup results indicated inverse associations between change in cardiorespiratory fitness and psychological difficulties among boys (b = −0.009; 95% CI = −0.015 to −0.003; p = .006); change in muscular strength and psychological difficulties among immigrants (b = −1.97; 95% CI = −4.03 to 0.09; p = .061). Subgroup results also indicated an association between change in cardiorespiratory fitness and psychological difficulties among girls in the highest socioeconomic group (b = 0.014; 95% CI = 0.003 to 0.025; p = .014). Conclusions The associations for different fitness components were dependent on different moderators. Possibly, this indicates that associations in different subgroups are mediated by different mechanisms. Moderated associations should be addressed in future investigations.

• Brazendale, Keith; Beets, Michael W.; Armstrong, Bridget; Weaver, R. Glenn; Hunt, Ethan T. & Pate, Russell R. [Show all 24 contributors for this article] (2021). Children’s moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis. International Journal of Behavioral Nutrition and Physical Activity. 18:28, p. 1–13. doi: 10.1186/s12966-021-01095-x. Full text in Research Archive Show summary

  Purpose The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

• Zhou, Bin; Carrillo-Larco, Rodrigo M.; Danaei, Goodarz; Riley, Leanne M.; Paciorek, Christopher J. & Stevens, Gretchen A. [Show all 100 contributors for this article] (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet. ISSN 0140-6736. 398(10304), p. 957–980. doi: 10.1016/S0140-6736(21)01330-1. Full text in Research Archive Show summary

  Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Funding WHO.

• Solberg, Runar Barstad; Steene-Johannessen, Jostein; Anderssen, Sigmund Alfred; Ekelund, Ulf; Säfvenbom, Reidar & Haugen, Tommy [Show all 11 contributors for this article] (2021). Effects of a school-based physical activity intervention on academic performance in 14-year old adolescents: a cluster randomized controlled trial – the School in Motion study. BMC Public Health. 21. doi: 10.1186/s12889-021-10901-x. Full text in Research Archive Show summary

  Background: School-based physical activity interventions evaluating the effect on academic performance usually includes children. We aimed to investigate the effect of a nine-month, school-based physical activity intervention titled School in Motion (ScIM) on academic performance in adolescents. Methods: Thirty secondary schools in Norway were cluster-randomized into three groups: the Physically active learning (PAL) group (n = 10), the Don’t worry – Be Happy (DWBH) group (n = 10) or control (n = 10). Target dose in both intervention groups was 120 min/week of additional PA during school hours. Parental consent was obtained from 2084 adolescent students (76%). Standardized national tests in reading and numeracy was conducted at baseline and at the end of the intervention. We used linear mixed model to test intervention effects. We found significant intervention effects in numeracy and reading among students in both interventions when compared with controls. Results: The mean difference in change in numeracy was 1.7 (95% CI: 0.9 to 2.5; Cohen’s d = 0.12) and 2.0 (95% CI: 1.4 to 2.7; Cohen’s d = 0.23) points in favour of students in the PAL and DWBH intervention, respectively. Similar results were found for reading, where the mean difference in change was 0.9 (95% CI 0.2 to 1.6; Cohen’s d = 0.06) and 1.1 (95% CI 0.3 to 1.9; Cohen’s d = 0.18) points in favour of students in the PAL and DWBH intervention, respectively. When conducting intention to treat analysis with imputed data the estimates were attenuated and some no longer significant. Conclusion: The ScIM study demonstrates that two different school-based PA interventions providing approximately 120 min of additional PA weekly over nine months, significantly improved numeracy and reading performance in 14-year old students compared with controls. However, the results should be interpreted with caution as the effect sizes reported were very small or small and the estimates were attenuated when conducting intention to treat analysis. Despite this, our results are still positive and suggest that PA interventions are viable models to increase academic performance among adolescents.

• Steene-Johannessen, Jostein; Anderssen, Sigmund Alfred; Kolle, Elin; Hansen, Bjørge Hermann; Bratteteig, Mari & Dalhaug, Emilie Frederikke Mass [Show all 10 contributors for this article] (2021). Temporal trends in physical activity levels across more than a decade – a national physical activity surveillance system among Norwegian children and adolescents. International Journal of Behavioral Nutrition and Physical Activity. 18. doi: 10.1186/s12966-021-01120-z. Full text in Research Archive Show summary

  Background: There is a scarcity of device measured data on temporal changes in physical activity (PA) in large population-based samples. The purpose of this study is to describe gender and age-group specific temporal trends in device measured PA between 2005, 2011 and 2018 by comparing three nationally representative samples of children and adolescents. Methods: Norwegian children and adolescents (6, 9 and 15-year-olds) were invited to participate in 2005 (only 9- and 15-year-olds), 2011 and 2018 through cluster sampling (schools primary sampling units). A combined sample of 9500 individuals participated. Physical activity was assessed by hip worn accelerometers, with PA indices including overall PA (counts per minute), moderate-to-vigorous intensity PA (MVPA), and PA guideline adherence (achieving on average ≥ 60 min/day of moderate-to-vigorous PA). Random-effects linear regressions and logistic regressions adjusted for school-level clusters were used to analyse temporal trends. Findings: In total, 8186 of the participating children and adolescents provided valid PA data. Proportions of sufficiently active 6-year-olds were almost identical in 2011 and 2018; boys 95% (95% CI: 92, 97) and 94% (95%CI: 92, 96) and girls 86% (95% CI: 83, 90) and 86% (95% CI: 82, 90). Proportions of sufficiently active 15-year-olds in 2005 and 2018 were 52% (95% CI: 46, 59) and 55% (95% CI: 48, 62) in boys, and 48% (95% CI: 42, 55) and 44% (95% CI: 37, 51) in girls, respectively, resulting from small differences in min/day of MVPA. Among 9-year-old boys and girls, proportions of sufficiently active declined between 2005 and 2018, from 90% (95% CI: 87, 93) to 84% (95% CI: 80, 87)) and 74% (95% CI: 69, 79) to 68% (95% CI: 64, 72), respectively. This resulted from 9.7 min/day less MVPA in boys (95% CI: − 14.8, − 4.7; p < 0.001) and 3.2 min/day less MVPA (95% CI: − 7.0, 0.7; p = 0.106) in girls. Conclusions: PA levels have been fairly stable between 2005, 2011 and 2018 in Norwegian youth. However, the declining PA level among 9-year-old boys and the low proportion of 15-year-olds sufficiently active is concerning. To evaluate the effect of, and plan for new, PA promoting strategies, it is important to ensure more frequent, systematic, device-based monitoring of population-levels of PA.

• Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Dalene, Knut Eirik; Kolle, Elin; Northstone, Kate & Møller, Niels Christian [Show all 51 contributors for this article] (2020). Variations in accelerometry measured physical activity and sedentary time across Europe – harmonized analyses of 47,497 children and adolescents. International Journal of Behavioral Nutrition and Physical Activity. 17. doi: 10.1186/s12966-020-00930-x. Full text in Research Archive Show summary

  Background: Levels of physical activity and variation in physical activity and sedentary time by place and person in European children and adolescents are largely unknown. The objective of the study was to assess the variations in objectively measured physical activity and sedentary time in children and adolescents across Europe. Methods: Six databases were systematically searched to identify pan-European and national data sets on physical activity and sedentary time assessed by the same accelerometer in children (2 to 9.9 years) and adolescents (≥10 to 18 years). We harmonized individual-level data by reprocessing hip-worn raw accelerometer data files from 30 different studies conducted between 1997 and 2014, representing 47,497 individuals (2–18 years) from 18 different European countries. Results: Overall, a maximum of 29% (95% CI: 25, 33) of children and 29% (95% CI: 25, 32) of adolescents were categorized as sufficiently physically active. We observed substantial country- and region-specific differences in physical activity and sedentary time, with lower physical activity levels and prevalence estimates in Southern European countries. Boys were more active and less sedentary in all age-categories. The onset of age-related lowering or leveling-off of physical activity and increase in sedentary time seems to become apparent at around 6 to 7 years of age. Conclusions: Two third of European children and adolescents are not sufficiently active. Our findings suggest substantial gender-, country- and region-specific differences in physical activity. These results should encourage policymakers, governments, and local and national stakeholders to take action to facilitate an increase in the physical activity levels of young people across Europe.

• Taddei, Cristina; Jackson, Rod; Zhou, Bin; Bixby, Honor; Danaei, Goodarz & Cesare, Mariachiara Di [Show all 361 contributors for this article] (2020). National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: A pooled analysis of 458 population-based studies in Asian and Western countries. International Journal of Epidemiology. ISSN 0300-5771. 49(1), p. 173–192. doi: 10.1093/ije/dyz099. Full text in Research Archive
• Sundgot-Borgen, Christine; Stenling, Andreas; Rosenvinge, Jan H; Pettersen, Gunn; Friborg, Oddgeir & Sundgot-Borgen, Jorunn [Show all 10 contributors for this article] (2020). The Norwegian healthy body image intervention promotes positive embodiment through improved self-esteem. Body image. ISSN 1740-1445. 35, p. 84–95. doi: 10.1016/j.bodyim.2020.08.014. Full text in Research Archive Show summary

  We examined both direct and indirect effects of the Healthy Body Image (HBI) intervention on positive embodiment among Norwegian high school students. In total, 2446 12th grade boys (43 %) and girls (mean age 16.8 years) from 30 schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. We tested mediation models using path analysis and found that among several hypothesized mediators, only self-esteem mediated a positive intervention effect on positive embodiment for both boys and girls. A direct effect of the intervention on positive embodiment was only found in girls. The study provides novel findings indicating that health promotion interventions to address a positive embodiment should focus on enhancing adolescent’s self-esteem. Serial mediation modeling might reveal more complex explanations of change mechanisms and could further evolve current knowledge.

• Rodriguez-Martinez, Andrea; Zhou, Bin; Sophiea, Marisa K.; Bentham, James; Paciorek, Christopher J. & Turilli, Maria L.C. [Show all 54 contributors for this article] (2020). Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants. The Lancet. ISSN 0140-6736. 396(10261), p. 1511–1524. doi: 10.1016/S0140-6736(20)31859-6. Full text in Research Archive Show summary

  Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m². In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in subSaharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks. Funding Wellcome Trust, AstraZeneca Young Health Programme, EU.

• Aandstad, Anders; Sandberg, Frank; Hageberg, Rune & Kolle, Elin (2020). Change in anthropometrics and physical fitness in norwegian cadets during 3 years of military academy education. Military medicine. ISSN 0026-4075. 185(7-8), p. E1112–E1119. doi: 10.1093/milmed/usz470. Full text in Research Archive Show summary

  Introduction: High physical fitness is associated with increased occupational performance, better health, and reduced risk of injuries in military personnel. Thus, the military emphasizes physical training to maintain or develop physical fitness in their soldiers. It is important to monitor the effect of the physical training regime, but such information is lacking for Norwegian military cadets. Hence, the primary aim of this study was to investigate changes in anthropometrics and physical fitness among male and female army, navy and air force cadets during 3 years of military academy education. Materials and methods: 260 male and 29 female Norwegian cadets from the army, navy, and air force academies volunteered to participate. Anthropometrics, muscular power, muscular endurance, and maximal oxygen uptake were measured at entry (T0) and end of each year (T1, T2, and T3). Linear mixed models were used to examine the development in anthropometrics and physical fitness. We applied to the Regional Committee for Medical and Health Research Ethics to review the study before start-up, but the study was considered exempted from notification. The study was reviewed and approved by the Norwegian Social Science Data Services. Results: Male and female cadets significantly increased their body weight, fat-free mass, body mass index, and percent body fat by 1 to 5% from T0 to T3. Skeletal muscle mass was unchanged. Muscular power (medicine ball throw and vertical jump) and muscular endurance (pull-ups and push-ups) increased by 3 to 20% in male cadets, while female cadets only increased results significantly for the medicine ball throw (10%). Relative maximal oxygen uptake decreased by 4% in both sexes, while absolute maximal oxygen uptake only decreased significantly (by 2%) in male cadets. Most of the observed changes were classified as trivial or small, according to calculated effect sizes. The observed changes were generally of similar magnitude for male and female cadets, and similar among the three academies. Conclusions: Anthropometrics and physical fitness were relatively stable in Norwegian male and female army, navy, and air force cadets during 3 years of military academy education. Observed changes were typically classified as trivial or small. The initial gap in physical fitness between male and female cadets did not narrow during the education years. Norwegian male and female cadets displayed relatively good physical fitness profiles, compared to sex-matched cadets and soldiers from previously studied military populations.

• Bernhardsen, Guro Pauck; Stensrud, Trine; Hansen, Bjørge Hermann; Steene-Johannessen, Jostein; Kolle, Elin & Nystad, Wenche [Show all 17 contributors for this article] (2020). Birth weight, cardiometabolic risk factors and effect modification of physical activity in children and adolescents: pooled data from 12 international studies. International Journal of Obesity. ISSN 0307-0565. 44(10), p. 2052–2063. doi: 10.1038/s41366-020-0612-9. Full text in Research Archive Show summary

  Objectives: Low and high birth weight is associated with higher levels of cardiometabolic risk factors and adiposity in children and adolescents, and increases the risk of cardiovascular diseases, obesity, and early mortality later in life. Moderate-to-vigorous physical activity (MVPA) is associated with lower cardiometabolic risk factors and may mitigate the detrimental consequences of high or low birth weight. Thus, we examined whether MVPA modified the associations between birth weight and cardiometabolic risk factors in children and adolescents. Methods: We used pooled individual data from 12 cohort- or cross-sectional studies including 9,100 children and adolescents. Birth weight was measured at birth or maternally reported retrospectively. Device-measured physical activity (PA) and cardiometabolic risk factors were measured in childhood or adolescence. We tested for associations between birth weight, MVPA, and cardiometabolic risk factors using multilevel linear regression, including study as a random factor. We tested for interaction between birth weight and MVPA by introducing the interaction term in the models (birth weight x MVPA). Results: Most of the associations between birth weight (kg) and cardiometabolic risk factors were not modified by MVPA (min/day), except between birth weight and waist circumference (cm) in children (p = 0.005) and HDL-cholesterol (mmol/l) in adolescents (p = 0.040). Sensitivity analyses suggested that some of the associations were modified by VPA, i.e., the associations between birth weight and diastolic blood pressure (mmHg) in children (p = 0.009) and LDL- cholesterol (mmol/l) (p = 0.009) and triglycerides (mmol/l) in adolescents (p = 0.028). Conclusion: MVPA appears not to consistently modify the associations between low birth weight and cardiometabolic risk. In contrast, MVPA may mitigate the association between higher birth weight and higher waist circumference in children. MVPA is consistently associated with a lower cardiometabolic risk across the birth weight spectrum. Optimal prenatal growth and subsequent PA are both important in relation to cardiometabolic health in children and adolescents.

• Hansen, Bjørge Hermann; Dalene, Knut Eirik; Ekelund, Ulf; Fagerland, Morten; Kolle, Elin & Steene-Johannessen, Jostein [Show all 8 contributors for this article] (2020). Step by step: Association of device‐measured daily steps with all‐cause mortality - A prospective cohort Study. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 30(9), p. 1705–1711. doi: 10.1111/sms.13726. Full text in Research Archive Show summary

  Introduction: Walking is free, does not require special training, and can be done almost everywhere. Therefore, walking is a feasible behavior on which to tailor public health messages. This study assesses the prospective association and dose‐response relationship between daily steps and all‐cause mortality. Materials and Methods: Daily steps were measured by waist‐mounted accelerometers in 2183 individuals (53% women) for seven consecutive days at baseline (2008‐09). Participants were followed for a median period of 9.1 years and associations between steps and all‐cause mortality determined by registry linkage were assessed using Cox proportional hazard regression with adjustment for relevant covariates. Results: Mean age was 57.0 (SD 10.9) years at baseline. Median (IQR) daily steps across ascending quartiles were 4651 (3495‐5325), 6862 (6388‐7350), 8670 (8215‐9186), and 11 467 (10 556‐13 110), respectively. During follow‐up, 119 individuals died (68% men). Higher number of daily steps was associated with a lower risk of all‐cause mortality with hazard ratios of 1.00 (referent), 0.52 (0.29‐0.93), 0.50 (0.27‐0.94), and 0.43 (0.21‐0.88) across ascending quartiles of daily steps in the multivariable‐adjusted model with follow‐up commencing 2 years after baseline. Risk differences per 1000 individuals for ascending quartiles were 6.8 (2.9‐9.3), 7.1 (0.8‐11.1), and 8.0 (1.7‐12.1), respectively. Conclusions: Daily steps were associated with lower mortality risk in a non‐linear dose‐response pattern. The risk is almost halved when comparing the least active referent against the second quartile equivalent to a difference of about 2200 daily steps. Encouraging those least active to increase their daily steps may have substantial public health implications.

• Taddei, Cristina; Zhou, Bin; Bixby, Honor; Carrillo-Larco, Rodrigo M.; Danaei, Goodarz & Jackson, Rod T. [Show all 55 contributors for this article] (2020). Repositioning of the global epicentre of non-optimal cholesterol. Nature. ISSN 0028-0836. 582(7810), p. 73–77. doi: 10.1038/s41586-020-2338-1. Full text in Research Archive Show summary

  High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.

• Kolle, Elin; Solberg, Runar Barstad; Säfvenbom, Reidar; Dyrstad, Sindre Mikal; Berntsen, Sveinung & Resaland, Geir Kåre [Show all 10 contributors for this article] (2020). The effect of a school-based intervention on physical activity, cardiorespiratory fitness and muscle strength: the School in Motion cluster randomized trial. International Journal of Behavioral Nutrition and Physical Activity. 17(1). doi: 10.1186/s12966-020-01060-0. Full text in Research Archive Show summary

  Background: Physical activity (PA) declines throughout adolescence, therefore PA promotion during this period is important. We analyzed the effect of two school-based PA interventions on daily PA levels, cardiorespiratory fitness (CRF) and muscle strength among adolescents. Methods: For the nine-month School in Motion intervention study (ScIM), we cluster-randomized 30 Norwegian secondary schools (N = 2084, mean age [SD] = 14 [0.3] years) to one of three study arms. The physically active learning (PAL) intervention included 30 min physically active learning, 30 min PA and a 60 min physical education (PE) lesson per week. The Don’t worry-Be happy (DWBH) intervention included a 60 min PA lesson and a 60 min PE lesson per week, both tailored to promote friendships and wellbeing. Both intervention arms were designed to engage the adolescents in 120 min of PA per week in addition to recess and mandatory PE lessons. The control group continued as per usual, including the standard amount of mandatory PE. PA (main outcome) was assessed by accelerometers, CRF and muscle strength (secondary outcomes) were assessed by an intermittent running test and selected tests from the Eurofit test battery. Results: Daily PA and time spent in moderate- to vigorous-intensity PA (MVPA) decreased in all groups throughout the intervention. The mean difference in PA level and MVPA for participants in the PAL-intervention arm was 34.7 cpm (95% CI: 4.1, 65.3) and 4.7 min/day (95% CI: 0.6, 8.8) higher, respectively, compared to the control arm. There were no significant intervention effects on daily PA level, MVPA or time spent sedentary for adolescents in the DWBH-intervention arm. Adolescents in the PAL-intervention arm increased distance covered in the running test compared to controls (19.8 m, 95% CI: 10.4, 29.1), whilst a negative intervention effect was observed among adolescents in the DWBH-intervention arm (− 11.6 m, 95% CI: − 22.0, − 1.1). Conclusion: The PAL-intervention resulted in a significantly smaller decrease in daily PA level, time spent in MVPA, and increased CRF compared to controls. Our results indicate that a teacher-led intervention, including three unique intervention components, is effective in curbing the decline in PA observed across our cohort and improving CRF.

• Åvitsland, Andreas; Leibinger, Eva; Resaland, Geir Kåre; Solberg, Runar Barstad; Kolle, Elin & Dyrstad, Sindre Mikal (2020). Effects of school-based physical activity interventions on mental health in adolescents: The School in Motion cluster randomized controlled trial. Mental Health and Physical Activity. ISSN 1755-2966. 19, p. 1–10. doi: 10.1016/j.mhpa.2020.100348. Full text in Research Archive Show summary

  Purpose To investigate the effects of two school-based physical activity interventions on mental health in Norwegian adolescents. Methods Students from 29 lower secondary schools in Norway (n = 2084; 14–15 years; 49% female) were cluster-randomized into either a control group or one of two intervention groups (M1 and M2). Two interventions based on different theoretical frameworks aimed to increase physical activity in school by approximately 120 min per week, throughout a 29-week intervention period. M1 consisted of 30 min physically active learning, 30 min physical activity and one 60 min physical education lesson. M2 consisted of one physical education lesson and one physical activity lesson, both focusing on facilitating students’ interest, responsibility and social relationships. The self-report version of the Strengths and Difficulties Questionnaire was used to assess mental health. Physical activity was measured by accelerometry. Linear mixed effects models were used to examine the effects of the interventions. Results No effects were found for the overall study population. Interaction effects warranted subgroup analyses: M1 showed favorable results in the subgroup with the highest levels of psychological difficulties at baseline (b = −2.9; −5.73 to −0.07; p = .045) and in the immigrant subgroup (b = −1.6; −3.53 to 0.27; p = .093). M2 showed favorable results in the immigrant subgroup (b = −2.1; −4.36 to 0.21; p = .075). Conclusions The two interventions did not improve mental health in the full study population. However, results indicated beneficial effects among immigrants and those with poor mental health at baseline. More research is needed due to missing values and the results should therefore be interpreted with caution.

• Åvitsland, Andreas; Leibinger, Eva; Haugen, Tommy; Lerum, Øystein; Solberg, Runar Barstad & Kolle, Elin [Show all 7 contributors for this article] (2020). The association between physical fitness and mental health in Norwegian adolescents. BMC Public Health. 20(1). doi: 10.1186/s12889-020-08936-7. Full text in Research Archive Show summary

  Background Studies indicate that health-related components of physical fitness are associated with mental health outcomes. However, research is scarce concerning this relationship in young adolescents in general and non-existent in Norwegian populations specifically. The aim of the study was to examine whether body composition, muscular strength and cardiorespiratory fitness were associated with self-reported mental health in Norwegian adolescents. Methods Adolescents from four regions of Norway (n = 1486; mean age = 13.9; girls = 50.6%) participated. Self-reported mental health (psychological difficulties) was measured by completing the Strengths and Difficulties Questionnaire. Cardiorespiratory fitness was assessed with an intermittent running test; muscular strength was assessed by measuring handgrip strength, standing broad jump and sit-ups; and body composition was assessed by calculating body mass index from weight and height. Linear mixed effects models were conducted to assess the associations between the health-related components of physical fitness and psychological difficulties. School clusters were included as random effects and all models were controlled for sex, socioeconomic status and birthplace (domestic or foreign). Results Body composition was not associated with psychological difficulties. Muscular strength was independently associated with psychological difficulties, but when all independent variables were entered in the fully adjusted model, only cardiorespiratory fitness was associated with psychological difficulties. Conclusions There was a small but significant inverse association between cardiorespiratory fitness and levels of psychological difficulties in Norwegian adolescents. The results suggest that muscular strength is not associated with psychological difficulties in adolescents, when controlling for cardiorespiratory fitness. Future research should focus on the prospective association between physical fitness components and mental health outcomes in adolescents.

• Gjestvang, Christina; Stensrud, Trine; Hansen, Bjørge Hermann; Kolle, Elin & Haakstad, Lene Annette Hagen (2019). Are fitness club members likely to meet the current physical activity recommendations? Translational Sports Medicine (TSM). 3(2), p. 75–83. doi: 10.1002/tsm2.120. Full text in Research Archive
• Bixby, Honor; Bentham, James; Zhou, Bin; Cesare, Mariachiara Di; Paciorek, Christopher J. & Bennett, James E. [Show all 51 contributors for this article] (2019). Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature. ISSN 0028-0836. 569, p. 260–264. doi: 10.1038/s41586-019-1171-x. Full text in Research Archive Show summary

  Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.

• Kwon, Soyang; Andersen, Lars Bo; Grøntved, Anders; Kolle, Elin; Cardon, Greet & Davey, Rachel [Show all 14 contributors for this article] (2019). A closer look at the relationship among accelerometer-based physical activity metrics: ICAD pooled data. International Journal of Behavioral Nutrition and Physical Activity. 16. doi: 10.1186/s12966-019-0801-x. Full text in Research Archive Show summary

  Background Accelerometers are widely used to assess child physical activity (PA) levels. Using the accelerometer data, several PA metrics can be estimated. Knowledge about the relationships between these different metrics can improve our understanding of children’s PA behavioral patterns. It also has significant implications for comparing PA metrics across studies and fitting a statistical model to examine their health effects. The aim of this study was to examine the relationships among the metrics derived from accelerometers in children. Methods Accelerometer data from 24,316 children aged 5 to 18 years were extracted from the International Children’s Accelerometer Database (ICAD) 2.0. Correlation coefficients between wear time, sedentary behavior (SB), light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA), moderate- and vigorous-intensity PA (MVPA), and total activity counts (TAC) were calculated. Results TAC was approximately 22X103 counts higher (p < 0.01) with longer wear time (13 to 18 h/day) as compared to shorter wear time (8 to < 13 h/day), while MVPA was similar across the wear time categories. MVPA was very highly correlated with TAC (r = .91; 99% CI = .91 to .91). Wear time-adjusted correlation between SB and LPA was also very high (r = −.96; 99% CI = -.96, − 95). VPA was moderately correlated with MPA (r = .58; 99% CI = .57, .59). Conclusions TAC is mostly explained by MVPA, while it could be more dependent on wear time, compared to MVPA. MVPA appears to be comparable across different wear durations and studies when wear time is ≥8 h/day. Due to the moderate to high correlation between some PA metrics, potential collinearity should be addressed when including multiple PA metrics together in statistical modeling.

• Wijndaele, Katrien; White, Thomas; Andersen, Lars Bo; Bugge, Anna; Kolle, Elin & Northstone, Kate [Show all 17 contributors for this article] (2019). Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children’s Accelerometry database (ICAD). International Journal of Behavioral Nutrition and Physical Activity. 16:96, p. 1–10. doi: 10.1186/s12966-019-0858-6. Full text in Research Archive Show summary

  Background Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children. Methods Cross-sectional data from 14 studies (7 countries) in the International Children’s Accelerometry Database (ICAD, 1998–2009) was included. Accelerometry in 19,502 participants aged 3–18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed. Results Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (− 0.44 (− 0.62; − 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (− 3.07 (− 4.47; − 1.68) cm), systolic blood pressure (− 1.53 (− 2.42; − 0.65) mmHg) and clustered cardio-metabolic risk (− 0.18 (− 0.3; − 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: − 0.81 (− 1.38; − 0.24) mmHg). Conclusions Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of ≈1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.

• Bernhardsen, Guro Pauck; Stensrud, Trine; Nystad, Wenche; Dalene, Knut Eirik; Kolle, Elin & Ekelund, Ulf (2019). Early life risk factors for childhood obesity—Does physical activity modify the associations? The MoBa cohort study. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 29(10), p. 1636–1646. doi: 10.1111/sms.13504. Full text in Research Archive Show summary

  Objectives: High maternal pre‐pregnancy body mass index (BMI), high birth weight, and rapid infant weight gain are associated with increased risk of childhood obesity. We examined whether moderate‐to‐vigorous physical activity (MVPA) or vigorous physical activity (VPA) in 9‐ to 12‐year‐olds modified the associations between these early life risk factors and subsequent body composition and BMI. Methods: We used data from a sub‐cohort of the Norwegian Mother and Child Cohort Study (MoBa), including 445 children with available data on accelerometer assessed physical activity (PA). All participants had data on BMI, 186 of them provided data on body composition (dual energy X‐ray absorptiometry (DXA)). We used multiple regression analyses to examine the modifying effect of PA by including interaction terms. Results: Maternal pre‐pregnancy BMI and infant weight gain were more strongly related to childhood body composition in boys than in girls. Higher VPA attenuated the association between maternal pre‐pregnancy BMI and BMI in boys (low VPA: B = 0.32, 95% CI = 0.22, 0.41; high VPA B = 0.22, 95% CI = 0.12, 0.31). Birth weight was unrelated to childhood body composition, and there was no effect modification by PA. PA attenuated the associations between infant weight gain and childhood fat mass (low MVPA: B = 2.32, 95% CI = 0.48, 4.17; high MVPA: B = 1.00, 95% CI = 0.10, 1.90) and percent fat (low MVPA: B = 3.35, 95% CI = 0.56, 6.14; high MVPA: B = 1.41, 95% CI = −0.06, 2.87) in boys, but not girls. Conclusion: Findings from this study suggest that MVPA and VPA may attenuate the increased risk of an unfavorable body composition and BMI due to high maternal pre‐pregnancy BMI and rapid infant weight gain in boys, but not in girls.

• Sundgot-Borgen, Christine; Friborg, Oddgeir; Kolle, Elin; Torstveit, Monica Klungland; Sundgot-Borgen, Jorunn & Engen, Kethe Marie Elgesem [Show all 9 contributors for this article] (2019). Does the Healthy Body Image program improve lifestyle habits among high school students? A randomized controlled trial with 12-month follow-up. Journal of International Medical Research. ISSN 0300-0605. doi: 10.1177/0300060519889453. Full text in Research Archive Show summary

  <i>Objectives</i> - Positive embodiment and healthy lifestyle habits seem to be related; therefore, stimulating positive embodiment should promote healthy lifestyle habits. In the current study, we delivered the Healthy Body Image (HBI) intervention among Norwegian high school students and examined the effects on healthy lifestyle habits.<p> <p><i>Methods</i> - The HBI intervention comprises three interactive workshops, with three overarching themes related to body image, social media literacy, and lifestyle. A total of 2446 boys (43%) and girls in grade 12 (mean age 16.8 years) from 30 high schools participated in this cluster-randomized controlled study. Schools were randomized to the HBI intervention or control study arm. Data on physical activity, eating habits, and sleep were collected at baseline, post intervention, and 3- and 12-month follow-up and analyzed using linear mixed regression models.<p> <p><i>Results</i> - The intervention had a minor negative effect on physical activity levels in boys at 12-month follow-up and short-term small-to-moderate positive effects on consumption of breakfast and fruit and vegetables, and sleep duration on school days.<p> <p><i>Conclusions</i> - In future, the lack of satisfactorily long-term effects might be better addressed using a combination of cognitive and behavioral approaches to more optimally integrate positive embodiment and lifestyle changes in the daily life of adolescents.

• Sundgot-Borgen, Christine; Friborg, Oddgeir; Kolle, Elin; Engen, Kethe Marie Elgesem; Sundgot-Borgen, Jorunn & Rosenvinge, Jan H [Show all 10 contributors for this article] (2019). The healthy body image (HBI) intervention: Effects of a school-based cluster-randomized controlled trial with 12-months follow-up. Body image. ISSN 1740-1445. 29, p. 122–131. doi: 10.1016/j.bodyim.2019.03.007. Full text in Research Archive Show summary

  We examined the effects of the Healthy Body Image (HBI) intervention on positive embodiment and health-related quality of life among Norwegian high school students. The intervention comprised three interactive workshops, with body image, media literacy, and lifestyle as main themes. In total, 2,446 12th grade boys (43%) and girls (mean age 16.8 years) from 30 high schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. Data were collected at baseline, post-intervention, 3- and 12-months follow-up, and analysed using linear mixed regression models. The HBI intervention caused a favourable immediate change in positive embodiment and health-related quality of life among intervention girls, which was maintained at follow-up. Among intervention boys, however, weak post-intervention effects on embodiment and health-related quality of life vanished at the follow-ups. Future studies should address steps to make the HBI intervention more relevant for boys as well as determine whether the number of workshops or themes may be shortened to ease implementation and to enhance intervention effects.

• Hansen, Bjørge Hermann; Anderssen, Sigmund Alfred; Andersen, Lars Bo; Hildebrand, Maria; Kolle, Elin & Steene-Johannessen, Jostein [Show all 14 contributors for this article] (2018). Cross-sectional associations of reallocating time between sedentary and active behaviours on cardiometabolic risk factors in young people : an International Children’s Accelerometry Database (ICAD) analysis. Sports Medicine. ISSN 0112-1642. 48(10), p. 2401–2412. doi: 10.1007/s40279-018-0909-1. Full text in Research Archive Show summary

  Introduction Sedentary time and time spent in various intensity-specific physical activity are co-dependent, and increasing time spent in one behaviour requires decreased time in another. Objective The aim of the present study was to examine the theoretical associations with reallocating time between categories of intensities and cardiometabolic risk factors in a large and heterogeneous sample of children and adolescents. Methods We analysed pooled data from 13 studies comprising 18,200 children and adolescents aged 4–18 years from the International Children’s Accelerometry Database (ICAD). Waist-mounted accelerometers measured sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Cardiometabolic risk factors included waist circumference (WC), systolic blood pressure (SBP), fasting high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), triglycerides, insulin, and glucose. Associations of reallocating time between the various intensity categories with cardiometabolic risk factors were explored using isotemporal substitution modelling. Results Replacing 10 min of sedentary time with 10 min of MVPA showed favourable associations with WC, SBP, LDL-C, insulin, triglycerides, and glucose; the greatest magnitude was observed for insulin (reduction of 2–4%), WC (reduction of 0.5–1%), and triglycerides (1–2%). In addition, replacing 10 min of sedentary time with an equal amount of LPA showed beneficial associations with WC, although only in adolescents. Conclusions Replacing sedentary time and/or LPA with MVPA in children and adolescents is favourably associated with most markers of cardiometabolic risk. Efforts aimed at replacing sedentary time with active behaviours, particularly those of at least moderate intensity, appear to be an effective strategy to reduce cardiometabolic risk in young people.

• Dalene, Knut Eirik; Anderssen, Sigmund Alfred; Andersen, Lars Bo; Steene-Johannessen, Jostein; Ekelund, Ulf & Hansen, Bjørge Hermann [Show all 7 contributors for this article] (2018). Cross-sectional and prospective associations between sleep, screen time, active school travel, sports/exercise participation and physical activity in children and adolescents. BMC Public Health. 18(1). doi: 10.1186/s12889-018-5610-7. Full text in Research Archive Show summary

  Background: The aim of this study was to investigate how sleep, screen time, active school travel and sport and/or exercise participation associates with moderate-to-vigorous physical activity (MVPA) in nationally representative samples of Norwegian 9- and 15-y-olds, and whether these four behaviors at age nine predict change in MVPA from age nine to 15 years. Method: We pooled cross-sectional accelerometer and questionnaire data from 9- (n = 2366) and 15-y-olds (n = 1554) that participated in the first (2005/06) and second (2011/12) wave of the Physical Activity among Norwegian Children Study to investigate cross-sectional associations. To investigate prospective associations, we used data from a sub-sample that participated in both waves (at age nine and 15 years, n = 517). Results: Cross-sectional analyses indicated a modest, inverse association between screen time and MVPA among 9- (− 2.2 min/d (95% CI: -3.1, − 1.3)) and 15-y-olds (− 1.7 min/d (95% CI: -2.7, − 0.8)). Compared to their peers with 0–5 min/d of active travel to school, 9- and 15-y-olds with ≥16 min/d accumulated 7.2 (95% CI: 4.0, 10.4) and 9.0 (95% CI: 3.8, 14.1) more min/d of MVPA, respectively. Nine-y-old boys and 15-y-olds reporting ≥8 h/week of sports and/or exercise participation accumulated 14.7 (95% CI: 8.2, 21.3) and 17.9 (95% CI: 14.0, 21.8) more min/d of MVPA, respectively, than those reporting ≤2 h/week. We found no cross-sectional association between sleep duration and MVPA in either age group. None of the four behaviors predicted change in MVPA from age nine to 15 years (p ≥ 0.102). Conclusion: Active travel to school and sport/exercise participation may be important targets for future interventions aimed at increasing MVPA in children and adolescents. However, future studies are needed to determine causality.

• Aadland, Eivind; Anderssen, Sigmund Alfred; Andersen, Lars Bo; Resaland, Geir Kåre; Kolle, Elin & Steene-Johannessen, Jostein (2018). Aerobic fitness thresholds to define poor cardiometabolic health in children and youth. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 29(2), p. 240–250. doi: 10.1111/sms.13330. Full text in Research Archive Show summary

  Aerobic fitness is an apparent candidate for screening children and youth for poor cardiometabolic health and future risk of cardiovascular disease (CVD). Yet, age‐ and sex‐specific cut points for children and youth determined using a maximal protocol and directly measured peak oxygen consumption (VO2peak) does not exist. We used a nationally representative sample of 1462 Norwegian children and youth (788 boys and 674 girls aged 8.7–10.4 years and 14.7–16.7 years) who in 2005–2006 performed a maximal cycle ergometer test with direct measurement of VO2peak, along with measurement of several other risk factors for CVD (systolic blood pressure, waist circumference:height ratio, total:high density lipoprotein cholesterol ratio, triglycerides, Homeostasis Model Assessment for Insulin Resistance). Based on the proportion of children having clustering (least favorable quartile) of 6 (1.6%), ≥ 5 (5.2%), and ≥ 4 (10.6%) CVD risk factors, we established the 2nd, 5th, and 10th percentile cut points for VO2peak (ml/kg/min) for children and youth aged 8–18 years. Classification accuracy was determined using the Kappa coefficient (k), sensitivity and specificity. For boys, the 2nd, 5th, and 10th percentile VO2peak cut points were 33.6–36.4, 36.3–39.8, and 38.7–43.0 ml/kg/min, respectively. For girls, the corresponding cut points were 29.7–29.1, 32.4–31.4, and 34.8–33.5 ml/kg/min, respectively. Together with BMI, but without more invasive measures of traditional risk factors for CVD, these cut points can be used to screen schoolchildren for poor cardiometabolic health with moderate discriminating ability (k ≤ 0.53).

• Hansen, Bjørge Hermann; Kolle, Elin; Steene-Johannessen, Jostein; Dalene, Knut Eirik; Ekelund, Ulf & Anderssen, Sigmund Alfred (2018). Monitoring population levels of physical activity and sedentary time in Norway across the lifespan. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. doi: 10.1111/sms.13314. Full text in Research Archive Show summary

  Purpose: The pandemic of physical inactivity is recognized globally but there is a scarcity of studies employing valid and reliable assessment methods of physical activity (PA) across the lifespan. The purpose of this study is to provide a comprehensive description of objectively measured PA, sedentary time, and prevalence of meeting PA recommendations, in a population‐based sample of Norwegian children, adolescents and adults. Methods: Children and adolescents (6, 9 and 15‐year‐olds) were surveyed in 2011, and adults and older people (20‐85‐year‐olds) were surveyed in 2014/15, including more than 8000 individuals. Anthropometric data were measured in children and adolescents and self‐reported in the adult sample. PA was assessed by ActiGraph accelerometers for seven consecutive days, and PA indices include total PA (counts per minute), intensity‐specific PA, and adherence to PA recommendations. Results: Six‐year‐olds are 21% and 70% more active than 9‐ and 15‐year‐olds, respectively (P < 0.001). Nine‐year‐olds are 40% more active compared to 15‐year‐olds (P < 0.001). Moving from adolescence (15‐year‐olds) into adulthood (20‐65 years) yields a further reduction in total PA by 18%. Among six‐, nine‐ and 15‐year olds, 90%, 77%, and 48% meet the current PA recommendations, respectively, while adherence among adults and older people are 33% and 31%, respectively. Overweight and obese individuals had lower odds of meeting PA recommendations. Conclusions: The results from the Norwegian surveillance system indicate a strong association between age and indices of physical activity. The vast majority of Norwegian adults do not meet the PA recommendations and public health action are needed to increase PA in Norway.

• Zhou, Bin; Bentham, James; Cesare, Mariachiara Di; Bixby, Honor; Danaei, Goodarz & Hajifathalian, Kaveh [Show all 847 contributors for this article] (2018). Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants. International Journal of Epidemiology. ISSN 0300-5771. 47(3), p. 872–883i. doi: 10.1093/ije/dyy016. Full text in Research Archive Show summary

  Background Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.

• Kolle, Elin & Grydeland, May (2018). Begrepsavklaringer. In Torstveit, Monica Klungland; Lohne-Seiler, Hilde; Berntsen, Sveinung & Anderssen, Sigmund Alfred (Ed.), Fysisk aktivitet og helse: Fra begrepsforståelse til implementering av kunnskap. Cappelen Damm Akademisk. ISSN 9788202568313. p. 40–54. Full text in Research Archive
• Sundgot-Borgen, Christine; Bratland-Sanda, Solfrid; Engen, Kethe Marie Elgesem; Pettersen, Gunn; Friborg, Oddgeir & Torstveit, Monica Klungland [Show all 10 contributors for this article] (2018). The Norwegian healthy body image programme: Study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students. BMC Psychology. 6(8). doi: 10.1186/s40359-018-0221-8. Full text in Research Archive Show summary

  Background: <br>Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating.<br> Methods and design:<br> Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students’ benefits and satisfaction with the programme.<br> Discussion:<br> The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services.

• Hansen, Bjørge Hermann; Steene-Johannessen, Jostein & Kolle, Elin (2018). Status fysisk aktivitet og fysisk form i befolkningen. In Torstveit, Monica Klungland; Lohne-Seiler, Hilde; Berntsen, Sveinung & Anderssen, Sigmund Alfred (Ed.), Fysisk aktivitet og helse: Fra begrepsforståelse til implementering av kunnskap. Cappelen Damm Akademisk. ISSN 9788202568313. p. 92–113. Full text in Research Archive
• Zhou, Bin; Bentham, James; Cesare, Mariachiara Di; Bixby, Honor; Danaei, Goodarz & Cowan, Melanie J. [Show all 114 contributors for this article] (2017). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. The Lancet. ISSN 0140-6736. 389(10064), p. 37–55. doi: 10.1016/S0140-6736(16)31919-5. Full text in Research Archive Show summary

  Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings We pooled 1479 studies that had measured the blood pressures of 19·1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127·0 mm Hg (95% credible interval 125·7–128·3) in men and 122·3 mm Hg (121·0–123·6) in women; age-standardised mean diastolic blood pressure was 78·7 mm Hg (77·9–79·5) for men and 76·7 mm Hg (75·9–77·6) for women. Global age-standardised prevalence of raised blood pressure was 24·1% (21·4–27·1) in men and 20·1% (17·8–22·5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1·13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe.

• Kolle, Elin; Horta, Bernardo L; Wells, Jonathan; Brage, Soren; Barros, Fernando C. & Ekelund, Ulf [Show all 7 contributors for this article] (2017). Does objectively measured physical activity modify the association between early weight gain and fat mass in young adulthood? BMC Public Health. 17(1). doi: 10.1186/s12889-017-4924-1. Full text in Research Archive Show summary

  Background: Substantial evidence suggests that weight gain in early life is associated with increased adiposity and other metabolic disorders later in life. It is, however, unknown whether physical activity (PA) may modify these associations. We aimed to examine whether objectively measured PA at 30 years modified the associations between conditional weight gain in infancy (0–2 y) and childhood (2–4 y) with fat mass index (FMI) and visceral abdominal fat measured at age 30 years. Methods: Prospective birth cohort study in Pelotas, Brazil, including 1874 participants with weight data at birth, two and four years of age, and measures of FMI, visceral abdominal fat and PA at a mean age of 30.2 years. At age 30, time spent (min/day) in moderate-to-vigorous physical activity (MVPA) was measured objectively using a wrist-worn accelerometer worn for four to seven consecutive days.. Multiple linear regression analyses was performed to assess the associations between conditional weight gain and outcome variables at 30 years, adjusting for covariates. We examined whether PA modified the association between conditional weight gain and the outcomes of interest by introducing an interaction term (conditional weight gain × PA) in the models. Results: Conditional weight gain in infancy and childhood were both positively associated with later FMI (infancy weight gain: β = 0.68, 95% CI: 0.48, 0.88; P < 0.001; childhood weight gain: β = 0.91, 95% CI: 0.70, 1.11; P < 0.001). A formal test for interaction suggested that MVPA at 30 years of age modified the association between childhood relative weight gain and later FMI (β = −0.006, 95% CI: -0.011, −0.001; P = 0.029), suggesting stronger associations between weight gain and FMI in those with lower levels of MVPA. Conditional weight gain in childhood was also positively associated with visceral abdominal fat (β = 0.24, 95% CI: 0.15, 0424, P < 0.001). There was no evidence for a modification of the latter association after adjustment for physical activity. Conclusion: Conditional weight gain between 2 and 4 years of age is associated with increased FMI at age 30 years. However, higher levels of MVPA appear to attenuate this detrimental association.

• Dalene, Knut Eirik; Anderssen, Sigmund Alfred; Andersen, Lars Bo; Steene-Johannessen, Jostein; Ekelund, Ulf & Hansen, Bjørge Hermann [Show all 7 contributors for this article] (2017). Secular and longitudinal physical activity changes in population-based samples of children and adolescents. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 28(1), p. 161–171. doi: 10.1111/sms.12876. Full text in Research Archive Show summary

  The aims of this study were to investigate whether physical activity (PA) and sedentary time (ST) in 9-and 15-year- olds differed between 2005-2006 and 2011-2012 (secular change), and to investigate changes in PA and ST from age 9 to 15 (longitudinal change). In 2005-2006, we invited nationally representative samples of Norwegian 9-( n=1470) and 15-year- olds (n=1348) to participate. In 2011-2012, we invited a new nationally representative sample of 9-year- olds (n=1945), whereas 15-year- olds (n=1759) were invited to participate either based on previous participation in 2005-2006 or from a random sample of schools. We assessed PA and ST objectively using accelerometers. In 2011-2012, both 9-and 15-year- olds spent more time sedentary (≥35.7 min/d, P<.001) and less time in light PA (≥35.2 min/d, P<.001) compared to their peers in 2005-2006. Nine-year- old girls also spent less time in moderate-to- vigorous PA (MVPA) (4.2 min/d, P=.041). In both age groups, the proportion accumulating an average of 60 min/d of MVPA did not differ between the two cohorts. From age 9 to 15, girls and boys decreased their time spent in LPA (≥106.7 min/d, P<.001) and in MVPA (≥20.8 min/d, P<.001). During the same period, ST increased by a mean of >2 h/d (P<.011). We observed an adverse secular change in PA from 2005-2006 to 2011-2012 among 9-and 15-year- olds, and a large decline in PA in the participants followed longitudinally from age 9 to 15 years.

• Dalene, Knut Eirik; Anderssen, Sigmund Alfred; Andersen, Lars Bo; Steene-Johannessen, Jostein; Ekelund, Ulf & Hansen, Bjørge Hermann [Show all 7 contributors for this article] (2017). Cross-sectional and prospective associations between physical activity, body mass index and waist circumference in children and adolescents. Obesity Science & Practice. 3(3), p. 249–257. doi: 10.1002/osp4.114. Full text in Research Archive Show summary

  Objective: To study the cross-sectional and prospective associations between physical activity (PA) of different intensities, body mass index (BMI) and waist circumference (WC) in children and adolescents using isotemporal substitution modelling. Methods: Physical activity (accelerometry), BMI and WC were assessed in 6- (n = 970), 9- (n = 2,423) and 15-year-olds (n = 1,544) in 2005/2006 and 2011/2012. Participants aged 9 years in 2005/2006 were followed prospectively to 2011/12 (age 15). Associations between PA of different intensities (light, moderate and vigorous), BMI and WC were examined using isotemporal substitution models. Results: Substituting 10 min per day of sedentary time with light PA was associated with higher WC (0.17 to 0.29 cm, p ≤ 0.003)) in all age groups. Substituting 10 min per day of sedentary time with moderate PA was associated with lower WC in 6- and 9-year-olds (−0.32 to −0.47 cm, p ≤ 0.013)). Substituting 10 min per day of sedentary time with vigorous PA was associated with lower WC in 9- and 15-year-olds (−1.08 to −1.79 cm, p ≤ 0.015)). Associations were similar with BMI as the outcome. In prospective analyses, substituting sedentary time with light, moderate or vigorous PA at age 9 was not associated with BMI or WC at age 15. Conclusion: Substituting sedentary time with moderate PA appears favourably associated with adiposity in children, whereas vigorous PA may be required in adolescents. Cross-sectional associations were not replicated in prospective analyses.

• Ekelund, Ulf; Kolle, Elin; Steene-Johannessen, Jostein; Dalene, Knut Eirik; Nilsen, Ada Kristine Ofrim & Anderssen, Sigmund Alfred [Show all 7 contributors for this article] (2017). Objectively measured sedentary time and physical activity and associations with body weight gain: does body weight determine a decline in moderate and vigorous intensity physical activity? International Journal of Obesity. ISSN 0307-0565. 41(12), p. 1769–1774. doi: 10.1038/ijo.2017.186. Full text in Research Archive Show summary

  OBJECTIVES: High levels of physical activity (PA) may prevent the development of obesity. However, the magnitude and direction of the association between PA of various intensities, sedentary time and weight status remain unclear. Thus, we examined whether objectively measured sedentary time and PA independently predict gain in body weight, change in body weight and to examine the possibility of reverse causation. METHODS: We examined the prospective associations between sedentary time, PA and body weight (BW). Baseline measurements were conducted in 2008/2009 and follow-up measurements in 2014/2015 in a random sample of the adult Norwegian population (N = 1710, 45.1% men). Moderate and vigorous intensity PA (MVPA) and sedentary time were measured by accelerometry and BW and height self-reported. We first modelled the associations between baseline sedentary time and PA with BW at follow-up. We then modelled the reverse associations (BW as the exposure) and sedentary time and PA (as outcomes) in separate models. All models were adjusted for age, sex, baseline value of the outcome, socio-economic status, alcohol consumption, smoking, monitor wear time and follow-up time. RESULTS: Body mass index (BMI) increased by 0.2 units (P = 0.003) between baseline and follow-up, and 46.5% of participants were either overweight (36.4%) or obese (10.1%) at baseline increasing to 49.6% (11.7% obese) at follow-up. Baseline sedentary time, MVPA and vigorous PA were not associated with BW at follow-up after adjustment for covariates. In contrast, baseline BW was inversely associated with MVPA (β = − 0.11; 95% confidence interval (CI); − 0.21, − 0.009) and VPA (β = − 0.035; 95% CI; − 0.059, − 0.011) in adjusted models. These associations were unchanged when BW was substituted by BMI. CONCLUSIONS: Baseline BW seems to determine a decrease in MVPA in healthy adult Norwegian men and women, more so than the reverse.

• Mitchell, Jonathan A.; Dowda, Marsha; Pate, Russell R.; Kordas, Katarzyna; Froberg, Karsten & Sardinha, Luís B. [Show all 8 contributors for this article] (2017). Physical Activity and Pediatric Obesity: A Quantile Regression Analysis. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 49(3), p. 466–473. doi: 10.1249/MSS.0000000000001129. Full text in Research Archive Show summary

  Purpose: We aimed to determine whether moderate to vigorous physical activity (MVPA) and sedentary behavior (SB) were independently associated with body mass index (BMI) and waist circumference (WC) in children and adolescents. Methods: Data from the International Children"s Accelerometry Database were used to address our objectives (N = 11,115; 6–18 yr; 51% female). We calculated ageand gender-specific BMI and WC z-scores and used accelerometry to estimate MVPA and total SB. Self-reported television viewing was used as a measure of leisure time SB. Quantile regression was used to analyze the data. Results: MVPA and total SB were associated with lower and higher BMI and WC z-scores, respectively. These associations were strongest at the higher percentiles of the z-score distributions. After including MVPA and total SB in the same model, the MVPA associations remained, but the SB associations were no longer present. For example, each additional hour per day of MVPA was not associated with BMI z-score at the 10th percentile (b = j0.02, P = 0.170) but was associated with lower BMI z-score at the 50th (b = j0.19, P G 0.001) and 90th percentiles (b = j0.41, P G 0.001). More television viewing was associated with higher BMI and WC, and the associations were strongest at the higher percentiles of the z-score distributions, with adjustment for MVPA and total SB. Conclusions: Our observation of stronger associations at the higher percentiles indicates that increasing MVPA and decreasing television viewing at the population-level could shift the upper tails of the BMI and WC frequency distributions to lower values, thereby lowering the number of children and adolescents classified as obese.

• Solbraa, Ane; Anderssen, Sigmund Alfred; Holme, Ingar Morten K; Kolle, Elin; Hansen, Bjørge Hermann & Ashe, Maureen C (2017). The built environment correlates of objectively measured physical activity in Norwegian adults: A cross-sectional study. Journal of Sport and Health Science. ISSN 2095-2546. 7(1), p. 19–26. doi: 10.1016/j.jshs.2017.11.002. Full text in Research Archive Show summary

  Background: Built environments that are designed to provide accessible, attractive, and convenient locales promote regular physical activity (PA). Norway has great variability in its geographic, natural, and built environment features. Urban areas have well-developed built environment features, whereas the rural areas are less walkable and this may influence the mode of transport. In general, active transport is more common in urban centers. Further, public transportation is more developed in urban areas, whereas motorized transport may be more widespread in the rural areas. Despite this, in Sogn & Fjordane, a rural county in western Norway, high PA levels are frequently observed. Thus, the aims of this study were to (1) explore perceived built environment features and characterize their associations with objectively measured PA levels in Norwegian adults and (2) explore the differences in these correlates between Sogn & Fjordane and the rest of Norway. Methods: In this cross-sectional study, participants used questionnaires to rate perceptions of their built environments, and their PA was objectively measured for 7 consecutive days using the ActiGraph GT1M accelerometer. There were 972 Norwegian adults who were included in the study. The average age was 46.9 ± 6.5 years and 43.8% of participants were men. Data were analyzed using multiple linear regression. Results: Total PA and moderate-to-vigorous physical activity (MVPA) were both associated with perceived walkability, the community perception score, and active transport for commuting (all p ≤ 0.004). We also observed geographic-area-specific associations: the community perception score was negatively associated with total PA and MVPA in the rest of Norway (p ≤ 0.012) but not in Sogn & Fjordane. Public transport for commuting was positively associated with MVPA in Sogn & Fjordane (p = 0.03) but not in the rest of Norway. Conclusion: Total PA level and MVPA were associated with built environment factors, such as perceptions of community, perceived walkability, and engaging in active transport for commuting. Geographic differences in the PA correlates were observed, and thus, locally customized environmental population approaches aimed at increasing PA levels may be essential complements to individual behavior and lifestyle strategies. Further, objective measures of Norwegian built environments, such as geographic information system data, and validated walk- and bike-scores would advance the field.

• Bentham, James; Cesare, Mariachiara Di; Bilano, Ver; Bixby, Honor; Zhou, Bin & Stevens, Gretchen A. [Show all 110 contributors for this article] (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet. ISSN 0140-6736. 390(10113), p. 2627–2642. doi: 10.1016/S0140-6736(17)32129-3. Full text in Research Archive Show summary

  Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (−0·01 kg/m2 per decade; 95% credible interval −0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69–1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64–1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (−0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50–1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.

• Cesare, Mariachiara Di; Bentham, James; Stevens, Gretchen A; Zhou, Bin; Danaei, Goodarz & Lu, Yuan [Show all 740 contributors for this article] (2016). Trends in adult body-mass index in 200 countries from 1975 to 2014: A pooled analysis of 1698 population-based measurement studies with 19.2 million participants. The Lancet. ISSN 0140-6736. 387(10026), p. 1377–1396. doi: 10.1016/S0140-6736(16)30054-X. Full text in Research Archive Show summary

  Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

• Seiler, Hilde Lohne; Kolle, Elin; Anderssen, Sigmund Alfred & Hansen, Bjørge Hermann (2016). Musculoskeletal fitness and balance in older individuals (65-85 years) and its association with steps per day: A cross sectional study Physical functioning, physical health and activity. BMC Geriatrics. 16. doi: 10.1186/s12877-016-0188-3. Full text in Research Archive Show summary

  Background: There is limited normative, objective data combining musculoskeletal fitness (MSF), balance and physical activity (PA) among older adults. The aims were therefore to; 1) describe MSF and balance in older Norwegian adults focusing on age- and sex-related differences; 2) investigate the associations among MSF, balance and objectively-assessed PA levels. Methods: This was part of a national multicenter study. Participants (65 – 85 years) were randomly selected from the national population registry. We used ActiGraph GT1M accelerometers to measure PA. Balance and MSF were assessed using: one leg standing (OLS), handgrip strength (HG), static back extension (SBE), sit and reach (SR), back scratch right, left arm over (BSR, BSL). Univariate analyses of variance were used to assess sex differences within the different MSF and balance tests and for comparisons among multiple age groups. Linear regression analysis was used to investigate how PA (expressed in 1000 steps increments) was associated with MSF and balance. Results: 85 women and 76 men were included. Mean age (standard deviation (SD)) was 73.2 (5.4) years for women and 72.3 (4.8) years for men. The youngest participants (65 – 69 years) had significantly better mean OLS- and SBE results compared with older participants. Women (65 – 85 years) had significantly better mean SR, BSR, BSL and SBE results compared with men (65 – 85 years). Men had significantly better mean HG results compared with women. No sex differences in mean OLS results were observed. A daily increment of 1000 steps was associated with better mean test scores for OLS- and SBE tests (b = 1.88, 95 % CI: 0.85 to 2.90 (p ≤ 0.001) and b = 4.63, 95 % CI: 1.98 to 7.29 ( p = 0.001), respectively). Conclusion: The youngest (65 – 69 years) had better static balance and muscular endurance in trunk extensors compared with older participants. Older women (65 – 85 years) had better joint flexibility than older men (65 – 85 years), whereas older men had better handgrip strength than older women. A higher PA level was associated with better static balance and muscular endurance in trunk extensors in older individuals. This study provides important normative data, and further investigation of trunk endurance and static balance as key foci for PA interventions in elderly is warranted.

• Bentham, James; Cesare, Mariachiara Di; Stevens, Gretchen A.; Zhou, Bin; Bixby, Honor & Cowan, Melanie [Show all 794 contributors for this article] (2016). A century of trends in adult human height. eLIFE. 5. doi: 10.7554/elife.13410. Full text in Research Archive
• Dalene, Knut Eirik; Anderssen, Sigmund Alfred; Ekelund, Ulf; Thoren, Anne-Karine Halvorsen; Hansen, Bjørge Hermann & Kolle, Elin (2016). Permanent play facility provision is associated with children's time spent sedentary and in light physical activity during school hours: A cross-sectional study. Preventive Medicine Reports. 4, p. 429–434. doi: 10.1016/j.pmedr.2016.08.011. Full text in Research Archive Show summary

  Objective: To study the associations between: 1) number of permanent outdoor play facilities per pupil and 2) the size of the outdoor play area per pupil with sedentary time and physical activity (PA) during school hours in six-, nine-, and 15-year olds. We conducted a cross-sectional study of nationally representative samples of Norwegian six- (n = 1071), nine- (n = 1421) and 15-year-olds (n = 1106) in 2011 (the Physical Activity Among Norwegian Children Study). The participation rates were 56.4%, 73.1% and 57.8% for six-, nine- and 15-year olds, respectively. We assessed PA objectively for seven consecutive days using accelerometers, the size of a school's outdoor play area (SOPA) using an online map service and the permanent play facility (PPF) provision using a standardized form during school site visits. We successfully measured SOPA and PPF in 99 schools, from which 3040 participants provided valid accelerometer data. We used generalized least-squares random-effects models with robust variance estimation to assess associations. Our results indicate that better provision of permanent play facilities may reduce sedentary time and increase time spent in light PA among six-year-olds. Permanent play facility provision was not associated with sedentary time or PA among nine- and 15-year-olds. Associations found between outdoor play area size, physical activity and sedentary time were negligible. Future research should investigate what types of permanent play facilities may be associated with physical activity in both children and adolescents.

• Kjær, Ingirid Geirsdatter Heald; Torstveit, Monica Klungland; Kolle, Elin; Hansen, Bjørge Hermann & Anderssen, Sigmund Alfred (2016). Normative values for musculoskeletal- and neuromotor fitness in apparently healthy Norwegian adults and the association with obesity: a cross-sectional study. BMC sports science, medicine and rehabilitation. 8. doi: 10.1186/s13102-016-0059-4. Full text in Research Archive Show summary

  Background: Up-to-date research on musculoskeletal- and neuromotor fitness (MSMF) is lacking. The aims of the present paper were to a) establish normative values of MSMF by gender and age, and b) to assess how much of the variance in MSMF can be explained by obesity in adults. Methods: A random selection of 726 Norwegians (20–65 years) participated in a national cross-sectional study. Muscular endurance, muscular strength, explosive power, flexibility and balance were assessed in addition to waist circumference (WC). Results: Females displayed significantly higher scores compared to males on muscular endurance of the back extensors and on the flexibility tests (p < 0.001). Males displayed significantly higher scores than females (p < 0.001) on handgrip strength, modified push-ups, and explosive power. An inverse association was found between age and all MSMF scores for females (Beta:−0.06–(−0.92), p ≤ 0.044) and males (Beta:−0.15–(0.91), p ≤ 0.006), where younger participants displayed higher test scores on all MSMF tests, compared to older participants. Furthermore, participants showing higher scores on WC displayed lower scores on the following MSMF tests for both females and males: muscular endurance of the back extensors, balance, flexibility of the shoulder, and explosive power (p < 0.001). Additionally, male participants with higher WC scores showed lower scores on muscular endurance of the upper body and flexibility of the hamstrings compared to males with lower WC scores (p < 0.001). Conclusions: The data provide normative values of MSMF for adults based on age and gender, and support an inverse relationship of MSMF to age and WC.

• Hildebrand, Maria; Kolle, Elin; Hansen, Bjørge Hermann; Collings, Paul J.; Wijndaele, Katrien & Kordas, Katarzyna [Show all 14 contributors for this article] (2015). Association between birth weight and objectively measured sedentary time is mediated by central adiposity: data in 10,793 youth from the International Children’s Accelerometry Database. American Journal of Clinical Nutrition. ISSN 0002-9165. 101(5), p. 983–990. doi: 10.3945/ajcn.114.103648. Full text in Research Archive Show summary

  Background: Birth weight is an early correlate of disease later in life, and animal studies suggest that low birth weight is associated with reduced activity and increased sedentary time. Whether birth weight predicts later sedentary time in humans is uncertain. Objectives: We examined the relation between birth weight and sedentary time in youth and examined whether this association was mediated by central adiposity. Design: We used pooled cross-sectional data from 8 observational studies conducted between 1997 and 2007 that consisted of 10,793 youth (boys: 47%) aged 6–18 y from the International Children’s Accelerometry Database. Birth weight was measured in hospitals or maternally reported, sedentary time was assessed by using accelerometry (<100 counts/min), and abdominal adiposity (waist circumference) was measured according to WHO procedures. A mediation analysis with bootstrapping was used to analyze data. Results: The mean (±SD) time spent sedentary was 370 ± 91 min/d. Birth weight was positively associated with sedentary time (B = 4.04, P = 0.006) and waist circumference (B = 1.59, P < 0.001), whereas waist circumference was positively associated with sedentary time (B = 0.82, P < 0.001). Results of the mediation analysis showed a significant indirect effect of birth weight on sedentary time through waist circumference (B: 1.30; 95% bias-corrected CI: 0.94, 1.72), and when waist circumference was controlled for, the effect of birth weight on sedentary time was attenuated by 32% (B = 2.74, P = 0.06). Conclusion: The association between birth weight and sedentary time appears partially mediated by central adiposity, suggesting that both birth weight and abdominal adiposity may be correlates of sedentary time in youth.

• Kjær, Ingirid Geirsdatter Heald; Kolle, Elin; Hansen, Bjørge Hermann; Anderssen, Sigmund Alfred & Torstveit, Monica Klungland (2015). Obesity prevalence in Norwegian adults assessed by body mass index, waist circumference and fat mass percentage. Clinical Obesity. ISSN 1758-8103. 5(4), p. 211–218. doi: 10.1111/cob.12100. Full text in Research Archive Show summary

  The prevalence of obesity presents serious public health challenges worldwide and is most commonly estimated by the categorization of body mass index (BMI). The purpose of this study was (i) to describe the sensitivity of BMI, waist circumference (WC) and fat mass percentage in the classification of overweight and obesity and (ii) to describe the prevalence of overweight and obesity using different measurement methods in a national sample of Norwegians. A total of 904 Norwegians (20–85 years) were randomly enrolled. Body weight, height, WC and skinfold thickness were measured; BMI and fat mass percentage (FPskf) were calculated. The sensitivity and specificity varied from 77.0% to 86.9% and from 60.6% to 82.3%, respectively. Area under the curve was 0.837 (95% confidence interval [CI]: 0.801–0.872) for the ability of BMI to predict obesity by FPskf and 0.811 (95% CI: 0.770–0.852) for WC. A total of 12.7% (male: 12.1%, female: 13.4%) were obese based on BMI classifications, 29.1% (male: 36.5%, female: 20.0%) of the sample were obese based on FPskf and 24.3% of men and 37.8% of women were abdominally obese by WC. The agreement between selected measuring methods was fair to good, although the variation in obesity prevalence rates between the different assessments methods varied markedly.

• Grydeland, May; Hansen, Bjørge Hermann; Ried-Larsen, Mathias; Kolle, Elin & Anderssen, Sigmund Alfred (2014). Comparison of three generations of ActiGraph activity monitors under free-living conditions: Do they provide comparable assessments of overall physical activity in 9-year old children? BMC sports science, medicine and rehabilitation. 6(1). doi: 10.1186/2052-1847-6-26. Full text in Research Archive
• Hansen, Bjørge Hermann; Børtnes, Ingvild; Hildebrand, Maria; Holme, Ingar Morten K; Kolle, Elin & Anderssen, Sigmund Alfred (2014). Validity of the ActiGraph GT1M during walking and cycling. Journal of Sports Sciences. ISSN 0264-0414. 32(6), p. 510–516. doi: 10.1080/02640414.2013.844347. Full text in Research Archive Show summary

  The ActiGraph activity monitors have developed and newer versions of the ActiGraph accelerometers (GT1M, GT3X and GT3X +) are now available, including changes in hardware and software compared to the old version (AM7164). This is problematic as most of the validation and calibration work includes the AM7164. The aims of the study were to validate the ActiGraph GT1M during level and graded walking and to assess the potential underestimation of physical activity during cycling. Data were obtained from 20 participants during treadmill walking and ergometer cycling. Energy expenditure was measured via indirect calorimetry and used as the criterion method. Activity counts were highly correlated with energy expenditure during level walking (R2 = 0.82) and graded walking at 5% and 8% (R2 = 0.82 and R2 = 0.67, respectively). There was no linear relationship between activity counts and energy expenditure during cycling. The average activity counts for all data points during cycling was 1,157 counts per minute (CPM) (SD = 974), and mean energy expenditure was 5.0 metabolic equivalents. The GT1M is a valid tool for assessing walking across a wide range of speeds and gradients. However, there is no relationship between activity counts and energy expenditure during cycling and physical activity is underestimated by ≈73% during cycling compared to walking.

• Hansen, Bjørge Herman; Ommundsen, Yngvar; Holme, Ingar Morten K; Kolle, Elin & Anderssen, Sigmund Alfred (2014). Correlates of objectively measured physical activity in adults and older people: a cross-sectional study of population-based sample of adults and older people living in Norway. International Journal of Public Health. ISSN 1661-8556. 59(2), p. 221–230. doi: 10.1007/s00038-013-0472-3. Full text in Research Archive Show summary

  Objectives: The aims of the study were to identify correlates of objectively measured physical activity and to determine whether the explanatory power of the correlates differed with sex, weight status or level of education. Methods: Physical activity was assessed objectively in 3,867 participants, aged 20–85 years, for a consecutive 7 days using the ActiGraph GT1M activity monitor. Demographic and biological variables and levels of psychological, social environmental and physical environmental correlates were selfreported. Results: The complete set of correlates explained 18.6 % (p\0.001) of the variance in overall physical activity. Age and physical activity identity were the most important factors, explaining 4.8 and 3.2 % of the variance, respectively, whereas social environmental and physical environmental correlates did not significantly increase the amount of explained variance. Small interaction effects between demographic and biological variables and the correlates were observed. Conclusions: Self-efficacy, perceived behavioural control and physical activity identity might be important targets for intervention. Intervention efforts aimed at influencing psychological correlates of physical activity may prove equally effective regardless of sex, weight status and level of education.

• Seiler, Hilde Lohne; Hansen, Bjørge Hermann; Kolle, Elin & Anderssen, Sigmund Alfred (2014). Accelerometer-determined physical activity and self-reported health in a population of older adults (65-85 years): A cross-sectional study. BMC Public Health. 14. doi: 10.1186/1471-2458-14-284. Full text in Research Archive Show summary

  Background: The link between physical activity (PA) and prevention of disease, maintenance of independence, and improved quality of life in older adults is supported by strong evidence. However, there is a lack of data on population levels in this regard, where PA level has been measured objectively. The main aims were therefore to assess the level of accelerometer-determined PA and to examine its associations with self-reported health in a population of Norwegian older adults (65–85 years). Methods: This was a part of a national multicenter study. Participants for the initial study were randomly selected from the national population registry, and the current study included those of the initial sample aged 65–85 years. The ActiGraph GT1M accelerometer was used to measure PA for seven consecutive days. A questionnaire was used to register self-reported health. Univariate analysis of variance with Bonferroni adjustments were used for comparisons between multiple groups. Results: A total of 560 participants had valid activity registrations. Mean age (SD) was 71.8 (5.6) years for women (n = 282) and 71.7 (5.2) years for men (n = 278). Overall PA level (cpm) differed considerably between the age groups where the oldest (80–85 y) displayed a 50% lower activity level compared to the youngest (65–70 y). No sex differences were observed in overall PA within each age group. Significantly more men spent time being sedentary (65–69 and 70–74 years) and achieved more minutes of moderate to vigorous PA (MVPA) (75–79 years) compared to women. Significantly more women (except for the oldest), spent more minutes of low-intensity PA compared to men. PA differed across levels of self-reported health and a 51% higher overall PA level was registered in those, with “very good health” compared to those with “poor/very poor health”. Conclusion: Norwegian older adults PA levels differed by age. Overall, the elderly spent 66% of their time being sedentary and only 3% in MVPA. Twenty one percent of the participants fulfilled the current Norwegian PA recommendations. Overall PA levels were associated with self-reported health.

• Hansen, Bjørge Hermann; Holme, Ingar Morten K; Anderssen, Sigmund Alfred & Kolle, Elin (2013). Patterns of Objectively Measured Physical Activity in Normal Weight, Overweight, and Obese Individuals (20-85 Years): A Cross-Sectional Study. PLOS ONE. 8(1). doi: 10.1371/journal.pone.0053044. Full text in Research Archive Show summary

  Background: The magnitude of the association between physical activity (PA) and obesity has been difficult to establish using questionnaires. The aim of the study was to evaluate patterns of PA across BMI-defined weight categories and to examine the independent contribution of PA on weight status, using accelerometers. Methods:The study was a cross-sectional population-based study of 3,867 adults and older people aged 20–85 years, living in Norway. PA was assessed for seven consecutive days using the ActiGraph GT1M accelerometer. Anthropometrical data was self-reported and overweight and obesity was defined as having a body mass index (BMI) of 25–<30 and ≥30 kg/m2, respectively. Results:Overweight and obese participants performed less overall PA and PA of at least moderate intensity and took fewer steps, compared to normal weight participants. Although overall PA did not differ between weekdays and weekends, an interaction between BMI category and type of day was present, indicating a larger difference in overall PA between BMI categories on weekends compared to weekdays. Obese participants displayed 19% and 25% lower overall physical activity compared to normal weight participants, on weekdays and weekends, respectively. Participants in the most active quintile of overall PA had a 53% lower risk (OR 0.47, 95% CI: 0.37 to 0.60) for having a BMI above or below 25 kg/m2, and a 71% lower risk (OR: 0.29, 95% CI: 0.20 to 0.44) for having a BMI above or below 30 kg/m2. Conclusions:Overweight and obese participants engaged in less overall PA and moderate and vigorous PA compared with normal weight individuals. The weight related differences in overall PA were most pronounced on the weekend and the risk of being overweight or obese decreases across quintiles of PA.

• Kolle, Elin & Ekelund, Ulf (2013). Is Sitting Time a Strong Predictor of Weight Gain? Current Obesity Reports. 2(1), p. 77–85. doi: 10.1007/s13679-012-0039-2. Full text in Research Archive Show summary

  The current review aimed to examine the evidence on prospective associations between sedentary behavior (i.e., sitting time) and weight gain. Prospective studies published between January 2010 and August 2012 were identified from searches in the Medline databases. In total 13 studies (seven in adolescents and six in adults) examining the prospective association between sedentary behavior and any measure of weight gain met inclusion criteria. In adolescents, mixed evidence was observed for a positive association between sedentary behavior at baseline and weight gain at follow-up. In adults, there was insufficient evidence that sedentary time at baseline was a strong predictor of weight gain at follow-up. The majority of the included studies used self- or parent-reported sedentary time which can be affected by social desirability and recall bias. Marked heterogeneity in study populations, exposure and outcome measures precluded a quantitative meta-analysis. Failure to appropriately adjust the results for baseline measures of the outcome particularly in the studies in children and adolescents may partly explain the observations. Therefore, firm conclusions whether prolonged sitting time predict weight gain in young people and adults is currently not possible. High-quality studies using repeated objective measures of sedentary behavior is warranted to establish a causal association.

• Østergaard, Lars; Kolle, Elin; Steene-Johannessen, Jostein; Anderssen, Sigmund Alfred & Andersen, Lars Bo (2013). Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents. International Journal of Behavioral Nutrition and Physical Activity. 10. doi: 10.1186/1479-5868-10-91. Full text in Research Archive Show summary

  Objective: To investigate the associations between body composition, cardiorespiratory and muscular fitness in relation to travel mode to school in children and adolescents. Method: Children and adolescents from 40 elementary schools and 23 high schools representing all regions in Norway were invited to participate in the study. Anthropometry, cardiorespiratory and muscular fitness were tested at the school location. Questionnaires were used in order to register mode of transport to school, age, gender and levels of leisure time physical activity. Results: A total of 1694 (i.e. 60% of all invited participants) children and adolescents at a mean age of 9.6 and 15.6 respectively (SD = 0.4 for both groups) were analyzed for associations with physical fitness variables. Males cycling to school had lower sum of skin folds than adolescents walking to school. Higher cardiorespiratory fitness in adolescents and male cyclists compared to walkers and passive commuters were observed. Among children, cycling and walking to school, higher isometric muscle endurance in the back extensors compared to passive commuters was observed. Conclusion: Based on this national representative cross-sectional examination of randomly selected children and adolescents there is evidence that active commuting, especially cycling, is associated with a favourable body composition and better cardiorespiratory and muscular fitness as compared to passive commuting.

• Steene-Johannessen, Jostein; Kolle, Elin; Andersen, Lars Bo & Anderssen, Sigmund Alfred (2013). Adiposity, Aerobic Fitness, Muscle Fitness, and Markers of Inflammation in Children. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 45(4), p. 714–721. doi: 10.1249/MSS.0b013e318279707a. Full text in Research Archive Show summary

  Purpose: The purpose of this study was to describe levels of inflammation markers in Norwegian children and to examine the associations of adiposity, aerobic fitness and muscle fitness with markers of inflammation. Methods: In 2005-2006, 1467 9-year-olds wererandomly selected from all regions in Norway. The participation rate was 89%. The inflammatory markers evaluated included C-reactive protein (CRP), leptin, adiponectin, plasminogen activator inhibitor-1, tumor necrosis factor- [alpha] (TNF-[alpha]), hepatocyte growth factor, resistin and interleukin-6. We assessed muscular strength by measuring explosive, isometric and endurance strength. Aerobic fitness was measured directly during a maximal cycle ergometer test. Adiposity was expressed as waist circumference (WC). Results: The girls had significantly higher levels of CRP, leptin, adiponectin and resistin and lower levels of TNF-[alpha] compared to the boys. We observed a graded association of CRP and leptin levels across quintiles of WC, aerobic fitness and muscle fitness (P <=0.001 for all participants). The regression analyses revealed that WC, aerobic fitness and muscle fitness were independently associated with the CRP (WC [beta]= 0.158, P < 0.001; aerobic fitness [beta]= -0.190, P < 0.001; muscle fitness [beta]= -0.158, P < 0.002) after adjustments for gender, age, Tanner pubertal stage and the other independent variables. The same pattern was observed for leptin levels (WC [beta]= 0.406, P < 0.001; aerobic fitness [beta]= -0.298, P < 0.001; muscle fitness [beta]= -0.064, P < 0.036). Conclusions: These data represent a reference material with respect to inflammatory markers. Our results show that adiposity, aerobic and muscle fitness were independently associated with the CRP and leptin levels.

• Hansen, Bjørge Hermann; Kolle, Elin; Dyrstad, Sindre Mikal; Holme, Ingar Morten K & Anderssen, Sigmund Alfred (2012). Accelerometer-Determined Physical Activity in Adults and Older People. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 44(2), p. 266–272. doi: 10.1249/MSS.0b013e31822cb354. Full text in Research Archive Show summary

  Purpose: There is a lack of large-scale comparable data on the population levels of physical activity (PA) and sedentary activity. We conducted a cross-sectional population-based multicenter study to describe the levels of PA and sedentary activity and to determine adherence to current national PA recommendations in Norwegian adults and older people. Methods: In 2008 and 2009, PA was assessed objectively for seven consecutive days using the ActiGraph GT1M accelerometer in 3867 participants age 20–85 yr. A total of 3267 participants provided valid PA assessments that met all inclusion criteria. Results: Women and men did not differ in the overall activity levels (335 and 342 counts per minute, respectively) or in steps per day (8113 and 7951 steps per day, respectively). However, for intensity-specific PA, men accumulated significantly more minutes of sedentary activity and moderate-to-vigorous PA (MVPA) compared with women (557 vs 533 min of sedentary activity, P <= 0.001 and 35 vs 33 min of MVPA, P = 0.01). Both overall activity levels and steps per day remained steady with age, until 65 yr, after which activity levels declined. Conclusions: Overall, the study sample spent 62% of their time being sedentary, 25% in low-intensity PA, 9% in lifestyle activity, and 4% in MVPA. One in five people met current national PA recommendations. These results suggest that adults and older people spend the majority of their time being sedentary and that adherence to PA recommendations is low.

• Svege, Ida Charlott; Kolle, Elin & Risberg, May Arna (2012). Reliability and validity of the Physical Activity Scale for the Elderly (PASE) in patients with hip osteoarthritis. BMC Musculoskeletal Disorders. 13. doi: 10.1186/1471-2474-13-26. Full text in Research Archive Show summary

  Background: Physical activity (PA) is beneficial in reducing pain and improving function in lower limb osteoarthritis (OA), and is recommended as a first line treatment. Self-administered questionnaires are used to assess PA, but knowledge about reliability and validity of these PA questionnaires are limited, in particular for patients with OA. The purpose of this study was to evaluate the reliability and validity of the Physical Activity Scale for the Elderly (PASE) in patients with hip OA. Methods: Forty patients with hip OA (20 men and 20 women, mean age 61.3 ± 10 years) were included. For test-retest reliability PASE was administered twice with a mean time between tests of 9 ± 4 days. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated for the total score and for the particular items assessing different PA intensity levels. In addition a Bland-Altman analysis for the total PASE score was performed. Construct validity was evaluated by comparing the PASE results with the Actigraph GT1M accelerometer and the International Physical Activity Questionnaire (IPAQ), using the Spearman rank correlation coefficient. Results: ICC for the total PASE score was 0.78, with relatively large error of measurement; SEM = 31 and MDC = 87. ICC for the intensity items was 0.20 for moderate PA intensity, 0.46 for light PA intensity and to 0.68 for vigorous PA intensity. The Spearman rank correlation coefficient between the Actigraph GT1M total counts per minute and the total PASE score was 0.30 (p = 0.089), and ranging from 0.20-0.38 for the different PA intensity categories. The Spearman rank correlation between IPAQ and PASE was 0.61 (p = 0.001) for the total scores. Conclusions: In patients with hip OA the test-retest reliability of the total PASE score was moderate, with acceptable ICC, but with large measurement errors. The construct validity of the PASE was poor when compared to the Actigraph GT1M accelerometer. Test-retest reliability and construct validity revealed that the PASE was unable to assess PA intensity levels. PASE is not recommended as a valid tool to examine PA level for patients with hip OA.

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• Kolle, Elin; Steene-Johannessen, Jostein & Anderssen, Sigmund Alfred (2025). The Impact of Screen Time and Social Media Use on Physical Activity. Nordic Journal of Digital Literacy. 20(1), p. 40–44. doi: 10.18261/njdl.20.1.7. Full text in Research Archive
• Malnes, Lena; Berntsen, Sveinung; Kolle, Elin; Ivarsson, Andreas & Dyrstad, Sindre Mikal (2023). School-based physical activity in relation to active travel among adolescents. Full text in Research Archive
• Steinacker, Jürgen M.; Mechelen, Willem Van; Bloch, Wilhelm; Börjesson, Mats; Casasco, Maurizio & Wolfarth, Bernd [Show all 113 contributors for this article] (2023). Global Alliance for the Promotion of Physical Activity: the Hamburg Declaration. BMJ Open Diabetes Research & Care. 9(3). doi: 10.1136/bmjsem-2023-001626. Full text in Research Archive Show summary

  Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the ‘Hamburg Declaration’. This represented an international commitment to take all necessary actions to increase PA and improve the health of individuals to entire communities. Individuals and organisations are working together as the ‘Global Alliance for the Promotion of Physical Activity’ to drive long-term individual and population-wide behaviour change by collaborating with all stakeholders in the community: active hospitals, physical activity specialists, community services and healthcare providers, all achieving sustainable health goals for their patients/clients. The ‘Hamburg Declaration’ calls on national and international policymakers to take concrete action to promote daily PA and exercise at a population level and in healthcare settings.

• Åvitsland, Andreas; Dyrstad, Sindre Mikal; Lerum, Øystein; Leibinger, Eva; Solberg, Runar Barstad & Kolle, Elin [Show all 7 contributors for this article] (2019). Physical fitness and mental health in adolescents - What we know, and what we don't. Full text in Research Archive
• Kwon, Soyang; Andersen, Lars Bo; Grøntved, Anders; Kolle, Elin; Cardon, Greet & Davey, Rachel [Show all 14 contributors for this article] (2019). Correction to: A closer look at the relationship among accelerometer-based physical activity metrics: ICAD pooled data (Int J Behav Nutr Phys Act (2019) 16:40 DOI: 10.1186/s12966-019-0801-x). International Journal of Behavioral Nutrition and Physical Activity. 16(1). doi: 10.1186/s12966-019-0828-z. Full text in Research Archive
• Leibinger, Eva; Åvitsland, Andreas; Resaland, Geir Kåre; Solberg, Runar Barstad; Kolle, Elin & Dyrstad, Sindre Mikal (2019). Relationship between health-related quality of life, cardiorespiratory fitness and muscular fitness in adolescents​. Full text in Research Archive
• Åvitsland, Andreas; Säfvenbom, Reidar; Tjomsland, Hege Eikeland; Kolle, Elin; Resaland, Geir Kåre & Berntsen, Sveinung [Show all 9 contributors for this article] (2019). A new approach to school time physical activity: The "Don't worry, be happy" intervention model. Full text in Research Archive
• Engen, Kethe Marie Elgesem; Sundgot-Borgen, Christine; Torstveit, Monica Klungland; Rosenvinge, Jan H; Friborg, Oddgeir & Bratland-Sanda, Solfrid [Show all 8 contributors for this article] (2018). Is disordered eating related to muscle-enhancing supplement use and exercise context in adolescents? Full text in Research Archive
• Sundgot-Borgen, Christine; Engen, Kethe Marie Elgesem; Rosenvinge, Jan H; Pettersen, Gunn; Friborg, Oddgeir & Sundgot-Borgen, Jorunn [Show all 9 contributors for this article] (2018). Positive body image and meeting the physical activity recommendations across physical activity arenas in adolescents. Full text in Research Archive
• Solbraa, Ane; Anderssen, Sigmund Alfred; Holme, Ingar Morten K; Kolle, Elin; Hansen, Bjørge Hermann & Ashe, Maureen C (2016). The built environment correlates of objectively measured physical activity in Norwegian adults: a cross-sectional study. Full text in Research Archive
• Hansen, Bjørge Hermann; Nilsen, Ada Kristine Ofrim; Dalene, Knut Eirik; Steene-Johannessen, Jostein; Kolle, Elin & Ekelund, Ulf [Show all 7 contributors for this article] (2016). Cross-sectional and Longitudinal Associations of Replacing Sedentary Time with Active Behaviors on the Body Mass Index. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 48, p. 232–232. doi: 10.1249/01.mss.0000485698.85376.e6. Full text in Research Archive
• Solbraa, Ane; Anderssen, Sigmund Alfred; Holme, Ingar Morten K; Kolle, Elin; Hansen, Bjørge Hermann & Ashe, Maureen C (2014). Walk the talk – built environment and physical activity. The Complexity of Obesity Proceedings. 2. doi: 10.6084/m9.figshare.1211862. Full text in Research Archive
• Solbraa, Ane; Anderssen, Sigmund Alfred; Holme, Ingar Morten K; Kolle, Elin; Hansen, Bjørge Hermann & Ashe, Maureen C (2014). Walk the talk – built environment and physical activity. Full text in Research Archive
• Kolle, Elin; Stokke, Johanne Støren; Hansen, Bjørge Hermann & Anderssen, Sigmund Alfred (2013). Accelerometer-derived Physical Activity Levels And Transport To School Among A Population-based Sample Of Norwegian 6-year-olds. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 45(5), p. 390–391. Full text in Research Archive
• Stokke, Johanne Støren; Kolle, Elin; Hansen, Bjørge Hermann & Anderssen, Sigmund Alfred (2013). Physical Activity Among Children And Youth With Ethnic Minority Background In Norway. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 45(5), p. 466–466. Full text in Research Archive
• Svege, Ida Charlott; Kolle, Elin & Risberg, Marianne (2012). RELIABILITY AND VALIDITY OF THE PHYSICAL ACTIVITY SCALE FOR THE ELDERLY (PASE) IN PATIENTS WITH HIP OSTEOARTHRITIS. Osteoarthritis and Cartilage. ISSN 1063-4584. 20, p. S266–S266. Full text in Research Archive
• Kolle, Elin; Steene-Johannessen, Jostein; Andersen, Lars Bo & Anderssen, Sigmund Alfred (2012). Sedentary Behavior And Overweight In Children And Adolescents. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 44, p. 664–664. Full text in Research Archive
• Stokke, Johanne Støren; Kolle, Elin; Hansen, Bjørge Hermann & Anderssen, Sigmund Alfred (2012). Fysisk aktivitet blant barn og unge med innvandringsbakgrunn (ungKan2). Full text in Research Archive
• Stokke, Johanne Støren; Kolle, Elin; Hansen, Bjørge Hermann & Anderssen, Sigmund Alfred (2012). Fysisk aktivitet blant barn og unge med innvandringsbakgrunn (ungKan2). Norsk idrettsmedisin. ISSN 0806-9328. 27(3), p. 23–23. Full text in Research Archive
• Hansen, Bjørge Hermann; Holme, Ingar Morten K; Anderssen, Sigmund Alfred & Kolle, Elin (2012). Body Mass Index And Accelerometer-determined Physical Activity: A Linear Dose-response Relationship. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 44, p. 232–232. Full text in Research Archive
• Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Teinung, Elisabeth; Kolle, Elin; Riiser, Amund & Mølmen, Knut Sindre [Show all 12 contributors for this article] (2024). Fysisk form blant voksne og eldre i Norge 2022-2023 (Kan3). Folkehelseinstituttet. Full text in Research Archive Show summary

  <b>Sammendrag av hovedfunn</b> - Kartleggingen av fysisk form blant voksne og eldre i Norge 2022-23 (Kan3 fase 2) er utført ved Norges idrettshøgskole i samarbeid med Folkehelseinstituttet. Kan3 fase 2 inngår som en del av det nasjonale kartleggingssystemet for fysisk aktivitet og fysisk form der formålet er å følge opp tidligere undersøkelser av voksne og eldre for å øke kunnskapen om status, trender og utviklingen av fysisk form i den norske befolkingen. Datainnsamlingen i Kan3 fase 2 er gjennomført i samarbeid med Universitetet i Stavanger, Universitetet i Agder, UiT Norges arktiske universitet, Høgskulen på Vestlandet og Høgskolen i Innlandet i perioden august 2022 til april 2023.<p> <p>Et tilfeldig utvalg av deltakere som deltok i Kan3 fase 1 (hovedutvalg) ble invitert til fysisk oppmøte for gjennomføring av tester for å måle fysisk form i Kan3 fase 2. Som beskrevet i Kan 3 fase 1 rapport ble det også rekruttert deltakere som var 67+ år gjennom egne rekrutteringsstrategier mot seniorsenter i de store byene. Disse deltakerne gjennomførte tester av gripestyrke, balanse og bevegelighet, men de gjennomførte ikke test av maksimalt oksygenopptak.<p> <p>Av totalt 2001 personer som ble invitert, samtykket 1503 personer til deltakelse i Kan3 fase 2. Som vist i Kan 3 fase 1 er utvalget noe selektert da det er forholdsvis flere med høy sosioøkonomisk status i utvalget sammenlignet med den øvrige befolkningen. Den samme selekteringen er følgelig med videre inn i fase 2, og det betyr at beregninger for fysisk form trolig vil være noe overestimert.<p> <p><b>Maksimalt oksygenopptak (VO2max)</b> - Menn hadde høyere maksimalt oksygenopptak enn kvinner i alle aldergrupper. Oksygenopptaket falt med henholdsvis 2.8 ml∙kg-1∙min-1 og 3.9 ml∙kg-1∙min-1 blant kvinner og menn per 10 års økning i alder. Blant både menn og kvinner, hadde den femtedelen av deltakerne med høyest oksygenopptak et oksygenopptak som var omtrent dobbelt så høyt som den femtedelen av deltakerne med lavest oksygenopptak. Deltakere som tilfredsstilte Helsedirektoratets anbefaling for fysisk aktivitet, hadde høyere oksygenopptak sammenlignet med de som ikke tilfredsstilte anbefalingen. Oksygenopptaket økte med høyere utdanningsnivå blant menn, men ikke blant kvinner.<p> <p><b>Gripestyrke, balanse og bevegelighet</b> - Yngre hadde høyere gripestyrke enn eldre, og menn hadde høyere gripestyrke enn kvinner. Balansen reduseres med økende alder og en stor reduksjon sees etter fylte 60 år. Generelt var bevegeligheten i hofte og skulderledd bedre blant kvinner enn menn. For begge kjønn reduseres bevegeligheten med økende alder. Det var ingen sammenheng mellom gripestyrke, balanse og utdanning, men bevegelighet i hofteledd økte med høyere utdanning blant kvinner.<p> <p><b>Trender</b> - Både menn og kvinner i Kan3 fase 2 hadde et høyere maksimalt oksygenopptak enn menn og kvinner som deltok i Kan1 fase 2 i 2008-09. Menn hadde et oksygenopptak som var 2.3 ml∙kg-1∙min-1 (95% KI: 1.1 – 3.4) høyere i Kan3 sammenliknet med i Kan1, og tilsvarende forskjell for kvinner var 2.6 ml∙kg-1∙min-1 (95% KI: 1.6 – 3.5). Dette tilsvarer en prosentuell forskjell mellom Kan1 og Kan3 på 6-7%. Data må dog tolkes med forsiktighet fordi utvalget i Kan 1 er noe ulikt utvalget i Kan 3. Det var ingen forskjeller i gripestyrke når vi sammenlignet deltakere i Kan3 med deltakere i Kan1.<p> <p><b>Praktiske implikasjoner</b> - I gjennomsnitt har deltakere i Kan3 et oksygenopptak som er godt over eller på nivå med foreslåtte internasjonale og nasjonale grenseverdier for anbefalt VO2max. Spredningen i materialet er imidlertid betydelig og for den femtedelen av deltakerne med lavest oksygenopptak ligger verdiene betydelig lavere enn anbefalte verdier, noe som kan gi økt risiko for sykdom og tidlig død. I denne gruppen vil selv dagligdagse aktiviteter, som det å gå i trapper eller å sykle kreve en så stor andel av det maksimale oksygenopptaket at det vil være vanskelig å delta i slike aktiviteter i mer enn noen få minutter. Oksygenopptaket er imidlertid trenbart uansett alder og utgangspunkt. En økning i det maksimale oksygenopptaket hos denne gruppen vil kunne ha stor betydning for å sikre en god fysisk funksjon, det vil si gi økt mestring av dagliglivets aktiviteter.<p> <p>Lav gripestyrke er også assosiert med økt risiko for sykelighet og tidlig død. Selv om muskelmassen og maksimal styrke faller naturlig med økende alder, vil regelmessig styrketrening kunne forebygge mye av dette fallet. Styrketrening er spesielt viktig fra 50–60-årsalderen, og selv personer over 70 år vil kunne øke både muskelmassen og styrken betraktelig ved å starte med regelmessig styrketrening.

• Kolle, Elin; Lyngdal, Anne Bang; Hofmann, Peder & Egset, Kristoffer Myklebust (2023). Tilsynsrapport - Oslo Nye Høyskole - Periodisk tilsyn med systematisk kvalitetsarbeid. NOKUT. Full text in Research Archive
• Hansen, Bjørge Hermann; Steene-Johannessen, Jostein; Kolle, Elin; Udahl, Karine; Kaupang, Oda Bjørge & Andersen, Inge Dehli [Show all 10 contributors for this article] (2023). Kartlegging av fysisk aktivitet blant voksne og eldre 2020-22 (Kan3). Folkehelseinstituttet. Full text in Research Archive Show summary

  Kartlegging av fysisk aktivitet og stillesittende tid blant voksne og eldre (Kan3) er utført ved Norges idrettshøgskole i samarbeid med Folkehelseinstituttet. Formålet med Kan3 er å følge opp tidligere undersøkelser av voksne og eldre for å øke kunnskapen om status, trender og utviklingen av fysisk aktivitet i den norske befolkingen. Kan3 inngår som en del av det nasjonale kartleggingssystemet av fysisk aktivitet og fysisk form. De norske ungKan- og Kan-undersøkelsene er unike ved at fysisk aktivitet er målt objektivt ved hjelp av akselerometre i populasjonsbaserte utvalg ved flere tidspunkt. Dette gir mer nøyaktige estimater av befolkingens fysiske aktivitetsnivå enn ved spørreskjemabaserte undersøkelser. Slik kunnskap er nødvendig for å kunne iverksette tiltak for å redusere stillesitting og øke det fysiske aktivitetsnivået.

• Kolle, Elin; Steene-Johannessen, Jostein; Säfvenbom, Reidar; Anderssen, Sigmund Alfred; Grydeland, May & Ekelund, Ulf [Show all 17 contributors for this article] (2019). Hovedrapport: School in motion. Utdanningsdirektoratet. Full text in Research Archive
• Hagen, Aina Landsverk; Andersen, Bengt; Brattbakk, Ingar; Dahlgren, Kenneth; Ascher, Barbara Elisabeth & Kolle, Elin (2016). Ung & ute. En studie av ungdom og unge voksnes bruk av uterom. Arbeidsforskningsinstituttet. ISSN 9788276093742. Full text in Research Archive
• Kolle, Elin; Stokke, Johanne Støren; Hansen, Bjørge Hermann & Anderssen, Sigmund Alfred (2012). Fysisk aktivitet blant 6-, 9- og 15-åringer i Norge : resultater fra en kartlegging i 2011. Helsedirektoratet. ISSN 9788280812629. Full text in Research Archive

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