Jakob Tarp

• Tarp, Jakob; Sanchez-Lastra, Miguel Adriano; Dalene, Knut Eirik; Luo, Mengyun; Nguyen, Binh & Mielke, Gregore Iven [Vis alle 9 forfattere av denne artikkelen] (2026). Long-term physical activity and risk of obesity in Australian women using target-trial emulation: an OBCT study. International Journal of Epidemiology. ISSN 0300-5771. 55(5). doi: 10.1093/ije/dyag174. Fulltekst i vitenarkiv Vis sammendrag

  Background: Physical activity is recommended for obesity prevention, but the evidence is limited by possible biases from reverse causation and confounding, and there are limited data on the long-term effects of physical activity through middle age on the development of obesity. Methods: We emulated a target trial by using 10 waves of observational data from the 1946–51 Australian Longitudinal Study on Women’s Health collected between 1996 and 2022. The target trial would determine the effect of randomizing women to either meeting or not meeting the World Health Organization’s recommended level of physical activity over an 18-year period on the 21-year incidence of obesity. Targeted maximum-likelihood estimation controlling for time-constant and time-varying confounders was used to emulate the target trial, assuming conditional exchangeability, positivity, consistency, and no interference. Results: In total, 779 women aged 47–52 years at study entry were included. The cumulative incidence of obesity was 9.9% [99.5% confidence interval (CI): 8.6%, 11.1%] in the scenario with 18-year adherence to the recommendation and 15.1% (99.5% CI: 12.8%, 17.4%) with consistent non-adherence (risk ratio: 1.5, 99.5% CI: 1.2, 1.9; risk difference: 5.3%-point, 99.5% CI: 2.3%, 8.3%). Each additional survey with non-adherence increased the risk of obesity (risk ratio: 1.1, 99.5% CI: 1.0, 1.1). There was no additional benefit of meeting a higher physical-activity target. Conclusion: The results of our analysis, designed specifically to address the key limitations of previous evidence, underscore the benefits of long-term adherence to the recommended ≥150 minutes of moderate-to-vigorous physical activity per week for obesity prevention in middle-aged women.

• Luo, Mengyun; Clare, Philip James; Tarp, Jakob; Dalene, Knut Eirik; Sanchez-Lastra, Miguel Adriano & Nguyen, Binh [Vis alle 11 forfattere av denne artikkelen] (2026). Dose-response interplay between light and moderate-to-vigorous physical activity on all-cause mortality risk: a causal inference analysis. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2025-110782. Fulltekst i vitenarkiv
• Ekelund, Ulf; Tarp, Jakob; Ding, Ding; Sanchez-Lastra, Miguel Adriano; Dalene, Knut Eirik & Anderssen, Sigmund Alfred [Vis alle 20 forfattere av denne artikkelen] (2026). Deaths potentially averted by small changes in physical activity and sedentary time: an individual participant data meta-analysis of prospective cohort studies. The Lancet. ISSN 0140-6736. 407(10526), s. 339–349. doi: 10.1016/S0140-6736(25)02219-6. Fulltekst i vitenarkiv
• Salvo, Deborah; Crochemore-Silva, Inacio; Wendt, Andrea; Tarp, Jakob; Shiroma, Eric J. & Simpson, Richard J. [Vis alle 19 forfattere av denne artikkelen] (2026). Physical activity for public health in the 21st century. Nature Medicine. ISSN 1078-8956. doi: 10.1038/s41591-026-04237-5. Fulltekst i vitenarkiv
• Sanchez-Lastra, Miguel Adriano; Cruz, Borja del Pozo; Tarp, Jakob; Dalene, Knut Eirik; Nilsen, Tormod Skogstad & Ding, Ding [Vis alle 7 forfattere av denne artikkelen] (2026). Dose‒response associations of self-reported and device-measured physical activity with major adverse cardiovascular events in people with prevalent diseases. Journal of Sport and Health Science. ISSN 2095-2546. 15. doi: 10.1016/j.jshs.2025.101116. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: To investigate the dose-response associations of self-reported and device-measured physical activity with major adverse cardiovascular events (MACE) and cardiovascular disease (CVD) mortality in individuals with a history of CVD, type 2 diabetes mellitus (T2DM), or cancer. Methods: We analyzed data from 34,183 UK Biobank participants (CVD: n = 8703; T2DM: n = 11,623; cancer: n = 13,857; age = 60.0 ± 7.1 years, mean ± SD; 45.3% women). Physical activity was assessed using self-reports and wrist-worn accelerometers in a subsample (n = 6077). Dose‒response associations with MACE and CVD mortality were evaluated using Fine-Gray competing-risk models with penalized splines, adjusting for confounders. Results: During a median follow-up of 13.1 years, 8729 MACE and 982 CVD deaths were recorded. Self-reported physical activity showed non-linear inverse associations with MACE, with the optimal dose (nadir) observed at ≈4000 MET-min/week in CVD (hazard ratio (HR) = 0.95) and cancer (HR = 0.92) and ≈6000 MET-min/week in T2DM (HR = 0.91), compared to participants in the 5th centiles of activity. For CVD mortality, the optimal dose was observed at ≈5000 MET-min/week in CVD (HR = 0.86) and cancer (HR = 0.62), respectively. Device-measured moderate-to-vigorous intensity physical activity showed stronger dose‒response associations with MACE for T2DM (optimal dose observed at ≈200 min/week, HR = 0.88) and cancer (optimal dose at ≈700 min/week, HR = 0.27, wide confidence intervals). Conclusion: Physical activity could reduce MACE risk in people with a history of CVD, T2DM, or cancer. While a similar shape of dose-response patterns was observed across these groups, self-reported data suggested the minimal effective dose might exceed current World Health Organization recommendations. However, device-measured data supported existing guidelines for people with T2DM and cancer survivors.

• Cadenas-Sanchez, Cristina; Sanchez-Lastra, Miguel Adriano; Tarp, Jakob; Ekelund, Ulf & Dalene, Knut Eirik (2025). Occupational physical activity and incidence and mortality of 14 cancers in 404,249 adults. Nature Communications. 16. doi: 10.1038/s41467-025-65326-6. Fulltekst i vitenarkiv Vis sammendrag

  Leisure physical activity is considered protective against several cancers, but the impact of physical activity at work remains unclear. We analyze data from over 400,000 Norwegian adults followed for a median of 27 years to examine how different levels of occupational physical activity are associated with cancer incidence and mortality. Participants report their typical work activity as sedentary, walking, walking-and-lifting, or heavy labor. Here we show that individuals with more physically active jobs have a lower risk of developing several cancers (i.e., endometrial, colon, breast, rectal, and prostate), and to a lesser extent, the risk of breast cancer mortality. However, occupational physical activity is also associated with increased risk of esophageal and kidney cancer death. These findings suggest that occupational physical activity may lower the incidence of some cancers but are associated with a higher mortality from other cancer types. Understanding these patterns could help tailor public health recommendations related to physical activity and occupational health.

• Lam, Thao Minh; Aarestrup, Julie; Akker, Erica L. T. van den; Baker, Jennifer L.; Banik, Anna & Berntzen, Bram J. [Vis alle 56 forfattere av denne artikkelen] (2025). Advancing knowledge, maps and tools to address obesity and related socio-economic disparities in Europe: the OBCT project. Global health action. ISSN 1654-9716. 18(1). doi: 10.1080/16549716.2025.2517492. Fulltekst i vitenarkiv Vis sammendrag

  The steady rise in overweight and obesity in Europe disproportionately affects people and communities with a lower socio-economic position (SEP). Many obesity prevention approaches exist, but these have had limited reach and unsatisfactory effects thus far, especially in low-SEP populations. In this context, there is a need for implementation of effective individual-level and population-based preventive strategies that also tackle health inequalities. Effective strategies require consideration of the complex and cross-domain obesity risk factors across the life course. Feasible and acceptable strategies require multisectoral collaborations and innovative approaches, including a whole-of community and systems perspective. With the Horizon Europe-funded OBCT project, we aim to quantify the relative contribution of biological, socio-cultural and built environment factors to obesity and the interactions of these risks within and across various life course stages; and translate the resulting knowledge into practical, equitable, and effective tools for action. These tools will include: a comprehensive obesity risk screener; a map of the obesogenicity of neighbourhood environments as well as trends in obesity prevalence of each European country; recommendations for lifestyle behaviours (diet, physical activity, sedentary behaviours) to prevent obesity during key life transition stages; a decision support dashboard for policy makers; and co-developed toolboxes to support implementation of policy recommendations in low-SEP communities. OBCT’s outputs will highlight the areas and domains in which obesity should be targeted and will empower the research community, policymakers, health professionals and residents in Europe to adapt and implement strategies to effectively reduce obesity risk, particularly in low-SEP communities.

• Sanchez-Lastra, Miguel Adriano; Cruz, Borja del Pozo; Ekelund, Ulf; Tarp, Jakob & Ding, Ding (2025). Physical Activity and Life Expectancy Free of Cancer: Prospective Evidence From the UK Biobank Study. Journal of Physical Activity and Health. ISSN 1543-3080. 22(5), s. 636–639. doi: 10.1123/jpah.2024-0390. Fulltekst i vitenarkiv
• Sanchez-Lastra, Miguel Adriano; Strain, Tessa; Ding, Ding; Dalene, Knut Eirik; Cruz, Borja del Pozo & Ekelund, Ulf [Vis alle 7 forfattere av denne artikkelen] (2025). Associations of adiposity and device-measured physical activity with cancer incidence: UK Biobank prospective cohort study. Journal of Sport and Health Science. ISSN 2095-2546. 14. doi: 10.1016/j.jshs.2024.101018. Fulltekst i vitenarkiv
• Dohrn, Ing-Mari; Tarp, Jakob; Steene-Johannessen, Jostein; Vasankari, Tommi & Hagströmer, Maria (2024). Device-measured physical activity and sedentary time in the Nordic countries: A scoping review of population-based studies. Journal of Sport and Health Science. ISSN 2095-2546. 13(5), s. 650–660. doi: 10.1016/j.jshs.2024.04.003. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time measured with devices in the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) and published in 2000 or later. Methods: A systematic search was carried out in PubMed and Web of Science in June 2023 using predefined search terms. Results: Fourteen unique research projects or surveillance studies were identified. Additionally, 2 surveillance studies published by national agencies were included, resulting in a total of 16 studies for inclusion. National surveillance systems exist in Finland and Norway, with regular survey waves in school-aged children/adolescents and adults. In Denmark, recent nationally representative data have been collected in school children only. So far, Sweden has no regular national surveillance system using device-based data collection. No studies were found from Iceland. The first study was conducted in 2001 and the most recent in 2022, with most data collected from 2016 to date. Five studies included children/adolescents 6–18 years, no study included preschoolers. In total 11 studies included adults, of which 8 also covered older adults. No study focused specifically on older adults. The analytical sample size ranged from 205 to 27,890. Detailed methodology is presented, such as information on sampling strategy, device type and placement, wear protocols, and physical activity classification schemes. Levels of physical activity and sedentary time in children/adolescents, adults, and older adults across the Nordic countries are presented. Conclusion: A growing implementation of device-based population surveillance of physical activity and sedentary behavior in the Nordic countries has been identified. The variety of devices, placement, and data procedures both within and between the Nordic countries highlights the challenges when it comes to comparing study outcomes as well as the need for more standardized data collection.

• Zhou, Bin; Cesare, Mariachiara Di; Aguilar-Salinas, Carlos A; Ahmad, Nor Ani; Bovet, Pascal & Chen, Zhengming [Vis alle 51 forfattere av denne artikkelen] (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), s. 851–863. doi: 10.1016/S0140-6736(24)01405-3. Fulltekst i vitenarkiv Vis sammendrag

  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).

• Ekelund, Ulf; Tarp, Jakob; Sanchez-Lastra, Miguel Adriano & Dalene, Knut Eirik (2024). Physical activity, sedentary time and health – a narrative review with new insights. Danish Medical Journal. 71(11). doi: 10.61409/A06240433. Fulltekst i vitenarkiv Vis sammendrag

  Physical activity and sedentary time are associated with multiple health outcomes, and benefits also extend to those living with chronic conditions. These observations are primarily based on data from studies in which self-reported data assessed physical activity. Recent data where physical activity and sedentary time are measured with devices suggest that the dose-response association between device-measured physical activity and risk of incident diseases and mortality is greater and observed at lower levels of physical activity than indicated by self-reported data.

• Tarp, Jakob; Dalene, Knut Eirik; Fagerland, Morten; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann & Anderssen, Sigmund Alfred [Vis alle 23 forfattere av denne artikkelen] (2024). Physical Activity Volume, Intensity, and Mortality: Harmonized Meta-Analysis of Prospective Cohort Studies. American Journal of Preventive Medicine. ISSN 0749-3797. 67(6), s. 887–896. doi: 10.1016/j.amepre.2024.07.022. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: It is unclear whether moderate-to-vigorous physical activity (MVPA) is associated with a lower mortality risk, over and above its contribution to total physical activity volume. Methods: 46,682 adults (mean age: 64 years) were included in a meta-analysis of nine prospective cohort studies. Each cohort generated tertiles of accelerometry-measured physical activity volume and volume-adjusted MVPA. Hazard ratios (HR, with 95% confidence intervals) for mortality were estimated separately and in joint models combining volume and MVPA. Data was collected between 2001 and 2019 and analyzed in 2023. Results: During a mean follow-up of 9 years, 4,666 deaths were recorded. Higher physical activity volume, and a greater contribution from volume-adjusted MVPA, were each associated with lower mortality hazard in multivariable-adjusted models. Compared to the least active tertile, higher physical activity volume was associated with a lower mortality (HRs: 0.62; 0.58, 0.67 and 0.50; 0.42, 0.60 for ascending tertiles). Similarly, a greater contribution from MVPA was associated with a lower mortality (HRs: 0.94; 0.85, 1.04 and 0.88; 0.79, 0.98). In joint analysis, a lower mortality from higher volume-adjusted MVPA was only observed for the middle tertile of physical activity volume. Conclusions: The total volume of physical activity was associated with a lower risk of mortality to a greater extent than the contribution of MVPA to physical activity volume. Integrating any intensity of physical activity into daily life may lower mortality risk in middle-aged and older adults, with a small added benefit if the same amount of activity is performed with a higher intensity.

• Tarp, Jakob; Luo, Mengyun; Sanchez-Lastra, Miguel Adriano; Dalene, Knut Eirik; Cruz, Borja Del Pozo & Ried-Larsen, Mathias [Vis alle 9 forfattere av denne artikkelen] (2023). Leisure-time physical activity and all-cause mortality and cardiovascular disease in adults with type 2 diabetes: Cross-country comparison of cohort studies. Journal of Sport and Health Science. ISSN 2095-2546. 13(2), s. 212–221. doi: 10.1016/j.jshs.2023.10.004. Fulltekst i vitenarkiv Vis sammendrag

  Background: This study aimed to quantify the dose–response association and the minimal effective dose of leisure-time physical activity (PA) to prevent mortality and cardiovascular disease in adults with type 2 diabetes. Methods: Cross-country comparison of 2 prospective cohort studies including 14,913 and 17,457 population-based adults with type 2 diabetes from the UK and China. Baseline leisure-time PA was self-reported and categorized by metabolic equivalent hours per week (MET-h/week) according to World Health Organization recommendations: none, below recommendation (>0–7.49 MET-h/week); at recommended level (7.5–14.9 MET-h/week); above recommendation (≥15 MET-h/week). Mortality and cardiovascular disease data were obtained from national registries. Results: During a median follow-up of 12.4 and 9.7 years, higher levels of leisure-time PA were inversely associated with all-cause (1571 and 2351 events) and cardiovascular mortality (392 and 1060 events) in both cohorts, mostly consistent with a linear dose–response relationship. PA below, at, and above recommendations, compared with no activity, yielded all-cause mortality hazard ratios of 0.94 (95% confidence interval (95%CI): 0.79–1.12), 0.90 (95%CI: 0.74–1.10), and 0.85 (95%CI: 0.70–1.02) in British adults and 0.87 (95%CI: 0.68–1.10), 0.88 (95%CI: 0.74–1.03), and 0.77 (95%CI: 0.70–0.85) in Chinese adults. Associations with cardiovascular mortality were more pronounced in British adults (0.80 (95%CI: 0.58–1.11), 0.75 (95%CI: 0.52–1.09), and 0.69 (95%CI: 0.48–0.97)) but less pronounced in Chinese adults (1.06 (95%CI: 0.76–1.47), 1.01 (95%CI: 0.80–1.28), and 0.79 (95%CI: 0.69–0.92)). PA at recommended levels was not associated with lower rates of major adverse cardiovascular events (2345 and 4458 events). Conclusion: Leisure-time PA at the recommended levels was not convincingly associated with lower mortality and had no association with risk of major adverse cardiovascular events in British or Chinese adults with type 2 diabetes. Leisure-time PA above current recommendations may be needed to prevent cardiovascular disease and premature mortality in adults with type 2 diabetes.

• Mishra, Anu; Zhou, Bin; Rodriguez-Martinez, Andrea; Bixby, Honor; Singleton, Rosie K. & Carrillo-Larco, Rodrigo M. [Vis alle 1 626 forfattere av denne artikkelen] (2023). Diminishing benefits of urban living for children and adolescents’ growth and development. Nature. ISSN 0028-0836. 615(7954), s. 874–883. doi: 10.1038/s41586-023-05772-8. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Sanchez-Lastra, Miguel Adriano; Ding, Ding; Dalene, Knut Eirik; Cruz, Borja del Pozo; Ekelund, Ulf & Tarp, Jakob (2023). Body composition and mortality from middle to old age: a prospective cohort study from the UK Biobank. International Journal of Obesity. ISSN 0307-0565. 47(8), s. 709–716. doi: 10.1038/s41366-023-01314-4. Fulltekst i vitenarkiv Vis sammendrag

  Background: How the association between adiposity and the risk of death changes with age, and which is the optimal level of adiposity to reduce mortality in older ages, is still not completely understood. We aimed to ascertain the age-specific risks of mortality associated with different measures of adiposity. Methods: This was a prospective UK Biobank cohort study. Participants were categorized based on five different adiposity and body composition metrics. We explored the age-varying associations between body composition indices and all-cause mortality from 45 to 85 years of age at follow-up using hazard ratios (HR) from flexible parametric survival models with multivariable adjustment and age as timescale. Participants were followed from baseline (2006–2010) through 31 March 2020. Results: We included 369,752 participants (mean baseline age = 56.3 ± 8.1 years; range 38.9–73.7 years; 54.1% women) and 10,660 deaths during a median follow-up of 11.4 years. Associations between body mass index and mortality were similar when using the fat mass index in magnitude and shape. Compared to participants with normal weight, overweight was not associated with the risk of death regardless of age and the adiposity measure used. Participants with obesity class I showed an HR of 1.20 (95% confidence interval [CI]: 1.08, 1.33) and 1.14 (95%CI: 0.98, 1.30) at ages 60 and 80, respectively, and participants with obesity class II an HR about 1.55 across all age. More attenuated associations with higher age were found in individuals with the highest obesity using the fat mass index. Very high lean mass was associated with an increased risk of mortality in those aged 55–75 years (HR about 1.20 across all ages). Conclusion: Obesity should be prevented at any age. Attenuated associations with older age were observed only among the individuals with the highest obesity, but the risk remained higher compared to normal-weight participants. Lean mass did not reduce mortality risk at any age.

• Ekelund, Ulf; Sanchez-Lastra, Miguel Adriano; Dalene, Knut Eirik & Tarp, Jakob (2023). Dose–response associations, physical activity intensity and mortality risk: A narrative review. Journal of Sport and Health Science. ISSN 2095-2546. 13(1), s. 24–29. doi: 10.1016/j.jshs.2023.09.006. Fulltekst i vitenarkiv Vis sammendrag

  Physical activity is consistently associated with reduced mortality, decreased risk for non-communicable diseases, and improved mental health in observational studies. Randomized controlled trials and observational Mendelian randomization studies support causal links between physical activity and health outcomes. However, the scarcity of evidence from randomized controlled trials, along with their inherent challenges like exposure contrasts, healthy volunteer biases, loss to follow-up, and limited real-world dose–response data, warrants a comprehensive approach. This review advocates synthesizing insights from diverse study designs to better understand the causal relationship between physical activity, mortality risk, and other health outcomes. Additionally, it summarizes recent research since the publication of current physical activity recommendations. Novel observational studies utilizing device-measured physical activity underscore the importance of every minute of activity and suggest that all intensity levels confer health benefits, with vigorous-intensity potentially requiring lower volumes for substantial benefits. Future guidelines, informed by device-measured physical activity studies, may offer refined age-specific recommendations, emphasize vigorous-intensity physical activity, and include daily step counts as a simple, easily assessable metric using commercial wearables.

• Sagelv, Edvard Hamnvik; Hopstock, Laila Arnesdatter; Morseth, Bente; Hansen, Bjørge Hermann; Steene-Johannessen, Jostein & Johansson, Jonas Lars [Vis alle 12 forfattere av denne artikkelen] (2023). Device-measured physical activity, sedentary time, and risk of all-cause mortality: an individual participant data analysis of four prospective cohort studies. British Journal of Sports Medicine. ISSN 0306-3674. 57(22), s. 1457–1463. doi: 10.1136/bjsports-2022-106568. Fulltekst i vitenarkiv Vis sammendrag

  Objectives - To examine whether moderate-to-vigorous physical activity (MVPA) modifies the association between sedentary time and mortality and vice versa, and estimate the joint associations of MVPA and sedentary time on mortality risk.<p> <p>Methods - This study involved individual participant data analysis of four prospective cohort studies (Norway, Sweden, USA, baseline: 2003–2016, 11 989 participants ≥50 years, 50.5% women) with hip-accelerometry-measured physical activity and sedentary time. Associations were examined using restricted cubic splines and fractional polynomials in Cox regressions adjusted for sex, education, body mass index, smoking, alcohol, study cohort, cardiovascular disease, cancer, and/or diabetes, accelerometry wear time and age.<p> <p>Results - 6.7% (n=805) died during follow-up (median 5.2 years, IQR 4.2 years). More than 12 daily sedentary hours (reference 8 hours) was associated with mortality risk only among those accumulating <22 min of MVPA per day (HR 1.38, 95% CI 1.10 to 1.74). Higher MVPA levels were associated with lower mortality risk irrespective of sedentary time, for example, HR for 10 versus 0 daily min of MVPA was 0.85 (95% CI 0.74 to 0.96) in those accumulating <10.5 daily sedentary hours and 0.65 (95% CI 0.53 to 0.79) in those accumulating ≥10.5 daily sedentary hours. Joint association analyses confirmed that higher MVPA was superior to lower sedentary time in lowering mortality risk, for example, 10 versus 0 daily min of MVPA was associated with 28–55% lower mortality risk across the sedentary time spectrum (lowest risk, 10 daily sedentary hours: HR 0.45, 95% CI 0.31 to 0.65).<p> <p>Conclusions - Sedentary time was associated with higher mortality risk but only in individuals accumulating less than 22 min of MVPA per day. Higher MVPA levels were associated with lower mortality risk irrespective of the amount of sedentary time.

• Sanchez-Lastra, Miguel Adriano; Ding, Ding; Cruz, Borja Del Pozo; Dalene, Knut Eirik; Ayán, Carlos & Ekelund, Ulf [Vis alle 7 forfattere av denne artikkelen] (2023). Joint associations of device-measured physical activity and abdominal obesity with incident cardiovascular disease: a prospective cohort study. British Journal of Sports Medicine. ISSN 0306-3674. 58(4), s. 196–203. doi: 10.1136/bjsports-2023-107252. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To examine the joint associations between physical activity and abdominal obesity with the risk of cardiovascular disease (CVD) events. Methods: We included 70 830 UK Biobank participants (mean age±SD=61.6 ± 7.9 years; 56.4% women) with physical activity measured by wrist-worn accelerometers and without major chronic diseases. Participants were jointly categorised into six groups based on their physical activity level (tertiles of total volume and specific intensity levels) and presence or absence of abdominal obesity based on measured waist circumference. Associations with incident CVD (fatal and non-fatal events) were determined using proportional subdistribution hazard models with multivariable adjustment. Results: After excluding events during the first 2 years of follow-up, participants were followed for a median of 6.8 years, during which 2795 CVD events were recorded. Compared with the low abdominal adiposity and highest tertile of physical activity, abdominal obesity was associated with higher risk of incident CVD, especially in those with low levels of vigorous-intensity physical activity (HR 1.42, 95% CI 1.22 to 1.64). Approximately 500 min per week of moderate-to-vigorous intensity and approximately 30–35 min of vigorous-intensity physical activity offset the association of abdominal obesity and the risk of having a CVD event. Conclusion: Physical activity equivalent to approximately 30–35 min of vigorous intensity per week appears to offset the association between abdominal obesity and incident CVD. About 15 times more physical activity of at least moderate intensity is needed to achieve similar results.

• Dalene, Knut Eirik; Kolle, Elin; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Ekelund, Ulf & Grydeland, May [Vis alle 8 forfattere av denne artikkelen] (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), s. 1556–1567. doi: 10.1093/ije/dyac063. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Argent, Rob; Hetherington-Rauth, Megan; Stang, Julie; Tarp, Jakob; Ortega, Francisco B. & Molina-Garcia, Pablo [Vis alle 14 forfattere av denne artikkelen] (2022). Recommendations for Determining the Validity of Consumer Wearables and Smartphones for the Estimation of Energy Expenditure: Expert Statement and Checklist of the INTERLIVE Network. Sports Medicine. ISSN 0112-1642. 52(8), s. 1817–1832. doi: 10.1007/s40279-022-01665-4. Fulltekst i vitenarkiv Vis sammendrag

  Background: Consumer wearables and smartphone devices commonly offer an estimate of energy expenditure (EE) to assist in the objective monitoring of physical activity to the general population. Alongside consumers, healthcare professionals and researchers are seeking to utilise these devices for the monitoring of training and improving human health. However, the methods of validation and reporting of EE estimation in these devices lacks rigour, negatively impacting on the ability to make comparisons between devices and provide transparent accuracy. Objectives: The Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The network was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables and smartphones in the estimation of EE. Methods: The recommendations were developed through (1) a systematic literature review; (2) an unstructured review of the wider literature discussing the potential factors that may introduce bias during validation studies; and (3) evidence-informed expert opinions from members of the INTERLIVE network. Results: The systematic literature review process identified 1645 potential articles, of which 62 were deemed eligible for the final dataset. Based on these studies and the wider literature search, a validation framework is proposed encompassing six key domains for validation: the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. Conclusions: The INTERLIVE network recommends that the proposed protocol, and checklists provided, are used to standardise the testing and reporting of the validation of any consumer wearable or smartphone device to estimate EE. This in turn will maximise the potential utility of these technologies for clinicians, researchers, consumers, and manufacturers/developers, while ensuring transparency, comparability, and replicability in validation.

• Tarp, Jakob; Rossen, Jenny; Ekelund, Ulf & Dohrn, Ing-Mari (2022). Joint associations of physical activity and sedentary time with body mass index: A prospective study of mortality risk. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. doi: 10.1111/sms.14297. Fulltekst i vitenarkiv Vis sammendrag

  Device-measured physical activity and sedentary time are suggested to be more important determinants of all-cause mortality compared to body mass index (BMI) in mainly older adults. However, the joint associations of physical activity and sedentary time with BMI in relation to mortality risk in relatively healthy middle-aged individuals are unclear. We followed 770 adults (56% women, mean age 55.6 years) from a population-based cohort study for up to 15.3 years. BMI categories were combined with tertiles of total, light, and moderate-to-vigorous physical activity and sedentary time. Cox proportional hazards models estimated hazard ratios (HR) of all-cause mortality with 95% confidence intervals (CI). High total and light intensity physical activity and low sedentary time were associated with a lower risk of mortality in normal weight individuals compared with low active overweight/obese; HR: 0.35 (CI: 0.14, 0.86), HR: 0.33 (CI: 0.12, 0.89), and HR: 0.34 (CI: 0.13, 0.92). Among overweight/obese individuals, those who were medium active in light physical activity had a lower mortality risk, HR: 0.36 (CI: 0.15, 0.83), compared with low active. Medium sedentary individuals had a lower risk, HR: 0.43 (CI: 0.20, 0.94) compared with those who were most sedentary. Associations among the most active or least sedentary tertiles were similar irrespective of BMI category. In conclusion, higher physical activity and lower sedentary time were associated with lower mortality risk irrespective of BMI. Physical activity should be promoted and prescribed to individuals with low physical activity levels irrespective of weight status.

• 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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Tarp, Jakob; Grøntved, Anders; Sanchez-Lastra, Miguel A.; Dalene, Knut Eirik; Ding, Ding & Ekelund, Ulf (2021). Fitness, fatness, and mortality in men and women from the UK biobank: Prospective cohort study. Journal of the American Heart Association (JAHA). 10(6). doi: 10.1161/JAHA.120.019605. Fulltekst i vitenarkiv Vis sammendrag

  Background: Cardiorespiratory fitness may moderate the association between obesity and all‐cause mortality (ie, the “fat‐but‐fit” hypothesis), but unaddressed sources of bias are a concern. Methods and Results: Cardiorespiratory fitness was estimated as watts per kilogram from a submaximal bicycle test in 77 169 men and women from the UK Biobank cohort and combined with World Health Organization standard body mass index categories, yielding 9 unique fitness‐fatness combinations. We also formed fitness‐fatness combinations based on bioimpedance as a direct measure of body composition. All‐cause mortality was ascertained from death registries. Multivariable‐adjusted Cox regression models were used to estimate hazard ratios and 95% CIs. We examined the association between fitness‐fatness combinations and all‐cause mortality in models with progressively more conservative approaches for accounting for reverse causation, misclassification of body composition, and confounding. Over a median follow‐up of 7.7 years, 1731 participants died. In our base model, unfit men and women had higher risk of premature mortality irrespective of levels of adiposity, compared with the normal weight–fit reference. This pattern was attenuated but maintained with more conservative approaches in men, but not in women. In analysis stratified by sex and excluding individuals with prevalent major chronic disease and short follow‐up and using direct measures of body composition, mortality risk was 1.78 (95% CI, 1.17–2.71) times higher in unfit‐obese men but not higher in obese‐fit men (0.94 [95% CI, 0.60–1.48]). In contrast, there was no increased risk in obese‐unfit women (1.09 [95% CI, 0.44–1.05]) as compared with the reference. Conclusions: Cardiorespiratory fitness modified the association between obesity and mortality in men, but this pattern appeared susceptible to biases in women.

• Iurilli, Maria Laura Caminia; Zhou, Bin; Bennett, James E.; Carrillo-Larco, Rodrigo M.; Sophiea, Marisa K. & Rodriguez-Martinez, Andrea [Vis alle 77 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Tarp, Jakob; Gejl, Anne Kær; Hillman, Charles H.; Wedderkopp, Niels & Bugge, Anna (2021). Does additional physical education improve exam performance at the end of compulsory education? A secondary analysis from a natural experiment: The champs-study dk. Children. 8(1). doi: 10.3390/children8010057. Fulltekst i vitenarkiv Vis sammendrag

  It remains unclear whether the provision of additional physical activity in school improves academic outcomes. We conducted a secondary analysis of the Childhood Health, Activity, and Motor Performance School Study Denmark (CHAMPS-study DK), a natural experiment based on a trebling of curricular physical education, to investigate whether children receiving additional physical education performed better on their academic exams at the conclusion of compulsory education (i.e., 9th grade). Children from six intervention schools received 3–7 years of exposure to 270 weekly minutes of physical education (sports schools), while children from four control schools received the 90-min national standard (normal schools). Academic performance was based on the standard Danish 7-point scale (ranging from −03 to 12) and retrieved from national registries. The primary outcome was calculated as the average exam grade. Comparisons of participants at sports and normal schools were adjusted for individual socioeconomic factors and school-level academic environment. There were no differences in the pooled exam performance among 691 sports- and 510 normal-school participants (0.20 (95% confidence interval: −0.12 to 0.52)). Results for subject-specific exams indicated similar results. This analysis from a non-randomized natural experiment did not provide evidence that simply adding additional physical education is sufficient to affect academic performance relative to the national standard.

• Sanchez-Lastra, Miguel A.; Ding, Ding; Dalene, Knut Eirik; Pozo-Cruz, Borja Del; Ekelund, Ulf & Tarp, Jakob (2021). Stair climbing and mortality: a prospective cohort study from the UK Biobank. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 12(2), s. 298–307. doi: 10.1002/jcsm.12679. Fulltekst i vitenarkiv Vis sammendrag

  Background: Regular stair climbing has the potential to lower the risk of premature death, but current evidence is scarce. We aimed to examine whether daily stair climbing is associated with lower risk of all-cause, cancer, and cardiovascular disease (CVD) mortality. Methods: Using the UK Biobank cohort, we extracted information of self-reported daily flights of stairs climbed at home, categorized as none, 1 to 5, 6 to 10, 11 to 15, and ≥16 flights per day. Associations between flights of stair climbed per day and mortality were examined as hazard ratios (HRs) from Cox proportional hazards models adjusted for demographic, clinical, and behavioural covariates including time spent in other physical activities. We calculated the restricted mean survival time as an absolute measure of association. The risk of residual confounding was examined using propensity score matching and by using lung cancer as negative control outcome. Participants were followed from baseline (2006–2010) through 31 March 2020. Results: A total of 280 423 participants (median follow-up 11.1 years, during which 9445 deaths occurred) were included. Compared with not climbing any stairs, climbing more than five flights of stairs at home per day was associated with lower risk of premature mortality. The lowest risk was found for those climbing 6–10 flights per day: 0.91; 95% confidence interval (CI): 0.85, 0.98, translated to approximately 44 to 55 days of additional survival. A similar pattern was found after applying propensity score matching and for cancer mortality (6–10 flights per day HR: 0.88; 95% CI: 0.80, 0.97), but not for CVD mortality (6–10 flights per day HR: 1.08; 95% CI: 0.91, 1.29). The association between stair climbing and lung cancer was similar to that of all-cause mortality. Conclusions: Climbing more than five flights of stairs at home per day was associated with a lower risk of all-cause and cancer mortality, but not CVD mortality, compared with those who did not take the stairs. The magnitude of the association was small and appeared susceptible to residual confounding. It is unlikely that at-home stair climbing is sufficient physical activity stimuli to lower the risk of premature mortality.

• Hartwig, Timothy Bryan; Sanders, Taren; Vasconcellos, Diego; Noetel, Michael; Parker, Philip D. & Lubans, David Revalds [Vis alle 49 forfattere av denne artikkelen] (2021). School-based interventions modestly increase physical activity and cardiorespiratory fitness but are least effective for youth who need them most: an individual participant pooled analysis of 20 controlled trials. British Journal of Sports Medicine. ISSN 0306-3674. 55(13), s. 721–729. doi: 10.1136/bjsports-2020-102740. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if physical activity intensity mediates improvements in cardiorespiratory fitness. Design Pooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity. Participants Data for 6621 children and adolescents aged 4–18 years from 20 trials were included. Main outcome measures Peak oxygen consumption (VO2Peak mL/kg/min) and minutes of moderate and vigorous physical activity. Results Interventions modestly improved students’ cardiorespiratory fitness by 0.47 mL/kg/min (95% CI 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness. Conclusions Future interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level.

• Tarp, Jakob; Fagerland, Morten Wang; Dalene, Knut Eirik; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann & Jefferis, Barbara [Vis alle 24 forfattere av denne artikkelen] (2021). Device-measured physical activity, adiposity and mortality: a harmonised meta-analysis of eight prospective cohort studies. British Journal of Sports Medicine. ISSN 0306-3674. 56(13), s. 725–732. doi: 10.1136/bjsports-2021-104827. Fulltekst i vitenarkiv Vis sammendrag

  Background: The joint associations of total and intensity-specific physical activity with obesity in relation to all-cause mortality risk are unclear. Methods: We included 34 492 adults (72% women, median age 62.1 years, 2034 deaths during follow-up) in a harmonised meta-analysis of eight population-based prospective cohort studies with mean follow-up ranging from 6.0 to 14.5 years. Standard body mass index categories were cross-classified with sample tertiles of device-measured total, light-to-vigorous and moderate-to-vigorous physical activity and sedentary time. In five cohorts with waist circumference available, high and low waist circumference was combined with tertiles of moderate-to-vigorous physical activity. Results: There was an inverse dose–response relationship between higher levels of total and intensity-specific physical activity and mortality risk in those who were normal weight and overweight. In individuals with obesity, the inverse dose–response relationship was only observed for total physical activity. Similarly, lower levels of sedentary time were associated with lower mortality risk in normal weight and overweight individuals but there was no association between sedentary time and risk of mortality in those who were obese. Compared with the obese-low total physical activity reference, the HRs were 0.59 (95% CI 0.44 to 0.79) for normal weight-high total activity and 0.67 (95% CI 0.48 to 0.94) for obese-high total activity. In contrast, normal weight-low total physical activity was associated with a higher risk of mortality compared with the obese-low total physical activity reference (1.28; 95% CI 0.99 to 1.67). Conclusions: Higher levels of physical activity were associated with lower risk of mortality irrespective of weight status. Compared with obesity-low physical activity, there was no survival benefit of being normal weight if physical activity levels were low.

• Dalene, Knut Eirik; Tarp, Jakob; Selmer, Randi Marie; Ariansen, Inger Kristine Holtermann; Nystad, Wenche & Coenen, Pieter [Vis alle 9 forfattere av denne artikkelen] (2021). Occupational physical activity and longevity in working men and women in Norway: a prospective cohort study. The Lancet Public Health. ISSN 2468-2667. 6(6), s. e386–e395. doi: 10.1016/S2468-2667(21)00032-3. Fulltekst i vitenarkiv Vis sammendrag

  Background: Studies suggest that high occupational physical activity increases mortality risk. However, it is unclear whether this association is causal or can be explained by a complex network of socioeconomic and behavioural factors. We aimed to examine the association between occupational physical activity and longevity, taking a complex network of confounding variables into account. Methods: In this prospective cohort study, we linked data from Norwegian population-based health examination surveys, covering all parts of Norway with data from the National Population and Housing Censuses and the Norwegian Cause of Death Registry. 437 378 participants (aged 18–65 years; 48·7% men) self-reported occupational physical activity (mutually exclusive groups: sedentary, walking, walking and lifting, and heavy labour) and were followed up from study entry (between February, 1974, and November, 2002) to death or end of follow-up on Dec 31, 2018, whichever came first. We estimated differences in survival time (death from all causes, cardiovascular disease, and cancer) between occupational physical activity categories using flexible parametric survival models adjusted for confounding factors. Findings: During a median of 28 years (IQR 25–31) from study entry to the end of follow-up, 74 203 (17·0%) of the participants died (all-cause mortality), of which 20 111 (27·1%) of the deaths were due to cardiovascular disease and 29 886 (40·3%) were due to cancer. Crude modelling indicated shorter mean survival times among men in physically active occupations than in those with sedentary occupations. However, this finding was reversed following adjustment for confounding factors (birth cohort, education, income, ethnicity, prevalent cardiovascular disease, smoking, leisure-time physical activity, body-mass index), with estimates suggesting that men in occupations characterised by walking, walking and lifting, and heavy labour had life expectancies equivalent to 0·4 (95% CI −0·1 to 1·0), 0·8 (0·3 to 1·3), and 1·7 (1·2 to 2·3) years longer, respectively, than men in the sedentary referent category. Results for mortality from cardiovascular disease and cancer showed a similar pattern. No clear differences in survival times were observed between occupational physical activity groups in women. Interpretation: Our results suggest that moderate to high occupational physical activity contributes to longevity in men. However, occupational physical activity does not seem to affect longevity in women. These results might inform future physical activity guidelines for public health.

• Husøy, Anders; Dalene, Knut Eirik; Steene-Johannessen, Jostein; Anderssen, Sigmund Alfred; Ekelund, Ulf & Tarp, Jakob (2020). Effect modification by cardiorespiratory fitness on the association between physical activity and cardiometabolic health in youth: A systematic review. Journal of Sports Sciences. ISSN 0264-0414. doi: 10.1080/02640414.2020.1847919. Fulltekst i vitenarkiv Vis sammendrag

  Physical activity and cardiorespiratory fitness are inversely associated with markers of cardiometabolic risk in children and adolescents, but the interplay between these variables in relation to the cardiometabolic risk profile is unclear. We systematically reviewed the literature to examine whether the association between physical activity and cardiometabolic health differs by levels of cardiorespiratory fitness in youth. A literature search was conducted in PubMed and EMBASE, filtered from 2001 up until July 2019. We obtained 8980 citations, with 6915 remaining after removal of duplicates. Estimates were retrieved from 18 studies. All included articles went through a risk of bias assessment. We found that 14 out of 20 (70%) effect-estimates supported stronger associations between physical activity and cardiometabolic health markers among low-fit youth as compared to their high-fit peers. The most consistent findings were observed with biochemical markers and blood pressure as outcomes. However, substantial uncertainty is associated with these findings as most of the included studies (~72%) had a high risk of bias. More than two-thirds of the findings supported greatest benefits of physical activity on cardiometabolic risk markers in youth with low cardiorespiratory fitness, although the clinical importance of this difference is unclear.

• Tarp, Jakob; Hansen, Bjørge Hermann; Fagerland, Morten; Steene-Johannessen, Jostein; Anderssen, Sigmund Alfred & Ekelund, Ulf (2020). Accelerometer-measured physical activity and sedentary time in a cohort of US adults followed for up to 13 years: The influence of removing early follow-up on associations with mortality. International Journal of Behavioral Nutrition and Physical Activity. 17. doi: 10.1186/s12966-020-00945-4. Fulltekst i vitenarkiv Vis sammendrag

  Background: Observational studies linking physical activity with mortality are susceptible to reverse causation bias from undiagnosed and prevalent diseases. Researchers often attempt to deal with reverse causation bias by excluding deaths occurring within the first 1 or 2 years from the analysis, but it is unclear if excluding deaths within this time-frame is sufficient to remove bias. Methods: We examined associations between total and intensity-specific physical activity and sedentary time with all-cause mortality in a prospective cohort of 3542 individuals from the 2003–2006 NHANES cycles. In order to yield measures of association hypothesized as minimally influenced by reverse causation bias the primary analysis excluded individuals with < 5 years of follow-up. Accelerometer-measured physical activity was linked with recently updated vital status from the National Death Index with a median follow-up of 10.8 years. Results: Hazard ratios (95% confidence intervals) were 0.74 (0.53, 1.04), 0.52 (0.37, 0.73), and 0.61 (0.38, 1.01) for ascending quartiles of total physical activity against the least active reference. Hazard ratios for ascending moderate-to-vigorous physical activity quartiles against the reference were 0.67 (0.47, 1.96), 0.67 (0.47, 0.95), and 0.68 (0.39, 1.18). Associations for light intensity physical activity and sedentary time were smaller in magnitude and all confidence intervals included unity. Total activity and moderate-to-vigorous physical activity hazard ratios from analyses only excluding deaths within the first 2 years were inflated by 13 and 26% relative to analysis restricted to ≥5 years of follow-up. Conclusions: The pattern of associations suggested total physical activity and moderate-to-vigorous physical activity were associated with lower mortality after more than 10 years of follow-up and excluding the first 5 years of observation time to minimize the impact of reverse causation bias. Excluding deaths within the first 2 years appeared insufficient to minimize the impact of reserve causation bias.

• Rodriguez-Martinez, Andrea; Zhou, Bin; Sophiea, Marisa K.; Bentham, James; Paciorek, Christopher J. & Turilli, Maria L.C. [Vis alle 54 forfattere av denne artikkelen] (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), s. 1511–1524. doi: 10.1016/S0140-6736(20)31859-6. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Ekelund, Ulf; Tarp, Jakob; Fagerland, Morten Wang; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann & Jefferis, Barbara [Vis alle 23 forfattere av denne artikkelen] (2020). Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals. British Journal of Sports Medicine. ISSN 0306-3674. 54(24), s. 1499–1506. doi: 10.1136/bjsports-2020-103270. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: To examine the joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality. Methods: We conducted a harmonised meta-analysis including nine prospective cohort studies from four countries. 44 370 men and women were followed for 4.0 to 14.5 years during which 3451 participants died (7.8% mortality rate). Associations between different combinations of moderate-to-vigorous intensity physical activity (MVPA) and sedentary time were analysed at study level using Cox proportional hazards regression analysis and summarised using random effects meta-analysis. Results: Across cohorts, the average time spent sedentary ranged from 8.5 hours/day to 10.5 hours/day and 8 min/day to 35 min/day for MVPA. Compared with the referent group (highest physical activity/lowest sedentary time), the risk of death increased with lower levels of MVPA and greater amounts of sedentary time. Among those in the highest third of MVPA, the risk of death was not statistically different from the referent for those in the middle (16%; 95% CI 0.87% to 1.54%) and highest (40%; 95% CI 0.87% to 2.26%) thirds of sedentary time. Those in the lowest third of MVPA had a greater risk of death in all combinations with sedentary time; 65% (95% CI 1.25% to 2.19%), 65% (95% CI 1.24% to 2.21%) and 263% (95% CI 1.93% to 3.57%), respectively. Conclusion: Higher sedentary time is associated with higher mortality in less active individuals when measured by accelerometry. About 30–40 min of MVPA per day attenuate the association between sedentary time and risk of death, which is lower than previous estimates from self-reported data.

• Sanchez-Lastra, Miguel A.; Ding, Ding; Dalene, Knut Eirik; Ekelund, Ulf & Tarp, Jakob (2020). Physical activity and mortality across levels of adiposity: A prospective cohort study from the UK biobank. Mayo Clinic proceedings. ISSN 0025-6196. 96(1), s. 105–119. doi: 10.1016/j.mayocp.2020.06.049. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To examine the combined and stratified associations of physical activity and adiposity measures, modelled as body mass index (BMI), abdominal adiposity (waist circumference), and body fat percentage (BF) with all-cause mortality. Patients and Methods: Using the UK Biobank cohort, we extracted quintiles of self-reported weekly physical activity. Categories of measured BMI, waist circumference, and BF were generated. Joint associations between physical activity-adiposity categories and mortality were examined using Cox proportional hazards models adjusted for demographic, behavioral, and clinical covariates. Physical activity-mortality associations were also examined within adiposity strata. Participants were followed from baseline (2006 to 2010) through January 31, 2018. Results: A total of 295,917 participants (median follow-up, 8.9 years, during which 6684 deaths occurred) were included. High physical activity was associated with lower risk of premature mortality in all strata of adiposity except for those with BMI ≥35 kg/m2. Highest risk (HR, 1.54; 95% CI; 1.33 to 1.79) was observed in individuals with low physical activity and high BF as compared with the high physical activity–low BF referent. High physical activity attenuated the risk of high adiposity when using BF (HR, 1.24; 95% CI; 1.04 to 1.49), but the association was weaker with BMI (HR, 1.45; 95% CI; 1.21 to 1.73). Physical activity also attenuated the association between mortality and high waist circumference. Conclusion: Low physical activity and adiposity were both associated with a higher risk of premature mortality, but high physical activity attenuated the increased risk with adiposity irrespective of adiposity metric, except in those with a BMI ≥35 kg/m2.

• Hansen, Bjørge Hermann; Dalene, Knut Eirik; Ekelund, Ulf; Fagerland, Morten; Kolle, Elin & Steene-Johannessen, Jostein [Vis alle 8 forfattere av denne artikkelen] (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), s. 1705–1711. doi: 10.1111/sms.13726. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Hansen, Louise Sølund; Pedersen, Marlene Rosager Lund; Tarp, Jakob; Bugge, Anna; Wedderkopp, Niels & Møller, Niels Christian (2020). Weekly variation in markers of cardiometabolic health - The possible effect of weekend behavior - A cross-sectional study. BMC Cardiovascular Disorders. 20. doi: 10.1186/s12872-020-01692-x. Fulltekst i vitenarkiv Vis sammendrag

  Background: Adolescents’ health-related behavior varies from weekday to weekend. Only few studies, however, have examined to which degree such variation will affect markers of cardiometabolic health. Therefore, the primary aim of this study is to examine if markers of cardiometabolic health differ between different days of the week in adolescents. Methods: This cross-sectional school-based study included up to 581 participants, 11–17 years old. Markers of metabolic health were insulin, glucose, triglyceride, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and blood pressure. Linear mixed regression modelling was used to examine the cardiometabolic profile across weekdays. Results: Significant declining trends were observed across the week in adolescents’ levels of cardiometabolic health markers. Lower levels of insulin (16.1%), glucose (2.6%) and triglyceride (24.7%) were observed on Fridays compared to Mondays (p ≤ 0.006). Gradual improvement in measurement profiles across weekdays was less apparent for HDL-C, LDL-C, systolic blood pressure and diastolic blood pressure (P ≥ 0.06). Analyses stratified by sex suggested a more noticeable pattern of gradual improvement across weekdays in boys than in girls. Conclusion: Significantly lower levels of insulin, glucose and triglyceride were observed in adolescents on Fridays compared to Mondays. However, when sex specific analyses were performed significant profile variations were only observed across the week in boys. More research is needed to better understand which behavioral factors in particular seem to influence weekly variation in markers of cardiometabolic health - especially since such variation potentially will have an impact on how assessments of markers of cardiometabolic health optimally should be planned, standardized and carried out, both in research and in medical practice.

• Bixby, Honor; Bentham, James; Zhou, Bin; Cesare, Mariachiara Di; Paciorek, Christopher J. & Bennett, James E. [Vis alle 51 forfattere av denne artikkelen] (2019). Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature. ISSN 0028-0836. 569, s. 260–264. doi: 10.1038/s41586-019-1171-x. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Ekelund, Ulf; Tarp, Jakob; Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Jefferis, Barbara & Fagerland, Morten [Vis alle 20 forfattere av denne artikkelen] (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. The BMJ. 366. doi: 10.1136/bmj.l4570. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To examine the dose-response associations between accelerometer assessed total physical activity, different intensities of physical activity, and sedentary time and all cause mortality. Design: Systematic review and harmonised meta-analysis. Data sources: PubMed, PsycINFO, Embase, Web of Science, Sport Discus from inception to 31 July 2018. Eligibility criteria: Prospective cohort studies assessing physical activity and sedentary time by accelerometry and associations with all cause mortality and reported effect estimates as hazard ratios, odds ratios, or relative risks with 95% confidence intervals. Data extraction and analysis: Guidelines for meta-analyses and systematic reviews for observational studies and PRISMA guidelines were followed. Two authors independently screened the titles and abstracts. One author performed a full text review and another extracted the data. Two authors independently assessed the risk of bias. Individual level participant data were harmonised and analysed at study level. Data on physical activity were categorised by quarters at study level, and study specific associations with all cause mortality were analysed using Cox proportional hazards regression analyses. Study specific results were summarised using random effects meta-analysis. Main outcome measure: All cause mortality. Results: 39 studies were retrieved for full text review; 10 were eligible for inclusion, three were excluded owing to harmonisation challenges (eg, wrist placement of the accelerometer), and one study did not participate. Two additional studies with unpublished mortality data were also included. Thus, individual level data from eight studies (n=36 383; mean age 62.6 years; 72.8% women), with median follow-up of 5.8 years (range 3.0-14.5 years) and 2149 (5.9%) deaths were analysed. Any physical activity, regardless of intensity, was associated with lower risk of mortality, with a non-linear dose-response. Hazards ratios for mortality were 1.00 (referent) in the first quarter (least active), 0.48 (95% confidence interval 0.43 to 0.54) in the second quarter, 0.34 (0.26 to 0.45) in the third quarter, and 0.27 (0.23 to 0.32) in the fourth quarter (most active). Corresponding hazards ratios for light physical activity were 1.00, 0.60 (0.54 to 0.68), 0.44 (0.38 to 0.51), and 0.38 (0.28 to 0.51), and for moderate-to-vigorous physical activity were 1.00, 0.64 (0.55 to 0.74), 0.55 (0.40 to 0.74), and 0.52 (0.43 to 0.61). For sedentary time, hazards ratios were 1.00 (referent; least sedentary), 1.28 (1.09 to 1.51), 1.71 (1.36 to 2.15), and 2.63 (1.94 to 3.56). Conclusion: Higher levels of total physical activity, at any intensity, and less time spent sedentary, are associated with substantially reduced risk for premature mortality, with evidence of a non-linear dose-response pattern in middle aged and older adults.

• Tarp, Jakob; Støle, Andreas; Blond, Kim & Grøntved, Anders (2019). Cardiorespiratory fitness, muscular strength and risk of type 2 diabetes: a systematic review and meta-analysis. Diabetologia. ISSN 0012-186X. 62(7), s. 1129–1142. doi: 10.1007/s00125-019-4867-4. Fulltekst i vitenarkiv Vis sammendrag

  Aims/hypothesis The study aimed to quantitatively summarise the dose–response relationships between cardiorespiratory fitness and muscular strength on the one hand and risk of type 2 diabetes on the other and estimate the hypothetical benefits associated with population-wide changes in the distribution of fitness. Methods We performed a systematic review with meta-analysis. The PubMed and EMBASE electronic databases were searched from inception dates to 12 December 2018 for cohort studies examining the association of cardiorespiratory fitness or muscular strength with risk of incident type 2 diabetes in adults. The quality of included studies was evaluated using the Newcastle–Ottawa Scale. Results Twenty-two studies of cardiorespiratory fitness and 13 studies of muscular strength were included in the systematic review with both exposures having ten estimates available for the primary adiposity- or body size-controlled meta-analysis. In random-effects meta-analysis including 40,286 incident cases of type 2 diabetes in 1,601,490 participants, each 1 metabolic equivalent (MET) higher cardiorespiratory fitness was associated with an 8% (95% CI 6%, 10%) lower RR of type 2 diabetes. The association was linear throughout the examined spectrum of cardiorespiratory fitness. In 39,233 cases and 1,713,468 participants each 1 SD higher muscular strength was associated with a 13% (95% CI 6%, 19%) lower RR of type 2 diabetes. We estimated that 4% to 21% of new annual cases of type 2 diabetes among 45–64-year-olds could be prevented by feasible and plausible population cardiorespiratory fitness changes. Conclusions/interpretation Relatively small increments in cardiorespiratory fitness and muscle strength were associated with clinically meaningful reductions in type 2 diabetes risk with indication of a linear dose–response relationship for cardiorespiratory fitness.

• Bentham, James; Cesare, Mariachiara Di; Stevens, Gretchen A.; Zhou, Bin; Bixby, Honor & Cowan, Melanie [Vis alle 794 forfattere av denne artikkelen] (2016). A century of trends in adult human height. eLIFE. 5. doi: 10.7554/elife.13410. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Ding, Ding; Tarp, Jakob; Giovannucci, Edward & Clare, Philip James (2025). Causal inference in physical activity epidemiology research: An opportunity for better evidence. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2024-109102. Fulltekst i vitenarkiv
• Sagelv, Edvard Hamnvik; Hopstock, Laila Arnesdatter; Morseth, Bente; Hansen, Bjørge Hermann; Steene-Johannessen, Jostein & Anderssen, Sigmund Alfred [Vis alle 13 forfattere av denne artikkelen] (2022). Physical activity and mortality: Effect modification by sedentary time. An individual participant data analysis of four cohorts with accelerometry measured physical activity. Fulltekst i vitenarkiv
• Ekelund, Ulf; Dalene, Knut Eirik; Tarp, Jakob & Lee, I-Min (2020). Physical activity and mortality: what is the dose response and how big is the effect? British Journal of Sports Medicine. ISSN 0306-3674. 54(19), s. 1125–1126. doi: 10.1136/bjsports-2019-101765. Fulltekst i vitenarkiv
• Tarp, Jakob; Dalene, Knut Eirik; Hansen, Bjørge Hermann; Steene-Johannessen, Jostein & Ekelund, Ulf (2020). Double counting individuals in meta‐analysis artificially inflates precision. Comment on “Device‐measured light‐intensity physical activity and mortality: A meta‐analysis”. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 30(6), s. 1083–1084. doi: 10.1111/sms.13693. Fulltekst i vitenarkiv
• Tarp, Jakob; Dalene, Knut Eirik; Steene-Johannessen, Jostein & Ekelund, Ulf (2019). Comment on: "Cardiorespiratory Fitness in Childhood and Adolescence Affects Future Cardiovascular Risk Factors: A Systematic Review of Longitudinal Studies". Sports Medicine. ISSN 0112-1642. 49(1), s. 159–161. doi: 10.1007/s40279-018-01035-z. Fulltekst i vitenarkiv

Se alle arbeider i NVA