Sigmund Alfred Anderssen

• Bratteteig, Mari; Grydeland, May; Anderssen, Sigmund Alfred; Ruud, Ellen; Torsvik, Ingrid Kristin & Thorsen, Lene [Vis alle 14 forfattere av denne artikkelen] (2026). Weekly physical activity trajectories in short- and long-term survivors of childhood cancer: the PACCS and SURfit studies. Journal of cancer survivorship. ISSN 1932-2259. doi: 10.1007/s11764-026-02086-2. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Identify and describe weekly physical activity (PA) trajectories in adolescent and adult childhood cancer survivors (survivors), describe characteristics of survivors following different PA trajectories, and compare PA trajectories to controls. Methods This study includes adolescent (9–18 years) survivors and controls from the Physical Activity in Childhood Cancer Survivors (PACCS) study and adult (18–49 years) survivors from the survivor fitness (SURfit) study and controls from the Norwegian National Physical Activity Survey 2. Weekly trajectories of accelerometer-measured PA were identified by multivariate latent class mixed models using daily minutes of moderate-to-vigorous and light PA (MVPA, LPA). Survivors’ characteristics related to different PA trajectories were assessed using a descriptive approach, and PA trajectories between survivors and controls were visually compared. Results We identified four PA trajectories among adolescents (Low regular; Medium, drop weekend; Medium, peak Friday; and Medium regular) and four among adult survivors (Medium regular; Medium, drop weekend; Medium regular MVPA, high regular LPA; and High, drop weekend). The main factors related to the different PA trajectories were sex, age at assessment, sleep, and (parental) education, whereas diagnosis seemed important in adolescent survivors only. In adolescents, trajectories were comparable between survivors and controls, while in adults, only three trajectories were comparable. The allocation to the different trajectories was more favorable in adolescent survivors (fewer in the Low trajectory) and adult survivors (no Low regular MVPA trajectory was identified in survivors) compared to controls. Implications for Cancer Survivors Our findings show many different behavioral approaches to accumulate PA over a week. They highlight the need for targeted PA interventions in a subset of survivors (i.e., adolescent, female survivors of CNS tumors). Developing interventions to prevent PA drops on the weekend holds high potential.

• 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
• Edvardsen, Elisabeth; Anderssen, Sigmund Alfred; Borchsenius, Fredrik; Holme, Ingar Morten K; Nordsletten, Lars & Skjønsberg, Ole Henning (2026). Long-Term Effects of High-Intensity Training following Lung Cancer Surgery - A Five-Year Follow-Up of a Randomized Controlled Trial. Medicine & Science in Sports & Exercise. ISSN 0195-9131. Publish Ahead of Print. doi: 10.1249/MSS.0000000000003984. Fulltekst i vitenarkiv
• 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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Atkin, Andrew J.; Sherar, Lauren B.; Ekelund, Ulf; Hansen, Bjørge Hermann; Andersen, Lars Bo & Anderssen, Sigmund Alfred [Vis alle 17 forfattere av denne artikkelen] (2025). Age-related change in children’s physical activity and sedentary time: The International Children’s Accelerometry Database (ICAD). PLOS ONE. 20(9). doi: 10.1371/journal.pone.0327394. Fulltekst i vitenarkiv Vis sammendrag

  Background Many young people fail to achieve the minimum recommended amount of physical activity to benefit their health. Understanding the nature of age-related changes in behaviour and how this varies for population sub-groups is informative for intervention design. The aim of this study was to describe age-related changes in physical activity and sedentary time and examine variability in patterns of change across demographic sub-groups. Methods Data are from 13 studies in the International Children’s Accelerometry Database (ICAD), all of which provided ≥2 waves of waist-worn accelerometer data. Annual change in sedentary time, light intensity physical activity (LPA) and moderate to vigorous intensity physical activity (MVPA) were estimated using three level mixed effects linear regression models, using participant age as the exposure variable. In interaction models, we examined whether changes in behaviour differed by day of the week (weekday/ weekend), age at baseline assessment (<10/ ≥ 10 years), sex, weight category, maternal education and ethnicity. Results In total, 6567 participants provided two or more waves of valid accelerometer data (44.5% boys, mean (SD) baseline age 10.6 (2.1) years (range 4.1–15.8 years)). Across the week and for all studied sub-groups, sedentary time increased by approximately 25 minutes/day/year of age, LPA decreased by approximately 22 minutes/day/year of age and MVPA decreased by approximately 3 minutes/day/year of age. The annual increase in sedentary time was greater in girls compared to boys (β (95% confidence interval) change (min) for each additional year of age: girls, 25.9 (25.4, 26.4); boys, 23.6 (23.0, 24.2)) and in adolescents compared to children (adolescents, 27.0 (26.5, 27.6); children, (23.5 (22.9, 24.2)). The annual decrease in MVPA was greater in boys compared to girls (boys, −2.7 (−3.0, −2.5); girls, −2.2 (−2.4, −2.0)) and at the weekend compared to during the week (weekend, −3.0 (−3.3, −2.8); weekday −2.3 (−2.5, −2.1)). Conclusion Accelerometer assessed sedentary time increased whilst LPA and MVPA decreased during childhood and adolescence. This overall pattern was observed across the week and in all studied sub-groups, but small differences in the magnitude of changes can be used to guide the timing and targeting of behaviour change interventions, such as designing physical activity interventions which focus on weekends where a child’s time is less structured.

• 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), s. 535–543. doi: 10.1249/MSS.0000000000003595. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Edvardsen, Elisabeth; Ruud, Ellen; Rueegg, Corina Silvia; Kvidaland, Haakon Kristian; Torsvik, Ingrid Kristin & Bovim, Lars Peder Vatshelle [Vis alle 11 forfattere av denne artikkelen] (2025). Physical Fitness and Physical Activity in Adolescent Childhood Cancer Survivors and Controls: The PACCS Study. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 57(10), s. 2286–2293. doi: 10.1249/MSS.0000000000003758. Fulltekst i vitenarkiv Vis sammendrag

  Objectives This study aimed to compare physical fitness, function, and physical activity (PA) in adolescent childhood cancer survivors (CCSs) to age- and sex-matched controls and across different cancer diagnoses. Methods This multicenter cross-sectional study (Physical Activity among Childhood Cancer Survivors) included CCSs aged 9–18 yr (≥1-yr after cancer treatment) and age- and sex-matched controls. Physical fitness tests included cardiorespiratory fitness (V̇O2max) and muscular strength (maximal isometric handgrip, knee extension, and chest press). Physical function tests included a 1-min sit-to-stand test (STS) and countermovement jump (CMJ). PA was measured by accelerometer for 7 d. We used linear mixed-effects models to compare outcomes between CCSs and controls, and across diagnostic groups. Results We included 157 CCSs and 113 controls aged 13.4 ± 2.6 yr (mean ± SD). Cancer types were leukemia (n = 78), central nervous system (CNS) tumors (n = 18), lymphoma (n = 16), and other solid tumors (n = 45). CCSs had lower V̇O2max (marginal mean (95% confidence interval), 41.7 (38.4–45.0) vs 46.4 (42.9–49.8) mL·kg−1·min−1; P < 0.001), knee-extension strength (35.4 (34.1–36.8) vs 38.2 (36.7–39.7) kg, P = 0.003), chest-press strength (30.0 (28.4–31.6) vs 32.8 (31.0–34.7) kg, P = 0.007), STS repetitions (57.5 (55.8–59.3) vs 60.0 (58.0–62.0) P = 0.017), and CMJ height (22.1, (20.5–23.8) vs 24.9 (23.2–26.6) cm, P < 0.001). PA levels and sedentary time were similar in both groups (8513 (7993–9034) vs 9000 (8404–9596) steps per day, P = 0.174, respectively). Survivors of CNS tumors had the lowest values for V̇O2max, muscular strength, physical function, and PA. Conclusions Despite no significant difference in PA levels, adolescent CCSs had 4.2% to 11% lower physical fitness and function compared with controls, where survivors of CNS tumors performed the poorest.

• 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).

• Bergum, Hilde Marie; Grimsmo, Jostein; Anderssen, Sigmund Alfred & Klemsdal, Tor Ole (2024). Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care. BMC Cardiovascular Disorders. 24. doi: 10.1186/s12872-024-03892-1. Fulltekst i vitenarkiv Vis sammendrag

  Background: Cardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme. Methods: A random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein). Results: Self-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables. Conclusions: Participation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group.

• Zhou, Bin; Rayner, Archie W.; Gregg, Edvard W; Sheffer, Kate E.; Carrillo-Larco, Rodrigo M & Bennett, James E [Vis alle 49 forfattere av denne artikkelen] (2024). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. The Lancet. ISSN 0140-6736. 404(10467), s. 2077–2093. doi: 10.1016/S0140-6736(24)02317-1. Fulltekst i vitenarkiv Vis sammendrag

  Background Diabetes can be detected at the primary health-care level, and effective treatments lower the risk of complications. There are insufficient data on the coverage of treatment for diabetes and how it has changed. We estimated trends from 1990 to 2022 in diabetes prevalence and treatment for 200 countries and territories. Methods We used data from 1108 population-representative studies with 141 million participants aged 18 years and older with measurements of fasting glucose and glycated haemoglobin (HbA1c), and information on diabetes treatment. We defined diabetes as having a fasting plasma glucose (FPG) of 7·0 mmol/L or higher, having an HbA1c of 6·5% or higher, or taking medication for diabetes. We defined diabetes treatment as the proportion of people with diabetes who were taking medication for diabetes. We analysed the data in a Bayesian hierarchical meta-regression model to estimate diabetes prevalence and treatment. Findings In 2022, an estimated 828 million (95% credible interval [CrI] 757–908) adults (those aged 18 years and older) had diabetes, an increase of 630 million (554–713) from 1990. From 1990 to 2022, the age-standardised prevalence of diabetes increased in 131 countries for women and in 155 countries for men with a posterior probability of more than 0·80. The largest increases were in low-income and middle-income countries in southeast Asia (eg, Malaysia), south Asia (eg, Pakistan), the Middle East and north Africa (eg, Egypt), and Latin America and the Caribbean (eg, Jamaica, Trinidad and Tobago, and Costa Rica). Age-standardised prevalence neither increased nor decreased with a posterior probability of more than 0·80 in some countries in western and central Europe, sub-Saharan Africa, east Asia and the Pacific, Canada, and some Pacific island nations where prevalence was already high in 1990; it decreased with a posterior probability of more than 0·80 in women in Japan, Spain, and France, and in men in Nauru. The lowest prevalence in the world in 2022 was in western Europe and east Africa for both sexes, and in Japan and Canada for women, and the highest prevalence in the world in 2022 was in countries in Polynesia and Micronesia, some countries in the Caribbean and the Middle East and north Africa, as well as Pakistan and Malaysia. In 2022, 445 million (95% CrI 401–496) adults aged 30 years or older with diabetes did not receive treatment (59% of adults aged 30 years or older with diabetes), 3·5 times the number in 1990. From 1990 to 2022, diabetes treatment coverage increased in 118 countries for women and 98 countries for men with a posterior probability of more than 0·80. The largest improvement in treatment coverage was in some countries from central and western Europe and Latin America (Mexico, Colombia, Chile, and Costa Rica), Canada, South Korea, Russia, Seychelles, and Jordan. There was no increase in treatment coverage in most countries in sub-Saharan Africa; the Caribbean; Pacific island nations; and south, southeast, and central Asia. In 2022, age-standardised treatment coverage was lowest in countries in sub-Saharan Africa and south Asia, and treatment coverage was less than 10% in some African countries. Treatment coverage was 55% or higher in South Korea, many high-income western countries, and some countries in central and eastern Europe (eg, Poland, Czechia, and Russia), Latin America (eg, Costa Rica, Chile, and Mexico), and the Middle East and north Africa (eg, Jordan, Qatar, and Kuwait). Interpretation In most countries, especially in low-income and middle-income countries, diabetes treatment has not increased at all or has not increased sufficiently in comparison with the rise in prevalence. The burden of diabetes and untreated diabetes is increasingly borne by low-income and middle-income countries. The expansion of health insurance and primary health care should be accompanied with diabetes programmes that realign and resource health services to enhance the early detection and effective treatment of diabetes.

• Bratteteig, Mari; Rueegg, Corina Silvia; Lie, Hanne Cathrine; Thorsen, Lene; Larsen, Elna Hamilton & Larsen, Marie Hamilton [Vis alle 14 forfattere av denne artikkelen] (2024). Physical activity behaviors and screen time in young childhood cancer survivors: the Physical Activity in Childhood Cancer Survivors Study. Journal of cancer survivorship. ISSN 1932-2259. doi: 10.1007/s11764-024-01671-7. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: In childhood cancer survivors (CCS), high physical activity (PA) and low sedentary time may reduce risks of late-effects. PA behaviors and screen time, and how they relate to moderate-to-vigorous PA (MVPA) in CCS, are largely unknown. We examined PA behaviors and screen time, and their cross-sectional associations with MVPA. Methods: CCS from any cancer diagnosis (≥ l year post-treatment), aged 9–16 years at study, were eligible in the international Physical Activity in Childhood Cancer Survivors (PACCS) study. PA behaviors (school transport, intensity-effort in physical education (“PE intensity”), leisure-time PA) and screen time were assessed by self-report, and MVPA by accelerometers (ActiGraph GT3X-BT). Multivariable linear regressions were used to assess associations between PA behaviors and screen time with MVPA. Results: We included 481 CCS (48% girls, mean age 12.2 years). Passive school transport (prevalence 42%) was associated with 10% lower MVPA/day (β = 6.6 min, 95% CI 3.3–10.0), low PE

• 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.

• Ostojic, Sergej; Phelps, Nowell H.; Singleton, Rosie K.; Zhou, Bin; Heap, Rachel & Mishra, Anu [Vis alle 54 forfattere av denne artikkelen] (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), s. 1027–1050. doi: 10.1016/S0140-6736(23)02750-2. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Mandelid, Mathias; Dyngeland, Espen Søreide; Teslo, Ståle Bye; Lerum, Øystein; Tjomsland, Hege Eikeland & Jenssen, Eirik Sørnes [Vis alle 16 forfattere av denne artikkelen] (2024). Workplace-based continuing professional development program for physically active learning: designing a framework and prospective directions. Frontiers in Education. 9. doi: 10.3389/feduc.2024.1407542. Fulltekst i vitenarkiv Vis sammendrag

  In 2018, the Centre for Physical Active Learning (SEFAL) designed a comprehensive one-year workplace-based continuous professional development (CPD) program for in-service teachers in Norway. The CPD program aimed to enhance the pedagogical feasibility of integrating physically active learning (PAL) within all theoretical subjects by advancing teachers’ competence. This article provides an overview of the SEFAL CPD program’s conceptual framework and design. Although the article does not provide an independent evaluation of the framework, we discuss it based on our continual development during the period from 2018 to 2023, during which 1,363 teachers from 77 schools participated. As the framework continues to inform the SEFAL CPD, the article concludes by identifying prospective directions and potential avenues for further refinement and utilisation of this and similar programs.

• Strain, Tessa; Flaxman, Seth; Guthold, Regina; Semenova, Elizaveta; Cowan, Melanie & Riley, Leanne M [Vis alle 92 forfattere av denne artikkelen] (2024). National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants. The Lancet Global Health. ISSN 2572-116X. 12(8), s. e1232–e1243. doi: 10.1016/S2214-109X(24)00150-5. Fulltekst i vitenarkiv Vis sammendrag

  Background: Insufficient physical activity increases the risk of non-communicable diseases, poor physical and cognitive function, weight gain, and mental ill-health. Global prevalence of adult insufficient physical activity was last published for 2016, with limited trend data. We aimed to estimate the prevalence of insufficient physical activity for 197 countries and territories, from 2000 to 2022. Methods: We collated physical activity reported by adults (aged ≥18 years) in population-based surveys. Insufficient physical activity was defined as not doing 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or an equivalent combination per week. We used a Bayesian hierarchical model to compute estimates of insufficient physical activity by country or territory, year, age, and sex. We assessed whether countries or territories, regions, and the world would meet the global target of a 15% relative reduction of the prevalence of insufficient physical activity by 2030 if 2010–22 trends continue. Findings: We included 507 surveys across 163 countries and territories. The global age-standardised prevalence of insufficient physical activity was 31·3% (95% uncertainty interval 28·6–34·0) in 2022, an increase from 23·4% (21·1–26·0) in 2000 and 26·4% (24·8–27·9) in 2010. Prevalence was increasing in 103 (52%) of 197 countries and territories and six (67%) of nine regions, and was declining in the remainder. Prevalence was 5 percentage points higher among female (33·8% [29·9–37·7]) than male (28·7% [25·0–32·6]) individuals. Insufficient physical activity increased in people aged 60 years and older in all regions and both sexes, but age patterns differed for those younger than 60 years. If 2010–22 trends continue, the global target of a 15% relative reduction between 2010 and 2030 will not be met (posterior probability

• Husøy, Anders; Kolle, Elin; Steene-Johannessen, Jostein; Dalene, Knut Eirik; Andersen, Lars Bo & Ekelund, Ulf [Vis alle 7 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Bratteteig, Mari; Rüegg, Corina Silvia; Raastad, Truls; Grydeland, May; Torsvik, Ingrid Kristin & Schindera, Christina [Vis alle 8 forfattere av denne artikkelen] (2023). Physical Activity, Fitness, and Cardiovascular Disease Risk in Adolescent Childhood Cancer Survivors Compared to Controls: The Physical Activity in Childhood Cancer Survivors Study. Journal of Adolescent and Young Adult Oncology. ISSN 2156-5333. s. 1–9. doi: 10.1089/jayao.2023.0063. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Childhood cancer survivors have increased risk of cardiac late effects that can be potentially mitigated by physical activity and fitness. We aimed to (1) compare cardiovascular disease (CVD) risk between survivors and controls, and (2) examine whether the associations of moderate-to-vigorous physical activity (MVPA), cardiorespiratory fitness (CRF), and musculoskeletal fitness (MSF) with CVD risk factors differed between survivors and controls. Methods: Within the Physical Activity in Childhood Cancer Survivors (PACCS) study, we assessed CVD risk factors (android fat mass, systolic blood pressure [SBP], total cholesterol/high-density lipoprotein [HDL]-cholesterol, and glycosylated hemoglobin) in 157 childhood cancer survivors and 113 age- and sex-matched controls aged 9–18 years. We used multivariable mixed linear regression models to compare CVD risk factors between survivors and controls, and assess associations of MVPA, CRF, and MSF with CVD risk factors. Results: Compared with controls, survivors had more android fat mass (861 vs. 648 g, p = 0.001) and lower SBP (114 vs. 118 mmHg, p = 0.002). MVPA, CRF, and MSF were associated with lower levels of android fat mass and total cholesterol/HDL-cholesterol, and higher SBP in survivors. Associations of MVPA, CRF, and MSF with CVD risk factors were similar in survivors and controls (Pinteraction > 0.05), except the associations of CRF and MSF with android fat mass, which were stronger in survivors than in controls (Pinteraction ≤ 0.001). Conclusion: Owing to higher levels of android fat mass and its stronger association with physical fitness in childhood cancer survivors compared with controls, survivors should get targeted interventions to increase fitness to reduce future risk of CVD.

• 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.

• Resaland, Geir Kåre; Bartholomew, J.B.; Andersen, Lars Bo; Anderssen, Sigmund Alfred & Aadland, Eivind (2023). Effects of a school-based physical activity intervention on cardiometabolic health 5 years after cessation. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 33(7), s. 1177–1189. doi: 10.1111/sms.14350. Fulltekst i vitenarkiv Vis sammendrag

  Background: While there have been several school-based physical activity (PA) interventions targeting improvement in cardiovascular disease (CVD) risk factors, few have assessed long-term effects. The aim of this paper was therefore to determine intervention effects on CVD risk factors 5 years after cessation. Methods: Two schools were assigned to intervention (n = 125) or control (n = 134). The intervention school offered 210 min/week more PA than the control school over two consecutive years (fourth and fifth grades). Follow-up assessment was conducted 5-year post-intervention (10th grade) where 180–210 (73%–85%) children provided valid data. Outcomes were CVD risk factors: triglyceride, total-to-high-density-lipoprotein-cholesterol ratio (TC:HDL ratio), insulin resistance, blood pressure (BP), waist circumference, and cardiorespiratory fitness (VO2peak). Variables were analyzed individually and as a composite score through linear mixed models, including random intercepts for children. Results: Analyses revealed significant sustained 5-year intervention effects for HDL (effect sizes [ES] = 0.22), diastolic BP (ES = 0.48), VO2peak (ES = 0.29), and composite risk score (ES = 0.38). These effects were similar to the immediate results following the intervention. In contrast, while TC:HDL ratio initially decreased post-intervention (ES = 0.27), this decrease was not maintained at 5-year follow-up (ES = 0.09), whereas WC was initially unchanged post-intervention (ES = 0.02), but decreased at 5-year follow-up (ES = 0.44). Conclusion: The significant effects of a 2-year school-based PA intervention remained for CVD risk factors 5 years after cessation of the intervention. As cardiometabolic health can be maintained long-term after school-based PA, this paper demonstrates the sustainability and potential of schools in the primary prevention of future CVD risk in children.

• Grydeland, May; Bratteteig, Mari; Rüegg, Corina Silvia; Lie, Hanne Cathrine; Thorsen, Lene & Larsen, Elna Hamilton [Vis alle 14 forfattere av denne artikkelen] (2023). Physical Activity Among Adolescent Cancer Survivors: The PACCS Study. Pediatrics. ISSN 0031-4005. 152(3). doi: 10.1542/peds.2023-061778. Fulltekst i vitenarkiv Vis sammendrag

  OBJECTIVES: Physical activity (PA) may modify risks of late effects after cancer. We aimed to examine levels of PA and sedentary time (ST) in a large, international sample of adolescent childhood cancer survivors in relation to sociodemographic and cancer-related factors and compare levels of PA and ST to reference cohorts. METHODS: Survivors from any cancer diagnosis who had completed cancer treatment ≥1 year ago, aged 9 to 16 years, were eligible for the multicenter Physical Activity in Childhood Cancer Survivors study. PA and ST were measured by ActiGraph GT3X+ accelerometers. We performed linear regression analyses to assess factors associated with moderate-to-vigorous PA (MVPA) and ST, and compared marginal means of total PA, MVPA, and ST in 432 survivors to sex- and age-stratified references (2-year intervals) using immediate t-tests for aggregated data. RESULTS: Among survivors, 34% fulfilled the World Health Organization’s PA recommendation of ≥60 min of daily MVPA on average and their ST was 8.7 hours per day. Being female, older, overweight, a survivor of central nervous system tumor, or having experienced relapse were associated with lower MVPA and/or higher ST. Generally, male survivors spent less time in MVPA compared with references, whereas female survivors had similar levels. Both male and female survivors had higher ST than references in nearly all age groups. CONCLUSIONS: The low PA and high ST in this large sample of adolescent childhood cancer survivors is worrisome. Combined, our results call for targeted interventions addressing both PA and ST in follow-up care after childhood cancer.

• Borodulin, Katja & Anderssen, Sigmund Alfred (2023). Physical activity: associations with health and summary of guidelines. Food & Nutrition Research (FNR). ISSN 1654-6628. 67. doi: 10.29219/fnr.v67.9719. Fulltekst i vitenarkiv Vis sammendrag

  The understanding of how physical activity and insufficient physical activity are associated with health outcomes has increased considerably over the past decades. Along with physical activity, the evidence on the associations between sedentary behavior and health has increased, which has resulted in the introduction of recommendations of sedentary behavior. In this article, we 1) present terminology for physical activity and sedentary behavior epidemiology, 2) show the relevant scientific evidence on associations of physical activity and sedentary behavior with selected health-related outcomes and 3) introduce the global guidelines for physical activity and sedentary behavior by the World Health Organization (WHO). Health-related outcomes include cardiovascular morbidity and mortality, total mortality, glucose regulation and type 2 diabetes, adiposity, overweight, obesity, cancer, musculoskeletal and bone health, brain health, and quality of life. These health-related outcomes are reflected across age groups and some population groups, such as pregnant and postpartum women. Furthermore, we discuss physical activity levels across Nordic countries and over time. For the Nordic Nutrition Recommendations, shared common physical activity guidelines were not developed. Instead, each country has created their own guidelines that are being referenced in the article, along with the global WHO guidelines.

• 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.

• Jones, Paul Remy; Rajalahti, Tarja; Resaland, Geir Kåre; Aadland, Eivind; Steene-Johannessen, Jostein & Anderssen, Sigmund Alfred [Vis alle 10 forfattere av denne artikkelen] (2022). Associations of lipoprotein particle profile and objectively measured physical activity and sedentary time in schoolchildren: a prospective cohort study. International Journal of Behavioral Nutrition and Physical Activity. 19(1). doi: 10.1186/s12966-022-01244-w. Fulltekst i vitenarkiv Vis sammendrag

  Background: Our understanding of the mechanisms through which physical activity might benefit lipoprotein metabolism is inadequate. Here we characterise the continuous associations between physical activity of different intensities, sedentary time, and a comprehensive lipoprotein particle profile. Methods: Our cohort included 762 fifth grade (mean [SD] age = 10.0 [0.3] y) Norwegian schoolchildren (49.6% girls) measured on two separate occasions across one school year. We used targeted proton nuclear magnetic resonance (1H NMR) spectroscopy to produce 57 lipoprotein measures from fasted blood serum samples. The children wore accelerometers for seven consecutive days to record time spent in light-, moderate-, and vigorous-intensity physical activity, and sedentary time. We used separate multivariable linear regression models to analyse associations between the device-measured activity variables—modelled both prospectively (baseline value) and as change scores (follow-up minus baseline value)—and each lipoprotein measure at follow-up. Results: Higher baseline levels of moderate-intensity and vigorous-intensity physical activity were associated with a favourable lipoprotein particle profile at follow-up. The strongest associations were with the larger subclasses of triglyceride-rich lipoproteins. Sedentary time was associated with an unfavourable lipoprotein particle profile, the pattern of associations being the inverse of those in the moderate-intensity and vigorous-intensity physical activity analyses. The associations with light-intensity physical activity were more modest; those of the change models were weak. Conclusion: We provide evidence of a prospective association between time spent active or sedentary and lipoprotein metabolism in schoolchildren. Change in activity levels across the school year is of limited influence in our young, healthy cohort.

• Bergum, Hilde Marie; Sandven, Irene; Abdelnoor, Michael; Anderssen, Sigmund Alfred; Grimsmo, Jostein & Rivrud, Dag Elle [Vis alle 12 forfattere av denne artikkelen] (2022). Randomized trial of cardiovascular prevention in Norway combining an in-hospital lifestyle course with primary care follow-up: the Hjerteløftet study. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 29(17), s. 2252–2263. doi: 10.1093/eurjpc/zwac211. Fulltekst i vitenarkiv Vis sammendrag

  Aims Cardiovascular risk factor control is suboptimal in Europe, including Norway. The present study examined the efficacy of a multimodal primary prevention intervention programme based on the existing Norwegian health care system. Methods and results In this open-label randomized controlled trial, adult patients with elevated cardiovascular risk were randomly assigned to an intervention programme including a hospital-based lifestyle course and primary care follow-up or to a control group (CG). The participants were recruited between 2011 and 2015. Primary outcome was change in validated cardiovascular risk scores, national and international (NORRISK, NORRISK 2, Framingham, PROCAM) between baseline and follow-up. Secondary outcomes included major cardiovascular risk factors. After 36 months the NORRISK score was significantly improved in patients assigned to the intervention group (IG) compared to patients assigned to the CG; absolute difference in mean delta score in the IG (n = 305) compared to mean delta score in the CG (n = 296): −0.92, 95% CI: −1.48 to −0.36, P = 0.001. The results for NORRISK 2, Framingham and PROCAM showed similar significant effects. The secondary endpoints including total cholesterol and blood pressure were only minimally, and non-significantly, reduced in the IG, but the proportion of smokers (P = 0.0028) and with metabolic syndrome (P < 0.0001) were significantly reduced. A limited number of cardiovascular events were observed, IG (n = 9), CG (n = 16). Conclusion In subjects with elevated cardiovascular risk, a newly developed prevention programme, combining a hospital-based lifestyle course and primary care follow-up, significantly reduced cardiovascular risk scores after 36 months. This benefit appeared achievable primarily through improvements in metabolic syndrome characteristics and smoking habits. The study protocol was registered in ClinicalTrials.gov (NCT01741428). Primary prevention, Cardiovascular disease, Cardiovascular risk, Metabolic syndrome, Smoking cessation, Lifestyle intervention Issue Section: Prevention In Practice

• Gammon, Catherine; Atkin, Andrew J.; Corder, Kirsten; Ekelund, Ulf; Hansen, Bjørge Hermann & Sherar, Lauren B. [Vis alle 19 forfattere av denne artikkelen] (2022). Influence of Guideline Operationalization on Youth Activity Prevalence in the International Children's Accelerometry Database. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 54(7), s. 1114–1122. doi: 10.1249/MSS.0000000000002884. Fulltekst i vitenarkiv Vis sammendrag

  Introduction The United Kingdom and World Health Organization recently changed their youth physical activity (PA) guidelines from 60 min of moderate- to vigorous-intensity PA (MVPA) every day, to an average of 60 min of MVPA per day, over a week. The changes are based on expert opinion due to insufficient evidence comparing health outcomes associated with different guideline definitions. This study used the International Children’s Accelerometry Database to compare approaches to calculating youth PA compliance and associations with health indicators. Methods Cross-sectional accelerometer data (n = 21,612, 5–18 yr) were used to examine compliance with four guideline definitions: daily method (DM; ≥60 min MVPA every day), average method (AM; average of ≥60 min MVPA per day), AM5 (AM compliance and ≥5 min of vigorous PA [VPA] on ≥3 d), and AM15 (AM compliance and ≥15 min VPA on ≥3 d). Associations between compliance and health indicators were examined for all definitions. Results Compliance varied from 5.3% (DM) to 29.9% (AM). Associations between compliance and health indicators were similar for AM, AM5, and AM15. For example, compliance with AM, AM5, and AM15 was associated with a lower BMI z-score (statistics are coefficient [95% CI]): AM (−0.28 [−0.33 to −0.23]), AM5 (−0.28 [−0.33 to −0.23], and AM15 (−0.30 [−0.35 to −0.25]). Associations between compliance and health indicators for DM were similar/weaker, possibly reflecting fewer DM-compliant participants with health data and lower variability in exposure/outcome data. Conclusions Youth completing 60 min of MVPA every day do not experience superior health benefits to youth completing an average of 60 min of MVPA per day. Guidelines should encourage youth to achieve an average of 60 min of MVPA per day. Different guideline definitions affect inactivity prevalence estimates; this must be considered when analyzing data and comparing studies.

• Bratteteig, Mari; Anderssen, Sigmund Alfred; Rueegg, Corina Silvia; Ruud, Ellen; Torsvik, Ingrid Kristin & Kriemler, Susi [Vis alle 7 forfattere av denne artikkelen] (2022). Device-measured physical activity and cardiovascular disease risk in adolescent childhood cancer survivors. A physical activity in childhood cancer survivors (PACCS) study. Frontiers in Pediatrics. 10. doi: 10.3389/fped.2022.977365. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: We aimed to compare cardiovascular disease (CVD) risk factors in childhood cancer survivors (CCS) with age- and sex-stratified reference material and examine the association between physical activity (PA) intensities and CVD risk factors in CCS. Materials and methods: Within the cross-sectional, multicenter Physical Activity in Childhood Cancer Survivors (PACCS) study, we collected data on CVD risk factors [VO2–peak (mL⋅kg–1⋅min–1), body mass index (BMI, kg/m2), systolic blood pressure (SBP, mmHg), and total-cholesterol/HDL-cholesterol (Total/HDL)] among CCS aged 9–18 years. CVD risk factors were compared to references with immediate t-tests. We transformed CVD risk factors into z-scores based on international references and generated an individual CVD risk score: [inverse ZVO2–peak + ZBMI + ZSBP + ZTotal/HDL)/4]. Multivariable mixed linear regression models were used to analyze the associations between device-measured PA intensities and CVD risk factors. Results: We included 157 CCS aged on average 13.4 years at inclusion and 8.2 years from diagnosis. Male CCS had lower VO2–peak compared to references (45.4 vs. 49.4 mL⋅kg–1⋅min–1, P = 0.001), higher diastolic BP (67 vs. 63 mmHg, P < 0.001), lower HDL (1.35 vs. 1.44 mmol/L, P = 0.012), as well as a tendency to higher CVD risk score (z-score=0.14 vs. 0.00, P = .075). Female CCS’ CVD risk factors were comparable to references. Vigorous-intensity PA (VPA) was associated with CVD risk factors. A 10-min increase in VPA was associated with higher VO2–peak (β = 4.9, 95% CI, 2.1–7.7), lower Total/HDL (β = −0.3, 95% CI, −0.6 to −0.1) and a lower CVD risk score (β = −0.4, 95% CI, −0.6 to −0.2). Conclusion: Male adolescent CCS had less favorable values of CVD risk factors compared to references. VPA in adolescent CCS is associated with clinically meaningful favorable values of CVD risk factors.

• Paluch, Amanda E; Bajpai, Shivangi; Bassett, David R; Carnethon, Mercedes R; Ekelund, Ulf & Evenson, Kelly R [Vis alle 45 forfattere av denne artikkelen] (2022). Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. The Lancet Public Health. ISSN 2468-2667. 7(3), s. e219–e228. doi: 10.1016/S2468-2667(21)00302-9. Fulltekst i vitenarkiv Vis sammendrag

  Background Although 10000 steps per day is widely promoted to have health benefits, there is little evidence to support this recommendation. We aimed to determine the association between number of steps per day and stepping rate with all-cause mortality.<p> <p>Methods In this meta-analysis, we identified studies investigating the effect of daily step count on all-cause mortality in adults (aged ≥18 years), via a previously published systematic review and expert knowledge of the field. We asked participating study investigators to process their participant-level data following a standardised protocol. The primary outcome was all-cause mortality collected from death certificates and country registries. We analysed the dose– response association of steps per day and stepping rate with all-cause mortality. We did Cox proportional hazards regression analyses using study-specific quartiles of steps per day and calculated hazard ratios (HRs) with inversevariance weighted random effects models. <p>Findings We identified 15 studies, of which seven were published and eight were unpublished, with study start dates between 1999 and 2018. The total sample included 47 471 adults, among whom there were 3013 deaths (10·1 per 1000 participant-years) over a median follow-up of 7·1 years ([IQR 4·3–9·9]; total sum of follow-up across studies was 297 837 person-years). Quartile median steps per day were 3553 for quartile 1, 5801 for quartile 2, 7842 for quartile 3, and 10 901 for quartile 4. Compared with the lowest quartile, the adjusted HR for all-cause mortality was 0·60 (95% CI 0·51–0·71) for quartile 2, 0·55 (0·49–0·62) for quartile 3, and 0·47 (0·39–0·57) for quartile 4. Restricted cubic splines showed progressively decreasing risk of mortality among adults aged 60 years and older with increasing number of steps per day until 6000–8000 steps per day and among adults younger than 60 years until 8000–10000 steps per day. Adjusting for number of steps per day, comparing quartile 1 with quartile 4, the association between higher stepping rates and mortality was attenuated but remained significant for a peak of 30 min (HR 0·67 [95% CI 0·56–0·83]) and a peak of 60 min (0·67 [0·50–0·90]), but not significant for time (min per day) spent walking at 40 steps per min or faster (1·12 [0·96–1·32]) and 100 steps per min or faster (0·86 [0·58–1·28]). <p>Interpretation Taking more steps per day was associated with a progressively lower risk of all-cause mortality, up to a level that varied by age. The findings from this meta-analysis can be used to inform step guidelines for public health promotion of physical activity.

• Rajalahti, Tarja; Aadland, Eivind; Resaland, Geir Kåre; Anderssen, Sigmund Alfred & Kvalheim, Olav Martin (2021). Influence of adiposity and physical activity on the cardiometabolic association pattern of lipoprotein subclasses to aerobic fitness in prepubertal children. PLOS ONE. 16(11). doi: 10.1371/journal.pone.0259901. Fulltekst i vitenarkiv Vis sammendrag

  Aerobic fitness (AF) and lipoprotein subclasses associate to each other and to cardiovascular health. Adiposity and physical activity (PA) influence the association pattern of AF to lipoproteins almost inversely making it difficult to assess their independent and joint influence on the association pattern. This study, including 841 children (50% boys) 10.2 ± 0.3 years old with BMI 18.0 ± 3.0 kg/m2 from rural Western Norway, aimed at examining the association pattern of AF to the lipoprotein subclasses and to estimate the independent and joint influence of PA and adiposity on this pattern. We used multivariate analysis to determine the association pattern of a profile of 26 lipoprotein features to AF with and without adjustment for three measures of adiposity and a high-resolution PA descriptor of 23 intensity intervals derived from accelerometry. For data not adjusted for adiposity or PA, we observed a cardioprotective lipoprotein pattern associating to AF. This pattern withstood adjustment for PA, but the strength of association to AF was reduced by 58%, while adjustment for adiposity weakened the association of AF to the lipoproteins by 85% and with strongest changes in the associations to a cardioprotective high-density lipoprotein subclass pattern. When adjusted for both adiposity and PA, the cardioprotective lipoprotein pattern still associated to AF, but the strength of association was reduced by 90%. Our results imply that the (negative) influence of adiposity on the cardioprotective association pattern of lipoproteins to AF is considerably stronger than the (positive) contribution of PA to this pattern. However, our analysis shows that PA contributes also indirectly through a strong inverse association to adiposity.

• 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.

• Solberg, Runar Barstad; Steene-Johannessen, Jostein; Fagerland, Morten; Anderssen, Sigmund Alfred; Berntsen, Sveinung & Resaland, Geir Kåre [Vis alle 9 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Berglund, Ida Johnsen; Vesterbekkmo, Elisabeth Kleivhaug; Retterstøl, Kjetil; Anderssen, Sigmund Alfred; Singh, Maria A. Fiatarone & Helge, Jørn Wulff [Vis alle 9 forfattere av denne artikkelen] (2021). The Long-term Effect of Different Exercise Intensities on High-Density Lipoprotein Cholesterol in Older Men and Women Using the Per Protocol Approach: The Generation 100 Study. Mayo Clinic Proceedings: Innovations, Quality & Outcomes (MCP:IQ&O). 5(5), s. 859–871. doi: 10.1016/j.mayocpiqo.2021.07.002. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To examine whether 5 years of high-intensity interval training (HIIT) increases high-density lipoprotein cholesterol (HDL-C) concentration more than moderate-intensity continuous training (MICT) and control (CON) in older men and women. Methods: A total of 1567 older adults (790 [50.4%] women) were randomized (2:1:1) to either CON (n=780; asked to follow the national recommendations for physical activity) or 2 weekly sessions of HIIT (10-minute warm-up followed by 4×4-minute intervals at ∼90% of peak heart rate) or MICT (50 minutes of continuous work at ∼70% of peak heart rate). Serum HDL-C concentration was measured by standard procedures at baseline and at 1 year, 3 years, and 5 years. The study took place between August 21, 2012, and June 31, 2018. Linear mixed models were used to determine between-group differences during 5 years using the per protocol approach. Results: Men in HIIT had a smaller reduction in HDL-C (−1.2%) than men in CON (−6.9%) and MICT (−7.8%) after 5 years (P=.01 and P=.03 for CON vs HIIT and MICT vs HIIT, respectively). No effect of exercise intensity on HDL-C was seen in women. Changes in peak oxygen uptake were associated with changes in HDL-C in both men and women, whereas changes in body weight and fat mass were not. Conclusion: In men, HIIT seems to be the best strategy to prevent a decline in HDL-C during a 5-year period. No effect of exercise intensity was seen for older women.

• Rajalahti, Tarja; Aadland, Eivind; Resaland, Geir Kåre; Anderssen, Sigmund Alfred & Kvalheim, Olav Martin (2021). Cardiometabolic associations between physical activity, adiposity, and lipoprotein subclasses in prepubertal norwegian children. Nutrients. 13(6), s. 1–14. doi: 10.3390/nu13062095. Fulltekst i vitenarkiv Vis sammendrag

  Lipoprotein subclasses possess crucial cardiometabolic information. Due to strong multicollinearity among variables, little is known about the strength of influence of physical activity (PA) and adiposity upon this cardiometabolic pattern. Using a novel approach to adjust for covariates, we aimed at determining the “net” patterns and strength for PA and adiposity to the lipoprotein profile. Principal component and multivariate pattern analysis were used for the analysis of 841 prepubertal children characterized by 26 lipoprotein features determined by proton nuclear magnetic resonance spectroscopy, a high-resolution PA descriptor derived from accelerometry, and three adiposity measures: body mass index, waist circumference to height, and skinfold thickness. Our approach focuses on revealing and validating the underlying predictive association patterns in the metabolic, anthropologic, and PA data to acknowledge the inherent multi-collinear nature of such data. PA associates to a favorable cardiometabolic pattern of increased high-density lipoproteins (HDL), very large and large HDL particles, and large size of HDL particles, and decreased triglyceride, chylomicrons, very low-density lipoproteins (VLDL), and their subclasses, and to low size of VLDL particles. Although weakened in strength, this pattern resists adjustment for adiposity. Adiposity is inversely associated to this pattern and exhibits unfavorable associations to low-density lipoprotein (LDL) features, including atherogenic small and very small LDL particles. The observed associations are still strong after adjustment for PA. Thus, lipoproteins explain 26.0% in adiposity after adjustment for PA compared to 2.3% in PA after adjustment for adiposity.

• 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.

• Vedøy, Ingeborg Barth; Skulberg, Knut Ragnvald; Anderssen, Sigmund Alfred; Fagerland, Morten Wang; Tjomsland, Hege Eikeland & Thurston, Miranda N. (2021). The longitudinal association between objectively measured physical activity and mental health among Norwegian adolescents. International Journal of Behavioral Nutrition and Physical Activity. 18:149, s. 1–11. doi: 10.1186/s12966-021-01211-x. Fulltekst i vitenarkiv Vis sammendrag

  Background: Mental health among young people in many countries, including Norway, seems to be deteriorating. Physical activity (PA) has been positively associated with mental health. However, methodological issues related to study design and measurement of PA and mental health outcomes currently limits our understanding of the relationship. The purpose of the present study is to explore the prospective relationship between objectively measured PA and mental health outcomes. More specifically, volume (total PA), intensity (moderate-to-vigorous PA [MVPA]) and sedentary behaviour (SED) were explored in relation to mental health problems (MHP) and mental wellbeing (MWB). Methods: Data from 599 adolescents (54.4% female, mean age at baseline ±SD 13.3 ± 0.3 years) were collected annually during their 3 years (T1, T2 and T3) at lower secondary school. PA was measured using accelerometry. MWB was measured using the ‘Warwick-Edinburgh Mental Wellbeing Scale’ and MHP by the ‘Strengths and Difficulties Questionnaire’. Multiple linear regression was performed to explore relationships between changes in PA/SED (between T1-T3) and MWB/MHP (at T3). The term ‘movement categories’ was used to refer to components on the movement continuum and includes volume (total PA), intensity (MVPA) and SED. Results: Among boys, any increase in SED was positively associated with MWB (β = 0.05, 95% CI: 0.01 to 0.10), whereas a small positive association between an increase in total PA (volume) and MWB was found among girls (β = 1.13, 95% CI: 0.05 to 2.21). There were no associations between changes in any movement categories [total PA (volume), MVPA, SED] and score on MHP at T3, neither for girls nor boys. Conclusion: This study provided no clear evidence of any association between change in volume or intensity of PA and MHP among an overall healthy adolescent study sample. There was, however, evidence of a relationship between increased SED and MWB among boys and increased volume of PA and MWB among girls. The relationship between movement categories and mental health may depend on the measurement used to assess both PA/SED and variables of mental health. Future research would be strengthened by researchers clarifying what construct of mental health is being used and measured.

• Zhou, Bin; Carrillo-Larco, Rodrigo M.; Danaei, Goodarz; Riley, Leanne M.; Paciorek, Christopher J. & Stevens, Gretchen A. [Vis alle 100 forfattere av denne artikkelen] (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), s. 957–980. doi: 10.1016/S0140-6736(21)01330-1. Fulltekst i vitenarkiv Vis sammendrag

  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.

• 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.

• Solberg, Runar Barstad; Steene-Johannessen, Jostein; Anderssen, Sigmund Alfred; Ekelund, Ulf; Säfvenbom, Reidar & Haugen, Tommy [Vis alle 11 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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 [Vis alle 10 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Jones, Paul Remy; Rajalahti, Tarja; Resaland, Geir Kåre; Aadland, Eivind; Steene-Johannessen, Jostein & Anderssen, Sigmund Alfred [Vis alle 10 forfattere av denne artikkelen] (2021). Cross-sectional and prospective associations between aerobic fitness and lipoprotein particle profile in a cohort of Norwegian schoolchildren. Atherosclerosis. ISSN 0021-9150. 321, s. 21–29. doi: 10.1016/j.atherosclerosis.2021.02.002. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims The associations between aerobic fitness and traditional measures of lipid metabolism in children are uncertain. We investigated whether higher levels of aerobic fitness benefit lipoprotein metabolism by exploring associations with a comprehensive lipoprotein particle profile. Methods In our prospective cohort study, we used targeted proton nuclear magnetic resonance (1H NMR) spectroscopy to profile 57 measures of lipoprotein metabolism from fasting serum samples of 858 fifth-grade Norwegian schoolchildren (49.0% girls; mean age 10.0 years). Aerobic fitness was measured using an intermittent shuttle run aerobic fitness test. We used multiple linear regression adjusted for potential confounders to examine cross-sectional and prospective associations between aerobic fitness and lipoprotein particle profile. Results Higher levels of aerobic fitness were associated with a favourable lipoprotein particle profile in the cross-sectional analysis, which included inverse associations with all measures of very low-density lipoprotein (VLDL) particles (e.g., −0.06 mmol·L−1 or –0.23 SD units; 95% CI = −0.31, −0.16 for VLDL cholesterol concentration). In the prospective analysis, the favourable pattern of associations persisted, though the individual associations tended to be more consistent with those of the cross-sectional analysis for the VLDL subclass measures compared to the low-density lipoproteins and high-density lipoproteins. Adjustment for adiposity attenuated the associations in both cross-sectional and prospective models. Nevertheless, an independent effect of aerobic fitness remained for some measures. Conclusions Improving children's aerobic fitness levels should benefit lipoprotein metabolism, though a concomitant reduction in adiposity would likely potentiate this effect.

• Vedøy, Ingeborg Barth; Skulberg, Knut Ragnvald; Anderssen, Sigmund Alfred; Tjomsland, Hege Eikeland & Thurston, Miranda (2021). Physical activity and academic achievement among Norwegian adolescents: Findings from a longitudinal study. Preventive Medicine Reports. 21:101312, s. 1–7. doi: 10.1016/j.pmedr.2021.101312. Fulltekst i vitenarkiv Vis sammendrag

  Regular physical activity (PA) has been associated with academic achievement, but the evidence is mainly based on cross-sectional research and self-reported measures of PA. The purpose of the current study was to explore the longitudinal relationship between objectively measured PA and academic achievement among a cohort of adolescents in Norway between 2016 and 2018. As a secondary aim, an indirect relationship via waist circumference (WC) and sleep duration was assessed. Data from 599 adolescents (54.4% female, mean age at baseline ± SD 13.3 ± 0.3 years) were collected annually during their three years at lower secondary school. PA was measured objectively using accelerometry. Academic achievement was assessed using grade point average (GPA) from school records. Linear regression analysis was performed to explore associations between longitudinal changes in measures of PA (Total PA and moderate-to-vigorous PA [MVPA]) and academic achievement directly or via mediators. Results showed no significant associations between Total PA or MVPA and academic achievement, either in the main analyses or through mediation of WC and sleep duration. The results contribute to a growing evidence base of studies showing no association between objectively measured PA and academic achievement among adolescents.

• Letnes, Jon Magne; Berglund, Ida Johnsen; Johnson, Kristin Espolin; Dalen, Håvard; Nes, Bjarne & Lydersen, Stian [Vis alle 25 forfattere av denne artikkelen] (2021). Effect of 5 years of exercise training on the cardiovascular risk profile of older adults: the Generation 100 randomized trial. European Heart Journal. ISSN 0195-668X. 43(21), s. 2065–2075. doi: 10.1093/eurheartj/ehab721. Fulltekst i vitenarkiv Vis sammendrag

  Aims The aim of this study was to compare the effects of 5 years of supervised exercise training (ExComb), and the differential effects of subgroups of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), with control on the cardiovascular risk profile in older adults. Methods and results Older adults aged 70–77 years from Trondheim, Norway (n = 1567, 50% women), able to safely perform exercise training were randomized to 5 years of two weekly sessions of HIIT [∼90% of peak heart rate (HR), n = 400] or MICT (∼70% of peak HR, n = 387), together forming ExComb (n = 787), or control (instructed to follow physical activity recommendations, n = 780). The main outcome was a continuous cardiovascular risk score (CCR), individual cardiovascular risk factors, and peak oxygen uptake (VO2peak). CCR was not significantly lower [−0.19, 99% confidence interval (CI) −0.46 to 0.07] and VO2peak was not significantly higher (0.39 mL/kg/min, 99% CI −0.22 to 1.00) for ExComb vs. control. HIIT showed higher VO2peak (0.76 mL/kg/min, 99% CI 0.02–1.51), but not lower CCR (−0.32, 99% CI −0.64 to 0.01) vs. control. MICT did not show significant differences compared to control or HIIT. Individual risk factors mostly did not show significant between-group differences, with some exceptions for HIIT being better than control. There was no significant effect modification by sex. The number of cardiovascular events was similar across groups. The healthy and fit study sample, and contamination and cross-over between intervention groups, challenged the possibility of detecting between-group differences. Conclusions Five years of supervised exercise training in older adults had little effect on cardiovascular risk profile and did not reduce cardiovascular events. ClinicalTrials.gov: NCT01666340

• Skrede, Turid; Aadland, Eivind; Anderssen, Sigmund Alfred; Resaland, Geir Kåre & Ekelund, Ulf (2021). Bi-directional prospective associations between sedentary time, physical activity and adiposity in 10-year old Norwegian children. Journal of Sports Sciences. ISSN 0264-0414. 39(15), s. 1772–1779. doi: 10.1080/02640414.2021.1898114. Fulltekst i vitenarkiv Vis sammendrag

  There is an adverse cross-sectional association between sedentary time, physical activity (PA) and adiposity, but weak and inconsistent estimates raise question to the direction of associations. The present study aims to examine whether the prospective association between sedentary time, different PA intensities and indicators of adiposity is bi-directional. The Active Smarter Kids Study obtained data from 869 ten-year-old children with valid measurements for sedentary time, PA, and adiposity at baseline and follow-up. Time spent sedentary and PA was measured by accelerometry, adiposity was assessed by three different measures: body mass index (BMI), waist circumference (WC) and sum of four skinfolds (S4SF). Neither overall PA nor time spent sedentary predicted lower BMI or WC at follow-up, but the time spent in moderate-and-vigorous PA (MVPA) and vigorous PA (VPA) predicted lower S4SF at follow-up among boys (MVPA β − 0.066 [95% CI −0.105, −0.027] p = 0.001). Baseline BMI and WC predicted less overall PA, MVPA and VPA in boys. All adiposity measures predicted more time spent sedentary at follow-up in boys. The results suggest that overall PA and sedentary time do not predict future adiposity. Baseline adiposity may rather predict more sedentary time and less higher intensity activity.

• Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Dalene, Knut Eirik; Kolle, Elin; Northstone, Kate & Møller, Niels Christian [Vis alle 51 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Vedøy, Ingeborg Barth; Anderssen, Sigmund Alfred; Tjomsland, Hege Eikeland; Skulberg, Knut Ragnvald & Thurston, Miranda (2020). Physical activity, mental health and academic achievement: a cross-sectional study of Norwegian adolescents. Mental Health and Physical Activity. ISSN 1755-2966. 18. doi: 10.1016/j.mhpa.2020.100322. Fulltekst i vitenarkiv Vis sammendrag

  Background The purpose of this study was to describe associations between physical activity (PA), mental health and academic achievement in a Norwegian adolescent cohort. Methods In total, 1001 adolescents were invited to participate, of whom 599 (54.4% female, mean age ± SD 13.3 ± 0.3y) entered the study. PA was measured objectively using accelerometers, variables on mental health were assessed through an online questionnaire and academic achievement was assessed using grade point average (GPA) collected through school records. The associations between PA, mental health and academic achievement were modelled using multiple linear regression. Results PA was positively associated with mental wellbeing (p ≤ .05), self-perception of athletic competence (p ≤ .001) and self-perception of social acceptance (p ≤ .001). It was not associated with global self-esteem or mental health complaints. No significant association between PA and GPA was found. However, results showed a significant association between PA and grade in physical education among girls (p ≤ .001). Conclusion PA was associated with mental wellbeing and domain specific self-esteem although the causal significance of the association requires further investigation. The current study does not support associations between PA and mental health problems or PA and academic achievement. Further studies are necessary to investigate the longitudinal relationship between PA, variables of mental health and academic achievement amongst adolescents.

• Taddei, Cristina; Jackson, Rod; Zhou, Bin; Bixby, Honor; Danaei, Goodarz & Cesare, Mariachiara Di [Vis alle 361 forfattere av denne artikkelen] (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), s. 173–192. doi: 10.1093/ije/dyz099. Fulltekst i vitenarkiv
• 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.

• Willeit, Peter; Tschiderer, Lena; Allara, Elias; Reuber, Kathrin; Seekircher, Lisa & Gao, Lu [Vis alle 76 forfattere av denne artikkelen] (2020). Carotid Intima-Media Thickness Progression as Surrogate Marker for Cardiovascular Risk : Meta-Analysis of 119 Clinical Trials Involving 100 667 Patients. Circulation. ISSN 0009-7322. 142(7), s. 621–642. doi: 10.1161/CIRCULATIONAHA.120.046361. Fulltekst i vitenarkiv Vis sammendrag

  Background: To quantify the association between effects of interventions on carotid intima-media thickness (cIMT) progression and their effects on cardiovascular disease (CVD) risk. Methods: We systematically collated data from randomized, controlled trials. cIMT was assessed as the mean value at the common-carotid-artery; if unavailable, the maximum value at the common-carotid-artery or other cIMT measures were used. The primary outcome was a combined CVD end point defined as myocardial infarction, stroke, revascularization procedures, or fatal CVD. We estimated intervention effects on cIMT progression and incident CVD for each trial, before relating the 2 using a Bayesian meta-regression approach. Results: We analyzed data of 119 randomized, controlled trials involving 100 667 patients (mean age 62 years, 42% female). Over an average follow-up of 3.7 years, 12 038 patients developed the combined CVD end point. Across all interventions, each 10 μm/y reduction of cIMT progression resulted in a relative risk for CVD of 0.91 (95% Credible Interval, 0.87–0.94), with an additional relative risk for CVD of 0.92 (0.87–0.97) being achieved independent of cIMT progression. Taken together, we estimated that interventions reducing cIMT progression by 10, 20, 30, or 40 μm/y would yield relative risks of 0.84 (0.75–0.93), 0.76 (0.67–0.85), 0.69 (0.59–0.79), or 0.63 (0.52–0.74), respectively. Results were similar when grouping trials by type of intervention, time of conduct, time to ultrasound follow-up, availability of individual-participant data, primary versus secondary prevention trials, type of cIMT measurement, and proportion of female patients. Conclusions: The extent of intervention effects on cIMT progression predicted the degree of CVD risk reduction. This provides a missing link supporting the usefulness of cIMT progression as a surrogate marker for CVD risk in clinical trials.

• Aadland, Eivind; Nilsen, Ada Kristine Ofrim; Ylvisåker, Einar; Johannessen, Kjersti & Anderssen, Sigmund Alfred (2020). Reproducibility of objectively measured physical activity: Reconsideration needed. Journal of Sports Sciences. ISSN 0264-0414. 38(10), s. 1132–1139. doi: 10.1080/02640414.2020.1743054. Fulltekst i vitenarkiv Vis sammendrag

  Reliability of accelerometer-determined physical activity (PA), and thus the required length of a monitoring period, appears to depend on the analytic approach used for its calculation. We compared reliability of objectively measured PA using different resolution of data in a sample of 221 Norwegian 2–6-year-old children providing 2–3 valid 14-day periods of accelerometer monitoring (ActiGraph GT3X+) during September–October, January–February, and May–June 2015–2016. Reliability (intra-class correlation [ICC]) was measured for 1–14 days of monitoring across the measurement periods using linear mixed effect modelling. These results were compared to reliability estimated using different resolution of data using the Spearman–Brown formula. The measured reliability improved only marginally with increased monitoring length and levelled off after 5–6 days. Estimated reliability differed substantially when derived from different resolution of data: 3.9–5.4, 6.7–9.2, 13.4–26.7 and 26.3–87.7 days of monitoring was required to achieve an ICC = 0.80 using an hour-by-hour, a day-by-day, a week-by-week and a period-by-period approach, respectively. Reliability could not be correctly estimated from any single resolution of data. We conclude that reconsideration is needed with regard to how reproducibility of objectively measured PA is analysed and interpreted.

• Stensvold, Dorthe; Viken, Hallgeir; Steinshamn, Sigurd Loe; Dalen, Håvard; Støylen, Asbjørn & Loennechen, Jan Pål [Vis alle 23 forfattere av denne artikkelen] (2020). Effect of exercise training for five years on all cause mortality in older adults-The Generation 100 study: Randomised controlled trial. The BMJ. 371. doi: 10.1136/bmj.m3485. Fulltekst i vitenarkiv Vis sammendrag

  Objective To evaluate the effect of five years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (70-77 years). Design Randomised controlled trial. Setting General population of older adults in Trondheim, Norway. Participants 1567 of 6966 individuals born between 1936 and 1942. Intervention Participants were randomised to two sessions weekly of high intensity interval training at about 90% of peak heart rate (HIIT, n=400), moderate intensity continuous training at about 70% of peak heart rate (MICT, n=387), or to follow the national guidelines for physical activity (n=780; control group); all for five years. Main outcome measure All cause mortality. An exploratory hypothesis was that HIIT lowers mortality more than MICT. Results Mean age of the 1567 participants (790 women) was 72.8 (SD 2.1) years. Overall, 87.5% of participants reported to have overall good health, with 80% reporting medium or high physical activity levels at baseline. All cause mortality did not differ between the control group and combined MICT and HIIT group. When MICT and HIIT were analysed separately, with the control group as reference (observed mortality of 4.7%), an absolute risk reduction of 1.7 percentage points was observed after HIIT (hazard ratio 0.63, 95% confidence interval 0.33 to 1.20) and an absolute increased risk of 1.2 percentage points after MICT (1.24, 0.73 to 2.10). When HIIT was compared with MICT as reference group an absolute risk reduction of 2.9 percentage points was observed (0.51, 0.25 to 1.02) for all cause mortality. Control participants chose to perform more of their physical activity as HIIT than the physical activity undertaken by participants in the MICT group. This meant that the controls achieved an exercise dose at an intensity between the MICT and HIIT groups. Conclusion This study suggests that combined MICT and HIIT has no effect on all cause mortality compared with recommended physical activity levels. However, we observed a lower all cause mortality trend after HIIT compared with controls and MICT.

• 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.

• Nilsen, Ada Kristine Ofrim; Anderssen, Sigmund Alfred; Johannessen, Kjersti; Aadland, Katrine Nyvoll; Ylvisåker, Einar & Loftesnes, Jan Morten [Vis alle 7 forfattere av denne artikkelen] (2020). Bi-directional prospective associations between objectively measured physical activity and fundamental motor skills in children: a two-year follow-up. International Journal of Behavioral Nutrition and Physical Activity. 17. doi: 10.1186/s12966-019-0902-6. Fulltekst i vitenarkiv Vis sammendrag

  Background: The direction of the longitudinal relationship between physical activity (PA) and fundamental motor skills (FMS) remains unclear. We evaluated the bi-directional, prospective relationships between intensity-specific physical activity (PA) and domain-specific fundamental motor skills (FMS) over 2 years in children attending preschool at baseline. Methods: A sample of 230 children (mean age at baseline 4.7 yr, 52% boys) from the 'Sogn og Fjordane Preschool Physical Activity Study' was measured 2 years apart. PA was assessed using ActiGraph accelerometers (GT3X+). FMS were evaluated by a test battery guided by the 'Test of Gross Motor Development 3' and the 'Preschooler Gross Motor Quality Scale'. PA outcomes were total PA (TPA [counts per minute]) and intensity specific PA and sedentary behaviour (SED) (min/day). FMS outcomes were locomotor, object control, and balance skills. Linear mixed model adjusting for potential co-variates was used to evaluate the bi-directional prospective associations between these variables, including the moderating effect of sex and age. Results: Baseline total PA, moderate-to-vigorous PA (MVPA), and vigorous PA predicted higher locomotor, object control, and balance skills at follow-up (standardized regression coefficient (β): 0.17 to 0.26, p = 0.002–0.017). Baseline SED predicted lower locomotor skills at follow-up (β: − 0.27, p = 0.012). Baseline light PA did not predict FMS at follow-up. Baseline FMS were not associated with PA or SED at follow-up. Conclusions: MVPA was positively associated with development of FMS in young children. In contrast, FMS were not related to future PA levels. Our results suggest promotion of MVPA is important for FMS development in young children.

• 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.

• Bernhardsen, Guro Pauck; Stensrud, Trine; Hansen, Bjørge Hermann; Steene-Johannessen, Jostein; Kolle, Elin & Nystad, Wenche [Vis alle 17 forfattere av denne artikkelen] (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), s. 2052–2063. doi: 10.1038/s41366-020-0612-9. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Aadland, Eivind; Kvalheim, Olav Martin; Hansen, Bjørge Hermann; Kriemler, Susi; Ried-Larsen, Mathias & Wedderkopp, Niels [Vis alle 12 forfattere av denne artikkelen] (2020). The multivariate physical activity signature associated with metabolic health in children and youth: An International Children's Accelerometry Database (ICAD) analysis. Preventive Medicine. ISSN 0091-7435. 141. doi: 10.1016/j.ypmed.2020.106266. Fulltekst i vitenarkiv Vis sammendrag

  There is solid evidence for an association between physical activity and metabolic health outcomes in children and youth, but for methodological reasons most studies describe the intensity spectrum using only a few summary measures. We aimed to determine the multivariate physical activity intensity signature associated with metabolic health in a large and diverse sample of children and youth, by investigating the association pattern for the entire physical intensity spectrum. We used pooled data from 11 studies and 11,853 participants aged 5.8–18.4 years included in the International Children's Accelerometry Database. We derived 14 accelerometry-derived (ActiGraph) physical activity variables covering the intensity spectrum (from 0–99 to ≥8000 counts per minute). To handle the multicollinearity among these variables, we used multivariate pattern analysis to establish the associations with indices of metabolic health (abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure). A composite metabolic health score was used as the main outcome variable. Associations with the composite metabolic health score were weak for sedentary time and light physical activity, but gradually strengthened with increasing time spent in moderate and vigorous intensities (up to 4000–5000 counts per minute). Association patterns were fairly consistent across sex and age groups, but varied across different metabolic health outcomes. This novel analytic approach suggests that vigorous intensity, rather than less intense activities or sedentary behavior, are related to metabolic health in children and youth.

• 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.

• Taddei, Cristina; Zhou, Bin; Bixby, Honor; Carrillo-Larco, Rodrigo M.; Danaei, Goodarz & Jackson, Rod T. [Vis alle 55 forfattere av denne artikkelen] (2020). Repositioning of the global epicentre of non-optimal cholesterol. Nature. ISSN 0028-0836. 582(7810), s. 73–77. doi: 10.1038/s41586-020-2338-1. Fulltekst i vitenarkiv Vis sammendrag

  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 [Vis alle 10 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Aadland, Eivind; Tjomsland, Hege Eikeland; Johannessen, Kjersti; Nilsen, Ada Kristine Ofrim; Resaland, Geir Kåre & Glosvik, Øyvind [Vis alle 18 forfattere av denne artikkelen] (2020). Active Learning Norwegian Preschool(er)s (ACTNOW) – Design of a Cluster Randomized Controlled Trial of Staff Professional Development to Promote Physical Activity, Motor Skills, and Cognition in Preschoolers [Study protocol]. Frontiers in Psychology. 11. doi: 10.3389/fpsyg.2020.01382. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: There is a dearth of high-quality evidence on effective, sustainable, and scalable interventions to increase physical activity (PA) and concomitant outcomes in preschoolers. Specifically, there is a need to better understand how the preschool context can be used to increase various types of physically active play to promote holistic child development. The implementation of such interventions requires highly competent preschool staffs, however, the competence in promoting PA is often low. The main aim of the ACTNOW study is therefore to investigate the effects of professional development for preschool staffs on child PA and developmental outcomes. Methods: The study will be conducted in Norway 2019–2022 and is designed as a two-arm (intervention, control) cluster randomized controlled trial (RCT) with 7- and 18-months follow-ups. We aim to recruit 60 preschools and 1,200 3- to 5-years-old children to provide sufficient power to detect effect sizes (ESs) between 0.20 and 0.30. The intervention is nested within two levels: the preschool and the child. Central to the ACTNOW intervention are opportunities for children to engage in a variety of “enriched,” meaningful, and enjoyable physically active play that supports the development of the whole child. To this end, the main intervention is a 7-month professional development/education module for preschool staff, aimed to provide them with the necessary capacity to deliver four core PA components to the children (moderate-to-vigorous PA, motor-challenging PA, cognitively engaging play, and physically active learning). We will include a range of child-level outcomes, including PA, physical fitness, adiposity, motor skills, socioemotional health, self-regulation, executive function, and learning. At the preschool level, we will describe implementation and adaptation processes using quantitative and qualitative data. Discussion: Professional development of staff and a whole-child approach that integrates PA with cognitively engaging play and learning activities in the preschool setting may provide a feasible vehicle to enhance both physical and cognitive development in young children. ACTNOW is designed to test this hypothesis to provide a sustainable way to build human capital and provide an early solution to lifelong public health and developmental challenges.

• Aarsland, Vera Vårin Birkemo; Borda, Miguel Germán; Aarsland, Dag; Garcia-Cifuentes, Elkin; Anderssen, Sigmund Alfred & Tover-Rios, Diego Alejandro [Vis alle 8 forfattere av denne artikkelen] (2020). Association between physical activity and cognition in Mexican and Korean older adults. Archives of Gerontology and Geriatrics. ISSN 0167-4943. 89. doi: 10.1016/j.archger.2020.104047. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: As the world's population ages, the prevalence of cognitive impairment associated with age in- creases. This increase is particularly pronounced in Asia and South-America. The objective of this study was to investigate separately the longitudinal association of physical activity and cognitive function in; older adults in Mexico and South Korea. Materials and Methods: This is a secondary analysis of two surveys, The Mexican Health and aging Study (MHAS) (n = 5853) and Korean Longitudinal Study of aging (KLoSA) (n = 5188), designed to study the aging process of older adults living in Mexico and South Korea. Participants older than 50 years were selected from rural and urban areas achieving a representative sample. Physical activity was assessed using self-report. Cognition was assessed using Cross-Cultural Cognitive Examination (CCCE) and Minimental state examination (MMSE) in Mexico and South Korea respectively. Here we investigate the longitudinal association between physical activity and cognition during 3 years for MHAS and 4 years for KLoSA using multiple linear regression analyses. Results: The prevalence of physical activity was 40.68 % in MHAS and 35.57 % in KLoSA. In the adjusted longitudinal multivariate analysis, an independent association was found between physical activity and MMSE score OR 0.0866 (CI 0.0266-0.1467 p-value 0.0047) in the Korean older adults, while there was no significant association in MHAS. Conclusions: Physical activity could have a protective effect on the cognitive decline associated with aging in the Korean population.

• Stavnsbo, Mette; Skrede, Turid; Aadland, Eivind; Aadland, Katrine Nyvoll; Chinapaw, Mai & Anderssen, Sigmund Alfred [Vis alle 8 forfattere av denne artikkelen] (2019). Cardiometabolic risk factor levels in Norwegian children compared to international reference values: The ASK study. PLOS ONE. 14(8). doi: 10.1371/journal.pone.0220239. Fulltekst i vitenarkiv Vis sammendrag

  Objective To investigate cardiometabolic risk factor levels in a group of Norwegian 10-year-old children compared to international values and examine the association between cardiorespiratory fitness (CRF) and the reference-standardized clustered risk score. Methods 913 children (49% girls) were included from the Active Smarter Kids (ASK) study. Body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) to HDL-C ratio, triglyceride (TG), glucose, insulin, homeostatic model assessment (HOMA) score and CRF, were standardized according to international age-and sex-specific reference values. Results The Norwegian children had significantly more favorable WC, DBP, glucose, HDL-C and CRF levels compared to the international reference values, but similar or less favorable levels of other cardiometabolic risk factors. CRF was the variable that differed the most from the international values (mean (95% CI) 1.20 (1.16 to 1.24) SD). The clustered risk score (excluding CRF) was higher in the Norwegian children, but decreased to below international levels when including CRF (mean (95% CI) - 0.08 (- 0.12 to –0.05) SD). CRF had a significant inverse association with the clustered risk score (excluding CRF) (β - 0.37 SD, 95% CI –0.43 to –0.31). Conclusions Norwegian children have substantially higher CRF levels than international standards, and including CRF in clustered risk scores reduces overall risk in Norwegian children below that of international levels. CRF is associated with improved cardiometabolic health in children.

• Resaland, Geir Kåre; Aadland, Eivind; Moe, Vegard Fusche; Kolotkin, Ronette L.; Anderssen, Sigmund Alfred & Andersen, John Roger (2019). Effects of a physical activity intervention on schoolchildren's health-related quality of life: The active smarter kids (ASK) cluster-randomized controlled trial. Preventive Medicine Reports. 13, s. 1–4. doi: 10.1016/j.pmedr.2018.11.002. Fulltekst i vitenarkiv Vis sammendrag

  We investigated whether a seven-month (November 2014 to June 2015), school-based cluster-randomized controlled physical activity intervention improved health-related quality of life (HRQoL) in 10-year old children. The participants (N = 1229) from 57 elementary schools in Sogn og Fjordane County, Norway, were cluster-randomized by school either to the intervention (I) or control (C) group. The planned intervention in the 28 I-schools was 300 min of physical activity per week, compared to 135 min in the 29C-schools. HRQoL was assessed by self-report, using the Kidscreen-27 questionnaire. Objectively measured physical activity did not differ between the I–schools and C-schools during the intervention. No effect of the intervention was found for HRQoL: Physical well-being (P = 0.789), Psychological well-being (P = 0.682), Autonomy & parents (P = 0.662), Social support & peers (P = 0.828) and School environment (P = 0.074). In conclusion, the ASK school-based physical activity intervention showed no significant effect on HRQoL.

• Aadland, Eivind; Andersen, Lars Bo; Anderssen, Sigmund Alfred; Resaland, Geir Kåre & Kvalheim, Olav Martin (2019). Accelerometer epoch setting is decisive for associations between physical activity and metabolic health in children. Journal of Sports Sciences. ISSN 0264-0414. 38(3), s. 256–263. doi: 10.1080/02640414.2019.1693320. Fulltekst i vitenarkiv Vis sammendrag

  When analysing physical activity (PA) levels using accelerometry, the epoch setting is critical to capture intensity-specific PA correctly. The aim of the present study was to investigate the PA intensity signatures related to metabolic health in children using different epoch settings. A sample of 841 Norwegian children (age 10.2 ± 0.3 years; BMI 18.0 ± 3.0; 50% boys) provided data on accelerometry (ActiGraph GT3X+) and several indices of metabolic health (aerobic fitness, abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure) that were used to create a composite metabolic health score. We created intensity spectra from 0–99 to ≥ 10000 counts per minute (cpm) for files aggregated using 1, 10, and 60-second epoch periods and used multivariate pattern analysis to analyse the data. The association patterns with metabolic health differed substantially between epoch settings. The intensity intervals most strongly associated with metabolic health were 7000–8000 cpm for data analysed using 1-second epoch, 5500–6500 cpm for data analysed using 10-second epoch, and 4000–5000 cpm analysed using 60-second epoch. Aggregation of data over different epoch periods has a clear impact on how PA intensities in the moderate and vigorous range are associated with childhood metabolic health.

• 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.

• Aadland, Eivind; Kvalheim, Olav Martin; Anderssen, Sigmund Alfred; Resaland, Geir Kåre & Andersen, Lars Bo (2019). Multicollinear physical activity accelerometry data and associations to cardiometabolic health: Challenges, pitfalls, and potential solutions. International Journal of Behavioral Nutrition and Physical Activity. 16. doi: 10.1186/s12966-019-0836-z. Fulltekst i vitenarkiv Vis sammendrag

  Background: The analysis of associations between accelerometer-derived physical activity (PA) intensities and cardiometabolic health is a major challenge due to multicollinearity between the explanatory variables. This challenge has facilitated the application of different analytic approaches within the field. The aim of the present study was to compare association patterns of PA intensities with cardiometabolic health in children obtained from multiple linear regression, compositional data analysis, and multivariate pattern analysis. Methods: A sample of 841 children (age 10.2 ± 0.3 years; BMI 18.0 ± 3.0; 50% boys) provided valid accelerometry and cardiometabolic health data. Accelerometry (ActiGraph GT3X+) data were characterized into traditional (four PA intensity variables) and more detailed categories (23 PA intensity variables covering the intensity spectrum; 0–99 to ≥10,000 counts per minute). Several indices of cardiometabolic health were used to create a composite cardiometabolic health score. Multiple linear regression and multivariate pattern analyses were used to analyze both raw and compositional data. Results: Besides a consistent negative (favorable) association between vigorous PA and the cardiometabolic health measure using the traditional description of PA data, associations between PA intensities and cardiometabolic health differed substantially depending on the analytic approaches used. Multiple linear regression lead to instable and spurious associations, while compositional data analysis showed distorted association patterns. Multivariate pattern analysis appeared to handle the raw PA data correctly, leading to more plausible interpretations of the associations between PA intensities and cardiometabolic health. Conclusions: Future studies should consider multivariate pattern analysis without any transformation of PA data when examining relationships between PA intensity patterns and health outcomes.

• Aadland, Eivind; Kvalheim, Olav Martin; Anderssen, Sigmund Alfred; Resaland, Geir Kåre & Andersen, Lars Bo (2019). The triaxial physical activity signature associated with metabolic health in children. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 51(10), s. 2173–2179. doi: 10.1249/MSS.0000000000002021. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The use of uniaxial summary measures from accelerometry (i.e., counts per minute or minutes spent in moderate-to-vigorous intensity) substantially restricts information about physical activity (PA), and is probably a result of reliance on analytic approaches that cannot handle collinear variables. In the present study, we aimed to determine the multivariate triaxial PA intensity signature related to metabolic health in children, by investigating associations of the whole spectra of PA intensities from all axes using multivariate pattern analysis. Methods We included 841 children (age, 10.2 ± 0.3 yr; body mass index, 18.0 ± 3.0; 50% boys) from the Active Smarter Kids study conducted in Norway 2014 to 2015 providing valid data on accelerometry (ActiGraph GT3X+) and several indices of metabolic health (aerobic fitness, abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure) that were used to create a composite metabolic health score. We created intensity spectra from 0 to 100 to ≥10,000 counts per minute for separate axes and used multivariate pattern analysis to analyze the data. Results The explained variance of metabolic health was 3.2% for counts per minute from the vertical axis, 17.0% for the vertical axis intensity spectrum, and 29.5% for the full model including all axes. Thus, including full triaxial intensity spectra improved the model for metabolic health tenfold compared with using overall PA (counts per minute) from the vertical axis only. The intensity signature associated with metabolic health differed across the axes. Conclusions Our findings show that the three different axes carry distinct information about children’s PA and the relation of PA to their health and demonstrate a great potential for triaxial accelerometry and a multivariate analytic approach to advance the field of PA epidemiology.

• Renninger, Marius; Hansen, Bjørge Hermann; Steene-Johannessen, Jostein; Kriemler, Susi; Froberg, Karsten & Northstone, Kate [Vis alle 10 forfattere av denne artikkelen] (2019). Associations between accelerometry measured physical activity and sedentary time and the metabolic syndrome: A meta-analysis of more than 6000 children and adolescents. Pediatric Obesity. ISSN 2047-6302. 15, s. 1–9. doi: 10.1111/ijpo.12578. Fulltekst i vitenarkiv Vis sammendrag

  Background: Metabolic syndrome is increasingly prevalent in the pediatric population. To prevent an early onset, knowledge about its association with modifiable lifestyle factors is needed. Objectives: To estimate the prevalence of the metabolic syndrome and examine its cross‐sectional associations with physical activity and sedentary time. Methods: Participants were 6009 children and adolescents from 8 studies of the International Children's Accelerometry Database. Physical activity and sedentary time were measured by accelerometer. Metabolic syndrome was defined based on International Diabetes Federation criteria. Logistic regression models adjusted for sex, age and monitor wear time were used to examine the associations between physical activity, sedentary time and the metabolic syndrome in each study and effect estimates were combined using random‐effects meta‐analysis. Results: The overall prevalence of the metabolic syndrome was 2.9%. In crude models, a 10 min increase in moderate‐to‐vigorous intensity physical activity and vigorous‐intensity physical activity were inversely associated with the metabolic syndrome [OR 0.88, 95% CI 0.82‐0.94, OR 0.80, 95% CI 0.70‐0.92]. One hour increase in sedentary time was positively associated with the metabolic syndrome [OR 1.28, 95% CI 1.13‐1.45]. After adjustment for sedentary time, the association between moderate‐to‐vigorous‐intensity physical activity and the metabolic syndrome remained significant [OR 0.91, 95% CI 0.84‐0.99]. Sedentary time was not associated with the metabolic syndrome after adjustment for moderate‐to‐vigorous intensity physical activity [OR 1.14 95% CI 0.96‐1.36]. Conclusions: Physical activity of at least moderate intensity but not sedentary time is independently associated with the metabolic syndrome.

• Stavnsbo, Mette; Aadland, Eivind; Anderssen, Sigmund Alfred; Chinapaw, Mai; Steene-Johannessen, Jostein & Andersen, Lars Bo [Vis alle 7 forfattere av denne artikkelen] (2019). Effects of the Active Smarter Kids (ASK) physical activity intervention on cardiometabolic risk factors in children: A cluster-randomized controlled trial. Preventive Medicine. ISSN 0091-7435. 130. doi: 10.1016/j.ypmed.2019.105868. Fulltekst i vitenarkiv Vis sammendrag

  The onset of cardiometabolic diseases are recognized to occur in childhood. We aimed to investigate the effect of a school-based cluster-randomized controlled trial of physical activity (PA) on single and clustered cardiometabolic risk factors. We included 1129 fifth-grade children from 57 schools (≥seven children in each class) in Sogn and Fjordane County, Norway, randomized to 28 intervention schools and 29 control schools. The PA intervention was conducted between November 2014 and June 2015. Cardiometabolic risk factors were waist circumference (WC), systolic blood pressure (SBP), total cholesterol (TC):high-density lipoprotein (HDL)-ratio, triglycerides (TG), homeostatic model assessment (HOMA)-score, and cardiorespiratory fitness (CRF). PA was measured by accelerometry. No significant intervention effects were found for single or clustered cardiometabolic risk factors. However, in children with the less favorable baseline values, beneficial effects were found for SBP (p = 0.07 for group ∗ tertile interaction), TC:HDL ratio (p = 0.03 for group ∗ tertile interaction) and the clustered cardiometabolic risk score (p = 0.01 for group ∗ tertile interaction). Compared to boys, girls had a greater effect of the intervention on WC (p = 0.03 for group ∗ sex interaction) and CRF (p < 0.001 for group ∗ sex interaction). The majority of the children had high PA levels, thus limited potential for change, and we found no effects of the PA intervention on cardiometabolic risk in the total sample. However, the intervention had a significantly enhanced effect on fatness and fitness of girls compared to boys. Furthermore, the data suggest that children with the least favorable cardiometabolic risk profile and therefore most in need of change can benefit from school-based PA interventions.

• 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.

• Nilsen, Ada Kristine Ofrim; Anderssen, Sigmund Alfred; Resaland, Geir Kåre; Johannessen, Kjersti; Ylvisåker, Einar & Aadland, Eivind (2019). Boys, older children, and highly active children benefit most from the preschool arena regarding moderate-to-vigorous physical activity: A cross-sectional study of Norwegian preschoolers. Preventive Medicine Reports. 14. doi: 10.1016/j.pmedr.2019.100837. Fulltekst i vitenarkiv Vis sammendrag

  The preschool environment exerts an important influence on children's behaviour, including physical activity (PA). However, information is lacking regarding where and when most of children's PA is undertaken. This study aimed to describe PA and sedentary time (SED) during preschool hours and time out-of-care, and on weekdays and weekend days, and to investigate differences in PA patterns according to sex, age, and MVPA levels. From September 2015 to June 2016, we measured PA levels of 1109 children (age range, 2.7–6.5 years; mean age 4.7 years; boys, 52%) using ActiGraph GT3X+ accelerometers for up to 14 consecutive days. We applied a linear mixed model to analyse associations and interactions between total PA (counts per minute [cpm]), light PA (LPA), moderate-to-vigorous PA (MVPA), SED, sex, age, and overall MVPA regardless of setting, during preschool hours versus time out-of-care, and on weekdays versus weekend days. Children undertook more PA and less SED on weekdays compared to weekend days (p < 0.01). For boys, MVPA levels were higher during preschool hours than during time out-of-care (p < 0.05). Differences in total PA and MVPA between preschool hours versus time out-of-care, and between weekdays and weekend days, were greater in boys, older children, and highly active children than in girls, younger children, and children with lower overall MVPA levels (p < 0.01). The preschool arena is important for children's PA. Concerning MVPA, this study showed that boys, older children, and highly active children benefit more from this environment compared to girls, younger preschoolers, and children with lower MVPA levels.

• Lerum, Øystein; Bartholomew, John; McKay, Heather; Resaland, Geir Kåre; Tjomsland, Hege Eikeland & Anderssen, Sigmund Alfred [Vis alle 8 forfattere av denne artikkelen] (2019). Active Smarter Teachers: Primary School Teachers’ Perceptions and Maintenance of a School-Based Physical Activity Intervention. Translational Journal of The American College of Sports Medicine. 4(17), s. 141–147. doi: 10.1249/TJX.0000000000000104. Fulltekst i vitenarkiv
• Jones, Paul Remy; Rajalahti, Tarja; Resaland, Geir Kåre; Aadland, Eivind; Steene-Johannessen, Jostein & Anderssen, Sigmund Alfred [Vis alle 10 forfattere av denne artikkelen] (2019). Associations of physical activity and sedentary time with lipoprotein subclasses in Norwegian schoolchildren: The Active Smarter Kids (ASK) study. Atherosclerosis. ISSN 0021-9150. 288, s. 186–193. doi: 10.1016/j.atherosclerosis.2019.05.023. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims: Physical activity is favourably associated with certain markers of lipid metabolism. The relationship of physical activity with lipoprotein particle profiles in children is not known. Here we examine cross-sectional associations between objectively measured physical activity and sedentary time with serum markers of lipoprotein metabolism. Methods: Our cohort included 880 children (49.0% girls, mean age 10.2 years). Physical activity intensity and time spent sedentary were measured objectively using accelerometers. 30 measures of lipoprotein metabolism were quantified using nuclear magnetic resonance spectroscopy. Multiple linear regression models adjusted for age, sex, sexual maturity and socioeconomic status were used to determine associations of physical activity and sedentary time with lipoprotein measures. Additional models were adjusted for adiposity. Isotemporal substitution models quantified theoretical associations of replacing 30 min of sedentary time with 30 min of moderate- to vigorous-intensity physical activity (MVPA). Results: Time spent in MVPA was associated with a favourable lipoprotein profile independent of sedentary time. There were inverse associations with a number of lipoprotein measures, including most apolipoprotein B-containing lipoprotein subclasses and triglyceride measures, the ratio of total to high-density lipoprotein (HDL) cholesterol, and non-HDL cholesterol concentration. There were positive associations with larger HDL subclasses, HDL cholesterol concentration and particle size. Reallocating 30 min of sedentary time to MVPA had broadly similar associations. Sedentary time was only partly and weakly associated with an unfavourable lipoprotein profile. Conclusions: Physical activity of at least moderate-intensity is associated with a favourable lipoprotein profile in schoolchildren, independent of time spent sedentary, adiposity and other confounders.

• Nilsen, Ada Kristine Ofrim; Anderssen, Sigmund Alfred; Loftesnes, Jan Morten; Johannessen, Kjersti; Ylvisåker, Einar & Aadland, Eivind (2019). The multivariate physical activity signature associated with fundamental motor skills in preschoolers. Journal of Sports Sciences. ISSN 0264-0414. 38(3), s. 264–272. doi: 10.1080/02640414.2019.1694128. Fulltekst i vitenarkiv Vis sammendrag

  Physical activity (PA) is essential for development of fundamental motor skills (FMS) in children, but it is uncertain which PA intensities are most influential. A limitation to current evidence is the reliance on analytic approaches that cannot handle collinearity. The aim of this study was to determine the PA signature related to FMS in preschoolers, by investigating the association pattern for the whole spectrum of PA intensities using multivariate pattern analysis. We used a sample of N = 1081 Norwegian preschoolers (4.7 yr; 52% boys) who provided valid accelerometer (ActiGraph GT3X+) and FMS data (TGMD-3, modified version). We created 33 PA variables (from 0–100 to ≥15,000 counts per minute [cpm]), and used partial least squares regression to analyse the associations between PA and FMS, after controlling for potential covariates. PA was positively associated with locomotor- and object control skills (explained variances for vertical axes; R2 = 9.7% and 3.9%, respectively). The strongest associations were found for PA between 5000–8000 cpm. No association pattern was found for PA and balance skills. This study is the first to determine the multivariate PA intensity signature related to FMS. This approach shows that PA within the vigorous range is strongest related to FMS in preschoolers.

• Resaland, Geir Kåre; Aadland, Eivind; Andersen, John Roger; Bartholomew, J.B.; Anderssen, Sigmund Alfred & Moe, Vegard Fusche (2019). Physical activity preferences of 10‐year‐old children and identified activities with positive and negative associations to cardiorespiratory fitness. Acta Paediatrica. ISSN 0803-5253. 108(2), s. 354–360. doi: 10.1111/apa.14487. Fulltekst i vitenarkiv Vis sammendrag

  Aim: This study investigated children's physical activity (PA) preferences, as these can aid the design of school‐based interventions. Methods: Data were collected in 2014 as a part of the Active Smarter Kids study and 1026 students (52% boys) from 57 Norwegian primary schools completed a questionnaire about their favourite physical activities at a mean age of 10.2 ± 0.3 years. We identified five patterns of PA and studied whether gender, cardiorespiratory fitness and abdominal adiposity were associated with these patterns. Results: Soccer and slalom skiing were the favourite activities, and the most pronounced gender differences were for activities favoured by girls, which included dancing, gymnastics, exercising to music and jumping rope (p < 0.001). When the five component patterns were analysed using linear mixed‐effect models, this showed a strong female preference for dancing, gymnastics, exercising to music and climbing. Cardiovascular fitness was negatively associated with frisbee, dodgeball, baseball and floorball, and positively associated with team handball, volleyball and basketball and with slalom skiing and cross‐country skiing. It was interesting that the children's preferences were not related to their abdominal adiposity. Conclusion: The results showed different gender‐based PA preferences and positive and negative associations with cardiovascular fitness, but no relationship with abdominal adiposity.

• Berntsen, Sveinung; Edvardsen, Elisabeth; Gerbi, Shlomi; Pollestad, Magnhild Louise & Anderssen, Sigmund Alfred (2019). Do obese children achieve maximal heart rate during treadmill running? Sports. 7(1). doi: 10.3390/sports7010026. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Maximal heart rate (HR) is commonly defined as the highest HR obtained during a progressive exercise test to exhaustion. Maximal HR is considered one of the criteria to assess maximum exertion in exercise tests, and is broadly used when prescribing exercise intensity. The aim of the present study was to compare peak HR measurements during maximal treadmill running and active play in obese children and adolescents. Design: Comparison of peak heart rate during active play vs. maximal treadmill running in 39 (7–17 years old, 18 males) obese children and adolescents. Methods: Heart rate was recorded during intensive active play sessions, as well as during a progressive running test on a treadmill until exhaustion. HR, respiratory exchange ratio (RER), and oxygen uptake were continuously measured during the test. The criteria for having reached maximal effort was a subjective assessment by the technician that the participants had reached his or her maximal effort, and a RER above 1.00 or reporting perceived exertion (RPE) above 17 using the Borg-RPE6–20-Scale. Results: Thirty-four children had a RER ≥1.00, and 37 reported a RPE ≥ 17. Thirty-two children fulfilled both criteria. During active play, peak HR was significantly (p < 0.0001) increased (4%) (mean and 95% confidence intervals; 204 (201, 207) beats/min), compared to during maximal treadmill running (196 (194, 199) beats/min), respectively. Conclusion: The results of the present study indicate that peak heart rate measurements during progressive running to exhaustion in obese children and adolescents cannot necessarily be determined as maximal heart rate.

• Nilsen, Ada Kristine Ofrim; Anderssen, Sigmund Alfred; Ylvisåker, Einar; Johannessen, Kjersti & Aadland, Eivind (2019). Physical activity among Norwegian preschoolers varies by sex, age, and season. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 29(6), s. 862–873. doi: 10.1111/sms.13405. Fulltekst i vitenarkiv Vis sammendrag

  Background: Knowledge of physical activity (PA) in preschool populations is im-portant for public health promotion. We investigated levels of PA in a large sample of Norwegian preschoolers and explored variations and development in PA by sex, age, and season.Methods: Physical activity levels of 1154 children (mean age 4.7 years, 52% boys) were measured by accelerometry (ActiGraph GT3X+) for 14 consecutive days be-tween autumn 2015 and summer 2016. Additionally, 330 children provided up to 3 repeated measurements of PA across seasons. A linear mixed model was applied to analyze associations and interactions of total PA (cpm), light PA (LPA), moderate PA (MPA), vigorous PA (VPA), moderate‐to‐vigorous PA (MVPA), sedentary time (SED), sex, age, and season.Results: Boys and girls spent mean (standard deviation) 72 (21) and 59 (18) min/d in MVPA and had a total PA of 790 (202) and 714 (192) cpm/d, respectively. Boys had higher PA levels than girls, PA increased with age, and PA was higher during spring/summer than autumn/winter (P< 0.001). Boys had a greater increase in PA by age than girls (P< 0.05), mainly due to increased MVPA during spring/summer (p for sex × age × season=0.009).Conclusions: Boys were consistently more active and less sedentary than girls, and PA increased with age for both sexes. Boys exhibited a greater increase than girls in PA by age, and PA differed across seasons, with higher levels of MVPA during spring/summer. Differences in MVPA between boys and girls, among age groups, and among seasons seem to be interrelated, indicating that many factors influence preschoolers’ PA.

• Brønd, Jan Christian; Aadland, Eivind; Andersen, Lars Bo; Resaland, Geir Kåre; Anderssen, Sigmund Alfred & Arvidsson, Daniel (2019). The ActiGraph counts processing and the assessment of vigorous activity. Clinical Physiology and Functional Imaging. ISSN 1475-0961. 39(4), s. 276–283. doi: 10.1111/cpf.12571. Fulltekst i vitenarkiv Vis sammendrag

  The purpose of this study was to investigate the effect of different band‐pass filters on the measurement bias with ActiGraph counts during high speed running and for estimating free‐living vigorous physical activity (VPA). Two alternative band‐pass filters were designed, extending the original frequency range from 0·29 to 1·66 Hz (AG) to 0·29–4 Hz (AC4) and 0·29–10 Hz (AC10). Sixty‐two subjects in three age groups participated in a structured locomotion protocol consisting of multiple walking and running speeds. The time spent in free‐living VPA using the three different band‐pass filters were evaluated in 1121 children. Band‐pass filter specific intensity cut‐points from both linear regression and ROC analysis was identified from a calibration experiment using indirect calorimetry. The ActiGraph GT3X+ device recording raw acceleration at 30 Hz was used in all experiments. The linear association between counts and running speed was negative for AG but positive for AC4 and AC10 across all age groups. The time spent in free‐living VPA was similar for all band‐pass filters. Considering higher frequency information in the generation of ActiGraph counts with a hip/waist worn device reduces the measurement bias with running above 10 km·h−1. However, additional developments are required to accurately capture all VPA, including intermittent activities.

• Aadland, Katrine Nyvoll; Ommundsen, Yngvar; Anderssen, Sigmund Alfred; Brønnick, Kolbjørn Selvåg; Moe, Vegard Fusche & Resaland, Geir Kåre [Vis alle 9 forfattere av denne artikkelen] (2019). Effects of the Active Smarter Kids (ASK) Physical Activity Schoolbased Intervention on Executive Functions: A Cluster-Randomized Controlled Trial. Scandinavian Journal of Educational Research. ISSN 0031-3831. 63(2), s. 214–228. doi: 10.1080/00313831.2017.1336477. Fulltekst i vitenarkiv Vis sammendrag

  The purpose of this study was to examine the effects of a seven-month curriculum prescribed physical activity (PA) intervention (the Active Smarter Kids [ASK] intervention) on executive functions in 10-year-old Norwegian children. A linear mixed model was used to analyze data from 971–1,123 fifth grade children at 28 intervention schools and 29 control schools. The intervention constituted three PA elements: PA educational lessons, PA breaks, and PA homework, adding 165 minutes of PA to the mandatory 135 minutes of PA and physical education. There was no effect of the intervention on executive functions in the intention-to-treat analyses. Per protocol analyses (n = 776–850) revealed small effects of the intervention on the composite score of executive functions, cognitive flexibility, and motor skills. Cognitively engaging and coordinative demanding activities/games seem viable options to increase executive functions and possibly improve academic performance in children.

• Hansen, Bjørge Hermann; Anderssen, Sigmund Alfred; Andersen, Lars Bo; Hildebrand, Maria; Kolle, Elin & Steene-Johannessen, Jostein [Vis alle 14 forfattere av denne artikkelen] (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), s. 2401–2412. doi: 10.1007/s40279-018-0909-1. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Aadland, Eivind; Andersen, Lars Bo; Anderssen, Sigmund Alfred & Resaland, Geir Kåre (2018). A comparison of 10 accelerometer non-wear time criteria and logbooks in children. BMC Public Health. 18:323, s. 1–9. doi: 10.1186/s12889-018-5212-4. Fulltekst i vitenarkiv Vis sammendrag

  Background: There are many unresolved issues regarding data reduction algorithms for accelerometry. The choice of criterion for removal of non-wear time might have a profound influence on physical activity (PA) and sedentary time (SED) estimates. The aim of the present study was to compare 10 different non-wear criteria and a log of non-wear periods in 11-year-old children. Methods: Children from the Active Smarter Kids study performed 7-days of hip-worn accelerometer monitoring (Actigraph GT3X+) and logged the number of non-wear periods each day, along with the approximate duration and reason for non-wear. Accelerometers were analyzed using 10 different non-wear criteria: ≥ 10, 20, 30, 45, 60, and 90 min of consecutive zero counts without allowance for interruptions, and ≥60 and 90 min with allowance for 1 and 2 min of interruptions. Results: 891 children provided 5203 measurement days, and reported 1232 non-wear periods ranging from 0 to 3 periods per day: on most days children reported no non-wear periods (77.1% of days). The maximum number of non-wear periods per day was 2 for the 90-min criterion, 3 to 5 for most criteria, 7 for the 20-min criterion, and 20 for the 10-min criterion. The non-wear criteria influenced overall PA (mean values across all criteria: 591 to 649 cpm; 10% difference) and SED time (461 to 539 min/day; 17% difference) estimates, especially for the most prolonged SED bouts. Estimates were similar for time spent in intensity-specific (light, moderate, vigorous, and moderate-to-vigorous) PA, but varied 6–9% among the non-wear criteria for proportions of time spent in intensity-specific PA (% of total wear time). Conclusions: Population level estimates of PA and SED differed between different accelerometer non-wear criteria, meaning that non-wear time algorithms should be standardized across studies to reduce confusion and improve comparability of children’s PA level. Based on the numbers and reasons for non-wear periods, we suggest a 45 or 60-min consecutive zero count-criterion not allowing any interruptions to be applied in future pediatric studies, at least for children older than 10 years. Trial Registration: The study is registered in Clinicaltrials.gov with identification number NCT02132494. Registered 7 April 2014.

• Dalene, Knut Eirik; Anderssen, Sigmund Alfred; Andersen, Lars Bo; Steene-Johannessen, Jostein; Ekelund, Ulf & Hansen, Bjørge Hermann [Vis alle 7 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

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• Hjartåker, Anette; Retterstøl, Kjetil; Müller, Hanne & Anderssen, Sigmund Alfred (2026). Grunnleggende ernæringslære. Gyldendal. ISBN 9788205614734. 485 s. Fulltekst i vitenarkiv Vis sammendrag

  Boken legger særlig vekt på betydningen av samspillet mellom kosthold og fysisk aktivitet for god helse. Innholdet i denne fjerde utgaven er oppdatert i tråd med aktuell forskningslitteratur og nasjonale anbefalinger, og den er spesielt tilpasset norske forhold. Boken henvender seg til et bredt spekter av studenter ved universitets- og høyskoler, blant annet innenfor medisin, ernæring, idrettsfag og fysioterapi, i tillegg til andre fagområder som jobber med forebygging og folkehelse. Boken gir også et solid grunnlag for videre studier innenfor mer spesialiserte, tilgrensende områder som klinisk ernæring, samfunnsernæring og næringsmiddelteknologi.

• Torstveit, Monica Klungland; Lohne-Seiler, Hilde; Berntsen, Sveinung & Anderssen, Sigmund Alfred (2026). Fysisk aktivitet og helse – fra begrepsforståelse til implementering av kunnskap. Cappelen Damm Akademisk. ISBN 9788202806040. 468 s. Fulltekst i vitenarkiv

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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), s. 40–44. doi: 10.18261/njdl.20.1.7. Fulltekst i vitenarkiv
• Mathisen, Therese Fostervold; Anderssen, Sigmund Alfred; Tangen, Marte Kvittum & Brækhus, Leni Aurora (2023). Fysisk aktivitet og forebygging: – Viktig å starte med barna og følge dem gjennom livet. [Internet]. Dagens Medisin. Fulltekst i vitenarkiv
• Kjær, Ingirid Geirsdatter Heald; Anderssen, Sigmund Alfred & Torstveit, Monica Klungland (2022). A SIX- MONTH TAILORED TELEPHONE AND EMAIL-BASED EXERCISE INTERVENTION INCREASED PHYSICAL FITNESS IN PHYSICALLY INACTIVE ADULT:A RANDOMIZED CONTROLLED TRIAL. Fulltekst i vitenarkiv
• Lie, Hanne Cathrine; Anderssen, Sigmund Alfred; Rueegg, Corina Silvia; Raastad, Truls; Grydeland, May & Thorsen, Lene [Vis alle 21 forfattere av denne artikkelen] (2022). The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) Study: Protocol for an International Mixed Methods Study. JMIR Research Protocols. 11(3). doi: 10.2196/35838. Fulltekst i vitenarkiv Vis sammendrag

  Methods Results Discussion References Abbreviations Copyright Abstract Background: Survivors of childhood cancer represent a growing population with a long life expectancy but high risks of treatment-induced morbidity and premature mortality. Regular physical activity (PA) may improve their long-term health; however, high-quality empirical knowledge is sparse. Objective: The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) study comprises 4 work packages (WPs) aiming for the objective determination of PA and self-reported health behavior, fatigue, and quality of life (WP 1); physical fitness determination (WP 2); the evaluation of barriers to and facilitators of PA (WP 1 and 3); and the feasibility testing of an intervention to increase PA and physical fitness (WP 4). Methods: The PACCS study will use a mixed methods design, combining patient-reported outcome measures and objective clinical and physiological assessments with qualitative data gathering methods. A total of 500 survivors of childhood cancer aged 9 to 18 years with ≥1 year after treatment completion will be recruited in follow-up care clinics in Norway, Denmark, Finland, Germany, and Switzerland. All participants will participate in WP 1, of which approximately 150, 40, and 30 will be recruited to WP 2, WP3, and WP 4, respectively. The reference material for WP 1 is available from existing studies, whereas WP 2 will recruit healthy controls. PA levels will be measured using ActiGraph accelerometers and self-reports. Validated questionnaires will be used to assess health behaviors, fatigue, and quality of life. Physical fitness will be measured by a cardiopulmonary exercise test, isometric muscle strength tests, and muscle power and endurance tests. Limiting factors will be identified via neurological, pulmonary, and cardiac evaluations and the assessment of body composition and muscle size. Semistructured, qualitative interviews, analyzed using systematic text condensation, will identify the perceived barriers to and facilitators of PA for survivors of childhood cancer. In WP 4, we will evaluate the feasibility of a 6-month personalized PA intervention with the involvement of local structures. Results: Ethical approvals have been secured at all participating sites (Norwegian Regional Committee for Medical Research Ethics [2016/953 and 2018/739]; the Oslo University Hospital Data Protection Officer; equivalent institutions in Finland, Denmark [file H-19032270], Germany, and Switzerland [Ethics Committee of Northwestern and Central Switzerland, project ID: 2019-00410]). Data collection for WP 1 to 3 is complete. This will be completed by July 2022 for WP 4. Several publications are already in preparation, and 2 have been published. Conclusions: The PACCS study will generate high-quality knowledge that will contribute to the development of an evidence-based PA intervention for young survivors of childhood cancer to improve their long-term care and health. We will identify physiological, psychological, and social barriers to PA that can be targeted in interventions with immediate benefits for young survivors of childhood cancer in need of rehabilitation.

• Jansson, Eva; Wennberg, Patrik; Anderssen, Sigmund Alfred; Ekelund, Ulf; Dohrn, Ing-Mari & Hagströmer, Maria (2022). Sitt mindre – all rörelse räknas. Läkartidningen. ISSN 0023-7205. 119. 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
• Kjær, Ingirid Geirsdatter Heald; Anderssen, Sigmund Alfred; Hansen, Bjørge Hermann & Torstveit, Monica Klungland (2020). A six- month tailored telephone- and email-based exercise intervention increased physical activity levels among inactive adults: A randomized controlled trial. Fulltekst i vitenarkiv
• Aadland, Katrine Nyvoll; Aadland, Eivind; Tjomsland, Hege Eikeland; Johannessen, Kjersti; Nilsen, Ada Kristine Ofrim & Resaland, Geir Kåre [Vis alle 18 forfattere av denne artikkelen] (2020). Visste du at barnehagelærarar i Sogn og Fjordane utviklar modellar for fysisk aktivitet i barnehagen? Fulltekst i vitenarkiv
• Nilsen, Ada Kristine Ofrim; Anderssen, Sigmund Alfred; Johannessen, Kjersti; Ylvisåker, Einar & Aadland, Eivind (2018). Boys, older children and highly active children accumulates more MVPA during preschool hours, than girls, younger children and less active children. Results from Sogn og Fjordane Preschool Physical Activity Study– A cross-sectional study of Norwegian pre-schoolers. Fulltekst i vitenarkiv
• Aadland, Eivind; Kvalheim, Olav Martin; Anderssen, Sigmund Alfred; Resaland, Geir Kåre & Andersen, Lars Bo (2018). The multivariate physical activity signature associated with metabolic health in children. Journal of Physical Activity and Health. ISSN 1543-3080. 15(10), s. 248–249. Fulltekst i vitenarkiv
• Aadland, Eivind; Andersen, Lars Bo; Anderssen, Sigmund Alfred; Resaland, Geir Kåre & Kvalheim, Olav Martin (2018). Associations for volumes and patterns of physical activity with metabolic health in children: a multivariate pattern analysis approach. Preventive Medicine. ISSN 0091-7435. Fulltekst i vitenarkiv
• Jones, Paul Remy; Kvalheim, Olav Martin; Resaland, Geir Kåre; Anderssen, Sigmund Alfred & Ekelund, Ulf (2018). Lipoprotein subclasses and their associations with physical activity and sedentary time in Norwegian schoolchildren: The Active Smarter Kids study. Journal of Physical Activity and Health. ISSN 1543-3080. 15(10), s. 109–110. Fulltekst i vitenarkiv
• Steene-Johannessen, Jostein; Hansen, Bjørge Hermann; Teinung, Elisabeth; Kolle, Elin; Riiser, Amund & Mølmen, Knut Sindre [Vis alle 12 forfattere av denne artikkelen] (2024). Fysisk form blant voksne og eldre i Norge 2022-2023 (Kan3). Folkehelseinstituttet. Fulltekst i vitenarkiv Vis sammendrag

  <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.

• Mandelid, Mathias Brekke; Dyngeland, Espen Søreide; Stokke, Rasmus; Wergeland, Tom Christian; Sandal, Marion Østenstad & Stein, Hege [Vis alle 25 forfattere av denne artikkelen] (2023). Senter for fysisk aktiv læring: Sluttrapport 2018-2023. Høgskulen på Vestlandet. Fulltekst i vitenarkiv
• Hansen, Bjørge Hermann; Steene-Johannessen, Jostein; Kolle, Elin; Udahl, Karine; Kaupang, Oda Bjørge & Andersen, Inge Dehli [Vis alle 10 forfattere av denne artikkelen] (2023). Kartlegging av fysisk aktivitet blant voksne og eldre 2020-22 (Kan3). Folkehelseinstituttet. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Kjær, Ingirid Geirsdatter Heald; Torstveit, Monica Klungland & Anderssen, Sigmund Alfred (2019). Health-related physical fitness: Status of body composition, musculoskeletal- and neuromotor fitness, and the e ect of a tailored, telephone and email based exercise intervention on body composition and physical fitness. Norges idrettshøgskole. ISSN 9788250205666. Fulltekst i vitenarkiv Vis sammendrag

  Background: The increasing obesity prevalence rates in addition to the increasing physical inactivity rates present serious public health challenges worldwide. The effect of these trends on aspects of health-related physical fitness is unclear as these trends are most commonly assessed by selfreport or simpler objective measures. Up-to-date research on obesity prevalence rates and musculoskeletal- and neuromotor fitness by various well established and objectively measures is lacking. Additionally, the need interventions aiming at reducing both the prevalence of physical inactivity in addition to the prevalence of obesity has been highlighted. Tailored physical activity interventions delivered in alternative technological modes have proven effective in enhancing physical activity levels in adults, however the effect of such interventions on objetively measured aspects of health-related physical fitness among physically inactive adults is lacking. Purpose: The overall purpose of this thesis was to investigate the status of various aspects of healthrelated physical fitness and to assess the effect of a six-month tailored telephone- and email based exercise intervention on various aspects of health-related physical fitness. Methods: The results presented in this thesis are based on two separate studies; a national cross-sectional study of Norwegian adults (20-65 years) (PAPERS I and II) and elderly (65-85 years) (PAPER I) in addition to a randomized controlled trial of a six-month tailored exercise intervention in physically inactive adults (40-55 years) (Papers III and IV). Main results: The main results from PAPER I revealed that obesity prevalence rates ranging from 12.7% based on BMI measures to 30.9% based on waist circumference. The sensitivity and specificity of the different measuring methods for estimating overweight and obesity, varied from 77.0% to 86.9% and from 60.6% to 82.3%, respectively. The main results from PAPER II were the normative data on musculoskeletal- and neuromotor fitness, displaying clear gender (p<0.001) and age related (p≤0.044) differences. Females displayed significantly higher scores on muscular endurance of the back extensors and on the flexibility tests (p < 0.001), while males displayed significantly higher scores on muscular strength, muscular dynamic endurance and ability to stabilize the upper body, as well as explosive power (p < 0.001). Additionally, younger participants displayed higher test scores on all musculoskeletal- and neuromotor fitness tests, compared to older participants (Females; Beta:−0.06–(−0.92), p ≤ 0.044, Males; Beta:−0.15–(0.91), p ≤ 0.006). Furthermore, waist circumference was inversely related to many aspects of musculoskeletal- and neuromotor fitness (p < 0.001).The main findings from PAPER III and PAPER IV revealed significant improvements in test scores on maximal oxygen consumption (VO2max, ml/kg/min) (ES:0.12, p=0.002), muscular endurance of the back extensors (ES:0.21, p<0.001), flexibility of the hamstrings muscles (ES:0.12, p=0.006) and explosive power (ES:0.09, p=0.022)from baseline to posttest in the intervention group, compared to the control group, when adjusting for baseline test scores. Furthermore, the intervention induced a larger reduction on all body compositional measures in the intervention group compared to the control group (p≤0.043) when controlling for baseline test scores, except for BMI. Additionally, a significantly higher percentage of the participants in the intervention group (64.1%) accomplished a clinically significant reduction in fat percentage by skinfolds compared to participants in the control group (36.2%, p=0.018). Conclusion: The agreement between various objective measures of obesity was fair to good, however, the variation in obesity prevalence rates between the different assessments methods was striking. Additionally, the status of musculoskeletal- and neuromotor fitness reveal clear gender differences and an inverse relationship between musculoskeletal- and neuromotor fitness and age and waist circumference. The six-month tailored telephone- and email based exercise intervention aiming at increasing cardiorespiratory fitness and musculoskeletal- and neuromotor fitness, in addition to reducing various body compositional measures, revealed promising results. Thus, this type of intervention should be further investigated as to elaborate on whether or not any of the components of the intervention are more effective than others, whether or not further elements should be implemented to enhance the effect size of- and adherence to similar interventions, and to assess the long term follow-up of interventions promoting aspects of health-related physical fitness in physically inactive adults.

• Kolle, Elin; Steene-Johannessen, Jostein; Säfvenbom, Reidar; Anderssen, Sigmund Alfred; Grydeland, May & Ekelund, Ulf [Vis alle 17 forfattere av denne artikkelen] (2019). Hovedrapport: School in motion. Utdanningsdirektoratet. Fulltekst i vitenarkiv

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