Publications by authors named "Eivind Aadland"

66 Publications

Influence of adiposity and physical activity on the cardiometabolic association pattern of lipoprotein subclasses to aerobic fitness in prepubertal children.

PLoS One 2021 18;16(11):e0259901. Epub 2021 Nov 18.

Department of Chemistry, University of Bergen, Bergen, Norway.

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. The trial was registered 7 May, 2014 in clinicaltrials.gov with trial reg. no.: NCT02132494 and the URL is https://clinicaltrials.gov/ct2/results?term=NCT02132494&cntry=NO.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259901PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601570PMC
November 2021

The role of weather conditions on time spent outdoors and in moderate-to-vigorous physical activity among Norwegian preschoolers.

J Sports Sci 2021 Sep 20:1-8. Epub 2021 Sep 20.

Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Campus Sogndal, Norway.

The aim of this study was to determine associations between weather and playground surface conditions and time spent outdoors and in moderate-to-vigorous PA (MVPA) in preschool children aged 3-6 years. We included 1201 children (mean age 4.8 years, 51% boys) from 68 preschools in Norway who provided 12,030 days of observation during 2015-2016. Preschool MVPA was measured by accelerometry (ActiGraph GT3X+) for 10 consecutive weekdays. During this period, outdoor time and playground surface conditions were logged by staff and weather conditions were obtained from the Norwegian Meteorological Institute. Associations were determined using linear mixed models. Associations for MVPA depended on whether the analyses were adjusted for outdoor time or not. In unadjusted analyses, rainfall, wind, and wet, icy, and mixed playground conditions were negatively associated with MVPA, while temperature, snowfall, and dry playground conditions were positively associated with MVPA. In adjusted analyses, temperature and wet and mixed playground conditions were negatively associated with MVPA, while snowfall and dry and snowy playground conditions were positively associated with MVPA. Outdoor time and MVPA should be addressed simultaneously to inform interpretation of associations with weather characteristics and intervention development in early childhood education settings.
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http://dx.doi.org/10.1080/02640414.2021.1976490DOI Listing
September 2021

Bi-directional prospective associations between sedentary time, physical activity and adiposity in 10-year old Norwegian children.

J Sports Sci 2021 Aug 30;39(15):1772-1779. Epub 2021 Mar 30.

Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.

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  - 0.066 [95% CI -0.105, -0.027]  = 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.
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http://dx.doi.org/10.1080/02640414.2021.1898114DOI Listing
August 2021

Cardiometabolic Associations between Physical Activity, Adiposity, and Lipoprotein Subclasses in Prepubertal Norwegian Children.

Nutrients 2021 Jun 19;13(6). Epub 2021 Jun 19.

Department of Chemistry, University of Bergen, N-5020 Bergen, Norway.

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 multicollinear 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 decreasedtriglyceride, 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.
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http://dx.doi.org/10.3390/nu13062095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234367PMC
June 2021

Resemblance in Physical Activity in Families with Children in Time Segments during the Week: The Lolland-Falster Health Study.

Med Sci Sports Exerc 2021 11;53(11):2283-2289

Lolland-Falster Health Study, Centre for Epidemiological Research, Nykøbing F. Hospital, Nykøbing, DENMARK.

Purpose: Evidence of shared physical activity (PA) habits within families is inconsistent. The present study aimed at examining intrafamily resemblance in PA during different time segments of the week.

Method: This cross-sectional study used data from the Danish household-based population study Lolland-Falster Health Study. We assessed time spent in various PA intensities and behaviors using a dual-accelerometer system (Axivity AX3). At least one parent and one child per household provided data for a minimum of three weekdays and one weekend day. We analyzed three time segments: early weekdays, late weekdays, and weekends. A linear mixed model regression analysis was used to estimate intraclass correlation coefficients (ICC) of the total family, parent-child dyads, siblings, and parent-parent dyads for PA outcomes, adjusting for sex, age, parental education, and the interaction between sex and age.

Results: We included 774 parents (57.9% female, 42.8 ± 7 yr) and 802 children (54.2% girls, 11.1 ± 4.3 yr) nested within 523 families. The clustering among the total family was stronger during late weekdays (ICC = 0.11-0.31) and weekends (ICC = 0.14-0.29) than during early weekdays (ICC = 0.02-0.19). We found stronger clustering among siblings (ICC = 0.08-0.47) and between parents (ICC = 0.02-0.52) than between parents and children (ICC < 0.01-0.37). Generally, the clustering was strongest for light PA, and among PA behaviors, walking showed the highest resemblance across all subgroups.

Conclusion: Initiatives to promote children's PA that involve parent or sibling coparticipation may focus on the time segment and activity types with the highest resemblance. For the family as a whole, promoting walking or limiting sedentary activities may be a potential target for interventions during late weekdays and weekends.Trial registration: Clinicaltrials.gov (NCT02482896).
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http://dx.doi.org/10.1249/MSS.0000000000002718DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542089PMC
November 2021

Validation of a Modified Submaximal Balke Protocol to Assess Cardiorespiratory Fitness in Individuals at High Risk of or With Chronic Health Conditions-A Pilot Study.

Front Sports Act Living 2021 22;3:642538. Epub 2021 Apr 22.

Department of Sport, Food and Natural Sciences, Faculty of Teacher Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.

This study aims to validate a submaximal treadmill walking test for estimation of maximal oxygen consumption (VO) in individuals at high risk of or with chronic health conditions. Eighteen participants (age 62 ± 16 years; VO 31.2 ± 5.9 ml kg min) at high risk of getting or with established chronic diseases performed two valid modified Balke treadmill walking protocols, one submaximal protocol, and one maximal protocol. Test duration, heart rate (HR), and rate of perceived exertion (RPE) were measured during both tests. VO was measured during the maximal test. VO was estimated from the submaximal test by multiple regression using time to RPE ≥ 17, gender, age, and body mass as independent variables. Model fit was reported as explained variance ( ) and standard error of the estimate (SEE). The model fit for estimation of VO from time to RPE ≥ 17 at the submaximal test, body mass, age, and gender was = 0.78 (SEE = 3.1 ml kg min, ≤ 0.001). Including heart rate measurement did not improve the model fit. The submaximal walking test is feasible and valid for assessing cardiorespiratory fitness in individuals with high risk of or chronic health conditions.
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http://dx.doi.org/10.3389/fspor.2021.642538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100189PMC
April 2021

GRANADA consensus on analytical approaches to assess associations with accelerometer-determined physical behaviours (physical activity, sedentary behaviour and sleep) in epidemiological studies.

Br J Sports Med 2021 Apr 12. Epub 2021 Apr 12.

PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain

The inter-relationship between physical activity, sedentary behaviour and sleep (collectively defined as physical behaviours) is of interest to researchers from different fields. Each of these physical behaviours has been investigated in epidemiological studies, yet their codependency and interactions need to be further explored and accounted for in data analysis. Modern accelerometers capture continuous movement through the day, which presents the challenge of how to best use the richness of these data. In recent years, analytical approaches first applied in other scientific fields have been applied to physical behaviour epidemiology (eg, isotemporal substitution models, compositional data analysis, multivariate pattern analysis, functional data analysis and machine learning). A comprehensive description, discussion, and consensus on the strengths and limitations of these analytical approaches will help researchers decide which approach to use in different situations. In this context, a scientific workshop and meeting were held in Granada to discuss: (1) analytical approaches currently used in the scientific literature on physical behaviour, highlighting strengths and limitations, providing practical recommendations on their use and including a decision tree for assisting researchers' decision-making; and (2) current gaps and future research directions around the analysis and use of accelerometer data. Advances in analytical approaches to accelerometer-determined physical behaviours in epidemiological studies are expected to influence the interpretation of current and future evidence, and ultimately impact on future physical behaviour guidelines.
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http://dx.doi.org/10.1136/bjsports-2020-103604DOI Listing
April 2021

Fitness, waist circumference and their association with future blood pressure in youth: The UP&DOWN Longitudinal Study.

J Sci Med Sport 2021 Jun 16;24(6):573-579. Epub 2021 Feb 16.

GALENO Research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA). Cádiz, Spain.

Objectives: The aim was to determine the independent associations of muscular fitness (MF), cardiorespiratory fitness (CRF) and waist circumference (WC) with blood pressure (BP) levels over 2 years in children and adolescents.

Methods: 1089 children (517 females) and 787 adolescents (378 females) with complete data on fitness, WC and BP (systolic [SBP] and diastolic [DBP]) were included. Upper MF was assessed through the handgrip strength test, and lower MF using the standing long jump test. The 20-m shuttle run test was used to assess CRF. WC was obtained following standardized methods. Different regression models were fitted by introducing fitness and WC at baseline and their changes as exposures and BP at follow-up and their changes as outcomes.

Results: WC at baseline was positively and independently associated with each BP variable at follow-up in children and adolescents (β=0.094-0.260; p≤0.05), and CRF was negatively associated with DBP in adolescents (β=-0.096; p=0.034). WC changes were associated with BP variables 2 years later in children (β=0.121-0.142; p<0.01). In adolescents, changes in upper MF (β=-0.116; p=0.001) and WC (β=0.080-0.098; p<0.05) were associated with SBP at follow-up. WC changes were independently associated with changes in each BP variable in children (β=0.111-0.145; all p<0.05) and SBP changes in adolescents (β=0.103 to 0.117; all p<0.01).

Conclusions: WC, but neither MF nor CRF, is independently associated with BP and its changes over 2 years. The attainment or maintenance of optimal fatness levels in the pediatric population should be highly encouraged for the prevention of future hypertension.
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http://dx.doi.org/10.1016/j.jsams.2021.02.002DOI Listing
June 2021

Cross-sectional and prospective associations between aerobic fitness and lipoprotein particle profile in a cohort of Norwegian schoolchildren.

Atherosclerosis 2021 03 8;321:21-29. Epub 2021 Feb 8.

Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.

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 (H 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 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.
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http://dx.doi.org/10.1016/j.atherosclerosis.2021.02.002DOI Listing
March 2021

The multivariate physical activity signature associated with body mass index in young children.

Prev Med 2021 04 23;145:106437. Epub 2021 Jan 23.

Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Campus Sogndal, Sogndal, Norway. Electronic address:

The evidence regarding associations between intensity-specific physical activity and adiposity in young children is conflicting. Moreover, the evidence is limited by analytical approaches that cannot handle the multicollinearity among multiple variables across the entire intensity spectrum. We aimed to determine the multivariate physical activity intensity signature associated with body mass index in a large sample of preschool children aged 3-6 years. 1182 Norwegian preschool children (mean age 4.7 years, 51% boys) provided data on physical activity (ActiGraph GT3X+) and body mass index during 2015-2016. Multivariate pattern analysis was used to determine associations between the entire triaxial intensity spectra (time spent in intensities from 0-99 to ≥ 15000 counts per minute) and body mass index in the total sample and in subgroups split by sex and age (median split). The association patterns were comparable across the three axes. For the vertical axis, associations were negative for time spent sedentary (0-99 counts per minute), positive for time spent in lower intensities (100-2999 counts per minute), and negative for time spent in vigorous intensities (4000-12,999 counts per minute). Associations were stronger in older than in younger children and no associations were observed for vigorous intensities among younger children. Association patterns were comparable for boys and girls. In conclusion, we found clear associations with body mass index across the physical activity intensity spectrum in preschool children. However, the age-specific association patterns suggest negative (unfavorable) associations with vigorous physical activity intensities develop around 5-6 years of age.
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http://dx.doi.org/10.1016/j.ypmed.2021.106437DOI Listing
April 2021

Resemblance in accelerometer-assessed physical activity in families with children: the Lolland-Falster Health Study.

Int J Behav Nutr Phys Act 2020 12 4;17(1):161. Epub 2020 Dec 4.

Lolland-Falster Health Study, Centre for Epidemiological Research, Nykøbing F. Hospital, Fjordvej 15, 4800, Nykøbing F., Denmark.

Background: Evidence of intra-family resemblance in physical activity (PA) is lacking. The association between parent and child PA appears weak, the influence of age and gender on this association is uncertain, and no studies have investigated the degree of resemblance in family members' PA behaviours such as walking, sitting/lying, and biking. Thus, the aims of the study were to examine the degree of resemblance in PA within families, specifically between parents and children, and to explore the size of resemblance across age of children, gender of parents and children, and intensity and type of PA.

Method: The study is a cross-sectional analysis of a subsample (902 parents and 935 children nested within 605 families) of the Danish population study Lolland-Falster Health Study. PA was measured using a dual-accelerometer system (Axivity AX3) with subsequent processing of time spent in light PA (LPA), moderate-to-vigorous PA (MVPA), and vigorous PA and classification of PA behaviour types. Families with at least one son/daughter aged 0-22 years and one parent providing minimum 4 days of valid accelerometer data were included in the analysis. A linear mixed model regression analysis was used to determine the intraclass correlation coefficient (ICC) of clustering among family members for PA intensities and PA behaviours, adjusted for sex, age, parental education, and the interaction between sex and age.

Results: In the analysis of within-family variation in PA, the ICCs across PA intensities and PA behaviours ranged from 0.06 to 0.34. We found stronger clustering in family members' PA for LPA and behaviours requiring low energy expenditure (LPA: ICC 0.22 (95% confidence interval (CI) 0.17; 0.28), sitting/lying: ICC 0.34 (95% CI 0.28; 0.40)), and walking: ICC 0.24 (95% CI 0.19; 0.30) than for higher intensities (e.g. MVPA: ICC 0.07 (95% CI 0.03; 0.14)). The ICC for biking was 0.23 (95% CI 0.18; 0.29). Analyses on parent-child dyads gave similar results. No interaction effects for gender and age (except for biking) were found.

Conclusion: Parents and children's time spent in PA behaviours requiring low energy expenditure had moderate resemblance within families, whereas engagement in PA with higher intensities showed small or close-to-zero resemblance.
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http://dx.doi.org/10.1186/s12966-020-01067-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718708PMC
December 2020

The multivariate physical activity signature associated with metabolic health in children and youth: An International Children's Accelerometry Database (ICAD) analysis.

Prev Med 2020 12 3;141:106266. Epub 2020 Oct 3.

Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway. Electronic address:

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.
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http://dx.doi.org/10.1016/j.ypmed.2020.106266DOI Listing
December 2020

Healthy Life Centres: a 3-month behaviour change programme's impact on participants' physical activity levels, aerobic fitness and obesity: an observational study.

BMJ Open 2020 09 28;10(9):e035888. Epub 2020 Sep 28.

Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Trøndelag, Norway.

Objectives: Individuals with low socioeconomic status and multimorbidity tend to have lower physical activity (PA) levels than the general population. Primary care is an important setting for reaching high-risk individuals to support behaviour change. This study aimed to investigate the impact of behaviour change interventions delivered by Norwegian Healthy Life Centres (HLCs) on participants' PA levels, aerobic fitness and obesity, and furthermore to investigate possible predictors of change.

Design: An observational study with a pre-post design and a 3-month follow-up.

Setting: Thirty-two HLCs in Norway were included.

Participants: A total of 713 participants (72% of the participants included at baseline), 71% women, with a mean age of 51 (18-87 years) and body mass index (BMI) of 32 (SD 7) met to follow-up.

Intervention: Individual consultations and tailored individual and group-based exercise and courses organised by the HLCs and cooperating providers.

Outcome Measures: The primary outcome was time spent in moderate to vigorous PA (MVPA, min/day) (ActiGraph GT3X+ accelerometer). The secondary outcomes were light PA (LPA, min/day), number of steps per day, time spent sedentary (SED, min/day), aerobic fitness (submaximal treadmill test, min), BMI (kg/m) and waist circumference (WC, cm).

Results: There was no change in MVPA (B 1.4, 95% CI -0.4 to 3.1) after 3 months. The participants had improved LPA (4.0, 95% CI 0.5 to 7.5), increased number of steps (362, 95% CI 172 to 552), reduced SED (-5.6, 95% CI -9.8 to -1.3), improved fitness (0.8, 95% CI 0.6 to 1.0), reduced BMI (-0.2, 95% CI -0.1 to -0.3) and reduced WC (-1.7, 95% CI -2.0 to -1.3). Positive predictors of change were number of exercise sessions completed per week, duration of adherence to HLC offers and participation in exercise organised by HLC.

Conclusion: Participation in the HLC interventions had small positive impacts on participants' PA levels, aerobic fitness and obesity. Further research to develop effective behaviour change programmes targeting individuals with complex health challenges is needed.

Trial Registration Number: NCT03026296.
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http://dx.doi.org/10.1136/bmjopen-2019-035888DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523218PMC
September 2020

A comparison of analytical approaches to investigate associations for accelerometry-derived physical activity spectra with health and developmental outcomes in children.

J Sports Sci 2021 Feb 20;39(4):430-438. Epub 2020 Sep 20.

Department of Chemistry, University of Bergen , Bergen, Norway.

The use of high-resolution physical activity intensity spectra obtained from accelerometry can improve knowledge of associations with health and development beyond the use of traditional summary measures of intensity. The aim of the present study was to compare three different approaches for determining associations for spectrum descriptors of physical activity (the intensity gradient, principal component analysis, and multivariate pattern analysis) with relevant outcomes in children. We used two datasets including physical activity spectrum data (ActiGraph GT3X+) and 1) a cardiometabolic health outcome in 841 schoolchildren and 2) a motor skill outcome in 1081 preschool children. We compared variance explained (R) and associations with the outcomes for the intensity gradient (slope) across the physical activity spectra, a two-component principal component model describing the physical activity variables, and multivariate pattern analysis using the intensity spectra as the explanatory data matrices. Results were broadly similar for all analytical approaches. Multivariate pattern analysis explained the most variance in both datasets, likely resulting from use of more of the information available from the intensity spectra. Yet, volume and intensity dimensions of physical activity are not easily disentangled and their relative importance may be interpreted differently using different methodology.
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http://dx.doi.org/10.1080/02640414.2020.1824341DOI Listing
February 2021

Interpretation of associations between the accelerometry physical activity spectrum and cardiometabolic health and locomotor skills in two cohorts of children using raw, normalized, log-transformed, or compositional data.

J Sports Sci 2020 Dec 29;38(23):2708-2719. Epub 2020 Jul 29.

Department of Chemistry, University of Bergen , Bergen, Norway.

It is discussed whether associations between accelerometer-derived physical activity intensities and outcomes should be analysed as absolute or relative data. The aim of the present study was to compare interpretation of association patterns of spectrum physical activity descriptions with outcome using raw, normalized, log-transformed, or compositional data. We used two datasets including 1) 841 schoolchildren and a cardiometabolic health outcome and 2) 1081 preschool children and a locomotor skill outcome. Accelerometry (ActiGraph GT3X+) data were described using multiple variables across the intensity spectrum. We varied the binning of variables to examine sensitivity of the compositional analyses to changes in the distribution centre. We used multivariate pattern analysis for all analyses and interpretations of data. Analyses of absolute (i.e., non-compositional) data showed weak associations for lower intensities and strongest associations with cardiometabolic health and locomotor skills for vigorous intensities. The same association patterns were partly observed for the compositional data, but association patterns were in some cases conflicting. The binning of variables had a major influence on associations for compositional data, but not for absolute data, meaning that conclusions depend on the operationalization of compositional data. These differences challenge and confuse interpretation of association patterns derived from the different approaches.
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http://dx.doi.org/10.1080/02640414.2020.1796462DOI Listing
December 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.

Front Psychol 2020 3;11:1382. Epub 2020 Jul 3.

Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.

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.

Clinical Trial Registration: www.ClinicalTrials.gov identifier NCT04048967.
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http://dx.doi.org/10.3389/fpsyg.2020.01382DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350704PMC
July 2020

Health-related quality of life and physical activity level after a behavior change program at Norwegian healthy life centers: a 15-month follow-up.

Qual Life Res 2020 Nov 20;29(11):3031-3041. Epub 2020 Jun 20.

Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491, Trondheim, Norway.

Purpose: The long-term impact of primary care behavior change programs on health-related quality of life (HRQoL) and physical activity (PA) level is unknown. The aim of this study was to investigate changes in HRQoL and PA among participants after a 3-month behavior change intervention at Norwegian healthy life center (HLCs) and at a 15-month follow-up. Furthermore, we aimed to study associations between changes in PA and HRQoL.

Methods: We followed 524 adult participants (18-83 years), recruited from 32 HLCs in August 2016-January 2018, who provided data on HRQoL (SF-36) and PA (ActiGraph accelerometers) 12 months after a 3-month behavior change intervention. Changes in HRQoL and PA between baseline, 3-month and 15-month follow-ups, and associations between changes in PA and HRQoL were analyzed by linear mixed models.

Results: All HRQoL dimensions improved from baseline to 3-month follow-up, and the improvements maintained at 15-month follow-up (mean 3.1-13.1 points, p < 0.001). PA increased from baseline to 3 months (mean 418 steps/day, p < 0.001), but declined from 3 to 15 months (mean - 371 steps/day, p < 0.001). We observed positive associations between changes in PA and HRQoL (0.84-3.23 points per 1000 steps/day, p < 0.023).

Conclusions: Twelve months after completing a 3-month HLC intervention we found improved HRQoL, but not PA level. Still, there were positive associations between PA and HRQoL over this period, indicating that participants increasing their PA were more likely to improve their HRQoL.
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http://dx.doi.org/10.1007/s11136-020-02554-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591434PMC
November 2020

Associations of Objectively-Assessed Physical Activity and Sedentary Time with Hippocampal Gray Matter Volume in Children with Overweight/Obesity.

J Clin Med 2020 Apr 10;9(4). Epub 2020 Apr 10.

PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain.

This study investigated physical activity (PA) and sedentary time (SED) in relation to hippocampal gray matter volume (GMV) in pediatric overweight/obesity. Ninety-three children (10 ± 1 year) were classified as overweight, obesity type I, or type II-III. PA was assessed with non-dominant wrist accelerometers. GMV was acquired by magnetic resonance imaging (MRI). Neither PA nor SED associated with GMV in the hippocampus in the whole sample ( > 0.05). However, we found some evidence of moderation by weight status ( < 0.150). Moderate-to-vigorous PA (MVPA) positively associated with GMV in the right hippocampus in obesity type I (B = 5.62, = 0.017), which remained when considering SED, light PA, and sleep using compositional data (γ = 375.3, = 0.04). Compositional models also depicted a negative association of SED relative to the remaining behaviors with GMV in the right hippocampus in overweight (γ = -1838.4, = 0.038). Reallocating 20 min/day of SED to MVPA was associated with 100 mm GMV in the right hippocampus in obesity type I. Multivariate pattern analysis showed a negative-to-positive association pattern between PA of increasing intensity and GMV in the right hippocampus in obesity type II-III. Our findings support that reducing SED and increasing MVPA are associated with greater GMV in the right hippocampus in pediatric overweight/obesity. Further studies should corroborate our findings.
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http://dx.doi.org/10.3390/jcm9041080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231303PMC
April 2020

Reproducibility of objectively measured physical activity: Reconsideration needed.

J Sports Sci 2020 May 23;38(10):1132-1139. Epub 2020 Mar 23.

Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences , Sogndal, Norway.

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.
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http://dx.doi.org/10.1080/02640414.2020.1743054DOI Listing
May 2020

Bi-directional prospective associations between objectively measured physical activity and fundamental motor skills in children: a two-year follow-up.

Int J Behav Nutr Phys Act 2020 01 2;17(1). Epub 2020 Jan 2.

Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Institute of Sports, Food, and Natural Sciences, Campus Sogndal, Post box 133, 6851, Sogndal, Sogn og Fjordane, Norway.

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.
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http://dx.doi.org/10.1186/s12966-019-0902-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6941400PMC
January 2020

Health-related quality of life and intensity-specific physical activity in high-risk adults attending a behavior change service within primary care.

PLoS One 2019 20;14(12):e0226613. Epub 2019 Dec 20.

Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.

Objectives: Health-related quality of life (HRQoL) is an important outcome for health interventions, such as physical activity (PA) promotion among high-risk populations. The aim of this study was to investigate levels of PA and HRQoL, and associations between PA and HRQoL, in participants attending a behavior change service within primary care in Norway.

Methods: Adult participants (≥ 18 years) from 32 Healthy Life Centers (HLCs) in four regions of Norway, who provided valid data on HRQoL (SF-36) and PA (ActiGraph accelerometer) were included (N = 835). HRQoL scores were compared to normative data by independent sample t-tests. Associations between eight dimensions of HRQoL and time spent sedentary (SED), in light PA (LPA) or in moderate to vigorous PA (MVPA) were determined using general linear models adjusted for relevant confounders.

Results: Nineteen percent of the participants (mean age 50; body mass index 32) met PA recommendations of > 150 min MVPA per week. SF-36 scores were 10 to 28 points lower than the norm (all p < 0.001). Positive associations were found between MVPA and the SF-36 dimensions physical functioning, role physical, general health and vitality, (all p < 0.045). LPA was positively associated with physical functioning, role physical, general health, vitality and role emotional (all p < 0.046). Time spent SED was negatively associated with physical functioning, general health, vitality, social functioning and mental health (all p < 0.030).

Conclusions: Individuals attending a Norwegian behavior change service within primary care had low PA level and low HRQoL compared to the general population. Our study suggest there is a positive dose-response relationship between PA and HRQoL, and a negative relationship between SED and HRQoL. Furthermore, that specific PA intensities and SED are related to different dimensions of HRQoL.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226613PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924667PMC
April 2020

Accelerometer epoch setting is decisive for associations between physical activity and metabolic health in children.

J Sports Sci 2020 Feb 17;38(3):256-263. Epub 2019 Nov 17.

Department of Chemistry, University of Bergen, Bergen, Norway.

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.
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http://dx.doi.org/10.1080/02640414.2019.1693320DOI Listing
February 2020

Effects of the Active Smarter Kids (ASK) physical activity intervention on cardiometabolic risk factors in children: A cluster-randomized controlled trial.

Prev Med 2020 01 22;130:105868. Epub 2019 Oct 22.

Western Norway University of Applied Sciences, Center for Physically Active Learning, Faculty of Education, Arts and Sports, Sogndal, Norway.

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. Trial registration number: Clinicaltrials.gov ID no.: NCT02132494.
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http://dx.doi.org/10.1016/j.ypmed.2019.105868DOI Listing
January 2020

The Triaxial Physical Activity Signature Associated with Metabolic Health in Children.

Med Sci Sports Exerc 2019 10;51(10):2173-2179

Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, NORWAY.

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.
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http://dx.doi.org/10.1249/MSS.0000000000002021DOI Listing
October 2019

Multicollinear physical activity accelerometry data and associations to cardiometabolic health: challenges, pitfalls, and potential solutions.

Int J Behav Nutr Phys Act 2019 08 27;16(1):74. Epub 2019 Aug 27.

Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences, Campus Sogndal, Western Norway University of Applied Sciences, Box 133, 6851, Sogndal, Norway.

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.

Trial Registration: The study was registered in Clinicaltrials.gov 7th of April 2014 with identification number NCT02132494 .
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http://dx.doi.org/10.1186/s12966-019-0836-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712694PMC
August 2019

Cardiometabolic risk factor levels in Norwegian children compared to international reference values: The ASK study.

PLoS One 2019 19;14(8):e0220239. Epub 2019 Aug 19.

Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway.

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.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220239PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699667PMC
March 2020

Interpretation of Multivariate Association Patterns between Multicollinear Physical Activity Accelerometry Data and Cardiometabolic Health in Children-A Tutorial.

Metabolites 2019 Jul 2;9(7). Epub 2019 Jul 2.

Department of Chemistry, University of Bergen, 5007 Bergen, Norway.

Associations between multicollinear accelerometry-derived physical activity (PA) data and cardiometabolic health in children needs to be analyzed using an approach that can handle collinearity among the explanatory variables. The aim of this paper is to provide readers a tutorial overview of interpretation of multivariate pattern analysis models using PA accelerometry data that reveals the associations to cardiometabolic health. A total of 841 children (age 10.2 ± 0.3 years) provided valid data on accelerometry (ActiGraph GT3X+) and six indices of cardiometabolic health that were used to create a composite score. We used a high-resolution PA description including 23 intensity variables covering the intensity spectrum (from 0-99 to ≥10000 counts per minute), and multivariate pattern analysis to analyze data. We report different statistical measures of the multivariate associations between PA and cardiometabolic health and use decentile groups of PA as a basis for discussing the meaning and impact of multicollinearity. We show that for high-resolution accelerometry data; considering all explanatory variables is crucial to obtain a correct interpretation of associations to cardiometabolic health; which is otherwise strongly confounded by multicollinearity in the dataset. Thus; multivariate pattern analysis challenges the traditional interpretation of findings from linear regression models assuming independent explanatory variables.
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http://dx.doi.org/10.3390/metabo9070129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680435PMC
July 2019

Impact and implementation of Healthy Life Centres, a primary-care service intervention for behaviour change in Norway: Study design.

Scand J Public Health 2020 Aug 19;48(6):594-601. Epub 2019 Jun 19.

Møreforsking Molde, Social science, Norway.

This ongoing study is investigating the implementation and long-term impact of Healthy Life Centres (HLCs), a primary-care service intervention for behaviour change in Norway. The primary aim is to study changes in objectively measured physical activity (PA) levels following a HLC intervention in the short (three months) and long term (15 months). Furthermore, the study is evaluating determinants concerning implementation and adaption of the HLC intervention that influence reach and impact on participants outcomes. : This prospective observational study includes 32 HLCs from four different geographical regions in Norway. Subjects aged ⩾18 years were invited to participate. The study has a pre-post design with a 15-month follow-up. The HLC intervention is a three-month individualised program, containing personal consultations and group-based behaviour-specific courses on PA, diet and smoking cessation. Data collection consists of registration of objectively measured PA level, physical examinations, interviews and questionnaires. In addition, HLC organisation, offers, professions and resources are being examined. The Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework is being applied to study the external validation of the HLC intervention. The study enrolled 1020 participants who gave their written informed consent. Post-tests and follow-up data collection is still ongoing and will continue until August 2019.
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http://dx.doi.org/10.1177/1403494819856832DOI Listing
August 2020

Associations of physical activity and sedentary time with lipoprotein subclasses in Norwegian schoolchildren: The Active Smarter Kids (ASK) study.

Atherosclerosis 2019 09 5;288:186-193. Epub 2019 Jun 5.

Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. Electronic address:

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.
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http://dx.doi.org/10.1016/j.atherosclerosis.2019.05.023DOI Listing
September 2019

The ActiGraph counts processing and the assessment of vigorous activity.

Clin Physiol Funct Imaging 2019 Jul 2;39(4):276-283. Epub 2019 May 2.

Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.

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 . However, additional developments are required to accurately capture all VPA, including intermittent activities.
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http://dx.doi.org/10.1111/cpf.12571DOI Listing
July 2019
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