Publications by authors named "Elin Kolle"

46 Publications

Body appreciation and body appearance pressure in Norwegian university students comparing exercise science students and other students.

BMC Public Health 2021 Mar 19;21(1):532. Epub 2021 Mar 19.

Østfold University College, Department of Health and Welfare, PO 700, 1757, Halden, Norway.

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

Method: Male and female exercise science students (n = 517) and reference students (n = 476), from nine large universities in Norway took part in this cross-sectional study. Participants responded to the Body appreciation scale-2, a self-developed questionnaire on body appearance pressure, Physical Appearance Comparison Scale-Revised, Sociocultural attitudes towards appearance questionnaire-4R, Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, and questions about physical activity and exercise. Between group differences were analyzed using student independent t-test and ANCOVA for parametric data and Chi-square test for categorical data, and associations were evaluated by Person's correlation. P-values ≤0.05 were defined as significant.

Results: Female exercise science students had higher scores on body appreciation compared to reference students. No group difference was found in males. A high percentage of students reported experiencing body appearance pressure, with 69 and 85% among male and female exercise science students, and 57 and 83% among male and female reference students. Fitness centers were the settings where most respondents experienced body appearance pressure. Body appreciation was strongly associated with favorable scores on body image related mental health constructs, while personally experienced body appearance pressure associated with destructive scores on the same constructs.

Conclusion: Body appearance pressure is an issue among university students regardless of study program. Actions to promote body appreciation and prevent body appearance pressure may include an implementation of media literacy, body functionality, and exercise as topics within the education program to safeguard students' health and well-being.

Clinical Trial Registry: No. NCT04256967 .
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http://dx.doi.org/10.1186/s12889-021-10550-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977603PMC
March 2021

Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis.

Int J Behav Nutr Phys Act 2021 02 10;18(1):28. Epub 2021 Feb 10.

MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK.

Purpose: The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity - such as physical activity - are more favorable on days that contain more 'structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset.

Methods: Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status.

Results/findings: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively.

Conclusions: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.
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http://dx.doi.org/10.1186/s12966-021-01095-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877033PMC
February 2021

Adapting the SPOTLIGHT Virtual Audit Tool to assess food and activity environments relevant for adolescents: a validity and reliability study.

Int J Health Geogr 2021 Jan 18;20(1). Epub 2021 Jan 18.

University of Oslo, Oslo, Norway.

Background: Physical inactivity and unhealthy diet are key behavioral determinants underlying obesity. The neighborhood environment represents an important arena for modifying these behaviors, and hence reliable and valid tools to measure it are needed. Most existing virtual audit tools have been designed to assess either food or activity environments deemed relevant for adults. Thus, there is a need for a tool that combines the assessment of food and activity environments, and which focuses on aspects of the environment relevant for youth.

Objective: The aims of the present study were: (a) to adapt the SPOTLIGHT Virtual Audit Tool (S-VAT) developed to assess characteristics of the built environment deemed relevant for adults for use in an adolescent population, (b) to assess the tool's inter- and intra-rater reliability, and (c) to assess its criterion validity by comparing the virtual audit to a field audit.

Methods: The tool adaptation was based on literature review and on results of a qualitative survey investigating how adolescents perceived the influence of the environment on dietary and physical activity behaviors. Sixty streets (148 street segments) in six neighborhoods were randomly selected as the study sample. Two raters assessed the inter- and intra-rater reliability and criterion validity, comparing the virtual audit tool to a field audit. The results were presented as percentage agreement and Cohen's kappa (κ).

Results: Intra-rater agreement was found to be moderate to almost perfect (κ = 0.44-0.96) in all categories, except in the category aesthetics (κ = 0.40). Inter-rater agreement between auditors ranged from fair to substantial for all categories (κ = 0.24-0.80). Criterion validity was found to be moderate to almost perfect (κ = 0.56-0.82) for most categories, except aesthetics and grocery stores (κ = 0.26-0.35).

Conclusion: The adapted version of the S-VAT can be used to provide reliable and valid data on built environment characteristics deemed relevant for physical activity and dietary behavior among adolescents.
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http://dx.doi.org/10.1186/s12942-021-00258-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7814470PMC
January 2021

The effect of a school-based intervention on physical activity, cardiorespiratory fitness and muscle strength: the School in Motion cluster randomized trial.

Int J Behav Nutr Phys Act 2020 11 26;17(1):154. Epub 2020 Nov 26.

Department of Physical Performance, Norwegian School of Sport Sciences, Ullevål Stadion, PB 4014, 0806, Oslo, Norway.

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.

Trial Registration: ClinicalTrials.gov ID nr: NCT03817047 . Registered 01/25/2019 'retrospectively registered'.
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http://dx.doi.org/10.1186/s12966-020-01060-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690135PMC
November 2020

The Norwegian healthy body image intervention promotes positive embodiment through improved self-esteem.

Body Image 2020 Dec 3;35:84-95. Epub 2020 Oct 3.

University College of Southeast Norway, Department of Sports, Physical Education and Outdoor Studies, P.O. Box 235, N-3603 Kongsberg, Norway. Electronic address:

We examined both direct and indirect effects of the Healthy Body Image (HBI) intervention on positive embodiment among Norwegian high school students. In total, 2446 12th grade boys (43 %) and girls (mean age 16.8 years) from 30 schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. We tested mediation models using path analysis and found that among several hypothesized mediators, only self-esteem mediated a positive intervention effect on positive embodiment for both boys and girls. A direct effect of the intervention on positive embodiment was only found in girls. The study provides novel findings indicating that health promotion interventions to address a positive embodiment should focus on enhancing adolescent's self-esteem. Serial mediation modeling might reveal more complex explanations of change mechanisms and could further evolve current knowledge.
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http://dx.doi.org/10.1016/j.bodyim.2020.08.014DOI Listing
December 2020

Birth weight, cardiometabolic risk factors and effect modification of physical activity in children and adolescents: pooled data from 12 international studies.

Int J Obes (Lond) 2020 10 3;44(10):2052-2063. Epub 2020 Jun 3.

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

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.
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http://dx.doi.org/10.1038/s41366-020-0612-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508671PMC
October 2020

The association between physical fitness and mental health in Norwegian adolescents.

BMC Public Health 2020 May 24;20(1):776. Epub 2020 May 24.

Department of Education and Sport Science, University of Stavanger, 4036, Stavanger, Norway.

Background: Studies indicate that health-related components of physical fitness are associated with mental health outcomes. However, research is scarce concerning this relationship in young adolescents in general and non-existent in Norwegian populations specifically. The aim of the study was to examine whether body composition, muscular strength and cardiorespiratory fitness were associated with self-reported mental health in Norwegian adolescents.

Methods: Adolescents from four regions of Norway (n = 1486; mean age = 13.9; girls = 50.6%) participated. Self-reported mental health (psychological difficulties) was measured by completing the Strengths and Difficulties Questionnaire. Cardiorespiratory fitness was assessed with an intermittent running test; muscular strength was assessed by measuring handgrip strength, standing broad jump and sit-ups; and body composition was assessed by calculating body mass index from weight and height. Linear mixed effects models were conducted to assess the associations between the health-related components of physical fitness and psychological difficulties. School clusters were included as random effects and all models were controlled for sex, socioeconomic status and birthplace (domestic or foreign).

Results: Body composition was not associated with psychological difficulties. Muscular strength was independently associated with psychological difficulties, but when all independent variables were entered in the fully adjusted model, only cardiorespiratory fitness was associated with psychological difficulties.

Conclusions: There was a small but significant inverse association between cardiorespiratory fitness and levels of psychological difficulties in Norwegian adolescents. The results suggest that muscular strength is not associated with psychological difficulties in adolescents, when controlling for cardiorespiratory fitness. Future research should focus on the prospective association between physical fitness components and mental health outcomes in adolescents.

Trial Registration: The study is registered in ClinicalTrials.gov ID nr: NCT03817047. Retrospectively registered January 25, 2019.
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http://dx.doi.org/10.1186/s12889-020-08936-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247223PMC
May 2020

Step by step: Association of device-measured daily steps with all-cause mortality-A prospective cohort Study.

Scand J Med Sci Sports 2020 Sep 17;30(9):1705-1711. Epub 2020 Jun 17.

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

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.
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http://dx.doi.org/10.1111/sms.13726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496562PMC
September 2020

Variations in accelerometry measured physical activity and sedentary time across Europe - harmonized analyses of 47,497 children and adolescents.

Int J Behav Nutr Phys Act 2020 03 18;17(1):38. Epub 2020 Mar 18.

Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway.

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.
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http://dx.doi.org/10.1186/s12966-020-00930-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7079516PMC
March 2020

Change in Anthropometrics and Physical Fitness in Norwegian Cadets During 3 Years of Military Academy Education.

Mil Med 2020 08;185(7-8):e1112-e1119

Department of Sports Medicine, Norwegian School of Sport Sciences, P.O. Box 4014 Ullevaal Stadion, Oslo N-0806, Norway.

Introduction: High physical fitness is associated with increased occupational performance, better health, and reduced risk of injuries in military personnel. Thus, the military emphasizes physical training to maintain or develop physical fitness in their soldiers. It is important to monitor the effect of the physical training regime, but such information is lacking for Norwegian military cadets. Hence, the primary aim of this study was to investigate changes in anthropometrics and physical fitness among male and female army, navy and air force cadets during 3 years of military academy education.

Materials And Methods: 260 male and 29 female Norwegian cadets from the army, navy, and air force academies volunteered to participate. Anthropometrics, muscular power, muscular endurance, and maximal oxygen uptake were measured at entry (T0) and end of each year (T1, T2, and T3). Linear mixed models were used to examine the development in anthropometrics and physical fitness. We applied to the Regional Committee for Medical and Health Research Ethics to review the study before start-up, but the study was considered exempted from notification. The study was reviewed and approved by the Norwegian Social Science Data Services.

Results: Male and female cadets significantly increased their body weight, fat-free mass, body mass index, and percent body fat by 1 to 5% from T0 to T3. Skeletal muscle mass was unchanged. Muscular power (medicine ball throw and vertical jump) and muscular endurance (pull-ups and push-ups) increased by 3 to 20% in male cadets, while female cadets only increased results significantly for the medicine ball throw (10%). Relative maximal oxygen uptake decreased by 4% in both sexes, while absolute maximal oxygen uptake only decreased significantly (by 2%) in male cadets. Most of the observed changes were classified as trivial or small, according to calculated effect sizes. The observed changes were generally of similar magnitude for male and female cadets, and similar among the three academies.

Conclusions: Anthropometrics and physical fitness were relatively stable in Norwegian male and female army, navy, and air force cadets during 3 years of military academy education. Observed changes were typically classified as trivial or small. The initial gap in physical fitness between male and female cadets did not narrow during the education years. Norwegian male and female cadets displayed relatively good physical fitness profiles, compared to sex-matched cadets and soldiers from previously studied military populations.
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http://dx.doi.org/10.1093/milmed/usz470DOI Listing
August 2020

Does the Healthy Body Image program improve lifestyle habits among high school students? A randomized controlled trial with 12-month follow-up.

J Int Med Res 2020 Mar 5;48(3):300060519889453. Epub 2019 Dec 5.

University College of Southeast Norway, Department of Sports, Physical Education and Outdoor Studies, Kongsberg, Norway.

Objectives: Positive embodiment and healthy lifestyle habits seem to be related; therefore, stimulating positive embodiment should promote healthy lifestyle habits. In the current study, we delivered the Healthy Body Image (HBI) intervention among Norwegian high school students and examined the effects on healthy lifestyle habits.

Methods: The HBI intervention comprises three interactive workshops, with three overarching themes related to body image, social media literacy, and lifestyle. A total of 2446 boys (43%) and girls in grade 12 (mean age 16.8 years) from 30 high schools participated in this cluster-randomized controlled study. Schools were randomized to the HBI intervention or control study arm. Data on physical activity, eating habits, and sleep were collected at baseline, post intervention, and 3- and 12-month follow-up and analyzed using linear mixed regression models.

Results: The intervention had a minor negative effect on physical activity levels in boys at 12-month follow-up and short-term small-to-moderate positive effects on consumption of breakfast and fruit and vegetables, and sleep duration on school days.

Conclusions: In future, the lack of satisfactorily long-term effects might be better addressed using a combination of cognitive and behavioral approaches to more optimally integrate positive embodiment and lifestyle changes in the daily life of adolescents. ClinicalTrials.gov ID: PRSNCT02901457. Approved by the Regional Committee for Medical and Health Research Ethics.
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http://dx.doi.org/10.1177/0300060519889453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607281PMC
March 2020

Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD).

Int J Behav Nutr Phys Act 2019 10 31;16(1):96. Epub 2019 Oct 31.

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

Background: Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children.

Methods: Cross-sectional data from 14 studies (7 countries) in the International Children's Accelerometry Database (ICAD, 1998-2009) was included. Accelerometry in 19,502 participants aged 3-18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed.

Results: Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (- 0.44 (- 0.62; - 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (- 3.07 (- 4.47; - 1.68) cm), systolic blood pressure (- 1.53 (- 2.42; - 0.65) mmHg) and clustered cardio-metabolic risk (- 0.18 (- 0.3; - 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: - 0.81 (- 1.38; - 0.24) mmHg).

Conclusions: Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of ≈1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.
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http://dx.doi.org/10.1186/s12966-019-0858-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822444PMC
October 2019

Correction to: A closer look at the relationship among accelerometer-based physical activity metrics: ICAD pooled data.

Int J Behav Nutr Phys Act 2019 08 8;16(1):62. Epub 2019 Aug 8.

Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.

Following publication of the original article [1], the author reported that the name of the collaborator group was missing from the author group.
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http://dx.doi.org/10.1186/s12966-019-0828-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686467PMC
August 2019

Early life risk factors for childhood obesity-Does physical activity modify the associations? The MoBa cohort study.

Scand J Med Sci Sports 2019 Oct 3;29(10):1636-1646. Epub 2019 Jul 3.

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

Objectives: High maternal pre-pregnancy body mass index (BMI), high birth weight, and rapid infant weight gain are associated with increased risk of childhood obesity. We examined whether moderate-to-vigorous physical activity (MVPA) or vigorous physical activity (VPA) in 9- to 12-year-olds modified the associations between these early life risk factors and subsequent body composition and BMI.

Methods: We used data from a sub-cohort of the Norwegian Mother and Child Cohort Study (MoBa), including 445 children with available data on accelerometer assessed physical activity (PA). All participants had data on BMI, 186 of them provided data on body composition (dual energy X-ray absorptiometry (DXA)). We used multiple regression analyses to examine the modifying effect of PA by including interaction terms.

Results: Maternal pre-pregnancy BMI and infant weight gain were more strongly related to childhood body composition in boys than in girls. Higher VPA attenuated the association between maternal pre-pregnancy BMI and BMI in boys (low VPA: B = 0.32, 95% CI = 0.22, 0.41; high VPA B = 0.22, 95% CI = 0.12, 0.31). Birth weight was unrelated to childhood body composition, and there was no effect modification by PA. PA attenuated the associations between infant weight gain and childhood fat mass (low MVPA: B = 2.32, 95% CI = 0.48, 4.17; high MVPA: B = 1.00, 95% CI = 0.10, 1.90) and percent fat (low MVPA: B = 3.35, 95% CI = 0.56, 6.14; high MVPA: B = 1.41, 95% CI = -0.06, 2.87) in boys, but not girls.

Conclusion: Findings from this study suggest that MVPA and VPA may attenuate the increased risk of an unfavorable body composition and BMI due to high maternal pre-pregnancy BMI and rapid infant weight gain in boys, but not in girls.
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http://dx.doi.org/10.1111/sms.13504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852336PMC
October 2019

A closer look at the relationship among accelerometer-based physical activity metrics: ICAD pooled data.

Int J Behav Nutr Phys Act 2019 04 29;16(1):40. Epub 2019 Apr 29.

Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.

Background: Accelerometers are widely used to assess child physical activity (PA) levels. Using the accelerometer data, several PA metrics can be estimated. Knowledge about the relationships between these different metrics can improve our understanding of children's PA behavioral patterns. It also has significant implications for comparing PA metrics across studies and fitting a statistical model to examine their health effects. The aim of this study was to examine the relationships among the metrics derived from accelerometers in children.

Methods: Accelerometer data from 24,316 children aged 5 to 18 years were extracted from the International Children's Accelerometer Database (ICAD) 2.0. Correlation coefficients between wear time, sedentary behavior (SB), light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA), moderate- and vigorous-intensity PA (MVPA), and total activity counts (TAC) were calculated.

Results: TAC was approximately 22X10 counts higher (p < 0.01) with longer wear time (13 to 18 h/day) as compared to shorter wear time (8 to < 13 h/day), while MVPA was similar across the wear time categories. MVPA was very highly correlated with TAC (r = .91; 99% CI = .91 to .91). Wear time-adjusted correlation between SB and LPA was also very high (r = -.96; 99% CI = -.96, - 95). VPA was moderately correlated with MPA (r = .58; 99% CI = .57, .59).

Conclusions: TAC is mostly explained by MVPA, while it could be more dependent on wear time, compared to MVPA. MVPA appears to be comparable across different wear durations and studies when wear time is ≥8 h/day. Due to the moderate to high correlation between some PA metrics, potential collinearity should be addressed when including multiple PA metrics together in statistical modeling.
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http://dx.doi.org/10.1186/s12966-019-0801-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489360PMC
April 2019

The healthy body image (HBI) intervention: Effects of a school-based cluster-randomized controlled trial with 12-months follow-up.

Body Image 2019 Jun 28;29:122-131. Epub 2019 Mar 28.

University College of Southeast Norway, Department of Sports, Physical Education and Outdoor Studies, P.O. Box 235, N-3603, Kongsberg, Norway. Electronic address:

We examined the effects of the Healthy Body Image (HBI) intervention on positive embodiment and health-related quality of life among Norwegian high school students. The intervention comprised three interactive workshops, with body image, media literacy, and lifestyle as main themes. In total, 2,446 12 grade boys (43%) and girls (mean age 16.8 years) from 30 high schools participated in a cluster-randomized controlled study with the HBI intervention and a control condition as the study arms. Data were collected at baseline, post-intervention, 3- and 12-months follow-up, and analysed using linear mixed regression models. The HBI intervention caused a favourable immediate change in positive embodiment and health-related quality of life among intervention girls, which was maintained at follow-up. Among intervention boys, however, weak post-intervention effects on embodiment and health-related quality of life vanished at the follow-ups. Future studies should address steps to make the HBI intervention more relevant for boys as well as determine whether the number of workshops or themes may be shortened to ease implementation and to enhance intervention effects.
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http://dx.doi.org/10.1016/j.bodyim.2019.03.007DOI Listing
June 2019

Aerobic fitness thresholds to define poor cardiometabolic health in children and youth.

Scand J Med Sci Sports 2019 Feb 20;29(2):240-250. Epub 2018 Nov 20.

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

Aerobic fitness is an apparent candidate for screening children and youth for poor cardiometabolic health and future risk of cardiovascular disease (CVD). Yet, age- and sex-specific cut points for children and youth determined using a maximal protocol and directly measured peak oxygen consumption (VO ) does not exist. We used a nationally representative sample of 1462 Norwegian children and youth (788 boys and 674 girls aged 8.7-10.4 years and 14.7-16.7 years) who in 2005-2006 performed a maximal cycle ergometer test with direct measurement of VO , along with measurement of several other risk factors for CVD (systolic blood pressure, waist circumference:height ratio, total:high-density lipoprotein cholesterol ratio, triglycerides, Homeostasis Model Assessment for Insulin Resistance). Based on the proportion of children having clustering (least favorable quartile) of 6 (1.6%), ≥5 (5.2%), and ≥4 (10.6%) CVD risk factors, we established the 2nd, 5th, and 10th percentile cut points for VO (mL/kg/min) for children and youth aged 8-18 years. Classification accuracy was determined using the Kappa coefficient (k), sensitivity, and specificity. For boys, the 2nd, 5th, and 10th percentile VO cut points were 33.6-36.4, 36.3-39.8, and 38.7-43.0 mL/kg/min, respectively. For girls, the corresponding cut points were 29.7-29.1, 32.4-31.4, and 34.8-33.5 mL/kg/min Together with BMI, but without more invasive measures of traditional risk factors for CVD, these cut points can be used to screen schoolchildren for poor cardiometabolic health with moderate discriminating ability (k ≤ 0.53).
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http://dx.doi.org/10.1111/sms.13330DOI Listing
February 2019

The built environment correlates of objectively measured physical activity in Norwegian adults: A cross-sectional study.

J Sport Health Sci 2018 Jan 20;7(1):19-26. Epub 2017 Nov 20.

Centre for Hip Health and Mobility, Vancouver, BC V5Z 1M9, Canada.

Background: Built environments that are designed to provide accessible, attractive, and convenient locales promote regular physical activity (PA). Norway has great variability in its geographic, natural, and built environment features. Urban areas have well-developed built environment features, whereas the rural areas are less walkable and this may influence the mode of transport. In general, active transport is more common in urban centers. Further, public transportation is more developed in urban areas, whereas motorized transport may be more widespread in the rural areas. Despite this, in Sogn & Fjordane, a rural county in western Norway, high PA levels are frequently observed. Thus, the aims of this study were to (1) explore perceived built environment features and characterize their associations with objectively measured PA levels in Norwegian adults and (2) explore the differences in these correlates between Sogn & Fjordane and the rest of Norway.

Methods: In this cross-sectional study, participants used questionnaires to rate perceptions of their built environments, and their PA was objectively measured for 7 consecutive days using the ActiGraph GT1M accelerometer. There were 972 Norwegian adults who were included in the study. The average age was 46.9 ± 6.5 years and 43.8% of participants were men. Data were analyzed using multiple linear regression.

Results: Total PA and moderate-to-vigorous physical activity (MVPA) were both associated with perceived walkability, the community perception score, and active transport for commuting (all  ≤ 0.004). We also observed geographic-area-specific associations: the community perception score was negatively associated with total PA and MVPA in the rest of Norway ( ≤ 0.012) but not in Sogn & Fjordane. Public transport for commuting was positively associated with MVPA in Sogn & Fjordane ( = 0.03) but not in the rest of Norway.

Conclusion: Total PA level and MVPA were associated with built environment factors, such as perceptions of community, perceived walkability, and engaging in active transport for commuting. Geographic differences in the PA correlates were observed, and thus, locally customized environmental population approaches aimed at increasing PA levels may be essential complements to individual behavior and lifestyle strategies. Further, objective measures of Norwegian built environments, such as geographic information system data, and validated walk- and bike-scores would advance the field.
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http://dx.doi.org/10.1016/j.jshs.2017.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180549PMC
January 2018

Monitoring population levels of physical activity and sedentary time in Norway across the lifespan.

Scand J Med Sci Sports 2019 Jan 11;29(1):105-112. Epub 2018 Oct 11.

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

Purpose: The pandemic of physical inactivity is recognized globally but there is a scarcity of studies employing valid and reliable assessment methods of physical activity (PA) across the lifespan. The purpose of this study is to provide a comprehensive description of objectively measured PA, sedentary time, and prevalence of meeting PA recommendations, in a population-based sample of Norwegian children, adolescents and adults.

Methods: Children and adolescents (6, 9 and 15-year-olds) were surveyed in 2011, and adults and older people (20-85-year-olds) were surveyed in 2014/15, including more than 8000 individuals. Anthropometric data were measured in children and adolescents and self-reported in the adult sample. PA was assessed by ActiGraph accelerometers for seven consecutive days, and PA indices include total PA (counts per minute), intensity-specific PA, and adherence to PA recommendations.

Results: Six-year-olds are 21% and 70% more active than 9- and 15-year-olds, respectively (P < 0.001). Nine-year-olds are 40% more active compared to 15-year-olds (P < 0.001). Moving from adolescence (15-year-olds) into adulthood (20-65 years) yields a further reduction in total PA by 18%. Among six-, nine- and 15-year olds, 90%, 77%, and 48% meet the current PA recommendations, respectively, while adherence among adults and older people are 33% and 31%, respectively. Overweight and obese individuals had lower odds of meeting PA recommendations.

Conclusions: The results from the Norwegian surveillance system indicate a strong association between age and indices of physical activity. The vast majority of Norwegian adults do not meet the PA recommendations and public health action are needed to increase PA in Norway.
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http://dx.doi.org/10.1111/sms.13314DOI Listing
January 2019

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 2018 06 7;18(1):705. Epub 2018 Jun 7.

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

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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http://dx.doi.org/10.1186/s12889-018-5610-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992852PMC
June 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 Med 2018 Oct;48(10):2401-2412

Department of Sports Medicine, Norwegian School of Sport Sciences, Ullevål Stadion, 0806, Oslo, Norway.

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.
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http://dx.doi.org/10.1007/s40279-018-0909-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132434PMC
October 2018

The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students.

BMC Psychol 2018 Mar 6;6(1). Epub 2018 Mar 6.

Faculty of Health Sciences Department of Psychology, UiT -The Arctic University of Norway, 9037, Tromsø, Norway.

Background: Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating.

Methods And Design: Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme.

Discussion: The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services.

Trial Registration: The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.
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http://dx.doi.org/10.1186/s40359-018-0221-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840729PMC
March 2018

Does objectively measured physical activity modify the association between early weight gain and fat mass in young adulthood?

BMC Public Health 2017 11 25;17(1):905. Epub 2017 Nov 25.

Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.

Background: Substantial evidence suggests that weight gain in early life is associated with increased adiposity and other metabolic disorders later in life. It is, however, unknown whether physical activity (PA) may modify these associations. We aimed to examine whether objectively measured PA at 30 years modified the associations between conditional weight gain in infancy (0-2 y) and childhood (2-4 y) with fat mass index (FMI) and visceral abdominal fat measured at age 30 years.

Methods: Prospective birth cohort study in Pelotas, Brazil, including 1874 participants with weight data at birth, two and four years of age, and measures of FMI, visceral abdominal fat and PA at a mean age of 30.2 years. At age 30, time spent (min/day) in moderate-to-vigorous physical activity (MVPA) was measured objectively using a wrist-worn accelerometer worn for four to seven consecutive days.. Multiple linear regression analyses was performed to assess the associations between conditional weight gain and outcome variables at 30 years, adjusting for covariates. We examined whether PA modified the association between conditional weight gain and the outcomes of interest by introducing an interaction term (conditional weight gain × PA) in the models.

Results: Conditional weight gain in infancy and childhood were both positively associated with later FMI (infancy weight gain: β = 0.68, 95% CI: 0.48, 0.88; P < 0.001; childhood weight gain: β = 0.91, 95% CI: 0.70, 1.11; P < 0.001). A formal test for interaction suggested that MVPA at 30 years of age modified the association between childhood relative weight gain and later FMI (β = -0.006, 95% CI: -0.011, -0.001; P = 0.029), suggesting stronger associations between weight gain and FMI in those with lower levels of MVPA. Conditional weight gain in childhood was also positively associated with visceral abdominal fat (β = 0.24, 95% CI: 0.15, 0424, P < 0.001). There was no evidence for a modification of the latter association after adjustment for physical activity.

Conclusion: Conditional weight gain between 2 and 4 years of age is associated with increased FMI at age 30 years. However, higher levels of MVPA appear to attenuate this detrimental association.
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http://dx.doi.org/10.1186/s12889-017-4924-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702210PMC
November 2017

Normative values for musculoskeletal- and neuromotor fitness in apparently healthy Norwegian adults and the association with obesity: a cross-sectional study.

BMC Sports Sci Med Rehabil 2016 18;8:37. Epub 2016 Nov 18.

Department of Sports Medicine, The Norwegian School of Sport Sciences, Sognsveien 220, Oslo, Norway.

Background: Up-to-date research on musculoskeletal- and neuromotor fitness (MSMF) is lacking. The aims of the present paper were to a) establish normative values of MSMF by gender and age, and b) to assess how much of the variance in MSMF can be explained by obesity in adults.

Methods: A random selection of 726 Norwegians (20-65 years) participated in a national cross-sectional study. Muscular endurance, muscular strength, explosive power, flexibility and balance were assessed in addition to waist circumference (WC).

Results: Females displayed significantly higher scores compared to males on muscular endurance of the back extensors and on the flexibility tests ( < 0.001). Males displayed significantly higher scores than females ( < 0.001) on handgrip strength, modified push-ups, and explosive power. An inverse association was found between age and all MSMF scores for females (Beta:-0.06-(-0.92),  ≤ 0.044) and males (Beta:-0.15-(0.91),  ≤ 0.006), where younger participants displayed higher test scores on all MSMF tests, compared to older participants. Furthermore, participants showing higher scores on WC displayed lower scores on the following MSMF tests for both females and males: muscular endurance of the back extensors, balance, flexibility of the shoulder, and explosive power ( < 0.001). Additionally, male participants with higher WC scores showed lower scores on muscular endurance of the upper body and flexibility of the hamstrings compared to males with lower WC scores ( < 0.001).

Conclusions: The data provide normative values of MSMF for adults based on age and gender, and support an inverse relationship of MSMF to age and WC.
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http://dx.doi.org/10.1186/s13102-016-0059-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116214PMC
November 2016

Physical Activity and Pediatric Obesity: A Quantile Regression Analysis.

Med Sci Sports Exerc 2017 03;49(3):466-473

1Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA; 2Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; 3Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Columbia, SC; 4School of Social and Community Medicine, University of Bristol, Bristol, UNITED KINGDOM; 5Centre of Research in Childhood Health, University of Southern Denmark, Odense, DENMARK; 6Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, PORTUGAL; 7Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY; and 8Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UNITED KINGDOM.

Purpose: We aimed to determine whether moderate to vigorous physical activity (MVPA) and sedentary behavior (SB) were independently associated with body mass index (BMI) and waist circumference (WC) in children and adolescents.

Methods: Data from the International Children's Accelerometry Database were used to address our objectives (N = 11,115; 6-18 yr; 51% female). We calculated age- and gender-specific BMI and WC z-scores and used accelerometry to estimate MVPA and total SB. Self-reported television viewing was used as a measure of leisure time SB. Quantile regression was used to analyze the data.

Results: MVPA and total SB were associated with lower and higher BMI and WC z-scores, respectively. These associations were strongest at the higher percentiles of the z-score distributions. After including MVPA and total SB in the same model, the MVPA associations remained, but the SB associations were no longer present. For example, each additional hour per day of MVPA was not associated with BMI z-score at the 10th percentile (b = -0.02, P = 0.170) but was associated with lower BMI z-score at the 50th (b = -0.19, P < 0.001) and 90th percentiles (b = -0.41, P < 0.001). More television viewing was associated with higher BMI and WC, and the associations were strongest at the higher percentiles of the z-score distributions, with adjustment for MVPA and total SB.

Conclusions: Our observation of stronger associations at the higher percentiles indicates that increasing MVPA and decreasing television viewing at the population-level could shift the upper tails of the BMI and WC frequency distributions to lower values, thereby lowering the number of children and adolescents classified as obese.
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http://dx.doi.org/10.1249/MSS.0000000000001129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321492PMC
March 2017

Permanent play facility provision is associated with children's time spent sedentary and in light physical activity during school hours: A cross-sectional study.

Prev Med Rep 2016 Dec 13;4:429-34. Epub 2016 Aug 13.

Department of Sports Medicine, The Norwegian School of Sport Sciences, P.O. Box 4014, Ullevål Stadion, N-0806 Oslo, Norway.

Objective: To study the associations between: 1) number of permanent outdoor play facilities per pupil and 2) the size of the outdoor play area per pupil with sedentary time and physical activity (PA) during school hours in six-, nine-, and 15-year olds. We conducted a cross-sectional study of nationally representative samples of Norwegian six- (n = 1071), nine- (n = 1421) and 15-year-olds (n = 1106) in 2011 (the Physical Activity Among Norwegian Children Study). The participation rates were 56.4%, 73.1% and 57.8% for six-, nine- and 15-year olds, respectively. We assessed PA objectively for seven consecutive days using accelerometers, the size of a school's outdoor play area (SOPA) using an online map service and the permanent play facility (PPF) provision using a standardized form during school site visits. We successfully measured SOPA and PPF in 99 schools, from which 3040 participants provided valid accelerometer data. We used generalized least-squares random-effects models with robust variance estimation to assess associations. Our results indicate that better provision of permanent play facilities may reduce sedentary time and increase time spent in light PA among six-year-olds. Permanent play facility provision was not associated with sedentary time or PA among nine- and 15-year-olds. Associations found between outdoor play area size, physical activity and sedentary time were negligible. Future research should investigate what types of permanent play facilities may be associated with physical activity in both children and adolescents.
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http://dx.doi.org/10.1016/j.pmedr.2016.08.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995570PMC
December 2016

Association between birth weight and objectively measured sedentary time is mediated by central adiposity: data in 10,793 youth from the International Children's Accelerometry Database.

Am J Clin Nutr 2015 05 1;101(5):983-90. Epub 2015 Apr 1.

From the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway (MH, EK, BHH, LBA, and UE); the Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom (PJC, KW, EvS, and UE); the School of Social and Community Medicine (KK) and the Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies (ARC), University of Bristol, Bristol, United Kingdom; the School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (LB Sherar); the Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (LBA); the Department of Sport and Health, University of Lisbon, Lisbon, Portugal (LB Sardinha); the Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland (SK); and the Department of Physical Education, Federal University of Pelotas, Pelotas, Brazil (PH).

Background: Birth weight is an early correlate of disease later in life, and animal studies suggest that low birth weight is associated with reduced activity and increased sedentary time. Whether birth weight predicts later sedentary time in humans is uncertain.

Objectives: We examined the relation between birth weight and sedentary time in youth and examined whether this association was mediated by central adiposity.

Design: We used pooled cross-sectional data from 8 observational studies conducted between 1997 and 2007 that consisted of 10,793 youth (boys: 47%) aged 6-18 y from the International Children's Accelerometry Database. Birth weight was measured in hospitals or maternally reported, sedentary time was assessed by using accelerometry (<100 counts/min), and abdominal adiposity (waist circumference) was measured according to WHO procedures. A mediation analysis with bootstrapping was used to analyze data.

Results: The mean (±SD) time spent sedentary was 370 ± 91 min/d. Birth weight was positively associated with sedentary time (B = 4.04, P = 0.006) and waist circumference (B = 1.59, P < 0.001), whereas waist circumference was positively associated with sedentary time (B = 0.82, P < 0.001). Results of the mediation analysis showed a significant indirect effect of birth weight on sedentary time through waist circumference (B: 1.30; 95% bias-corrected CI: 0.94, 1.72), and when waist circumference was controlled for, the effect of birth weight on sedentary time was attenuated by 32% (B = 2.74, P = 0.06).

Conclusion: The association between birth weight and sedentary time appears partially mediated by central adiposity, suggesting that both birth weight and abdominal adiposity may be correlates of sedentary time in youth.
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http://dx.doi.org/10.3945/ajcn.114.103648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409689PMC
May 2015

Comparison of three generations of ActiGraph activity monitors under free-living conditions: do they provide comparable assessments of overall physical activity in 9-year old children?

BMC Sports Sci Med Rehabil 2014 28;6:26. Epub 2014 Jun 28.

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

Background: A recent review concludes that the agreement of data across ActiGraph accelerometer models for children and youth still is uncertain. The aim of this study was to evaluate the agreement of three generations of ActiGraph accelerometers in children in a free-living condition.

Methods: Sixteen 9-year-olds wore the ActiGraph AM7164, GT1M and GT3X+ simultaneously for three consecutive days. We compared mean counts per minute (mcpm) and time spent at different intensities from the three generations of monitors, and the agreement of outputs were evaluated by intra-class correlation coefficients (ICC) and Bland-Altman plots.

Results: The ICC for mcpm was 0.985 (95% CI = 0.898, 0.996). We found a relative difference of 11.6% and 9.8% between the AM7164 and the GT1M and AM7164 and the GT3X+, respectively. The relative difference between mcpm assessed by the GT1M and GT3X+ was 1.7%. The inter-generation differences varied in magnitude and direction across intensity levels, with the largest difference found in the highest intensities.

Conclusion: We found that the ActiGraph model AM7164 yields higher outputs of mean physical activity intensity (mcpm) than the models GT1M and GT3X+ in children in free-living conditions. The generations GT1M and GT3X+ provided comparable outputs. The differences between the old and the newer monitors were more complex when investigating time spent at different intensities. Comparisons of data assessed by the AM7164 with data assessed by newer generations ActiGraphs should be done with caution.
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http://dx.doi.org/10.1186/2052-1847-6-26DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100529PMC
July 2014

Accelerometer-determined physical activity and self-reported health in a population of older adults (65-85 years): a cross-sectional study.

BMC Public Health 2014 Mar 27;14:284. Epub 2014 Mar 27.

Norwegian School of Sport Sciences, Department of Sport Medicine, P,B, 4014 Ullevaal Stadion, 0806 Oslo, Norway.

Background: The link between physical activity (PA) and prevention of disease, maintenance of independence, and improved quality of life in older adults is supported by strong evidence. However, there is a lack of data on population levels in this regard, where PA level has been measured objectively. The main aims were therefore to assess the level of accelerometer-determined PA and to examine its associations with self-reported health in a population of Norwegian older adults (65-85 years).

Methods: This was a part of a national multicenter study. Participants for the initial study were randomly selected from the national population registry, and the current study included those of the initial sample aged 65-85 years. The ActiGraph GT1M accelerometer was used to measure PA for seven consecutive days. A questionnaire was used to register self-reported health. Univariate analysis of variance with Bonferroni adjustments were used for comparisons between multiple groups.

Results: A total of 560 participants had valid activity registrations. Mean age (SD) was 71.8 (5.6) years for women (n=282) and 71.7 (5.2) years for men (n=278). Overall PA level (cpm) differed considerably between the age groups where the oldest (80-85 y) displayed a 50% lower activity level compared to the youngest (65-70 y). No sex differences were observed in overall PA within each age group. Significantly more men spent time being sedentary (65-69 and 70-74 years) and achieved more minutes of moderate to vigorous PA (MVPA) (75-79 years) compared to women. Significantly more women (except for the oldest), spent more minutes of low-intensity PA compared to men. PA differed across levels of self-reported health and a 51% higher overall PA level was registered in those, with "very good health" compared to those with "poor/very poor health".

Conclusion: Norwegian older adults PA levels differed by age. Overall, the elderly spent 66% of their time being sedentary and only 3% in MVPA. Twenty one percent of the participants fulfilled the current Norwegian PA recommendations. Overall PA levels were associated with self-reported health.
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http://dx.doi.org/10.1186/1471-2458-14-284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984636PMC
March 2014

Validity of the ActiGraph GT1M during walking and cycling.

J Sports Sci 2014 11;32(6):510-6. Epub 2013 Oct 11.

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

The ActiGraph activity monitors have developed and newer versions of the ActiGraph accelerometers (GT1M, GT3X and GT3X +) are now available, including changes in hardware and software compared to the old version (AM7164). This is problematic as most of the validation and calibration work includes the AM7164. The aims of the study were to validate the ActiGraph GT1M during level and graded walking and to assess the potential underestimation of physical activity during cycling. Data were obtained from 20 participants during treadmill walking and ergometer cycling. Energy expenditure was measured via indirect calorimetry and used as the criterion method. Activity counts were highly correlated with energy expenditure during level walking (R(2) = 0.82) and graded walking at 5% and 8% (R(2) = 0.82 and R(2) = 0.67, respectively). There was no linear relationship between activity counts and energy expenditure during cycling. The average activity counts for all data points during cycling was 1,157 counts per minute (CPM) (SD = 974), and mean energy expenditure was 5.0 metabolic equivalents. The GT1M is a valid tool for assessing walking across a wide range of speeds and gradients. However, there is no relationship between activity counts and energy expenditure during cycling and physical activity is underestimated by ≈73% during cycling compared to walking.
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http://dx.doi.org/10.1080/02640414.2013.844347DOI Listing
October 2014