Longitudinal changes in device-measured physical activity from childhood to young adulthood: the PANCS follow-up study.

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

Effects of a school-based physical activity intervention on cardiometabolic health 5 years after cessation.

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

The multivariate physical activity signature associated with fundamental motor skills in preschoolers.

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

The prospective association between objectively measured sedentary time, moderate-to-vigorous physical activity and cardiometabolic risk factors in youth: a systematic review and meta-analysis.

Sedentary time and moderate-to-vigorous physical activity (MVPA) may be uniquely related to cardiometabolic health. Excessive sedentary time is suggested as an independent cardiometabolic risk factor, while MVPA is favourably associated with cardiometabolic health. This systematic review and meta-analysis summarizes the evidence on a prospective relationship between objectively measured sedentary time, MVPA and cardiometabolic health indicators in youth. PubMed, Embase, CINAHL, PhyscINFO and SPORTDiscus were systematically searched from January 2000 until April 2018. Studies were included if sedentary time and physical activity were measured objectively and examined associations with body mass index, waist circumference, triglycerides, high-density lipoprotein, insulin, blood pressure or the clustering of these cardiometabolic risk factors. We identified 30 studies, of which 21 were of high quality. No evidence was found for an association between sedentary time and cardiometabolic outcomes. The association between MVPA and individual cardiometabolic risk factors was inconsistent. The meta-analysis for prospective studies found a small but significant effect size between MVPA at baseline and clustered cardiometabolic risk at follow-up (ES -0.014 [95% CI, -0.024 to -0.004]). We conclude that there is no prospective association between sedentary time and cardiometabolic health, while MVPA is beneficially associated with cardiometabolic health in youth.

Physical activity preferences of 10-year-old children and identified activities with positive and negative associations to cardiorespiratory fitness.

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

Secular and longitudinal physical activity changes in population-based samples of children and adolescents.

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

The effect of a two-year school-based daily physical activity intervention on a clustered CVD risk factor score-The Sogndal school-intervention study.

To evaluate changes in clustered cardiovascular disease (CVD) risk factors in 9-year-old children following a 2-year school-based physical activity intervention. In total, 259 children (age 9.3 ± 0.3 years) were invited, of whom 256 participated. The intervention group (63 boys, 62 girls) carried out 60-minute teacher-controlled daily physical activity over two school years. The control group (62 boys, 69 girls) had the curriculum-defined amount of physical education (45 minutes twice each week). Of these, 67% (171 total, 91 intervention) successfully completed both baseline and post-intervention of six CVD risk factors: systolic blood pressure (SBP), triglyceride (TG), total cholesterol-to-high-density lipoprotein cholesterol ratio (TC:HDL ratio), waist circumference (WC), the homeostasis model assessment for insulin resistance (HOMA), and peak oxygen uptake (VO2peak ). All variables were standardized by sex prior to constructing a cluster score (sum of z scores for all variables). The effect of the intervention on the cluster score was analyzed using linear multiple regression. The cluster score improved after the intervention (ES = .29). Furthermore, the analyses showed significant effects in favor of the intervention group for systolic blood pressure (ES = .35), total cholesterol-to-HDL-c ratio (ES = .23), triglyceride (ES = .40), and VO2peak (ES = .57). A teacher-led school-based physical activity intervention that is sufficiently long and includes a substantial amount of daily physical activity can beneficially modify children's clustered CVD risk profile.

Gender-specific effects of physical activity on children's academic performance: The Active Smarter Kids cluster randomized controlled trial.

Active learning combines academic content with physical activity (PA) to increase child PA and academic performance, but the impact of active learning is mixed. It may be that this is a moderated relationship in which active learning is beneficial for only some children. This paper examine the impact of baseline academic performance and gender as moderators for the effects of active learning on children's academic performance. In the ASK-study, 1129 fifth-graders from 57 Norwegian elementary schools were randomized by school to intervention or control in a physical activity intervention between November 2014 and June 2015. Academic performance in numeracy, reading, and English was measured and a composite score was calculated. Children were split into low, middle and high academic performing tertiles. 3-way-interactions for group (intervention, control)∗gender (boys, girls)∗academic performance (tertiles) were investigated using mixed model regression. There was a significant, 3-way-interaction (p=0.044). Both boys (ES=0.11) and girls (ES=0.18) in the low performing tertile had a similar beneficial trend. In contrast, middle (ES=0.03) and high performing boys (ES=0.09) responded with small beneficial trends, while middle (ES=-0.11) and high performing girls (ES=-0.06) responded with negative trends. ASK was associated with a significant increase in academic performance for low performing children. It is likely that active learning benefited children most in need of adapted education but it may have a null or negative effect for those girls who are already performing well in the sedentary classroom. Differences in gendered responses are discussed as a possible explanation for these results. TRIAL REGISTRATION: Clinicaltrials.gov registry, trial registration number: NCT02132494.

Cross-sectional and prospective associations between physical activity, body mass index and waist circumference in children and adolescents.

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

Objectively measured sedentary time and physical activity and associations with body weight gain: does body weight determine a decline in moderate and vigorous intensity physical activity?

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

Validity of noninvasive composite scores to assess cardiovascular risk in 10-year-old children.

Agreement between and classification accuracy of six different noninvasive composite scores and a cardiovascular disease (CVD) risk factor score were investigated in 911 (466 boys and 445 girls) 10-year-old Norwegian children. A CVD risk factor score (triglyceride, total cholesterol/HDL ratio, homeostasis model assessment of insulin resistance, systolic blood pressure (SBP), waist-to-height ratio (WHtR), and cardiorespiratory fitness) and six noninvasive risk scores (fitness+three different measurements of fatness (body mass index (BMI), WHtR, and skinfolds), with and without inclusion of SBP) were calculated (mean z-score by gender). Agreement was assessed using Bland-Altman plots. The ability of noninvasive scores to correctly classify children with clustered CVD risk was examined by receiver operating characteristic (ROC) analysis and Cohen's kappa coefficient (κ). For both sexes, the noninvasive scores without SBP showed excellent AUC values (AUC=0.93-0.94, 95% CI=0.88-0.98) and moderate kappa values (κ=0.49-0.64) and had limits of agreement of 0.0±0.78-0.89 (arbitrary unit). Inclusion of SBP increased AUC values (AUC=0.96-0.97, 95% CI=0.94-0.99), kappa values (κ=0.58-0.69), and reduced limits of agreement (0.0±0.68-0.76). Noninvasive scores that include fitness and fatness provide acceptable agreement and classification accuracy, allowing for widespread early identification of children that might be at risk for developing CVD later in life. SBP should be included in the noninvasive score to improve classification accuracy if possible.

Reference values for and cross-validation of time to exhaustion on a modified Balke protocol in Norwegian men and women.

The aims of the present study were to provide reference values for time to exhaustion (TTE) on a modified Balke treadmill protocol, and to perform a cross-validation of TTE as a measure of maximal oxygen consumption (VO2max ), in Norwegian men and women 20-85 years of age. Reference values for TTE were derived from a national sample of 765 subjects. An additional sample of 119 subjects was included in the cross-validation (total n = 884), where prediction equations for VO2max was established. A decline in TTE was seen with increased age. Prediction of VO2max in an independent dataset (n = 319) resulted in a R2  = 0.78 and standard error of the estimate = 4.55 mL/kg/min. The observed-predicted bias was small (mean difference <1.24 mL/kg/min), whereas random error was considerable (95% limits of agreement ± 7.11-9.70 mL/kg/min) across age in both men and women. Despite limitations concerning the prediction of VO2max on an individual level, TTE from the Balke protocol is a good measure of aerobic fitness in adults across a range of settings, and could be evaluated according to the suggested reference values.

Musculoskeletal fitness and balance in older individuals (65-85 years) and its association with steps per day: a cross sectional study.

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

Cardiorespiratory fitness in groups with different physical activity levels.

The aim of the study was to determine how different categorizations of self-reported and objectively measured physical activity (PA) reflect variations in cardiorespiratory fitness (VO2max ). A total of 759 individuals (366 women) with a mean age of 48.5 years (SD 14.4) wore an accelerometer (ActiGraph GT1M) for seven consecutive days and answered the short International Physical Activity Questionnaire (IPAQ). VO2max was directly measured during a continuous graded exercise treadmill test until exhaustion. Men and women categorized as highly active by IPAQ had 9% and 13% higher VO2max , respectively, than those reporting a low PA level (P < 0.05). Men and women meeting the PA recommendation of 150 min/week of daily moderate intensity PA, measured by accelerometer, had 13% and 9% higher VO2max , respectively, than participants not meeting this recommendation (P < 0.01). No significant differences in average sedentary time, analyzed in total min/day and in bouts of 10 and 30 min, were found between participants with high or low cardiorespiratory fitness. However, women spent less time than men in bouts of sedentary behaviors. Self-reported PA by IPAQ and objectively measured PA by accelerometer were both useful instruments for detecting differences in VO2max .

Obesity prevalence in Norwegian adults assessed by body mass index, waist circumference and fat mass percentage.

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

Increases in physical activity is as important as smoking cessation for reduction in total mortality in elderly men: 12†years of follow-up of the Oslo II study.

BACKGROUND: Physical activity (PA) at leisure by the elderly, and its relationship to cardiovascular (CV) and non-CV mortality, with and without competing risk, has been scarcely described. We determined the relationships between PA, smoking and 12-year CV, non-CV and all-cause mortality in elderly Oslo men screened for CV disease in 1972-1973 and 2000. METHODS: Among 14,846 men born during 1923-1932 and participating in 1972-1973, there were 5738 participants in 2000. During the 12 years follow-up 2154 died. Cox regression modelling of mortality endpoints, with and without competing risk, was applied analysing PA variables hours per week of light or vigorous PA intensity and degree of PA at leisure. Comparisons of predictive ability between PA and smoking were done by receiver operating characteristics. RESULTS: Thirty minutes of PA per 6 days a week was associated with about 40% mortality risk reduction. There was a 5 years increased lifetime when comparing sedentary and moderate to vigorous physically active men. Associations to CV or non-CV mortality were slightly weakened, allowing competing risk. Conditional on the prevalence of smoking and PA, the degree of PA at leisure was almost as predictive as smoking with regard to the effects on mortality. Increase in PA was as beneficial as smoking cessation in reducing mortality. CONCLUSIONS: Even at the age of 73 years, PA is associated highly with mortality between groups of sedentary and active persons. Allowing for competing risk did not weaken these associations markedly. Public health strategies in elderly men should include efforts to increase PA in line with efforts to reduce smoking behaviour.

High-intensity training following lung cancer surgery: a randomised controlled trial.

BACKGROUND: Many patients with lung cancer are deconditioned with poor physical fitness. Lung resection reduces physical fitness further, impairing the patient's ability to function in daily life. METHODS: We conducted a single-blind randomised controlled trial of high-intensity endurance and strength training (60 min, three times a week, 20 weeks), starting 5-7 weeks after surgery. The control group received standard postoperative care. The primary outcome was the change in peak oxygen uptake measured directly during walking until exhaustion. Other outcomes included changes in pulmonary function, muscular strength by one-repetition maximum (1RM), total muscle mass measured by dual energy X-ray absorptiometry, daily physical functioning and quality of life (QoL). RESULTS: The intention-to-treat analysis of the 61 randomised patients showed that the exercise group had a greater increase in peak oxygen uptake (3.4 mL/kg/min between-group difference, p=0.002), carbon monoxide transfer factor (Tlco) (5.2% predicted, p=0.007), 1RM leg press (29.5 kg, p<0.001), chair stand (2.1 times p<0.001), stair run (4.3 steps, p=0.002) and total muscle mass (1.36 kg, p=0.012) compared with the controls. The mean±SD QoL (SF-36) physical component summary score was 51.8±5.5 and 43.3±11.3 (p=0.006), and the mental component summary score was 55.5±5.3 and 46.6±14.0 (p=0.015) in the exercise and control groups, respectively. CONCLUSIONS: In patients recently operated for lung cancer, high-intensity endurance and strength training was well tolerated and induced clinically significant improvements in peak oxygen uptake, Tlco, muscular strength, total muscle mass, functional fitness and QoL. This study may provide a basis for exercise therapy after lung cancer surgery. TRIAL REGISTRATION NUMBER: NCT01748981.

Impact of physical activity and diet on lipoprotein particle concentrations in severely obese women participating in a 1-year lifestyle intervention.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Physical activity and high aerobic fitness protects against cardiovascular disease and early death, besides having a very modest impact on lipoprotein-cholesterol in obese subjects. Physical activity has been shown to favourably alter lipoprotein particle concentrations and apolipoprotein B with minimal weight loss in overweight to moderately obese subjects. WHAT THIS STUDY ADDS: We studied the impact of physical activity on lipoprotein subclass particle concentrations in women with severe obesity. Increased physical activity duration was associated with favourable changes, whereas increased PA intensity was associated with adverse changes in some lipoprotein particle subclasses in severely obese women. Severely obese women that manage to increase their physical activity level can improve their lipoprotein profile, whether or not they lose fat mass Physical activity (PA) and high aerobic fitness protects against cardiovascular disease and early death possibly among others because of an anti-atherogenic impact on lipoprotein particle concentrations. The objective of this study was to determine the impact of PA and diet on lipoprotein particle concentrations. Thirty-one severely obese women (age 43.6 ± 10.2 years; body mass index 43.0 ± 6.3 kg m(-2) ) participated in a 1-year lifestyle intervention with repeated measurements of lipoprotein particle subclass concentrations and size of very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL), as well as fat mass, PA and diet. Multiple regression was used to determine associations with change (Δ) in two principal components (PCs) describing lipoprotein distributions: ΔPC 1 LIPO (dominated by VLDL and LDL) and ΔPC 2 LIPO (dominated by large HDL and mean HDL particle size). ΔPA duration was the only variable that was significantly related to ΔPC 1 LIPO (partial r = -0.40, P = 0.008), while ΔPA intensity was the only variable that was significantly related to ΔPC 2 LIPO (partial r = -0.43, P = 0.003) in adjusted models. Increased PA duration was associated with favourable changes, whereas increased PA intensity was associated with adverse changes in some lipoprotein particle subclasses in severely obese women.

Effects of a 2-year school-based daily physical activity intervention on cardiovascular disease risk factors: the Sogndal school-intervention study.

The aim of this study was to investigate the effect of a 2-year school-based physical activity (PA) intervention in 9-year-old children on cardiovascular disease (CVD) risk factors. One intervention school (I-school) (n=125) and one control school (C-school) (n=131) were included. The children at the I-school carried out 60 min of PA daily. The PA lessons were planned, organized and led by expert physical education (PE) teachers. In the C-school, children were offered the normal 45 min of PE twice weekly. The intervention resulted in a greater beneficial development in systolic (P=0.003) and diastolic (P=0.002) blood pressure, total cholesterol-to-high-density lipoprotein cholesterol ratio (P=0.011), triglyceride (P=0.030) and peak oxygen uptake (P<0.001) in I-school children than in C-school children. No significant differences were observed in waist circumference, body mass index and the homeostasis model assessment for insulin resistance between the two groups. Furthermore, the intervention, primarily carried out at moderate intensity, had the strongest impact in children with the least favorable starting point. In conclusion, a daily school-based PA intervention can beneficially modify children's CVD risk profile if the intervention has sufficient duration and includes a substantial amount of daily PA, and if the PA is implemented by expert PE teachers.

Personal and social-environmental correlates of objectively measured physical activity in Norwegian pre-adolescent children.

The aim of this study was to examine modifiable biological, psychological, behavioral and social-environmental correlates of physical activity among 1129 Norwegian 11-year-old children within a cross-sectional sample from the HEalth In Adolescents study. Physical activity was assessed by accelerometer, and weight and height were measured objectively. Age- and gender-specific cut-off points proposed by the International Obesity Task Force were used to define body mass index. Social-environmental variables were self-reported by questionnaire. Hierarchical regression (linear mixed models) revealed that normal weight children scored higher on percentage daily moderate-to-vigorous physical activity [% daily moderate to vigorous physical activity (MVPA)] than overweight/obese children (P<0.001). Self-efficacy (P<0.01) and perceived social support from friends (P<0.01) were positively associated with children's % daily MVPA, and a negative association was found for computer/game-use on weekends (P<0.01). A moderator effect of weight category (normal vs overweight/obese) in the relationship between computer/game-use on weekends and % daily MVPA was detected (P<0.05), reflecting that higher computer/game-use on weekends was associated with lower % MVPA among the overweight/obese, but not among the normal weight. Modifiable correlates from multiple domains accounted for 14% of the variance in % daily MVPA. Prospective and intervention studies are needed to examine whether these factors act as mediators for physical activity change in pre-adolescent children.