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

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 p ≤ 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 (p ≤ 0.012) but not in Sogn & Fjordane. Public transport for commuting was positively associated with MVPA in Sogn & Fjordane (p = 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.

Physical activity and cardiovascular risk factors in a 40- to 42-year-old rural Norwegian population from 1975-2010: repeated cross-sectional surveys.

BACKGROUND: Geographical differences in cardiovascular diseases (CVD) have been observed among Norwegian counties. Better long-term health status and higher physical activity (PA) levels have been documented in the county of Sogn & Fjordane compared with other counties. However, recent trends in CVD risk factors have not been documented. The aim of this study was to investigate the secular trends in leisure time physical activity (LTPA) and other CVD risk factors over a 35-year period in a rural population of 40- to 42-year-olds in western Norway and to compare these trends with national trends. METHODS: Data from eight cross-sectional studies from 1975-2010 (n = 375,682) were obtained from questionnaires and physical examinations and were analyzed using mixed model regression analyses. RESULTS: Decreasing trends were observed for sedentary behavior (for women), moderate PA, smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL-c) and total cholesterol (TC), whereas increasing trends were observed for body mass index (BMI), triglycerides (TG), light PA, vigorous PA and sedentary behavior for men. Compared to the national trends, the trends in the 40-42-year-olds from Sogn & Fjordane were more beneficial in terms of TG, HDL-c and BMI but less beneficial in terms of SBP and DBP. CONCLUSIONS: Over a 35-year-period, this study indicates that the LTPA level has been relatively stable in the county of Sogn & Fjordane. Upward trends were observed in light and vigorous PA, whereas a downward trend was observed in moderate PA. For sedentary behavior, an upward trend was observed in men, whereas a downward trend was observed in women. For smoking, BP and cholesterol decreasing trends were found, but increasing trends were observed in BMI and TG. Compared with the national data, the trends in Sogn & Fjordane were more beneficial for TG, HDL-c and BMI but less beneficial for BP.

Reference values for cardiorespiratory response and fitness on the treadmill in a 20- to 85-year-old population.

BACKGROUND: Existing reference values for clinical exercise testing have been derived from small nonrandom samples, lacking women and older individuals and some with poor or no maximal end criteria. The objective was to study the cardiorespiratory response during maximal exercise in a representative predominantly Caucasian sample of men and women. METHODS: Nine hundred four randomly sampled men and women, 20 to 85 years old, exercised on a treadmill to exhaustion. Oxygen uptake (V.O2), heart rate (HR), BP, blood lactate concentration, and ventilatory variables were measured. RESULTS: Seven hundred fifty-nine participants met the criteria for an acceptable maximal V.O2 (V.O2max) based on a respiratory exchange ratio≥1.10 or a Borg score≥17. In the 20- to 29-year-old age group, V.O2max (mL/kg/min) was 40.3 (±7.1) in women and 48.6 (±9.6) in men. A linear decline (8% per decade) was observed after age 30 years in both sexes. Maximal HR decreased with age by ±6.3 beats/min per decade. The maximal oxygen pulse was 33% lower in women and decreased significantly with age in both sexes by 5% and 3% per decade for women and men, respectively. Women's maximal ventilation was 66% that of men and decreased with age after 40 to 49 years in both sexes. Breathing reserve was higher and blood lactate was lower in women than in men. CONCLUSIONS: This study establishes reference values for V.O2max (absolute, relative to body weight and fat-free weight), maximal HR, oxygen pulse, BP, ventilation, breathing reserve, respiratory exchange ratio, and blood lactate concentration during maximal exercise on treadmill in a large population.

Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians - the association with adiposity is strongest for ethnic minority women.

BACKGROUND: The difference in diabetes susceptibility by ethnic background is poorly understood. The aim of this study was to assess the association between adiposity and diabetes in four ethnic minority groups compared with Norwegians, and take into account confounding by socioeconomic position. METHODS: Data from questionnaires, physical examinations and serum samples were analysed for 30-to 60-year-olds from population-based cross-sectional surveys of Norwegians and four immigrant groups, comprising 4110 subjects born in Norway (n = 1871), Turkey (n = 387), Vietnam (n = 553), Sri Lanka (n = 879) and Pakistan (n = 420). Known and screening-detected diabetes cases were identified. The adiposity measures BMI, waist circumference and waist-hip ratio (WHR) were categorized into levels of adiposity. Gender-specific logistic regression models were applied to estimate the risk of diabetes for the ethnic minority groups adjusted for adiposity and income-generating work, years of education and body height used as a proxy for childhood socioeconomic position. RESULTS: The age standardized diabetes prevalence differed significantly between the ethnic groups (women/men): Pakistan: 26.4% (95% CI 20.1-32.7)/20.0% (14.9-25.2); Sri Lanka: 22.5% (18.1-26.9)/20.7% (17.3-24.2), Turkey: 11.9% (7.2-16.7)/12.0% (7.6-16.4), Vietnam: 8.1% (5.1-11.2)/10.4% (6.6-14.1) and Norway: 2.7% (1.8-3.7)/6.4% (4.6-8.1). The prevalence increased more in the minority groups than in Norwegians with increasing levels of BMI, WHR and waist circumference, and most for women. Highly significant ethnic differences in the age-standardized prevalence of diabetes were found for both genders in all categories of all adiposity measures (p < 0.001). The Odds Ratio (OR) for diabetes adjusted for age, WHR, body height, education and income-generating work with Norwegians as reference was 2.9 (1.30-6.36) for Turkish, 2.7 (1.29-5.76) for Vietnamese, 8.0 (4.19-15.14) for Sri Lankan and 8.3 (4.37-15.58) for Pakistani women. Men from Sri Lanka and Pakistan had identical ORs (3.0 (1.80-5.12)). CONCLUSIONS: A high prevalence of diabetes was found in 30-to 60-year-olds from ethnic minority groups in Oslo, with those from Sri Lanka and Pakistan at highest risk. For all levels of adiposity, a higher susceptibility for diabetes was observed for ethnic minority groups compared with Norwegians. The association persisted after adjustment for socioeconomic position for all minority women and for men from Sri Lanka and Pakistan.

Effects of a three-year intervention: the Copenhagen School Child Intervention Study.

INTRODUCTION: This study assessed short-term and long-term effects of a 3-yr controlled school-based physical activity (PA) intervention on fatness, cardiorespiratory fitness (VO(2peak)) and CVD risk factors in children. METHODS: The study involved 18 schools (10 intervention and 8 controls) and included a follow-up 4 yr after the end of intervention. The analyses included 696, 6- to 7-yr-old children at baseline, 612 postintervention (age 9.5 yr) and 441 at follow-up (age 13.4 yr). The intervention consisted of a doubling of the amount of physical education (PE; from 90 to 180 min·wk(-1)), training of PE teachers, and upgrading of PE and playing facilities. Anthropometrics and systolic blood pressure (SBP) were measured. VO(2peak) was directly measured, and PA was assessed using accelerometry. Fasting blood samples were analyzed for CVD risk factors. A composite risk score was computed from z-scores of SBP, triglycerides, total cholesterol-to-HDL cholesterol ratio, homeostatic model assessment (HOMA score), skinfolds, and inverse VO(2peak). RESULTS: The HOMA score of the intervention group boys had a smaller increase from baseline to postintervention compared with control boys (P = 0.004). From baseline to follow-up intervention group boys had a smaller increase in SBP compared with control boys (P = 0.010). There were no other significant differences between groups. CONCLUSIONS: This 3-yr school-based PA intervention caused positive changes in SBP and HOMA score in boys but not in girls, and no effects were seen in PA, VO(2peak), fatness, and the other measured CVD risk factors. Our results indicate that a doubling of PE and providing training and equipment may not be sufficient to induce major improvements in CVD risk factors in a normal population.

Do minor head impacts in soccer cause concussive injury? A prospective case-control study.

OBJECTIVE: Our objective was to determine whether minor head trauma in elite soccer matches causes measurable impairment in brain function. METHODS: Baseline neuropsychological testing was completed by professional soccer players in the Norwegian elite league, Tippeligaen, before the 2004 and 2005 seasons (n = 462). A player who experienced a head impact during a league match completed a follow-up test the next day (head impact group). Videotapes of all impacts were collected and reviewed. A group of players without head impacts was also tested after a league match to serve as controls (matched control group; n = 47). RESULTS: A total of 228 impacts were identified, and 44 (19.3%) of these were followed up with a CogSport test (CogState, Ltd., Charlton South, Australia; the players who were tested tended to have more severe injuries, but there were only 6 cases with loss of consciousness). The head impact group had a greater change in reaction time from baseline to follow-up compared with the matched control group with regard to the 3 simplest tasks. The largest deficits were seen among the players reporting acute symptoms after the impact, but deficits were also demonstrated among asymptomatic players. Players who experienced 1 or more head impacts during the 2004 season showed a reduction in neuropsychological performance when tested before the 2005 season. However, none of these players was impaired when compared with the test manufacturer's normative data. CONCLUSION: A reduced neuropsychological performance was found after minor head impacts in soccer, even in allegedly asymptomatic players. However, the long-term cognitive consequences are uncertain.

Two short questionnaires on leisure-time physical activity compared with serum lipids, anthropometric measurements and aerobic power in a suburban population from Oslo, Norway.

UNLABELLED: The aim was to indirectly validate two short postal questionnaires measuring leisure-time physical activity (LPA) by comparing the answers with serum lipids and anthropometric measurements. METHODS: All inhabitants aged 31-67 years in two suburban, multicultural areas of Oslo, Norway were invited to "Romsås in Motion", a community intervention survey, in 2000. Of those, 2950 participants (48%) met and were re-invited in 2003. LPA was measured by two short instruments used since the 1970s (referred to as the Gothenburg instrument) and since 1994 in Cohort of Norway (CONOR). Each instrument was compared with relevant measurements at baseline including LPA according to an adapted version of the long International Physical Activity Questionnaire (IPAQ-L). In addition, changes during 2000--2003 in reported LPA were compared with changes in body weight, waist-to-hip ratio, lipids and other measurements. RESULTS: LPA measured by the Gothenburg instrument correlated weakly, but consistently with relevant biological and anthropometrical measurements and with IPAQ-L. The correlation coefficients were -0.1-(-0.2) with triglycerides, total-to-high density lipoprotein (HDL)-cholesterol ratio and waist-to-hip ratio, around 0.1 with HDL-cholesterol and 0.3 with maximal aerobic power. For the CONOR instrument a similar pattern was found in both sexes for the hard LPA and in women for light LPA. LPA measured by each short instrument was in line with LPA measured with IPAQ-L. CONCLUSIONS: In a multi-linguistic, suburban population in Oslo, Norway, LPA measurements by each of two short questionnaires were weakly, but consistently correlated with relevant biological and anthropometric measurements and strongly with IPAQ-L.