Katja Borodulin

Physical activity patterns during pregnancy.

PURPOSE The aim of the study was to describe the mode, frequency, duration, and intensity of physical activity among pregnant women, to explore whether these women reached the recommended levels of activity, and to explore how these patterns changed during pregnancy. METHODS This study, as part of the third phase of the Pregnancy, Infection, and Nutrition Study, investigated physical activity among 1482 pregnant women. A recall of the different modes, frequency, duration, and intensity of physical activity during the past week was assessed in two telephone interviews at 17-22 and 27-30 wk of gestation. RESULTS Most women reported some type of physical activity during both periods. Child and adult care giving, indoor household, and recreational activities constituted the largest proportion of total reported activity. The overall physical activity level decreased during pregnancy, particularly in care giving, outdoor household, and recreational activity. Women who were active during the second and the third trimesters reported higher levels of activity in all modes of activity than those who became active or inactive during pregnancy. The majority did not reach the recommended level of physical activity. CONCLUSION These data suggest that self-reported physical activity decreased from the second to the third trimesters, and only a small proportion reached the recommended level of activity during pregnancy. Further research is needed to explore if physical activity rebounds during the postpartum period.

Forty-year trends in cardiovascular risk factors in Finland

BACKGROUND Finland has experienced remarkable changes in population levels of coronary heart disease risk factors and mortality over the past decades. The National FINRISK studies have monitored risk factors in major non-communicable diseases from 1972 to 2012. The 40-year changes in those risk factors are presented. METHODS Study population included participants aged 30-59 years in the series on independent random population samples. Data were collected in 5-year intervals in 1972-2012. FINRISK studies so far comprised 53 589 men and women who participated in a health examination, gave a venous blood sample and filled in questionnaires. Serum total cholesterol, systolic and diastolic blood pressure, and body mass index (BMI) were measured using standardized protocol, and smoking status was recorded. RESULTS Total serum cholesterol decreased remarkably until 2007, but after that has increased. Systolic blood pressure has continued to decline over time since 1972, while decrease in diastolic blood pressure has levelled off during the last 10 years. Smoking prevalence has markedly decreased. BMI has increased in the population, but most significantly in the earlier survey years, not the past 10 years. CONCLUSIONS After three decades of favourable development, the population risk factor levels showed some increase in total cholesterol and diastolic blood pressure. This emphasizes the need for continued efforts towards national disease prevention and health promotion.

Physical Activity Beliefs, Barriers, and Enablers among Postpartum Women

BACKGROUND AND METHODS Physical activity during postpartum is both a recommended and an essential contributor to maternal health. Understanding the beliefs, barriers, and enablers regarding physical activity during the postpartum period can more effectively tailor physical activity interventions. The objective of this study was to document self-reported beliefs, barriers, and enablers to physical activity among a cohort of women queried at 3 and 12 months postpartum. Five questions about beliefs and two open-ended questions about their main barriers and enablers regarding physical activity and exercise were asked of 667 women at 3 months postpartum. Among the sample, 530 women answered the same questions about barriers and enablers to physical activity at 12 months postpartum. RESULTS Agreement on all five beliefs statements was high (>or=89%), indicating that women thought that exercise and physical activity were appropriate at 3 months postpartum, even if they continued to breastfeed. For the cohort, the most common barriers to physical activity at both 3 and 12 months postpartum were lack of time (47% and 51%, respectively) and issues with child care (26% and 22%, respectively). No barrier changed by more than 5% from 3 to 12 months postpartum. For the cohort, the most common enablers at 3 months postpartum were partner support (16%) and desire to feel better (14%). From 3 to 12 months postpartum, only one enabler changed by >5%; women reported baby reasons (e.g., baby older, healthier, not breastfeeding, more active) more often at 12 months than at 3 months postpartum (32% vs. 10%). Environmental/policy and organizational barriers and enablers were reported less often than intrapersonal or interpersonal barriers at both time points. CONCLUSIONS A number of barriers and enablers were identified for physical activity, most of which were consistent at 3 and 12 months postpartum. This study provides information to create more successful interventions to help women be physically active postpartum.

Twenty-five year socioeconomic trends in leisure-time and commuting physical activity among employed Finns

The trend of socioeconomic differences in physical activity is largely unknown in Finland. In this study, we examined socioeconomic trends in leisure‐time and commuting physical activity among Finns in 1978–2002. Nationwide data were derived from an annually repeated cross‐sectional Finnish Adult Health Behavior Survey. People under the age of 25, students, the unemployed, and retirees were excluded from the analysis. The final data set included 25 513 women and 25 302 men. Socioeconomic variables included education, occupation, and household income. Odds ratios for being physically active and 95% confidence intervals were calculated. People with the lowest income were less leisure‐time and commuting physically active. Among women, low occupational status was associated with high commuting physical activity whereas among men such an association was not found. No educational differences among men in leisure‐time and commuting physical activity over time were found. Some indications were found that educational differences in leisure‐time physical activity among women might have been reversed. Our data suggest that socioeconomic differences in leisure‐time and commuting physical activity are quite small and have remained similar between 1978 and 2002.

Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study

Objective To estimate how much changes in the main risk factors of cardiovascular disease (smoking prevalence, serum cholesterol, and systolic blood pressure) can explain the reduction in coronary heart disease mortality observed among working aged men and women in eastern Finland. Design Population based observational study. Setting Eastern Finland. Participants 34 525 men and women aged 30-59 years who participated in the national FINRISK studies between 1972 and 2012. Interventions Change in main cardiovascular risk factors through population based primary prevention. Main outcome measures Predicted and observed age standardised mortality due to coronary heart disease. Predicted change was estimated with a logistic regression model using risk factor data collected in nine consecutive, population based, risk factor surveys conducted every five years since 1972. Data on observed mortality were obtained from the National Causes of Death Register. Results During the 40 year study period, levels of the three major cardiovascular risk factors decreased except for a small increase in serum cholesterol levels between 2007 and 2012. From years 1969-1972 to 2012, coronary heart disease mortality decreased by 82% (from 643 to 118 deaths per 100 000 people) and 84% (114 to 17) among men and women aged 35-64 years, respectively. During the first 10 years of the study, changes in these three target risk factors contributed to nearly all of the observed mortality reduction. Since the mid-1980s, the observed reduction in mortality has been larger than predicted. In the last 10 years of the study, about two thirds (69% in men and 66% in women) of the reduction could be explained by changes in the three main risk factors, and the remaining third by other factors. Conclusion Reductions in disease burden and mortality due to coronary heart disease can be achieved through the use of population based primary prevention programmes. Secondary prevention among high risk individuals and treatment of acute events of coronary heart disease could confer additional benefit.

Associations between estimated aerobic fitness and cardiovascular risk factors in adults with different levels of abdominal obesity.

Background We investigated the association between estimated aerobic fitness and cardiovascular risk factors, and how the association is affected by abdominal obesity. Design Cross-sectional population study. Methods Participants comprised 3820 adults aged 25 to 64 years from the FIN RISK 2002 Study in Finland. Aerobic fitness was estimated using a non-exercise test. Waist-to-hip ratio (WHR), blood pressure, total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides, HDL-C to total cholesterol ratio, and gamma-glutamyl transferase (GGT) levels were measured by standardized methods. Results After controlling for age, smoking and alcohol consumption, aerobic fitness was inversely associated with systolic (P=0.027) and diastolic (P<0.001) blood pressure, total cholesterol (P=0.009), triglycerides (P=0.001), and GGT (P<0.001), and directly associated with HDL-C (P<0.001) and HDL-C to total cholesterol ratio (P<0.001) in men. In women, inverse associations were found for diastolic blood pressure (P=0.027) and triglycerides (P<0.001), and direct association for HDL-C (P<0.001) and HDL-C to total cholesterol ratio (P<0.001). Waist-to-hip ratio was independently associated with a better risk factor profile in both sexes. Interactions were found between fitness and WHR in relation to total cholesterol (P=0.001), HDL-C to total cholesterol ratio (P=0.005), triglycerides (P=0.001), and systolic (P=0.009) and diastolic (P<0.001) blood pressure among men only. Conclusions Our data suggest that good estimated aerobic fitness is associated with a better cardiovascular risk factor profile, regardless of the level of abdominal obesity in Finnish men and women. Men in the highest WHR third seem to have more benefit of aerobic fitness on their cardiovascular risk levels than men with lower WHR. Eur J Cardiovasc Prev Rehabil 12: 126–131

Physical activity and sleep among pregnant women

Sleep disturbances are common among pregnant women and safe treatments to improve sleep are needed. Generally, physical activity improves sleep, but studies are lacking on the associations of physical activity with sleep among pregnant women. Our aim was to investigate the cross-sectional association of various modes of physical activity and activity clusters with sleep quality and duration among 1259 pregnant women. Participants were recruited into the Pregnancy, Infection, and Nutrition Study from prenatal clinics at the University of North Carolina Hospitals. Women self-reported sleep quality and duration and physical activity in the past week. We used cluster analysis to create seven physical activity profiles and multivariable logistic regression analysis, with adjustments for age, race/ethnicity, education, marital status, parity, self-rated general health, anxiety and depressive symptoms. Women with higher levels of occupational physical activity were more likely to report either short or normal sleep duration than longer duration. Women with higher levels of indoor household physical activity were less likely to report normal sleep duration than shorter duration. Women in the recreational-indoor household activity cluster were less likely than women in the inactivity cluster to report normal sleep duration as compared with longer duration. Our data suggest weak associations of physical activity with sleep duration and quality in late pregnancy. Physical activity is recommended to pregnant women for health benefits, yet more research is needed to understand if physical activity should be recommended for improving sleep.

Time trends in physical activity from 1982 to 2012 in Finland

The aim of this study was to examine population trends from 1982 to 2012 in Finland for leisure time physical activity (LTPA), commuting physical activity (CPA), occupational physical activity (OPA), and total physical activity. Furthermore, time trends in physical activity by educational levels and body mass index (BMI) categories were explored. Data were collected in independent cross‐sectional population surveys, implemented every 5 years from 1982 to 2012. The data comprised 21 903 men and 24 311 women. Participants underwent a health examination and filled in questionnaires. Information on LTPA, CPA, and OPA was used both separately and combined to create an index of total physical activity. Between 1982 and 2012, high LTPA has increased in men (from 21% to 33%) and women (from 12% to 27%). High CPA and high OPA have decreased in men (from 17% to 12% and from 48% to 36%, respectively) and women (from 30% to 20% and from 26% to 21%, respectively). Total physical activity has remained fairly stable. Differences by education and BMI have increased, particularly for LTPA. Marked changes in physical activity have taken place over time. Differences in LTPA and OPA have grown wider across educational groups and BMI categories.

The effects of adolescence sports and exercise on adulthood leisure-time physical activity in educational groups

BackgroundPhysical inactivity has become a major public health problem and clear educational differences in physical activity have been reported across Europe and USA. The origins of adulthood physical activity are suggested to be in childhood and adolescence physical activity. Hardly any studies have, however, examined if the educational differences in physical activity might also be due to educational differences in early experiences in physical activity. Thus, our aim was to examine how competitive sports in youth, and exercise in late adolescence, and opinions on physical education (PE) in childhood determined adulthood leisure-time physical activity (LTPA) in different educational groups.MethodsWe used cross-sectional population-based National FINRISK 2002 data for 1918 men and 2490 women aged 25 to 64 years. Competitive sports in youth, exercise in late adolescence, and opinions on PE in childhood were assessed retrospectively via self-reports. Adulthood LTPA was collected with 12-month recall. In 2008, we calculated structural equation models including latent variables among the low- (<12 years) and high- (≥12 years) educated.ResultsMen more often than women reported that their experience of PE was interesting and pleasant as well as having learned useful skills during PE classes. Men, compared to women, had also been more active in the three selected competitive sports in youth and exercised in late adolescence. Participation in competitive sports in youth among the low-educated and exercise in late adolescence among the high-educated had a direct effect on adulthood LTPA. Among the low-educated, opinions on PE in childhood had an indirect effect on adulthood LTPA through participation in competitive sports in youth whereas among the high-educated, the indirect effect went through exercise in late adolescence. The effects were mainly similar between genders.ConclusionsOur study answers to a strong need to assess the determinants of leisure-time physical activity to promote physical activity in low-educated individuals. The pathways of physical activity from childhood to adulthood LTPA may be different depending on the pursued educational career. Further prospective studies are needed to confirm our results.

Effects of childhood socio-economic conditions on educational differences in leisure-time physical activity

BACKGROUND Our purpose was to assess the direct and indirect contribution of childhood socio-economic conditions to educational differences in leisure-time physical activity among women and men. METHODS Population-based data were derived from a representative sample of Finns aged >or=30 years (N = 7112) as part of Health 2000 Survey. Multinomial logistic regression analysis was applied. Leisure-time physical activity was divided into inactivity, moderate and high activity. RESULTS Childhood socio-economic conditions had both a direct and indirect effect through adulthood socio-economic conditions on educational differences in leisure-time physical activity. The direct effect of childhood socio-economic conditions on educational differences in inactivity was stronger than its indirect effects through adulthood socio-economic conditions and other health behaviours and related factors. Adulthood socio-economic conditions had a considerable indirect effect on educational differences in leisure-time physical activity through other adulthood health behaviours and related factors among men. CONCLUSIONS In order to narrow educational differences in leisure-time physical activity, we should secure a childhood environment that enables a physically active lifestyle, support leisure-time physical activity in diverse occupational groups, guarantee equal physical activity possibilities across different educational careers and support those with insufficient material resources.