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  • 1.
    Brännholm Syrjälä, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Bennet, L.
    Department of Clinical Sciences, Lund University, Malmö, Sweden; Center for Primary Health Care Research, Region Skåne and Lund University, Malmö, Sweden; Clinical Research and Trial Center, Lund University Hospital, Lund, Sweden.
    Dempsey, P.C.
    Baker Heart and Diabetes Institute, Melbourne, Australia; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom.
    Fhärm, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hellgren, M.
    Skaraborg Institute, Skövde, Sweden.
    Jansson, S.
    School of Medical Sciences, University Health Care Research Center, Örebro University, Örebro, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Nilsson, S.
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Rådholm, K.
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
    Ugarph-Morawski, A.
    Academic Primary Care Center, Region Stockholm, Stockholm, Sweden; Department of Neurobiology, Care Sciences, and Society, Division of Family Medicine and Primary Care, The Karolinska Institute, Huddinge, Sweden.
    Wändell, P.
    Department of Neurobiology, Care Sciences, and Society, Division of Family Medicine and Primary Care, The Karolinska Institute, Huddinge, Sweden.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Health effects of reduced occupational sedentary behaviour in type 2 diabetes using a mobile health intervention: a study protocol for a 12-month randomized controlled trial—the ROSEBUD study2022In: Trials, E-ISSN 1745-6215, Vol. 23, no 1, article id 607Article in journal (Refereed)
    Abstract [en]

    Background: Short-term trials conducted in adults with type 2 diabetes mellitus (T2DM) showed that reducing sedentary behaviour by performing regular short bouts of light-intensity physical activity enhances health. Moreover, support for reducing sedentary behaviour may be provided at a low cost via mobile health technology (mHealth). There are a wide range of mHealth solutions available including SMS text message reminders and activity trackers that monitor the physical activity level and notify the user of prolonged sitting periods. The aim of this study is to evaluate the effects of a mHealth intervention on sedentary behaviour and physical activity and the associated changes in health in adults with T2DM.

    Methods: A dual-arm, 12-month, randomized controlled trial (RCT) will be conducted within a nationwide Swedish collaboration for diabetes research in primary health care. Individuals with T2DM (n = 142) and mainly sedentary work will be recruited across primary health care centres in five regions in Sweden. Participants will be randomized (1:1) into two groups. A mHealth intervention group who will receive an activity tracker wristband (Garmin Vivofit4), regular SMS text message reminders, and counselling with a diabetes specialist nurse, or a comparator group who will receive counselling with a diabetes specialist nurse only. The primary outcomes are device-measured total sitting time and total number of steps (activPAL3). The secondary outcomes are fatigue, health-related quality of life and musculoskeletal problems (self-reported questionnaires), number of sick leave days (diaries), diabetes medications (clinical record review) and cardiometabolic biomarkers including waist circumference, mean blood pressure, HbA1c, HDL-cholesterol and triglycerides.

    Discussion: Successful interventions to increase physical activity among those with T2DM have been costly and long-term effectiveness remains uncertain. The use of mHealth technologies such as activity trackers and SMS text reminders may increase awareness of prolonged sedentary behaviour and encourage increase in regular physical activity. mHealth may, therefore, provide a valuable and novel tool to improve health outcomes and clinical management in those with T2DM. This 12-month RCT will evaluate longer-term effects of a mHealth intervention suitable for real-world primary health care settings.

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  • 2.
    Dam, Veerle
    et al.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Netherlands Heart Institute, Utrecht, Netherlands.
    Onland-Moret, N. Charlotte
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
    Burgess, Stephen
    MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom; MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Homerton College, Cambridge, United Kingdom.
    Chirlaque, Maria-Dolores
    Department of Epidemiology, Regional Health Authority, IMIB-Arrixaca, Murcia University, Murcia, Spain.
    Peters, Sanne A. E
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; The George Institute for Global Health, Imperial College London, London, United Kingdom.
    Schuit, Ewoud
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
    Tikk, Kaja
    Division of Clinical Epidemiology and Aging Research, German Cancer Research Centre (DKFZ), Heidelberg, Germany; German Cancer Consortium, DKFZ, Heidelberg, Germany.
    Weiderpass, Elisabete
    International Agency for Research on Cancer, World Health Organization, Lyon, France.
    Oliver-Williams, Clare
    MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Homerton College, Cambridge, United Kingdom.
    Wood, Angela M
    MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Tjønneland, Anne
    Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Dahm, Christina C
    Department of Public Health, Aarhus University, Aarhus, Denmark.
    Overvad, Kim
    Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
    Boutron-Ruault, Marie-Christine
    INSERM, Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones, and Women's Health Team, Institut Gustave Roussy, Villejuif, France.
    Schulze, Matthias B
    Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.
    Trichopoulou, Antonia
    Hellenic Health Foundation, Athens, Greece; WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
    Ferrari, Pietro
    International Agency for Research on Cancer, World Health Organization, Lyon, France.
    Masala, Giovanna
    Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy.
    Krogh, Vittorio
    Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
    Tumino, Rosario
    Cancer Registry and Histopathology Department, "Civic - M.P. Arezzo" hospital, ASP Ragusa, Ragusa, Italy.
    Matullo, Giuseppe
    Department of Medical Sciences, University of Torino, Torino, Italy; Italian Institute for Genomic Medicine–IIGM/HuGeF, Torino, Italy.
    Panico, Salvatore
    Dipartimento di medicina clinica e chirurgia, Federico II University, Naples, Italy.
    Boer, Jolanda M. A
    National Institute for Public Health and the Environment, Bilthoven, Netherlands.
    Verschuren, W. M. Monique
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; National Institute for Public Health and the Environment, Bilthoven, Netherlands.
    Waaseth, Marit
    Department of Pharmacy, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.
    PCrossed D sign©rez, Maria JosCrossed D sign© Sánchez
    Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
    Amiano, Pilar
    CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
    Imaz, Liher
    CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
    Moreno-Iribas, Conchi
    Instituto de Salud Pública de Navarra, IdiSNA, Navarre Institute for Health Research, REDISSEC, Pamplona, Spain.
    Melander, Olle
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Harlid, Sophia
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Key, Timothy J
    Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
    Riboli, Elio
    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
    Santiuste, Carmen
    CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Epidemiology, Murcia Regional Health Authority, IMIB-Arrixaca, Murcia, Spain.
    Kaaks, Rudolf
    Division of Cancer Epidemiology, DKFZ, Foundation under Public Law, Heidelberg, Germany.
    Katzke, Verena
    Division of Cancer Epidemiology, DKFZ, Foundation under Public Law, Heidelberg, Germany.
    Langenberg, Claudia
    MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
    Wareham, Nicholas J
    MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
    Schunkert, Heribert
    Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
    Erdmann, Jeanette
    Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.
    Willenborg, Christina
    Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.
    Hengstenberg, Christian
    Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
    Kleber, Marcus E
    Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
    Delgado, Graciela
    Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
    März, Winfried
    Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
    Kanoni, Stavroula
    William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
    Dedoussis, George
    Department of Nutrition-Dietetics/Harokopio University, Athens, Greece.
    Deloukas, Panos
    William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; Centre for Genomic Health, Queen Mary University of London, London, United Kingdom; Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia.
    Nikpay, Majid
    Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, ON, Ottawa, Canada.
    Mcpherson, Ruth
    Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, ON, Ottawa, Canada.
    Scholz, Markus
    Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
    Teren, Andrej
    LIFE Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Heart Center Leipzig, Leipzig, Germany.
    Butterworth, Adam S
    MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Van Der Schouw, Yvonne T
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
    Genetically Determined Reproductive Aging and Coronary Heart Disease: A Bidirectional 2-sample Mendelian Randomization2022In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 107, no 7, p. E2952-E2961Article in journal (Refereed)
    Abstract [en]

    Background: Accelerated reproductive aging, in women indicated by early natural menopause, is associated with increased coronary heart disease (CHD) risk in observational studies. Conversely, an adverse CHD risk profile has been suggested to accelerate menopause. Objectives: To study the direction and evidence for causality of the relationship between reproductive aging and (non-)fatal CHD and CHD risk factors in a bidirectional Mendelian randomization (MR) approach, using age at natural menopause (ANM) genetic variants as a measure for genetically determined reproductive aging in women. We also studied the association of these variants with CHD risk (factors) in men. Design: Two-sample MR, using both cohort data as well as summary statistics, with 4 methods: simple and weighted median-based, standard inverse-variance weighted (IVW) regression, and MR-Egger regression. Participants: Data from EPIC-CVD and summary statistics from UK Biobank and publicly available genome-wide association studies were pooled for the different analyses. Main Outcome Measures: CHD, CHD risk factors, and ANM. Results: Across different methods of MR, no association was found between genetically determined reproductive aging and CHD risk in women (relative risk estimateIVW = 0.99; 95% confidence interval (CI), 0.97-1.01), or any of the CHD risk factors. Similarly, no associations were found in men. Neither did the reversed analyses show evidence for an association between CHD (risk factors) and reproductive aging. Conclusion: Genetically determined reproductive aging is not causally associated with CHD risk (factors) in women, nor were the genetic variants associated in men. We found no evidence for a reverse association in a combined sample of women and men.

  • 3.
    Dam, Veerle
    et al.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispostnr. STR 6.131, GA Utrecht, Netherlands; Netherlands Heart Institute, Utrecht, Netherlands.
    Van Der Schouw, Yvonne T.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispostnr. STR 6.131, GA Utrecht, Netherlands.
    Onland-Moret, N. Charlotte
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispostnr. STR 6.131, GA Utrecht, Netherlands.
    Groenwold, Rolf H. H.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispostnr. STR 6.131, GA Utrecht, Netherlands.
    Peters, Sanne A. E.
    George Institute for Global Health, University of Oxford, Oxford, United Kingdom.
    Burgess, Stephen
    MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom; Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Wood, Angela M.
    Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Chirlaque, Maria-Dolores
    Department of Epidemiology, Regional Health Authority, IMIB-Arraxaca, Murcia University, Murcia, Spain; Department of Epidemiology, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
    Moons, Karel G. M.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispostnr. STR 6.131, GA Utrecht, Netherlands.
    Oliver-Williams, Clare
    Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Homerton College, Cambridge, United Kingdom.
    Schuit, Ewoud
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispostnr. STR 6.131, GA Utrecht, Netherlands.
    Tikk, Kaja
    Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
    Weiderpass, Elisabete
    Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
    Holm, Marianne
    Department of Diet Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
    Tjønneland, Anne
    Department of Diet Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
    Kühn, Tilman
    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
    Fortner, Renée T.
    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
    Trichopoulou, Antonia
    2nd Pulmonary Medicine Department, Hellenic Health Foundation, Athens, Greece; Department of Hygiene Epidemiology and Medical Statistics, WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian, University of Athens, Athens, Greece.
    Karakatsani, Anna
    2nd Pulmonary Medicine Department, Hellenic Health Foundation, Athens, Greece; 2nd Pulmonary Medicine Department, School of Medicine, National, Kapodistrian University of Athens, ATTIKON' University Hospital, Haidari, Greece.
    La Vecchia, Carlo
    2nd Pulmonary Medicine Department, Hellenic Health Foundation, Athens, Greece; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
    Ferrari, Pietro
    International Agency for Research on Cancer, Lyon, France.
    Gunter, Marc
    International Agency for Research on Cancer, Lyon, France.
    Masala, Giovanna
    Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute, ISPO, Florence, Italy.
    Sieri, Sabina
    Epidemiology and Prevention Unit, Fondazione IRCCS Instituto Nazionale Dei Tumori, Milan, Italy.
    Tumino, Rosario
    Cancer Registry and Histopathology Department, 'Civic-M.P.Arezzo' Hospital, ASP Ragusa, Ragusa, Italy.
    Panico, Salvatore
    Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy.
    Boer, Jolanda M. A.
    Center for Nutrition Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
    Monique Verschuren, W.M.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispostnr. STR 6.131, GA Utrecht, Netherlands; Center for Nutrition Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
    Salamanca-Fernández, Elena
    Department of Epidemiology, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria Ibs, Hospitales Universitarios de Granada, Universidad de Granada, Granada, Spain.
    Arriola, Larraitz
    Department of Epidemiology, CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Instituto BIO-Donostia, Basque Government, Donostia, Spain.
    Moreno-Iribas, Conchi
    Instituto de Salud Pública de Navarra, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain; Red de Servicios de Salud Orientados A Enfermedades Crónicas, REDISSEC, Pamplona, Spain.
    Engström, Gunnar
    Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
    Melander, Olle
    Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Key, Timothy J.
    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
    Colorado-Yohar, Sandra
    Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia.
    Matullo, Giuseppe
    Department of Medical Sciences, University of Torino, Turin, Italy; Department Medical Sciences, Italian Institute for Genomic Medicine -IIGM/HuGeF, Turin, Italy.
    Overvad, Kim
    Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
    Clavel-Chapelon, Francoise
    INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones, and Women's Health Team, Institut Gustave Roussy, Villejuif, France.
    Boeing, Heiner
    Department of Epidemiology, German Institute of Human Nutrition (DIfE), Potsdam-Rehbrücke, Germany.
    Ramon Quiros, J.
    Public Health Direct., Asturias, Spain.
    Di Angelantonio, Emanuele
    MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom.
    Langenberg, Claudia
    MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom.
    Sweeting, Michael J.
    MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom.
    Riboli, Elio
    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
    Wareham, Nicholas J.
    MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom.
    Danesh, John
    MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom.
    Butterworth, Adam
    Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Association of menopausal characteristics and risk of coronary heart disease: A pan-European case-cohort analysis2019In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 48, no 4, p. 1275-1285Article in journal (Refereed)
    Abstract [en]

    Background: Earlier age at menopause has been associated with increased risk of coronary heart disease (CHD), but the shape of association and role of established cardiovascular risk factors remain unclear. Therefore, we examined the associations between menopausal characteristics and CHD risk; the shape of the association between age at menopause and CHD risk; and the extent to which these associations are explained by established cardiovascular risk factors.

    Methods: We used data from EPIC-CVD, a case-cohort study, which includes data from 23 centres from 10 European countries. We included only women, of whom 10 880 comprise the randomly selected sub-cohort, supplemented with 4522 cases outside the sub-cohort. We conducted Prentice-weighted Cox proportional hazards regressions with age as the underlying time scale, stratified by country and adjusted for relevant confounders.

    Results: After confounder and intermediate adjustment, post-menopausal women were not at higher CHD risk compared with pre-menopausal women. Among post-menopausal women, earlier menopause was linearly associated with higher CHD risk [HRconfounder and intermediate adjusted per-year decrease = 1.02, 95% confidence interval (CI) = 1.01-1.03, p = 0.001]. Women with a surgical menopause were at higher risk of CHD compared with those with natural menopause (HRconfounder-adjusted = 1.25, 95% CI = 1.10-1.42, p < 0.001), but this attenuated after additional adjustment for age at menopause and intermediates (HR = 1.12, 95% CI = 0.96-1.29, p = 0.15). A proportion of the association was explained by cardiovascular risk factors.

    Conclusions: Earlier and surgical menopause were associated with higher CHD risk. These associations could partially be explained by differences in conventional cardiovascular risk factors. These women might benefit from close monitoring of cardiovascular risk factors and disease.

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  • 4.
    Di Castelnuovo, Augusto
    et al.
    Mediterranea Cardiocentro, Naples, Italy.
    Bonaccio, Marialaura
    Department of Epidemiology and Prevention, IRCCS NEUROMED, IS, Pozzilli, Italy.
    Costanzo, Simona
    Department of Epidemiology and Prevention, IRCCS NEUROMED, IS, Pozzilli, Italy.
    McElduff, Patrick
    Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
    Linneberg, Allen
    Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    Salomaa, Veikko
    Finnish Institute for Health and Welfare, Helsinki, Finland.
    Männistö, Satu
    Finnish Institute for Health and Welfare, Helsinki, Finland.
    Ferrières, Jean
    Department of Cardiology and INSERM UMR 1295, Toulouse University Hospital, Toulouse, France.
    Dallongeville, Jean
    Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE, Lille, France.
    Thorand, Barbara
    Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
    Brenner, Hermann
    Division of Clinical Epidemiology and Aging Research and Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany.
    Ferrario, Marco
    Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.
    Veronesi, Giovanni
    Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.
    Tamosiunas, Abdonas
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Grimsgaard, Sameline
    Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.
    Drygas, Wojciech
    Department of Epidemiology CVD Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland; Calisia University, Kalisz, Poland.
    Malyutina, Sofia
    The Institute of Internal and Preventive Medicine -Branch of the “FRC Institute of Cytology and Genetics SB RAS”, Novosibirsk, Russian Federation.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Kee, Frank
    Centre for Public Health, Queens University of Belfast, Belfast, United Kingdom.
    Grassi, Guido
    Clinica Medica, Università Milano-Bicocca, Milan, Italy.
    Dabboura, Salim
    Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for Cardiovascular Research, partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.
    Borchini, Rossana
    Occupational and Preventive Medicine, ASST Lariana, Como, Italy.
    Westermann, Dirk
    Department for Cardiology and Angiology, Medical Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Freiburg, Germany.
    Schrage, Benedikt
    Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for Cardiovascular Research, partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.
    Zeller, Tanja
    Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for Cardiovascular Research, partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.
    Kuulasmaa, Kari
    Finnish Institute for Health and Welfare, Helsinki, Finland.
    Blankenberg, Stefan
    Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for Cardiovascular Research, partner site Hamburg/Lübeck/Kiel, Hamburg, Germany.
    Donati, Maria Benedetta
    Department of Epidemiology and Prevention, IRCCS NEUROMED, IS, Pozzilli, Italy.
    Iacoviello, Licia
    Department of Epidemiology and Prevention, IRCCS NEUROMED, IS, Pozzilli, Italy; Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy.
    de Gaetano, Giovanni
    Department of Epidemiology and Prevention, IRCCS NEUROMED, IS, Pozzilli, Italy.
    Drinking alcohol in moderation is associated with lower rate of all-cause mortality in individuals with higher rather than lower educational level: findings from the MORGAM project2023In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 38, no 8, p. 869-881Article in journal (Refereed)
    Abstract [en]

    The association between socioeconomic status (SES) and alcohol-related diseases has been widely explored. Less is known, however, on whether the association of moderate drinking with all-cause mortality is modified by educational level (EL). Using harmonized data from 16 cohorts in the MORGAM Project (N = 142,066) the association of pattern of alcohol intake with hazard of all-cause mortality across EL (lower = primary-school; middle = secondary-school; higher = university/college degree) was assessed using multivariable Cox-regression and spline curves. A total of 16,695 deaths occurred in 11.8 years (median). In comparison with life-long abstainers, participants drinking 0.1–10 g/d of ethanol had 13% (HR = 0.87; 95%CI: 0.74–1.02), 11% (HR = 0.89; 0.84–0.95) and 5% (HR = 0.95; 0.89–1.02) lower rate of death in higher, middle and lower EL, respectively. Conversely, drinkers > 20 g/d had 1% (HR = 1.01; 0.82–1.25), 10% (HR = 1.10; 1.02–1.19) and 17% (HR = 1.17; 1.09–1.26) higher rate of death. The association of alcohol consumption with all-cause mortality was nonlinear, with a different J-shape by EL levels. It was consistent across both sexes and in various approaches of measuring alcohol consumption, including combining quantity and frequency and it was more evident when the beverage of preference was wine. We observed that drinking in moderation (≤ 10 g/d) is associated with lower mortality rate more evidently in individuals with higher EL than in people with lower EL, while heavy drinking is associated with higher mortality rate more evidently in individuals with lower EL than in people with higher EL, suggesting that advice on reducing alcohol intake should especially target individuals of low EL.

  • 5.
    Erelund, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Sundström, Nina
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Heart rate variability and long-term survival in females with ischemic heart diseaseManuscript (preprint) (Other academic)
  • 6. Iurilli, Maria LC
    et al.
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Filippi, Sarah
    Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight2021In: eLIFE, E-ISSN 2050-084X, Vol. 10, article id e60060Article in journal (Refereed)
    Abstract [en]

    From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

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  • 7.
    Mughal, Rabya
    et al.
    Department of Psychiatry, Cambridge Public Health, School of Clinical Medicine, University of Cambridge, Herchel Smith Building, Cambridge, United Kingdom.
    DeMarinis, Valerie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Innlandet Hospital Trust, Ottestad, Norway; Center for Research on Extremism, University of Oslo, Oslo, Norway.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Lone, Hassan
    St George’s Medical School, University of London, London, United Kingdom.
    Phillips, Veronica
    School of Clinical Medicine, University of Cambridge Medical Library, Cambridge, United Kingdom.
    Boyd-MacMillan, Eolene
    Department of Psychiatry, Cambridge Public Health, School of Clinical Medicine, University of Cambridge, Herchel Smith Building, Cambridge, United Kingdom.
    Public mental health approaches to online radicalisation: an empty systematic review2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 16, article id 6586Article, review/survey (Refereed)
    Abstract [en]

    This systematic review seeks to position online radicalisation within whole system frameworks incorporating individual, family, community and wider structural influences whilst reporting evidence of public mental health approaches for individuals engaging in radical online content. Methods: the authors searched Medline (via Ovid), PsycInfo (via Ebscohost) and Web of Science (Core Collection) with the use of Boolean operators across “extremism”, “online content” and “intervention”. Results: Following full-text assessments, all retrieved papers were excluded. No publications fulfilled the primary objective of reporting public mental health interventions specifically addressing online radicalisation. However, six publications fulfilled the secondary objective of identifying theoretical and conceptual relationships amongst elements in the three inclusion criteria (online extremism, psychological outcomes and intervention strategy) that could inform interventions within public mental health frameworks. These publications were quality assessed and discussed following the Cochrane Effective Practice and Organisation of Care guide for reporting empty reviews. Conclusions: there is an immediate need for further research in this field given the increase in different factions of radicalised beliefs resulting from online, particularly social media, usage.

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    fulltext
  • 8.
    Syrjälä, Maria B.
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Fhärm, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Dempsey, Paddy C.
    Nordendahl, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Reducing occupational sitting time in adults with type 2 diabetes: Qualitative experiences of an office-adapted mHealth intervention2021In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 38, no 6, article id e14514Article in journal (Refereed)
    Abstract [en]

    Aim: Understanding barriers and facilitators for limiting occupational sitting and what impact it has on health on those with type 2 diabetes is essential for future trials and intervention development in primary healthcare settings. This study aimed to explore the feasibility and acceptability of an intervention using mobile health (mHealth) technology, together with counselling by a diabetes specialist nurse, to reduce occupational sitting in adults with type 2 diabetes.

    Methods: Individual semi-structured interviews were conducted in 15 participants with type 2 diabetes who completed a 3-month intervention including mHealth; activity tracker (Garmin Vivofit3) and SMS reminders, one initial face-to-face patient-centred counselling session and three telephone follow-up calls by a diabetes specialist nurse within the primary healthcare system in Sweden. The interviews were recorded, transcribed verbatim and analysed using qualitative content analysis.

    Results: Two themes were identified: (1) 'From baby steps to milestones' reflecting three categories; 'Small changes make it easier to reduce sitting', 'Encouraged by trustworthy coaching', 'Physical and mental rewards matter' and (2) 'Tailoring strategies that fit me and my workplace' reflecting four categories; 'It's up to me', 'Taking advantage of the support', 'Using creativity to find practical solutions for interrupting sitting' and 'Living up to expectations'.

    Conclusion: The intervention was perceived as feasible and acceptable in different office workplaces, and led to increased awareness of sedentary behaviour in adults with type 2 diabetes. Stepwise goal setting together with personalization of the mHealth intervention should be emphasized in individual type 2 diabetes programmes aiming to reduce workplace sitting.

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