Physical activity and peripheral artery disease : Two prospective cohort studies and a systematic review

Background and aims: Physical activity is a modifiable risk factor for cardiovascular disease and an important therapy in individuals with intermittent claudication. However, its role in the development of peripheral artery disease (PAD) is unclear. We have examined the evidence of the association between physical activity and development of PAD. Methods: We searched PubMed, EMBASE and CINAHL Plus in August 2018 for original studies of physical activity and PAD. Studies reporting prevalence or incidence of PAD by categories of physical activity (an amount of activity per unit of time) were included. In addition, we analysed unpublished individual-level data from two register-linked cohort studies, Finnish Public Sector Study (n=63,924) and Whitehall II (n=10,200). Due to heterogeneity in the assessment of physical activity and PAD, we provide a qualitative synthesis of the findings. Results: Evidence from 18 studies (15 cross-sectional/case-control and 7 prospective studies) of the association between physical activity and PAD in total of 152,188 participants, including 3971 PAD patients, suggests that individuals with a diagnosis or clinical findings of PAD were less physically active, regardless of whether activity was self-reported or measured using accelerometers. The findings from the longitudinal studies point to more intense physical activity being associated with lower odds of developing PAD; however, the study-specific findings lacked power to precisely estimate this relationship. Conclusions: Individuals with PAD were less physically active than those without PAD. The longitudinal findings suggest that physical activity decreases the risk of PAD, although better powered studies are needed to confirm this.Peer reviewe

Changes in Smoking During Retirement Transition : A Longitudinal Cohort Study

Aims: We examined the effect of retirement transition on changes in smoking, identified trajectories of smoking around the retirement transition, and investigated factors predicting the membership in the trajectories. Methods: This longitudinal cohort study included 1,432 current or former smokers who entered into statutory retirement in 2000-2011 and who filled out two to four questionnaires sent at four-year intervals. Effect of retirement on smoking was analysed as a non-randomized pseudo-trial in which we compared the likelihood of quitting and relapsing smoking between two subsequent survey waves among those who retired and did not retire. We used latent class analysis to identify trajectories of smoking status and smoking intensity (low: 10 cigarettes/day), and multinomial logistic regression models to assess pre-retirement factors associated with smoking trajectories. Results: Retirement transition was associated with 1.7-fold odds of quitting smoking (95% confidence intervals 1.3-2.2) compared with no retirement transition. We identified three smoking status trajectories: 'sustained non-smoking' (61% of the participants), 'sustained smoking' (23%) and 'decreasing smoking' (16%). For 489 baseline smokers, we identified three smoking intensity trajectories: 'sustained high intensity smoking' (32% of the participants), 'sustained low intensity smoking' (32%) and 'decreasing high intensity smoking' (35%). Living outside an inner urban area predicted membership in the 'decreasing smoking' versus 'sustained smoking' trajectory. Conclusions: Smokers are more likely to quit smoking during transition to retirement than before or after it. Characteristics of the smoking environment may affect smoking behaviour around retirement.Peer reviewe

Changes in drinking as predictors of changes in sickness absence : a case-crossover study

Background We investigated whether changes in alcohol use predict changes in the risk of sickness absence in a case-crossover design. Methods Finnish public sector employees were surveyed in 2000, 2004 and 2008 on alcohol use and covariates. Heavy drinking was defined as either a weekly intake that exceeded recommendations (12 units for women; 23 for men) or having an extreme drinking session. The responses were linked to national sickness absence registers. We analysed the within-person relative risk of change in the risk of sickness absence in relation to change in drinking. Case period refers to being sickness absent within 1 year of the survey and control period refers to not being sickness absent within 1 year of the survey. Results Periods of heavy drinking were associated with increased odds of self-certified short-term (1-3 days) sickness absence (multivariable-adjusted OR 1.21, 95% CI 1.07 to 1.38 for all participants; 1.62, 95% CI 1.19 to 2.21 for men and 1.15, 95% CI 1.00 to 1.33 for women). A higher risk of short-term sickness absence was also observed after increase in drinking (OR=1.27, 95% CI 1.07 to 1.52) and a lower risk was observed after decrease in drinking (OR=0.83, 95% CI 0.69 to 1.00). Both increase (OR=1.38, 95% CI 1.21 to 1.57) and decrease (OR=1.27, 95% CI 1.19 to 1.43) in drinking were associated with increased risk of long-term (> 9 days) medically certified all-cause sickness absence. Conclusion Increase in drinking was related to increases in short-term and long-term sickness absences. Men and employees with a low socioeconomic position in particular seemed to be at risk.Peer reviewe

Finland's National Forest Programme 2010. Follow-up Report 2000

On the 18th of November 1999 the Finnish Government made the decision on the implementation of Finland's National Forest Programme 2010 as a balanced whole, comprising the economic, ecological and social dimensions of sustainability. The implementation started in the beginning of 2000. The implementation of the programme is monitored by means of annual follow-up reports. The first report covers the period from the completion of the programme until the end of 2000, and it contains a description of the realised development as well as proposals for 23 further measures concerning the different aspects of the National Forest Programme 2010

Night work and risk of common mental disorders : analyzing observational data as a non-randomized pseudo trial

Objectives The aim of this study was to examine the status of night work as a risk factor for common mental disorders (CMD). Methods A cohort study with three data waves was conducted on populations of social and healthcare employees for a duration of eight years (total N=46 010). Data were analyzed as a non-randomized pseudo trial to examine (i) whether moving from non-night work to night work is associated with the development of CMD, (ii) the extent to which moving back to non-night work biases this association and (iii) whether moving from night to non-night work is associated with the recovery from CMD. Results According to logistic regression with generalized estimating equation and without bias-correction, changing to night work was not associated with the odds of acquiring CMD [odds ratio (OR) 1.03, 95% confidence interval (CI) 0.82-1.30]. However, night workers with CMD had higher odds of recovery from CMD when changing to non-night work compared to continuing night work (1.99, 95% CI 1.20-3.28). When night workers developed CMD, the odds of moving back to non-night work increased by 68%. In analyses corrected for this bias, changing from non-night to night work was associated with a 1.25-fold (95% CI 1.03-1.52) increased odds of acquiring CMD. Conclusions A change from non-night to night work may increase the risk of CMD, while moving back from night to non-night work increased recovery from CMD.Peer reviewe

Neighbourhood characteristics as a predictor of adherence to dietary recommendations : A population-based cohort study of Finnish adults

Aims: To investigate the association of six-year cumulative level of socioeconomic neighbourhood disadvantage and population density with subsequent adherence to dietary recommendations, controlling for preceding dietary adherence, in adults in Finland. Methods: Population-based Health and Social Support (HeSSup) study participants from four age groups (20-24, 30-34, 40-44 and 50-54 years at baseline in 1998). Data on diet and alcohol consumption were obtained from the 2003 and 2012 surveys and information on neighbourhoods from Statistics Finland Grid database (n = 10,414 men and women). Participants diet was measured as adherence to Nordic Nutrition recommendation (score range 0-100). Neighbourhood disadvantage was measured by median household income, proportion of those with primary education only and unemployment rate, and population density by the number of adult population between years 2007 and 2012. Linear models were used to assess the associations of neighbourhood characteristics with the score for adherence to dietary recommendations in 2012. Results: Cumulative neighbourhood socioeconomic disadvantage was associated with slightly weaker (1.49 (95% confidence interval (CI) -1.89 to -1.09) point decrease in dietary score) adherence while higher population density was associated with better (0.70 (95% CI 0.38-1.01) point increase in dietary score) adherence to dietary recommendations. These associations remained after controlling for prior dietary habits, sociodemographic, chronic cardio-metabolic diseases, and severe life events. Conclusions: These longitudinal findings support the hypothesis that neighbourhood characteristics affect dietary habits.Peer reviewe

Physical Activity across Retirement Transition by Occupation and Mode of Commute

Purpose Retirement induces changes in the composition of daily physical activity. Our aim was to examine changes in accelerometer-measured physical activity around transition to statutory retirement among men and women by occupational category and by preretirement modes of commuting. Methods We included 562 workers (mean [SD] age, 63.3 [1.1] yr; 85% women) from the Finnish Retirement and Aging study. The participants wore an accelerometer on their nondominant wrist for 1 wk before and 1 wk after retirement, with 1 yr between the measurements. We compared mean daily activity counts before and after retirement between manual and nonmanual occupations by gender and by preretirement commuting mode using linear models with generalized estimating equations. Results Before retirement, women were more active than men (2550 (95% confidence interval, 2500-2590) vs 2060 (1970-2140) mean daily activity counts), with the most active group being women in manual occupations. After retirement, physical activity decreased by 3.9% among women and increased, albeit nonsignificantly, by 3.1% in men. The decrease was most pronounced among women in manual and increase among men in nonmanual occupations. After retirement, women remained more active than men (2450 (95% confidence interval 2390-2500) vs 2120 (2010-2230) counts). Active commuting, especially cycling, before retirement was associated with higher physical activity both before and after retirement, and these people also maintained their total activity lever better than did those who commuted by public transportation. Conclusions Although women in manual occupations decreased and men in nonmanual occupations increased their activity after retirement, women were more active than men both before and after retirement. Those who engaged in active commuting before retirement maintained their activity level also after retirement.Peer reviewe

Diet quality in preschool children and associations with individual eating behavior and neighborhood socioeconomic disadvantage. The STEPS Study

A good quality diet in childhood is important for optimal growth as well as for long-term health. It is not well established how eating behaviors affect overall diet quality in childhood. Moreover, very few studies have considered the association of diet quality and a neighborhood socioeconomic disadvantage in childhood. Our aim was to investigate how diet quality is associated with eating behaviors and neighborhood disadvantage and their interaction in preschool age children in Finland. The participants were from the Steps to Healthy Development Study at age 2 y (n = 780) and 5 y (n = 653). Diet quality was measured with a short questionnaire on habitual food consumption and eating behavior was assessed with the child eating behavior questionnaire to indicate the child's eating style regarding food approach and food avoidance dimensions. Information on neighborhood socioeconomic disadvantage were obtained from the statistics Finland grid database. We found that diet quality was higher at 5 years compared to 2 years of age (p < 0.001). Food approach subscale, enjoyment of food, was positively associated with the diet quality (p < 0.001 for 2 and 5 y) while subscale desire to drink was negatively associated with the diet quality (p = 0.001 for 2 and 5 y). Food avoidance was negatively associated with the diet quality both at 2 and at 5 years of age (p < 0.001). A higher neighborhood disadvantage was negatively associated with the diet quality at the age of 2 years (p = 0.02), but not at the age of 5 years. Eating behavior had similar associations with diet quality both in affluent and deprived neighborhoods. Our results suggest that both the eating behavior and neighborhood disadvantage are, already in the early age, important factors when considering children's diet quality.Peer reviewe

Parental feeding practices and child eating behavior in different socioeconomic neighborhoods and their association with childhood weight : The STEPS study

Child obesity risk, child eating behavior and parental feeding practices show a graded association with individual level socioeconomic status. However, their associations with neighborhood socioeconomic disadvantage are largely unknown. In this study (n = 682), we investigated how parental feeding practices and child eating behaviors were associated with body mass index and risk of overweight at preschool age in affluent and disadvantaged neighborhoods. We found that high food approach tendency in disadvantaged neighborhoods predicted higher body mass index and increased the risk of overweight at the age of 6 years compared with affluent neighborhoods. Our results suggest that children's eating habits may have stronger impact on overweight risk in disadvantaged than in affluent neighborhoods.Peer reviewe

Response to letter "Do all hypnotic drugs and sedatives have risk for cancer?"

Non peer reviewe