Oulu Deaconess Institute

Prolonged sitting is linked to poor health outcomes; however, its context, particularly work versus leisure, and its economic impact are less understood. This study examined the extent and context of daily sitting time and its association with annual healthcare costs at midlife in a large Finnish cohort. A sample (n=7147) of Finnish adults at the 46-year (46-yr) follow-up point of the Northern Finland Birth Cohort 1966 study was used. Data were collected between 2012 and 2014, including self-reported sitting time (work and leisure) and healthcare costs estimated from self-reported visits to public, private, and occupational primary healthcare services using unit costs based on the Finnish Institute for Health and Welfare. Finally, a generalized linear model (gamma distribution with log link), was used to examine the associations between sitting time and annual healthcare costs. Total sitting time was 7.3 ± 3.3 hours per day (h·d⁻¹), including 4.0 ± 2.2 h·d⁻¹ during leisure and 3.4 ± 2.6 h·d⁻¹ at work. In adjusted GLM analyses, participants in the second quartile of work-related sitting (1.01-3.00 h·d⁻¹) had approximately 20% higher annual primary healthcare costs compared with those in the lowest quartile (p = 0.025). Leisure-time sitting showed no independent association. In this population-based cohort, work-related sitting, but not leisure-time sitting, was associated with higher annual primary healthcare costs. These findings highlight the potential economic impact of occupational sedentary behavior and suggest that work-related sitting should be considered in future strategies and studies addressing sedentary behavior in workplace settings.

Childhood overweight and obesity are major public health concerns. We examined the associations between sociodemographic factors, including urban-rural differences, and adiposity indicators in 3–4-year-old children. The SUNRISE Finland study included 1,081 children from five cities (57%) and adjacent rural areas (43%), and their 1,485 caregivers. Children’s height, weight, and waist circumference were measured, from which overweight (ISO-BMI category overweight including obesity) and central obesity (waist-to-height ratio ≥85th percentile) were calculated. Caregivers completed questionnaires on sociodemographic factors. Rural residence was associated with higher likelihood of overweight and central obesity. Other sociodemographic factors were differently associated with BMI and waist-to-height ratio. Boys had a higher BMI and likelihood of being overweight, while waist-to-height ratio and likelihood of living with central obesity were higher in girls and lower in older children. Maternal sociodemographic factors were more often associated with child adiposity indicators than paternal ones. Middle-level income, assets, and education, small household size, and home ownership were associated with higher adiposity indicators, whereas parental leave, maternal foreign background, being married or cohabiting, and low relative household income were associated with lower adiposity indicators. Sosiodemographic inequalities in overweight are already present in early childhood, highlighting the need for targeted strategies, especially in rural areas.

Cerebral Palsy (CP) is a common motor disorder in children, leading to reduced physical activity (PA) and increased health risks. To complement traditional PA methods (e.g. accelerometers, self-reports), electromyography (EMG) provides physiologically relevant information on muscle activity during free-living. This study used EMG for assessing daily muscle activity in individuals with CP and their typically developing (TD) peers. Shorts with embedded EMG electrodes and hip-worn tri-axial accelerometer recorded daily PA in 8 children with spastic CP (mean age 14y 7mo, Gross Motor Function Classification System (GMFCS) I (n=5), III (n=3)) and 6 TD children (mean age 15y 4mo) during free-living. Daily EMG activity levels are reported as a percentage of mean EMG amplitude during the 6MWT. Inactivity time and light, moderate and vigorous PA are reported relative to recording time using established cut-off values for accelerometry, and EMG amplitude categorized based on a two-minute average from the middle of 6MWT. Free-living EMG inactivity (CP: 58.4%, TD: 50.4%) and activity levels did not differ statistically between CP and TD groups. Accelerometry showed a greater inactivity time than EMG in CP (p=0.021) and TD (p=0.010) groups. In CP, few statistically significant differences were observed between legs, muscles, and GMFCS levels. Free-living EMG monitoring did not reveal excessive muscle activity in individuals with CP during daily activities compared to TD peers. EMG detects light PA that accelerometry may underestimate, offering a more detailed view of daily muscle use.

BackgroundRegular physical activity (PA) has been associated with lower risk of infections, and frequent nature contact with improved immune functioning. Population-based studies considering the associations between outdoor PA involving contact with nature and infections are lacking. This study examines how regular outdoor PA is associated with self-reported severe lifetime infections among urban and rural middle-aged residents. Regular outdoor PA may support exposure to nature contact and benefit immune health at population level.MethodsCross-sectional associations between outdoor PA based on self-reported frequency of different outdoor activities and occurrence of self-reported lifetime severe infections were analysed with binary logistic regression analysis among participants from the Northern Finland Birth Cohort 1966 living in urban and rural areas in midlife (N = 4472). Sex, marital status, household income, sleep duration, alcohol consumption, smoking, body mass index, moderate-to-vigorous physical activity and diet quality were adjusted for.ResultsIn urban areas 85.5% and in rural areas 88.6% of the participants reported outdoor PA at least 12 times per month. A little over a fourth of the respondents reported having any severe lifetime infection. Participants living in urban areas who regularly engaged in outdoor PA had lower odds of reporting infections than those who engaged in outdoor PA less often (adjusted OR 0.76, 95% CI 0.60-0.96).ConclusionsLiving in urban areas and practicing regular outdoor PA was associated with lower risk of severe infections. Participation in outdoor activities should be encouraged, especially among urban residents.Key messages• Outdoor physical activity is a potential means of enhancing contact with nature and obtaining related health benefits.• Provision of natural areas and nature elements should be emphasized in urban planning for providing health promoting environments to all urban residents.

BackgroundWhile the health effects of physical activity (PA) and factors that promote or restrict PA have been well studied, it is still unclear if PA motivators or barriers differ among older adults with different PA behavior. The aim of this study was to compare PA motivators and barriers in older adults with different movement profiles.MethodsThe study used a population-based sample of older adults aged 67-70 years (n = 714) from the Oulu1945 cohort. Four PA profiles (Couch potatoes, Light movers, Sedentary actives, Actives) were created based on medians of moderate-to-vigorous PA and sedentary time measured with a wrist-worn Polar Active accelerometer (n = 660). PA motivators and barriers were identified using a questionnaire and quantitative differences in their prevalence between PA profiles were assessed using the Kruskal-Wallis test with post-hoc pairwise comparisons.ResultsAll profiles had similar most important motivators: promoting health, enjoying nature, enjoying PA, mood enhancement and increasing energy. Those in the least active profile (Couch potatoes) were less likely to report that these factors motivated them for engaging PA. In all PA profiles, laziness and illness/injury emerged as the two most common factors restricting PA. Unlike in other profiles, lack of physical skills emerged as one of the five most significant barriers in the least active profile (17% identified it as a barrier). Overall, the two least active profiles reported higher number of barriers compared to the most active profile (p ≤ 0.001). The differences in the number of barriers were related to the individual-level factors and the differences persisted even after excluding those with illness/injury-related PA restrictions (p ≤ 0.003).ConclusionsThere are differences in the experience of PA motivators and barriers among older adults with different PA profiles. The findings can be utilized when planning strategies aimed at promoting health-enhancing PA among sedentary older adults.Key messages• Physical activity motivators and barriers differ among older adults with different movement profiles.• Physical activity programs and strategies should consider the individuality of older adults to motivate especially sedentary older adults.

Passive non-invasive sensing signals from wearable devices and smartphones are typically collected continuously without user input. This passive and continuous data collection makes these signals suitable for moment-by-moment monitoring of health-related outcomes, disease diagnosis, and prediction modeling. A growing number of studies have utilized machine learning (ML) approaches to predict and analyze health indicators and diseases using passive non-invasive signals collected via wearable devices and smartphones. This systematic review identified peer-reviewed journal articles utilizing ML approaches for digital phenotyping and measuring digital biomarkers to analyze, screen, identify, and/or predict health-related outcomes using passive non-invasive signals collected from wearable devices or smartphones. PubMed, PubMed with Mesh, Web of Science, Scopus, and IEEE Xplore were searched for peer-reviewed journal articles published up to June 2024, identifying 66 papers. We reviewed the study populations used for data collection, data acquisition details, signal types, data preparation steps, ML approaches used, digital phenotypes and digital biomarkers, and health outcomes and diseases predicted using these ML techniques. Our findings highlight the promising potential for objective tracking of health outcomes and diseases using passive non-invasive signals collected from wearable devices and smartphones with ML approaches for characterization and prediction of a range of health outcomes and diseases, such as stress, seizure, fatigue, depression, and Parkinson’s disease. Future studies should focus on improving the quality of collected data, addressing missing data challenges, providing better documentation on study participants, and sharing the source code of the implemented methods and algorithms, along with their datasets and methods, for reproducibility purposes.

To investigate eating behavior domains-emotional, uncontrolled, and cognitive restraint eating-in women with polycystic ovary syndrome (PCOS) with different PCOS phenotypes and women without PCOS at midlife. A prospective cohort study. Eating behavior domains were assessed at age of 46 years. Predictors of eating behaviors were evaluated using variables collected at ages of 31 and 46 years. Women identified as having PCOS (n = 251) at age of 31 years using the updated Rotterdam criteria were compared with women without any PCOS criteria (n = 935). The PCOS population comprised women with the classic A+B-phenotype (hyperandrogenism and oligomenorrhea, with or without elevated antimüllerian hormone, n = 60), C-phenotype (hyperandrogenism and elevated antimüllerian hormone, n = 84), and D-phenotype (oligomenorrhea and elevated antimüllerian hormone, n = 86). Not applicable. Revised Three-Factor Eating Questionnaire-18 scores for eating behavior domains. Compared with women without PCOS, women with PCOS exhibited higher scores for emotional (33.1 ± 27.8 vs. 39.0 ± 29.9) and uncontrolled eating (26.7 ± 18.2 vs. 30.7 ± 19.4) but no difference in cognitive restraint (46.6 ± 18.6 vs. 45.9 ± 18.5) at age of 46 years. Emotional and uncontrolled eating scores were higher in the A+B-phenotype compared with women without PCOS, whereas uncontrolled eating scores in the C-phenotype were higher than in women without PCOS and the D-phenotype. At age of 46 years, the perception of overweight was an independent predictor of emotional eating among women with PCOS (B = 11.96 [95% confidence interval {CI}: 2.81-20.29]), whereas a history of weight loss attempts was a predictor of uncontrolled eating (B = 6.06 [95% CI: 1.05-10.83]). Among women with PCOS, higher psychological distress at age of 31 years was a significant risk factor for scoring in the highest quartile of emotional (adjusted odds ratio [aOR]: 2.85 [95% CI: 1.19-6.85]) and uncontrolled eating (aOR: 4.37 [95% CI: 1.77-10.80]) at age of 46 years. Women with PCOS at midlife showed a high tendency for unfavorable eating behaviors. Our findings emphasize the need for sensitivity in weight management counseling and addressing psychological distress to prevent unfavorable eating in this population.

Objectives This study focused on how adolescents’ perceptions of coaches’ health promotion activity predict maintained participation and dropout in organized sports in emerging adulthood. In addition, differences in lifestyle habits between maintainers, dropouts, and nonparticipants in organized sports were explored. Materials and Methods Overall, 616 adolescents reported organized sports participation in the Finnish Health Promoting Sports Club (FHPSC) study at ages 15 and 19. Of these, 323 reported coach’s health promotion activity on health topics at the age of 15. An index of a coach’s general health promotion activity was formed. At age 19, all study participants reported their lifestyle habits. Results Among males, those who had perceived coaches’ general health promotion activity as frequent were more likely to be maintainers than dropouts (48.6% vs. 20.0%) (p = .002). Among females, there was no significant difference (32.0% vs. 28.4%). Logistic regression analysis adjusted for gender showed that perceiving coach’s general health promotion activity as frequent increased the odds of being a maintainer rather than a dropout. Moreover, maintainers had higher odds of having healthy lifestyle habits when compared to nonparticipants (related to physical activity; sleep; fruit and vegetable consumption; and cigarette use) or dropouts (related to physical activity; and cigarette use). In addition, dropouts had higher odds of having healthy lifestyle habits than nonparticipants (related to sleep; and cigarette use). Conclusions Perceiving coaches’ health promotion activity as frequent was related to maintained participation in organized sports among males. Maintainers were more likely to have more healthy lifestyle habits than nonparticipants and dropouts. There is a need to invest in coaches’ health promotion activity when it is infrequent. A more detailed understanding is needed of coaches’ health promotion activity that supports both maintained participation in sports, especially among females, and healthy lifestyle habits in emerging adulthood.

BackgroundThe World Health Organization (WHO) has identified the prevention of obesity in young children as one of its key priorities for the 21st century, and 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) play a key role in this priority. The SUNRISE Finland Study is part of the international SUNRISE Study, which examines the movement behaviours of young children in 64 low-, middle- and high-income countries. The SUNRISE Finland Study will investigate what proportion of 3- to 4-year-old children living in Finland meet the WHO global guidelines on 24-hour movement behaviours, and how that proportion and children’s motor and cognitive skills compare with children from other countries involved in the SUNRISE Study. We also aim to identify potential correlates of children’s movement behaviours, focusing on socioeconomic factors, residential environmental features, and parents’ mental health. In addition, this study will examine the associations between children’s movement behaviours, motor and cognitive skills, adiposity, and psychosocial wellbeing. Finally, we aim to establish a cohort of families who participate in the study and conduct follow-ups in the future.MethodsWe will recruit 1,000 children aged 3.0 to 4.9 years and their caregivers through early childhood education and care centres in Finland (50% in urban and 50% in rural areas). We will assess children’s 24-h movement behaviours using two accelerometers and a parental report. Children will perform validated tests to measure gross and fine motor skills and executive functions, and their height, weight and waist circumference will be measured. Caregivers will complete questionnaires regarding sociodemographic factors, nature visits, their own movement behaviours, symptoms of depression, anxiety, stress, insomnia, nomophobia, social media self-control failure, and happiness, and child’s psychosocial wellbeing. Geographic Information System (GIS) will be used to examine residential environmental features.DiscussionIn addition to facilitating international comparisons on movement behaviours and motor and cognitive skills, the SUNRISE Finland Study will provide novel evidence on factors associated with movement behaviours in young children. The results of this study will help in planning actions to promote healthy levels of movement behaviours at an early age and equal opportunities for healthy development.Clinical Trial NumberThis is not a trial study.