Research projects in Obesity and Physical Activity | PRIME Health

Research projects in the area obesity and physical activity by the PRIME Health research group.

SCOUTS and SPRING

This series of projects was started when local governments realized that overcrowding at preschool and increasing assignments in the field of health promotion, which often competed for resources and attention and put a strain on the preschool staff.

At the same time the preschool staff was aware of health risks that the children (and they themselves) were exposed to such as obesogenic environment and cramped sun-exposed areas (a problem from spring to autumn). In addition, the short-term consequences (overweight, sunburn, stress) as well as the long-term consequences (increased risk of morbidity related to a lack of physical activity and skin cancer (the most rapidly increasing cancer in Sweden), and mental ill-health.

We wanted to test the hypothesis that outdoor physical environment has an impact upon the children’s physical activity and sun exposure. This cross-sectional study was a collaboration between KI, the Swedish university of Agricultural Sciences, Haninge municipality, the Radiation Protection Authority and the Stockholm County Council. 

The aim of this study was to simultaneously examine the impact of outdoor environment upon physical activity, sun exposure and attention abilities, by triggering spontaneous play underneath and between vegetation, which in extension triggered physical activity and sun-protective behaviour.

The study found that outdoor environment that fulfilled certain criteria increased children’s physical activity by >20%, made outdoor stay all day possible without sunburn, and increased attention ability scores. This has led to improvement of preschool environments in the municipality of Nynäshamn, Stockholm County, City of Malmö, and other municipalities in Sweden are following suit.

Funding from Stockholm County Council, The Radiation Protection Authority (former Radiation Protection Institute) The Research Council Formas, the municipality of Nynäshamn.

Publications

Upgrading Preschool Environment in a Swedish Municipality: Evaluation of an Implementation Process.
Altin C, Kvist Lindholm S, Wejdmark M, Lättman-Masch R, Boldemann C
Health Promot Pract 2015 Jul;16(4):583-91

 Outdoor environmental assessment of attention promoting settings for preschool children.
Mårtensson F, Boldemann C, Söderström M, Blennow M, Englund J, Grahn P
Health Place 2009 Dec;15(4):1149-57

Impact of preschool environment upon children's physical activity and sun exposure.
Boldemann C, Blennow M, Dal H, Mårtensson F, Raustorp A, Yuen K, et al
Prev Med 2006 Apr;42(4):301-8

Swedish pre-school children's UVR exposure - a comparison between two outdoor environments.
Boldeman C, Dal H, Wester U
Photodermatol Photoimmunol Photomed 2004 Feb;20(1):2-8

Contact

Associated

Cecilia Boldemann

Organizational unit: Social Medicin
E-mail: Cecilia.Boldemann@ki.se

Kidscape I

Collaborators: The project is a collaboration between Karolinska Institutet&nbsand the University of Gothenburg and Linnaeus University (Anders Raustorp, Peter Pagels, Andreas Fröberg), the Swedish University of Agricultural Sciences (Fredrika Mårtensson), the Universities of Lund and Copenhagen (Margareta Söderström), and North Carolina State University (Robin Moore, Nilda Cosco, and Brad Bieber).

This project is a continuation of the 2nd of the project series (SCAMPER). The aim was to explore if the findings of the study that was conducted in the Stockholm would be similar or different in areas of different latitudes, climates and landscapes. The same concept was tested in Research Triangle Park (Raleigh), North Carolina, USA and in the City of Malmö.

It was found that the findings in Stockholm also held true for other places. During the course of this study the local government of Nynäshamn had integrated new routines in their interior management so that upgrading of preschool outdoor environment is a natural component in land use issues as well as certain components are included in mandatory occupational safety inspection rounds.

Other municipalities in Stockholm County, City of Malmö, and other parts of Sweden start to follow suit, following a recommendation by the National Board of Housing, Building and Planning (Boverket) as a consequence of amongst others this project.

Funding from the Research Council Formas

Collaborators

  • Cecilia Boldemann, Department of Public Health Sciences, KI
  • Andreas Fröberg, Peter Pagels, Anders Raustorp, the University of Gothenburg and Linnaeus University
  • Fredrika Mårtensson, the Swedish University of Agricultural Sciences
  • Margareta Söderström, the Universities of Lund and Copenhagen
  • Robin Moore, Nilda Cosco and Brad Bieber, North Carolina State University.

Publications

Boldemann C, Söderström M, Mårtensson F, Moore R, Cosco N, Bieber B, Pagels P, Raustorp A, Wester U. The Health-Promoting Potential of Preschool Outdoor Enviroments: Linking Research to Policy. In: Revisiting “Social Factors”. Advancing Research into People and Place. Eds: Lindsay G and Morhayim L. Cambridge Scholars Publishing, 2015.

The quality of the outdoor environment influences childrens health -- a cross-sectional study of preschools.
Söderström M, Boldemann C, Sahlin U, Mårtensson F, Raustorp A, Blennow M
Acta Paediatr. 2013 Jan;102(1):83-91

Accelerometer measured level of physical activity indoors and outdoors during preschool time in Sweden and the United States.
Raustorp A, Pagels P, Boldemann C, Cosco N, Söderström M, Mårtensson F
J Phys Act Health 2012 Aug;9(6):801-8

Comparison of pedometer and accelerometer measures of physical activity during preschool time on 3- to 5-year-old children.
Pagels P, Boldemann C, Raustorp A
Acta Paediatr. 2011 Jan;100(1):116-20

Preschool outdoor play environment may combine promotion of children's physical activity and sun protection. Further evidence from Southern Sweden and North Carolina.
Boldemann C, H. Dal H, Mårtensson F, Cosco N, Moore R, Bieber B, Blennow M, Pagels P, Raustorp A, Wester U, Söderström M. Sci Sports 2011; 26 (2) : 72-82 

Contact

Associated

Cecilia Boldemann

Organizational unit: Social Medicin
E-mail: Cecilia.Boldemann@ki.se

Kidscape II

The point of departure for the Kidscape II-study was to investigate the significance of the outdoors for the same variables at compulsory school across ages and seasons during one academic year.

Among children, the lack of physical activity (PA) is widespread, and 80-90% of all skin cancers depend on overexposure to ultraviolet (UV) radiation in early life. The combination of sufficient PA and suberythemal UV exposure dispersed over the day is vital to general wellbeing and bone health.

In Western societies children increasingly spend most of the workday sitting indoors during long regulated schooldays which may have implications for sustainable health benefits like bone growth and a healthy body weight. Studies have shown that outdoor stay is a strong predictor of primary school children's physical activity.

There is evidence that from an early age physical activity is related to physical capacity, improved motor skills, quality of life and self-esteem, as well as reduction of common diseases such as cardiovascular disease and osteoporosis. One obstacle of outdoor stay may be hazardous exposure to UV radiation from the sun.

The aim of this project is to investigate the combined impact upon physical activity and UV exposure in schoolchildren across different ages and seasons in schools with a different set-up of play settings.

Funding from the Research Council Formas

Collaborators

  • Cecilia Boldemann, Department of Public Health Sciences, KI
  • Anders Raustorp, Peter Pagels, and Andreas Fröberg, University of Gothenburg and Linnaeus University
  • Fredrika Mårtensson, Swedish University of Agricultural Sciences
  • Margareta Söderström, Universities of Lund and Copenhagen

Publications

Levels of physical activity during physical education lessons in Sweden.
Fröberg A, Raustorp A, Pagels P, Larsson C, Boldemann C
Acta Paediatr. 2017 Jan;106(1):135-141

Suberythemal Sun Exposures at Swedish Schools Depend on Sky Views of the Outdoor Environments - Possible Implications for Pupils' Health.
Pagels P, Wester U, Söderström M, Lindelöf B, Boldemann C
Photochem. Photobiol. ;92(1):201-7

Compulsory School In- and Outdoors-Implications for School Children's Physical Activity and Health during One Academic Year.
Pagels P, Raustorp A, Guban P, Fröberg A, Boldemann C
Int J Environ Res Public Health 2016 07;13(7):

Physical activity decreased by a quarter in the 11- to 12-year-old Swedish boys between 2000 and 2013 but was stable in girls: a smartphone effect?
Raustorp A, Pagels P, Fröberg A, Boldemann C
Acta Paediatr. 2015 Aug;104(8):808-14

A repeated measurement study investigating the impact of school outdoor environment upon physical activity across ages and seasons in Swedish second, fifth and eighth graders.
Pagels P, Raustorp A, De Leon A, Mårtensson F, Kylin M, Boldemann C
BMC Public Health 2014 Aug;14():803

Contact

Associated

Cecilia Boldemann

Organizational unit: Social Medicin
E-mail: Cecilia.Boldemann@ki.se

School Grounds Intervention

This project began in 2010 as a result of Malmö city’s Green School Grounds initiative which involved the redevelopment and greening of two school grounds in Malmö. The longitudinal character of school ground greening requires follow-up study after some time had passed and the greenery had become more established, before drawing further conclusions on the effects of school ground greening.

The aim of the project is to continue with the work started in the previous study, with a focus on analysing the data collected in order to see how schoolyard design as a whole and the presence of vegetation affects children’s activity and use of their schoolyard.

Funding from the City of Malmö

Publications

The role of greenery for physical activity play at school grounds .
Martensson F, Jansson M, Johansson M, Raustorp A, Boldemann C. 
Urban Forestry & Urban Greening 2014; 13(1):103-113

Contact

Associated

Cecilia Boldemann

Organizational unit: Social Medicin
E-mail: Cecilia.Boldemann@ki.se

The How to Act Project

This project aims to explore sedentariness and physical activity among children and adolescents in a deprived housing area and to elucidate means of empowerment for healthy living in this target group.

Funding from University of Gothenburg (PhD student Andreas Fröberg)

Publications

Accelerometer-measured physical activity among adolescents in a multicultural area characterized by low socioeconomic status.
Fröberg A, Larsson C, Berg C, Boldemann C, Raustorp A
Int J Adolesc Med Health 2016 Aug;30(3):

Contact

Associated

Cecilia Boldemann

Organizational unit: Social Medicin
E-mail: Cecilia.Boldemann@ki.se

A novel technique with artificial intelligence to assess physical activity, sitting and screen-time behavior

The overreaching aim of this project is to develop and validate artificial intelligence technique machine learning algorithms for accelerometer data to assess different modalities of physical activity and sedentary behavior in children and adults.

Funding from VR

Public Engagement

Collaborators: KI, KTH and the private motion intelligence company Imagimob.

Publications

Accelerometer-Measured Versus Self-Reported Physical Activity Levels and Sedentary Behavior in Women Before and 9 Months After Roux-en-Y Gastric Bypass.
Berglind D, Willmer M, Tynelius P, Ghaderi A, Näslund E, Rasmussen F
Obes Surg 2016 07;26(7):1463-70

Levels and Patterns of Objectively Measured Physical Activity and Sedentary Time in 4-Year-Old Swedish Children.
Berglind D, Hansson L, Tynelius P, Rasmussen F
J Phys Act Health 2017 02;14(2):117-122

Contact

Associated

Daniel Berglind

Organizational unit: Social Medicin
E-mail: Daniel.Berglind@ki.se

A dissonance-based psychosocial intervention study to improve quality of life, eating behaviour, physical activity and sedentary time in women after Roux-en-Y gastric bypass surgery

The overreaching goal of the RCT is to find ways of optimizing the outcome after Roux-en-Y gastric bypass surgery, not only in terms of weight loss, but also and primarily in terms of health-related quality of life, eating behaviour, body esteem, social adjustment, physical activity (PA) and sedentary time.

Collaborators: 

  • Daniel Berglind, Department of Public Health Sciences, KI
  • Fanny Sellberg, Department of Public Health Sciences, KI
  • Sofie Possmark, Department of Public Health Sciences, KI
  • Mikaela Willmer, Department of health and caring sciences, University of Gävle
  • Ata Ghaderi, Department of Clinical Neuroscience, KI

Publications

A dissonance-based intervention for women post roux-en-Y gastric bypass surgery aiming at improving quality of life and physical activity 24 months after surgery: study protocol for a randomized controlled trial.
Sellberg F, Possmark S, Ghaderi A, Näslund E, Willmer M, Tynelius P, et al
BMC Surg 2018 May;18(1):25

Contact

Associated

Daniel Berglind

Organizational unit: Social Medicin
E-mail: Daniel.Berglind@ki.se

An observational study to investigate the effect of maternal Roux-en-Y-gastric bypass on the families’ physical activity, sedentary time, eating behaviour and psychosocial outcomes

The study includes women with a large weight loss induced by obesity surgery and their spouses and children. Several outcome measures such as physical activity, sedentary time, eating behaviour, body-esteem, self-concept, sleep quality, depression and anxiety has been measured and evaluated during several follow ups, up to five years after surgery.

The overall aim was to see how Roux-en-Y gastric bypass surgery and its consequences could affect the whole family, not only with focus on weight loss. After surgery the patients need to change their life style and can only eat small portions and usually not to fat or sugary beverages which all together with the change of anatomy from surgery leads to massive weight loss.

Some of the women have also participated in qualitative interviews to explore their experiences and perceptions of physical activity after surgery.

Collaborators: 

  • Daniel Berglind, Department of Public Health Sciences, KI
  • Fanny Sellberg, Department of Public Health Sciences, KI
  • Sofie Possmark, Department of Public Health Sciences, KI
  • Mikaela Willmer, Department of health and caring sciences, University of Gävle
  • Ata Ghaderi, Department of Clinical Neuroscience, KI

Publications

Longitudinal assessment of physical activity in women undergoing Roux-en-Y gastric bypass.
Berglind D, Willmer M, Eriksson U, Thorell A, Sundbom M, Uddén J, et al
Obes Surg 2015 Jan;25(1):119-25

Changes in BMI and psychosocial functioning in partners of women who undergo gastric bypass surgery for obesity.
Willmer M, Berglind D, Thorell A, Sundbom M, Uddén J, Raoof M, et al
Obes Surg 2015 Feb;25(2):319-24

Children's weight status, body esteem, and self-concept after maternal gastric bypass surgery.
Willmer M, Berglind D, Tynelius P, Ghaderi A, Näslund E, Rasmussen F
Surg Obes Relat Dis ;11(4):927-32

Changes in eating behaviour and food choices in families where the mother undergoes gastric bypass surgery for obesity.
Willmer M, Berglind D, Tynelius P, Ghaderi A, Näslund E, Rasmussen F
Eur J Clin Nutr 2016 Jan;70(1):35-40

Four years' follow-up changes of physical activity and sedentary time in women undergoing roux-en-Y gastric bypass surgery and appurtenant children.
Sellberg F, Willmer M, Tynelius P, Berglind D
BMC Surg 2017 Dec;17(1):133

Accelerometer-Measured Versus Self-Reported Physical Activity Levels and Sedentary Behavior in Women Before and 9 Months After Roux-en-Y Gastric Bypass.
Berglind D, Willmer M, Tynelius P, Ghaderi A, Näslund E, Rasmussen F
Obes Surg 2016 07;26(7):1463-70

Change in Children's Self-Concept, Body-Esteem, and Eating Attitudes Before and 4 Years After Maternal RYGB.
Sellberg F, Ghaderi A, Willmer M, Tynelius P, Berglind D
Obes Surg 2018 Oct;28(10):3276-3283

Women undergoing Roux-en-Y Gastric Bypass surgery: Family resemblance in pre- to postsurgery physical activity and sedentary behavior in children and spouses.
Berglind D, Willmer M, Tynelius P, Ghaderi A, Näslund E, Rasmussen F
Surg Obes Relat Dis ;11(3):690-6

Contact

Associated

Daniel Berglind

Organizational unit: Social Medicin
E-mail: Daniel.Berglind@ki.se