The UKK Institute for Health Promotion Research

Tampere, Finland

The UKK Institute for Health Promotion Research

Tampere, Finland
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Slotte S.,The UKK Institute for Health Promotion Research | Slotte S.,University of Jyväskylä | Saakslahti A.,University of Jyväskylä | Metsamuuronen J.,University of Helsinki | Rintala P.,University of Jyväskylä
Early Child Development and Care | Year: 2015

Objective: The main aim was to examine the association between fundamental movement skills (FMS) and objectively measured body composition using dual energy X-ray absorptiometry (DXA). Methods: A study of 304 eight-year-old children in Finland. FMS were assessed with the Test of gross motor development, 2nd ed. Total body fat percentage (BF%), abdominal region fat percentage (AF%) and fat-free mass (FFM) were assessed by DXA. Waist circumference, height and weight were measured, and International Obesity Task Force cut-off values for body mass index were used for the definition of healthy weight and overweight/obesity. Results: Better FMS proficiency (object control, locomotor and total FMS) was significantly and strongly associated with lower BF% and lower AF% measured with DXA. Conclusions: The inverse association between FMS and body composition measured with DXA (BF% and AF%) is an important finding, as body fatness and specifically abdominal fatness are associated with less favourable cardiovascular risk factor status in children. © 2014, © 2014 Taylor & Francis.


Heikkinen A.,University of Turku | Alaranta A.,University of Turku | Helenius I.,University of Turku | Vasankari T.,Finnish National Institute for Health and Welfare | Vasankari T.,The UKK Institute for Health Promotion Research
Journal of the International Society of Sports Nutrition | Year: 2011

Background: The aim of this study was to assess the frequency of use of dietary supplements (DS) among large sample of elite Finnish athletes and to describe possible changes in dietary supplement use between the years 2002 and 2009.Methods: A prospective follow-up study was conducted on Olympic athletes. The first survey was conducted on Olympic athletes in 2002 (N = 446) and the follow-up study was conducted between May 2008 and June 2009 (N = 372).Results: In 2002, a total of 81% of the athletes used dietary supplements (a mean of 3.37 ± 3.06 DS per user) and in 2009, a total of 73% of the athletes (a mean of 2.60 ± 2.69 per DS user) used them. After adjusting for age-, sex- and sport type, the OR (95% confidence interval, CI) for use of any dietary supplement was significantly less in 2009 as compared with 2002 results (OR, 0.62; 95% CI, 0.43-0.90). Decrease in DS use was observed in all supplement subgroups (vitamins, minerals, nutritional supplements). Athletes in speed and power events and endurance events reported use of any dietary supplement significantly more often than team sport athletes both in 2002 and 2009. In year 2009, the frequency of all dietary supplement use increased when athlete's age increased and the increase was significant in older age groups: of the athletes under 21 years 63%, 21-24 years 83% and over 24 years 90% consumed nutritional supplements.Conclusions: Based in our study, there seems to be a lowering trend of dietary supplement use among elite Finnish athletes although differences between sport subgroups and age groups are considerable. © 2011 Heikkinen et al; licensee BioMed Central Ltd.


Jarvinen T.L.N.,University of Helsinki | Michaelsson K.,Uppsala University | Aspenberg P.,Linköping University | Sievanen H.,The UKK Institute for Health Promotion Research
Journal of Internal Medicine | Year: 2015

Current prevention strategies for low-trauma fractures amongst older persons depend on the notions that fractures are mainly caused by osteoporosis (pathophysiology), that patients at high risk can be identified (screening) and that the risk is amenable to bone-targeted pharmacotherapy (treatment). However, all these three notions can be disputed. Pathophysiology: Most fracture patients have fallen, but actually do not have osteoporosis. A high likelihood of falling, in turn, is attributable to an ageing-related decline in physical functioning and general frailty. Screening: Currently available fracture risk prediction strategies including bone densitometry and multifactorial prediction tools are unable to identify a large proportion of patients who will sustain a fracture, whereas many of those with a high fracture risk score will not sustain a fracture. Treatment: The evidence for the viability of bone-targeted pharmacotherapy in preventing hip fracture and other clinical fragility fractures is mainly limited to women aged 65-80 years with osteoporosis, whereas the proof of hip fracture-preventing efficacy in women over 80 years of age and in men at all ages is meagre or absent. Further, the antihip fracture efficacy shown in clinical trials is absent in real-life studies. Many drugs for the treatment of osteoporosis have also been associated with increased risks of serious adverse events. There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20-25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment. © 2015 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of The Association for the Publication of the Journal of Internal Medicine.


Karinkanta S.,The UKK Institute for Health Promotion Research | Kannus P.,The UKK Institute for Health Promotion Research | Kannus P.,University of Tampere | Uusi-Rasi K.,The UKK Institute for Health Promotion Research | And 2 more authors.
Age and Ageing | Year: 2015

Background and objective: previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this followup study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures. Design: five-year health-care register-based follow-up study after a 1-year, four-arm RCT. Setting: community-dwelling older women in Finland. Subjects: one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning. Methods: participants' health-care visits were collected from computerised patient register. An injurious fall was defined as an event in which the subject contacted the health-care professionals or was taken to a hospital, due to a fall. The rate of injured fallers was assessed by Cox proportional hazards model (hazard ratio, HR), and the rate of injurious falls and fractures by Poisson regression (risk ratio, RR). Results: eighty-one injurious falls including 26 fractures occurred during the follow-up. The rate of injured fallers was 62% lower in COMB group compared with the controls (HR 0.38, 95% CI 0.17 to 0.85). In addition, COMB group had 51% less injurious falls (RR 0.49, 95% CI 0.25 to 0.98) and 74% less fractures (RR 0.26, 95% CI 0.07 to 0.97). Conclusions: home-dwelling older women who participated in a 12-month intensive multi-component exercise training showed a reduced incidence for injurious falls during 5-year post-intervention period. Reduction in fractures was also evident. These long-term effects need to be confirmed in future studies. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.


Sievanen H.,The UKK Institute for Health Promotion Research | Karinkanta S.,The UKK Institute for Health Promotion Research | Moisio-Vilenius P.,Koukkuniemi Home for the Elderly | Ripsaluoma J.,Rauhaniemi Hospital
Aging Clinical and Experimental Research | Year: 2014

Background and aims Whole-body vibration (WBV) training may offer an efficient option to improve physical performance of nursing home residents, but the feasibility of WBV training among frail elderly who require continuous institutional care is still open. Methods Fifteen nursing home residents (mean age 84 years) with low physical performance (mean SPPB score 3.7) participated in this blinded, randomized controlled pilot trial. The intervention was either a 10 week, twice-a-week progressive vibration training with slight exercises done on a side-alternating device or similar sham training without vibration. Physical performance was assessed with Short Physical Performance Battery (SPPB), Timed Up and Go, walk speed and grip strength tests. Results Low 12 Hz frequency was well tolerated with mean 95 % compliance in contrast to higher 18 Hz (or 26 Hz) frequency, which was poorly (<30 %) tolerated. While treatment effects were not significant, the mean change in SPPB score was 0.4 (range from -2 to +4) in the WBV group in contrast to -0.1 (from -3 to +3) in the sham group. Discussion and conclusion Frail nursing home residents form not only a potential but also challenging target group for physical rehabilitation with WBV. Side-alternating WBV training performed at low 12 Hz frequency was found generally feasible, whereas higher frequencies appeared formidable. Nevertheless, it is possible that physical performance of some frail elderly without contraindications to WBV can be improved with this type of rapidly executable physical training. © 2014 Springer International Publishing Switzerland.


Kantele S.,University of Tampere | Karinkanta S.,The UKK Institute for Health Promotion Research | Sievanen H.,The UKK Institute for Health Promotion Research
Journal of the neurological sciences | Year: 2015

BACKGROUND: This meta-analysis evaluated feasibility and efficacy of long-term whole-body vibration (WBV) training in improving mobility of multiple sclerosis (MS) patients.METHODS: The primary search of this meta-analysis was conducted from four electronic databases (PubMed, Sport, CINAHL and Cochrane) in order to find all relevant randomized, controlled WBV intervention trials of MS patients published between January 2000 and October 2013. The primary search was complemented by a recent (Aug 2015) PubMed search. Data on patients' characteristics and type of WBV intervention were extracted from the published reports and supplementary material. Two researchers independently assessed the methodological quality of these studies and outcomes. Standardized mean differences based on the baseline-adjusted follow-up results were calculated as indicators of the effect size (ES) of WBV training.RESULTS: Seven randomized controlled trials (RCTs) involving 250 MS patients were found. Relevant group-based data for analysis were available from 109 patients in WBV groups and from 100 control patients; 41 patients withdrew from the studies. Quality assessment revealed that the WBV training protocols were heterogeneous and the methodological quality of the studies was generally poor. We found borderline indication for improved 2-6 min walking endurance [ES=0.25 (95% CI=-0.06-0.0.55)] favoring WBV training whereas no benefits were indicated for short-distance (20m or less) walking speed or balance.CONCLUSION: This meta-analysis suggests that WBV training has potential in improving walking endurance in MS patients with low disability status. However, evidence for more severely disabled MS patients is lacking, and further well-designed, long-term RCTs with adequate sample sizes are needed. Copyright © 2015 Elsevier B.V. All rights reserved.


Sievanen H.,The UKK Institute for Health Promotion Research | Karinkanta S.,The UKK Institute for Health Promotion Research | Moisio-Vilenius P.,The UKK Institute for Health Promotion Research | Ripsaluoma J.,The UKK Institute for Health Promotion Research
Aging clinical and experimental research | Year: 2014

BACKGROUND AND AIMS: Whole-body vibration (WBV) training may offer an efficient option to improve physical performance of nursing home residents, but the feasibility of WBV training among frail elderly who require continuous institutional care is still open.METHODS: Fifteen nursing home residents (mean age 84 years) with low physical performance (mean SPPB score 3.7) participated in this blinded, randomized controlled pilot trial. The intervention was either a 10 week, twice-a-week progressive vibration training with slight exercises done on a side-alternating device or similar sham training without vibration. Physical performance was assessed with Short Physical Performance Battery (SPPB), Timed Up and Go, walk speed and grip strength tests.RESULTS: Low 12 Hz frequency was well tolerated with mean 95 % compliance in contrast to higher 18 Hz (or 26 Hz) frequency, which was poorly (<30 %) tolerated. While treatment effects were not significant, the mean change in SPPB score was 0.4 (range from -2 to +4) in the WBV group in contrast to -0.1 (from -3 to +3) in the sham group.DISCUSSION AND CONCLUSION: Frail nursing home residents form not only a potential but also challenging target group for physical rehabilitation with WBV. Side-alternating WBV training performed at low 12 Hz frequency was found generally feasible, whereas higher frequencies appeared formidable. Nevertheless, it is possible that physical performance of some frail elderly without contraindications to WBV can be improved with this type of rapidly executable physical training.


Kinnunen T.I.,University of Tampere | Luoto R.,The UKK Institute for Health Promotion Research | Luoto R.,Finnish National Institute for Health and Welfare | Helin A.,University of Tampere | Hemminki E.,Finnish National Institute for Health and Welfare
Maternal and Child Nutrition | Year: 2016

Observational studies suggest that high iron intake during pregnancy is associated with the risk of gestational diabetes. As such studies are prone to bias, we re-analysed data from a randomised controlled trial of iron supplementation to see whether it supports the risk found in observational studies. The trial was conducted in primary health care setting in five municipalities in Finland in 1985-1986. The participants were 2944 women (95% of pregnant women in the area) who were randomly allocated either to (1) the selective iron group (elemental iron 50mg twice a day only if diagnosed as anaemic, continuing until their haemoglobin increased to 110gL-1) or (2) the routine iron group (elemental iron 100mgday-1 throughout the pregnancy regardless of haemoglobin level). The numbers of women in the analyses were 1358 and 1336, respectively. The main outcome measure was a composite variable including any glucose intolerance-related outcome (e.g. glucosuria, gestational diabetes, large-for-gestational-age child) in mothers' or children's patient records during pregnancy and post-partum. There were no statistically significant differences in the incidence of the primary outcome between the selective iron and the routine iron groups (13.0 vs. 11.0%, P=0.12). The most common outcome was large-for-gestational-age calculated from children's hospital data (8.3 vs. 8.2%, P=0.95). The results were mainly similar when stratified by the mothers' baseline haemoglobin level, body mass index or gestational weight gain. Routine iron supplementation throughout pregnancy did not increase the risk of glucose intolerance during pregnancy. The results need to be confirmed in future trials. © 2016 John Wiley & Sons Ltd.


Patil R.,The UKK Institute for Health Promotion Research
Gerontology | Year: 2015

Background: Evidence for the effects of exercise and vitamin D supplementation on quality of life (QoL), fear of falling (FoF) and mental wellbeing in older adults is conflicting. Objective: To study the effects of vitamin D supplementation and multimodal group exercise on psychosocial functions of wellbeing, including QoL, mental wellbeing and FoF. Method: This is a 2-year, double-blind, placebo-controlled vitamin D and open exercise intervention trial with 409 older Finnish women (70-80 years of age) randomized to 4 treatment arms: (1) placebo without exercise, (2) vitamin D (800 IU/day) without exercise, (3) placebo and exercise, and (4) vitamin D (800 IU/day) with exercise. Exercisers participated in group exercise twice per week for 12 months and once per week for the subsequent 12 months, plus home exercises. Results: When comparing with the placebo without exercise group, there were no statistically significant differences between groups receiving either vitamin D, exercise or both treatments for changes in QoL or mental wellbeing (although a slight decline was seen in mental wellbeing in those receiving vitamin D only, p = 0.044). The initial slight reduction in FoF was significant in all intervention groups compared with controls (p < 0.05), but this was only temporary. Conclusion: Neither vitamin D nor exercise contributes to better QoL, FoF or mental wellbeing in community-dwelling healthy older women with sufficient vitamin D levels. © 2015 S. Karger AG, Basel Copyright © 2015, S. Karger AG. All rights reserved.


Aittasalo M.,The UKK Institute for Health Promotion Research | Raitanen J.,The UKK Institute for Health Promotion Research | Raitanen J.,University of Tampere | Kinnunen T.I.,University of Tampere | And 4 more authors.
International Journal of Behavioral Nutrition and Physical Activity | Year: 2012

Background: Women who are physically active during early pregnancy have notably lower odds of developing gestational diabetes than do inactive women. The purpose of the intervention was to examine whether intensified physical activity (PA) counseling in Finnish maternity care is feasible and effective in promoting leisure-time PA (LTPA) among pregnant women at risk of gestational diabetes.Methods: Fourteen municipalities were randomized to intervention (INT) and usual care group (UC). Nurses in INT integrated five PA counseling sessions into routine maternity visits and offered monthly group meetings on PA instructed by physiotherapists. In UC conventional practices were continued. Feasibility evaluation included safety (incidence of PA-related adverse events; questionnaire), realization (timing and duration of sessions, number of sessions missed, attendance at group meetings; systematic record-keeping of the nurses and physiotherapists) and applicability (nurses' views; telephone interview). Effectiveness outcomes were weekly frequency and duration of total and intensity-specific LTPA and meeting PA recommendation for health self-reported at 8-12 (baseline), 26-28 and 36-37 weeks' gestation. Multilevel analysis with adjustments was used in testing for between-group differences in PA changes.Results: The decrease in the weekly days of total and moderate-to-vigorous-intensity LTPA was smaller in INT (N = 219) than in UC (N = 180) from baseline to the first follow-up (0.1 vs. -1.2, p = 0.040 and -0.2 vs. -1.3, p = 0.016). A similar trend was seen in meeting the PA recommendation (-11%-points vs. -28%-points, p = 0.06). INT did not experience more adverse events classified as warning signs to terminate exercise than UC, counseling was implemented as planned and viewed positively by the nurses.Conclusions: Intensified counseling had no effects on the duration of total or intensity-specific weekly LTPA. However, it was able to reduce the decrease in the weekly frequency of total and moderate-to-vigorous-intensity LTPA from baseline to the end of second trimester and was feasibly embedded into routine practices.Trial registration: ISRCTN 33885819 (http://www.isrctn.org). © 2012 Aittasalo et al.; licensee BioMed Central Ltd.

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