1 RAPORTTI LIIKUNTATIETEELLISESTÄ TUTKIMUSPROJEKTISTA Tutkimuksen nimi: Tracking physical activity/inactivity from childhood and adolescence to adulthood in relation to health profiles of middle-aged adults: a 27-year follow-up study Tutkimuksen johtaja ja suorituspaikka: Xiaolin Yang, Risto Telama, Mirja Hirvensalo, Olli Raitakari and Jorma Viikari LIKES-Research Center for Sport and Health Sciences, Jyväskylä Opetusministeriöltä saatu rahoitus tutkimukseen yhteensä ( ): Tutkimuksen alkamis- ja päättymisajankohta: TUTKIMUKSEN TIETEELLISET TULOKSET: - Tutkimuksen tieteenala ja tavoite - Keskeiset tieteelliset tulokset ja julkaisut. - Tutkimuksen vaikutukset liikuntatieteellisesti ja tieteenalan kannalta: Implementation and proceeding of the research As a part of the Cardiovascular Risk in Young Finns Study the project has proceeded according to the original plan. The main task has been the development of longitudinal and multidisciplinary models explaining physical activity and its relations to health-related factors (i.e. obesity, cardiovascular risk, and metabolic syndrome) from childhood to adulthood. During the three years ( ), the following research questions have been formulated and studied. 1) The longitudinal effects of physical activity on obesity Youth physical activity had an indirect effect on overweight and obesity though the maintenance of physical activity in adulthood. The changes in physical activity were also associated with obesity or overweight. Both decreasingly active and persistently inactive subjects were more likely to be obese than persistently active adults. 2) The longitudinal effects of physical activity on the risk and prevalence of MetS High physical activity in young adulthood was related with low risk and prevalence of MetS 9 years later, and persistent physical activity and increasing physical activity during 9 years were related with low MetS risk and prevalence. This means that physically active lifestyle may prevent or delay MetS in young adulthood. 3) The effects of sustained intensive youth sport participation on cardiovascular health in adulthood Adults who had participated persistently in intensive youth sport during 3 years had lower prevalence and risk of MetS than non-athletes and those who had dropped out from sport. Participation in sustained organized youth sport is associated with reduced the risk of MetS in adulthood. 4) Determinants of adult physical activity in youth and in adulthood Youth physical activity, leadership dimension of Type A behavior, and attention paid to personal health habits were the best predictors of adult physical activity. Education, occupational status, and living environment (urban rural) were also related to adult physical activity. Enhancing youth physical activity plays an important role in the promotion of physical activity and health in the general population. 5) Type A personality as a longitudinal predictor of life-course habitual physical activity High leadership component of Type A behavior predicted high level of physical activity in both sexes. Persons with high score in leadership were more often persistently active than low score persons. Leadership component is an important determinant of long-term changes in physical activity in a longitudinal perspective. 6) Tracking of physical activity from childhood to adulthood Persistent physical activity considerably increased the probability that an individual would be active in adulthood. Adult physical activity was best predicted by items connected to competitive organized sport and intensive activity at young age. Regular and persistent participation in youth sports increased remarkably the probability to be physically active in adulthood, particularly in men. The intensive, regular and persistent participation is more important than the sport
2 event participated. Enhancement of physical activity in childhood and adolescence is of great importance for the promotion and improvement of public health. 7) Pedometer determined physical activity in Finnish adults In physical activity was also assessed with pedometers. The participants took approximately 7500 total steps per day during winter months. Step counts included approximately 1900 aerobic steps per day gathered in bouts of at least ten minutes continuous ambulatory activity. Significant differences were noted by sex, occupation, and the day of week. Women had more total steps than men. Although participants had higher mean total steps on weekdays than on weekend days, they took more aerobic steps on weekend days than weekdays. High level non manual work, and unemployment were associated with having fewer total steps, but high level non-manual workers had more aerobic steps than other occupation groups. One quarter of men and one fifth of women were considered as sedentary based on the number of daily total steps (<5,000 steps per day) and 20% of women and 15% of men would be classified as active (>10,000 steps per day). Pedometer assessment increases the reliability and validity of physical activity data and gives new information about participants physical activity. Furthermore, in the latest data collection of the Young Finns Project during , the preliminary analyses have been done in the following. A new index of leisure time physical activity has been computed. A new index of computing physical activity has been computed. A new index of household activities has been computed. Tracking of physical activity from 1980 (aged 3-18) to 2007 (30-45). The patterns of change in physical activity during the life-course over 27 years. Prevalence and tracking of commuting physical activity (biking and walking to school and to job) from youth to adulthood. Youth sports activities as a predictor adult physical and job strain after 27 years. In addition to the problems above, LIKES researchers have participated in the study of many other problems in the Yang Finns Study as representatives of Sport Science. Postgraduate studies undertaken in the research team A PhD candidate student (Irinja Lounassalo) has been accepted to participate in the research project. Publishing Referee articles Yang X, Telama R, Hirvensalo M, Viikari JSA, Raitakari OT. Sustained participation in youth sport decreases metabolic syndrome in adulthood. Int J Obes 2009; 33: Yang X. Sustained physical activity and metabolic syndrome. Invited commentary for the International Atherosclerosis Society (IAS) Website (www.athero.org), July 2009: 1-4. Yang X, Telama R, Hirvensalo M, Mattsson N, Viikari JSA, Raitakari OT. The longitudinal effects of physical activity history on metabolic syndrome. Med Sci Sports Exerc 2008; 40 (8): Yang X, Telama R, Leskinen E, Mansikkaniemi K, Viikari J, Raitakari OT. Testing a model of physical activity and obesity tracking from youth to adulthood: The Cardiovascular Risk in Young Finns Study. Int J Obes Relat Metab Disord 2007; 31: Yang X, Telama R, Laakso L, Keltikangas-Järvinen L, Pulkki L. Determinants of adult physical activity: Relative importance of youth physical activity and demographic, psychological, behavioral, and environmental factors in adulthood. Acta Kinesiologiae Universitatis Tartuensis 2007; Vol. 12: Telama R, Laakso L, Nupponen H, Rimpelä A, Pere L. Secular trends in youth physical activity and parents'
3 socioeconomic status from 1977 to Pediatr Exerc Sci Nov;21(4): Telama R. Tracking of physical activity from childhood to adulthood: a review. Obes Facts. 2009;2(3): Merjonen P, Pulkki-Råback L, Puttonen S, Keskivaara P, Juonala M, Telama R, Viikari J, Raitakari O, Keltikangas- Järvinen L. Anger is associated with subclinical atherosclerosis in low SES but not in higher SES men and women. The Cardiovascular Risk in Young Finns Study. J Behav Med 2008; 31: Raitakari O, Juonala M, Rönnemaa T, Keltikangas-Järvinen L, Räsänen L, Pietikäinen M, Nutri-Kähönen N, Taittonen L, Jokinen E, Marniemi J, Jula A, Telama R, Kähönen M, Lehtimäki T, Åkerclom HK, Viikari J. Cohort profile: The Cardiovascular Risk in Young Finns Study. Int J Epidemiol 2008; 8:1-7. Puttonen, S. Kivimäki, M. Elovainio, M. Pulkki-Råback, Hintsanen, M. Vahtera, J. Telama, R. Juonala M. Viikari, J. Raitakari, O. & Keltikangas-Järvinen, L. Shift work in young adults and carotid artery intima-media thickness. The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2009;205: Juonala M, Viikari JS, Kähönen M, Taittonen L, Laitinen T, Hutri-Kähönen N, Lehtimäki T, Jula A, Pietikäinen M, Jokinen E, Telama R, Räsänen L, Mikkilä V, Helenius H, Kivimäki M, Raitakari OT. Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study. Eur Heart J 2010;31(14): Elovainio M, Pulkki-Råback L, Kivimäki M, Jokela M, Viikari J, Raitakari OT, Telama R, Keltikangas-Järvinen L. Lipid trajectories as predictors of depressive symptoms: the Young Finns Study. Health Psychol 2010;29(3): Alatupa S, Pulkki-Råback L, Hintsanen M, Ravaja N, Raitakari OT, Telama R, Viikari JSA, Keltikangas-Järvinen L. School performance as a predictor of adulthood obesity: a 21-year follow-up study. Eur J Epidemiol 2010;25(4): Yang X, Telama R, Hirvensalo M, Hintsa T, Pulkki-Råback L, Hintsanen M, Keltikangas-Järvinen L, Viikari JSA, Raitakari OT. Leadership component of Type A behavior predicted physical activity in early midlife. Int J Behav Med (accepted). Hirvensalo, M, Telama R, Schmidt MD, Tammelin T, Yang X, Magnussen CG, Viikari JSA, Raitakari OT. Daily steps among Finnish adults: variation by age, gender and socioeconomic position. Scand J Pub Health (submitted) Shiri R, Solovieva S, Husgafvel-Pursiainen K, Telama R, Yang X, Viikari J, Raitakari OT, Viikari-Juntura E. The effects of obesity and physical inactivity on non-specific and radiating low back pain: The Cardiovascular Risk in Young Finns Study. (manuscript) Oral presentations in Congress and seminar Telama R, Yang X. Physical activity along the life-course - The Young Finns Study. Life-course Consortium meeting, October 28, 2009, Helsinki, Finland Yang X, Telama R, Hirvensalo M, Viikari J.S.A, Raitakari OT. Sustained benefits of youth sport for metabolic syndrome in adulthood. 14 th European College of Sport Science, June 24-27, 2009, Oslo, Norway Yang, X Telama R, Hirvensalo M, Hintsanen M, Hintsa T, Pulkki-Råback L, Viikari JSA, Keltikangas-Järvinen L, Raitakari OT. Physical activity and job strain. Työn ja hyvinvoinnin tulevaisuus tutkimusohjelman vuosiseminaari , , Turku, Finland Hirvensalo M, Yang X, Lounassalo I, Telama R. Overview of physical activity research. LASERI symposium , Turku, Finland Telama R, Yang X, Hirvensalo M. Liikunta työ hyvinvointi (Physical activity Job Well-being). Work Consortium-Academy of Finland, December 19, 2008 Turku, Finland. Yang X, Telama R. Longitudinal and secular trends in moderate-vigorous physical activity among Finns from 1986 to The ICSEMIS2008 Congress, August 1-5, 2008, CD-rom. Guangzhou, China Yang X. Tracking of organized and unorganized sports activities and health: The Cardiovascular Risk in Young Finns Study. China-Finland Colloquium on Sport Sciences, July 28-29, 2008, Guangzhou, China
4 Yang X, Telama R, Hirvensalo M, Viikari J.S.A, Raitakari OT. Increase in leisure-time physical activity over 9 years decreases the risk of metabolic syndrome in young adults. 13 th European College of Sport Science, July 9-12, 2008, p Estoril, Portugal Telama R, Yang X, Hirvensalo M, Raitakari OT. Youth sport participation as a basis for a physically active lifestyle and health. 13 th European College of Sport Science, July 9-12, 2008, p Estoril, Portugal Yang X, Telama R, Hirvensalo M. Effects of youth sport participation on adult physical activity and health a 21-year follow-up study. Abstract in Science for Success II 2007 Congress Book, October 10-12, 2007, p Jyväskylä, Finland Yang X, Telama R, Hirvensalo M. Type A factors as predictors of physical activity in young Finns A 18-year followup study. 12 th European College of Sport Science, July 11-14, 2007, p Jyväskylä, Finland Yang X, Telama R, Hirvensalo M, Viikari J, Raitakari O. Effects of physical activity tracking on the metabolic syndrome in young adults. Satellite Symposium of the EAS 76 th Congress, June 8-9, 2007, Turku, Finland Other reports Hirvensalo M, Telama R, Tammelin T, Yang X, Viikari J, Raitakari O. Suomalaisten naisten arjessa enemmän askeleita kuin miehilla. Liikunta & Tiede 2010; 47(4): Telama R, Yang X, Hirvensalo M. Nuorisourheilusta vauhtia aktiiviseen elämäntapaan. Liikkuva Lapsi 2007;1: Nuorena harrastettu liikunta ehkäisee työstressiä aikuisiällä. DYSFASIA, 2010;3:20. Nuorena harrastettu liikunta ehkäisee työstressiä. BODAUS, 2010;5:31. Työstressi aikuisena. Aktiivinen lapsi välttyy työstressiltä. KESKISUOMALAINEN/26 - World Sport for All, Lasten liikunta. Vaikutukset yltävät aikuisuuteen saakka. KESKISUOMALAINEN/2 - Pääkirjoitus, SVT Uutiset: nuorena haraastettu liikunta... tutkimus: interview by Sveriges Television Uutiset (svt.se/uutiset) and showing in Sweden on Wednesday The social significance of the study The social significance of research work depends, among other things, on the quality of the research and on the information dissemination of the results. The Cardiovascular Risk of Young Finns Study has an excellent opportunities to produce new scientific information of high quality because it is 1) a longitudinal study with 27 follow-up years, 2) includes six age cohorts in representative sample, 3) is multi-disciplinary study covering all most important scientific areas relevant for the research of cardiovascular disease (CVD). Because of the long follow-up time, 27 years, it is possible to study the development of CVD from early childhood to middle age and to investigate the influence of different individual and environmental variables in various phases of life. Life-course habitual physical activity is an important and independent risk factor of several chronic diseases. No longterm studies exist that support or reject the notion that physical activity during childhood and adolescence is beneficial to adult health. In particular, it is essential to identify how much and what kind of physical activity is needed in youth in order to maintain physically active lifestyle and health as they reach young and middle adulthood. It is also possible to examine effects of a sedentary lifestyle on long-term health. Therefore, the study had unique opportunities to investigate physical activity patterns, socio-demographics, psychological, genetic, biological, environmental and health-related factors that all are interesting from epidemiological and public health perspectives. The study produced new information about physical activity in youth and in young adulthood and its impact on active lifestyle and health in early midlife. The results provided further evidence base for physical activity guidelines for children and adolescents: how much and what kind of physical activity is needed in order to enhance lifelong physical activity and health in adulthood. Pedometers were incorporated in the 2007 Young Finns Study for objective assessment of physical activity. This is the first time that objective physical activity data are available on adult population-based Finnish samples. The use of pedometers allows researchers to measure total physical activity, including light intensity and unstructured activities, which may be a better predictor of health outcomes than structured activity alone. The pedometer data in this study provided objective information about physical activity in different environments, social groups and during week days and week-end days. The results of the Young Finns Study have been mainly published in the high quality scientific journal but in addition to that, we have reported results also in congresses and seminars, and in more popular form in Finnish language to
5 promote information dissemination outside scientific community. Our main message to governmental level decision makers is that it is really worth of investing in children s and adolescents physical activity and sport. This is not a new message. What is new in our message is that our statement is based on valid and reliable research results which show in a very concrete way how important youth physical activity is for the adult activity and health. Our message for the grass root level decision makers and workers is that persistent physical activity lasting many years at young age can be very important for the public health. People working with children and adolescents in schools, clubs and associations are in key position in promotion active life style and public health, but only so if they are willing and able to enhance children s intrinsic motivation and positive attitude towards learning and doing physical activities. The results of our study should be a core content of the in-service training courses of school teachers and coaches of young people. Our results open a new perspective to drop out problem of youth sport. The main problem in drop out is not a possibility to loose potential talents but missing a good opportunity to enhance young people s future active lifestyle. Because one reason for drop out is a lack of opportunities to participate in competitive sport without heavy emphasis on winning, also sport management people should consider our results and put more efforts on organising more facilities and opportunities for participation.