Physical activity, nutrition and stress response in young adults born preterm - determinants of health and disease The Helsinki Study of Very Low Birth Weight Adults
Year: 2014
Type: dissertation
Study design: Observational Study
Abstract: Advancements in neonatal care are resulting in increasing numbers of adult survivors after preterm birth at very low birth weight (VLBW, ≤ 1500 g). VLBW is associated with risk factors of non-communicable diseases, e.g. cardiovascular disease, osteoporosis and diabetes. We investigated mechanisms underlying the effects of preterm birth on later health in VLBW adults, with a focus on 1) physical activity, 2) nutrition and 3) stress response. The participants come from a follow-up cohort study, the Helsinki Study of Very Low Birth Weight Adults. Different subgroups from the original birth cohort (born in 1978-1985) have as young adults participated in the studies of this thesis. The controls, born at term, were group-matched for birth hospital, age and sex. We evaluated physical activity by self-report and objective measurement. The participants completed a physical activity questionnaire and underwent wrist-worn accelerometer measurement. To assess dietary intake, the participants completed a 3-day food record. For evaluation of stress response, the participants underwent the Trier Social Stress Test (TSST). In conjunction with TSST, we measured heart rate, salivary cortisol, plasma ACTH, cortisol, glucose, insulin, adrenalin and noradrenalin. 1) Based on self-report, healthy VLBW adults undertake approximately 50% less conditioning leisure-time physical activity, with lower yearly frequency, total time, total volume and energy expenditure than controls. We were unable to confirm our finding of lower physical activity with wrist-worn accelerometer measurement. 2) VLBW adults had lower consumption of vegetables, fruits, berries and milk products. This was combined with lower intake of calcium and vitamin D. 3) VLBW adults showed a lower hypothalamic-pituitary-adrenal axis (HPAA) response to stress than controls. This was accompanied by a lower insulin response. No evidence of a higher sympathetic-adrenal-medullary (SAM) system stress response was found. Furthermore, we observed a lower noradrenalin response to stress in VLBW women. This study showed that VLBW adults undertake less conditioning leisure-time physical activities and have unhealthier diets, both factors that negatively affect future health in this high-risk population. They may in part underlie the increased risk for chronic non-communicable diseases in VLBW individuals. Further, a lower HPAA response to stress was found in VLBW adults than in controls. For SAM stress response, the results were similar in VLBW and control groups, with lower noradrenalin response to stress in VLBW women only. These findings reinforce the supposition that stress response is programmed early in life. In sum, this study increased understanding of possible mechanisms linking preterm birth and adult risk of disease.
Source: Työväentutkimus Vuosikirja
Author: Nina Kaseva
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1588514398