Finnish Culture Research Articles

Future Finland – A nationwide Finnish multidisciplinary birth cohort initiative

Abstract Increasing evidence suggests that early-life conditions may have substantial consequences on individual health and wellbeing throughout the lifecycle. Development of complex social and health issues may be best understood through longitudinal studies that combine the perspectives of social and health sciences. Future Finland aims to collect a nationwide lifelong data resource that through collaborative multidisciplinary research will strengthen future population welfare. Future Finland will be based on index children born in Finland (43.000/year) during a specific time period. National registers and other administrative data sources will provide data for the age cohort (children), their parents and siblings, with special effort on data from more rarely used sources (e.g., electronic health records, school records). Subsets of cohort members will be recruited in early pregnancy (consent) to undergo deeper data collection through questionnaires, biological and environmental samples and measurements, and digital monitoring data (e.g., physical activity, citizens digital footprint). The Future Finland preparatory phase started in 2023 at the Finnish Institute for Health and Welfare (THL). The Future Finland design and focus areas are currently being planned based on identified information gaps and with consultations of experts from other birth cohort studies. Data collection is planned to start in 2025 by piloting and foreseen to expand to full-scale in 2027-2028. The Future Finland data resource will be made available for the entire research community as openly as possible, at the same time maintaining the highest possible data security standards to protect privacy now and in the future. Future Finland enables novel interdisciplinary research and intervention setups, which will strengthen the knowledge base for societal decision-making and promote the future population welfare. Future Finland is funded by the Finnish Cultural Foundation. Key messages • Future Finland initiative will collect a nationwide lifelong data resource enabling novel cross-disciplinary research designs to produce groundbreaking and impactful scientific results. • A larger-scale use of data enables novel interdisciplinary research and intervention setups strengthening the knowledge base for societal decision-making and promoting the future population welfare.

Maternal exercise during pregnancy is associated with reduced risk of asthma in the child: A prospective birth cohort study.

The means of primary prevention of asthma are limited. Maternal physical activity during pregnancy promotes fetal lung development and the newborn's lung function; thus, it could lower asthma risk and aid in asthma prevention. The objective of this study is to determine whether maternal physical activity during pregnancy is associated with asthma development in the child. The study population included 963 mother-infant pairs from the prospective Kuopio Birth Cohort study. Data on maternal physical activity during pregnancy, confounding factors, and children's asthma at 5 to 7 years of age were obtained from the Kuopio University Hospital birth registry and questionnaires. Maternal physical activity during pregnancy, when practiced three or more times per week, was associated with a reduced risk of asthma in the child, with an adjusted odds ratio of 0.54 (95% confidence interval 0.33-0.89; p= 0.02). The association was stable across a comprehensive set of adjustments, including length of gestation, mode of delivery, and maternal health indicators (e.g., asthma, smoking, pre-pregnancy body mass index and weight gain during pregnancy, infections, medication, healthy diet, stress), as well as various family environment variables. Maternal physical activity during pregnancy may be associated with marked protection of asthma in childhood and should be studied further as an applicable measure for asthma prevention. The study has been financially supported by grants from the Academy of Finland (no. 349427), the Emil Aaltonen Foundation, the Finnish Cultural Foundation, the Yrjö Jahnsson Foundation, the Juho Vainio Foundation (no. 202200461), the Kuopio Area Respiratory Foundation, and the Ida Montini Foundation.

The Impact of Sauna on Health

This review examines the health implications of regular sauna use, a tradition deeply rooted in Finnish culture now gaining global interest for its potential health benefits. It consolidates findings from various scientific studies, emphasizing the physiological and health impacts of traditional sauna practices on cardiovascular health, mental well-being, and overall mortality. The review highlights the positive cardiovascular outcomes associated with regular sauna use, such as reduced risks of hypertension, coronary artery disease, and sudden cardiac death, attributing these benefits to improved endothelial function, decreased arterial stiffness, and positive changes in blood pressure. Additionally, sauna bathing is shown to offer mental health benefits by reducing stress, depression, anxiety levels, and possibly lowering the risk of neurodegenerative diseases like Alzheimer's and dementia. Despite the substantial benefits, the review also acknowledges potential risks, especially for individuals with specific health conditions, underscoring the importance of hydration and caution against alcohol consumption before sauna sessions. Conclusively, the evidence supports the integration of sauna bathing into health promotion strategies, with a call for further research to explore the mechanisms underlying its health benefits and to develop guidelines for optimizing these benefits while minimizing risks. Sauna bathing emerges as a promising, non-invasive approach to enhancing overall health and well-being, warranting its consideration in complementary health practices.

The harm of normalized violence: re-identifying intimate partner violence as torture in acknowledging the stakes of abusive relationships

ABSTRACT In this article, I draw on the work of radical feminist legal scholars, who have argued for using the terminology of torture in international law as a means to take intimate partner violence (IPV) seriously and to recognize the harm of normalized violence. I explore lived experiences of IPV based on my feminist activist research, which has included co-moderating online support groups and conducting follow-up interviews with women who have been subjected to coercive control. I examine in detail the similarities between torture and IPV in terms of the purposiveness, severity, and effects of violence, and show how these were concretized in the lives of research participants. This research took place in Finland, which has been referred to as the “Nordic paradox,” as IPV is both common and normalized within Finnish culture and society and the harm of private violence is generally dismissed. I conclude that drawing these parallels could serve as a means to raise awareness of the stakes of abusive relationships and validate targets’ experiences of abuse. Moreover, focusing research on experiences of violence in a Nordic country can expand our understanding of gender-based violence in the context of feminist international relations.

Folklore сomponents of Finnish Rock Poetry

This article explores the folklore components of Finnish rock poetry in Finnish and Swedish. It highlights how Finnish rock culture has revived an ancient tradition where poetry and music were intertwined. While musicians of Amorphis reference “Kalevala” mythology in the songs like “Tuonela”, “Sampo” and “Kantele”, they do not explicitly mention the names of “Kalevala” heroes in their adaptations of runes. The themes of their lyrics seem to take on a universal quality and are set in modern times. The influence of folklore traditions on Finnish authors is evident even in their English-language works. Ville Sorvali of Moonsorrow interprets the runes, trying to understand the intention of their creators, believing that these lyrics resonate with people worldwide. Similarly, Jan Jämsen (Katla), a Swedish-speaking Finn, infuses his native Swedish lyrics for Finntroll with imagery of fantastical creatures and incorporates Sámi folk chants joik to emphasize their uniqueness. Modern Finnish rock poetry stands out for its multilingualism and references to mythological themes from Finnish and Scandinavian folk poetry. However, the resurgence of metrics and imagery from the “Kalevala” and “Kanteletar” in rock poetry was unexpected. Authors use figurative symbolism that may require a deep understanding of Finnish culture to fully appreciate, even in Englishlanguage works. Finnish rock poetry is a diverse and vibrant art form that resonates with universal themes and emotions.

Stereotypes and meta-stereotypes among Finnish Muslim- and Christian-background youth

ABSTRACT Previous empirical research on meta-stereotypes has shown that they have a great influence on intergroup relations, which makes it interesting to study interreligious meta-stereotypes in Finland – a society that has traditionally been characterised as Christian, but which today is more culturally diverse, and in which Islam is perceived as incompatible with Finnish culture. This article examines the meta-stereotypes and stereotypes held by Muslim- and Christian-background adolescents (N = 186) by defining how Muslim- and Christian-background youth perceive that the outgroup (Christians and Muslims, respectively) appraises them, and by investigating whether the shared meta-stereotypes of the outgroup reflect their stereotypes. The participants described their meta-stereotypes and stereotypes in their responses to the open-ended questions of a questionnaire. The qualitative and quantitative content analysis showed that the Christian-background youth thought that Muslims were norm-conforming and sociable, whereas the Muslim-background youth thought Christians see them as radicalised and unsociable. The Christian-background youth in turn believed that Muslims see them as infidels and intolerant, but the Muslim-background youth mostly described Christians as sociable. The findings are discussed from the Finnish societal perspective; participants are not only affiliated with different religions; they may also differ from each other in terms of status and power.

Neo-Nazi Imagery and Musical References in Finnish Far-Right Group Soldiers of Odin Online Videos

AbstractIn this article, I study three videos by the Finnish far-right grouping Soldiers of Odin and investigate their audiovisual messages, which present different ‘cultural politics of emotion’ for members and non-members of the group. Special attention is given to the concepts of nationalism, masculinity, and their intertwined meanings, which play a defining role in many neo-fascist cultures. Despite their slap-dash, DIY nature, the videos’ use of global popular culture contradicts their logic of an exclusively ‘national’ Finnish culture, as every reference has global reach. This shows that the group’s nationalism is not about Finnishness, but about a hegemonic, global, Euro-Western, white masculinist, and xenophobic culture.

Under the Radar – Expatriate Children and Integration in Finland

In policies and research, migrant children tend to be seen as underprivileged and vulnerable. This discourse ignores the more privileged migrant children, those labelled expatriates or third culture kids. Finland wants to attract skilled professionals from abroad. They are often accompanied by their children. Although the families typically intend to sojourn in the country temporarily, Finnish society tends to see them as ‘permanent immigrants’ who need to be integrated. This is visible in international schools that follow the national curriculum, including extensive Finnish language studies and exposure to Finnish culture. This article is based on an ethnographic study among expatriate children in an international school in a Finnish town. I ask how the integration aims affect the expatriate children’s lives, and how they navigate those aims. Using empirical examples, I elaborate on the contradiction between being a ‘privileged’ temporary expatriate child and being defined as an ‘underprivileged’ permanent immigrant.

Subjective Reactions to First Coitus in Relation to Participant Sex, Partner Age, and Context in a German Nationally Representative Sample of Adolescents and Young Adults.

Analysis of a Finnish nationally representative student sample found that subjective reactions to first intercourse (mostly heterosexual; usually in adolescence) were highly positive for boys and mostly positive for girls, whether involved with peers or adults (Rind, 2022). The present study examined the generality of these findings by examining subjective reactions to first coitus (heterosexual intercourse) in a German nationally representative sample of young people (data collected in 2014). Most first coitus was postpubertal. Males reacted mostly positively and uncommonly negatively in similar fashion in all age pairings: boy-girl (71% positive, 13% negative); boy-woman (73% positive; 17% negative); man-woman (73% positive, 15% negative). Females' reactions were more mixed, similar in the girl-boy (48% positive; 37% negative) and woman-man (46% positive, 36% negative) groups, but less favorable in the girl-man group (32% positive, 47% negative). In logistic regressions, adjusting for other factors, rates of positive reactions were unrelated to age groups. These rates did increase, in order of importance, when participants were male, their partners were close, they expected the coitus to happen, and they affirmatively wanted it. Reaction rates were computed from the Finnish sample, restricting cases to first coitus occurring in the 2000s, and then compared to minors' reactions in the German sample. The Finns reacted more favorably, similarly in both minor-peer and minor-adult coitus, with twice the odds of reacting positively. It was argued that this discrepancy was due to cultural differences (e.g., Finnish culture is more sex-positive). To account for the reaction patterns shown in the adolescent-adult coitus, sizably at odds with expectations from mainstream professional thinking, an evolutionary framework was employed.

Feeling Good, Living Well: The Importance of Happiness for Health

Feeling Good, Living Well: The Importance of Happiness for Health

Фразеологические единицы с компонентом «птица» в мордовских и финском языках (семантический анализ)

The purpose of the study is to identify common and distinctive features of Mordovian and Finnish phraseological units with the zoonym component “bird”. The relevance of this study is due to the need for a comprehensive study of phraseological units in order to identify common and specific features inherent in these linguistic cultures. The object of the study was the phraseological units of the Mordovian and Finnish languages, in which the zoonym component “bird” was identified. Based on the methods of descriptive, comparative, component analysis, the semantic characteristics of phraseological units are studied, dominant images are identified, universal phenomena and distinctive features in the meanings conveyed by phraseological units in the compared languages are determined. The main material of the study is presented by phraseological units with a zoocomponent, identified by continuous sampling from explanatory monolingual and bilingual dictionaries, as well as phraseological developments, texts of fiction and journalistic literature. The properties that the Mordovians and Finns attribute to poultry are in most cases similar, which is why both languages have a lot of phraseological units that coincide in meaning. In both Mordovian and Finnish cultures, the bird is considered a creature that is not very smart. The observed phenomenon is to a greater extent associated with domestic poultry, and to a lesser extent with wild birds.

Students of an International Degree Programme Go Local

This study examines the interactions and communication between a group of African university students and a local Finnish community, as discussed by local friendship family members. Studies show that ensuring the well-being of international students and their study success is challenging in a foreign country. Students tend to remain in their own groups, and interaction with native students and local society may be minimal. To support international students’ adjustment, the university unit in question organised volunteer family support. The data consist of interviews with eleven participants. Interpretation of the data is based on the applied theoretical framework of cultural communication and various types of social and emotional support. The findings reveal that the local friendship families and adult friends had international backgrounds and were interested in international issues. The interaction was an evolving process with some difficulties in communication. The process included three main approaches: accepting the students as family members, introducing them to Finnish culture and providing them with emotional and instrumental support. When asked about communication with members of the local community, most participants described the students’ encounters with local residents as friendly and beneficial, but some also used the words ‘racism’ or ‘racist’ when describing certain situations. A local network is a flexible and versatile resource for supporting international students. The results indicate that friendship families could be used more effectively and better organised as part of the support programme for international students.

Shapes of water—A multidisciplinary composing project visioning an eco-socially oriented approach to music education

This article presents a project, Shapes of Water, funded by the Finnish Cultural Foundation, which gave music education students the opportunity to compose children’s songs about climate change with the help of artists from two fields (contemporary circus and music) and a scientist (chemistry). The article outlines the ways in which the composing project challenged students’ attitudes toward composing as a method for educating children about climate change, and brings together the experiences of the artists and scientist during the project. Finally, three focus areas are presented with recommendations for a sustainable eco-socially oriented approach to music education.

Edward Dutton. The Finnuit: Finnish Culture and the Religion of Uniqueness .

Edward Dutton. The Finnuit: Finnish Culture and the Religion of Uniqueness. Budapest: Akadémiai Kiadó, 2009. Pp. 288. ISBN: 978-963-05-8731-0.

Explaining Finnish Economic and Social Success – And Happiness

This article explores the reasons behind the high economic and social rankings for Finland. It also refl ects on why Finland is considered the “happiest” country in the world (according to a World Happiness Report). Using empirical data from two studies – an article comparing high-andlow-tax countries, and the aforementioned recent World Happiness Report – it compares Finland with its Nordic neighbours and other Western, especially Anglo-American, countries. The essay outlines a so-called “Finnish model’ and looks for the roots of this model. Comparing measures in several dimensions – effort, culture, institutions, and economic and social outcomes – the essay tries to find characteristics that are particular for Finland. Education, innovation, and economic security, as well as trust, gender equality, resilient conflict solutions, and geo-historical luck, are crucial to Finland’s success. Three notable Germans – Luther, Hegel, and Marx – have influenced Finnish culture and society in different ways. Is Finland the country that comes closest to the ideal – “From each according to his ability, to each according to his needs” (Marx, 1875).

Cumulative dyslipidaemia from mid-adolescence through young adulthood with carotid intima-media thickness progression: a 9-year longitudinal study

Abstract Background Carotid intima-media thickness (cIMT) progression was recently established as a predictor of cardiovascular events among adults. To date, a single cIMT measure has largely been used as a marker of preclinical atherosclerotic changes in the young population and dyslipidaemia has been associated with single measured cIMT. The longitudinal relationship between dyslipidaemia and repeated measure of cIMT in a large apparently healthy young population remains unknown. Purpose To investigate the longitudinal associations of total cholesterol (TC), non–high-density lipoprotein cholesterol (non–HDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, and low-density lipoprotein cholesterol (LDL-C) with cIMT progression in adolescence. Methods We studied 1779 British 15-year-olds (50% females) followed up for 9 years. TC, triglyceride, and HDL-C were measured in line with standard protocols at ages 15, 17, and 24 years, respectively. LDL-C and non-HDL-C were estimated. Lipid phenotypes were categorized based on the 2011 National Heart, Lung, and Blood Institute classification into normal (reference), elevated, and dyslipidaemia. cIMT from the right and left common carotid arteries at 17 years was assessed by ultrasound using a linear 12-MHz transducer and cIMT from the right and left common carotid arteries at 24 years was measured using an ultrasound machine (CardioHealth Panasonic and a 13.5 MHz linear array broadband transducer (probe; centre frequency 9.0 MHz). We conducted linear mixed-effect model analyses and adjusted for sex, age, high sensitivity C-reactive protein, glucose, insulin, total fat mass, lean mass, heart rate, systolic blood pressure, diastolic blood pressure, sedentary time, light physical activity, moderate to vigorous physical activity, family history of cardiometabolic disease, socioeconomic status, pubertal attainment, and smoking status, in addition to lipid covariates such as HDL-C, LDL-C, or triglyceride depending on the predictor. However, TC and non-HDL-C analyses were not adjusted for lipids. Results Participants mean (SD) age in years at different time points were 15.43 (0.29), 17.69 (0.31), and 24.53 (0.72). Persistently elevated TC: effect estimate 0.026 mm [95% CI 0.004 to 0.049; p=0.024], elevated non–HDL-C: 0.033 mm [0.009 to 0.056; p=0.007], and elevated LDL-C: 0.035 mm [0.003 to 0.067); p=0.034], from 15 through 24 years were cumulatively associated with the 7-year cIMT progression. Persistent borderline-low HDL-C: −0.027 mm [−0.050 to −0.005; p=0.019] and very-low HDL-C: −0.035 mm [−0.057 to −0.013; p=0.002] levels were associated with cIMT progression. Triglyceride was not associated with cIMT progression. Conclusion These findings suggest that elevated lipids from mid-adolescence through young adulthood were associated with the progression of carotid wall thickening, a marker of preclinical atherosclerosis. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Finnish Cultural Foundation

Cumulative hyperinsulinemia, hyperglycaemia, and insulin resistance from mid-adolescence through young adulthood with carotid intima-media thickness progression: a 9-year longitudinal study

Abstract Background In a recent meta-analysis of randomized clinical trials conducted among adults, carotid intima-media thickness (cIMT) progression was established as a predictor of cardiovascular morbidity and mortality. However, due to the paucity of hard outcomes among adolescents and young adults, a single cIMT measure has largely been used as a marker of preclinical atherosclerotic changes. The repeated measure of cIMT in the young population is scarce thus a knowledge gap exists on the associations of metabolic indices with cIMT progression. Purpose To investigate the associations of cumulative fasting plasma glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) with cIMT progression in adolescence. Methods We studied 1779 British 15-year-olds (50% females) followed up for 9 years. Fasting insulin and glucose were measured in line with standard protocols at ages 15, 17, and 24 years, respectively. HOMA-IR was computed for each time point. Metabolic indices were age and sex-specifically dichotomized as ≥75%, indicating high category and <75% indicating moderate or reference category. cIMT from the right and left common carotid arteries at 17 years was assessed by ultrasound using a linear 12-MHz transducer (Vivid7, GE Medical, Chicago, Illinois) and cIMT from the right and left common carotid arteries at 24 years was measured using an ultrasound machine (CardioHealth Panasonic and a 13.5 MHz linear array broadband transducer (probe; centre frequency 9.0 MHz). We conducted linear mixed-effect model analyses and adjusted for statistically significant determinants of cIMT progression, viz: sex, age, high sensitivity C-reactive protein, insulin or glucose, dual-energy Xray absorptiometry measured total fat mass and lean mass, systolic blood pressure, diastolic blood pressure, smoking status, and ActiGraph measured sedentary time and light physical activity. Covariates were repeatedly measured. Results Participants mean (SD) age in years at different time points were 15.43 (0.29), 17.69 (0.31), and 24.53 (0.72). Cumulative high exposures to glucose: effect estimate 0.009 mm [95% CI −0.003 to 0.021; p=0.130], insulin: 0.002 mm [−0.030 to 0.013; p=0.704], and HOMA-IR: 0.003 mm [−0.009 to 0.016; p=0.608] from 15 to 24 years of age were not associated with the 7-year cIMT progression after full covariate adjustments. Sex-based analyses were consistent with the group analyses in both males and females. Conclusion These findings suggest that hyperinsulinemia, hyperglycaemia, and elevated insulin resistance from mid-adolescence through young adulthood may not be associated with progressive carotid wall thickening during late adolescence through young adulthood. Future studies investigating the role of other metabolic indices such as cumulative elevated lipid exposures on cIMT progression in the young population are warranted. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Finnish Cultural Foundation

Longitudinal associations of cumulative dyslipidaemia from mid-adolescence through young adulthood with arterial stiffness progression: the ALSPAC study

Abstract Background Arterial stiffness assessed with carotid-femoral pulse wave velocity (cfPWV) strongly predicts the risk of cardiovascular morbidity and mortality. Recent temporal causal evidence suggests that cfPWV progression may precede the development of cardiometabolic diseases in adolescence, young adults, and middle-aged adults. However, the longitudinal relationship between cfPWV progression and dyslipidaemia in the young population is unclear. Purpose To investigate the longitudinal associations of total cholesterol (TC), non–high-density lipoprotein cholesterol (non–HDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, and low-density lipoprotein cholesterol (LDL-C) with cfPWV progression in adolescents. Methods We studied 1779 British 15-year-olds (50% females) followed up for 9 years. TC, triglyceride, and HDL-C were measured in line with standard protocols at ages 15, 17, and 24 years, respectively. LDL-C and non-HDL-C were estimated. Lipid phenotypes were categorized based on the 2011 National Heart, Lung, and Blood Institute classification into normal (reference), and elevated/dyslipidaemia. At age 17 and 24 years, cfPWV was computed from pressure waveforms obtained using the Vicorder device. We conducted linear mixed-effect model analyses and adjusted for sex, age, high sensitivity C-reactive protein, glucose, insulin, total fat mass, lean mass, heart rate, systolic blood pressure, diastolic blood pressure, sedentary time, light physical activity, moderate to vigorous physical activity, family history of cardiometabolic disease, socioeconomic status, pubertal attainment, and smoking status, in addition to lipid covariates such as HDL-C, LDL-C, or triglyceride depending on the predictor. However, TC and non-HDL-C analyses were not adjusted for lipids. Results Participants' mean (SD) age in years at different time points were 15.43 (0.29), 17.69 (0.31), and 24.53 (0.72). Persistently elevated/dyslipidaemia TC: effect estimate 0.006 m/s [95% CI −0.023 to 0.035; p=0.683], non–HDL-C: 0.004 m/s [−0.025 to 0.033; p=0.771], LDL-C: 0.017 m/s [−0.019 to 0.052; p=0.351], and Triglyceride: −0.009 m/s [−0.036 to 0.018; p=0.532] from 15 through 24 years were not cumulatively associated with the 7-year cfPWV progression. Persistent borderline-low/very-low HDL-C: 0.007 m/s [−0.017 to 0.031; p=0.556] was not associated with cfPWV progression. Conclusion These findings suggest that elevated lipids and dyslipidaemia from mid-adolescence through young adulthood were not associated with arterial stiffness progression, a marker of preclinical arteriosclerosis. Thus, lipid-lowering interventions targeted at preventing or reversing arterial stiffness progression in the young may be ineffective, particularly in a healthy young population. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Finnish Cultural Foundation

Does arterial stiffness progression temporally precede higher low-grade inflammation in adolescents? Causal longitudinal evidence using auto-regressive cross-lagged structural equation models

Abstract Background Arterial stiffness, a precursor of arteriosclerosis, measured using carotid-femoral pulse wave velocity (cfPWV) is a strong predictor of cardiovascular morbidity and mortality in adults. Emerging evidence among adolescents, young adults, and middle-aged adults suggest that arterial stiffness may predict the risk of hypertension, obesity, insulin resistance, and the onset of type 2 diabetes and could be a causal risk factor for these diseases. However, it is unknown whether higher arterial stiffness temporally precedes elevated inflammation in the young population or if there is a bi-directional relationship. This evidence is crucial to developing interventions for attenuating arterial stiffness in early life. Purpose To examine the temporal causal longitudinal associations between repeated measures of cfPWV and high sensitivity C-reactive protein (hsCRP). Methods We studied 3862 adolescents, aged 17.7 years, followed-up for 7 years, from Avon Longitudinal Study of Parents and Children, birth cohort, UK. Fasting plasma hsCRP was assessed at 17.7 and 24.5-year clinic visits. In the same clinic visits, cfPWV was computed from pressure waveforms obtained using the Vicorder device (Skidmore Medical, Bristol, UK), 5 minutes after participants rested in a semi-prone position, with 2 blood pressure measurement channels and 2 Velcro pressure sensor cuffs applied over each of the carotid and femoral arteries. The assessment was repeated until three readings that were within 0.5 m/s of each other were recorded. We conducted autoregressive cross-lagged structural equation model path analyses to untangle temporal associations. We adjusted for sex, time in years between ages 17.7 and 24.5 years, age, low-density lipoprotein cholesterol, insulin, triglyceride, high-density lipoprotein cholesterol, fasting blood glucose, systolic blood pressure, heart rate, dual-energy Xray absorptiometry measured total fat mass and lean mass, ActiGraph measured moderate to vigorous physical activity at 15.5 years, smoking status, and family history of cardiovascular and metabolic diseases. Results Among 3862 adolescents (55.5% female), median (IQR) hsCRP at 17.7 and 24.5 years were 0.56 (0.98) mg/L and 0.84 (1.62) mg/L, respectively. The median (IQR) cfPWV at 17.7 and 24.5 years were 5.79 (0.66) m/s and 6.12 (1.12) m/s, respectively. Higher hsCRP at age 17.7 years was associated with higher cfPWV [Standardized β = 0.058, standard error = 0.004, p=0.037] at age 24.5 years. However, higher cfPWV at age 17.7 years was not associated with higher hsCRP [β = 0.023, standard error = 0.243, p=0.341] at 24.5 years. Conclusion We observed that elevated low-grade inflammation in adolescence may temporally cause higher arterial stiffness 7 years later, but not vice versa. Clinical and public health interventions targeted at reducing low-grade inflammation to regress the development of arteriosclerotic cardiovascular disease before mid-adulthood are needed. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Finnish Cultural Foundation

Simulated intervention and optimal timing for attenuating dyslipidaemia-related atherosclerotic progression in the young: a temporal inverse allocation analysis of the ALSPAC cohort

Abstract Background Carotid intima-media thickness (cIMT) progression strongly predicts cardiovascular events among adults. We recently reported that cumulative dyslipidaemia was longitudinally associated with cIMT progression among adolescents and young adults. It is of clinical and public health significance to identify the most sensitive or crucial timing for preventing cardiovascular diseases before mid-adulthood. One method for addressing these issues is to perform a temporal inverse allocation to simulate the effects of treatment for dyslipidaemia at specific life stages, in order to inform effective timing of treatment. The temporal inverse allocation is similar to the principle of isotemporal substitution, however, rather than eliminating variables of interest, participants' categories are reversed, i.e participants with dyslipidaemia at a specific time point are assigned normal lipid levels and vice versa, while variables at other time points are unchanged. Purpose To simulate a treatment intervention on the longitudinal associations of total cholesterol (TC), non–high-density lipoprotein cholesterol (non–HDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, and low-density lipoprotein cholesterol (LDL-C) with cIMT progression. Methods We studied 1779 British 15-year-olds (50% females) followed up for 9 years. TC, triglyceride, and HDL-C were measured in line with standard protocols at ages 15, 17, and 24 years, respectively. non-HDL-C and LDL-C were estimated. Lipid phenotypes were categorized based on the 2011 National Heart, Lung, and Blood Institute classification into normal (reference) and elevated/dyslipidaemia. cIMT of the right and left common carotid arteries were measured at 17 and 24 years with ultrasound. We conducted linear mixed-effect model analyses with temporal inverse allocation and adjusted for age, sex, cardiometabolic, and lifestyle factors. Results Normalized lipid at age 24 years, with elevated lipid and dyslipidaemia at 15 and 17 years did not alter the longitudinal associations of elevated/dyslipidaemia TC: effect estimate 0.028 mm [95% CI 0.007 to 0.049; p=0.010], non–HDL-C: 0.027 mm [0.006 to 0.049; p=0.013], and low HDL-C: −0.030 mm [−0.048 to −0.013; p=0.001] from 15 through 24 years with the 7-year cIMT progression. However, normalized lipid level at age 17 years with elevated lipid and dyslipidaemia at 15 and 24 years significantly attenuated the longitudinal associations of elevated/dyslipidaemia TC: effect estimate 0.005 mm [−0.015 to 0.025; p=0.627], non–HDL-C: 0.013 mm [−0.008 to 0.034; p=0.235], and low HDL-C: −0.016 mm [−0.031 to −0.0001; p=0.049] from 15 through 24 years with cIMT progression. Triglyceride and LDL-C were not associated with cIMT progression. Conclusion This simulated intervention suggests that lowering lipids during late adolescence may be effective in preventing and reversing cIMT progression, a marker of preclinical atherosclerosis, in the young. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Finnish Cultural Foundation