Mediation effects of lean mass and fat mass on the relationship between body mass index and handgrip strength.

OBJECTIVE: This study aimed to assess the mediation effects of lean mass and fat mass on the relationship between body mass index (BMI) and handgrip strength (HGS) in adolescents. METHOD: The sample included 118 adolescents (60 girls) aged 10-14 years. Body composition, determined from lean mass (LM) and fat mass (FM), was measured by dual-energy x-ray absorptiometry. HGS was measured using a digital dynamometer. Moderate-to-vigorous physical activity and sexual maturation, treated as covariates, were evaluated by accelerometry and pubic hair development, respectively. Spearman correlation and simple mediation analysis were used for statistical analysis. RESULTS: A positive relationship was observed between BMI and HGS (rho = .364, p < .001), BMI and LM (rho = .466, p < .001), LM and HGS (rho = .784, p < .001), BMI and FM (rho = .907, p < .001), and FM and HGS (rho = .291, p = .001). LM was the only significant mediator of the relationship between BMI and HGS. CONCLUSION: Only LM mediated the association between BMI and HGS, almost entirely explaining the relationship. The findings reinforce the need to include LM measurements in routine strength testing. Furthermore, strategies focused on LM development may be promising in preventing low muscle strength in adolescents.

Impact of exergames on bmi and cardiovascular risk factors: a systematic review / Impacto de exergames sobre imc y los factores de riesgo cardiovascular: revisión sistemática / Impacto de exergames no imc e fatores de risco cardiovascular: uma revisão sistemática

ABSTRACT Introduction: Exergames or active video games are digital platforms with functionality associated with body movement, which dialogue with improving physical activity levels, stimulating pleasure in practice and adherence to change habits, physically active behavior, and better quality of life. Objective: This study aimed to synthesize the available evidence on the contribution of exergame to Body Mass Index, physical activity level, glycemic control, blood pressure, and cardiorespiratory fitness in adolescents. Methods: This is a systematic review, reported following the PRISMA writing recommendations, without language restrictions, for articles indexed in the following databases: MEDLINE / PubMed, Embase, Cochrane Library, and Lilacs. Data extraction was performed analogously in a spreadsheet previously tested and standardized. The assessment of the risk of bias in the included studies was carried out by the RoB 1.0 tool in all of its domains in duplicate of reviewers. Initially, 3.039 studies were found. Results: The studies cover a total of 526 adolescents aged ten to 19. The most used platform in the studies was the Nintendo Wii, followed by the PlayStation, Xbox 360, and Dance Dance Revolution. The results indicated that interventions using exergames were effective for changing BMI, but there was no evidence on cardiovascular outcomes, with no effective changes in glycemic control and blood pressure and a significant response (p <0.05) in cardiorespiratory fitness. Conclusion: The exergame points to satisfactory results in improving health and can be incorporated as a relevant public policy in the adolescent health promotion. (PROSPERO Registration CRD42020181772). Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMEN Introducción: Los Exergames o videojuegos activos son plataformas digitales con funcionalidad asociada al movimiento corporal, que dialogan con la mejora de los niveles de actividad física, estimulando el placer en la práctica y la adherencia a cambios de hábitos, conducta físicamente activa y mejor calidad de vida. Objetivo: Este estudio tuvo como objetivo sintetizar la evidencia disponible sobre la contribución del exergame al índice de masa corporal, nivel de actividad física, control glucémico, presión arterial y aptitud cardiorrespiratoria en adolescentes. Métodos: Se trata de una revisión sistemática, reportada siguiendo las recomendaciones de redacción de PRISMA, sin restricción de idioma, para artículos indexados en las siguientes bases de datos: MEDLINE / PubMed, Embase, Cochrane Library y Lilacs. La extracción de datos se realizó de manera similar en una hoja de cálculo estandarizada y probada previamente. La evaluación del riesgo de sesgo en los estudios incluidos se realizó mediante la herramienta RoB 1.0 en todos sus dominios por duplicado de revisores. Inicialmente, se encontraron 3.039 estudios. Resultados: Los estudios abarcaron un total de 526 adolescentes de 10 a 19 años. La plataforma más utilizada en estudios fue la Nintendo Wii, seguida de la PlayStation, Xbox 360 y Dance Dance Revolution. Los resultados indicaron que las intervenciones con exergames fueron efectivas para cambiar el IMC, pero no hubo evidencia sobre los resultados cardiovasculares, no hubo cambios efectivos en el control glucémico y la presión arterial, y una respuesta explicativa (p <0.05) en la aptitud cardiorrespiratoria. Conclusión: El exergame muestra resultados satisfactorios en la mejora de la salud y puede ser incorporado como una política pública relevante en la promoción de la salud de los adolescentes. (Registro PROSPERO CRD42020181772). Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

RESUMO Introdução: Exergames ou vídeo games ativos são plataformas digitais com funcionalidade associada ao movimento corporal, que dialogam com a melhora dos níveis de atividade física, estimulando o prazer na prática e a adesão à mudança de hábitos, comportamento ativo e melhor qualidade de vida. Objetivo: Este estudo teve como objetivo sintetizar as evidências disponíveis sobre a contribuição do exergame para o Índice de Massa Corporal, nível de atividade física, controle glicêmico, pressão arterial e aptidão cardiorrespiratória em adolescentes. Métodos: Trata-se de uma revisão sistemática, relatada seguindo as recomendações de redação do PRISMA, sem restrição de idioma, para artigos indexados nas seguintes bases de dados: MEDLINE / PubMed, Embase, Cochrane Library e Lilacs. A extração dos dados foi realizada de forma análoga em planilha previamente testada e padronizada. A avaliação do risco de viés nos estudos incluídos foi realizada pela ferramenta RoB 1.0 em todos os seus domínios em duplicata de revisores. Inicialmente, foram encontrados 3.039 estudos. Resultados: Os estudos abrangeram um total de 526 adolescentes de dez a 19 anos. A plataforma mais utilizada nos estudos foi o Nintendo Wii, seguido do PlayStation, Xbox 360 e Dance Dance Revolution. Os resultados indicaram que as intervenções com exergames foram eficazes para alterar o IMC, mas não houve evidências sobre os desfechos cardiovasculares, sem alterações eficazes no controle glicêmico e na pressão arterial e uma resposta significativa (p <0,05) na aptidão cardiorrespiratória. Conclusão: O exergame aponta resultados satisfatórios na melhoria da saúde e pode ser incorporado como uma política pública relevante na promoção da saúde do adolescente. (Registro PROSPERO CRD42020181772). Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

Analysis of the elaboration and proposal of a Brazilian intersectoral strategy for the prevention and care of childhood obesity.

The Brazilian Strategy for the Prevention and Care of Childhood Obesity (PROTEJA) aims to implement a set of actions to prevent obesity in Brazil. As such, this qualitative and descriptive documentary study presents the Strategy's stages of the operational design, general proposal, evaluation and monitoring conducted by the Brazilian Ministry of Health's technical coordination. After analyzing the epidemiological data on children and the existing policies aimed at obesity prevention, and reviewing the scientific literature and recommendations, PROTEJA was formulated and approved by the Brazilian Ministry of Health, and 1,320 municipalities committed to implementing 20 essential and 5 complementary actions, from 41, including some structural to improve environments. Coordinated by the Brazilian Ministry of Health in partnership with subnational governments and universities, the Strategy also relies on a local team for implementation support, as well as implementation and impact evaluations. Actions will be monitored annually, and the indicators will impact financial incentives. As a strong, evidence-based and innovative strategy aiming to promote healthy environments in cities, PROTEJA has the potential to open a path to childhood obesity reversal, as well as add to the implementation science and contribute to the development and improvement of public policies for obesity prevention; however, its implementation remains a challenge.

Secular trends in body image dissatisfaction and associated factors among adolescents (2007-2017/2018).

OBJECTIVE: To assess secular trends in body image dissatisfaction and associated factors among adolescents over a 10-year period (2007-2017/2018). METHODS: The sample included 1,479 (2007, n = 531; 2017/2018, n = 948) high school adolescents of both sexes, aged 14 to 18 years, of schools in a city in southern Brazil, in 2007 and 2017/2018. Data were collected on sex, age, physical activity (IPAQ, short form), anthropometric measurements (body weight, height, and triceps and subscapular skinfolds), and body image dissatisfaction (figure rating scale). The variables were compared with Independent samples t-test and Mann-Whitney U-test. The associations between sex and other variables were examined with chi-square test, and the factors associated with body image were identified with multinomial logistic regression. RESULTS: Most adolescents were dissatisfied with their body image in 2007 (65,2%) and 2017/2018 (71,1%). The prevalence of body dissatisfaction increased by 9.2% over the 10-year period, particularly dissatisfaction with thinness (21.3%). After stratification by sex, in 2017/2018 sample, dissatisfaction with overweight was 46.1% greater in boys, and dissatisfaction with thinness was 66.9% greater in girls. Factors found to be significantly associated with body image dissatisfaction were physical activity level, and body adiposity. CONCLUSIONS: There was a secular trend toward increased body image dissatisfaction in both sexes. Future efforts should go beyond scientific production, in public and private environments aimed at increasing awareness of health issues related to body care in the physical, psychological, and environmental domains.

Agreement and validity between body fat estimated by skinfold measurement and air displacement plethysmography in adolescents / Concordância e validade entre a gordura corporal estimada por medidas de dobras cutâneas e pletismografia por deslocamento de ar em adolescentes

ABSTRACT Objective: Assess the agreement and validity between relative body fat percentages estimated using anthropometric measurements and air displacement plethysmography (ADP). Methods: A cross-sectional study was conducted on 118 adolescents (60 females) aged 10 to 14 years (x̄=12.19, sd=1.18). Adolescents were classified as eutrophic or with overweight according to body mass index (body weight/height2) (x̄=20,12, sd=3,56). Measurements of skinfold thickness (triceps and medial calf) were collected and used to estimate relative body fat by the Slaughter equation. ADP was used as a reference method for the estimation of relative body fat. Agreement between body fat measurement methods (anthropometry × ADP) was analyzed by the Bland-Altman method. The mean error (ME) was calculated by subtracting the body fat percentage estimated by the Slaughter equation from the body fat percentage estimated by ADP. Validity was tested with the concordance correlation coefficient (CCC). Results: There was no agreement between the methods, regardless of sex and weight status. For boys with overweight (ME = 4.52; p = 0.007), eutrophic girls (ME = 6.37; p < 0.001), and girls with overweight (ME = 5.55; p < 0.001), the Slaughter equation resulted in overestimation of body fat compared with ADP. Skinfold equations did not demonstrate validity when compared with ADP. Conclusion: Slaughter's skinfold equations did not demonstrate agreement and validity compared with ADP in either sex or weight status. Skinfold equations should be used with caution and, whenever possible, in combination with other body composition indicators.

RESUMO Objetivo: Avaliar a concordância e validade entre os percentuais de gordura corporal estimados usando medidas antropométricas e pletismografia por deslocamento de ar (PDA). Métodos: Um estudo transversal foi conduzido em 118 adolescentes (60 meninas) com idade entre 10 e 14 anos (x̄=12,19, dp=1,18). Os adolescentes foram classificados como eutróficos ou com sobrepeso de acordo com o índice de massa corporal (peso/altura2) (x̄=20,12, dp=3,56). Medidas de dobras cutâneas (tríceps e panturrilha medial) foram coletadas e utilizadas para estimar a gordura corporal relativa pela equação de Slaughter. A PDA foi utilizada como método de referência para a estimativa da gordura corporal relativa. A concordância entre os métodos de medida de gordura corporal (antropometria × PDA) foi analisada pelo método de Bland-Altman. O erro médio (EM) foi calculado subtraindo o percentual de gordura corporal estimado pela equação de Slaughter do percentual de gordura corporal estimado pela PDA. A validade foi testada com o coeficiente de correlação de concordância (CCC). Resultados: Não houve concordância entre os métodos, independente do sexo e status de peso. Para meninos com excesso de peso (EM = 4,52; p = 0,007), meninas eutróficas (EM = 6,37; p < 0,001) e meninas com excesso de peso (EM = 5,55; p < 0,001), a equação de Slaughter resultou em superestimação da gordura corporal comparada com PDA. As equações de dobras cutâneas não demonstraram validade quando comparadas ao PDA. Conclusão: As equações de dobras cutâneas de Slaughter não demonstraram concordância e validade em comparação com PDA em ambos os sexos ou status de peso. As equações de dobras cutâneas devem ser utilizadas com cautela e, sempre que possível, acompanhada de outros indicadores de composição corporal.

Analysis of the elaboration and proposal of a Brazilian intersectoral strategy for the prevention and care of childhood obesity / Análise do processo de construção e proposta de uma estratégia intersetorial brasileira para prevenção e atenção à obesidade infantil / Análisis del proceso de construcción y propuesta de una estrategia intersectorial brasileña para la prevención y atención de la obesidad infantil

Abstract: The Brazilian Strategy for the Prevention and Care of Childhood Obesity (PROTEJA) aims to implement a set of actions to prevent obesity in Brazil. As such, this qualitative and descriptive documentary study presents the Strategy's stages of the operational design, general proposal, evaluation and monitoring conducted by the Brazilian Ministry of Health's technical coordination. After analyzing the epidemiological data on children and the existing policies aimed at obesity prevention, and reviewing the scientific literature and recommendations, PROTEJA was formulated and approved by the Brazilian Ministry of Health, and 1,320 municipalities committed to implementing 20 essential and 5 complementary actions, from 41, including some structural to improve environments. Coordinated by the Brazilian Ministry of Health in partnership with subnational governments and universities, the Strategy also relies on a local team for implementation support, as well as implementation and impact evaluations. Actions will be monitored annually, and the indicators will impact financial incentives. As a strong, evidence-based and innovative strategy aiming to promote healthy environments in cities, PROTEJA has the potential to open a path to childhood obesity reversal, as well as add to the implementation science and contribute to the development and improvement of public policies for obesity prevention; however, its implementation remains a challenge.

Resumo: A Estratégia de Prevenção e Atenção à Obesidade Infantil (PROTEJA) visa promover a implementação de um pacote de ações para prevenção da obesidade no Brasil. Este estudo apresenta as etapas de desenho operacional, proposta geral, avaliação e monitoramento do PROTEJA realizadas pela coordenação técnica do Ministério da Saúde. Trata-se de um estudo qualitativo baseado em análise descritiva documental. A formulação da estratégia envolveu análise de dados epidemiológicos de crianças brasileiras, análise de políticas existentes, e uma revisão da literatura científica e das recomendações O PROTEJA foi então formulado e aprovado pelo Ministério da Saúde e 1.320 municípios se comprometeram a implementar 20 ações essenciais e 5 complementares das 41 ações, incluindo algumas estruturais para melhoria dos ambientes. A estratégia é coordenada pelo Ministério da Saúde em parceria com governos subnacionais e universidades. Sua implementação conta com apoio de uma equipe em nível local, e prevê a avaliação da implementação e de impacto. As ações serão monitoradas anualmente, e os indicadores também implicarão nos incentivos financeiros. O PROTEJA é uma estratégia forte, baseada em evidências e inovadora que visa promover ambientes saudáveis nas cidades, mas sua implementação é desafiadora. Não obstante, apresenta um possível caminho para a reversão da obesidade infantil. Também pode agregar à ciência de implementação e contribuir para o desenvolvimento e aprimoramento de políticas públicas de prevenção da obesidade.

Resumen: La Estrategia Brasileña para la Prevención y Atención de la Obesidad Infantil (PROTEJA) tiene como objetivo promover la implementación de un conjunto de acciones para prevenir la obesidad en Brasil. Este estudio presenta las etapas del diseño operativo, la propuesta general, la evaluación y el seguimiento de PROTEJA realizadas por la coordinación técnica del Ministerio de Salud brasileño. Se trata de un estudio cualitativo basado en el análisis descriptivo de documentos. La formulación de la estrategia implicó el análisis de datos epidemiológicos de niños brasileños, el análisis de las políticas existentes y una revisión de la literatura científica y de las recomendaciones. PROTEJA fue entonces formulado y aprobado por el Ministerio de Salud, y 1.320 municipios se comprometieron a implementar 20 acciones esenciales y 5 complementarias de las 41 acciones, incluidas algunas estructurales para mejorar los entornos. La estrategia es coordinada por el Ministerio de Salud en colaboración con gobiernos subnacionales y universidades. Su implementación cuenta con el apoyo de un equipo a nivel local, y prevé una evaluación de la implementación y de impacto. Las acciones se monitorearán anualmente, y los indicadores también implicarán incentivos económicos. PROTEJA es una estrategia sólida, basada en evidencias e innovadora que busca promover entornos saludables en las ciudades, pero su implementación es un desafío. Sin embargo, presenta una posible vía para revertir la obesidad infantil. También puede agregar a la ciencia de implementación y contribuir al desarrollo y a la mejora de políticas públicas para prevenir la obesidad.

Ações de práticas corporais e atividade física no Programa Saúde na Escola por ciclos de adesão (2014 a 2020) / Actions of body practices and physical activity in the School Health Program by accession cycles (2014 to 2020)

RESUMO A promoção da atividade física integra uma das 13 ações do Programa Saúde da Escola (PSE). O objetivo deste estudo foi descrever as ações de práticas corporais e atividade física registradas em três ciclos de adesão (2014-2015, 2017-2018 e 2019-2020), por região e Unidade Federativa (UF). Por meio de análise descritiva, foram apresentados os números de ações realizadas em cada ano, ciclo, UF e região. Observou-se aumento de municípios e escolas nas adesões a cada ciclo em todas as regiões. Considerando o total de municípios compreendidos em cada região, 100% dos municípios do Nordeste aderiram ao PSE nos dois últimos ciclos. O Sudeste teve a menor proporção de municípios aderidos em todos os ciclos. Em cada ciclo, a maior parte das ações foi realizada no primeiro ano na maioria das UF. Nacionalmente, houve aumento do número de ações em todos os ciclos, com destaque para o Nordeste e o Sudeste. Do primeiro para o terceiro ciclo, esse aumento foi maior no Sudeste e no Sul. Minas Gerais, Bahia, Ceará e Maranhão totalizaram quase metade das ações. Os resultados evidenciaram diferentes nuances na implementação da promoção da atividade física e podem subsidiar tecnicamente gestores e técnicos vinculados ao PSE.

ABSTRACT The promotion of physical activities is one of the 13 actions of the School Health Program. This study aims to describe the actions of body practices and physical activity registered in three accession cycles (2014-2015, 2017-2018, and 2019-2020) by region and Federative Unit (FU). Using descriptive analysis, the number of actions, in each year, cycle, FU, and region were presented. In all regions, the number of municipalities and schools adhering increased in each cycle. When considering the total number of municipalities of each region, 100% of the Northeast region municipalities adhered to the program in the last two cycles. The Southeast region had the lowest proportion of municipalities that adhered to all the cycles. In most FUs, in each cycle, the majority of actions were conducted in the first year. Nationally, there was an increase in the number of actions in all the cycles, mainly in the Northeast and Southeast. From the first to the third cycle, this increase was higher in the Southeast and South. Minas Gerais, Bahia, Ceará, and Maranhão comprised almost half of the actions. The results showed different nuances in the implementation of the promotion of physical activity and can technically subsidize the managers and technicians linked to the program.

Autoconceito, imagem corporal e nível de atividade física em escolares praticantes de educação física, dança e ginástica rítmica / Self-concept, body image and physical activity level in schoolchildren who practice physical education, dance and rhythmic gymnastics

Objetivo: Analisar o autoconceito, a imagem corporal e o nível de atividade física e verificar as relações dessas variáveis com a prática de Educação Física, de dança e de ginástica rítmica (GR), em meninas escolares. Método: Participaram 90 escolares do ensino fundamental (de 7 a 12 anos de idade, 9,5±1,4), classificadas em praticantes de Educação Física escolar somente, de dança e de GR. Utilizou-se um questionário direcionado aos pais e/ou responsáveis sobre o nível econômico; e outro às escolares, com informações de caracterização; autoconceito (EAC-IJ); imagem corporal (Escala Adaptada de Kakeshita); e atividade física (PAQ-C). Resultados: As escolares apresentaram pontuações de baixas a médias para todos os tipos de autoconceito investigados (pessoal, social, escolar e familiar). Houve diferença nas pontuações do autoconceito social em relação às diferentes modalidades praticadas, sendo que as escolares que praticavam Educação Física apresentaram autoconceito social inferior comparadas às que praticavam dança e GR. Quanto à imagem corporal, maior parte das praticantes de dança (51,7%) e de Educação Física (58,6%) subestimaram as medidas corporais, enquanto maior parte das praticantes de GR (62,1%) superestimaram as medidas corporais. A maioria das escolares apresentou desejo de diminuir as medidas corporais (62,1%). Não houve associação entre o tipo de modalidade praticada e as variáveis de imagem corporal. Sobre o nível de atividade física, 89% das escolares eram ativas fisicamente. Houve associação entre o nível de atividade física e o tipo de modalidade praticada, sendo que as praticantes de GR eram mais ativas fisicamente. Conclusão: Os resultados deste estudo poderão auxiliar professores e profissionais de Educação Física no planejamento e no desenvolvimento de suas atividades junto ao público infantil, além de servir de alerta para a sociedade sobre a necessidade da promoção de ações que oportunizem o desenvolvimento saudável do autoconceito e da imagem corporal de crianças e de adolescentes. (AU)

Objective: To examine self-concept, body image, and physical activity level and the relationship of these variables with the practice of Physical Education, dance and rhythmic gymnastics (GR), in school girls. Method: 90 elementary school girls (aged 7 to 12, with a mean age of 9.5±1.4 years) participated in the study, who were classified as practitioners of Physical Education in school only, dance, and GR. A questionnaire regarding economic level was applied to parents and/or guardians, and another questionnaire was employed with schoolchildren, with characterization information, self-concept (EAC-IJ), body image (figure rating scale adapted from Kakeshita), and physical activity (PAQC). Results: Participants presented low to medium scores for all types of self-concept investigated (personal, social, school and family). There was a difference in the scores of the social self-concept in relation to the different modalities practiced. Girls who practiced Physical Education lower social self-concept compared to those who practiced dance and GR. Regarding body image, most dance (51.7%) and Physical Education (58.6%) practitioners underestimated their body measures, while most GR practitioners (62.1%) overestimated their body measures. Most participants presented a desire to decrease their body measures (62.1%). There was no association between the type of modality practiced and the body image variables. Regarding physical activity level, 89% of the participants were physically active. There was an association between physical activity level and the type of modality practiced. GR practitioners were more physically active. Conclusion: The results of the present study may help teachers and Physical Education professionals in the planning and development of their activities with children and adolescents. The results might also alert society about the need to promote actions that provide opportunities for the healthy development of children's selfconcept and body image. (AU)

Relationship Between Muscle Strength, Body Composition and Bone Mineral Density in Adolescents.

Adolescence is an important period for the acquisition of bone mass, which can be enhanced by several factors. This study aimed examine the relationships of handgrip strength, free-fat mass, and fat mass with bone mineral density in adolescents. 118 adolescents (60 girls), aged 10 to 14 years, participated in the study. Information on sex, age, handgrip strength, free-fat mass, fat mass and bone mineral density were collected. Multiple linear regression analyses were conducted to examine possible relationships between bone mineral density and handgrip strength, free-fat mass and fat mass. There was a relation between handgrip strength and free-fat mass with bone mineral density in both sexes. Fat mass was correlated with bone mineral density only in girls (r= 0.314, p< 0.014). The final models, adjusted for sexual maturation, included free-fat mass (girls - ß= 0.419, p< 0.001; boys - ß= 0.455; p< 0.001) and handgrip strength (girls - ß= 0.358, p< 0.05; boys - ß= 0.325; p< 0.05) and these variables together explained 51.8% and 62.9% of the variation of bone mineral density, in girls and boys, respectively. Handgrip strength and free-fat mass were positively associated with bone mineral density. A sex-specific difference indicated that higher levels of free-fat mass are of paramount importance for both sexes.

High waist-to-height ratio and associated factors in adolescents from a city in Southern Brazil: a cross-sectional study / Razão cintura-estatura elevada e fatores associados em adolescentes de uma cidade do Sul do Brasil: um estudo transversal

ABSTRACT Objective: To verify the prevalence of abdominal obesity with the waist-to-height ratio (WHtR) and associated factors in adolescents from a city in Southern Brazil. Methods: A total of 960 adolescents (494 boys) aged 15-18 years old participated in this study. The dependent variable was WHtR; independent variables were self-reported age, economic level, sexual maturation, physical activity level, screen time, and body fat. Data were analyzed using descriptive statistics and logistic regression. Results: It was observed that 36.7% of the adolescents presented high WHtR (50.2% in girls and 23.9% in boys). Regardless of sex, adolescents with high body fat were more likely of having high WHtR (boys: Odds Ratio [OR] 29.79; 95% confidence interval [95%CI] 16.87-52.62; girls: OR 19.43; 95%CI 10.51-35.94). In girls, high WHtR was associated with age (OR 1.83; 95%CI 1.17-2.87), and in boys, with economic level (OR 2.34; 95%CI 1.01-5.45). Conclusions: One in each three adolescents has abdominal obesity. Among adolescents with high body fat, girls aged 15-16 and boys with high-income are the groups most exposed to abdominal obesity.

RESUMO Objetivo: Verificar a prevalência de obesidade abdominal, por meio da razão cintura-estatura (RCE), e fatores associados em adolescentes de uma cidade do sul do Brasil. Métodos: Participaram 965 adolescentes (499 meninos) de 15 a 18 anos. A variável dependente foi a RCE elevada e as variáveis independentes foram idade, nível econômico, maturação sexual, nível de atividade física, tempo de tela e adiposidade corporal. Os dados foram analisados por meio de estatística descritiva e regressão logística. Resultados: 36,7% dos adolescentes apresentaram RCE elevada (50,2% das meninas e 23,9% dos meninos). Independentemente do sexo, os adolescentes com adiposidade corporal elevada apresentaram maiores chances de terem RCE elevada (masculino: OR 30,91; IC95% 17,37-55,00; feminino: OR 19,18; IC95% 10,39-35,40). Nas meninas, observou-se associação da RCE elevada com idade (OR 1,88; IC95% 1,20-2,94) e, nos meninos, com nível econômico (OR 2,35; IC95% 1,01-5,46). Conclusões: Um em cada três adolescentes tem obesidade abdominal. Adolescentes com adiposidade corporal elevada, meninas de 15-16 anos e meninos de nível econômico alto são os grupos mais expostos à obesidade abdominal.

Handgrip strength and associated factors among Brazilian adolescents: A cross-sectional study.

BACKGROUND: The handgrip strength (HGS) is an indicator of muscle strength associated with several health outcomes in adolescents and adults. This cross-sectional study aimed to identify HGS levels and associated modifiable and non-modifiable risk factors in adolescents. METHODS: The study included 971 adolescents (496 boys) aged 15-18 years. The HGS was measured by a dynamometer, and the maximum value of right and left hands were summed for a total score. Age, economic status, balanced diet, physical activity, and sedentary behavior were assessed by questionnaires, while body mass index was determined by measuring body weight and height. Multiple linear regression was carried out to examine the association. RESULTS: 65.4% of the adolescents presented low levels of HGS (boys: 73.8%; girls: 56.6%). Low levels of HGS were associated with weight status and height in both sexes. In boys, low levels of HGS were associated with age, balanced diet, physical activity, and sedentary behavior. CONCLUSION: About six out of ten adolescentes presented low levels of HGS. The main predictors of low levels of HGS in boys were age, physical activity, sedentary behavior, and balanced diet, and weight status and height in both sexes.

High waist-to-height ratio and associated factors in adolescents from a city in Southern Brazil: a cross-sectional study.

OBJECTIVE: To verify the prevalence of abdominal obesity with the waist-to-height ratio (WHtR) and associated factors in adolescents from a city in Southern Brazil. METHODS: A total of 960 adolescents (494 boys) aged 15-18 years old participated in this study. The dependent variable was WHtR; independent variables were self-reported age, economic level, sexual maturation, physical activity level, screen time, and body fat. Data were analyzed using descriptive statistics and logistic regression. RESULTS: It was observed that 36.7% of the adolescents presented high WHtR (50.2% in girls and 23.9% in boys). Regardless of sex, adolescents with high body fat were more likely of having high WHtR (boys: Odds Ratio [OR] 29.79; 95% confidence interval [95%CI] 16.87-52.62; girls: OR 19.43; 95%CI 10.51-35.94). In girls, high WHtR was associated with age (OR 1.83; 95%CI 1.17-2.87), and in boys, with economic level (OR 2.34; 95%CI 1.01-5.45). CONCLUSIONS: One in each three adolescents has abdominal obesity. Among adolescents with high body fat, girls aged 15-16 and boys with high-income are the groups most exposed to abdominal obesity.

Translation and validation of the Brazilian version of the Physical Appearance Comparison Scale-Revised in college women.

Brazilian women are known to present high levels of physical appearance concerns, and data suggest they often compare themselves with others. Nevertheless, there is no validated instrument to systematically assess appearance comparisons in the Brazilian population. Thus, this study aimed to translate the Physical Appearance Comparison Scale-Revised (PACS-R) into Brazilian Portuguese and evaluate its factor structure, internal consistency, and convergent validity in Brazilian college women. The translated version into Brazilian Portuguese of the PACS-R was completed by 832 Brazilian college women and its factor structure was examined through exploratory and confirmatory factor analyses, internal consistency through McDonald's omega, and convergent validity through its associations with measures of eating disorder symptoms, internalization of appearance ideals, appearance-related sociocultural pressures, body satisfaction, and self-esteem. The results suggested an 11-item single-factor scale. The Brazilian Portuguese PACS-R showed adequate internal consistency and was significantly associated with all measures of convergent validity in the expected direction, indicating its adequate convergent validity. The Brazilian Portuguese PACS-R might be useful in the investigation of the appearance comparison among women in Brazil, as also in the study of body image and eating disorders.

Body image dissatisfaction in adolescents: Comparison with physical activity, teasing and social support.

This study aimed to compare the adolescents' body dissatisfaction with physical activity, teasing during physical activity and social support. Participants were 938 Brazilian adolescents aged 15-19 years. Study variables were investigated through questionnaires. There was no difference in body dissatisfaction among adolescents who practiced and did not practice physical activity, but among the former, those who had been teased had greater body dissatisfaction. Also, adolescents who had a relative or friend to talk, in addition to giving and receiving affection, more frequently, presented lower body dissatisfaction. Stratifying the sample by gender, the results were similar in females but were not significant in males.

[Association between dissatisfaction with body image and health-related physical fitness among adolescents]. / Associação entre insatisfação com a imagem corporal e aptidão física relacionada à saúde em adolescentes.

The scope of this study was to estimate the prevalence of dissatisfaction with body image and verify the association between dissatisfaction with thinness or with overweight and health-related physical fitness components among adolescents. Participants included 1058 adolescents (570 girls and 488 boys), with mean age of 16.3 (±1.0) years. The investigated variables were dissatisfaction with body image (Figure Rating Scale), and health-related physical fitness: body fat (skin folds), muscle strength (handgrip strength) and cardiorespiratory fitness (mCAFT test). The association of body image and the health-related physical fitness variables was tested by Multinomial Regression analysis. The prevalence of body dissatisfaction was 75.2% (girls = 79.5%; boys = 70.3%). Girls and boys with high body fat were less likely to be dissatisfied with thinness and more likely to be dissatisfied with overweight. Those who needed to improve muscle strength and cardiorespiratory fitness were more likely to be dissatisfied with thinness and with overweight, respectively. In conclusion, physical fitness was associated with body image, with the adolescents with less healthy conditions of the components being more dissatisfied.

O objetivo deste estudo foi estimar a prevalência de insatisfação com a imagem corporal e verificar a associação entre a insatisfação pela magreza e pelo excesso de peso e componentes da aptidão física relacionada à saúde em adolescentes. Participaram 1.058 adolescentes (570 moças e 488 rapazes), com média de idade de 16,3(± 1,0) anos. As variáveis investigadas foram a insatisfação com a imagem corporal (escala de silhuetas), e as relativas à aptidão física relacionada à saúde: adiposidade corporal (dobras cutâneas), força muscular (preensão manual) e aptidão cardiorrespiratória (teste mCAFT). A associação entre a imagem corporal e as variáveis de aptidão física foi testada por meio da Regressão Multinomial. A prevalência de insatisfação corporal foi de 75,2% (moças = 79,5%; rapazes = 70,3%). Moças e rapazes com adiposidade corporal elevada tiveram menor chance de insatisfação pela magreza e maior chance de insatisfação pelo excesso de peso. Os que necessitavam melhorar a força muscular e a aptidão cardiorrespiratória tiveram maior chance de insatisfação pela magreza e pelo excesso de peso, respectivamente. Conclui-se que a aptidão física relacionada à saúde esteve associada à imagem corporal, sendo que os adolescentes com níveis menos saudáveis dos diferentes componentes foram os mais insatisfeitos.

Associação entre insatisfação com a imagem corporal e aptidão física relacionada à saúde em adolescentes / Association between dissatisfaction with body image and health-related physical fitness among adolescents

Resumo O objetivo deste estudo foi estimar a prevalência de insatisfação com a imagem corporal e verificar a associação entre a insatisfação pela magreza e pelo excesso de peso e componentes da aptidão física relacionada à saúde em adolescentes. Participaram 1.058 adolescentes (570 moças e 488 rapazes), com média de idade de 16,3(± 1,0) anos. As variáveis investigadas foram a insatisfação com a imagem corporal (escala de silhuetas), e as relativas à aptidão física relacionada à saúde: adiposidade corporal (dobras cutâneas), força muscular (preensão manual) e aptidão cardiorrespiratória (teste mCAFT). A associação entre a imagem corporal e as variáveis de aptidão física foi testada por meio da Regressão Multinomial. A prevalência de insatisfação corporal foi de 75,2% (moças = 79,5%; rapazes = 70,3%). Moças e rapazes com adiposidade corporal elevada tiveram menor chance de insatisfação pela magreza e maior chance de insatisfação pelo excesso de peso. Os que necessitavam melhorar a força muscular e a aptidão cardiorrespiratória tiveram maior chance de insatisfação pela magreza e pelo excesso de peso, respectivamente. Conclui-se que a aptidão física relacionada à saúde esteve associada à imagem corporal, sendo que os adolescentes com níveis menos saudáveis dos diferentes componentes foram os mais insatisfeitos.

Abstract The scope of this study was to estimate the prevalence of dissatisfaction with body image and verify the association between dissatisfaction with thinness or with overweight and health-related physical fitness components among adolescents. Participants included 1058 adolescents (570 girls and 488 boys), with mean age of 16.3 (±1.0) years. The investigated variables were dissatisfaction with body image (Figure Rating Scale), and health-related physical fitness: body fat (skin folds), muscle strength (handgrip strength) and cardiorespiratory fitness (mCAFT test). The association of body image and the health-related physical fitness variables was tested by Multinomial Regression analysis. The prevalence of body dissatisfaction was 75.2% (girls = 79.5%; boys = 70.3%). Girls and boys with high body fat were less likely to be dissatisfied with thinness and more likely to be dissatisfied with overweight. Those who needed to improve muscle strength and cardiorespiratory fitness were more likely to be dissatisfied with thinness and with overweight, respectively. In conclusion, physical fitness was associated with body image, with the adolescents with less healthy conditions of the components being more dissatisfied.

Deslocamento ativo para a escola e indicadores antropométricos de obesidade em adolescentes / Active commuting to school and anthropometric indicators of obesity in adolescents

Os baixos níveis de atividade física e a obesidade na população adolescente têm requerido estratégias urgentes em saúde pública, pois são potenciais fatores de risco para o desenvolvimento de doenças crônicas não transmissíveis. O objetivo deste estudo foi comparar os indicadores antropométricos de obesidade em adolescentes, considerando diferentes formas de deslocamento para a escola. Trata-se de uma pesquisa epidemiológica, de delineamento transversal, conduzida em 818 adolescentes (375 rapazes e 443 moças) com média de idade de 16,3±1,0 anos, estudantes do ensino médio de escolas públicas estaduais do município de São José-SC, Brasil. Os adolescentes informaram, por meio de questionário autoadministrado, como normalmente se deslocavam para a escola (a pé ­ considerado como deslocamento ativo ­ ou por meio de carro/moto ou ônibus ­ analisado como deslocamento passivo). Foram aferidas as medidas de massa corporal e estatura (para cálculo do IMC), perímetro da cintura e dobras cutâneas das regiões do tríceps e subescapular (considerando-se o somatório das duas dobras). Empregou-se o teste Kruskal-Wallis para comparar os indicadores antropométricos de obesidade entre os tipos de deslocamento realizados no percurso da residência para a escola. Os resultados apontaram que os adolescentes que se deslocavam ativamente para a escola apresentaram menores medidas de perímetro da cintura (p= 0,034). Entre os sexos, as menores medidas do somatório de dobras cutâneas e perímetro da cintura foram observadas, respectivamente, entre rapazes (p= 0,043) e moças (p= 0,009) que se deslocavam de maneira ativa para a escola. Conclui-se que, nos adolescentes investigados, as menores medidas da gordura corporal foram observadas entre aqueles que se deslocavam de maneira ativa, o que reforça a importância do deslocamento ativo como um hábito a ser considerado pelos escolares como um meio de melhorar seus indicadores antropométricos. Faz-se necessário, portanto, a implementação de políticas públicas que promovam o deslocamento ativo para a escola entre os adolescentes...(AU)

Obesity and low levels of physical activity among the adolescent population have been required urgent strategies in public health, since they are potential risk factors for the development of chronic non-communicable diseases. This study aimed to compare the anthropometric indicators of obesity in adolescents considering different forms of commuting to school. This is an epidemiological research, with a cross-sectional design, that included 818 adolescents (375 boys and 443 girls) with mean age of 16.3±1.0 years, who were high school students in state public schools of the city of São José-SC, Brazil. The adolescents reported, by means of a questionnaire self-administered, as they normally commuted to school (walking - considered as active commuting -or by means of car/bike or bus - considered as passive commuting). Body mass and height were measured (to calculate BMI), and also the waist circumference and skinfold thickness in the regions of the triceps and subscapular (considering the sum of the two folds). We used the Kruskal-Wallis test to compare the anthropometric indicators of obesity among the types of commuting undertaken in the course of the residence to school. The results showed that the adolescents who used active commuting to school had lower measures of waist circumference (p= 0.034). Between the sexes, smaller measures of sum of skinfolds and waist circumference were observd, respectively, among boys (p= 0.043) and girls (p= 0.009) that used active commuting to school. We concluded that, in the adolescents investigated, a healthier body composition among adolescents who used the active commuting from the residence to the school was observed, which reinforces the importance of active commuting as a behavior to be considered by the students and a way to improve levels of physical activity as well as their anthropometric indicators...(AU)

CROSS-CULTURAL ADAPTATION TO BRAZILIAN PORTUGUESE OF AN INSTRUMENT TO ASSESS TEASING DURING PHYSICAL/SPORTS ACTIVITY AMONG BRAZILIAN ADOLESCENTS. / ADAPTAÇÃO TRANSCULTURAL PARA O PORTUGUÊS DE UM INSTRUMENTO PARA AVALIAÇÃO DE PROVOCAÇÕES DURANTE A ATIVIDADE FÍSICA/ESPORTIVA EM ADOLESCENTES BRASILEIROS.

OBJECTIVE: To translate and adapt a questionnaire aimed to evaluate teasing during the practice of physical/sports activities in the adolescent population. METHODS: The whole process had six stages: four translations, elaboration of a synthesis version, two back-translations, evaluation by a committee of experts, test of pre-final version with the target population, and presentation of final version to a committee of experts. Thirty-eight adolescents aged between 11 and 18 years participated in the pre-final version test, all of them from the 6th grade of elementary school to senior year of high school in a public school of the state of Santa Catarina. RESULTS: The steps were strictly followed and then the need for change in the instrument emerged. The questions were altered according to discrepancies observed in back-translations, as well as suggestions by specialists to improve understanding and/or clarity and notes of adolescents participating in the pre-final test. CONCLUSIONS: The instrument was translated into Portuguese and adapted to the Brazilian context according to the reality and culture of adolescents aged 11 to 18 years old, with possible understanding failures in younger age groups.

OBJETIVO: Traduzir e adaptar para o português brasileiro um questionário para avaliação das provocações durante a prática de atividades físicas/esportivas para utilização com a população adolescente. MÉTODOS: O processo foi conduzido em seis etapas: quatro traduções, elaboração de uma versão sintética, duas retrotraduções, avaliação por um comitê de especialistas, teste da versão pré-final com a população-alvo e apresentação da versão final ao comitê de especialistas. Participaram do teste da versão pré-final 38 adolescentes com idades de 11 a 18 anos, estudantes do sexto ano do ensino fundamental ao terceiro ano do ensino médio em uma escola pública de Santa Catarina. RESULTADOS: As etapas foram seguidas rigorosamente, e a partir delas surgiram necessidades de alteração no instrumento. As questões foram modificadas de acordo com as divergências observadas nas retrotraduções, as sugestões realizadas pelos especialistas para melhoria da compreensão e/ou clareza e baseadas nos apontamentos dos adolescentes participantes do teste da versão pré-final. CONCLUSÕES: O instrumento foi traduzido para o português e adaptado para o contexto brasileiro, conforme a realidade e a cultura de adolescentes de 11 a 18 anos, apresentando dificuldades de compreensão para faixas etárias menores.

Adaptação transcultural para o português de um instrumento para avaliação de provocações durante a atividade física/esportiva em adolescentes brasileiros / Cross-cultural adaptation to brazilian portuguese of an instrument to assess teasing during physical/sports activity among brazilian adolescents

RESUMO Objetivo: Traduzir e adaptar para o português brasileiro um questionário para avaliação das provocações durante a prática de atividades físicas/esportivas para utilização com a população adolescente. Métodos: O processo foi conduzido em seis etapas: quatro traduções, elaboração de uma versão sintética, duas retrotraduções, avaliação por um comitê de especialistas, teste da versão pré-final com a população-alvo e apresentação da versão final ao comitê de especialistas. Participaram do teste da versão pré-final 38 adolescentes com idades de 11 a 18 anos, estudantes do sexto ano do ensino fundamental ao terceiro ano do ensino médio em uma escola pública de Santa Catarina. Resultados: As etapas foram seguidas rigorosamente, e a partir delas surgiram necessidades de alteração no instrumento. As questões foram modificadas de acordo com as divergências observadas nas retrotraduções, as sugestões realizadas pelos especialistas para melhoria da compreensão e/ou clareza e baseadas nos apontamentos dos adolescentes participantes do teste da versão pré-final. Conclusões: O instrumento foi traduzido para o português e adaptado para o contexto brasileiro, conforme a realidade e a cultura de adolescentes de 11 a 18 anos, apresentando dificuldades de compreensão para faixas etárias menores.

ABSTRACT Objective: To translate and adapt a questionnaire aimed to evaluate teasing during the practice of physical/sports activities in the adolescent population. Methods: The whole process had six stages: four translations, elaboration of a synthesis version, two back-translations, evaluation by a committee of experts, test of pre-final version with the target population, and presentation of final version to a committee of experts. Thirty-eight adolescents aged between 11 and 18 years participated in the pre-final version test, all of them from the 6th grade of elementary school to senior year of high school in a public school of the state of Santa Catarina. Results: The steps were strictly followed and then the need for change in the instrument emerged. The questions were altered according to discrepancies observed in back-translations, as well as suggestions by specialists to improve understanding and/or clarity and notes of adolescents participating in the pre-final test. Conclusions: The instrument was translated into Portuguese and adapted to the Brazilian context according to the reality and culture of adolescents aged 11 to 18 years old, with possible understanding failures in younger age groups.

Percepção das condições de trabalho e estresse ocupacional em policiais civis e militares de unidades de operações especiais / Perception of work conditions and occupational stress among civil and military police officers of special operations units

Resumo Introdução: Condições adversas de trabalho são inerentes ao serviço policial e podem ter impacto negativo na saúde física e mental desses profissionais, interferindo também em sua prática laboral. Objetivo: Analisar a percepção das condições de trabalho e o estresse ocupacional em policiais civis e militares de Unidades de Operações Especiais de Santa Catarina. Método: Participaram do estudo 84 policiais civis e militares, do sexo masculino, com média de idade de 34,68 (DP = 6,00) anos, atuantes em Unidades de Operações Especiais (BOPE, COPE, SAER, BAPM). Foram coletadas informações sobre a percepção das condições de trabalho, por meio do questionário intitulado Perfil de Ambiente e Condições de Trabalho, e sobre o estresse ocupacional, por meio da Job Stress Scale. Resultados: A percepção das condições de trabalho, em relação ao escore geral, foi de 24,12 pontos, sendo o ambiente social (6,92 pontos) o componente que apresentou maior escore e a remuneração e benefícios (4,50 pontos), o menor escore. Quanto ao estresse ocupacional, mais da metade dos policiais identificou seu trabalho como de baixa demanda, baixo controle e baixo apoio social. Ainda, quase metade (45,2%) deles teve seu trabalho classificado como ativo. Observou-se correlação negativa entre as condições de trabalho e o estresse ocupacional. Conclusão: Os policiais civis e militares apresentaram percepção regular de suas condições de trabalho, de modo geral, e percepção mais negativa em relação à remuneração e benefícios e ao ambiente físico. Um em cada quatro policiais apresentou trabalho passivo e de alto desgaste, considerados de maior risco para adoecimento.

Abstract Introduction: Adverse working conditions are inherent in the police service and might have a negative impact in the physical and mental health of these professionals, interfering also in their work practice. Objective: To analyze the perception of working conditions and the occupational stress among civil and military police officers of the special operations units of Santa Catarina. Method: Participants were 84 civil and military male police officers, with mean age of 34.68 (sd = 6.00) years, acting in the special operations units (BOPE, COPE, SAER, and BAPM). The information about the perception of working conditions were collected using the Environment and Working Conditions Profile questionnaire, and information about occupational stress were collected using Job Stress Scale. Results: The perception of working conditions related to total score were 24.12 points, with social environment (6.92 points) the component with the highest score, and remuneration and benefits (4.50 points) the component with the lowest score. In relation to occupational stress, more than a half of the police officers identified their work as low demand, low control, and low social support. Moreover, almost a half (42.2%) of the police officers had their work classified as active. A negative correlation between working conditions and occupational stress was found. Conclusion: Civil and military police officers demonstrated a regular perception of their working conditions, and a worse perception related to remuneration and benefits and physical environment. One in four police officers performs passive and high-wear work, considered to be at a greater risk of illness.