Low handgrip strength is associated with falls after the age of 50: findings from the Brazilian longitudinal study of aging (ELSI-Brazil).

AIM: This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life. METHODS: This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions. RESULTS: A total of 8,112 participants aged 50-105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p < 0.05) for falls for age groups, until 80 s, even when considering confounding variables. CONCLUSIONS: Low HGS is associated with falls in middle-aged adults over their 50 s and remained a strong measure of falls across each subsequent half-decade of life, until 80 s.

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study.

OBJECTIVE: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. METHOD: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. RESULTS: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. CONCLUSION: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study / Qualidade do sono e quedas em adultos de meia-idade e idosos: Estudo ELSI-Brasil / Calidad del sueño y caídas en adultos de mediana edad y mayores: Estudio ELSI-Brasil

ABSTRACT Objective: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. Method: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. Results: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. Conclusion: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

RESUMO Objetivo: Verificar a associação entre baixa qualidade do sono autorrelatada (BQS) e quedas em adultos de meia-idade e idosos a cada meia década de vida. Método: Um estudo transversal foi conduzido utilizando dados da primeira onda (2015-2016) do Estudo Longitudinal Brasileiro do Envelhecimento (ELSI-Brasil), que é nacionalmente representativo. A população consistiu em 8.950 participantes que foram alocados em oito grupos etários: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 e ≥ 85 anos. Os questionários utilizados incluíram qualidade do sono autorrelatada e o Questionário Internacional de Atividade Física versão curta. O teste exato de Fisher seguido pela análise de regressão logística binária foi conduzida para identificar a razão de chances da BQS para ocorrência de queda, controlando por variáveis de confusão. Resultados: Pessoas com idades entre 50 e 105 anos (63,6 ± 10,2 anos), sendo 57,0% do sexo feminino e 43,0% do sexo masculino, participaram deste estudo. No geral, 21,5% dos participantes experimentaram pelo menos uma queda. A frequência relativa de participantes classificados como tendo BQS ou alta permaneceu constante em cada meia década de vida. A BQS exibiu uma OR (p < 0,05) notável para quedas em grupos etários até 84 anos, mesmo após o ajuste para variáveis de confusão. Conclusão: A BQS está significativamente associada a uma maior ocorrência de queda em adultos com mais de 50 anos, mas não para ≥ 85 anos, independentemente do sexo e do nível de atividade física.

RESUMEN Objetivo: Verificar la asociación entre la baja calidad del sueño autorreportada (BCS) y las caídas en adultos de mediana edad y mayores cada media década de vida. Método: Se realizó un estudio transversal utilizando datos de la primera oleada (2015-2016) del Estudio Longitudinal Brasileño sobre el Envejecimiento (ELSI-Brasil), que es representativo a nivel nacional. La muestra consistió en 8,950 participantes que fueron asignados a ocho grupos de edad: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 y ≥ 85 años. Los cuestionarios utilizados incluyeron calidad del sueño autorreportada y el Cuestionario Internacional de Actividad Física versión corta. Se realizó una prueba exacta de Fisher seguida por un análisis de regresión logística binaria para identificar la razón de probabilidades de la calidad del sueño para la ocurrencia de caídas, controlando las variables de confusión. Resultados: Participaron en este estudio individuos con edades entre 50 y 105 años (63,6 ± 10,2 años), siendo el 57,0% mujeres y el 43,0% hombres. En general, el 21,5% de los participantes experimentaron al menos una caída. La frecuencia relativa de participantes clasificados como con alta calidad de sueño o baja calidad de sueño (BCS) se mantuvo constante a lo largo de cada media década de vida. La BCS mostró un OR (p < 0,05) notable para las caídas en grupos de edad hasta los 84 años, incluso después de ajustar por variables de confusión. Conclusión: La BCS está significativamente asociada con una mayor ocurrencia de caídas en adultos mayores de 50 años, pero no para ≥ 85 años, independientemente del sexo y del nivel de actividad física.

Body composition indicators in the metabolic syndrome risk prediction in 6-10-year-old children / Indicadores de composição corporal na predição de risco de síndrome metabólica em crianças de 6 a 10 anos de idade

ABSTRACT The aim of this study was to develop percentiles of body composition indicators and determine cutoff points to predict metabolic syndrome (MS) risk in 6-10-year-old children. This is a cross-sectional, population-based epidemiological study with the participation of 1480 schoolchildren aged 6-10-year. Anthropometric assessment (body mass, height, and skinfolds) and blood pressure measurement were performed in schools. The body mass index (BMI), as well as the body fat percentage (%BF), lean body mass (LBM), fat body mass (FBM), were calculated according to standardized formulas for children. Blood collection to assess the lipid and glycemic profile was also performed at school, on pre-established days and times. The MS diagnosis was determined based on changes in triglycerides, HDL-c, blood glucose, waist circumference, and blood pressure. The LMS method was used to develop the percentiles, the area under the ROC curve (AUC) to identify the accuracy of the indicators, and the sensitivity and specificity to determine the cutoff points. FBM and %BF had significantly higher values in girls, who also had lower values for %LM compared to boys (p<0.05). The indicators of body composition, BMI, FBM, and %BF were accurate in predicting the MS risk for both sex at all ages. The main indicators of body composition to predict the MS risk, in both sex, were BMI, FBM, and %BF. These findings suggest that simple anthropometric measurements, which can be performed in clinical practice, have the potential to direct non-pharmacological actions.

RESUMO Objetivou-se desenvolver percentis de indicadores de composição corporal e determinar pontos de corte para predizer o risco de síndrome metabólica (SM) em crianças de seis a 10 anos de idade. Estudo epidemiológico de corte transversal, de base populacional, com participação de 1480 escolares de seis a 10 anos de idade. A avaliação antropométrica (massa corporal, estatura e dobras cutâneas) e a aferição da pressão arterial foram realizadas nas escolas. O índice de massa corporal (IMC) bem como o percentual de gordura (%GC), percentual de massa magra (%MM), massa corporal gorda (MCG) foram calculados de acordo com fórmulas padronizadas para crianças. A coleta de sangue para avaliar o perfil lipídico e glicêmico também foi realizada na escola, em dias e horários pré-estabelecidos. O diagnóstico da SM foi determinado com base em alterações nos triglicerídeos, HDL-c, glicemia, perímetro de cintura e pressão arterial. O método LMS foi utilizado para desenvolver os percentis, a área sob a curva ROC (AUC) para identificar a acurácia dos indicadores e a sensibilidade e especificidade para determinar os pontos de corte. MCG e %GC apresentaram valores significativamente superior nas meninas e também valores inferiores para a MCM em relação aos meninos (p<0,05). Os indicadores de composição corporal, IMC, MCG e %GC apresentaram acurácia na predição do risco de SM para ambos os sexos em todas as idades. Os principais indicadores de composição corporal para predição do risco de SM, em ambos os sexos, foram o IMC, %GC e MCG. Esses achados sugerem que medidas antropométricas simples, que podem ser realizadas na prática clínica, tem potencial para direcionar ações não medicamentosas

Daily Undulating Periodization Is More Effective Than Nonperiodized Training on Maximal Strength, Aerobic Capacity, and TCD4+ Cell Count in People Living With HIV.

ABSTRACT: Soares, VL, Soares, WF, Zanetti, HR, Neves, FF, Silva-Vergara, ML, and Mendes, EL. Daily undulating periodization is more effective than nonperiodized training on maximal strength, aerobic capacity, and TCD4+ cell count in people living with HIV. J Strength Cond Res 36(6): 1738-1748, 2022-The aim of this study was to evaluate the effects of daily undulating periodization (DUP) and nonperiodized training (NPT) programs on maximal muscle strength, body composition, aerobic capacity, muscle power, and immune markers in people living with HIV (PLWHIV). A total of 41 PLWHIV were randomly assigned to control (CON [n = 15]), DUP (n = 13), and NPT (n = 13) groups. The DUP and NPT groups performed combined training 3 times a week on nonconsecutive days during 12 weeks, whereas the CON group was asked to maintain their current level of activity. After the 12-week training program, DUP produced greater gains in muscle strength (except for bench press), V̇o2peak, and muscle power than NPT (p < 0.05). Compared to CON, the training groups showed significantly (p < 0.05) increased muscle strength (DUP = 31.0 ± 13.9 kg; NPT = 17.7 ± 9.2 kg; CON = -0.3 ± 1.5 kg), fat-free mass (DUP = 1.9 ± 1.5 kg; NPT = 1.4 ± 1.9 kg; CON = -0.1 ± 1.2 kg), and metabolic equivalent (DUP = 2.3 ± 1.3; NPT = 1.8 ± 1.9), and decreased body fat mass (DUP = -2.1 ± 1.6 kg; NPT = -1.4 ± 1.5 kg; CON = 0.1 ± 0.2) and functional aerobic impairment (DUP = -35.9 ± 17.0%; NPT = -25.8 ± 22.0%; CON = 0.8 ± 3.0%). There was an increase in TCD4+ cells only in the DUP group (p < 0.05). The training effect generally provided a positive correlation between change in leg press strength (r = 0.393, p < 0.05), triceps pulley strength (r = 0.417, p < 0.05), lat pull-down strength (r = 0.459, p < 0.05), and muscle power (r = 0.324, p < 0.05) with changing CD4 + lymphocyte count. Daily undulating periodization protocol showed to be safe, applicable, and more efficient for increasing strength, aerobic capacity, and TCD4+ cells compared to NPT in PLWHIV.

[Association between excessive TV viewing time and body mass index among Brazilian adolescents: quantile regression analysis of the National Student Health Survey (PeNSE), 2015]. / Associação entre tempo excessivo frente à TV e índice de massa corporal em adolescentes brasileiros: uma análise de regressão quantílica da PeNSE, 2015.

The study aimed to investigate whether excessive TV viewing time is associated with body mass index (BMI), irrespective of physical activity (PA) and interaction with consumption of ultra-processed foods (UPFs), among Brazilian adolescents. It is a cross-sectional study with data on 13-17-year-old adolescents from the 2015 National Student Health Survey. BMI was the outcome (direct measurement of height and body mass) and exposure was excessive TV viewing time (>2 h/day), daily consumption of UPFs and PA. Quantile regression was used to test associations and interactions. Excessive screen time was associated with higher BMI values (e.g., 25th percentile =0.060 kg/m² versus 95th percentile =0.891 kg/m², p<0.001). After adjusting for PA, the association remained, however, attenuated. The inclusion of UPFs in the model potentiated the association (e.g., 25th percentile =0.062 kg/m² versus 95th percentile =0.956 kg/m², p<0.001). Excessive screen time was associated with BMI percentiles, irrespective of PA - the absence of PA and the presence of UPF consumption affect the upper BMI percentiles more. Actions to reduce excessive TV viewing time, consumption of UPFs and promoting PA are essential to positively impact BMI and its reflexes on the health of Brazilian adolescents.

O objetivo do estudo foi investigar se tempo excessivo frente à TV está associado com índice de massa corporal (IMC), independente da atividade física (AF) e da interação com consumo de alimentos ultraprocessados (AUPs), em adolescentes brasileiros. Estudo transversal com dados de adolescentes de 13-17 anos da Pesquisa Nacional de Saúde do Escolar 2015. IMC foi o desfecho (medida direta da estatura e massa corporal) e as exposições foram tempo excessivo frente à TV (>2 h/dia), consumo diário de AUPs e AF. Regressão quantílica foi usada para testar associações e interações. Tempo excessivo frente à TV foi associado a maiores valores de IMC (ex.: 25º percentil =0,060 kg/m² versus 95º percentil =0,891 kg/m², p<0,001). Após ajuste para AF, a associação se manteve, porém, atenuada. A inclusão de AUPs no modelo potencializou a associação (ex.: 25º percentil =0,062 kg/m² versus 95º percentil =0,956 kg/m², p<0,001). Tempo excessivo frente à TV foi associado a percentis do IMC, independente da AF - ausência da AF e presença do consumo de AUPs afetam mais os percentis superiores do IMC. Ações para reduzir tempo excessivo frente à TV, consumo de AUPs e fomentar AF, são essenciais para impactar positivamente no IMC e seus reflexos na saúde dos adolescentes brasileiros.

Associação entre tempo excessivo frente à TV e índice de massa corporal em adolescentes brasileiros: uma análise de regressão quantílica da PeNSE, 2015 / Association between excessive TV viewing time and body mass index among Brazilian adolescents: quantile regression analysis of the National Student Health Survey (PeNSE), 2015

Resumo O objetivo do estudo foi investigar se tempo excessivo frente à TV está associado com índice de massa corporal (IMC), independente da atividade física (AF) e da interação com consumo de alimentos ultraprocessados (AUPs), em adolescentes brasileiros. Estudo transversal com dados de adolescentes de 13-17 anos da Pesquisa Nacional de Saúde do Escolar 2015. IMC foi o desfecho (medida direta da estatura e massa corporal) e as exposições foram tempo excessivo frente à TV (>2 h/dia), consumo diário de AUPs e AF. Regressão quantílica foi usada para testar associações e interações. Tempo excessivo frente à TV foi associado a maiores valores de IMC (ex.: 25º percentil =0,060 kg/m² versus 95º percentil =0,891 kg/m², p<0,001). Após ajuste para AF, a associação se manteve, porém, atenuada. A inclusão de AUPs no modelo potencializou a associação (ex.: 25º percentil =0,062 kg/m² versus 95º percentil =0,956 kg/m², p<0,001). Tempo excessivo frente à TV foi associado a percentis do IMC, independente da AF - ausência da AF e presença do consumo de AUPs afetam mais os percentis superiores do IMC. Ações para reduzir tempo excessivo frente à TV, consumo de AUPs e fomentar AF, são essenciais para impactar positivamente no IMC e seus reflexos na saúde dos adolescentes brasileiros.

Abstract The study aimed to investigate whether excessive TV viewing time is associated with body mass index (BMI), irrespective of physical activity (PA) and interaction with consumption of ultra-processed foods (UPFs), among Brazilian adolescents. It is a cross-sectional study with data on 13-17-year-old adolescents from the 2015 National Student Health Survey. BMI was the outcome (direct measurement of height and body mass) and exposure was excessive TV viewing time (>2 h/day), daily consumption of UPFs and PA. Quantile regression was used to test associations and interactions. Excessive screen time was associated with higher BMI values (e.g., 25th percentile =0.060 kg/m² versus 95th percentile =0.891 kg/m², p<0.001). After adjusting for PA, the association remained, however, attenuated. The inclusion of UPFs in the model potentiated the association (e.g., 25th percentile =0.062 kg/m² versus 95th percentile =0.956 kg/m², p<0.001). Excessive screen time was associated with BMI percentiles, irrespective of PA - the absence of PA and the presence of UPF consumption affect the upper BMI percentiles more. Actions to reduce excessive TV viewing time, consumption of UPFs and promoting PA are essential to positively impact BMI and its reflexes on the health of Brazilian adolescents.

Time Course of Recovery for Performance Attributes and Circulating Markers of Muscle Damage Following a Rugby Union Match in Amateur Athletes.

BACKGROUND: We sought to determine the time course of changes in neuromuscular performance and muscle damage following a single rugby union match. METHODS: Fourteen male amateur rugby players (28.9 ± 3.5 yrs; 1.7 ± 5.1 m; 86.1 ± 11.1 kg) participated. Plasma activity of creatine kinase ([CK]) and lactate dehydrogenase (LDH), L-run test (change of direction) and 30-m sprint (T30; speed) with 10-m lap time (T10; acceleration) were assessed on six occasions: one week before the match (PRE) and immediately, 24, 48, 72, and 96 h post-match. RESULTS: Relative to PRE, LDH was elevated immediately post-match (+33.6% ± 13.6%; p < 0.001) and [CK] was elevated immediately (+64.1% ± 38.8%, p = 0.001) and 24 h post-match (+352% ± 317%; p = 0.024). L-run test time increased 16.0 ± 8.7% relative to PRE at 24 h post (p < 0.001) and remained elevated through 96 h post-match (p < 0.05). T10 and T30 times increased relative to PRE immediately post-match (+12.0% ± 10.4%, p = 0.008; and +6.1% ± 4.9%; p = 0.006, respectively), though T30 times were similar to baseline by 48 h post-match whereas T10 times remained elevated through 72 h post-match. CONCLUSIONS: A single, competitive rugby union match induces significant muscle damage and performance decrements with distinct time courses of recovery in amateur athletes. Notably, change of direction attributes (i.e., L-run) appear to have the longest time course to full recovery.

Effects of Exercise Training and Statin Use in People Living with Human Immunodeficiency Virus with Dyslipidemia.

PURPOSE: To evaluate the effects of the combination of exercise training (ET) and statins in people living with human immunodeficiency virus. METHODS: This was a randomized, double-blind, placebo-controlled clinical trial. Eighty-three people living with human immunodeficiency virus were assigned to either placebo (PL), statins (STA), PL + ET (PLET) or STA + ET (STAET) groups. Volunteers assigned to STA and STAET groups were administered 10 mg of rosuvastatin, whereas the PL and PLET groups were administered a placebo. The PLET and STAET groups performed ET three times a week. Before and after the 12-wk follow-up, the volunteers underwent to anthropometric assessment and blood collection to evaluate lipid profile, cardiovascular markers, inflammatory profile; a Doppler ultrasound examination, muscle strength (MS) and cardiorespiratory fitness (CF) tests were performed. RESULTS: There was a decrease in total cholesterol, triglycerides, low-density lipoprotein, C-reactive protein, fibrinogen, interleukin (IL)-1ß and right carotid intima-media thickness in the STA, PLET, and STAET groups compared with PL group (P < 0.001). Furthermore, there was a decrease in total cholesterol, triglycerides, low-density lipoprotein, IL-1ß, IL-6, and IL-8 levels and in left and right carotid intima-media thickness and an increase in HDL-c levels in the STAET groups compared with the STA (P ≤ 0.001) and PLET groups (P ≤ 0.001). There was an increase in IL-10 levels, peak-systolic velocity, end-diastolic velocity, wall shear rate in the PLET and STAET groups compared with the PL (P ≤ 0.001) and STA groups (P ≤ 0.001). The PLET and STAET groups reduced body fat mass, body fat percentage and increased lean body mass, MS and CF compared with PL (P ≤ 0.001) and STA (P ≤ 0.001) groups. CONCLUSIONS: The combination of ET and statins is useful to enhance lipid and inflammatory profiles, reduce cardiovascular disease markers, and improve Doppler ultrasound findings, MS and CF in people living with HIV.

Using the medicine ball throw test to predict upper limb muscle power: validity evidence / Teste do arremesso de bola medicinal para predizer potência muscular de membros superiores: evidências de validade

Abstract Muscle power is the product of muscle force and velocity, which translates into the ability to produce force in a short time interval. Periodic evaluations of strength and power, coupled with training strategies for these capacities, are of great value to athletes and multi-sports coaches, since they are key determinants for team success. Specifically, in rugby, where passing is a predominant and determinant element of sporting success, few field tests are available for assessing upper limb muscle power. The purpose of this point of view is to correct the upper limb power prediction equation previously published by our group and to highlight its concepts and applicability in sports, especially in rugby.

Resumo Potência muscular é o produto entre força e velocidade, que se traduz na capacidade de produzir força em um curto intervalo de tempo. Avaliações periódicas de força e potência, combinadas a estratégias de treinamento para essas capacidades, são de grande valor para atletas e treinadores multi-esportivos, pois são determinantes para o sucesso da equipe. Especificamente no rugby, onde o passe é elemento predominante e determinante do sucesso esportivo, poucos testes de campo estão disponíveis para avaliar força muscular de membro superior. O objetivo deste ponto de vista é corrigir a equação de predição de potência do membro superior previamente publicada pelo nosso grupo e destacar seus conceitos e aplicabilidade nos esportes, especialmente no rugby.

Food consumption, physical activity level and sedentary behavior in schoolchildren / Consumo alimentar, nível de atividade física e comportamento sedentário em escolares

Abstract Dietary intake inquiry, physical activity (PA) and sedentary behavior (SB) surveys are practical tools for identifying habits among the pediatric population; however, the results of describing these behaviors appear to be restricted to large centers. The objective was to analyze dietary intake, PA and SB level in schoolchildren. Children from 6 to 10 years old, coming from public and private schools were evaluated for anthropometry, dietary pattern, PA and SB level. A total of 1408 children (48.1% male) with a mean age of 8.05 (± 1.53) years participated in the study. Only 4.6%, 4.9% and 17.2% of children met the recommendations for fruit, milk and dairy products, respectively. 40.4% and 59.5% of the children did not meet the recommendation for soft drinks and meat consumption, respectively. More than 75% of children met the recommendation for the consumption of packaged snacks, candies and beans. There was a difference between genders only for candy consumption (p=0.003), with a higher proportion of boys meeting the recommendations. Approximately half and one third of the children complied with the recommendations for moderate to vigorous PA and SB, respectively. Risk behaviors for cardiovascular disease were observed in children, characterized by low consumption of fruits and vegetables, low levels of PA and excessive time in SB.

Resumo Inquéritos de consumo alimentar, atividade física (AF) e comportamento sedentário (CS) constituem instrumentos práticos na identificação de hábitos entre a população pediátrica. No entanto, os resultados de descrição desses comportamentos parecem estar restritos a grandes centros. Objetivou-se analisar consumo alimentar, nível de AF e CS em escolares. Crianças de seis a 10 anos de idade, oriundas de escolas públicas e privadas foram avaliadas quanto à antropometria, padrão dietético, nível de AF e de CS. Um total de 1408 crianças (48,1% do sexo masculino) com média de idade de 8,05 (± 1,53) anos participou do estudo. Apenas 4,6%, 4,9% e 17,2% das crianças atenderam às recomendações de consumo de frutas, leite e derivados e verduras/legumes, respectivamente. Não atenderam a recomendação para consumo de refrigerante e carnes 40,4% e 59,5% das crianças, respectivamente. Mais de 75% das crianças atenderam a recomendação para o consumo de salgadinho de pacote, doces e feijão. Houve diferença entre os sexos somente para o consumo de doces (p=0,003), com maior proporção de meninos a atender as recomendações. Aproximadamente, metade e um terço das crianças atenderam as recomendações para prática de AF de moderada a vigorosa intensidade e de CS, respectivamente. Comportamentos de risco para doenças cardiovasculares foram observados nas crianças, caracterizado pelo baixo consumo de frutas e verduras/legumes, baixos níveis de AF e excessivo tempo em CS.

Cluster and simultaneity of modifiable risk factors for cardiovascular diseases in adolescents of Southeast Brazil

Abstract Aim: This study aimed to evaluate the cluster of the five major modifiable risk factors for cardiovascular diseases (CVD) and their associated factors and to identify patterns of concurrency of modifiable obesogenic risk factors associated with overweight in Brazilian adolescents. Methods: A survey was conducted (2015) with 1,055 (boys, n = 475; girls, n = 580) high school (public and private schools) adolescents (14-20 years old) in a medium-sized city in Southeast Brazil. The observed prevalence ratio (O) for the expected (E) risk factors (smoking, alcohol, insufficient physical activity, sedentary behavior, and poor diet) greater than one (O/E > 1) was considered as a cluster. We use multinomial and binary logistic regressions (stratified by sex) in the analyzes. Results: Almost 30% of adolescents had three or more risk factors (no factor = 5.4%). The five risk factors tended to cluster in boys (O/E = 2.5; 95% CI = 1.6-3.5). In both sexes, smoking and alcohol consumption persisted in O/E > 1 ratio. Conclusions: Boys showed a consistent pattern of association for risk factors. Overweight was associated with pairs of obesogenic risk factors in both sexes. The results indicate the need for health interventions that consider the cluster and the simultaneity of risk factors for CVD among Brazilian youth.

Relationship between smartphone use and sedentary behavior: a school-based study with adolescents / Relacionamento entre smartphone e comportamento sedentário: estudo de base escolar com adolescentes

The aims of this study were a) to describe the smartphone use and sedentary behavior (SB) on typical weekdays and weekends, and b) to verify the association between smartphone use and SB among adolescents. This is a cross-sectional population school-based, which surveyed 984 students from Uberaba, Minas Gerais, in 2015. Gender-stratified analysis were performed using t-tests, Pearson's correlation (r) and multiple linear regression (ß). Girls used more smartphones than boys (weekdays: 6.58 hrs vs. 5.29 hrs, p < 0.001; weekend: 7.81 hrs vs. 6.18 hrs, p < 0.001). Both genders used more smartphones in the weekend (p < 0.001) than weekdays. SB was higher in girls than boys (weekdays: 5.34 hrs vs. 4.48 hrs, p < 0.001, weekend: 5.22 hrs vs. 4.38 hrs, p < 0.001). SB was higher for both genders at weekend (p < 0.001) than on weekdays. Correlation between SB and smartphone use ranged from weak to moderate in both genders (weekdays: boys, r = 0.30; girls, r = 0.17, p < 0.001; weekend: boys, r = 0.39; girls, r = 0.17, p < 0.001). Smartphone use was positively associated with SB during the weekdays (boys: ß = 0.25, girls: ß = 0.19, p < 0.001) and weekend (boys: ß = 0.31; girls: ß= 0.14, p < 0.001). Girls showed greater SB and smartphone use than boys, regardless if compared on weekdays or weekend. SB and smartphone were positively associated in both genders

Os objetivos deste estudo foram a) descrever o uso de smartphone e o comportamento sedentário (CS) em dias típicos de semana e final de semana (FDS) e, b) verificar a associação entre o uso de smartphone e o CS em adolescentes. Trata-se de um estudo transversal, com 984 escolares de Uberaba, Minas Gerais, conduzido em 2015. Para análises estratificadas por sexo, utilizou-se testes-t, correlação de Pearson (r) e regressão linear múltipla (ß). Moças usavam mais o smartphone que os rapazes (semana: 6,58 vs. 5,29 horas, p < 0,001; FDS: 7,81 vs. 6,18 horas, p < 0,001). Ambos os sexos usaram mais smartphone no FDS (p < 0,001). O CS foi maior nas moças que nos rapazes (semana: 5,34 vs. 4,48 horas, p < 0,001; FDS: 5,22 vs. 4,38 horas, p < 0,001). O CS foi maior no FDS, em ambos os sexos (p < 0,001). A correlação entre CS e smartphone foi de fraca a moderada em ambos os sexos (semana: rapazes, r = 0,30; moças, r = 0,17, p < 0,001; e FDS: rapazes, r = 0,39; moças, r = 0,17, p < 0,001). Uso de smartphone foi positivamente associado com CS durante a semana (rapazes: ß = 0,25; moças: ß = 0,19, p < 0,001) e FDS (rapazes: ß = 0,31; moças: ß = 0,14, p < 0,001). Moças apresentaram maior CS e uso de smartphone do que rapazes, independentemente se comparados na semana ou FDS. CS e uso de smartphones foram positivamente associados em ambos os sexos

High blood pressure screening in children and adolescents from Amargosa, Bahia: usefulness of anthropometric indices of obesity. / Triagem da pressão arterial elevada em crianças e adolescentes de Amargosa, Bahia: utilidade de indicadores antropométricos de obesidade.

OBJECTIVE: To determine the predictive power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), and their respective cut-off points for high blood pressure (BP) screening in Brazilian children and adolescents. METHOD: Cross-sectional study conducted with 1,139 students aged 6 to 17years. Body weight, height, WC, and BP were measured. High BP was classified as systolic or diastolic ≥ 95th percentile. Receiver Operating Characteristic (ROC) curves were constructed, and the area under the curve, sensitivity, and specificity were calculated. RESULTS: The prevalence of high BP was 27.0%. Anthropometric indices showed a significant association with high BP (accuracy ranging from 0.62 - 0.81), except for WHtR among male adolescents.Sensitivity was low, regardless of the anthropometric index, gender, and age group. CONCLUSION: BMI, WC, and WHtR were associated with high BP, but the cut-off points tested showed low sensitivity. Determining specific cut-off points for each population can enable the use of anthropometric indices in high BP screening.

OBJETIVO: Determinar o poder preditivo do índice de massa corporal (IMC), perímetro da cintura (PC) e razão da cintura pela estatura (RCEst) e de seus respectivos pontos de corte para triagem de pressão arterial (PA) elevada em crianças e adolescentes brasileiros. MÉTODO: Estudo transversal realizado com1.139 escolares de 6 a 17 anos de idade. A massa corporal, a estatura, o PC e a PA foram mensurados. A PA elevada foi classificada como sistólica ou diastólica≥ percentil 95. Curvas Receiver Operating Characteristic (ROC) foram construídas e a área sob a curva, a sensibilidade e a especificidade foram calculadas. RESULTADOS: A prevalência de PA elevada foi de 27,0%. Os indicadores antropométricos apresentaram associação significativa com PA elevada (acurácia variando de 0,62 - 0,81), exceto RCEst entre adolescentes do sexo masculino.Observou-se baixa sensibilidade, independentemente do indicador antropométrico, do sexo e da faixa etária. CONCLUSÃO: OIMC, o PC e a RCEst estiveram associados a PA elevada, porém os pontos de corte testados apresentaram baixa sensibilidade. A determinação de pontos de corte específicos para cada população pode viabilizar a triagem de PA elevada por meio de indicadores antropométricos.

Utility of anthropometric indicators to screen for clustered cardiometabolic risk factors in children and adolescents.

Background Anthropometric indicators are associated with cardiometabolic risk factors (CMRF), but there is no consensus as to which indicator is the most suitable to screen for clustered CMRF. This study aimed to evaluate the utility of five anthropometric indicators to screen for clustered CMRF in children and adolescents. Methods A cross-sectional study was conducted in 1139 schoolchildren aged 6-17 years from Northeastern Brazil. Body weight, height, waist circumference (WC) and subscapular (SSF) and triceps skinfold thickness (TSF) were measured. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. The following CMRF were evaluated: elevated total cholesterol, low high-density lipoprotein-cholesterol (HDL-C), elevated low-density lipoprotein-cholesterol (LDL-C), high triglyceride concentration, hyperglycemia and high blood pressure. The participants were categorized into no CMRF, 1 CMRF, 2 CMRF and ≥3 CMRF. Receiver operating characteristic (ROC) curves were constructed to assess the accuracy of the anthropometric indicators in predicting CMRF for age group and sex. Results Poor associations were observed between the anthropometric indicators and 1 CMRF (accuracy of 0.49-0.64). The indicators showed moderate associations with 2 CMRF (accuracy of 0.57-0.75) and ≥3 CMRF (accuracy of 0.59-0.79). In general, TSF exhibited the worst performance in predicting CMRF, followed by WHtR. The highest accuracies were observed for BMI, WC and SSF, with no significant difference between these indicators. Conclusions The routine use of BMI, WC and SSF as epidemiological screening tools for clustered CMRF in childhood and adolescence should be encouraged.

Efeitos de um programa de Mat Pilates sobre indicadores de saúde em servidores de um hospital / Effects of a Mat Pilates program on health indicators in servers of a hospital

Objetivo:Avaliar o efeito de um programa Mat Pilates sobre a composição corporal, qualidade de vida, nível de atividade física, flexibilidade e força em servidores de um hospital universitário. Procedimentos metodológicos: Trata-se de um estudo quasi-experimental com 22 servidores, que participaram de um programa de Mat Pilates uma vez por semana, durante 20 semanas. Os servidores foram submetidos à aferição da pressão arterial, avaliação corporal, teste de força abdominal e flexibilidade, e preencheram questionários de qualidade de vida, saúde e nível de atividade física, antes e depois da intervenção. Para análise das variáveis contínuas e categóricas foram utilizados os testes t pareado e qui-quadrado, respectivamente, ao nível de significância p<0,05. Resultados: Após intervenção observou-se redução significativa do perímetro da cintura, pressão arterial sistólica e diastólica, massa corporal gorda e percentagem de gordura. Ainda, houve melhora dos níveis de atividade física, força abdominal, flexibilidade e domínios da qualidade de vida. Conclusão: Mat Pilates se mostra eficiente em melhorar parâmetros hemodinâmicos, físicos e de qualidade de vida em servidores de um hospital universitário

Objective: To evaluate the effect of a Mat Pilates program regarding the body composition, quality of life, level of physical activity, flexibility and strength in servants of a university hospital. Methodological procedures: This is a quasi-experimental study with 22 servers, who participated in a Mat Pilates program once a week for 20 weeks. The servers were submitted to blood pressure measurement, body evaluation, abdominal strength test and flexibility, and filled out questionnaires on quality of life, health and physical activity level, before and after the intervention. For the analysis of the continuous and categorical variables, paired and chi-square tests were used, respectively, at the significance level p <0.05. Results: A significant reduction in waist circumference, systolic and diastolic blood pressure, fat body mass and fat percentage were observed after intervention. Still, there was improvement of physical activity levels, abdominal strength, flexibility and domains of quality of life. Conclusion: Mat Pilates is efficient in improving hemodynamic, physical and quality of life parameters in servants of a university hospita

Triagem da pressão arterial elevada em crianças e adolescentes de Amargosa, Bahia: utilidade de indicadores antropométricos de obesidade / High blood pressure screening in children and adolescents from Amargosa, Bahia: usefulness of anthropometric indices of obesity

RESUMO: Objetivo: Determinar o poder preditivo do índice de massa corporal (IMC), perímetro da cintura (PC) e razão da cintura pela estatura (RCEst) e de seus respectivos pontos de corte para triagem de pressão arterial (PA) elevada em crianças e adolescentes brasileiros. Método: Estudo transversal realizado com1.139 escolares de 6 a 17 anos de idade. A massa corporal, a estatura, o PC e a PA foram mensurados. A PA elevada foi classificada como sistólica ou diastólica≥ percentil 95. Curvas Receiver Operating Characteristic (ROC) foram construídas e a área sob a curva, a sensibilidade e a especificidade foram calculadas. Resultados: A prevalência de PA elevada foi de 27,0%. Os indicadores antropométricos apresentaram associação significativa com PA elevada (acurácia variando de 0,62 - 0,81), exceto RCEst entre adolescentes do sexo masculino.Observou-se baixa sensibilidade, independentemente do indicador antropométrico, do sexo e da faixa etária. Conclusão: OIMC, o PC e a RCEst estiveram associados a PA elevada, porém os pontos de corte testados apresentaram baixa sensibilidade. A determinação de pontos de corte específicos para cada população pode viabilizar a triagem de PA elevada por meio de indicadores antropométricos.

ABSTRACT: Objective: To determine the predictive power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), and their respective cut-off points for high blood pressure (BP) screening in Brazilian children and adolescents. Method: Cross-sectional study conducted with 1,139 students aged 6 to 17years. Body weight, height, WC, and BP were measured. High BP was classified as systolic or diastolic ≥ 95th percentile. Receiver Operating Characteristic (ROC) curves were constructed, and the area under the curve, sensitivity, and specificity were calculated. Results: The prevalence of high BP was 27.0%. Anthropometric indices showed a significant association with high BP (accuracy ranging from 0.62 - 0.81), except for WHtR among male adolescents.Sensitivity was low, regardless of the anthropometric index, gender, and age group. Conclusion: BMI, WC, and WHtR were associated with high BP, but the cut-off points tested showed low sensitivity. Determining specific cut-off points for each population can enable the use of anthropometric indices in high BP screening.

Waist circumference percentile curves as a screening tool to predict cardiovascular risk factors and metabolic syndrome risk in Brazilian children.

The goals of this study were to develop reference values for waist circumference (WC) in Brazilian children between 6-10 years old and to evaluate the WC performance in predicting cardiovascular risk factors and metabolic syndrome (MetS) in children. This is a population-based epidemiological cross-sectional study, in which 1,397 children participated, with a 6-10 years old probability sampling and from public and private schools in the city of Uberaba, Minas Gerais State, Brazil. WC was measured at the waist narrowest point (WC1) and at the umbilicus level (WC2). Blood samples and blood pressure were collected to determine the MetS diagnosis. There was a significant effect of age (p = 0.001), anatomical point (WC1 vs. WC2, p = 0.001) and sex-anatomical point interaction (p = 0.016) for WC. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th and 95th percentile curves of WC1 and WC2 were designed by the LMS method. WC was accurate to predict MetS, for all ages [area under the ROC curve (AUC) > 0.79 and p < 0.05], regardless of sex. This study presented percentile curves for WC at two anatomical points in a representative sample of Brazilian children. Furthermore, WC was shown to be a strong predictor of cardiovascular risk factors and MetS in children.

Comportamento sedentário em adolescentes: prevalência e fatores associados / Sedentary behavior in adolescents: prevalence and associated factors

Este estudo objetivou determinar a prevalência do comportamento sedentário (CS) e analisar os fatores sociodemográfi cos, comportamentais, de hábitos alimentares e de saúde associados em adolescentes. Este é um estudo transversal de base populacional escolar com participação de 1.009 adolescentes (55,0% do sexo feminino) de 14 a 19 anos das escolas públicas e privadas do município de Uberaba, Minas Gerais, Brasil. O CS foi estimado pelo tempo sedentário de tela (assistir TV + jogar videogame + uso de computador) ≥ 2 h/dia. Empregou-se a regressão logística hierárquica para analisar os fatores sociodemográfi cos (sexo, idade, situação de estágio/trabalho, renda familiar, turno e série de estudo), comportamentais e de hábitos alimentares (atividade física no lazer, participação nas aulas de Educação Física, consumo de frutas, frituras e refrigerantes) e de saúde (IMC, autopercepção do sono e da saúde) associados ao CS. A prevalência do CS foi de 81,6% (IC95%: 78,8 - 84,4) sendo maior entre o sexo masculino (84,9%; IC95%: 82,6 - 87,2) do que no feminino (78,6%; IC95%: 75,9 - 81,3, p = 0,018). Na análise ajustada, apresentaram maiores chances de CS: o sexo masculino (OR = 1,78; IC95%: 1,23 - 2,56), aqueles do 1º ano (OR = 1,89; IC95%: 1,22 -2,94) e 2º ano de estudo (OR = 1,97; IC95%: 1,22 -3,17), não ter vínculo de estágio/trabalho (OR = 2,23; IC95%: 1,54 -3,23) e menor consumo de frutas (OR = 1,43; IC95%: 1,01 - 2,14). A prevalência do CS foi alta e o sexo, a série de estudo, a situação de estágio/trabalho e o hábito alimentar foram fatores associados. Os adolescentes aqui identificados com maiores chances de apresentarem CS representam potenciais grupos para intervenções que objetivem a redução do entretenimento sedentário baseado em tela, seja em casa, na escola e no ambiente de estágio/trabalho....(AU)

The purpose of this study was to determine the prevalence of sedentary behavior (SB) and to analyze the sociodemographic, behavioral, eating habits and health associated factors in adolescents. This is a cross-sectional population-based study involving 1,009 adolescents (55.0% females) aged 14 to 19 from public and private schools in Uberaba, Minas Gerais, Brazil. SB was estimated by sedentary screen time (watch TV + play videogame + computer use) ≥ 2 h/day. The hierarchical logistic regression was used to analyze sociodemographic factors (sex, age, internship/work status, family income, shifts and study series), behavioral and eating habits (physical activity in leisure, participation in Physical Education classes, consumption of fruits, fried foods and soft drinks) and health (BMI, self-perception of sleep and health) associated with SB. The prevalence of SB was 81.6% (95%CI: 78.8 - 84.4), higher among males (84.9%; 95%CI: 82.6 - 87.2) than females (78.6%, 95% CI: 75.9-81.3, p = 0.018). Adjusted regression analyses showed SB higher to male (OR = 1.78, 95%CI: 1.23 - 2.56), in the 1st class (OR = 1.89, 95% CI: 1.22 - (OR = 1.97, 95% CI: 1.22 -3.17), not have internship/work (OR = 2.23, 95%CI: 1.54 -3.23) and lower fruit intake (OR = 1.43, 95% CI: 1.01 - 2.14). The prevalence of SB was high. The sex, study series, internship/ work status and eating habits were associated factors. The adolescents here identifi ed as being more likely to SB represent potential groups for interventions that aim to reduce screen-based sedentary entertainment, whether at home, at school or in the work / internship environment....(AU)

Número de passos para discriminar pressão arterial elevada em jovens: quantos são o suficiente? / Step count to discriminate high blood pressure in young: how many steps are enough?

A relação entre a prática de atividade física e pressão arterial (PA) tem sido reportada entre jovens. Contudo, pontos de corte do número de passos para discriminar PA elevada na população pediátrica ainda são incertos. O objetivo do presente estudo foi avaliar quantos passos por dia são suficientes para discriminar PA elevada em crianças e adolescentes. Estudo transversal com 1.044 escolares (456 meninos), de seis a 17 anos de idade, do município de Amargosa, Bahia, Brasil. A PA foi mensurada e a PA elevada foi classificada como sistólica ou diastólica ≥ percentil 95 de acordo com sexo, idade e estatura. O número de passos diários foi estimado por pedômetro. Curvas Receiver Operating Characteristic foram construídas e a área sob a curva, sensibilidade, especificidade e intervalos de confiança (IC) de 95% foram calculados, com análises separadas por sexo. A prevalência de PA elevada foi de 27,8%. O número de passos foi preditor de PA elevada tanto para o sexo masculino (acurácia = 0,55; IC95%: 0,51-0,60) quanto para o feminino (acuraria = 0,58; IC95%: 0,54-0,62). Os pontos de corte com maior equilíbrio entre sensibilidade e especificidade foram 14.228 passos para o sexo masculino e 10.796 passos para o feminino. O número de passos por dia, avaliado por pedômetro, foi preditor de PA elevada nas crianças e adolescentes investigados. Em termos práticos, sugere-se a utilização de 14.000 e 11.000 passos por dia para discriminar PA elevada em jovens do sexo masculino e feminino, respectivamente. Esses achados podem ser úteis para subsidiar ações de enfrentamento à PA elevada na infância e adolescência

The relationship between physical activity and blood pressure (BP) in children and adolescents has been extensively studied. However, step count cut-off points that discriminate high BP in the pediatric population are still uncertain. Thus, this study aimed to determine how many steps per day are enough to discriminate high BP in children and adolescents. Cross-sectional study involving 1,044 schoolchildren (456 boys) aged 6 to 17 years from the city of Amargosa, Bahia, Brazil. Blood pressure was measured and a high BP was defined as a systolic or diastolic value ≥ 95th percentile according to sex, age and height. The number of daily steps was estimated with a pedometer. Receiver operating curves were constructed and the area under the curve, sensitivity, specificity and 95% confidence interval (CI) were calculated, with analyzes separated by sex. The prevalence of high BP was 27.8%. Step count was a predictor of high BP in both boys (accuracy = 0.55; 95%CI: 0.51-0.60) and girls (accuracy = 0.58; 95%CI: 0.54-0.62). The cut-off points with the best balance between sensitivity and specificity were 14,228 steps for boys and 10,796 for girls. Pedometer-de-termined daily step count was a predictor of high BP in the children and adolescents studied. In practical terms, the use of 14,000 and 11,000 steps per day is recommended to discriminate high BP in young boys and girls, respectively. These findings could be useful to support actions designed to cope with high BP in childhood and adolescence