Effect of physical activity on the relationship between adiposity and cardiac autonomic modulation in female breast cancer survivors: a longitudinal study.

This longitudinal study aimed to analyze the influence of physical activity (PA) on the relationship between body adiposity and cardiac autonomic modulation (CAM) in women survivors of breast cancer. We collected body adiposity through electrical bioimpedance considering body fat percentage (BFP), CAM through heart rate variability (considering RMSSD, SDNN, PNN50, LF (m2), HF (m2), SD1 indexes and SD1/SD2 ratio) and PA through a questionnaire in 64 participants (58.0 ± 9.6 years), recruited through the local association of support for breast cancer and by direct indications from city mastologists. After insertion of PA into the multivariate statistical model, significant attenuation was observed in the relationship between body adiposity and CAM for the indices: SDNN (ß = -0.94; 95 percent CI: -1.93; 0.04; p = .060) and SD1/SD2 (ß = -0.01;95 percent CI = -0.02; 0.001; p = .065). In conclusion, it was observed that PA was able to mitigate the relationships between BFP and CAM (considering SDNN index and SD1/SD2 ratio) in breast cancer survivors.

Relationship of household composition with sedentary behavior and eating habits of 102,072 adolescents: A representative sample of Brazil (PeNSE Study).

PURPOSE: The household composition is important for adolescents and understanding its relationship with their lifestyle habits is essential. This study aimed to analyze the relationship of household composition with sedentary behavior and eating habits of adolescents. METHODS: This study analyzed data from the Brazilian National Scholar Health Survey-PeNSE 2015. The sample was composed by 102,072 adolescents (11-17 years). The independent variable of the study was the household composition (living with both parents versus living with only one parent or none of them), whereas outcome variables were eating habits and sedentary behavior patterns. Logistic regression models were used to analyze the association between variables. RESULTS: Adolescents living with both parents were less likely to have high sedentary behavior (≥2 h OR = 0.89; ≥4 h OR = 0.86), eat while watching TV for ≥5 days/week (OR = 0.88), frequent fried foods (OR = 0.89), sweets (OR = 0.92), soft drinks (OR = 0.86) and ultra processed foods (OR = 0.97) consumption, as were more likely to have lunch with parents (OR = 1.87), frequent vegetables (OR = 1.12), beans (OR = 1.14) and fruits (OR = 1.11) consumption than those who live with one parent or none of them. CONCLUSION: Households composed by both father and mother was associated with lower sedentary behavior and healthy eating habits in Brazilian adolescents.

Association of Musculoskeletal Pain With Sedentary Behavior in Public School Teachers: The Role of Habitual Physical Activity.

BACKGROUND: Sedentary behavior has been associated with musculoskeletal pain in school teachers. However, our hypothesis is that physical activity practice could mitigate this association. AIM: The aim of this study was to investigate the relationship of musculoskeletal pain with high screen-based sedentary behavior among public school teachers and whether physical activity could mitigate this relationship. METHOD: A sample of 246 teachers from 13 public schools were assessed (45.0 ± 10.4 years, 76.0% of women). Musculoskeletal pain was assessed using the Nordic Musculoskeletal Questionnaire, screen-based sedentary behavior was measured considering the sum of screen time in television, computer, and smartphone/tablet, and physical activity using the Baecke habitual physical activity questionnaire. Binary logistic regression was used to verify the associations between high screen-based sedentary behavior and musculoskeletal pain in school teachers (Model 1-unadjusted; Model 2-adjusted by age, sex, and socioeconomic status; Model 3-variables of Model 2 + adjusted by physical activity). RESULTS: High screen-based sedentary behavior was associated with pain in neck (odds ratio = 2.09; 95%confidence interval = 1.08-4.04), upper back (odds ratio = 2.21; 95%confidence interval = 1.07-4.56), and low back (odds ratio = 1.91; 95%confidence interval = 1.00-3.65). However, after inserting the variables, including physical activity, these associations were mitigated. CONCLUSIONS: High screen-based sedentary behavior was associated with musculoskeletal pain in public school teachers. However, this relationship was mitigated after the inclusion of confounding variables, including physical activity.

Association between cardiac autonomic modulation and sedentary behavior in breast cancer survivors: a 12-month cohort study.

PURPOSE: This study aimed to analyze the longitudinal influence of sitting time (ST) on cardiac autonomic modulation (CAM) and resting heart rate (RHR) in a 12-month cohort of 67 breast cancer survivors. METHODS: CAM was assessed by heart rate variability with heart monitor which also assessed RHR, and ST was self-reported. The relationship between the variables was analyzed by the Pearson correlation and its magnitude by linear regression. RESULTS: At baseline, no associations were found between ST and CAM or RHR. In the delta analyses, a decrease in RMSSD, SD1, and HF(ms2) was associated with sitting time. At 12-month follow-up, there was an increase in the ST and a decrease in RHR. ST was negatively related with CAM (RMSSD, PNN50, and SD1), but no association was observed between ST and RHR. CONCLUSION: The increase in ST was associated with worsening of CAM after 12-month follow-up. Promoting reduction in ST will be an important strategy against cardiovascular impairment in breast cancer survivors.

Bidirectional Association Between Sleep Quality and Low Back Pain in Older Adults: A Longitudinal Observational Study.

OBJECTIVE: To investigate the bidirectional relationship by determining whether baseline sleep quality predicts pain intensity and whether baseline pain intensity predicts sleep quality in older individuals with chronic low back pain (LBP). DESIGN: A prospective longitudinal cohort study with a 6-month follow-up period. SETTING: Community. PARTICIPANTS: Older adults with LBP aged 60 years or older (N=215). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Data collection occurred at baseline and at 6 months. Pain intensity and sleep quality were measured in both time points of assessment using the numeric pain rating scale (range, 0-10) and the Pittsburg Sleep Quality Index. At baseline, we also collected information on demographic anthropometric variables, cognitive status, depression, and comorbidities. Multivariable linear regression analyses adjusted for potential covariates were performed. RESULTS: A total of 215 individuals with LBP were recruited. Poor sleep quality at baseline predicted high pain intensity at 6 months (ß coefficient, 0.18; 95% confidence interval [CI], 0.07-0.30). High pain intensity at baseline predicted poor sleep quality 6 months later (ß coefficient, 0.14; 95% CI, 0.01-0.26). CONCLUSION: Our findings give some support to the bidirectional relationship between pain and sleep quality in older individuals with LBP. This bidirectional relationship may be used as prognostic information by clinicians when managing patients with LBP.

Relationship of sleep quality with screen-based sedentary time and physical activity in adolescents - the moderating effect of body mass index.

OBJECTIVE: To analyze the association of sleep quality with reported screen-based sedentary time and reported physical activity, among overweight adolescents. METHODS: Adolescents aged 10 to 17 years enrolled in public and private schools were included. Data collection was carried out during the school semesters of 2014-2015 and participants who did not participate in all evaluations were excluded. Sleep quality and physical activity were assessed by validated questionnaires. Screen-based sedentary time was assessed by self-reported mean daily hours spent on television, computer, smartphone/tablet, and videogames. Body mass index was objectively measured and adolescents were classified into normal weight and overweight according to cutoff points for age and sex. Multiple linear regression models adjusted by covariates (age, sex, ethnicity, and socioeconomic status) were used to analyze the relationship between variables. RESULTS: A total of 1008 adolescents were assessed, with a mean age of 13.2 ± 2.4 years and a mean body mass index of 20.4 ± 4.3 kg/m2. Overweight was observed in 28.0% of sample, while 53.0% reported non-white ethnicity. Self-reported screen-based sedentary time was significantly related to poor sleep quality in adolescents (ß = 0.116, p = 0.005), remaining significant only in those who were normal weight (ß = 0.101, p = 0.007) in sensitivity analysis. Self-reported physical activity showed no relationship with sleep quality in both normal weight and overweight adolescents. CONCLUSION: Self-reported screen-based sedentary time was associated with poor sleep quality in adolescents, mainly among those with normal weight. The time spent on screen-based sedentary activities can impair sleep quality even in normal weight adolescents.

Depressive Symptoms Associated With Musculoskeletal Pain in Inactive Adults During COVID-19 Quarantine.

BACKGROUND: Depression has been associated with episodes of musculoskeletal pain. However, it is not clear whether such relationships could be mitigated according to the physical activity level. AIM: To describe, during the COVID-19 pandemic, the relationship between depression and musculoskeletal pain according to the physical activity levels. DESIGN: Cross-sectional study. METHODS: This research was conducted in Brazil between May 5 and March 17, 2020. Participants (N = 1872; 58% women) were invited through social media to answer a structured online questionnaire. Depressive symptoms were assessed through self-report of perception of depression during quarantine. Musculoskeletal pain was assessed based on the Nordic questionnaire identifying nine possible pain points in the body. Physical activity was assessed based on the weekly frequency, intensity, and duration of each session of physical activity the participants engaged in during COVID-19. The logistic binary regression analyzed the associations between depressive symptoms and musculoskeletal pain according to the participants' level of physical activity. RESULTS: Depressive symptoms were associated with pain in six different regions of the body in physically inactive participants. In physically inactive participants, those with depressive symptoms 1.51 (95% CI = 1.04-2.19) and 2.78 (95% CI = 1.81-4.26) times more likely to have pain in one or two and ≥three regions body regions, respectively. In active participants, depressive symptoms were not associated with pain. CONCLUSION: During the COVID-19 pandemic, depression was associated with musculoskeletal pain in physically inactive participants.

Sports Participation from Childhood to Adolescence is Associated with Lower Body Dissatisfaction in Boys-A Sex-Specific Analysis.

OBJECTIVES: This study aimed to analyze the association between body dissatisfaction and sports participation from childhood to adolescence in a school-based sample of adolescents, according to sex. METHODS: A total of 1011 adolescents of 13.1 ± 2.3 years of age were evaluated. Body dissatisfaction was assessed by the Silhouettes Scale and sports participation for at least one consecutive year was retrospectively assessed by closed specific questions related to childhood and adolescence periods. Body mass index (BMI) and abdominal obesity were objectively measured. Habitual practice of physical activity (PA), socioeconomic status (SES), and ethnicity were assessed through questionnaires. RESULTS: Sports participation from childhood to adolescence was observed in 55.1% of boys and in 41.2% of girls. Boys with body dissatisfaction showed lower habitual PA in leisure time (Baecke score = 4.38 ± 2.27 vs. 5.15 ± 2.25, p < 0.05) and in total (Baecke score = 9.34 ± 2.64 vs. 9.96 ± 2.68, p < 0.05) than those who were satisfied. No differences were observed among girls. Sports participation from childhood to adolescence was associated with 42% less chance of having body dissatisfaction in boys (OR = 0.58 [95%CI = 0.36-0.94]). No significant association was observed among girls. CONCLUSIONS FOR PRACTICE: Sports participation from childhood to adolescence was negatively associated with body dissatisfaction in boys. The continuity of physical activity during youth may be an important modifiable factor to reduce body dissatisfaction.

Effects of active video games on children and adolescents: A systematic review with meta-analysis.

OBJECTIVE: To investigate the effectiveness of active video games (AVGs) on obesity-related outcomes and physical activity levels in children and adolescents. DESIGN: Systematic review with meta-analysis. METHODS: Literature search was performed in five electronic databases and the main clinical trials registries. Randomized controlled trials investigating the effect of AVGs compared with no/minimal intervention on obesity-related outcomes (body mass index [BMI], body weight, body fat, and waist circumference) and physical activity levels of children and adolescents were eligible. Two independent reviewers extracted the data of each included study. PEDro scale was used to assess risk of bias and GRADE approach to evaluate overall quality of evidence. Pooled estimates were obtained using random effect models. RESULTS: Twelve studies were considered eligible for this review. Included studies mostly reported outcome data at short-term (less or equal than three months) and intermediate-term follow-up (more than 3 months, but <12 months). AVGs were more effective than no/minimal intervention in reducing BMI/zBMI at short-term (SMD = -0.34; 95% CI: -0.62 to -0.05) and intermediate-term follow-up (SMD = -0.36; 95% CI: -0.01 to -0.71). In addition, AVGs were more effective in reducing body weight compared with no/minimal intervention at intermediate-term follow-up (SMD = -0.25; 95% CI: -0.46 to -0.04). Regarding physical activity levels, AVGs were not more effective compared with minimal intervention at short-term and intermediate-term follow-up. CONCLUSIONS: Our review identified that AVGs were better than minimal intervention in reducing BMI and body weight, but not for increasing physical activity in young people.

Sedentary behavior is more related with cardiovascular parameters in normal weight than overweight adolescents.

This study analyzed the relationship between sedentary behavior and cardiovascular parameters in normal weight and overweight adolescents. The sample included 449 boys and 555 girls with mean age of 13 years from public schools, which were divided into five geographical regions, with data collections performed in one selected school from each region. Sedentary behavior was assessed by screen time on TV, computer, videogame and cell phone/tablet, with good reliability in adolescents. Physical activity was assessed by Baecke's questionnaire, validated for adolescents. Measures of body weight, height and waist circumference were collected. Adolescents were classified as overweight or normal weight by cut-off points of body mass index for age and sex. Cardiovascular parameters were evaluated by oscillometric device and heart rate by specific monitor. Computer use was positively related to systolic blood pressure (SBP) (ß = 0.35; 95%CI = 0.07-0.62) and diastolic blood pressure (DBP) (ß = 0.25; 95%CI = 0.05-0.44) in normal weight but not in overweight adolescents. Similar results were observed for cell phone/tablet in SBP (ß = 0.46; 95%CI = 0.20-0.72) and DBP (ß = 0.36; 95%CI = 0.18-0.54), only for normal weight. The cluster of screen time was related to SBP in normal weight (ß = 0.44; 95%CI = 0.03-0.84) and overweight (ß = 0.60; 95%CI = 0.01-1.19). Screen time in computer and cell phone/tablet was more related to cardiovascular parameters in normal weight than overweight adolescents.

Body size dissatisfaction associated with dietary pattern, overweight, and physical activity in adolescents: A cross-sectional study.

This study analyzed the association of body size dissatisfaction with body mass index, dietary pattern, and physical activity in adolescents. A sample of 1074 participants between 10 and 17 years of age was recruited. Body size dissatisfaction was assessed with the silhouettes' scale. Dietary pattern, physical activity, and socioeconomic status were assessed with questionnaires. Body mass index was measured objectively. The prevalence of body size dissatisfaction was 77.0%, where 29.8% desired to increase body size and 47.2% desired to decrease body size. Adolescents who desired to increase body size were more likely to consume vegetables and sweets and less likely to be in the highest quartile of physical activity than satisfied adolescents. Adolescents who desired to reduce body size were more likely to report lower fruit and vegetable consumption than satisfied adolescents. Health actions aiming to reduce body dissatisfaction in adolescents should address improvement in dietary pattern and physical activity engagement, considering that desires to increase or decrease body size were differently associated in this study.

Effects of 9 Months of Martial Arts Training on Cardiac Autonomic Modulation in Healthy Children and Adolescents.

PURPOSE: The aim of the study was to evaluate the cardiac autonomic modulation after 9 months of martial arts practice in healthy children and adolescents. METHOD: The study included 59 children and adolescents who were divided into 3 groups: judo, Muay Thai, and control. Heart rate variability was measured by a heart rate monitor, model Polar RS800CX. The intervention occurred twice a week on nonconsecutive days, lasting 60 minutes each session. A 1-way analysis of variance was used to compare participants at baseline. The comparisons between groups at baseline and after the intervention were carried out by a 2-way analysis of variance for repeated measures. RESULTS: After 9 months of intervention, significant increases were observed for root mean square successive differences, with higher values post compared with baseline (19.5%; P = .04). For SD1, an interaction effect was observed, with increased posttraining values compared with baseline (24.1%; P = .04) for the judo group. Qualitative analysis of the Poincaré plot showed greater dispersion of RR intervals, mainly beat to beat, after the judo intervention compared with the baseline. The Muay Thai and control groups presented no improvement. CONCLUSION: After 9 months of intervention, there were increases in cardiac autonomic modulation of children and adolescents participating in judo training. The practice of martial arts, such as judo, can be encouraged from an early age to improve cardiovascular system functioning, possibly providing protection against cardiovascular problems.

Impact of Martial Arts (Judo, Karate, and Kung Fu) on Bone Mineral Density Gains in Adolescents of Both Genders: 9-Month Follow-Up.

PURPOSE: To compare bone mineral density (BMD) gains in adolescents of both genders stratified according to different martial art styles in a 9-month follow-up study. METHODS: The longitudinal study consisted of 29 adolescents of both genders and age between 11 and 17 years stratified into a control group (not engaged in any sport) and 50 fighters (kung fu/karate, n = 29; judo, n = 21). All 79 subjects underwent anthropometric measures (weight, height, leg length, and height set) and dual-energy X-ray absorptiometry (BMD, in g/cm2) at 2 moments, baseline and 9 months later. Maturity offset (age at peak height velocity), lean soft tissue, chronological age, and resistance training were treated as covariates. RESULTS: Male judoists presented higher gains in BMD-spine [0.098 g/cm2 (95% confidence interval, 0.068-0.128)] than control group [0.040 g/cm2 (95% confidence interval, 0.011-0.069)] (post hoc test with P = .030). There was no effect of martial art on BMD gains among girls. Independently of gender, in all multivariate models, lean soft tissue constituted the most relevant covariate. CONCLUSIONS: Judo practice in adolescents affected the bone accrual significantly after 9-month follow-up compared with controls, mainly in boys.

Association of cardiac autonomic modulation with physical and clinical features of young people with type 1 diabetes.

OBJECTIVE: The objective of this study was to verify possible associations between heart rate variability indices and physical activity, body composition, and metabolic and cardiovascular parameters in individuals with type 1 diabetes. METHOD: A total of 39 young patients with type 1 diabetes were included. Body composition, physical activity, cardiovascular parameters, and metabolic parameters were assessed. For the heart rate variability analysis, heart rate was recorded beat-by-beat using a Polar S810i heart rate monitor for 30 minutes, with the volunteers in the supine position; subsequently, the following indices were considered: standard deviation of all normal RR intervals; root-mean square of differences between adjacent normal RR intervals in a time interval; percentage of adjacent RR intervals with a difference of duration >50 ms; high frequency component in milliseconds squared; high frequency component in normalised units; standard deviation of the instantaneous variability beat-to-beat; and standard deviation of the long-term variability. The association between the heart rate variability indices and independent variables was verified through linear regression in unadjusted and adjusted models (considering gender and age). The statistical significance was set at 5% and the confidence interval at 95%. RESULTS: High values of at-rest heart rate were associated with reduced parasympathetic activity and global heart rate variability, and higher values of waist-to-hip ratio were related to lower parasympathetic activity, independent of age or gender. CONCLUSION: For young patients with type 1 diabetes, increases in at-rest heart rate values are associated with reduced parasympathetic activity and global heart rate variability, whereas higher waist-to-hip ratio values are related to lower parasympathetic activity, both independent of age and gender.

Breakfast frequency, adiposity, and cardiovascular risk factors as markers in adolescents.

OBJECTIVE: To analyse the relationship between skipping breakfast and haemodynamic, metabolic, inflammatory, and cardiovascular risk factors in adolescents. METHODS: A cross-sectional study was carried out with information from an ongoing cohort study in Presidente Prudente, São Paulo, Brazil. The sample comprised of 120 adolescents (11.7±0.8 years old) who met the following inclusion criteria: age between 11 and 14 years; enrolled in the school unit of elementary education; absence of any known disease; and no drug consumption. The parents or legal guardians of the patients signed a formal informed consent. Skipping breakfast was self-reported through face-to-face interviews. Blood pressure, intima-media thickness, trunk fatness, total and fractional cholesterol levels - high-density lipoprotein cholesterol and low-density lipoprotein cholesterol - triacylglycerol levels, and high-sensitivity C-reactive protein levels were measured. RESULTS: In this study, 47.5% (95% CI: 38.5-56.4%) of the adolescents reported skipping breakfast at least 1 day/week. Adolescents who skipped breakfast had higher values of trunk fatness and systolic blood pressure. Breakfast frequency was negatively related to systolic blood pressure (ß -1.99 [-3.67; -0.31]) and z score dyslipidaemia (ß -0.46 [-0.90; -0.01]), but this relationship was mediated by trunk fatness. CONCLUSION: Skipping breakfast is related to cardiovascular risk factors in adolescents, and this relationship was mainly mediated by trunk fatness.

The association between cardiovascular risk factors and high blood pressure in adolescents: a school-based study.

OBJECTIVE: Although previous studies have analyzed the association between cardiovascular risk factors and blood pressure in adolescents, few studies conducted in developing countries analyzed whether the aggregation of risk factors contributes to an increased risk of high blood pressure in adolescents. The objective of this study was to assess the association between cardiovascular risk factors (including general overweight, abdominal obesity, high consumption of foods rich in fats, and insufficient physical activity levels) and high blood pressure in adolescents. METHODS: This study was carried out from 2007 to 2008 with 1021 adolescents (528 girls) from primary schools located in the city of Londrina- Brazil. Blood pressure was assessed using an oscillometric device. General overweight was obtained through body mass index, abdominal obesity was assessed using waist circumference, and the consumption of foods rich in fat and physical activity were assessed using a questionnaire. The sum of these risk factors was determined. RESULTS: Adolescents with three or four aggregated risk factors were more likely to have higher values of systolic and diastolic blood pressure when compared with adolescents who did not have any cardiovascular risk factors (P = 0.001 for both). Logistic regression indicated that groups of adolescents with 2 (OR= 2.46 [1.11-5.42]; P = 0.026), 3 (OR= 4.97 [2.07-11.92]; P = 0.001) or 4 risk factors (OR= 6.79 [2.24-19.9]; P = 0.001) presented an increased likelihood of high blood pressure. CONCLUSIONS: The number of cardiovascular risk factors was found to be related to high blood pressure in adolescents.

Association of meeting the 24-h movement guidelines with high blood pressure in adolescents: a cross-sectional study.

The 24-h movement guidelines for children and adolescents comprise recommendations for adequate sleep, moderate to vigorous physical activity (MVPA) and sedentary behaviour (SB). However, whether adolescents who meet these 24-h movement guidelines may be less likely to have high blood pressure (HBP) has not been established. The present study assessed the association between meeting 24-h movement guidelines and HBP in a school-based sample of 996 adolescents between 10-17 years (13.2 ± 2.4 years, 55.4% of girls). Blood pressure was measured using a digital oscillometric device, while sleep, MVPA and SB were measured using the Baecke questionnaire. The association between the 24-h movement guidelines and HBP was performed using binary logistic regression adjusted for sex, age, socioeconomic status, and body mass index. It was observed that less than 1% of the sample meet the three 24-h movement guidelines. The prevalence of HBP was lower in adolescents who meet all three movement 24-h guidelines (11.1%) compared to those who did not meet any guidelines (27.2%). Individual 24-h movement guidelines analysis showed that adolescents with adequate sleep were 35% less likely to have HBP (OR = 0.65; 95% CI 0.46-0.91). Meeting sleep guidelines combined with meeting MVPA (OR = 0.69; 95% CI 0.50-0.95) or SB (OR = 0.67; 95% CI 0.48-0.94) was inversely associated with HBP. Adolescents who meet two or three 24-h movement guidelines were respectively 47% (OR = 0.53; 95% CI 0.29-0.98) and 34% (OR = 0.66; 95% CI 0.48-0.91) less likely to have HBP. In adolescents, meeting sleep and 24-h movement guidelines were inversely associated with HBP.

High workload is related to lower quality of life in public school teachers: A cross-sectional study.

BACKGROUND: People with long work hours, as evidenced by teachers, were more likely to present health problems that impact their quality of life (QoL). The reduced physical activity (PA) level or higher sedentary behavior in public school teachers was related to obesity. Although PA seems to improve the QoL in other professions, assessing whether the PA level could influence the relationship between workload and QoL in public school teachers is necessary. OBJECTIVE: To analyze whether the high workload was related to worse QoL in teachers considered less active and more active. METHODS: Two hundred forty-three teachers from public schools participated in this study. The domains of QoL and PA levels were assessed by SF-36 and Baecke questionnaires, respectively. Workload perception was assessed by a Likert scale. Binary logistic regression analyzed the association between high workload and QoL domains in teachers considering the PA level in a model adjusted by confounding factors (i.e., sex, age, and socioeconomic condition). RESULTS: Heavy workload was associated with less chances of having better physical limitation domain of both less and more physically active teachers. Less active teachers with heavy workloads were 53%, 61%, and 56% less likely to have better vitality, social functioning, and mental health, respectively. No such associations were observed in the more physically active teachers. CONCLUSION: Less active teachers with a heavy workload demonstrate lower QoL. Although the PA practice eliminated this relationship, both active and less active teachers with a heavy workload demonstrated lower QoL in physical limitation domain.

Analysis of the association between high workload and musculoskeletal pain in public school teachers according to physical activity level.

BACKGROUND: A high workload has been associated with musculoskeletal pain in public school teachers. However, the hypothesis of the present study was that physical activity (PA) practice is able to attenuate this association. OBJECTIVE: To analyze the associations between high workload with musculoskeletal pain according to PA levels in public school teachers. METHODS: Teachers (n = 239) from 13 public schools were evaluated. Workload was assessed using a Likert scale in which teachers reported their perception of their work routine as: very low, low, regular, high, and very high. Musculoskeletal pain and PA were assessed using questionnaires. Multivariate logistic regression models were used to investigate the association of high workload with PA levels and musculoskeletal pain in different body regions, compared to participants with normal workload, adjusted by sex, age, and socioeconomic status. RESULTS: A high workload was associated with higher chances of reporting pain in the wrists and hands (OR = 3.55; 95% CI = 1.27-9.89), knee (OR = 3.09; 95CI%  = 1.09-8.82), and feet and ankles (OR = 3.16; 95% CI = 1.03-9.76) in less active teachers. However, these associations were not observed in teachers considered more active. CONCLUSION: PA practice is able to act as a good protector against musculoskeletal pain in teachers, even in individuals with a high workload.

Parent-child associations of sleep quality: is physical activity a confounder? The EPI-FAMILY health study.

INTRODUCTION: The incidence of sleep deprivation has increased in pediatric populations, however, the relationship with physical activity (PA) remains uncertain and lacks evidence. Although some studies have shown that parents' lifestyle habits can influence this process, one point that requires further clarification in the literature is whether parents' sleep quality is linked to that of their children and whether parents' physical activity could play an important role in these possible relationships. OBJECTIVES: To investigate the relationship of sleep quality between parents and children and verify the role of physical activity in this association. METHODS: This is a cross-sectional study. Sleep quality was assessed using the Mini Sleep Questionnaire. The amount of sleep was estimated by the number of hours slept. PA domains (occupational activities, leisure, and active commuting) were assessed using the Baecke questionnaire, while moderate to vigorous PA (MVPA) was assessed with an accelerometer. Socioeconomic status was obtained through a questionnaire. The relationship of sleep quality between parents and children was carried out using hierarchical models with Binary Logistic Regression, where the factors were inserted one by one (1. unadjusted model; 2. sociodemographic variables; 3. children's PA; 4. parents' PA). RESULTS: The study sample consisted of 102 children and adolescents (6-17 years), 92 mothers, and 69 fathers. Poor sleep quality of mothers was associated with their children's sleep quality (OR = 3.95; 95%CI = 1.33-11.38; P = 0.013). After inserting mothers' PA intensity into the final model, the associations remained significant (OR = 8.05; 1.33-48.59; P = 0.023). No relationship was observed between poor sleep quality of fathers and their children's sleep quality. CONCLUSION: The relationship between poor sleep quality of mothers and that of their children remained significant, regardless of confounding variables.