Clusters of obesogenic behaviors and metabolic risk according to somatic maturity status among adolescents.

OBJECTIVE: This study aimed to identify the clusters of obesogenic behaviors, and verify the association with metabolic risk according to the categories of somatic maturity status of adolescents. METHODS: This is a cross-sectional study conducted with 1159 (55.1% girls) Brazilian adolescents aged between 10 and 16 years (mean age: 12.9 years). Measurements of waist circumference, blood pressure, blood glucose, HDL-C, and triglycerides were combined to calculate a metabolic risk score. Somatic maturity was assessed by estimating the peak of height velocity. The obesogenic behaviors analyzed were physical activity (Baecke questionnaire), sedentary behavior (screen-based behaviors) and dietary habits (consumption of healthy and unhealthy food). The Two Step clustering algorithm using the log-likelihood measure was employed to cluster formation and regression models were adopted to the main analysis. RESULTS: We observed a complex co-existence of obesogenic behaviors. Differences regarding the metabolic risk between clusters was only observed among the early-maturing adolescents, where the cluster with higher number of healthy behaviors but lower physical activity presented higher metabolic risk score. CONCLUSIONS: We conclude that physical activity has an important role on the association of clusters of obesogenic behaviors and metabolic risk in early-maturing adolescents.

Physical activity can attenuate, but not eliminate, the negative relationships of high TV viewing with some chronic diseases: findings from a cohort of 60 202 Brazilian adults.

BACKGROUND: This study examined the joint associations of leisure time physical activity and television (TV) viewing time with the prevalence of chronic diseases among Brazilian adults. METHODS: Data from the Brazilian Health Survey, a nationally representative survey conducted in 2013 (n = 60 202; ≥18 years), were used. Time spent in TV viewing and leisure physical activity, physician diagnoses of diabetes, hypertension and heart disease and information on co-variables (chronological age, education, ethnicity, candies/sweets consumption, sodium intake and tobacco smoking) were collected via interview. Descriptive statistics (mean and 95% confidence interval) and logistic regression models were used for etiological analyses. RESULTS: Physical activity attenuated but did not eliminate the risk associated with high TV viewing for at least one chronic disease in the general population [odds ratio [OR]: 1.29 (1.11-1.50)] and among women [OR: 1.31 (1.09-1.60)], adults [OR: 1.24 (1.05-1.46)] and older adults [OR: 1.63 (1.05-2.53)]. On the other hand, physical activity eliminated the risk associated with high TV viewing for at least one chronic disease among men [OR: 1.24 (0.98-1.58)]. CONCLUSIONS: We conclude that physical activity can attenuate but not eliminate the negative effects of high TV viewing on chronic disease among subgroups of Brazilian adults.

Tracking of health-related physical fitness between childhood and adulthood.

OBJECTIVE: The aim of the present study was to analyze the tracking of indicators of health-related physical fitness between childhood and adulthood. METHODS: The study presents a longitudinal design, with the first phase of data collection occurring annually between 2002 and 2006, and the second phase carried out in 2016. A total of 142 young adults, aged between 21 and 25 years, of both sexes participated in the study. Were evaluated body mass, stature, skinfold thickness, sit and reach test; abdominal resistance/strength test, and 20-m shuttle run test. RESULTS: The intraclass correlation coefficient (ICC) indicated that all health-related physical fitness variables presented values considered moderate to high tracking (0.37-0.67; P < 0.005) between the analyzed periods. It was verified that in all variables, tracking was higher in the female group, except for the result of the running test related to the cardiorespiratory fitness component which demonstrated greater tracking in the male group (ICC = 0.37 vs ICC = 0.50). The result of the running test for males was the only variable presenting a discrepancy in the values observed between baseline and follow-up (P < 0.05; k = 0.110). CONCLUSIONS: It was concluded that the indicators of body fat, abdominal and running tests demonstrated moderate tracking, while the sit and reach test presented high tracking.

Reproducibility and inter-observer agreement of Greulich-Pyle protocol to estimate skeletal age among female adolescent soccer players.

BACKGROUND: Skeletal age (SA) is considered the best method of assessing biological maturation. The aim of this study was to determine intra-observer (reproducibility) and inter-observer agreement of SA values obtained via the Greulich-Pyle (GP) method. In addition, the variation in calculated SAs by alternative GP protocols was examined. METHODS: The sample was composed of 100 Portuguese female soccer players aged 12.0-16.7 years. SAs were determined using the GP method by two observers (OB1: experience < 100 exams using GP; OB2: experience > 2000 exams using several methods). The radiographs were examined using alternative GP protocols: (wholeGP) the plate was matched to the atlas as an overall approach; (30-boneGP) bone-by-bone inspections of 30-bones; (GPpmb) bone-by-bone inspections of the pre-mature bones only. For the 30-boneGP and GPpmb approaches, SA was calculated via the mean (M) and the median (Md). RESULTS: Reproducibility ranged 82-100% and 88-100% for OB1 and OB2, respectively. Inter-observer agreement (100 participants multiplied by 30 bones) was 92.1%. For specific bones, agreement rates less than 90% were found for scaphoid (81%), medial phalange V (83%), trapezium (84%) and metacarpal V (87%). Differences in wholeGP SAs obtained by the two observers were moderate (d-cohen was 0.79). Mean differences between observers when using bone-by bone SAs were trivial (30-boneGP: d-cohen less than 0.05; GPpmb: d-cohen less than 0.10). The impact of using the mean or the median was negligible, particularly when analyses did not include bones scored as mature. CONCLUSION: The GP appeared to be a reasonably reproducible method to assess SA and inter-observer agreement was acceptable. There is evidence to support a recommendation of only scoring pre-mature bones during later adolescence. Further research is required to examine whether these findings are consistent in younger girls and in boys.

Independent and Combined Effects of Weight Status and Maturation on Aerobic Fitness in Adolescent School-Aged Males.

Batista, MB, Valente-dos-Santos, J, Duarte, JP, Sousa-e-Silva, P, Coelho-e-Silva, MJ, Werneck, AO, Ohara, D, Cyrino, ES, and Ronque, ERV. Independent and combined effects of weight status and maturation on aerobic fitness in adolescent school-aged males. J Strength Cond Res 34(9): 2663-2671, 2020-This study aimed to examine the independent and combined effects of pubertal and weight status on concurrent measurements of peak oxygen (V[Combining Dot Above]O2peak) in school-aged adolescent males. The final sample included 49 boys (12.3 ± 0.8 years). V[Combining Dot Above]O2peak was derived from an incremental progressive maximal protocol using a motorized treadmill. In addition, maximal oxygen uptake was estimated from a 20-m shuttle run test. Static allometric models were obtained as an alternative to performance output per unit of size descriptors. Weight status had a significant effect on V[Combining Dot Above]O2peak using simple ratio standards per unit of body mass (BM) with adolescents classified as overweight and obese (OWOB) attaining lower values of V[Combining Dot Above]O2peak. A similar trend was noted for the allometric models adopting body mass (ml·kgBM·min), stature (L·m·min), and fat-free mass (FFM; ml·kgFFM·min). Findings also suggest the influence and interaction of pubertal and weight status on absolute values of V[Combining Dot Above]O2peak. Considering the data obtained, linear equations to estimate V[Combining Dot Above]O2peak from the 20-m shuttle run test should not be applied to boys who are OWOB because it will produce inaccurate assessments of cardiorespiratory fitness and penalize those who are heavier. Equations for V[Combining Dot Above]O2peak prediction need to be specific for pubertal status and preferably consider FFM as a body size descriptor.

Tracking of physical fitness in elementary school children: The role of changes in body fat.

OBJECTIVES: The aim of the present study was to examine the stability of physical fitness, and the interrelationships among intra-individual changes in fitness and fatness among elementary school children. METHODS: A longitudinal study was conducted among 372 adolescents (196 boys) and followed up over 3 years (from childhood to adolescence). Physical fitness was estimated using three indicators: cardiorespiratory fitness (through a 9-minute running test), flexibility (through a sit-and-reach test), and muscle resistance (through maximal abdominals in 1 minute). Body adiposity was obtained through triceps and subscapular skinfolds. Somatic maturation was assessed by the peak of height velocity. Kappa and Lin's tests of concordance as well as logistic regression analyses were conducted with P < 0.05 in STATA 15.1. RESULTS: Tracking of physical fitness from childhood to adolescence was moderate for both sexes [boys: kappa = 0.441 (P < 0.001); LCCC = 0.591 (P < 0.001). Girls: kappa = 0.335 (P < 0.001); LCCC = 0.534 (P < 0.001)]. A larger increment in body fat was associated with a higher likelihood to decrease a tertile in physical fitness among boys [OR: 4.17 (95% CI: 1.31-13.22)] and with a lower likelihood to increase a tertile in physical fitness among both sexes [boys: OR = 0.25 (95% CI: 0.09-0.67); girls: OR: 0.37 (95% CI: 0.15-0.92)]. CONCLUSIONS: Health-related physical fitness has moderate tracking from childhood to adolescence. Increases in body adiposity from childhood to adolescence are associated with a reduction in physical fitness tertile.

Allometric scaling of aerobic fitness outputs in school-aged pubertal girls.

BACKGROUND: This study aimed to determine the allometric exponents for concurrent size descriptors (stature, body mass and fat-free mass) and also to examine the contribution of chronological age and pubertal status combined with above mentioned size descriptors to explain inter-individual variability in the peak of oxygen uptake (VO2peak) among girls during circumpubertal years. METHODS: The final sample included 51 girls (10.7-13.5 years). VO2peak was derived from an incremental progressive maximal protocol using a motorized treadmill. Anthropometry included body mass, stature and skinfolds. Measurements were performed by a single trained observer. Sexual maturation was assessed as self-reported stage of pubic hair (PH) development. Static allometric models were explored as an alternative to physiological output per unit of size descriptors. Allometry also considered chronological age and sexual maturation as dummy variable (PH2 vs. PH3 and PH3 vs. PH4). RESULTS: Scaling coefficients for stature, body mass and fat-free mass were 1.463 (95%CI: 0.476 to 2.449), 0.516 (95%CI: 0.367 to 0.666) and 0.723 (95%CI: 0.494 to 0.951), respectively. The inclusion of sexual maturation increased explained variance for VO2peak (55% for PH2 vs. PH3 and 47% for PH3 vs. PH4). Body mass was identified as the most prominent body size descriptor in the PH2 vs. PH3 while fat-free mass was the most relevant predictor combined with PH3 vs. PH4. CONCLUSIONS: Body mass and fat-free mass seemed to establish a non-linear relationship with VO2peak. Across puberty, inter-individual variability in VO2peak is explained by sexual maturation combined with whole body during early puberty and by sexual maturation and fat-free mass during late puberty. Additional studies need to confirm ontogenetic allometric models during years of maximal growth.

Association(s) Between Objectively Measured Sedentary Behavior Patterns and Obesity Among Brazilian Adolescents.

PURPOSE: To investigate the association between patterns of sedentary behavior and obesity indicators among adolescents. METHODS: This was a cross-sectional study conducted among 389 adolescents (186 boys) aged 10-14 years. Body mass index, body fat (skinfolds), and waist circumference were adopted as outcomes. Sedentary behavior patterns (total time, bouts, and breaks) measured through accelerometry (GT3X and GT3X+; ActiGraph, Pensacola, FL) were adopted as exposures. Peak height velocity, moderate to vigorous physical activity (accelerometer), cardiorespiratory fitness (Léger test), sex, and chronological age were adopted as covariates. Linear regression models adjusted for covariates were used to determine associations between outcome and exposure variables. RESULTS: The mean age of adolescents was 11.8 (0.7) years. Boys were more active than girls (P < .001). Accumulating shorter bouts (1-4 min) of sedentary behavior was negatively associated with body mass index (ß = -0.050; 95% confidence interval [CI], -0.098 to -0.003) and waist circumference (ß = -0.133; 95% CI, -0.237 to -0.028). Similarly, a higher number of breaks in sedentary behavior were negatively associated with body mass index (ß = -0.160; 95% CI, -0.319 to -0.001) and waist circumference (ß = -0.412; 95% CI, -0.761 to -0.064). CONCLUSION: Shorter bouts of sedentary behavior (1-4 min) and a higher number of breaks of sedentary behavior were associated with lower adiposity. Our findings also suggest that breaking up sedentary time to ensure bouts of sedentary behavior are short might contribute to the prevention of obesity in adolescents.

Body adiposity from childhood to adolescence in boys: Interaction with somatic maturity.

OBJECTIVES: To investigate the longitudinal relationship between adiposity and maturity status throughout the transition between childhood and adolescence in boys, and the moderation effect of maturation on adiposity trajectories. METHODS: This was a longitudinal study conducted with 197 boys who were followed over 3 years (from childhood to adolescence). Body adiposity was estimated through the subcutaneous skinfold method, with measures of triceps and subscapular skinfolds. Skinfolds were analyzed singly and aggregated through the sum of skinfolds. Maturity status was estimated through Moore's method of estimated peak of height velocity, which uses an algorithm with stature and chronological age values and was categorized according to mean and SD. Analysis of covariance was used to test moderation effects. All analyses were conducted in STATA 14.0, at a 0.05 level of significance. RESULTS: Early maturing adolescents presented higher values of body adiposity at all moments when compared with on-time and late maturing adolescents (P < .05). Moreover, maturity status moderated the association between sum of skinfolds at childhood and sum of skinfolds at adolescence (F = 2.49; P = .045). CONCLUSION: Somatic maturation moderates the relationship between adiposity in childhood and adolescence, with earlier maturation associated with a greater increase in adiposity. Future tracking studies should consider the effects of maturity status when analyzing body adiposity.

Physical activity maintenance and metabolic risk in adolescents.

Aim: Examine the association between child and adolescent physical activity maintenance categories and metabolic profile in adolescence. Methods: This cross-sectional study was conducted with 1152 adolescents (57.4% female) aged 10-16 years from Londrina, Brazil. Physical activity was self-reported in childhood (7-10 years old, retrospective data) and adolescence through questionnaires. Cardiorespiratory fitness (20 m shuttle-run test), body fat (skinfolds), waist circumference, blood pressure (automatic instrument) and blood variables (fasting glucose, HDL-cholesterol and triglycerides) were measured at adolescence. Results: Frequency of physical activity in childhood and adolescence was 50.3 and 17.2%, respectively, and only 25.7% of boys and 10.9% of girls were active at both ages. Adolescents who were physically active in childhood alone were less likely [OR = 0.71 (95% CI: 0.52-0.97)] to present low cardiorespiratory fitness in adolescence compared to those who were non-active in childhood. Regardless of controlled, actives in childhood and adolescence were less likely to present low cardiorespiratory fitness [OR = 0.50 (95% CI: 0.34-0.73)], high blood pressure [OR = 0.52 (95% CI: 0.32-0.85)] and high metabolic risk score [OR = 0.44 (95% CI: 0.22-0.90)] compared to the non-actives at both ages. Conclusions: Actives through childhood to adolescence are less likely to present low cardiorespiratory fitness, high blood pressure and high metabolic risk.

Total and regional bone mineral and tissue composition in female adolescent athletes: comparison between volleyball players and swimmers.

BACKGROUND: Exploring the osteogenic effect of different bone-loading sports is particular relevant to understand the interaction between skeletal muscle and bone health during growth. This study aimed to compare total and regional bone and soft-tissue composition between female adolescent swimmers (n=20, 15.71±0.93 years) and volleyball players (n=26, 16.20±0.77 years). METHODS: Dietary intake was obtained using food frequency questionnaires. Body size was given by stature, sitting height, and body mass. Six skinfolds were measured. Bone mineral content (BMC) and density (BMD), lean soft tissue, and fat tissue were assessed using dual-energy X-ray absorptiometry. Pearson's product moment correlation coefficients were calculated to examine the relationships among variables, by type of sport. Comparisons between swimmers and volleyball players were performed using student t-tests for independent samples and multivariate analysis of covariance (controlling for age, training history and body size). RESULTS: Swimmers (BMC: 2328±338 g) and volleyball players (BMC: 2656±470 g) exceeded respectively by 2.1 and 2.8 standard deviation scores the average of international standards for whole body BMC of healthy adolescents. Years of training in swimmers were positively related to the upper limbs BMC (r=+0.49, p<0.05). In volleyball players, years of training correlated significantly with lower limbs BMD (r=+0.43, p<0.05). After adjustments for potential confounders, moderate differences (ES-r=0.32) between swimmers and volleyball players were noted in BMD at the lower limbs (volleyball players: +0.098 g∙cm-2, +7.8%). CONCLUSIONS: Youth female athletes who participate in high-intensity weight-loading activities such as volleyball exhibit moderately higher levels of BMD at the lower limbs compared to non-loading sports such as swimming.

Age at menarche and cancer risk at adulthood.

AIM: The aim was to evaluate the association between age at menarche and cancer using a nationally representative sample of Brazilian women. METHODS: Data from the Brazilian Health Survey (PNS), a nationally representative survey conducted in 2013 (n = 33,715 women; ≥18 years), were used. Information on cancer diagnosis, age at menarche and other co-variables (chronological age, educational status, skin colour, menopause, leisure-time physical activity and tobacco smoking) were collected via interview. Logistic regression models were used for aetiological analyses. RESULTS: The prevalence of cancer diagnosis was greater among women with early age at menarche [2.6% (2.0-3.5%)] compared to on-time [1.6% (1.4-1.9%)] and late women [2.0% (1.1-3.4%)]. The onset of menarche ≤11 years was significantly associated with cancer risk, regardless of co-variables [OR =2.45 (1.34-4.48)], compared to the late group. CONCLUSION: Early age at menarche was associated with cancer risk in adulthood, regardless of race, educational status, chronological age, obesity, menopause onset, tobacco smoking or physical activity.

Family history of cardiovascular disease and parental lifestyle behaviors are associated with offspring cardiovascular disease risk markers in childhood.

INTRODUCTION: Cardiovascular disease risk markers have become more prevalent in childhood. To provide increased understanding of the etiology of this public health issue, we investigated associations between family characteristics with cardiovascular disease risk markers in adolescents from a developing nation. METHODS: In this cross-sectional study data for fasting glucose, lipoproteins (LDL-C and HDL-C), triglycerides, and total cholesterol were collected from 991 adolescents aged 10-17 who were recruited from public schools in Londrina city, Southern Brazil. Family history of cardiovascular disease and parental engagement in risk behavior (alcohol consumption and tobacco smoking) were collected using a self-reported parental questionnaire. Socioeconomic status, adolescent physical activity (estimated by Baecke questionnaire), self-reported tobacco and alcohol intake, and somatic maturation (age at peak height velocity) were used as covariates. Logistic regression was used for the main analyses. RESULTS: Independent of adolescent lifestyle behaviors, associations (ORadj [95% CI]) were found between: (1) paternal family history of cardiovascular disease with increased likelihood of high adolescent offspring BMI (1.53 [1.01 to 2.32]) and high triglycerides (2.93 [1.04 to 8.27]); (2) maternal family history of cardiovascular disease with heightened odds of high adolescent offspring triglycerides (2.84 [1.02 to 7.91]); (3) maternal cardiovascular disease with higher odds of high fasting glucose (2.16 [1.13 to 4.14]), and (4) maternal smoking with increased odds of high LDL-C (1.78 [1.14 to 2.79]) and high total cholesterol (1.77 [1.01 to 3.10]) in adolescent offspring. CONCLUSION: Family history of cardiovascular disease and maternal tobacco smoking are related to increased cardiovascular risk in adolescents, potentially independent of their own lifestyle behaviors.

Cardiorespiratory fitness effect may be under-estimated in 'fat but fit' hypothesis studies.

BACKGROUND: Both cardiorespiratory fitness and body fat have been independently related to metabolic syndrome in adolescents; however, the strength of these relationships seems to be dependent on the outcome composition. AIM: To analyse the relationship between cardiorespiratory fitness and body fat combined with different indicators of metabolic risk in adolescents. SUBJECTS AND METHODS: The sample was composed of 957 adolescents (58.7% girls). Cardiorespiratory fitness was obtained using the 20-metre shuttle run test and skinfold thickness was collected for body fat estimation. Metabolic risk score was calculated from waist circumference, systolic and diastolic blood pressure, glucose, HDL cholesterol and triglycerides measurements and an alternative outcome without the central obesity indicator was adopted. Chronological age and somatic maturity were used as covariates. RESULTS: Higher metabolic risk was observed in the highest fat/lowest fit adolescents (p < .05), regardless of sex and outcome. In the regression models, for full metabolic risk score, body fat presented higher coefficients compared to cardiorespiratory fitness in both sexes (boys: 0.501 vs -0.097; girls: 0.485 vs -0.087); however, in the metabolic risk without waist circumference, the coefficients became closer (boys: 0.290 vs -0.146; girls: 0.265 vs -0.120), with a concomitant decrease in body fat and increase in cardiorespiratory fitness coefficients. CONCLUSION: These findings suggest that body fat is strongly related to cardiovascular risk, but, when the outcome is calculated without the central obesity indicator, cardiorespiratory fitness becomes more related to metabolic risk.

Correlates of sports practice, occupational and leisure-time physical activity in Brazilian adolescents.

OBJECTIVES: To analyze the relationship between different physical activity (PA) domains and sociodemographic, psychological, behavioral and biological factors in Brazilian adolescents. METHODS: 1,220 adolescents (55.1% female) aged between 10 and 16 years-old participated in this study. The Baecke questionnaire was used to evaluate different PA domains, namely occupational, sports and leisure-time. Socioeconomic status, number of siblings, friendships satisfaction, mother's and father's PA level and previous experience with sports were self-reported. Cardiorespiratory fitness, waist circumference, and somatic maturity were estimated by objective indicators. Linear regression was used for the main statistical analysis. RESULTS: The variables consistently related to all of the PA domains were gender (boys more active), friendship satisfaction (positive with sports and leisure-time PA and negative with occupational PA) and cardiorespiratory fitness (positive). There were also domain-specific relationships for occupational (number of siblings [ß = 0.02] and father's PA [ß = 0.13]), sport practice (previous experience with sports [ß = 0.33], waist circumference [ß = 0.01] and somatic maturity [ß = -0.12]) and leisure-time PA (chronological age [ß = -0.15], mother's PA [ß = 0.47] and previous experience with sports [ß = 0.17]). CONCLUSIONS: The different domains of PA are related to specific variables in adolescence. This information may be helpful in formulating strategies for physical activity promotion, particularly in adolescents from low-to-middle income countries.

Validity of equations for estimating V[combining dot above]O2peak from the 20-m shuttle run test in adolescents aged 11-13 years.

The aim of this study was to analyze the validity of 4 regression equations to estimate the peak oxygen consumption (V[Combining Dot Above]O2peak) from the 20-m shuttle run test in adolescents aged 11-13 years. One hundred and fifteen adolescents, 61 boys (mean ± SD: age = 12.3 ± 0.9 years) and 54 girls (age = 12.1 ± 0.7 years) performed the 20-m shuttle run test and an incremental progressive maximal test for direct V[Combining Dot Above]O2peak analysis. Four linear regression equations were used to estimate the V[Combining Dot Above]O2peak: Barnett et al. (equation 1), Léger et al. (equation 2), Mahar et al. (equation 3), and Matsuzaka et al. (equation 4). For boys, only the V[Combining Dot Above]O2peak estimated by EQ3 did not differ from the value directly measured (p > 0.05). The EQ1, EQ2, and EQ4 underestimated the V[Combining Dot Above]O2peak, whereas the EQ3 overestimated, particularly in girls (p < 0.05). Large limits of agreement were found between the reference method and the 4 equations, with higher estimated values by EQ2 for boys (8.36 ± 15.24 mL·kg·min) and girls (2.45 ± 12.63 mL·kg·min). The highest correlation values were observed by EQ4 for boys (r = 0.80), EQ1 for girls (r = 0.72), and EQ3 for total sample (r = 0.80). The equations analyzed were not precise for individual V[Combining Dot Above]O2peak prediction; however, the EQ3 revealed better agreement, particularly for boys. Considering the data obtained in the boys and total sample, our results suggest that the EQ3 may provide the best predictive measure of V[Combining Dot Above]O2peak from the 20-m shuttle run test in adolescents aged 11-13 years.

Structural equation model of the effect of biological maturation on metabolic syndrome risk and C-reactive protein: effect of trunk fat and sports participation.

Our aim was to analyze the association between somatic maturation and alterations in metabolic syndrome (METs) risk and C-reactive protein (CRP), focusing on the effect of changes in trunk fat and sports practice. This was a longitudinal study with a one-year follow-up. The sample was composed of 139 adolescents (46 without sports participation and 93 young athletes), aged 10-17 years. As outcomes, we adopted CRP and METs risk (triglycerides, HDL-c, fasting glucose, and mean blood pressure). Somatic maturation was estimated using Mirwald's method. Structural equation models were used. Somatic maturation was not associated with sports practice, trunk fat, METs risk neither CRP. Sports practice was associated with a reduction in METs risk (ß = -0.926; 95%CI:-1.773, -0.080) and reduction in trunk fat (-10.957; -19.630, -2.283), which was associated with increases in METs risk (0.020; 0.004, 0.036). In the CRP model, sports practice was associated with a reduction in trunk fat (-10.324; -18.637, -2.010), which in turn was associated with a reduction in CRP (0.007; 0.001, 0.013). Sports practice and lower trunk adiposity were associated with reductions in trunk fat, METs risk, and CRP through direct and indirect pathways. Our findings highlight the role of sports practice in attenuating the negative effect of trunk adiposity.

Association of mentally-passive and mentally-active sedentary behaviors with device-measured bouts and breaks of sedentary time in adolescents.

Background: Our aim was to analyze the association of self-reported mentally-passive and mentally-active sedentary behaviors with different patterns (bouts and breaks) of device-measured sedentary time in adolescents. Methods: This was a cross-sectional study conducted among 375 adolescents (177 boys) aged 1015 years. Total time, bouts and breaks of sedentary time were measured through accelerometers. Self-reported sedentary behavior in different activities was summed and divided into mentally-active (playing electronic games, studying and reading) and mentally-passive (watching TV, watching DVD, and using computer for leisure). Bayesian linear regression models were used for association analyses. Results: Only mentally-passive sedentary behaviors were positively associated with longer bouts [1-4 minutes: mean posterior distribution: -0.431 (95% credible interval: -0.745 to -0.114); =15 minutes: 0.641 (0.122 to 1.222)] and lower number of breaks [-0.138 (-0.228 to -0.044)] of device-measured sedentary time. Conclusion: Self-reported mentally-passive sedentary behaviors are associated with longer bouts and lower breaks of device-measured sedentary time.

TV Viewing in 60,202 Adults From the National Brazilian Health Survey: Prevalence, Correlates, and Associations With Chronic Diseases.

BACKGROUND: This study describes the levels and patterns of television (TV) viewing in Brazilian adults and investigates associations of TV viewing with hypertension, type 2 diabetes, and heart disease. METHODS: Data from the Brazilian Health Survey, a nationally representative survey that was conducted in 2013 (N = 60,202 men and women aged ≥18 y), were used. Information regarding TV viewing, physician diagnoses of type 2 diabetes, hypertension, and heart disease was collected via interview-administered questionnaire. Data on covariables (including chronological age, educational status, skin color, sodium consumption, sugar consumption, tobacco smoking, alcohol consumption, and leisure-time physical activity) were also self-reported. Logistic regression models and population attributable fractions were used for the etiological analyses. RESULTS: The prevalence (95% confidence interval) of >4 hours per day of TV viewing was 12.7% (12.0-13.4) in men and 17.5% (16.8-18.3) in women. Men and women being younger or older, moderately educated, living alone, smoking tobacco, and drinking alcohol were associated with higher reported TV viewing time. Odds ratios (95% confidence interval) revealed that >4 hours per day of TV viewing was associated with type 2 diabetes [male: 1.64 (1.23-2.17) and female: 1.33 (1.09-1.63)], hypertension [male: 1.36 (1.14-1.63) and female: 1.20 (1.05-1.37)], and heart disease [male: 1.96 (1.43-2.69) and female: 1.30 (1.00-1.68)]. Exceeding 4 hours per day of TV viewing was responsible for 6.8% of type 2 diabetes, 3.7% of hypertension, and 7.5% of heart disease cases. CONCLUSIONS: Independent of covariates, >4 hours per day of TV viewing was associated with type 2 diabetes, hypertension, and heart disease. High volumes of TV viewing are prevalent and appear to contribute to chronic disease burden.

Relationship of Parental and Adolescents' Screen Time to Self-Rated Health: A Structural Equation Modeling.

AIM: To investigate the association of parental and adolescents' screen time with self-rated health and to examine the mediating effects of psychosocial factors (social relationships and distress) on this association. METHOD: A cross-sectional study was conducted among 984 Brazilian adolescents (10- to 17-year-olds). Self-rated health, screen time (adolescents and parental), and perception of social relationships and distress were evaluated through self-report questionnaires. Structural equation modeling was adopted to investigate the pathways of the relationship between adolescents' screen time and self-rated health. RESULTS: Adolescents' screen time was directly and negatively related to self-rated health only in boys ( r = -0.158, p = .015). In girls, screen time was related to self-rated health through distress ( r = -0.188, p = .007) and social relationships ( r = 0.176, p = .008). The models fit was adequate (χ2/ df ≤ 3.0, root mean square error of approximation <0.08, comparative fit index >0.90, and Tucker-Lewis Index >0.90). CONCLUSIONS: Higher screen time was associated with poor self-rated health in boys, while in girls, psychosocial factors mediated the adverse relationships between screen time and self-rated health.