The Positive Relationship between Moderate-to-Vigorous Physical Activity and Bone Mineral Content Is Not Mediated by Free Leptin Index in Prepubertal Children: The PANIC Study.

PURPOSE: Moderate-to-vigorous physical activity (MVPA) positively influences bone mineral content (BMC) in prepubertal children, but it is unknown whether this relationship is partially mediated by free leptin index. The aim of this study was to examine whether the relationship between MVPA and total body less head (TBLH) BMC is mediated or moderated by free leptin index in prepubertal children. METHODS: We performed a cross-sectional analysis on 401 children (194 girls) from baseline examinations of the Physical Activity and Nutrition in Childhood Study. We applied the four-way decomposition mediation analysis method to assess whether free leptin index, measured from fasted blood samples, mediated the relationship between accelerometer-measured MVPA and TBLH BMC measured by dual-energy X-ray absorptiometry. RESULTS: MVPA had a positive controlled direct effect on TBLH BMC in girls and boys (ß = 0.010 to 0.011, p < 0.05). There was no mediation or interaction between MVPA, free leptin index and TBLH BMC in girls or boys (ß = -0.000 to 0.001, p > 0.05). CONCLUSION: Our study indicates that MVPA positively influences TBLH BMC through pathways not related to free leptin index in predominantly normal-weight prepubertal children, likely primarily through mechanical loading. The relationships between MVPA, free leptin index and TBLH BMC may be influenced by other factors such as pubertal status and adiposity, so it is unknown whether these observations extend to overweight and obese children at different stages of puberty.

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.

Gender Analyses of Brazilian Parental Eating and Activity With Their Adolescents' Eating Habits.

OBJECTIVE: To explore the associations between the eating habits of sons and daughters and the eating habits, sedentary behavior, and physical activity of their fathers and mothers. DESIGN: A cross-sectional survey of adolescents. SETTING: The 6 largest schools in Londrina, Brazil. PARTICIPANTS: A total of 842 adolescents, 842 mothers, and 842 fathers participated in this study. MAIN OUTCOMES MEASURES: Eating habits of adolescents and sedentary behavior, physical activity, and eating habits of their fathers and mothers, measured by questionnaire. ANALYSIS: The associations were identified by binary logistic regression, adjusted by adolescent's age, family's socioeconomic status, parents' educational level, and the other parental behavior. RESULTS: Independent of educational level and socioeconomic condition, mothers' eating behaviors seem to be more closely related to their adolescent children's eating behavior (vegetables, fruits, fried foods, soft drinks, and sweets [P = .001]) than fathers' behaviors (fried foods and sweets [P = .01], soft drinks [P = .001]). In addition, the behaviors of mothers were more associated to the behaviors of daughters than to the behaviors of sons (7 vs 5 associated behaviors), while behaviors of fathers were more associated with the behaviors of sons than to the behaviors of daughters (4 vs 2 associated behaviors). No associations were noted for sedentary and physical activity behavior and eating behaviors between adolescents and their parents. CONCLUSIONS AND IMPLICATIONS: Many eating habits of adolescents were associated with eating habits of both fathers and mothers, emphasizing the importance of family-focused health promotion actions. Future research is needed incorporating into the analyses, among others, the nutritional statuses and the clustering of healthy and unhealthy behaviors of parents and their children.

The effects of physical activity during childhood, adolescence, and adulthood on cardiovascular risk factors among adults.

OBJECTIVES: To analyze the association between physical activity during life and cardiovascular risk factors among adults. DESIGN: The sample was composed of 101 adults (59 men) between 30 and 50 years old, who were recruited from different gyms and from a University in Brasil. Participants were divided according to their engagement in sports in early life (self-reported) and current physical activity (pedometer) (sports participation during childhood/adolescence and currently active [n=26], sports participation during childhood/adolescence and currently inactive [n=26], and control [n=49]). Cardiovascular risk factors were measured, such as body fat (through DXA), HDL-C, triglycerides, HOMA index, systolic blood pressure, diastolic blood pressure, and C-reactive protein. We adopted the covariates of chronological age, sex, alcohol consumption, tobacco, and body mass index. General estimating equations were used, with p<0.05. RESULTS: After the adjustments of the final model, individuals engaged in sports during childhood and adolescence and inactive during adulthood presented lower body fat, when compared to participants persistently inactive (p<0.001). Participants persistently active presented lower body fat (p<0.001) and lower c-reactive protein (p=0.010) when compared to the control group. CONCLUSION: Early sports participation was associated with reduced body fat, and being physically active throughout life was associated with reduced body fat and C-reactive protein.

The effects of physical activity during childhood, adolescence, and adulthood on cardiovascular risk factors among adults

SUMMARY OBJECTIVES: To analyze the association between physical activity during life and cardiovascular risk factors among adults. DESIGN: The sample was composed of 101 adults (59 men) between 30 and 50 years old, who were recruited from different gyms and from a University in Brasil. Participants were divided according to their engagement in sports in early life (self-reported) and current physical activity (pedometer) (sports participation during childhood/adolescence and currently active [n=26], sports participation during childhood/adolescence and currently inactive [n=26], and control [n=49]). Cardiovascular risk factors were measured, such as body fat (through DXA), HDL-C, triglycerides, HOMA index, systolic blood pressure, diastolic blood pressure, and C-reactive protein. We adopted the covariates of chronological age, sex, alcohol consumption, tobacco, and body mass index. General estimating equations were used, with p<0.05. RESULTS: After the adjustments of the final model, individuals engaged in sports during childhood and adolescence and inactive during adulthood presented lower body fat, when compared to participants persistently inactive (p<0.001). Participants persistently active presented lower body fat (p<0.001) and lower c-reactive protein (p=0.010) when compared to the control group. CONCLUSION: Early sports participation was associated with reduced body fat, and being physically active throughout life was associated with reduced body fat and C-reactive protein.

RESUMO OBJETIVO: Analisar a associação entre atividade física durante a vida e fatores de risco cardiovasculares entre adultos. DESIGN: A amostra foi composta por 101 adultos (59 homens) entre 30 e 50 anos, os quais foram recrutados em diferentes academias de ginástica e uma universidade brasileira. Os participantes foram divididos de acordo com o engajamento prévio (autorrelatado) e atual de atividade física (mensurada por pedômetro) (participação esportiva durante a infância/adolescência e prática atual [n=26], participação esportiva durante a infância/adolescência e ausência de prática atual [n=26] e controle [n=49]). Como fatores de risco cardiovasculares foram mensurados gordura corporal (por meio de DXA), HDL, triglicérides, índice Homa, pressão arterial sistólica e diastólica, além da proteína c-reativa. Foram adotadas como covariáveis: idade cronológica, sexo, consumo de álcool e índice de massa corporal. Equações gerais de estimativa foram utilizadas adotando p<0,05. RESULTADOS: Após os ajustes no modelo final, indivíduos engajados em esporte durante a infância e adolescência e inativos durante a idade adulta apresentaram menor gordura corporal quando comparados com participantes persistentemente inativos (p<0,001). Participantes persistentemente ativos apresentaram menor gordura corporal (p<0,001) e proteína c-reativa (p=0,010) quando comparados ao grupo controle. CONCLUSÃO: Prática esportiva prévia (durante infância e adolescência) foi associada com redução da gordura corporal e ser fisicamente ativo ao longo da vida foi associado à redução da gordura corporal e proteína c-reativa.

Leisure time physical activity reduces the association between TV-viewing and depressive symptoms: A large study among 59,401 Brazilian adults.

BACKGROUND: Both physical activity (PA) and TV-viewing are associated with depressive symptoms, but the combined association with depressive symptoms is unclear. Therefore, our aim was to analyze the joint association of PA and TV-viewing with depressive symptoms among a large cohort of adults. METHODS: We used data from the Brazilian National Survey, conducted in 2013 with 59,401 adults [≥18 years (34,282 women)]. Information regarding exposures (TV-viewing and leisure PA), outcome (depressive symptoms) and covariates (chronological age, race, educational status, employment status, tobacco smoking, alcohol consumption) were self-reported. Body mass index was estimated through the assessment of body mass and stature. Logistic regression models were used. RESULTS: Engaging in >5 hours of TV viewing was associated with elevated depressive symptoms [13.1% (CI95%: 11.6%-14.7%) vs. 7.4% (95%CI:7.0%-7.8%)]. However, this association was nullified when people met guidelines and engaged in >150 min of PA per week. Specifically, among men [Active: OR = 1.16 (95%CI: 0.58-2.32) vs. Inactive: OR = 3.63 (95%CI: 2.43-5.42)] and women [Active: OR=1.30 (95%CI: 0.80-2.11) vs. Inactive: OR = 1.84 (95%CI: 1.43-2.36)]. CONCLUSION: Whilst TV viewing is associated with increased depressive symptoms, meeting recommended physical activity levels reduces the association between TV-viewing and depressive symptoms.

Biocultural approach of the association between maturity and physical activity in youth / Abordagem biocultural da associação entre maturação e atividade física na juventude

Abstract Objective: To test the biocultural model through direct and indirect associations between biological maturation, adiposity, cardiorespiratory fitness, feelings of sadness, social relationships, and physical activity in adolescents. Methods: This was a cross-sectional study conducted with 1,152 Brazilian adolescents aged between 10 and 17 years. Somatic maturation was estimated through Mirwald's method (peak height velocity). Physical activity was assessed through Baecke questionnaire (occupational, leisure, and sport contexts). Body mass index, body fat (sum of skinfolds), cardiorespiratory fitness (20-m shuttle run test), self-perceptions of social relationship, and frequency of sadness feelings were obtained for statistical modeling. Results: Somatic maturation is directly related to sport practice and leisure time physical activity only among girls (β = 0.12, p < 0.05 and β = 0.09, respectively, p < 0.05). Moreover, biological (adiposity and cardiorespiratory fitness), psychological (sadness), and social (satisfaction with social relationships) variables mediated the association between maturity and physical activity in boys and for occupational physical activity in girls. In general, models presented good fit coefficients. Conclusion: Biocultural model presents good fit and emotional/biological factors mediate part of the relationship between somatic maturation and physical activity.

Resumo Objetivo: Testar o modelo biocultural por meio de associações diretas e indiretas entre maturação biológica, adiposidade, capacidade cardiorrespiratória, sentimentos de tristeza, relacionamentos sociais e atividade física em adolescentes. Métodos: Este foi um estudo transversal feito com 1.152 adolescentes brasileiros entre 10 e 17 anos. A maturação somática foi estimada por meio do método de Mirwald (pico da velocidade de crescimento). A atividade física foi avaliada por meio do questionário de Baecke (contextos ocupacional, lazer e prática de esportes). Foram obtidos o índice de massa corporal, gordura corporal (soma de dobras cutâneas), capacidade cardiorrespiratória (teste shuttle run de 20 metros), autopercepções de relação social e frequência de sensação de tristeza para modelagem estatística. Resultados: A maturação somática mostrou-se diretamente relacionada à prática de esportes e à atividade física de lazer somente entre meninas (β = 0,12, p < 0,05 e β = 0,09, respectivamente, p < 0,05). Ademais, as variáveis biológicas (adiposidade e aptidão cardiorrespiratória), psicológica (tristeza) e social (satisfação com os relacionamentos sociais) mediaram a associação entre maturação e atividade física em meninos e para atividade física ocupacional em meninas. Em geral, os modelos apresentaram bons coeficientes de ajuste. Conclusão: O modelo biocultural apresenta bom ajuste e fatores emocionais/biológicos mediam parte da relação entre maturação somática e atividade física.

Association between Sports Participation in Early Life and Arterial Intima-Media Thickness among Adults.

Background: Early sports practice is associated with several health benefits during childhood and adolescence, moreover, recent evidence also suggests that sports during childhood and adolescence can produce some benefits during adulthood. However, the association between early sports practice and arterial thickness is not clear. Thus, our aim was analyze the association between sports participation in childhood and adolescence, carotid/femoral intima⁻media thickness, and blood flow index in adulthood. Material and Methods: Sample was composed of 107 adults (64 males) between 30 years and 50 years, which were recruited from different gyms and university staff from São Paulo State University. Participants were divided according to sports participation in early life (engaged in sports during childhood and adolescence (n = 52) and no engagement in sports during childhood and adolescence (n = 55)). Carotid and femoral intima⁻media thickness were measured through Doppler ultrasonography method. Carotid and femoral index were estimated from ultrasonography measures. As covariates, the following were adopted: chronological age, sex, body fat (through dual-energy x-ray absorptiometry), c-reactive protein, HOMA, alcohol consumption, tobacco smoking, mean arterial pressure and current physical activity (pedometer). General estimating equations were used, adopting p < 0.05. Results: In the adjusted analyses, early sports participation was associated with lower carotid intima⁻media index (early sports participation: 0.64 mm ± 0.14 mm vs. no early sports participation: 0.71 mm ± 0.21 mm; p = 0.011), but not associated with femoral intima⁻media thickness, carotid resistive index and femoral resistive index after the adjustment by potential confounders. Conclusions: Sports participation in childhood and adolescence was associated with a reduced carotid intima⁻media thickness, independently of relevant confounders.

Physical activity of parents and of their children: a systematic review of Brazilian sample studies - Report Card Brazil / Atividade física de pais e filhos: uma revisão sistemática de estudos com amostras brasileiras - Report Card Brazil

Abstract The aim of this study was systematically review the researches in regard the association of PA of parents and the PA of their children. A literature search was performed in five databases (Medline, Embase, Cinahl, Lilacs and SciELO) using combined terms about youth, PA and social support, with restriction to publications with Brazilian sample and to English and Portuguese language. Thirteen studies were included in this review and was observed a positive association of parental PA and the PA of their children for the majority of the studies (n=11). Only two studies did not observed significant association between PA of parents and their children and, otherwise, it was not observed negative associations in the review. It was observed different associations according to the gender of both parents and children. This findings support the importance for the practice of PA by parents as encouragement for the practice of PA by their children among Brazilians. The strategies to promote the increase in practice of physical activity of children and adolescents of both genders may consider the social support as an important factor, especially in relation to the practice of PA of their parents.

Resumo O objetivo do presente estudo foi revisar sistematicamente estudos que analisaram a associação da prática de atividade física de pais e filhos. Foi realizada uma busca sistemática em cinco bases de dados (Medline, Embase, Cinahl, Lilacs e SciELO), por meio da combinação de termos sobre crianças e adolescentes, atividade física e suporte social, sendo restrita a estudos contendo amostras brasileiras e escritos em Inglês e/ou Português. Foram incluídos treze estudos na presente revisão e foi observada associação positiva da prática de atividade física de pais e filhos na maioria dos estudos (n=11). Somente dois estudos não observaram associação significativa da atividade física de pais e filhos, contudo não foram observadas associações negativas. Foram observadas diferentes associações de acordo com o gênero tanto dos pais quanto dos filhos. Estes achados ressaltam a importância da prática de atividade física dos pais como incentivo à prática de atividade física dos filhos em amostras brasileiras. Estratégias de promoção da prática de atividade física em crianças e adolescentes de ambos os sexos devem considerar o suporte social como um fator importante, especialmente a respeito da prática de atividade física dos pais.

Physical Activity and Skipping Breakfast Have Independent Effects on Body Fatness Among Adolescents.

OBJECTIVE: We analyzed the longitudinal relationship between breakfast intake and adiposity among adolescents, and the possible mediation role of physical activity on this phenomenon. METHODS: We conducted the longitudinal study composed of 86 adolescents (11-14 years old), absence of any known chronic diseases and no regular medicine use that returned the formal consent and assent both signed. Breakfast intake was reported through face-to-face interviews. Adiposity was assessed using a densitometry scanner. Physical activity was estimated through step counts performed using pedometers. Biological maturation was estimated through the maturity level. Student t test for independent samples was used to compare adolescents who were "nonskipping breakfast" and "skipping breakfast," whereas the relationship between adiposity, physical activity, and skipping breakfast was assessed using Pearson correlation. Structural equation model was created to identify the mediation role of physical activity on the relationship between nonskipping breakfast and adiposity. RESULTS: After 12 months, adolescents who had consumed breakfast regularly presented decreased trunk fatness (-3.5% [95% confidence interval (CI): -6.9 to -0.2]) and body fatness (-2.3% [95% CI: -3.9 to -0.7]) compared with their counterparts. Physical activity had an inverse relationship with trunk fatness (r = -0.270 [95% CI: -0.457 to -0.060]). Nonskipping breakfast was, however, not significantly related to trunk fatness; however, physical activity seems to reduce trunk fatness in our sample (r = -0.281; 95% CI: -0.479 to -0.083). CONCLUSIONS: Adolescents who ate breakfast regularly presented lower body fatness independent of physical activity, whereas trunk fatness decreased in adolescents who improved 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.

Relationship between amputation and risk factors in individuals with diabetes mellitus: A study with Brazilian patients.

Individuals with diabetes develop lower extremity amputation for several reasons. Investigations into pathways to the development of complications are important both for treatment and prevention. AIM: To evaluate the relationship between amputation and risk factors in people with diabetes mellitus. MATERIALS AND METHOD: All participants included in this study (n=165) were recruited from the Diabetic Foot Program, developed in a Brazilian University, over seven years (2007-2014) and all information for this study was extracted from their clinical records. RESULTS: The prevalence of amputation in patients with diabetes with four risk factors was up to 20% higher when compared to those with only one risk factor. The main predictive risk factors for amputation in this population were the presence of an ulcer and smoking. CONCLUSION: The risk factors for amputation can be predicted for people with diabetes mellitus and, in the present study, the main factors were the presence of an ulcer and the smoking habit.

Screen-based sedentary behaviors, mental health, and social relationships among adolescents

Abstract Aim: To analyze the association between screen-based sedentary behaviors, mental health, and social relationships in Brazilian adolescents. Methods: A representative sample of the adolescents from Londrina/PR was selected (n = 1,158; 10 to 17 y). Weekday and weekend screen time (TV-viewing and computer/video-game), mental health indicators (self-rated health, stress, feelings of sadness, and satisfaction with own body), and perceived social relationships (friends, family, and teachers) were collected through questionnaires. Somatic maturation, body mass index, and physical activity were assessed as covariates. Results: Adolescents who reported higher TV-viewing presented higher odds (p < 0.05) for poor self-rated health (boys), higher stress (both sexes), and dissatisfaction with own body (boys), friendships (girls), and teachers (girls). In contrast, higher computer/video-game use was associated with lower odds (p < 0.05) for poor self-rated health (girls), higher stress (boys), feelings of sadness (both sexes), and dissatisfaction with friends (both sexes) and family (both sexes). Conclusion: While higher TV-viewing is associated with negative outcomes, higher computer/video-game users demonstrate better mental health and lower satisfaction with their social relationships.

Cardiovascular risk factors and body fat distribution in brazilians aged 80 years or over / Fatores de risco cardiovascular e distribuição de gordura corporal em brasileiros com 80 anos ou mais

Study design: Cross-sectional study. Objective: To analyze the presence of cardiovascular risk factors (CRFs) according to the pattern of body fat distribution, in Brazilians aged 80 years or over. Methods: The sample consisted of 113 subjects, of 83.4 years, of both sexes. The percentages of total and abdominal body fat, hypertension and lipid profile were used for characterization of CRFs. The chisquare test was used to assess proportions of CRFs and the Mann-Whitney test was used to compare the results of adiposity. Results: Eutrophic subjects presented lower triglycerides (p=0.017), total cholesterol (p=0.001) and prevalence of both hypertension (p=0.003) and hypertriglyceridemia (p=0.007). Subjects with higher abdominal adiposity presented higher total cholesterol (p=0.026) and prevalence of hypertriglyceridemia (p=0.011) and hypercholesterolemia (p=0.026) than those with no excess abdominal adiposity. Those with excess fat (total, abdominal or both), with the exception of glucose(p=0.877), presented a high prevalence of CRFs. Those with both types of excess fat presented differences, with a higher prevalence level when compared to those with only one or neither of the excesses. Conclusion: Obesity, whether abdominal or total, is similarly associated with CRFs in subjects aged 80 years and over.

Modelo do estudo: Estudo transversal. Objetivo: Analisar a presença de fatores de risco cardiovascular (FRC) de acordo com o padrão de distribuição de gordura corporal em brasileiros com 80 anos ou mais. Materiais e Método: A amostra foi composta de 113 idosos, com média de idade de 83,4 anos, de ambos os sexos. O percentual de gordura corporal total e abdominal, hipertensão e perfil lipídico foram usados para caracterização dos FRC. O teste qui-quadrado foi utilizado para avaliação das proporções de FRC e o teste Mann-Whitney foi utilizado para comparar os resultados de adiposidade. Resultados: Idosos eutróficos apresentaram baixo triglicerídeos (p=0,017) e colesterol total (p=0,001) além de menores prevalências de hipertensão (p=0,003) e hipertrigliceridemia (p=0,007). Idosos com maior adiposidade abdominal apresentaram maior colesterol total (p=0,026) e prevalência de hipertrigliceridemia(p=0,011) e hipercolesterolemia (p=0,026) quando comparados com os de menor adiposidade abdominal. Aqueles com excesso de gordura (total, ou abdominal ou ambos), com exceção da glicemia (p=0,877), apresentaram alta prevalência de FRC. Aqueles com ambos os excessos de gordura apresentam diferenças, com maior nível de prevalência quando comparados aqueles com apenas um ou nenhum dos excessos. Conclusão: A obesidade, sendo abdominal ou total, é associada, da mesma maneira, com FRC em sujeitos com 80 anos ou mais.

Associação entre doenças cardiocirculatórias e internações hospitalares entre pacientes atendidos no Sistema Único de Saúde / Association between cardiovascular diseases and hospitalization among patients users of the Brazilian National Health System

Modelo do estudo: Transversal. Objetivo de estudo: Verificar a associação entre doenças cardiocirculatórias e internações hospitalares em pacientes atendidos pelo Sistema Único de Saúde da cidade de Presidente Prudente, SP, Brasil. Metodologia: A amostra foi composta por pacientes de duas Unidades Básicas de Saúde da cidade de Presidente Prudente/SP. Internações hospitalares, presença de doenças,prática habitual de atividades físicas, índice de massa corporal e medidas pressão arterial foram as variáveis analisadas. Correlação de Spearman indicou relacionamento entre as variáveis e significância estatística foi fixada em p-valor < 5%. Resultados: Foram entrevistados 514 adultos de ambos os sexos. A ocorrência de internação hospitalar no último ano foi de 14,9%. Houve relacionamento entre atividade física habitual, diagnóstico de HA, arritmia e infarto com número de dias internados. Após o ajuste por fatores de confusão, pacientes com dois e três/quatro diagnósticos para doenças cardiocirculatórias apresentaram maior ocorrência de internações hospitalares quando comparados aos sem diagnóstico de doenças. Conclusão: Foi encontrado relacionamento entre internações hospitalares e diagnóstico de hipertensão arterial, arritmia, infarto e menores níveis de prática de atividade física habitual entre pacientes atendidos pelo Sistema Público de Saúde de Presidente Prudente, SP, Brasil.

Study Design: Cross-sectional. Objective of the study: To investigate the relationship between cardiovascular disease and hospitalizations among users of the Brazilian Public Health care System of Presidente Prudente, SP, Brazil. Methods: The sample was composed by patients from two Basic Health care Units of Presidente Prudente / SP. Hospitalizations, presence of disease, habitual physical activity, body mass index and blood pressure measures were the variables analyzed. Spearman correlation indicated relationship between variables and statistical significance was set at p-value < 5%. Results: 514 adults of both sexes were interviewed. The occurrence of hospitalization in the previous year was 14.9%. There was relationship between habitual physical activity, diagnosis of hypertension, arrhythmia and stroke with number of days hospitalized. After adjustment for confounders, patients with two and three/four diagnostic for cardiovascular diseases were more frequent hospitalized compared to patients without diagnoses. Conclusion: It was found relationship between hospitalizations and diagnosis of hypertension, arrhythmia, stroke and lower levels of habitual physical activity among patients users of the public health care system in Presidente Prudente, SP, Brazil.

Association between risk behaviors and adiposity indicators in adolescents from Southern Brazil: A methodological approach.

The aim of this study was to analyze the association between risk behaviors and adiposity indicators in adolescents and to discuss some methodological aspects related to this relationship. We evaluated 1,321 adolescents (55.2% female) aged 10-16 years. Relative body fat (%fat) by measurement of triceps and subscapular skinfold thickness and waist circumference (WC) were used as total and central adiposity indicators, respectively. Physical inactivity, time spent in front of the TV, the consumption of soda and/or chocolate, alcohol, and tobacco smoking were analyzed as risk behaviors. Information about the socioeconomic status (categorized into three levels) and nutritional status of the mother (overweight or normal weight) were used as adjustment factors in the analyses of prevalence ratio (PR) of the outcomes and their associated 95% confidence intervals (95% CI). The chi-square test and Poisson regression were used for statistical analyses. Low associations were found between risk behaviors and adiposity indicators. Tobacco smoking was the most positively correlated behavior with adiposity in girls (%fat: PR = 1.61; 95% CI = 1.04-2.47; WC: PR = 1.90; 95% CI = 1.17-3.08) and in adolescents whose mothers were normal weight (%fat: PR = 2.31; 95% CI = 1.33-4.03; WC: PR: 2.31; CI: 1.19-4.46). Additionally, as an important methodological issue, we highlighted the assessment of risk behaviors in adolescents as crucial to producing more robust evidence on the subject. Of the investigated behaviors, we concluded that tobacco smoking is the behavior most associated with adiposity indicators.

Acute Mucociliary Clearance Response to Aerobic Exercise in Smokers.

BACKGROUND: Mucociliary clearance is the main defense mechanism of the respiratory system, and it is influenced by several stimuli, including aerobic exercise and cigarette smoking. We evaluated the acute response of mucociliary clearance to aerobic exercise in smokers and nonsmokers compared with that found after acute smoking and smoking combined with exercise. Also, we investigated whether there was a correlation between mucociliary clearance and the autonomic nervous system under these conditions. METHODS: Twenty-one smokers were evaluated for mucociliary clearance by saccharin transit time (STT), and the response of the autonomic nervous system was evaluated by heart rate variability after aerobic exercise, after exercise followed by smoking, after acute smoking, and after rest. For comparison, 17 nonsmokers were also assessed during exercise. Repeated-measures analysis of variance with the Tukey test or the Friedman test followed by the Dunn test was used to evaluate the STT, autonomic response, and other variables to exercise and/or smoking in smokers. A paired t test or Wilcoxon test was used to analyze responses to exercise in nonsmokers. Correlations were evaluated using Pearson or Spearman coefficients. RESULTS: The STT was reduced after exercise in both groups, with similar responses between them. Other stimuli also reduced the STT. The STT showed a negative correlation with sympathetic activity in smokers and a positive correlation with the parasympathetic system in nonsmokers. CONCLUSIONS: Although impaired in smokers, mucociliary clearance responded to the stimulus of exercise, as demonstrated by similar STTs compared with nonsmokers. This response was correlated with the autonomic nervous system in both groups. In smokers, mucociliary clearance also responded to the stimuli of smoking and exercise followed by smoking.

Effect of combined aerobic and resistance training in body composition of obese postmenopausal women

The aim of this study was to investigate the effects of a 16-week program of combined aerobic and resistance training on the body composition of postmenopausal women who are obese. The participants were divided into two groups: training group (TG, n = 37) and non-trained control group (CG, n = 18). The trunk fat, fat mass, percentage of fat mass and fat-free mass were estimated using DXA. Three nonconsecutive 24-hour dietary recalls were conducted. The training protocol consisted of 50 minutes of resistance training followed by 30 minutes of aerobic training. After the 16-week training program, differences were observed in trunk fat (CG= 0.064 x TG= -0.571 Kg; p-value = .020), fat mass (CG= -0.088 x TG= -1.037 Kg; p-value = .020) and fat-free mass (CG= -0.388 x TG= 1.049 Kg; p = .001). Therefore, a 16-week program of systematic combined aerobic and resistance training in obese postmenopausal women was effective in improving fat-free mass and decreasing both whole and abdominal adiposity.

O objetivo deste estudo foi investigar os efeitos de 16 semanas de treinamento aeróbio e resistido combinados na composição corporal de mulheres na pós-menopausa. As participantes foram divididas em dois grupos: grupo treinamento (GT, n = 37) e grupo controle (GC, n = 18). A gordura de tronco, massa gorda, percentual de gordura e massa livre de gordura foram estimadas pelo DEXA. O recordatório alimentar de 24 h foi realizado três dias não consecutivos para controle alimentar. O protocolo de treinamento consistiu de 50 minutos de treinamento resistido seguido por 30 minutos de treinamento aeróbio. Após 16 semanas de treinamento diferenças foram observadas na gordura de tronco (GC= 0,064 x GT= -0,571 Kg; p-valor= 0,020), massa gorda (GC= -0,088 x GT= -1,037 Kg; p-valor= 0,020) e massa livre de gordura (GC= -0,388 x GT= 1,049 Kg; p-valor=0,001). Assim, 16 semanas de treinamento aeróbio e resistido combinado em mulheres obesas na pós-menopausa é efetivo em aumentar a massa livre de gordura e reduzir adiposidade total e abdominal.

El objetivo de este estudio fue investigar los efectos de 16 semanas de entrenamiento aeróbico y de resistencia combinada en la composición corporal en mujeres posmenopáusicas obesas. Los participantes fueron divididos en dos grupos: grupo de entrenamiento (GE, n = 37) y control (C, n = 18). La grasa del tronco, la masa grasa, porcentaje de masa grasa y masa libre de grasa se ​​ utilizó el DXA. El recordatorio de 24 horas se realizó tres días no consecutivos para el control de los alimentos. El protocolo de entrenamiento consistió en 50 minutos de entrenamiento de resistencia, después 30 minutos de entrenamiento aeróbico. Después de 16 semanas de entrenamiento, no se observaron diferencias en la grasa del tronco (C= 0,064 x GE= -0,571 Kg; p-valor= 0,020), la masa grasa (C= -0,088 x GE= -1,037 Kg; p-valor = 0,020 Kg) y libre de grasa (C= -0,388 x GE= 1,049 Kg; p= 0,001). Así, 16-semana de entrenamiento aeróbico y de resistencia combinada en las mujeres posmenopáusicas con obesidad es eficaz en la mejora de la masa libre de grasa y la disminución de la masa grasa y la adiposidad abdominal.

The burden of abdominal obesity with physical inactivity on health expenditure in Brazil

The purpose of this study was to analyze the association between the clustering of physical inactivity with abdominal obesity and public health care expenditure in Brazilian adults. The sample was composed of 963 patients of both genders, randomly selected in the Brazilian Public Health care System during 2010. Entire health care expenditures during the last year were computed and stratified into: medical consultations, medication dispensing, laboratory tests and overall expenditure. Waist circumference was used to diagnose abdominal obesity and physical activity was assessed by previously validated questionnaire. Sedentary and abdominally obese patients (OR= 3.01 [OR95%CI= 1.81-4.99]) had higher likelihood be inserted in the group of higher expenditures than only abdominally obese patients (OR= 1.66 [OR95%CI= 1.07-2.59]). There is a synergic effect between abdominal obesity and physical inactivity on overall health care expenditures.

O objetivo deste estudo foi analisar a associação entre a agregação de inatividade física com a obesidade abdominal e despesas de saúde pública em adultos brasileiros. A amostra foi composta de 963 pacientes de ambos os sexos, selecionados aleatoriamente no Sistema Único de Saúde em 2010. Gastos com saúde durante o último ano foram computados e estratificados em: consultas médicas, distribuição de medicamentos, exames laboratoriais e gasto total. A circunferência da cintura foi usada para diagnosticar a obesidade abdominal e atividade física foi avaliada através de um questionário previamente validado. Pacientes sedentários e com obesidade abdominal (OR = 3.01 [IC95% = 1.81-4.99]) apresentaram maior probabilidade de ser inserido no grupo de despesas mais elevadas do que apenas os pacientes com obesidade abdominal (OR= 1.66 [IC95%= 1.07-2.59]). Existe um efeito sinérgico entre a obesidade abdominal e sedentarismo em despesas totais de saúde.

El objetivo de este estudio fue analizar la asociación entre la agregación de la inactividad física con la obesidad abdominal y el gasto público en salud en adultos brasileños. La muestra consistió en 963 pacientes de ambos sexos, seleccionados al azar en el Sistema de la Salud en 2010. El gasto en salud en el último año se calcula y se estratificó en: consultas médicas, medicamentos, exámenes de laboratorio y el gasto total. Circunferencia de la cintura se utiliza para diagnosticar la obesidad abdominal y la actividad física se evaluó mediante un cuestionario previamente validado. Pacientes sedentarios y con obesidad abdominal (OR= 3,01 [IC95%= 1,81-4,99]) tenían más probabilidades de ser incluido en el grupo de los mayores gastos que sólo los pacientes con obesidad abdominal (OR= 1,66 [IC95%= 1,07-2,59]). Existe un efecto sinérgico entre la obesidad abdominal y la inactividad física en el gasto total en salud.

Accumulation of Domain-Specific Physical Inactivity and Presence of Hypertension in Brazilian Public Healthcare System.

BACKGROUND: Hypertension is one of the most common noncommunicable diseases worldwide, and physical inactivity is a risk factor predisposing to its occurrence and complications. However, it is still unclear the association between physical inactivity domains and hypertension, especially in public healthcare systems. Thus, this study aimed to investigate the association between physical inactivity aggregation in different domains and prevalence of hypertension among users of Brazilian public health system. METHODS: 963 participants composed the sample. Subjects were divided into quartiles groups according to 3 different domains of physical activity (occupational; physical exercises; and leisure-time and transportation). Hypertension was based on physician diagnosis. RESULTS: Physical inactivity in occupational domain was significantly associated with higher prevalence of hypertension (OR = 1.52 [1.05 to 2.21]). The same pattern occurred for physical inactivity in leisure-time (OR = 1.63 [1.11 to 2.39]) and aggregation of physical inactivity in 3 domains (OR = 2.46 [1.14 to 5.32]). However, the multivariate-adjusted model showed significant association between hypertension and physical inactivity in 3 domains (OR = 2.57 [1.14 to 5.79]). CONCLUSIONS: The results suggest an unequal prevalence of hypertension according to physical inactivity across different domains and increasing the promotion of physical activity in the healthcare system is needed.