Physical fitness trends in a nationally representative sample of Portuguese youth: What has changed from 2008 to 2018?

This investigation aimed to describe the current physical fitness (PF) status of Portuguese youth, compare secular trends from 2008 and 2018, and establish updated age- and sex-specific percentile values for distinct PF tests. In 2008 and 2018, 22 048 and 8960 children and adolescents (10-18 years) were included in two national cross-sectional investigations. PF was evaluated using the FITESCOLA® battery tests and the handgrip strength test. Independent sample t-tests and chi-squared tests were used to model the results. Weight smoothed percentile values were calculated using Cole's Lambda-Mu-Sigma (LMS) method. All analyses were weighted according to age, sex, and geographic region. In 2018, boys surpassed girls in the 20-m shuttle run, curl-ups, push-ups, standing long, and vertical jump tests, while girls performed better in the sit-and-reach (p < 0.05). The percentage of boys and girls meeting the healthy zone in the 20-min shuttle run test did not differ between 2008 and 2018 (p ≥ 0.05). In boys, a higher percentage fell in the healthy zone for the curl-up and push-up tests in 2018 compared to 2008 (85.8% vs. 83.4%, and 57.8% vs. 53.8%; p < 0.05). Girls improved their flexibility component (sit-and-reach test), with a higher percentage meeting the healthy zone in 2018 (32.6% vs. 36.9%; p < 0.05); an opposite trend was seen for boys (65.5% vs. 50.1%; p < 0.05). The present investigation provides new and updated PF percentile curves for Portuguese youth, which can be used as a general overview of the current PF state among the Portuguese young population.

Benefits to Performance and Well-Being of Nature-Based Exercise: A Critical Systematic Review and Meta-Analysis.

Prior reviews point to the superior benefits of exercising in nature vs in conventional indoor venues, particularly in terms of well-being. However, physical exercise performance, neither in terms of efficacy nor efficiency, has not been sufficiently addressed by past reviews of this topic. Therefore, we conducted both a systematic review and meta-analysis of the experimental literature that relates to differences in exercise performance and well-being between exercising in nature and in conventional indoor venues. Forty-nine relevant studies─the outcome data of which were used for the systematic review─were located within the Web of Science, PubMed, and Scopus databases. The meta-analyses, using data from twenty-four of the relevant studies, revealed no significant overall environmental effect on task performance efficacy outcomes (p = 0.100). For nature-based exercise, however, marginally positive cognitive performance outcomes (p = 0.059), lower ratings of perceived exhaustion (p = 0.001), and higher levels of vigor (p = 0.017) were observed, indicating higher performance efficiency. As for the effects of environment on well-being, positive affect was significantly higher for nature-based exercise (p = 0.000), while perceived stress was significantly higher for indoor exercise (p = 0.032). These results must, however, be interpreted with caution. High levels of bias and between-study heterogeneity were observed. Nonetheless, given several noticeable trends in the results, it may be that exercising in nature enhances the efficiency of exercise task performance to a greater extent than does indoor exercise.

Effect of exercise-conditioned human serum on the viability of cancer cell cultures: A systematic review and meta-analysis.

Numerous epidemiological studies have shown the existence of a relationship between exercise and reduced risk of different types of cancer. In vitro studies have identified a direct effect of exercise-conditioned human serum on cancer cell lines of the lung, breast, prostate, and colon. The aim of this systematic review with meta-analysis (SRM) was to estimate the magnitude of the effect that exercise-conditioned human serum produced on the viability of cancer cell cultures. The design followed the PRISMA guidelines and the TREND statement to assess the quality of information (QoI) in each study. Nine in vitro studies were included in the SRM, involving a total of nine cancer cell lines and serum from 244 individuals from different countries, including namely healthy sedentary individuals, at risk of prostate cancer individuals and cancer patients, with ages ranging from 18 to 73 years. The impact of exerciseconditioned human serum on the viability of cancer cell cultures was analysed by a variety of assays, using pre-exercise human serum for comparison purposes. Globally, cultures of cancer cell lines exposed to human serum conditioned by exercise of various intensities exhibited a reduced viability, when compared with control cultures, with an overall effect size of -1.126 (95% CI; -1.300 to -0.952; p < 0.001). When the analysis only included human serum conditioned by high intensity exercise, the effect became more pronounced (ES -1.350; -1.522 to -1.179 (95% CI); p < 0.001). These results are in line with the hypothesis that changes in human serum induced by exercise might play a role in the beneficial effects of physical activity in cancer prevention and management and that these effects depend on exercise intensity.

Influence of an awareness program on Portuguese middle and high school students' perceptions of peers with disabilities.

The ongoing topic of attitudes toward inclusion of students with disabilities in Physical Education (PE) classes emphases the role of schools as a primary place where attitudes toward disabilities can be changed. The effect of an awareness program on students' attitudes toward the inclusion of peers with disabilities in PE was examined, as well as variables such as sex, age, previous contact with disability, and competitiveness. The participants were 509 students (235 girls, 274 boys; M age = 13.3 yr., SD = 1.1, range = 11-16), who attended middle and high Portuguese schools. The awareness intervention comprised a one-week program (2 PE classes, 90 min. and 45 min.). Attitudes were assessed before and after the intervention. The awareness program appeared to have a positive influence on changing students' attitudes toward inclusion in PE.

The effects of combined exercise training on glucose metabolism and inflammatory markers in sedentary adults: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to determine the magnitude of the effect of combined exercise training on glucose metabolism markers, adipokines, and inflammatory cytokines in non-diabetic sedentary adults. PubMed, Web of Science, Scopus, Cochrane Library electronic databases and reference lists of included studies were explored for randomized controlled trials (RCTs) that included physically inactive adults and provided combined training interventions (aerobic plus resistance exercise). Effects on fasting glucose and insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), HbA1c, adiponectin, leptin, IL-6, TNF-α, and C-reactive protein (CRP) in exercise vs control groups were analyzed using random effects meta-analysis. The Cochrane Risk of Bias Tool for Randomized Trials 2.0 (RoB 2) was used to assess the risk of bias. A total of 24 RCTs were included in the quantitative analysis. Combined exercise training significantly decrease fasting glucose (standardized mean difference, SMD: - 0.474, 95% CI [- 0.829, - 0.120], p = 0.009, 35 study arms), fasting insulin (SMD: - 1.024, 95% CI [- 1.502, - 0.545], p < 0.001, 27 study arms), HOMA-IR (SMD: - 0.946, 95% CI [- 1.450, - 0.442], p < 0.001, 23 study arms), TNF-α (SMD: - 0.972, 95% CI [- 1.361, - 0.582], p < 0.001, 10 study arms), and CRP (SMD: - 0.507, 95% CI [- 0.818, - 0.196], p = 0.001, 14 study arms). No significant effects were observed for HbA1c, adiponectin, leptin, and IL-6 levels. Random effects meta-regression models by age, sex, and intervention length were not able to explain any of the variation in the effect size of HOMA-IR. Findings from this systematic review and meta-analysis suggest that combined exercise training improves some glucose metabolism markers and inflammatory parameters in sedentary adults without diabetes.

Changes in Metabolic and Inflammatory Markers after a Combined Exercise Program in Workers: A Randomized Controlled Trial.

PURPOSE: We investigated the effects of a 16-week combined exercise training on body composition, metabolic and inflammatory markers in sedentary middle-aged workers. We also assessed whether significant alterations in metabolic markers were associated with changes in health-related outcomes. METHODS: This randomized controlled trial involved 46 participants randomly allocated into control and exercise groups. The exercise group performed 16-week combined aerobic and resistance training for 75 min/session, 3 times/week. Fasting blood samples were collected at baseline and after 16-week intervention to determine lipid profile, metabolic and inflammatory markers as primary outcomes. RESULTS: A total of 36 participants completed the intervention (53.70 ± 6.92 years old) (n = 18 in each group). Waist circumference (interaction effect: F = 7.423, p = 0.002), fat mass (interaction effect: F = 5.070, p = 0.011), and muscle mass (interaction effect: F = 5.420, p = 0.007) were improved in the exercise group compared to the control group. Fasting glucose increased after the 16-week follow-up (time effect: F = 73.253, p < 0.001), without an intergroup difference. Insulin levels were greater in the control compared to exercise group (group effect: F = 6.509, p = 0.015). The control group tended to increase the HOMA-IR index (interaction effect: F = 3.493, p = 0.070) and to decrease the QUICKI index (interaction effect: F = 3.364, p = 0.075) to a greater extent compared to the exercise group. Exercise group reduced leptin (interaction effect: F = 11.175, p = 0.002) and adiponectin (interaction effect: F = 4.437, p = 0.043) concentrations in a greater magnitude than control group. IL-6 (time effect: F = 17.767, p < 0.001) and TNF-α (time effect: F = 9.781, p = 0.004) concentrations decreased after the intervention, without an intergroup difference. IL-17A levels increased in the control compared to exercise group (interaction effect: F = 5.010, p = 0.033). Effects on adiponectin, IL-6 and IL-17A levels seem to depend on baseline BMI, age, and sex. Percentage changes in leptin correlated positively with changes in HOMA-IR index in the exercise (r = 0.565, p = 0.015) and control (r = 0.670, p = 0.002) groups. CONCLUSIONS: A combined training program can be an effective strategy to improve body composition and inflammatory markers and prevent marked reductions in insulin sensitivity among middle-aged workers.

Physical Activity and Sedentary Behavior in the Portuguese Population: What Has Changed from 2008 to 2018?

PURPOSE: Assessment of trends in physical activity (PA) and sedentary time (ST) is important for evaluating the effectiveness of national policies and setting goals to improve population PA. This study describes changes in measured PA and ST through motion sensors of the Portuguese population from 2008 to 2018. METHODS: PA and ST were measured with accelerometry from individuals (≥10 yr) participating in the 2008 ( n = 4 532) and 2018 ( n = 6 369) Portuguese PA Surveillance Systems. Changes were analyzed using generalized linear and logistic models adjusted for accelerometer wear time. A weight factor was applied to all analyses in order to achieve national representativeness of the present results. RESULTS: In 2018, 15.4%, 71.2%, and 30.6% of Portuguese youth, adults, and older adults met the PA recommendations. Compared with 2008, the percentage meeting the PA guidelines increased in youth females (4.7% vs 7.7%, P < 0.05) and adult males (72.2% vs 79.4%, P < 0.05). A decrease in ST was observed for adult males, whereas ST increased in all youth. Male youth decreased the number of breaks in ST (BST per hour), whereas a favorable increase was found for both adult and older adult males and females. CONCLUSIONS: PA has remained fairly stable between 2008 and 2018 for all groups, except for youth females and adult males. For ST, a favorable decrease was observed for adult males; however, an inverse trend was found in youth. These results are relevant for policy makers to develop health care policies aimed at promoting PA and reducing ST across all age-groups.

Functional fitness trends among older adults in Portugal between 2008 and 2018: Keeping up with a healthy aging process.

OBJECTIVES: Maintaining a healthy aging process is vital to combating and delaying the adverse health outcomes faced by the growing older adult population, where a key aspect to achieving healthy aging is the preservation of functional fitness. This study aims to present trends on the functional fitness of Portuguese older adults between 2008 and 2018 and build new normative reference standards for the Senior Fitness Battery Tests. DESIGN: Cross-sectional study. METHODS: Functional fitness was measured with the Senior Fitness Battery Tests in two national representative cohorts of the Portuguese older adult population (≥65 years) using the 2008 (n = 4712) and 2018 (n = 2717) surveys. Changes were assessed according to sex and age group. Sex and age-group normative fitness scores were developed. RESULTS: Overall findings suggested that older adults' point prevalence for arm-curl, 8-ft up-and-go, and 30-s chair sit-to-stand remained stable between 2008 and 2018, with declining trends being observed for the 6-min walk and back-scratch tests. However, results for trends varied when stratified by sex and age categories. CONCLUSIONS: Our results suggest a trend toward a stabilization of most of the functional fitness tests over the past decade, but with a critical decline in the 6-min walk test. Thus, this test should be targeted by future health-care policies. Moreover, this investigation provides new and updated normative reference standards for the Senior Fitness Battery Tests that should be used as a tool to promote a healthy aging process among Portuguese older adults.

Effects of Physical Exercise on Burnout Syndrome in University Students.

INTRODUCTION: Burnout syndrome has a negative impact on university students' health worldwide. Global prevalence of each dimension of the syndrome is estimated at 55.4% for emotional exhaustion, 31.6% for cynicism and 30.9% for academic inefficacy. OBJECTIVE: Evaluate the efficacy of physical exercise in reducing burnout levels in university students. METHODS: We carried out an investigation in students from the Technical University of Ambato, Ecuador. Students were in different career tracks, randomly selected, and were assigned to three different groups with pre-test and post-test measurements: two intervention groups (aerobic and strength exercise) and one control group (no exercise). The evaluation instrument was the Maslach Burnout Inventory-Student Survey, whose dimensions are exhaustion, cynicism and academic inefficacy. We also evaluated heart rate variability. RESULTS: The aerobic exercise group reduced cynicism by 21.1% (d = 0.252), inefficacy 13.1% (d = 0.397) and exhaustion by 31.0% (d = 0.532). The strength exercise group reduced cynicism by 27.4% (d = 0.315), inefficacy by 21.7% (d = 0.704) and exhaustion by 19.6% (d = 0.299). In the control group, exhaustion and inefficacy increased by 10.1% (d = 0.128) and 4.4% (d = 0.129) respectively; instead, cynicism was reduced by 7.3% (d = 0.062).The aerobic exercise group had the greatest increase in heart rate variability (at 16.8%), followed by the strength group (16.6%) and the control group (5.2%). CONCLUSIONS: Physical exercise (both aerobic and strength) was effective in reducing burnout levels in university students.

Exercise improves the social and behavioral skills of children and adolescent with autism spectrum disorders.

Background: Currently, there is no standard treatment for Autism Spectrum Disorders (ASD), but there are many ways to minimize the symptoms and maximize abilities. Some studies suggest that exercise and other physical activities with children with ASD may be beneficial. In this study, we hypothesized that a physical exercise program (48-week exercise-intervention) could improve symptomatology dyad among children and adolescents with ASD. Our main aim was to examine the effects of physical activity on the primary clinical symptoms and associated comorbidities in children and adolescents with ASD. Methods: We allocated 229 children with ASD, ranging in age from 2.3-17.3 years (M = 7.8, SD = 3.2), into three groups: (a) exercise- intervention group, (b) control group from the same institution, and (c) control group from another institution. The exercise program was performed at moderate intensity in a 30 min section twice a week for 48 weeks. We used Bayesian multilevel regression modeling to examine participant outcomes and responses to the exercise-intervention. Results: Our results showed that a 48-week exercise-intervention substantially decreased ASD social interaction problems, attention deficit, emotional reactivity, stereotypical verbal and motor behavior, and sleep disturbances. However, physical exercise did not affect eye contact and food selectivity. We also observed that ASD severity and socioeconomic status influence eye contact, attention deficit, and sleep disturbance responses. Conclusion: In conclusion, children and adolescents with ASD exposed to a 48-week physical exercise-intervention program had important improvements in ASD symptoms. This study highlights that structured exercise programs can be a powerful complementary therapy for the ASD population.

The Mediating Effect of Different Exercise Programs on the Immune Profile of Frail Older Women with Cognitive Impairment.

BACKGROUND: Frail individuals experience an accelerated immunosenescence, and exercise has been identified as a therapy to promote a better inflammatory environment. OBJECTIVE: To analyze the effects of 28-weeks of two different exercise protocols on the functional fitness and immune profiles of institutionalized pre-frail and frail women with mild cognitive impairment. METHODS: Participants residing in care homes (n=60, 81±7.84 years old) were randomized into three groups: a chair elastic band muscle-strength exercise (CSE, n=21; 81±4.79), a chair multimodal exercise (CME, n=20; 80±8.19), and a control non-exercise (CGne, n=19; 80±10.01). Both CME and CSE groups performed progressive circuit-training exercise sessions. The controls did not change their usual lifestyle. The Fried protocol and the Mini-Mental State Examination questionnaire were used to identify the frail subgroups and the participants with mild cognitive impairment. Data for anti and pro-inflammatory markers and physical fitness were analyzed pre and post-interventions. RESULTS: After the intervention, a significant effect of time and time by group for sIgA and time by group for IL- 10 levels were found (p > 0.05). Within-group analysis showed a significant moderate decrease in the TNF-α to IL-10 ratio for the CME group and an increase in the controls (p > 0.05) and a slight reduction in the IL-6 and IL- 1ß concentrations. The controls showed a negative trend towards a decrease in physical fitness and a trend for increased levels in the pro-inflammatory markers IL-6 and IL-1ß. CONCLUSION: The evidence regarding the use of systematic and moderate long-term exercise as therapy for promoting a better balance between pro- and anti-inflammatory environments and a decrease in the inflammatory index for the CME group were the most promising results from this study.

Growth and weight status of Brazilian children with autism spectrum disorders: A mixed longitudinal study.

OBJECTIVE: This study examined the growth status and physical development of Brazilian children with autism spectrum disorders from 4 to 15 years of age. Furthermore, it was examined whether variation in growth patterns and weight status was influenced by the use of psychotropic medications. METHODS: One-hundred and twenty children aged 3.6-12.1 years at baseline (average=7.2 years, SD=2.3 years) diagnosed with autism spectrum disorders were measured on three repeated occasions across a 4-year period. Stature, body mass, and body mass index were considered. Bayesian multilevel modeling was used to describe the individual growth patterns. RESULTS: Growth in stature was comparable to the age-specific 50th percentile for Centers for Disease Control and Prevention reference data until approximately 8 years, but a substantial decrease in growth rate was observed thereafter, reaching the age-specific 5th percentile at 15 years of age. Both body mass and body mass index values were, on average, higher than both the Brazilian and Centers for Disease Control and Prevention age-specific 95th percentile reference until 8 years, but below the 50th specific-age percentile at the age of 15 years. CONCLUSIONS: Brazilian boys with autism spectrum disorders between 4 and 15 years appear to have impaired growth in stature after 8-9 years of age, likely impacting pubertal growth. A high prevalence of overweight and obesity was observed in early childhood, although a trend of substantial decrease in body mass and body mass index was apparent when children with autism spectrum disorders entered the years of pubertal development.

Exercise Effects for Children With Autism Spectrum Disorder: Metabolic Health, Autistic Traits, and Quality of Life.

This study examined the effects of a 48-week exercise-based intervention on the metabolic profile, autism traits, and perceived quality of life in children with autism spectrum disorder (ASD). We randomly allocated 64 children with ASD (aged 6-12 years) to experimental ( n = 46) and control groups ( n = 18) and used multilevel regression modeling to examine responses to receiving or not receiving the intervention. The experimental group showed beneficial effects on metabolic indicators (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol), autism traits, and parent-perceived quality of life. Our results provide support for exercise and physical activity, including basic coordination and strength exercises, as important therapeutic interventions for children with ASD.

Strength Training Decreases Inflammation and Increases Cognition and Physical Fitness in Older Women with Cognitive Impairment.

Introduction: Cognitive impairment that affects older adults is commonly associated with an inflammatory imbalance, resulting in decreased physical fitness. Exercise has been pointed to mitigate immunosenescence and cognitive impairment associated with aging, while increase in physical fitness. However, few studies explored the relationship between changes in cytokine concentration and improvement on cognition due to elastic band strength training. The aim of this study was to investigate the effects of strength training on pro-and anti-inflammatory cytokines, hematological markers and physical fitness of older women with cognitive impairment. Methods: Thirty-three women (82.7 ± 5.7 years old) participated in the study and were divided in two groups: strength exercise training group (ST; n = 16) and Control Group (CG; n = 17) and were evaluated before and after 28 weeks of the exercise program. The CG did not undergo any type of exercise programs. Data for IL-10, TNF-α, IFN-γ, C-Reactive Protein (CRP), white blood counts (WBC), red blood counts (RBC), Mini Mental State Examination (MMSE) and physical fitness tests were analyzed in both moments. Results: IL-10 increased in the ST group without changes in CG. TNF-α and CRP increased in the control group while no changes were observed for IFN-γ in both groups. Strength training decreased leukocyte and lymphocyte counts and increase hemoglobin, mean cell volume and mean cell hemoglobin concentration. The MMSE score increased in strength training group but remained unchanged in the control group. A correlation between the variation of granulocyte counts and the MMSE scores was also observed within the total sample. An improvement in physical fitness was observed with strength training. Conclusion: Resistance exercise promoted better anti-inflammatory balance and physical performance simultaneously with an increase in cognitive profile in older women with cognitive impairment.

Prevalence of burnout syndrome in university students: A systematic review / Prevalencia del síndrome de burnout en estudiantes universitarios: Una revisión sistemática

Abstract Introdution Burnout syndrome is a social and health problem in college students. Objective To synthesize evidence from previous studies on the prevalence of burnout syndrome in university students in their three-dimensional approach. Method The search strategies followed the PRISMA guidelines and were based on the following descriptive terms: "burnout," "studies," "prevalence," "students." Pubmed, Web of Science Core Collection, PsicINFO, and Scielo were consulted. An evaluation of the quality of the information was carried out applying the STROBE positioning guidelines. Results We found 1,406 studies that were reduced to 46 studies for final analysis using the STROBE statement, eventually leaving 20 studies. One study (5%) was conducted in North America, five (25%) in Asia, nine (45%) in Latin America, and five (25%) in Europe. Of the 20 studies evaluated in the systematic review, those that had the best overall evaluation in the STROBE analysis were selected for discussion, corresponding to 10 (out of 75% of STROBE). Overall prevalence of each dimension of the syndrome was estimated at 55.4% for emotional exhaustion, 31.6% for cynicism, and 30.9% for academic efficacy. Discussion and conclusion Moderate levels of burnout syndrome prevail in the different populations of university students of different careers worldwide. In only a few studies is the prevalence low and this could be due to multiple evaluative variables.

Resumen Introducción El síndrome de burnout es un problema social y de salud en los estudiantes universitarios. Objetivo Sintetizar las pruebas de estudios anteriores sobre la prevalencia del síndrome de burnout en estudiantes universitarios en su enfoque tridimensional. Método Las estrategias de búsqueda siguieron las pautas de PRISMA y se basaron en los siguientes términos descriptivos: "burnout", "estudios", "prevalencia", "estudiantes". Se consultaron Pubmed, Web of Science Core Collection, PsicINFO y Scielo. Se llevó a cabo una evaluación de la calidad de la información aplicando las directrices de posicionamiento de STROBE. Resultados Se encontraron 1,406 estudios que se redujeron a 46 estudios para el análisis final utilizando la declaración STROBE, con lo que quedaron finalmente 20 estudios. Un estudio (5%) se llevó a cabo en América del Norte, cinco (25%) en Asia, nueve (45%) en América Latina y cinco (25%) en Europa. De los 20 estudios evaluados en la revisión sistemática, se seleccionaron para su discusión aquellos que tuvieron la mejor evaluación general en el análisis de la STROBE, correspondientes a 10 (de un 75% de la STROBE). La prevalencia general de cada dimensión del síndrome se estimó en un 55.4% para el agotamiento emocional, un 31.6% para el cinismo y un 30.9% para la eficacia académica. Discusión y conclusión Los niveles moderados del síndrome de burnout prevalecen en las diferentes poblaciones de estudiantes universitarios de distintas carreras en todo el mundo. En sólo unos pocos estudios la prevalencia es baja y esto podría deberse a múltiples variables evaluativas.

Growth and weight status of Brazilian children with autism spectrum disorders: A mixed longitudinal study / Crescimento e massa corporal em crianças brasileiras com transtornos do espectro autista: um estudo longitudinal misto

ABSTRACT Objective: This study examined the growth status and physical development of Brazilian children with autism spectrum disorders from 4 to 15 years of age. Furthermore, it was examined whether variation in growth patterns and weight status was influenced by the use of psychotropic medications. Methods: One-hundred and twenty children aged 3.6-12.1 years at baseline (average = 7.2 years, SD = 2.3 years) diagnosed with autism spectrum disorders were measured on three repeated occasions across a 4-year period. Stature, body mass, and body mass index were considered. Bayesian multilevel modeling was used to describe the individual growth patterns. Results: Growth in stature was comparable to the age-specific 50th percentile for Centers for Disease Control and Prevention reference data until approximately 8 years, but a substantial decrease in growth rate was observed thereafter, reaching the age-specific 5th percentile at 15 years of age. Both body mass and body mass index values were, on average, higher than both the Brazilian and Centers for Disease Control and Prevention age-specific 95th percentile reference until 8 years, but below the 50th specific-age percentile at the age of 15 years. Conclusions: Brazilian boys with autism spectrum disorders between 4 and 15 years appear to have impaired growth in stature after 8-9 years of age, likely impacting pubertal growth. A high prevalence of overweight and obesity was observed in early childhood, although a trend of substantial decrease in body mass and body mass index was apparent when children with autism spectrum disorders entered the years of pubertal development.

RESUMO Objetivo: Este estudo examinou o estado de crescimento e o desenvolvimento físico de crianças brasileiras com transtornos do espectro autista entre 4 e 15 anos. Adicionalmente, examinamos se a variação nos padrões de crescimento e na massa corporal foi influenciada pelo uso de medicamentos psicotrópicos. Métodos: 120 crianças com idades entre 3,6 e 12,1 anos no início do estudo (média = 7,2 anos, DP = 2,3 anos) diagnosticadas com transtornos do espectro autista foram avaliadas em três ocasiões repetidas em um período de 4 anos. Foram considerados estatura, massa corporal e índice de massa corporal. O modelo multinível bayesiano foi utilizado para descrever os padrões de crescimento individual. Resultados: O crescimento em estatura foi comparável ao percentil 50 específico para a idade para os dados de referência do Centro de Controle e Prevenção de Doenças dos Estados Unidos até cerca de 8 anos. Porém, foi observada uma redução substancial na taxa de crescimento depois dos 8 anos, atingindo o percentil 5 específico para a idade aos 15 anos de idade. Tanto os valores de massa corporal quanto de índice de massa corporal foram, em média, maiores comparativamente ao percentil 95 específico para a idade até aos 8 anos da referência brasileira e do Centro de Controle e Prevenção de Doenças dos Estados Unidos, porém abaixo do percentil 50 específico para a idade aos 15 anos de idade. Conclusões: Os meninos brasileiros com transtornos do espectro autista entre 4 e 15 anos parecem ter retardo do crescimento na estatura após os 8-9 anos, provavelmente afeta o crescimento púbere. Foi observada uma alta prevalência de sobrepeso e obesidade na primeira infância, apesar de uma tendência de redução substancial na massa corporal e no índice de massa corporal ter sido aparente quando as crianças com transtornos do espectro autista entraram nos anos de desenvolvimento púbere.

Prevalence of the Portuguese population attaining sufficient physical activity.

PURPOSE: Physical activity has many health benefits, and to implement strategies, mainly in those groups with insufficient levels of practice, it is important to evaluate physical activity. The main purpose of this study was to describe the prevalence of physical activity in the Portuguese population aged 10 yr and older using accelerometry. METHODS: The accelerometers were worn for four consecutive days, and a valid record was defined as at least 3 d with 10 h of wear time, including one weekend day. Considering these conditions, 4696 participants were included. RESULTS: According to the recommendations of 60 min·d(-1) of physical activity, 36% of participants age 10-11 yr (boys = 51.6%, girls = 22.5%) and 4% age 16-17 yr (boys = 7.9%, girls = 1.2%) were considered sufficiently active. In adulthood, ∼70% of participants age 18-64 yr (men = 76.6%, women = 65.2%) and 35% age older than 64 yr (men = 46%, women = 29%) reached the recommendation of 30 min·d(-1) of physical activity, when counting every minute of moderate or greater intensity. Considering bouts of 10 min or more of moderate or greater intensity in participants older than 17 yr, the prevalence was 4%-6% at 18-39 yr, 7%-9% at 40-64 yr, and ∼3% in persons age 65 yr or older. CONCLUSIONS: The design and implementation of strategies to promote physical activity for health among children and adolescents and older adults, particularly girls/women, should be encouraged.

Prevalence of overweight and obesity among Portuguese youth: a study in a representative sample of 10-18-year-old children and adolescents.

PURPOSE: The aim of this research was to report the prevalence of overweight and obesity in a representative sample of Portuguese youth. METHODS: This was a school-based study performed in Portugal. A total of 22 048 children and adolescents aged 10-18 years were included in the study. The World Health Organization (WHO) and the International Obesity Task Force (IOTF) cut-offs were used to categorise overweight and obese participants. RESULTS: Using IOTF cut-offs the prevalence of overweight and obesity was 17.0 and 4.6% in girls, and 17.7 and 5.8% in boys, respectively (p < 0.001 for overweight and p > 0.05 for obesity), whereas WHO cut-offs resulted in overweight and obesity prevalence scores of 23.1 and 9.6% in girls, and 20.4 and 10.3% in boys, respectively (p < 0.001 for overweight and p >0.05 for obesity). With IOTF cut-offs, a lower prevalence of obesity and overweight was observed at higher ages, in both genders. With the WHO cut-offs, a lower prevalence of obesity and overweight was observed at higher ages, in boys. In girls, the prevalence of overweight and obesity increases from 10 to 12 years of age and decreases from the age of 13 to 18 years. CONCLUSION: The prevalence for overweight/obesity among Portuguese children and adolescents vary according to the cut-off points used and are also of concern requiring strategies to promote healthy weight gain among children and adolescents.

[Congenital or neonatal cytomegalovirus infection?]. / Citomegalovirus. Infecção congénita ou neonatal?

Congenital Cytomegalovirus (CMV) infection occurs in about 1% of the newborns, but it is clinically unapparent in around 90% of the cases during the newborn period. This congenital infection may be the cause of neurological sequelae of variable severity, namely neuro-sensorial hearing loss. In most cases of hearing loss secondary to congenital CMV infection, the newborn was asymptomatic. The diagnosis of congenital CMV infection is made traditionally by culturing the virus from urine during the first three weeks of life. In the present case, the authors describe the situation of a two months old black female infant, admitted for irritability, vomiting and generalized convulsions. During investigation, the authors found lab results in favor of recent CMV infection. The imaging studies performed (cerebral ultrasound scan, computerized tomography and magnetic resonance imaging) were normal. As the infant was older than three weeks, it was not possible to make the diagnosis of congenital CMV infection by a positive urine sample. The diagnosis was made by a positive Polymerase Chain Reaction made on the Guthrie card, collected on the fifth day of life and archived in the national laboratory that centralizes the early diagnosis of phenylketonuria and hypothyroidism. The authors review the epidemiology, diagnosis, prognosis and prevention of the congenital CMV infection, giving a perspective of the magnitude of this disease, its sequelae and the new diagnostic methods available, even when the infection is clinically unapparent on the newborn period.