Mobile health apps to reduce sedentary behavior: a scoping review.

Given the continued increase in mobile health applications (apps) aimed at healthcare and the recognition of sedentary behavior (SB) as a public health problem, the goal of this scoping review study was to summarize the effects of interventions based on mobile health apps designed to reduce SB in adults, with a specific focus on SB. The electronic databases PubMed, PsycINFO, SportDISCUS, Web of Science, and manual searches in reference lists were conducted on papers published up to September 2020. Nine out of the 897 studies researched were included and composed the descriptive synthesis. The investigations found in the present study showed a decrease in time spent on television viewing and in total time spent sitting, as well as an increase in the number of SB breaks after interventions based on mobile health apps. In conclusion, despite the growing interest in intervention programs in SB, only nine studies have used smartphone apps as a strategy to reduce SB in adults. Mobile health apps were proved to be effective in SB reduction, as assessed by different parameters, and should be encouraged. However, further studies are needed to verify the long-term effects of the utilization of such applications.

Health related quality of life is differently associated with leisure-time physical activity intensities according to gender: a cross-sectional approach.

BACKGROUND: Several studies have demonstrated a positive association between physical activity (PA) and health-related quality of life (HRQL). However, studies have suggested that this association depends both on the PA intensity and the domain of HRQL evaluated. This study aimed to explore the association between physical, mental and overall HRQL with recommended levels of PA. PA levels were divided into moderate and vigorous intensity leisure-time PA and total leisure-time PA. METHODS: The study included 1001 adults, 582 women (46 ± 17 years) and 419 men (43 ± 16 years), residents in Rio Claro-SP, Brazil. All participants completed the SF-36 questionnaire to assess HRQL and the long version of the International Physical Activity Questionnaire (IPAQ) to assess level and intensities of leisure-time PA. Total leisure-time PA at moderate intensity was classified as: less than 9 min/week, 10-149 min/week, 150-299 min/week and 300 min/week or more. Total leisure-time PA at vigorous intensity was classified as: less than 9 min/week, 10 to 74.9 min/week, 75-149 min/week and 150 min/week or more. Multiple linear regression was performed in STATA version 12.0. RESULTS: Among women, moderate intensity and total leisure-time PA were associated with physical health. Among men, moderate and vigorous intensity and total leisure-time PA were associated with physical health and overall HRQL. Furthermore, moderate intensity and total leisure-time PA were associated with mental health in men. However, vigorous intensity PA was not associated with mental health for this group. CONCLUSION: The different domains of HRQL were associated with different levels and intensities of PA in leisure-time according to gender of adults. These findings indicate the complexity and importance of evaluating the HRQL stratified by gender and consider the different levels and intensities of PA.

The effect of a community-based, primary health care exercise program on inflammatory biomarkers and hormone levels.

The aim of this study was to analyze the impact of a community-based exercise program in primary care on inflammatory biomarkers and hormone levels. The 1-year quasiexperimental study involved 13 women (mean age = 56.8 ± 11.4 years) and it was developed in two basic health care units in Rio Claro City, Brazil. The physical exercise intervention was comprised of two, 60-minute sessions/week. The inflammatory biomarkers were measured at baseline, 6 months, and 1 year. Repeated measures ANOVA analyses indicated that the intervention was effective in reducing CRP and TNFα after 1 year compared to baseline and 6 months (P < 0.05). There were no changes in IL10, IL6, and insulin after 1 year. However, leptin significantly increased at 1 year (P = 0.016). The major finding of this study is that a community-based exercise program can result in a decrease or maintenance of inflammatory biomarkers after 1 year, and thus has the potential to be a viable public health approach for chronic disease prevention.

Development of the color scale of perceived exertion: preliminary validation.

This study developed a Color Scale of Perceived Exertion (RPE-color scale) and assessed its concurrent and construct validity in adult women. One hundred participants (18-77 years), who were habitual exercisers, associated colors with verbal anchors of the Borg RPE scale (RPE-Borg scale) for RPE-color scale development. For RPE-color scale validation, 12 Young (M = 21.7 yr., SD = 1.5) and 10 Older (M = 60.3 yr., SD = 3.5) adult women performed a maximal graded exercise test on a treadmill and reported perceived exertion in both RPE-color and RPE-Borg scales. In the Young group, the RPE-color scale was significantly associated with heart rate and oxygen consumption, having strong correlations with the RPE-Borg scale. In the Older group, the RPE-color scale was significantly associated with heart rate, having moderate to high correlations with the RPE-Borg scale. The RPE-color scale demonstrated concurrent and construct validity in the Young women, as well as construct validity in Older adults.

Habitual physical activity minimizes healthcare costs resulting from comorbidities among adults with cardiovascular diseases.

BACKGROUND: Habitual physical activity (HPA) can be used as a non-pharmacological strategy to prevent and control chronic diseases, as well as playing a role in minimizing healthcare costs. OBJECTIVE: To verify the impact of HPA on healthcare costs at different levels of care, over 24 months, in an adult population with cardiovascular diseases (CVD), including individuals with or without comorbidities. METHODS: Two-hundred and seventy-eight adults with CVD, aged between 30 and 65 years, participated in the study. Information on healthcare costs was obtained from medical records and included primary, secondary, and tertiary levels. Comorbidities such as diabetes, dyslipidemia, arterial hypertension, and obesity were registered. HPA was measured using the Baecke questionnaire. Comparisons between groups were performed using Student's t (

Aerobic fitness evaluation during walking tests identifies the maximal lactate steady state.

OBJECTIVE: The aim of this study was to verify the possibility of lactate minimum (LM) determination during a walking test and the validity of such LM protocol on predicting the maximal lactate steady-state (MLSS) intensity. DESIGN: Eleven healthy subjects (24.2 ± 4.5 yr; 74.3 ± 7.7 kg; 176.9 ± 4.1 cm) performed LM tests on a treadmill, consisting of walking at 5.5 km · h⁻¹ and with 20-22% of inclination until voluntary exhaustion to induce metabolic acidosis. After 7 minutes of recovery the participants performed an incremental test starting at 7% incline with increments of 2% at each 3 minutes until exhaustion. A polynomial modeling approach (LMp) and a visual inspection (LMv) were used to identify the LM as the exercise intensity associated to the lowest [bLac] during the test. Participants also underwent to 2-4 constant intensity tests of 30 minutes to determine the MLSS intensity. RESULTS: There were no differences among LMv (12.6 ± 1.7%), LMp (13.1 ± 1.5%), and MLSS (13.6 ± 2.1%) and the Bland and Altman plots evidenced acceptable agreement between them. CONCLUSION: It was possible to identify the LM during walking tests with intensity imposed by treadmill inclination, and it seemed to be valid on identifying the exercise intensity associated to the MLSS.

The rating of perceived exertion predicts intermittent vertical jump demand and performance.

The aims of this study were (a) to assess the ability of the rating of perceived exertion (RPE) to predict performance (i.e. number of vertical jumps performed to a fixed jump height) of an intermittent vertical jump exercise, and (b) to determine the ability of RPE to describe the physiological demand of such exercise. Eight healthy men performed intermittent vertical jumps with rest periods of 4, 5, and 6 s until fatigue. Heart rate and RPE were recorded every five jumps throughout the sessions. The number of vertical jumps performed was also recorded. Random coefficient growth curve analysis identified relationships between the number of vertical jumps and both RPE and heart rate for which there were similar slopes. In addition, there were no differences between individual slopes and the mean slope for either RPE or heart rate. Moreover, RPE and number of jumps were highly correlated throughout all sessions (r = 0.97-0.99; P < 0.001), as were RPE and heart rate (r = 0.93-0.97; P < 0.001). The findings suggest that RPE can both predict the performance of intermittent vertical jump exercise and describe the physiological demands of such exercise.

Physiological and perceived exertion responses at intermittent critical power and intermittent maximal lactate steady state.

The aim of this study was to compare the power outputs of the intermittent critical power (CPi) with the intermittent maximal lactate steady state (MLSSi) and to compare the physiological and perceptual responses exercising at CPi and MLSSi. Ten subjects performed intermittent trials on a cycle ergometer to determine CPi and MLSSi using 30:30 seconds of effort and pause. The oxygen uptake (&OV0312;o2), heart rate (HR), blood lactate concentration ([Lac]), and rating of perceived exertion (RPE) responses were compared during 30-minute cycling at CPi and MLSSi. The CPi (267 ± 45 W) was similar to MLSSi (254 ± 39 W), and they were correlated (r = 0.88; p < 0.05). The &OV0312;o2 and HR responses stabilized throughout exercising at CPi (2.52 ± 0.52 L·min; 156 ± 8 b·min) and MLSSi (2.41 ± 0.32 L·min; 152 ± 10 b·min). These physiological variables were similar between conditions. However, the [Lac] and RPE were higher from the middle to the end of exercise duration at CPi ([Lac] = 6.9 ± 2.6 mM; RPE = 17.1 ± 2.1 a.u.) compared to MLSSi ([Lac] = 5.1 ± 0.9 mM; RPE = 15.7 ± 1.8 a.u.). Therefore, CPi intensity determined from 30:30 seconds of effort and rest periods on a cycle ergometer is equivalent to the MLSSi, and there is a physiological steady state throughout both exercise intensities, although the [Lac] and RPE responses at CPi are higher than at MLSSi. Thus, the CPi and MLSSi may be used as tools for intermittent training evaluation and prescription.

Sedentary Behavior Is Associated With Low Leisure-Time Physical Activity and High Body Fatness in Older Brazilian Adults.

Sedentary behavior (SB) has emerged as a new health risk factor, including risk of premature death. This study examined the association between SB and measures of physical activity and body fatness in older Brazilian adults. Self-report measures of SB (ie, sitting time [ST]), leisure-time physical activity (LTPA), and body fatness (body mass index [BMI]) were collected from 355 older adults aged 60 years and older by trained interviewers. Statistical procedures were conducted using SPSS software with significance set at P < .05. Overall, the median ST was 3 hours per day. Mean values of LTPA and BMI for the entire sample were 90.0 (197.4) min/week and 26.5 (4.9) kg/m2, respectively. Partial correlations controlling for age revealed that ST was negatively associated with LTPA (pr = -.15 [-.25; -.04]; P = .006) and positively associated with BMI (pr = .25 [.14; .35]; P < .001). Age, BMI, and LTPA emerged as independent predictors of ST, explaining a small but significant variance in ST (R 2 = .12; P = .02). Furthermore, t test revealed a significant difference in LTPA and BMI between groups of different amounts of sitting. The findings suggest that prolonged ST may have a negative impact on LTPA and BMI in older Brazilian adults.

Cost-analysis and cost-effectiveness of physical activity interventions in Brazilian primary health care: a randomised feasibility study.

Physical exercise programs have been carried out in primary health care in Brazil and have provided good results in terms of effectiveness, their economic contribution has not been investigated yet. The aim of the study is to verify the feasibility of brief counseling physical activity intervention and to compare its economic cost and cost-effectiveness with supervised physical exercise intervention in primary care. A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG). Interventions lasted one year. The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons (session cost, annual cost and cost per participant annually). At leisure time, the cost to move one person to the physically active category at 12 months is estimated in R$369.00 for BCI and R$426.21 for the SPEI. The Incremental Cost-effectiveness Ratio (ICER) is R$310.32. The BCI is feasible and more economic, however, the cost effective is not that different. Thus, it is strongly recommended that the two interventions be offered at primary care in Brazil.

Effects of aerobic exercise on the blood pressure, oxidative stress and eNOS gene polymorphism in pre-hypertensive older people.

The polymorphisms of endothelial nitric oxide synthase (eNOS) are associated with reduced eNOS activity. Aerobic exercise training (AEX) may influence resting nitric oxide (NO) production, oxidative stress and blood pressure. The purpose of this study was to investigate the effect of AEX on the relationship among blood pressure, eNOS gene polymorphism and oxidative stress in pre-hypertensive older people. 118 pre-hypertensive subjects (59 ± 6 years) had blood samples collected after a 12 h overnight fast for assessing plasma NO metabolites (NOx) assays, thiobarbituric acid reactive substances (T-BARS) and superoxide dismutase activity (ecSOD). eNOS polymorphism (T-786C and G-894T) was done by standard PCR methods. All people were divided according to the genotype results (G1: TT/GG, G2: TT/GT + TT, G3: TC + CC/GG, G4: TC + CC/GT + TT). All parameters were measured before and after 6 months of AEX (70% of VO(2 max)). At baseline, no difference was found in systolic and diastolic blood pressure, ecSOD and T-BARS activity. Plasma NOx levels were significantly different between G1 (19 ± 1 µM) and G4 (14.2 ± 0.6 µM) and between G2 (20.1 ± 1.7 µM) and G4 (14.2 ± 0.6 µM). Therefore, reduced NOx concentration in G4 group occurred only when the polymorphisms were associated, suggesting that these results are more related to genetic factors than NO-scavenging effect. After AEX, the G4 increased NOx values (17.2 ± 1.2 µM) and decreased blood pressure. G1, G3 and G4 decreased T-BARS levels. These results suggest the AEX can modulate the NOx concentration, eNOS activity and the relationship among eNOS gene polymorphism, oxidative stress and blood pressure especially in C (T-786C) and T (G-894T) allele carriers.

Effects of preferred and nonpreferred music on continuous cycling exercise performance.

The aim of this study was to investigate the effects of preferred and nonpreferred music on exercise distance, Heart Rate (HR), and Rating of Perceived Exertion (RPE) during continuous cycling exercise performed at high intensity. Fifteen participants performed five test sessions. During two sessions, they cycled with fixed workload on ergometer to determine the Critical Power (CP) intensity. Then, they performed three more sessions cycling at CP intensity: listening to Preferred Music, listening to Nonpreferred Music, and No Music. The HR responses in the exercise sessions did not differ among all conditions. However, the RPE was higher for Nonpreferred Music than in the other conditions. The performance under Preferred Music (9.8 +/- 4.6 km) was greater than under Nonpreferred Music (7.1 +/- 3.5 km) conditions. Therefore, listening to Preferred Music during continuous cycling exercise at high intensity can increase the exercise distance, and individuals listening to Nonpreferred Music can perceive more discomfort caused by the exercise.

Changes of glycogen content in liver, skeletal muscle, and heart from fasted rats.

Glycogen content of white and red skeletal muscles, cardiac muscle, and liver was investigated in conditions where changes in plasma levels of non-esterified fatty acids (NEFA) occur. The experiments were performed in fed and 12 and 48 h-fasted rats. The animals were also submitted to swimming for 10 and 30 min. Glycogen content was also investigated in both pharmacologically induced low plasma NEFA levels fasted rats and pharmacologically induced high plasma NEFA levels fed rats. The participation of Akt and glycogen synthase kinase-3 (GSK-3) in the changes observed was investigated. Plasma levels of NEFA, glucose, and insulin were determined in all conditions. Fasting increased plasma NEFA levels and reduced glycogen content in the liver and skeletal muscles. However, an increase of glycogen content was observed in the heart under this condition. Akt and GSK-3 phosphorylation was reduced during fasting in the liver and skeletal muscles but it remained unchanged in the heart. Our results suggest that in conditions of increased plasma NEFA levels, changes in insulin-stimulated phosphorylation of Akt and GSK-3 and glycogen content vary differently in liver, skeletal muscles, and heart. Akt and GSK-3 phosphorylation and glycogen content are decreased in liver and skeletal muscles, but in the heart it remain unchanged (Akt and GSK-3 phosphorylation) or increased (glycogen content) due to consistent increase of plasma NEFA levels.

Determination of the lactate threshold and maximal blood lactate steady state intensity in aged rats.

The reliability of the lactate threshold (LT) determined in aged rats and its validity to identify an exercise intensity corresponding to the maximal blood lactate steady state (MLSS) were analyzed. Eighteen male aged Wistar rats (approximately 365 days) were submitted to two incremental swimming tests until exhaustion, consisting of an initial load corresponding to 1% of body mass (BM) and increments of 1% BM at each 3-min with blood lactate ([lac]) measurements. The LT was determined by visual inspection (LT(V)) as well by applying a polynomial function on the [lac]/workload ratio (LT(P)) by considering the vertices of the curve. For the MLSS, twelve animals were submitted, on different days, to 3-4 exercise sessions of 30-min with workload corresponding to 4, 5 or 6% BM. The MLSS was considered the highest exercise intensity at which the [lac] variation was not higher than 0.07 mM.min(-1) during the last 20-min. No differences were observed for the test-retest results (4.9 +/- 0.7 and 5.0 +/- 0.8 %BM for LTv; and 6.0 +/- 0.6 and 5.8 +/- 0.6 %BM for LTp) that did not differ from the MLSS (5.4 +/- 0.5 %BM). The LT identified for aged rats in swimming, both by visual inspection and polynomial function, was reliable and did not differ from the MLSS.

Can Off-Training Physical Behaviors Influence Recovery in Athletes? A Scoping Review.

Recently, the attention on recovery in sport increased enormously although there is lack of scientific evidence on the role of lifestyle in terms of movement [i.e., physical behaviors (PBs)], apart from sleep. Few studies assessed physical activity (PA) and sedentary behavior (SB) in athletes. The aims of this scoping review were to answer to the following scientific questions: (1) How active/inactive are competitive athletes out of training? (2) Do off-training PBs affect recovery, performance, and health? (3) What strategies can be implemented to improve recovery using off-training PBs, apart from sleep? From 1,116 potentially relevant articles, nine were eligible for inclusion in this review. The main issues identified were related to the heterogeneity concerning the types of sports, age category, gender, competitive level, sample size, and instruments/devices adopted, the paucity of studies investigating the effects of PBs while awake on recovery, and the lack of experimental designs manipulating PBs while awake to accelerate recovery. Furthermore, PA and SB domains were rarely investigated, while no research articles focused on the combined effect of 24-h PBs. Eight out of nine studies measured PA, seven SB, and two included sleep. Three studies included training practice into PA measurement by the means of accelerometry. Overall, almost the totality of the athletes achieved recommended PA levels although they sustained prolonged SB. In conclusion, more descriptive researches are needed in different athletic populations and settings. Furthermore, experimental designs aimed at investigating the effects of PBs manipulation on recovery and the putative mechanisms are encouraged.

The influence of resting period length on jumping performance.

The purpose of this study was to determine a resting interval between countermovement jumps (i.e., volleyball spikes) that allows the maintenance of maximal jumping performance. Ten male volleyball players (1.85 +/- 0.05 m, 77.2 +/- 10.6 kg, 21.6 +/- 5.3 years) performed 6 experimental jumping sessions. In the first and sixth sessions, maximal countermovement jump height was measured, followed by submaximal countermovement jumps to the point of volitional fatigue. The number of countermovement jumps was used as a reference to test the effect of rest period between volleyball spikes. From the second to fifth experimental sessions, 30 maximal volleyball spikes were performed with different resting periods (i.e., 8, 14, 17, and 20 seconds) followed by countermovement jumps. Between the 15th and 30th spikes, the blood lactate concentration and heart rate were measured. Because the performance on the first and sixth sessions was the same, no training effects were noticed. During the 8-second resting interval set, the lactate concentration increased significantly between the 15th and 30th spikes (i.e., from 3.37 +/- 1.16 mmol to 4.94 +/- 1.49 mmol); the number of countermovement jumps decreased significantly after spikes compared to those performed without a previous effort (i.e., from 23 +/- 7 jumps to 17 +/- 9 jumps); and these variables were significantly correlated (r = -0.7). On the other hand, the lactate concentration and number of countermovement jumps were stable across the other resting intervals, without a heart rate steady state. The results indicate that an adequate resting period between spikes allowed participants to achieve a lactate steady state in which the performance was maintained during the exercise. These findings show that resting intervals between 14 and 17 seconds, typical during volleyball matches, are indicated to use in volleyball spike drills due to their capacity to maintain maximal jumping performance.

Knowledge about recommendations for physical activity and personal practices of primary health care professionals / Conhecimento sobre as recomendações de atividades física e prática pessoal de profissionais da atenção primária em saúde

ABSTRACT Since the recommendations of moderate-to vigorous physical activity (PA) for health constitute important information to be shared in counseling practice, the present study was aimed to evaluate the level of knowledge of health professionals about the international PA recommendations for adults and elderly and to verify if there are associations between PA motivation with leisure time PA, readiness to change behavior and body mass index (BMI) of these professionals. In 2021, a questionnaire was applied remotely with health professionals from Brazilian health system. The survey had 34 participants, who answered sociodemographic and health questions, knowledge about international PA recommendations for adults and the elderly, PA duration, behavioral stage and motivations for PA practice. Of the five questions that assessed the knowledge of professionals, three had the highest prevalence of wrong answers, and professionals who have a more internal motivation to practice PA showed a significant association with reaching the minimum PA and eutrophic BMI recommendations. Professional qualification is important, together with encouragement to practice PA, through contents that consider internal motivations.

RESUMO Visto que as recomendações de atividade física (AF) moderadas e vigorosas para a saúde se constituem como uma importante informação a ser compartilhada no aconselhamento sobre AF, o presente estudo teve como objetivos avaliar o nível de conhecimento de profissionais da saúde sobre as recomendações internacionais de AF para adultos e idosos e verificar se existem associações entre a motivação para a prática de AF com o tempo de AF no lazer, o estágio de prontidão à mudança de comportamento e o índice de massa corporal (IMC) destes profissionais. Para isso, em 2021 foi aplicado, de maneira remota, um questionário com profissionais de saúde. A pesquisa contou com 34 participantes, que responderam questões sociodemográficas, de saúde, conhecimento sobre as recomendações internacionais de AF para adultos e idosos, tempo de AF, estágio comportamental e motivações para a prática de AF. Das cinco questões que avaliaram o conhecimento dos profissionais, três tiveram a maior prevalência de respostas erradas e, os profissionais que possuem uma motivação mais interna para a prática de AF apresentaram associação significativa com atingir as recomendações mínimas de AF e IMC eutrófico. É importante a qualificação profissional aliada ao incentivo à prática de AF, por meio de conteúdos que considerem motivações internas.

Valoração da atividade física: discussão sobre uma ideia identificada mas não contextualizada na literatura / Evaluación de la actividad física: discusión sobre una idea identificada pero no contextualizada en la literatura / Physical activity valuation: a discussion on an identified idea not contextualized in the literature

Resumo A valoração da atividade física é uma abordagem não evidenciada como conceito ou definição. Assim, o objetivo do presente estudo foi compreender a conceituação e fomentar uma discussão preliminar acerca da valoração da atividade física, por meio de uma revisão sistemática de literatura seguida de uma revisão integrativa utilizando diferentes estratégias de busca. A partir dos critérios de inclusão da revisão sistemática não foram identificados estudos que procuraram definir e/ou conceituar a valoração da atividade física. Porém, a partir da seleção e leitura dos artigos na revisão integrativa, buscou-se compreender em quais contextos os estudos foram desenvolvidos e quais os métodos de valoração se referiam à atividade física. Sugere-se que a valoração da atividade diz respeito à importância que o indivíduo direciona a atividade física, ou seja, um juízo de valor determinado à atividade física que pode se relacionar ao custo hedônico, valoração contingente e ao custo evitado.

Resumen La valoración de la actividad física es un enfoque no evidenciado como concepto o definición. Así, el objetivo del presente estudio fue comprender la conceptualización y promover una discusión preliminar sobre la valoración de la actividad física, a través de una revisión sistemática de la literatura seguida de una revisión integradora, utilizando diferentes estrategias de búsqueda. Con base en los criterios de inclusión de la revisión sistemática, no se identificaron estudios que buscaran definir y/o conceptualizar la valoración de la actividad física. Sin embargo, a partir de la selección y lectura de artículos en la revisión integradora, buscamos comprender en qué contextos se desarrollaron los estudios y qué métodos de valoración se referían a la actividad física. Se sugiere que la valoración de la actividad atañe a la importancia que el individuo le da a la actividad física, o sea, un juicio de valor determinado a la actividad física que puede relacionarse con el costo hedónico, la valoración contingente y el costo evitado.

Abstract The valuation of physical activity has not yet been established as a concept or definition in the literature. Thus, the objective of the present study was to understand the concept and foster a preliminary discussion about the valuation of physical activity, through a systematic literature review followed by an integrative review with different search strategies. Considering the systematic review inclusion criteria, studies addressing the concept or definition of physical activity valuation were not identified. However, from the selection and reading of the articles in the integrative review, we sought to understand in which contexts the studies about physical activity valuation methods were developed. It is suggested that the valuation of physical activity is associated with the importance given by the individuals to physical activity, i.e. a broad concept related to value judgment regarding physical activity; the valuation of physical activity can be related to the hedonic pricing, the contingent valuation, and the avoided costs.

Time trends in physical activity of adult users of the Brazilian National Health System: 2010-2014. Longitudinal study.

CONTEXT AND OBJECTIVE:: In this longitudinal study, we aimed to describe time trends of physical activity (PA) in different domains from 2010 to 2014 among users of the Brazilian National Health System, taking into account the effects of sex, age and economic status (ES). DESIGN AND SETTING:: Longitudinal study conducted in five primary care units in Bauru (SP), Brazil. METHODS:: The sample was composed of 620 men and women who were interviewed in 2010, 2012 and 2014. The same group of researchers conducted the interviews, using the questionnaire developed by Baecke et al. Scores for occupational, exercise/sport, leisure-time/transportation and overall PA were considered in this longitudinal survey. Time trends of PA over the four years of follow-up were assessed according to sex, age and ES. RESULTS:: We found that after four years of follow-up, the reduction in overall PA (-13.6%; 95% confidence interval, CI = -11.9 to -15.3) was statistically significant. Additionally, declines in the occupational domain and exercise/sports participation were affected by age, while the reduction in overall PA was affected by sex, age and ES. CONCLUSIONS:: Overall PA decreased significantly from 2010 to 2014 among these outpatients of the Brazilian National Health System, and age and male sex were important determinants of PA in its different domains.

Activity behavior, nutritional status and perceived health in older Brazilian adults: Does the number of chronic diseases matter?

AIM: The present study examined activity behavior, nutritional status and perceived health in relation to the number of chronic diseases (ChrD) in a representative sample of Brazilians aged ≥60 years. METHODS: A cross-sectional, population-based study was carried out in a midsize Brazilian city to evaluate different health risk factors. Using a stratified random sampling procedure to select a representative sample of adults, this study interviewed 1572 individuals face-to-face. Our analytical sample focused on those aged ≥60 years (n = 355). Statistical procedures were carried out using spss software, with the significance level set as P < 0.05. RESULTS: Older adults diagnosed with ≥2 ChrD were significantly less active during leisure time physical activity (P = 0.03), presented with significant higher body mass index values (P < 0.001) and were approximately fivefold (1.69-17.93) more likely to perceive their health as poor compared with those with zero ChrD. The group with ≥2 ChrD reported a similar amount of sitting time compared with older adults with zero or one ChrD (P > 0.05). CONCLUSIONS: Having multiple ChrD has a negative impact on older adults' leisure time physical activity, body mass index and the perception of health. The findings of the present study underscore the need for more infusive approaches tackling ChrD in Brazil focusing on healthy lifestyle behaviors, such as physical activity. Geriatr Gerontol Int 2017; 17: 2376-2382.