Effects of linear periodized and non-periodized combined training on body image perception of adults with obesity: A randomized clinical trial.

OBJECTIVE: Verify the effect of non-periodized and linear periodized combined training on body image perception and body dissatisfaction in adults with obesity. DESIGN: A randomized clinical trial on the effect of two types of combined training periodization was carried out on people with grade I and II obesity. SETTING: Participants were allocated into three groups: non-periodized periodization group, linear periodization group, and control group, with 23 participants in each. SUBJECTS: Adults with obesity, with a body mass index between 30 kg/m² and 40 kg/m². INTERVENTIONS: The intervention lasted 16 weeks (separated into three mesocycles of 4 weeks and 1 week of familiarization), in 3 weekly sessions of 1 hour each, composed of aerobic (30 min) and muscle strength exercises (six exercises) in the same session. The group with non-periodized model maintained uniform intensity, volume, and workload throughout the mesocycles. The group with the linear periodization model started with low initial intensity, subsequently introducing a gradual increase of intensity in the mesocycles. MAIN MEASURES: Body image perception (current and ideal silhouette) and body dissatisfaction were assessed using the Stunkard silhouette scale. RESULTS: The perception of the current silhouette increased only in the control group (Δ = 1.16; p = 0.04). There was a significant reduction in the ideal silhouette over time (p = 0.001), especially in non-periodized group (Δ = -1.26). Body dissatisfaction increased significantly only over time (p = 0.001), especially for control group (Δ = 1.47). CONCLUSIONS: Regardless of periodization, combined training effectively maintained the perception of the current silhouette and reduced the ideal silhouette in adults with obesity. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (RBR-3c7rt3).

Effect of Combined Physical Exercise Training in Reducing Cardiovascular Risk Among Adults with Obesity: A Randomized Clinical Trial.

It is necessary to understand the relationship between different models of exercise periodization and the reduction of cardiovascular risk in adults with obesity. The aim of this study was to verify the effect of two periodization models of combined training on the cardiovascular risk of adults with obesity of both sexes. A randomized clinical trial was conducted with adults of both sexes with obesity. They were divided into three groups: control group (CG), non-periodized combined training group (NG), and combined training group with linear periodization (PG). The NG and PG groups underwent physical exercise training regimen for 16 weeks, in three weekly sessions of 60 min each, with the volume and intensity equalized. Cardiovascular risk was measured by the overall Framingham risk score (FRS). Generalized estimation equations and individual responsiveness analyses were used, stratified by sex. A statistically significant reduction in FRS was observed only in men of the NG (pre: 2.50 ± 0.56; post: 0.50 ± 1.02; p-value = 0.001). There was no statistically significant intervention effect on the women's cardiovascular risk. It was found that, regardless of sex, subjects in the control group mostly presented results of increased cardiovascular risk. In contrast, those belonging to the exercise groups, if not reduced, at least stabilized the chances of suffering a cardiovascular event in the next ten years after 16 weeks of combined training. Sixteen weeks of non-periodized combined training were sufficient to reduce cardiovascular risk in men with obesity. Both periodization models were important to stabilize the risk of developing a cardiovascular disease in the next 10 years.

Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults.

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.

Noncommunicable chronic diseases clusters in Brazilian adults and older adults: correlations as multimorbidity / Agrupamento de doenças crônicas não transmissíveis em adultos e idosos brasileiros: correlações como multimorbidade

Abstract Background Health has dynamic conditions and overlapping pathophysiological factors. For health prevention and promotion, actions are necessary to understand the most common risk combinations. Objective Describe noncommunicable chronic diseases (NCDs) clusters and investigate specific multimorbidity combinations in Brazilian adults and older adults. Method This study used data from Vigitel 2013 survey held in the Brazilian capitals (52,929 interviews). A self-report of diabetes, dyslipidemia, hypertension, and obesity was used. The analyses were the descriptive cluster of NCDs and an adjusted binary logistic regression (odds ratio [OR]), stratified by age. Results Among adults, the clusters of diabetes, dyslipidemia, hypertension, and obesity (O/E = 18.74) and diabetes, hypertension, and obesity (O/E = 16.83) were higher. There was a higher clustering between diabetes and obesity (O/E = 7.25). Among adults, diabetes was associated with dyslipidemia (OR: 3.04), hypertension (OR: 3.84), and hypertension with obesity (OR: 3.34). In older adults, hypertension was associated with diabetes (OR: 2.79), dyslipidemia (OR: 2.06), and obesity (OR: 2.26). Conclusion Other diseases combined with diabetes and hypertension were more frequent in adults and older adults. It is suggested to combine preventive and control measures for these diseases for the non-occurrence of new diagnoses.

Resumo Introdução A saúde apresenta condições dinâmicas e fatores fisiopatológicos sobrepostos. Para ações de prevenção e promoção da saúde é necessário entender as combinações comuns de risco. Objetivo Descrever os agrupamentos de doenças crônicas não transmissíveis (DCNT) e investigar combinações específicas de multimorbidade em adultos e idosos no Brasil. Método Este estudo utilizou dados da pesquisa Vigitel 2013, realizada nas capitais brasileiras (total de 52.929 entrevistas). Foi utilizado um relato de diabetes, dislipidemia, hipertensão e obesidade. Nas análises foram utilizados o agrupamento descritivo de DCNT e uma regressão logística binária ajustada (razão de odds [RO]), estratificada por idade. Resultados Entre os adultos, os grupos de diabetes, dislipidemia, hipertensão e obesidade (O / E = 18,74), bem como diabetes, hipertensão e obesidade (O / E = 16,83) foram maiores. Nos idosos, houve maior agrupamento entre diabetes e obesidade (O / E = 7,25). Entre os adultos, o diabetes foi associado à dislipidemia (RO: 3,04) e hipertensão (RO: 3,84), enquanto a hipertensão à obesidade (RO: 3,34). Nos idosos, a hipertensão foi associada a diabetes (RO: 2,79), dislipidemia (RO: 2,06) e obesidade (RO: 2,26). Conclusão Os agrupamentos de outras doenças combinadas com diabetes e hipertensão foram mais frequentes em adultos e idosos. Sugere-se que além das medidas existentes de prevenção para essas doenças também sejam propostas medidas de controle para a não ocorrência de novos diagnósticos.

Factors associated with perception of the current silhouette and body image dissatisfaction in adults with obesity / Fatores associados à percepção da silhueta atual e à insatisfação da imagem corporal em adultos com obesidade

ABSTRACT Objective To verify the factors associated with the perception of current silhouette and body image dissatisfaction in adults with obesity. Methods Cross-sectional study derived from the baseline of a randomized clinical trial. The perception of current silhouette and dissatisfaction with body image, defined by the difference between the perception of current and ideal silhouette, were obtained from a scale that ranged from one (smallest silhouette) to nine (largest silhouette). The independent variables investigated as associated factors (crude and adjusted linear regression) were: sex, age, skin color, body mass index (kg/m2), percentage of body fat, level of physical activity, and food intake. Results Sixty-nine obese individuals (body mass index ≥30kg/m2) were studied, 42 of whom were female and with the following mean values: 34.7 (±7.2) years; 33.5 (±2.8) kg/m2, and current silhouette of 6.6 (±0.9). All were dissatisfied with their excess body weight. The categories associated with a perception that matched the current silhouettes were male sex, white skin color, and higher body mass index values when compared to female sex, non-white, and lower body mass index values, respectively. Regarding body image dissatisfaction, white people had lower scores than those with other skin colors. Conclusion Being male, having white skin color, and having a higher body mass index were risk factors for the perception of larger body silhouettes, while only non-white skin color was associated with dissatisfaction with body image.

RESUMO Objetivo Verificar os fatores associados à percepção da silhueta atual e à insatisfação com a imagem corporal em adultos com obesidade. Métodos Estudo transversal derivado da linha de base de um ensaio clínico randomizado. A percepção de silhueta atual e a insatisfação com a imagem corporal, definida pela diferença entre a percepção da silhueta atual e da ideal, foram obtidas a partir de uma escala variando de um (menor silhueta) a nove pontos (maior silhueta). As variáveis independentes investigadas como fatores associados (regressão linear bruta e ajustada) foram: sexo, idade, cor da pele, índice de massa corporal (kg/m2), percentual de gordura corporal, nível de atividade física e ingestão alimentar. Resultados Foram investigados 69 obesos (índice de massa corporal ≥30kg/m2), sendo 42 do sexo feminino e com os seguintes valores médios: 34,7 (±7,2) anos; 33,5 (±2,8) kg/m2 e silhueta atual de 6,6 (±0,9). Todos estavam insatisfeitos pelo excesso de peso corporal. As categorias que se associaram à percepção da silhueta atual foram o sexo masculino, a cor de pele branca e maiores valores de índice de massa corporal quando comparados os dados referentes ao sexo feminino, a pessoas de cor da pele não branca e a menores valores de índice de massa corporal, respectivamente. Quanto à insatisfação com a imagem corporal, pessoas consideradas brancas tiveram escores mais baixos que aquelas com outras cores de pele. Conclusão Ser do sexo masculino, ter cor da pele branca e ter maior índice de massa corporal foram fatores de risco para a percepção de silhuetas corporais maiores, enquanto apenas a cor da pele não branca esteve associada à insatisfação com a imagem corporal.

Association between simultaneity of health-risk behaviours and self-rated health in Brazilian adolescents.

INTRODUCTION: This study examined the association between simultaneity of four health-risk behaviours, namely, low levels of moderate-to-vigorous physical activity (insufficient MVPA: <420 min/week), tobacco use, alcohol consumption, and excessive television (TV)-(>2 h/d of TV viewing) and self-rated health (SRH) in Brazilian adolescents. METHODS: We used data of 100,551 adolescents from the National School Health Survey, a national cross-sectional study carried out in 2015. Association between simultaneity of health risk behaviours (i.e. the ratio between observed and expected prevalence rates) and SRH was examined using logistic regression models. RESULTS: The majority of the participants were female (51.9%) and 14 years of age (50.6%), and 26% of the participants' SRH ranged from 'average' to 'extremely poor'. Those who engaged in the following combinations of health-risk behaviours had higher odds of worse SRH than their healthier counterparts: insufficient MVPA and tobacco use (odds ratio-OR: 2.0, 95% confidence interval [CI]: 1.4 to 3.0); insufficient MVPA and alcohol consumption (OR: 1.6, 95%CI: 1.3 to 1.9); insufficient MVPA and >2 h/day of TV viewing (OR: 1.3, 95%CI: 1.1 to 1.6); insufficient MVPA, tobacco use and alcohol consumption (OR: 2.1, 95%CI: 1.7, to 2.7); and insufficient MVPA, alcohol consumption and >2 h/day of TV viewing (OR: 1.6, 95%CI: 1.4 to 2.0). CONCLUSIONS: Insufficient MVPA, alcohol consumption, and other health-risk behaviours were associated with worse SRH in Brazilian adolescents.

Effects of linear periodization of combined training on quality of life of adults with obesity: a blind randomized controlled trial.

This study aimed to compare the effect of 16-weeks of combining aerobic and strength training with a linear increase or fixed intensity on the health-related quality of life (HRQoL) of obese adults. This single-blinded clinical trial involved adults with obesity (BMI ≥ 30 kg/m2), randomized into control (CG), fixed intensity (FG), or linear increase (LG) groups. The FG and LG performed 16 weeks of combined (aerobic + strength) training for 60 min, three times a week. The FG performed aerobic exercises between 50 and 59% of the heart rate reserve (HRres) and strength at 10-12 maximum repetitions (RM). The LG started with 40-49% of HRres and 12-14 RM and progressively increased the intensity (50-59% and 10-12 RM; 60-69% and 8-10 RM). The HRQoL was assessed using the SF-36 questionnaire. Generalized estimation equations and mean differences (∆) were used. Of the 69 participants (23 per group), 36 completed the intervention (CG = 13, FG = 9, and LG = 14). A significant difference was observed in the time of the physical function, with superiority in the training groups (CG: ∆ = 1.2 vs. FG and LG, respectively: ∆ = 10.0). The mental health component and mental health domain showed significant differences for the FG (∆ = 30.2 and ∆ = 23.1, respectively). In conclusion, the combined training improved physical functioning. Specifically, fixed-intensity training effectively enhanced mental health indicators.Trial Registration: This study is registered at www.ensaiosclinicos.gov.br/ (No. RBR-3c7rt3), Date of registration: 07/02/2018.

Sex differences in the association between educational level and specific domains of physical activity: a Brazilian cross-national survey.

OBJECTIVE: To identify the association between educational level and physical activity (PA) in specific domains according to sex, among residents of 26 Brazilian state capitals and the Federal District. METHODS: This is a cross-national survey, with data obtained from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL), in 2017, conducted with individuals ≥ 18 years old (n = 53,034). The education level (classified as ≤ 4 years, 5 to 8 years, 9 to 11 years, and ≥ 12 years of education) and PA of participants (meeting PA recommendations and performing this active behaviour) in the commuting, domestic, leisure, and work domains were self-reported. Binary logistic regression was used to analyze the data obtained from the survey. RESULTS: Males and females with higher education were less likely to meet PA recommendations (males: OR = 0.68 [95% CI 0.52-0.91]; females: OR = 0.41 [0.34-0.48]) and perform the active behaviour (males: OR = 0.73 [0.57-0.93]; females: OR = 0.27 [0.23-0.32]) in the domestic domain. In the work domain, the two outcomes were associated with education only for males, indicating that those with more years of education had less chance of meeting PA recommendations (OR9 to 11 years = 0.61 [0.46-0.83]; OR≥12 years = 0.21 [0.15-0.30]) and performing it (OR9 to 11 years = 0.64 [0.49-0.84]; OR≥12 years = 0.25 [0.18-0.34]). However, more years of education seemed to positively influence meeting PA recommendations (males: OR9-11 years = 2.26 [1.79-2.87]; OR≥12 years = 2.91 [2.28-3.72]; females: OR5-8 years = 1.26 [1.04-1.54]; OR9-11 years = 1.81 [1.52-2.16]; OR≥12 years = 2.69 [2.25-3.22]) and practicing this behaviour (males: OR5-8 years = 1.29 [1.01-1.63]; OR9-11 years = 2.54 [2.04-3.17]; OR≥12 years = 3.31 [2.64-4.16]; females: OR5-8 years = 1.23 [1.03-1.46]; OR9-11 years = 1.75 [1.51-2.01]; OR≥12 years = 2.94 [2.53-3.40]) in leisure time for both sexes. CONCLUSION: Education level appears to be an important determinant in the relationship with PA in its different domains, especially in the leisure and domestic domains, for both sexes.

RéSUMé: OBJECTIF: Identifier l'association entre le statut éducatif et l'activité physique (AP) dans des domaines spécifiques, selon le sexe, chez les résidents des capitales du Brésil et du District Fédéral. MéTHODES: Il s'agit d'une enquête transnationale dérivée de la surveillance téléphonique des facteurs de risque et de protection pour les maladies chroniques (VIGITEL), menée en 2017, auprès de personnes âgées de ≥ 18 ans (n = 53 034). Le niveau d'éducation (≤ 4 ans, 5 à 8, 9 à 11 et ≥ 12 ans d'étude) et l'AP des participants (respecter les recommandations d'activité physique et adopter ce comportement actif) dans les domaines des déplacements domicile-travail, domestique, des loisirs et du travail ont été autodéclarés. Une régression logistique binaire a été utilisée. RéSULTATS: Les hommes et les femmes ayant fait des études supérieures étaient moins susceptibles de respecter les recommandations de l'AP (hommes : RC = 0,68 [IC95% 0,52­0,91]; femmes : RC = 0,41 [0,34­0,48]) et d'adopter un comportement actif (hommes : RC = 0,73 [0,57­0,93]; femmes : RC = 0,27 [0,23­0,32]) dans le domaine domestique. Dans le domaine du travail, les deux résultats n'étaient associés à l'éducation que pour les hommes, indiquant que ceux qui avaient plus d'années d'éducation avaient moins de chances de respecter les recommandations de l'AP (RC9 a 11 ans = 0,61 [0,46­0,83]; RC≥12 ans = 0,21 [0,15­0,30]) et de les exécuter (RC9 a 11 ans = 0,64 [0,49­0,84]; RC≥12 ans = 0,25 [0,18­0,34]). Cependant, plus d'années d'éducation semblent influencer positivement le respect des recommandations de l'AP (hommes : RC9 a 11 ans = 2,26 [1,79­2,87]; RC≥12 ans = 2,91 [2,28­3,72]; femmes : RC5 a 8 ans = 1,26 [1,04­1,54]; RC9 a 11 ans = 1,81 [1,52­2,16]; RC≥12 ans = 2,69 [2,25­3,22]) et la pratique de ce comportement (hommes : RC5 a 8 years = 1,29 [1,01­1,63]; RC9 a 11 ans = 2,54 [2,04­3,17]; RC≥12 ans = 3,31 [2,64­4,16]; femmes : RC5 a 8 ans = 1,23 [1,03­1,46]; RC9 a 11 ans = 1,75 [1,51­2,01]; RC≥12 ans = 2,94 [2,53­3,40]) pendant les loisirs pour les deux sexes. CONCLUSION: Le niveau d'éducation semble un déterminant important de la relation avec l'AP dans ses différents domaines, notamment dans les domaines des loisirs et domestique, pour les deux sexes.

Effects of Combined Training With Linear Periodization and Non-Periodization on Sleep Quality of Adults With Obesity.

Background: Combined exercise training has proven effective in preventing and treating sleep disorders among obese adults. However, structured progression of intensity in sleep parameters remains poorly investigated within this population. Purpose: To verify the effects of non-periodized and linear periodization combined training on the sleep quality of obese adults. Methods: This was a randomized controlled trial involving adults with body mass index ≥ 30 kg/m2, allocated to 3 groups: control (CG; n = 13), non-periodized training (NG; n = 9), and with linear periodization (PG; n = 13). Groups PG and NG trained for 16 weeks in 3 weekly sessions lasting of 60 minutes. The NG trained in 50-59% heart rate reserve (HRR) e 2 × 10-12 repetition maximum (RM) and the PG with progression in 3 mesocycles: 40-49%;50-59%; 60-69% HRR e 2x12-14; 2x10-12; 2 × 8-10 RM, with the total volume equated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. For statistics, we used Generalized Estimation Equations considering p ≤ 0.05. Results: Sleep latency was reduced in both training groups after intervention (NG-Δ = -25.56 minutes p = .028; PG-Δ = -22.23 minutes p = .035), while significant improvements in sleep efficiency were found only in the NG (Δ = 20.67%; p = .042). Conclusion: Despite the NG's apparent superiority, which model has the best sleep effects on obese adults cannot be stated. Hence, caution is needed while extrapolating the results.

Effects of Nonperiodized and Linear Periodized Combined Training on Health-Related Physical Fitness in Adults With Obesity: A Randomized Controlled Trial.

ABSTRACT: Streb, AR, Passos da Silva, R, Leonel, LdS, Possamai, LT, Gerage, AM, Turnes, T, and Del Duca, GF. Effects of nonperiodized and linear periodized combined training on health-related physical fitness in adults with obesity: a randomized controlled trial. J Strength Cond Res 36(9): 2628-2634, 2022-The aim of this randomized controlled trial study was to compare the effects of 16 weeks of linear periodized and nonperiodized combined training (CT) in cardiorespiratory fitness, muscle strength, and body composition indicators of adults with obesity. Thirty-four obese adults of both sexes (36.6 ± 4.4 years; body mass index, 32.9 ± 2.7 kg·m -2 ) were divided into nonperiodized (NG; n = 8), linear periodized (PG; n = 11), and control (CG; n = 15) groups. The NG and PG groups performed 3 weekly sessions of CT over 16 weeks in different ways. Anthropometric measures, maximal strength for leg press and barbell bench press, maximal oxygen uptake (V̇ o2 max), and ventilatory thresholds were determined before and after intervention. The generalized estimation equation was used, with the applied level of significance for the interaction of 0.10 and the isolated effect of time or group or both of 0.05. Significant and similar increases were observed in the 1-repetition maximum test for bench press (NG: 48.8 ± 5.7 to 55.0 ± 6.1 kg; PG: 48.7 ± 5.7 to 53.8 ± 5.9 kg; p = 0.001) and leg press (NG: 235.2 ± 18.7 to 268.3 ± 19.7 kg; PG: 223.1 ± 25.3 to 253.3 ± 23.1 kg; p = 0.05) in trained groups. Relative V̇ o2 max improved only in PG (27.8 ± 1.3 to 32.0 ± 1.4 mL·kg·min -1 ; p = 0.05), while ventilatory thresholds improved in NG and CG ( p = 0.004 and p = 0.06). There was an increase in body mass in CG (97.6 ± 3.4 to 99.1 ± 2.9 kg) and NG (92.5 ± 5.4 to 93.5 ± 5.4 kg; p = 0.05). Combined training improved maximal upper-body and lower-body strength, regardless of periodization. However, for improvement in V̇ o2 max, linear periodization may be superior to nonperiodization in obese adults.

Combined relationship of physical inactivity and sedentary behaviour with the prevalence of noncommunicable chronic diseases: data from 52,675 Brazilian adults and elderly.

This paper aims to verify the association between the combined relationship of physical inactivity and sedentary behaviour (SB) at leisure-time and the prevalence of noncommunicable chronic diseases (NCDs) in Brazilian adults and elderly. This is a cross-sectional study, derived from the VIGITEL system, with individuals ≥18 years old (n = 52,675). The presence of NCDs (diabetes, hypertension, and obesity) and the independent variables were defined by self-report. Binary logistic regression was used. While adults with the presence of, at least, one risky behaviour had a higher odds to have obesity (OR active + high SB: 1.25; 95%CI: 1.01;1.54; OR inactive + low SB: 1.47; 95%CI: 1.25;1.73; OR inactive + high SB: 1.77; 95%CI: 1.47;2.12), the elderly had an increased risk for this outcome only when classified as inactive (OR inactive + low SB: 1.43; 95%CI: 1.17;1.75; OR inactive + high SB: 1.87; 95%CI: 1.47;2.38). Inactive adults with low SB were more likely to have diabetes (OR inactive + low SB: 1.31; 95%CI: 1.00;1.71) and hypertension (OR inactive + low SB: 1.26; 95%CI: 1.08;1.46), while physical inactivity was again more strongly associated with these outcomes in the elderly, for diabetes (OR inactive + low SB: 1.23; 95%CI: 1.02;1.48; OR inactive + high SB: 1.75; 95%CI: 1.39;2.19), and hypertension (OR inactive + low SB: 1.22; 95%CI: 1.05;1.41; OR inactive + high SB: 1.60; 95%CI: 1.33;1.94) Both leisure-time behaviours carry a high risk of the prevalence of different NCDs, however, physical inactivity, isolated or combined, showed a greater association with the evaluated outcomes.HighlightsThis cross-national survey included representative sample of people ≥18 years old.Adults with at least one evident risky behavior had a higher chance of obesity.Inactive adults with low sedentary behavior had higher chances for diabetes and hypertension.Physical inactivity was more strongly associated with all diseases in the elderly.

Effects of Non-periodized and Linear Periodized Combined Exercise Training on Insulin Resistance Indicators in Adults with Obesity: A Randomized Controlled Trial.

BACKGROUND: The aim was to verify the effect of non-periodized and linear periodized combined (aerobic plus resistance) exercise training on insulin resistance markers in adults with obesity. METHODS: A blinded randomized control trial was conducted with three groups of individuals with obesity (BMI, 30-39.9 kg/m2): control group (CG, n = 23), non-periodized group (NG, n = 23), and linear periodized group (PG, n = 23). The NG and PG performed aerobic and resistance exercises in the same session in aerobic-resistance order for 16 weeks. Both intervention groups trained three sessions weekly, with a total duration of 60 min each. The aerobic training of the NG had a duration of 30 min always between 50% and 59% of the reserve heart rate (HRres), while resistance exercise was comprised of 6 exercises, performed always in 2 × 10-12 maximum repetitions (MRs). The PG progressed the aerobic and resistance training from 40%-49% to 60%-69% (HRres) and from 2 × 12-14 to 2 × 8-10 RM, respectively, along the intervention period. The evaluated indicators of insulin resistance included fasting glucose, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) collected pre- and post-intervention. The analyses to verify the exercise training effect were performed using generalized estimating equations. RESULTS: After 16 weeks of training, per protocol analysis (n = 39) showed significant reductions in HOMA-IR only in the training groups (NG: Δ = - 1.6, PG: Δ = - 0.6; p = 0.094). Intention-to-treat analysis demonstrated significant reductions in fasting insulin levels (NG: Δ = - 1.4, PG: Δ = - 1.0; p = 0.004) and HOMA-IR (NG: Δ = - 5.5, PG: Δ = - 3.8; p = 0.002). CONCLUSION: Periodized and non-periodized combined exercise training similarly reduces insulin resistance markers in adults with obesity. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-3c7rt3. Registered 07 February 2019- https://ensaiosclinicos.gov.br/trial/5970/1 .

Association between characteristics of physical activity in leisure time and obesity in Brazilians adults and elderly.

OBJECTIVE: To verify the association of obesity with volume, intensity and types of physical activity in leisure time among Brazilian adults and elderly. STUDY DESIGN: Cross-sectional study, with a secondary analysis of data from "Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey". METHODS: The target population comprised adults aged ≥18 years. The outcome was obesity (BMI≥30.0 ​​kg/m²) and the exposures were the volume, intensity, and main type of physical activity in leisure time. Binary logistic regression was used and the results were expressed as odds ratio (OR) and 95% confidence intervals (CI95%), with a significance level of 5%. RESULTS: Compared to inactive, the highest volume of leisure time physical activity (≥300min/week) had a lower occurrence of obesity in adults (OR=0.76; CI95%: 0.63, 0.92; p=0.001) and elderly (OR=0.62; CI95%: 0.46, 0.82; p=0.001). In adults, vigorous activities (OR=0.65; CI95%: 0.55, 0.78; p<0.001) and, in the elderly, light/moderate activities (OR=0.75; CI95%: 0.62, 0.89; p<0.001) and vigorous (OR=0.54; CI95%: 0.37, 0.78; p<0.001) presented protective effect for obesity. Among the types of physical activity, running was the most strongly associated with a lower occurrence of obesity in adults (OR=0.54; CI95%: 0.32, 0.92; p=0.024) and elderly (OR=0.27; CI95%: 0.10, 0.69; p=0.006). In adults, strength training (p<0.001), gymnastics (p=0.032) and sports (p=0.013) and in elderly, walking (p=0.001) and sports (p=0.003) also had protective effect. CONCLUSION: A greater volume, vigorous intensity and physical activities of a structuring character and intensity progression, such as running, were associated with the lower occurrence of obesity.

Phase angle associated with different indicators of health-related physical fitness in adults with obesity.

In obese populations, the exacerbated increase in adipose tissue results in a significant reduction of health-related physical fitness and can affect the phase angle (PhA), a promising health indicator of cell health and integrity. The aim of this study was to investigate the association of PhA with health-related physical fitness indicators in obese adults. This cross-sectional study had a non-probabilistic sample and was conducted from April to June 2018. The PhA was obtained by a bioelectrical impedance analysis, and the health-related physical fitness indicators evaluated were percentage of body fat (%BF), lower- and upper-body maximal strength, cardiorespiratory fitness (relative V̇O2peak), and flexibility. Pearson and Spearman´s linear correlations, crude and adjusted linear regression analyses were performed. A total of 69 obese adults (60.8% female; BMI = 33.5 ± 2.8 kg/m2) with a mean age of 34.6 ± 7.1 years were studied. The PhA means were 5.8 (±0.6º) and had an inverse correlation with %BF (r=-0.74; p<0.001) and positive correlation with V̇O2peak (r=0.50; p<0.001), lower- and upper-body maximal strength (r=0.65; r=0.70; p<0.001, respectively). After adjustment, %BF (ß=-0.065, adjusted R2=0.53; p<0.001), lower- and upper-body maximal strength (ß=0.004; adjusted R2=0.46; p<0.001, and ß=0.024; adjusted R2=0.50; p<0.001, respectively) were predictors of PhA. Our results suggest the favorable role of PhA as a clinically viable tool to screen and identify the physical fitness variables and functional status of obese adults.

Physical inactivity, television time and chronic diseases in Brazilian adults and older adults.

This study aimed to investigate the association between simultaneity of leisure-time physical inactivity and high television time with the presence of chronic diseases in adults and older adults in Brazil. We analyzed secondary data from Vigitel 2013 database, a cross-sectional national survey. It was included 37 947 adults (18-59 years) and 14 982 older adults (≥60 years) living in Brazilian state capitals. The association was between simultaneity of risk behaviors considering leisure-time physical inactivity (<10 min/day) and high television time (≥2 h/day), with the presence of chronic diseases (diabetes, dyslipidemia, hypertension and obesity), measured according to the age group. We performed a binary logistic regression, crude and adjusted analysis, using weighted to reflect population estimates. In adults, there was an association between leisure-time physical inactivity and television time with the presence of diseases. In practice, the simultaneity of risk behaviors when compared with those without risk behavior had higher odds for diabetes (OR = 1.83), dyslipidemia (OR = 1.17), hypertension (OR = 1.54) and obesity (OR = 1.60). In older adults, the simultaneity was associated with diabetes (OR = 1.61), hypertension (OR = 1.33) and obesity (OR = 1.81). We concluded that for adults and older adults the simultaneity of leisure-time physical inactivity and high television time increased the odds for the presence of chronic disease, especially for diabetes and obesity.

Is the availability of open public spaces associated with leisure-time physical activity in Brazilian adults?

This study aims to analyse the association between perceived presence of public spaces near residences and practice of physical activity during leisure time by adults in the state capitals of Brazil, based on sociodemographic characteristics. Participants were individuals aged ≥18 years living in the 27 state capitals of Brazil (n = 52 929, 53.9% female) who responded to a national survey called VIGITEL in 2013. Physical activity during leisure time (≥1 time/week), perception of space, population and sociodemographic variables (sex, age, years of study and geographic region) were self-reported. The adjusted binary logistic regression analysis was used. Among adults, the prevalence of physical activity during leisure was 45.1% (95% CI [44.2; 46.0]), and 71.1% (95% CI [70.2, 71.8]) perceived public space near their residence. A direct association between perceiving public space and physical activity ([OR] = 1.43; 95% CI [1.32; 1.55]) was observed. No significant difference was observed in the population groups (men and women, younger and older adults, and those with more and fewer years of study). Thus, even with the possible regional differences in Brazilian state capitals, the presence of public spaces increases the practice of physical activity during leisure time, independent of sociodemographic variables.

Comparison of linear periodized and non-periodized combined training in health markers and physical fitness of adults with obesity: Clinical trial protocol.

The literature discusses that combined training, aerobic more resistance exercises in the same session, is a suitable strategy for people with obesity and that exercise periodization leads to positive health outcomes; however, the implication of different periodizations of combined training for health outcomes in obese adults requires further investigation. The aim of the study will be to describe the methodology used to compare the effect of linear periodized and non-periodized combined training on health markers and health-related physical fitness in adults with obesity. This is a blinded randomized controlled clinical trial investigating adults with obesity in the age group 20-50 years. The sample will be non-probabilistic, and participants will be allocated randomly into one of three groups: control group (CG), non-periodized group (NG), and periodized group (PG). The intervention will occur in 60-min sessions, 3 days a week for 16 weeks, with 1 week dedicated to familiarization with the training and 15 weeks of combined training (aerobic followed by resistance in the same session). The PG group will perform three mesocycles of 5 weeks each, progressing in intensity throughout the intervention [aerobic: from 40-49% to 60-69% of heart rate reserve (HRR); strength: from 12 to 14 maximum repetitions (MR) to 8 to 10MR]; the NG group will maintain the same relative intensity throughout the study (aerobic: 50-59% of HRR; strength: 2 sets of 10-12 MR). Participants in the CG group will maintain their usual activities without the proposed intervention. Pre- and post-intervention assessments will be performed for biochemical markers, body composition, cardiovascular parameters, cardiorespiratory fitness, maximum upper and lower limb strength, flexibility, and subjective health-related parameters. This project was approved by the Committee of Ethics and Research with Human Beings of the institution of origin (protocol 2,448,674) and registered in the Brazilian Registry of Clinical Trials (RBR-3c7rt3).

Association between physical inactivity in leisure, work, commuting, and household domains and nutritional status in adults in the capital cities of Brazil / Associação entre a inatividade física nos domínios do lazer, trabalho, deslocamento e domicílio e o estado nutricional em adultos das capitais do Brasil

ABSTRACT Objective To investigate the association between different domains (leisure, work, commuting, and household) of physical activity, independent and cumulative, and excess weight and obesity in Brazilian adults. Methods This is a cross-sectional survey, conducted in 2015, through telephone interviews with a representative sample of adults from the capitals of Brazil. Physical inactivity was defined as non-participation in predefined physical activities for each assessed domain. Excess weight (Body Mass Index?25kg/m2) and obesity (Body Mass Index?30kg/m2) were determined from self-reported measurements of weight and height. A binary logistic regression was conducted after adjusting for sociodemographic factors. Results Among 54,174 subjects, physical inactivity in commuting (ORexcess weight=1.27, 95%CI=1.13,1.42 and ORobesity=1.25, 95%CI=1.06,1.47) and leisure (ORexcess weight=1.12, 95%CI=1.04,1.22 and ORobesity=1.30, 95%CI=1.17,1.45) domains were associated with nutritional status. In addition, a linear trend was observed between increasing obesity and cumulative physical inactivity of all four domains (p<0.001). Conclusion Cumulative physical inactivity, especially in the commuting and leisure domains, was associated with excess weight and obesity in adults living in the capitals of Brazil. One possible explanation of these findings is that these domains involve particularly longer duration and greater intensity of physical inactivity. Public policies concerning physical activity should prioritize actions focused in promoting physical activity on commuting and leisure-time to help prevent overweight and obesity in the Brazilian adult population.

RESUMO Objetivo Investigar a associação entre a atividade física em diferentes domínios (deslocamento, domicílio, lazer e trabalho) isolados e acumulados com a ocorrência de excesso de peso e obesidade em adultos brasileiros. Métodos Trata-se de um inquérito transversal, realizado em 2015, por meio de entrevista telefônica com uma amostra representativa de adultos das capitais do Brasil. A inatividade física foi determinada como a não participação em atividades físicas específicas para cada domínio avaliado. O excesso de peso (Índice de Massa Corporal?25kg/m2) e a obesidade (Índice de Massa Corporal ?30kg/m2) foram definidos pelo autorrelato de peso e altura. Na esta-tística, empregou-se a regressão logística binária ajustada para fatores sociodemográficos. Resultados Dentre os 54.174 sujeitos, observou-se que a inatividade física no deslocamento (OR=1,27; IC95%:1,13;1,42 e OR=1,25; IC95%:1,06;1,47) e no lazer (OR=1,12; IC95%:1,04;1,22 e OR=1,30; IC95%:1,17;1,45) estiveram associadas ao excesso de peso e à obesidade, respectivamente. Observou-se ainda uma tendência linear de aumento da obesidade à medida que se acumulam domínios com inatividade física (p<0,001). Conclusão A inatividade física acumulada em diferentes domínios, particularmente no deslocamento e no lazer, apresentou associação com o excesso de peso e obesidade em adultos residentes nas capitais do Brasil. Possivelmente, importantes características da atividade física nos referidos domínios, como a maior duração e a maior intensidade, sejam potenciais justificativas para o encontro de tais achados. Portanto, recomenda-se que políticas públicas de atividade física possam priorizar ações voltadas para os domínios do deslocamento e do lazer no combate ao excesso de peso e obesidade na população adulta brasileira.

Clustering of unhealthy food habits and its association with socioeconomic factors among Brazilian workers / Agrupamento de hábitos alimentares não saudáveis e sua associação com fatores socioeconômicos entre trabalhadores brasileiros

ABSTRACT Objective Investigate the clustering of four unhealthy food habits (low intake of fruits, low intake of vegetables, high intake of candy, and high intake of fried snacks), and to identify the association between the number of these clustered habits and sociodemographic variables. Methods This was a cross-sectional representative study of industrial workers from 24 Federative Units in Brazil conducted between 2006 and 2008. The low weekly intake of fruits and vegetables (<5 days/week) and high weekly intake of candy and fried snacks (≥5 days/weeks) were evaluated using a validated questionnaire. Simultaneity was analyzed with stratification by sex, calculating the Observed (O) and Expected (E) prevalence and the O/E ratio for each of the 16 possible food intake combinations. Results Among the 47,477 workers studied, in both men and women, the simultaneous presence of high weekly intake of candy and fried snacks(O/E=3.58; 95%CI=3.12-4.10 and O/E=2.17; 95%CI=1.76-2.62) and of the four unhealthy food habits (O/E=2.32; 95%CI=2.01-2.66 and O/E=4.02; 95%CI=3.44-4.65) exceeded the expected percentages if these foods were consumed separately. When compared to subjects without or with only one unhealthy food habit, the combination of the four negative dietary behaviors was more frequent among women, workers with a lower education level, and those living without a partner. Conclusion Unhealthy food habits tend to cluster together in both sexes, suggesting a strong interaction, particularly for the four unhealthy food habits together, especially among women, less educated workers and without a partner.

RESUMO Objetivo Investigar o agrupamento de quatro hábitos alimentares não saudáveis (baixo consumo de fruta, baixo consumo de verdura, alto consumo de doce e alto consumo de salgadinho), e identificar a associação entre a quantidade desses hábitos agrupados e variáveis sociodemográficas. Métodos Esse foi um estudo transversal e representativo de trabalhadores das indústrias de 24 Unidades Federativas do Brasil, realizado de 2006 e 2008. Os baixos consumos semanais de fruta e verdura (<5 dias/semana) e os altos consumos semanais de doce e salgadinho (>5 dias/semana) foram avaliados por questionário validado. A simultaneidade foi analisada com estratificação por sexo, conforme a prevalência Observada (O), Esperada (E), Razão (O/E) para cada uma das 16 combinações possíveis de consumo alimentar. Resultados Nos 47.477 trabalhadores investigados, tanto em homens quanto em mulheres, respectivamente, a presença simultânea alto consumo semanal de doce e salgadinho (O/E=3,58; IC95%=3,12-4,10 e O/E=2,17; IC95%=1,76-2,62) e dos quatro hábitos alimentares não saudáveis juntos (O/E=2,32; IC95%=2,01-2,66 e O/E=4,02; IC95%=3,44-4,65) foram aquelas que mais excederam os percentuais esperados, caso esses alimentos fossem ingeridos de forma independente. Comparados aos sujeitos com nenhum ou um hábito alimentar não saudável, a combinação de quatro comportamentos alimentares negativos foi mais frequente entre as mulheres, trabalhadores com menor nível de escolaridade e que viviam sem companhia. Conclusão Hábitos alimentares não saudáveis tendem a se agrupar em ambos os sexos, sugerindo uma forte interação, especialmente para os quatro hábitos alimentares não saudáveis em conjunto, principalmente nas mulheres, trabalhadores com menor escolaridade e que vivem sem parceiro.