School environment and physical activity in adolescents from São Paulo city.

We examined the association of physical activity (PA) facilities and access to school with total PA and domain-specific PA in adolescents. We enrolled 2610 adolescents (mean: 14.9 years) from Sao Paulo city. The number and presence of sports courts, swimming pools, locker rooms, running/athletics tracks, entrance accessible for student cyclists, bike racks, speed limit signal around the school, and pedestrian crossing were assessed in each school. All participants responded to a questionnaire about frequency and duration of physical education classes, leisure time, and active commuting. Total PA was obtained by adding up all PA domains. Presence of three or more (OR: 1.62; 95% CI: 1.15 to 2.30) sports courts, swimming pool available in usable conditions (OR: 1.45; 95% CI: 1.01 to 2.10), running/athletics tracks (OR: 2.35; 95% CI: 1.07 to 5.18), and bike racks (OR: 1.38; 95% CI: 1.07 to 1.78) were positively associated with total PA. Number of sports courts, swimming pool available in usable conditions, speed limit signals around the school, and pedestrian crossings were positively associated with physical education classes. The bike racks, speed limit signs around the school, and pedestrian crossings were positively associated with active commuting. School environment was associated with increased PA. Our findings should be considered in future epidemiologic studies and for educational and health policy makers.

Physical activity patterns in a representative sample of adolescents from the largest city in Latin America: a cross-sectional study in Sao Paulo.

OBJECTIVES: We examined the patterns of total and domain-specific physical activity (PA) by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo city, Brazil. DESIGN: Cross-sectional study. PARTICIPANTS: We included a representative sample of 2682 (52.2% boys) adolescents aged 14-15 years from public and private schools in Sao Paulo, 2017. Socioeconomic status was assessed using a wealth index derived from principal component analysis. Descriptive analyses evaluated differences in total and domain-specific PA by sex, socioeconomic status and maternal education level. OUTCOME MEASURES: We collected data on the frequency and duration that adolescents spent in each PA domain (active transportation, leisure PA and physical education classes) through a self-report questionnaire. RESULTS: On average, adolescents spent 197.7 min/week (95% CI 190.6-204.8) in total PA. The proportion of adolescents achieving at least 60 min/day (≥420 min/week) was 12.7% (95% CI 11.4-14.1), with a higher prevalence in boys (18.3%) and in those with higher socioeconomic status (17.4%). Similar patterns were observed for leisure PA and physical education classes. Active transportation was higher in girls (46.0 min/week; 95% CI 42.6-49.6) than in boys (43.4 min/week, 95% CI 39.9-46.6). Boys and adolescents with higher socioeconomic status and higher maternal education level had higher levels of total PA. CONCLUSIONS: We found a variation in patterns of total and domain-specific PA by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo. Initiatives for promoting PA in adolescents should take these findings into account.

Anxiety and Leisure-Domain Physical Activity Frequency, Duration, and Intensity During Covid-19 Pandemic.

This study investigated relationships between state anxiety and leisure-domain physical activity levels during Covid-19 pandemic. We used frequency, duration, and intensity as key variables of physical activity. Trait anxiety, state anxiety before pandemic, age, gender, and education level were also included in the analysis. Our general hypothesis was that participants who declared doing more physical activity levels would exhibit lower levels of anxiety during the Covid-19 pandemic. A convenient sample of 571 volunteer adults (mean age 39 ± 14 years) was drawn mainly from São Paulo State (89.2% of the sample), the epicenter of Covid-19 pandemic in Brazil. To obtain the participants' levels of anxiety (trait, state before pandemic, and state during pandemic) we used a validated short-version of the State and Trait Anxiety Inventory. Levels of physical activity were measured via questions from VIGITEL, a validated questionnaire about the individual's habits on risk factors. Answers were given regarding the first week of March 2020 (before pandemic) and at the very moment the participant was filling in the electronic form (June 2020). Data analyses were conducted through descriptive and inferential techniques, with the use of non-parametric tests and linear regression models. Overall, participants' responses indicate that anxiety levels were higher during the pandemic compared to the period that preceded the pandemic, and that frequent and long physical activity in the leisure-domain reduced anxiety, regardless its intensity. The regression models revealed an inverse relationship between physical activity and anxiety (the more physical activity, the less anxiety) and independent of gender, age, education level, trait anxiety, and physical activity before pandemic.

Physical activity promotion by health practitioners: a distance-learning training component to improve knowledge and counseling.

Aim To report an evaluation of health professionals' participation in a distance-learning physical activity training course developed in a low socio-economic region of São Paulo city, Brazil. BACKGROUND: In countries with public universal health systems, physical activity promotion in primary health care settings can reap results, particularly given that such interventions have the potential to reach a large percentage of the population. However, few studies proposed physical activity training for health professionals in low- and middle-income countries. Brazil is a continental country and has the Unified Health System which incorporates family health teams in over 85% of Brazilian cities. METHODS: The physical activity training was part of the fifth module of an educational intervention throughout a distance-learning course focusing on health professionals at M'Boi Mirim district in São Paulo city. The training totaled 3 h and had five themes of physical activity: (1) concepts, definitions benefits; (2) evaluation; (3) recommendation; (4) interventions; (5) physical activity counseling. The opinion of health professionals was evaluated after training by two open questions. Findings Out of 106 professionals who took part of the course, only 22.6% (n=24) had accessed the fifth module. These professionals were predominantly female (79.2%), nurses (66.7%) and aged 30 years or older. Responses highlighted the course approach focused on physical activity for improving patient's quality of life and well-being, disease prevention and health improvements. Regarding the themes for improvement, the health professionals identified that there was a need to experience physical activity classes first-hand, and the need to link physical activity counseling to the local venues that provide structured physical activity programs. We recommend that further training courses can be conducted based on this model for health professionals to promote physical activity to the community in Brazil.

Development of a dynamic framework to explain population patterns of leisure-time physical activity through agent-based modeling.

Despite the increasing body of evidences on the factors influencing leisure-time physical activity, our understanding of the mechanisms and interactions that lead to the formation and evolution of population patterns is still limited. Moreover, most frameworks in this field fail to capture dynamic processes. Our aim was to create a dynamic conceptual model depicting the interaction between key psychological attributes of individuals and main aspects of the built and social environments in which they live. This conceptual model will inform and support the development of an agent-based model aimed to explore how population patterns of LTPA in adults may emerge from the dynamic interplay between psychological traits and built and social environments. We integrated existing theories and models as well as available empirical data (both from literature reviews), and expert opinions (based on a systematic expert assessment of an intermediary version of the model). The model explicitly presents intention as the proximal determinant of leisure-time physical activity, a relationship dynamically moderated by the built environment (access, quality, and available activities) - with the strength of the moderation varying as a function of the person's intention- and influenced both by the social environment (proximal network's and community's behavior) and the person's behavior. Our conceptual model is well supported by evidence and experts' opinions and will inform the design of our agent-based model, as well as data collection and analysis of future investigations on population patterns of leisure-time physical activity among adults.

Health promoting practices and personal lifestyle behaviors of Brazilian health professionals.

BACKGROUND: This study was conducted to examine the lifestyle behaviors and health promoting practices of physicians, nurses, and community health workers in Brazil. METHODS: A random sample of primary health care units in Brazil was selected, and a pretested questionnaire was administered via phone interviews, in 2011, to 182 physicians, 347 nurses, and 269 community health workers, totaling 798 health professionals. The total initial sample included 1600 eligible health professionals. Variables measured included physical activity, alcohol intake, hours of sleep, diet, and perceived self-efficacy to provide preventive counseling on related lifestyle behaviors. RESULTS: More than 25 % of physicians, nurses, and community health workers reported eating 0-2 portions of fruits and vegetables per day. In terms of cervical and breast cancer, nurses reported to be 'very prepared' to advise patients on these topics more frequently than physicians. The prevalence of smoking ranged from 4.9 % among nurses to 7.4 % among community health workers. The proportion of physical inactivity ranged from 40.3 % among nurses to 52.1 % among community health workers. CONCLUSION: A reasonably high proportion of physicians, nurses, and community health workers report not engaging in healthy lifestyle behaviors that impact chronic diseases, thus, they may be less likely to encourage such behaviors in their patients.

Association of knowledge, preventive counseling and personal health behaviors on physical activity and consumption of fruits or vegetables in community health workers.

BACKGROUND: There is evidence that if a health professional is active and has a healthy diet, he/she is more likely to advise patients about the benefits of physical activity and healthy eating The aims of this study were to: (1) describe the personal physical activity, consumption of fruits and vegetables behaviors and nutritional status of community health workers; (2) evaluate the association between knowledge, delivery of preventive counseling and personal behaviors among community health workers. METHODS: This was a cross-sectional study conducted in a nationally sample of health professionals working in primary health care settings in Brazil in 2011. This survey was part of the second phase of the Guide for Useful Interventions for Activity in Brazil and Latin America project, and data were collected through telephone interviews of 269 community health workers from the Unified Health Care system of Brazil. We applied questionnaires about personal reported behaviors, knowledge and preventive counseling in physical activity and consumption of fruits and vegetables. We calculated the prevalence and associations between the variables with logistic regression. RESULTS: The proportion of community health workers that practiced 150 minutes per week of physical activity in leisure time or transportation was high (64.9%). Half of community health workers were overweight and only 26.2% reported consuming five portions/day of fruits or vegetables. Most community health workers reported counseling about physical activity for more than six months (59.7%), and most were not knowledgeable of the fruits and vegetables and physical activity recommendations. Meeting the fruits and vegetables recommendations was associated with correct knowledge (OR = 4.5; CI95% 1.03;19.7), with reporting 150 minutes or more of physical activity per week (OR = 2.0; CI95% 1.03;3.7) and with reporting physical activity in leisure time (OR = 2.0; CI95% 1.05;3.6). Regular physical activity counseling was associated with reporting 10-149 minutes per week (OR = 3.8; CI95% 1.1;13.3) and with more than 150 minutes of physical activity per week (OR = 4.9; CI95% 1.5;16.5). CONCLUSION: Actions to promote physical activity and healthy eating and to improve knowledge among community health workers within the health care system of Brazil could have a potential positive influence on delivery of preventive counseling to patients on this topic.

Characteristics of physical activity programs in the Brazilian primary health care system.

The aim of this study was to describe the characteristics of programs that promote physical activity in the public primary care system by region of Brazil, subject to the presence or absence of multidisciplinary primary care teams (NASF). We conducted a cross sectional and population-based telephone survey of the health unit coordinators from 1,251 health care units. Coordinators were asked about the presence and characteristics of physical activity programs. Four out of ten health units reported having a physical activity intervention program, the most common involving walking groups. Most of the activities were performed in the morning, once or twice a week, and in sessions of 30 minutes or more. Physical education professionals were primarily responsible for directing the activities. Interventions occurred in the health unit itself or in adjacent community spaces. In general, these characteristics were similar between units with or without NASF, but varied substantially across regions. These findings will guide future physical activity policies and programs within primary care in Brazil.

Characteristics of physical activity programs in the Brazilian primary health care system / Características de programas de atividade física na atenção básica de saúde do Brasil / Características de los programas de actividad física en la atención primaria de salud en Brasil

The aim of this study was to describe the characteristics of programs that promote physical activity in the public primary care system by region of Brazil, subject to the presence or absence of multidisciplinary primary care teams (NASF). We conducted a cross sectional and population-based telephone survey of the health unit coordinators from 1,251 health care units. Coordinators were asked about the presence and characteristics of physical activity programs. Four out of ten health units reported having a physical activity intervention program, the most common involving walking groups. Most of the activities were performed in the morning, once or twice a week, and in sessions of 30 minutes or more. Physical education professionals were primarily responsible for directing the activities. Interventions occurred in the health unit itself or in adjacent community spaces. In general, these characteristics were similar between units with or without NASF, but varied substantially across regions. These findings will guide future physical activity policies and programs within primary care in Brazil.

O objetivo foi descrever as características dos programas de atividade física na atenção básica de saúde de acordo com a presença de Núcleo de Apoio à Saúde da Família (NASF) no município e por regiões do Brasil. Foi realizado um estudo transversal por inquérito telefônico com 1.251 coordenadores de unidades de saúde. Foi aplicado um questionário sobre presença de intervenções com atividade física e suas características de funcionamento. Quatro em cada dez unidades de saúde relataram ter uma intervenção com atividade física, especialmente grupos de caminhada. A maior parte da atividade é realizada na manhã uma vez ou duas vezes por semana, com sessões de 30 minutos ou mais. Profissionais de educação física são os principais responsáveis por supervisionar as atividades. Os programas ocorrem na unidade de saúde ou outros espaços comunitários. Estas características, de modo geral, foram semelhantes entre unidades com ou sem NASF no município e apresentaram variação entre as regiões. Os resultados desse estudo irão permitir melhor direcionamento das próximas ações de promoção de atividade física na atenção básica de saúde.

El objetivo fue describir las características de los programas de actividad física en atención primaria, de acuerdo con el Centro de Apoyo a la Salud de la Familia (NASF) y las regiones de Brasil. Se realizó una encuesta transversal telefónica con 1.251 coordinadores de las unidades de salud. Se preguntó a los coordinadores acerca de la presencia y características de intervenciones de actividad física en funcionamiento. Cuatro de cada diez centros de salud reportaron tener una intervención de actividad física, especialmente, grupos de paseo. La mayor parte de las actividades se llevan a cabo por la mañana una vez o dos veces por semana con sesiones de 30 minutos o más. Los profesores de educación física son los principales responsables de la supervisión de las actividades. Los programas se llevan a cabo en la clínica o en otros espacios públicos. Estas características fueron similares en unidades con o sin NASF y mostraron una variación regional en su prevalencia. Estas características permitirán enfocar próximas acciones para promover la actividad física dentro de la atención primaria de salud.

Interventions for physical activity promotion applied to the primary healthcare settings for people living in regions of low socioeconomic level: study protocol for a non-randomized controlled trial.

BACKGROUND: Regular physical activity practice has been widely recommended for promoting health, but the physical activity levels remain low in the population. Therefore, the study of interventions to promote physical activity is essential. OBJECTIVE: To present the methodology of two physical activity interventions from the "Ambiente Ativo" ("Active Environment") project. METHODS: 12-month non-randomized controlled intervention trial. 157 healthy and physically inactive individuals were selected: health education (n = 54) supervised exercise (n = 54) and control (n = 49). Intervention based on health education: a multidisciplinary team of health professionals organized the intervention in group discussions, phone calls, SMS and educational material. Intervention based on supervised exercise program: consisted of offering an exercise program in groups supervised by physical education professionals involving strength, endurance and flexibility exercises. The physical activity level was assessed by the International Physical Activity Questionnaire (long version), physical activities recalls, pedometers and accelerometers over a seven-day period. RESULT: This study described two different proposals for promoting physical activity that were applied to adults attended through the public healthcare settings. The participants were living in a region of low socioeconomic level, while respecting the characteristics and organization of the system and its professionals, and also adapting the interventions to the realities of the individuals attended. CONCLUSION: Both interventions are applicable in regions of low socioeconomic level, while respecting the social and economic characteristics of each region. TRIAL REGISTRATION: ClinicalTrials.gov NCT01852981.

Health and fitness benefits of a resistance training intervention performed in the workplace.

This study examined the effects of a workplace-based resistance training intervention on different health-, fitness-, and work-related measures in untrained men (bus drivers). The subjects were recruited from a bus company and divided into a training (n = 48) and control (n = 48) groups after initial prescreening. The training group performed a 24-week resistance training program, whereas the control group maintained their normal daily activities. Each group was assessed for body composition, blood pressure (BP), pain incidence, muscular endurance, and flexibility before and after the 24-week period. Work absenteeism was also recorded during this period and after a 12-week follow-up phase. In general, no body composition changes were identified in either group. In the training group, a significant reduction in BP and pain incidence, along with improvements in muscle endurance and flexibility were seen after 24 weeks (p < 0.05). There were no changes in these parameters in the control group, and the between-group differences were all significant (p < 0.05). A reduction in worker absenteeism rate was also noted in the training (vs. control) group during both the interventional and follow-up periods (p < 0.05). In conclusion, it was found that a periodized resistance training intervention performed within the workplace improved different aspects of health and fitness in untrained men, thereby potentially providing other work-related benefits. Thus, both employers and employees may benefit from the setup, promotion, and support of a work-based physical activity program involving resistance training.

Time trends of physical activity in Brazil (2006-2009).

OBJECTIVE: To examine time trends in physical activity (PA) in Brazilian state capitals from 2006 to 2009. METHODS: This analysis is based on data from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL) accounting for an annual sample of approximately 54,000 individuals. PA indicators were analyzed in free time (leisure), work, home and transportation, time spent in front of the television and inactivity considering all PA domains. Poisson regression models were used to measure the variation of indicators over time. We considered the changes corresponding to a regression coefficient different from zero as being statistically significant (p<0.05). RESULTS: The percentage of active commuters increased from 11.7 to 14.4% (p<0.001) whereas the proportion of physically inactive individuals in the four domains decreased from 11.7 to 8.7% (p<0.001). There were no significant changes in the other indicators. Women were less active than men in all indicators, except for household chores. However, in this indicator the percentage of active women decreased from 71.4 to 67.1% (p<0.001). Between 2006 and 2009, PA levels in the Brazilian population were stable during free time and household chores, but increased in transportation, resulting in a decrease in the percentage of inactive individuals. CONCLUSION: The continued monitoring and strengthening of VIGITEL are public health priorities, and PA is a key part of it. In the long run, PA evolution may be re-evaluated.

Tendências temporais de atividade física no Brasil (2006-2009) / Time trends of physical activity in Brazil (2006-2009)

OBJETIVO: Analisar as tendências temporais de atividade física (AF) nas capitais brasileiras entre 2006 e 2009. MÉTODOS: A análise apresentada neste artigo é baseada nos dados do VIGITEL, totalizando uma amostra anual aproximada de 54.000 indivíduos. Foram analisados indicadores de AF no tempo livre, trabalho, em casa e no deslocamento, além do tempo assistindo à televisão e de inatividade considerando todos os domínios de AF. A variação dos indicadores no período foi aferida por meio de modelos de regressão de Poisson, tendo como variável explanatória o ano do inquérito. Foi considerada significativa a evolução correspondente a um coeficiente de regressão diferente de zero (p<0,05). RESULTADOS: O percentual de indivíduos ativos no deslocamento passou de 11,7 para 14,4 por cento (p<0,001), enquanto aqueles fisicamente inativos nos quatro domínios passaram de 11,7 para 8,7 por cento (p<0,001). Não foram observadas oscilações significantes nos demais indicadores. As mulheres foram menos ativas em todos os indicadores, exceto nos serviços domésticos. Neste domínio, houve redução das mulheres ativas de 71,4 para 67,1 por cento (p<0,001). Os níveis de AF da população brasileira entre 2006 e 2009 estão estáveis no tempo livre e nas atividades domésticas, mas aumentaram no deslocamento, acarretando uma diminuição no percentual de inativos no país. CONCLUSÃO: A continuidade do monitoramento e o fortalecimento do VIGITEL se colocam como prioridades e a área de AF se insere neste crescimento, e no longo prazo, poderá ter sua evolução temporal novamente avaliada.

OBJECTIVE: To examine time trends in physical activity (PA) in Brazilian state capitals from 2006 to 2009. METHODS: This analysis is based on data from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL) accounting for an annual sample of approximately 54,000 individuals. PA indicators were analyzed in free time (leisure), work, home and transportation, time spent in front of the television and inactivity considering all PA domains. Poisson regression models were used to measure the variation of indicators over time. We considered the changes corresponding to a regression coefficient different from zero as being statistically significant (p<0.05). RESULTS: The percentage of active commuters increased from 11.7 to 14.4 percent (p<0.001) whereas the proportion of physically inactive individuals in the four domains decreased from 11.7 to 8.7 percent (p<0.001). There were no significant changes in the other indicators. Women were less active than men in all indicators, except for household chores. However, in this indicator the percentage of active women decreased from 71.4 to 67.1 percent (p<0.001). Between 2006 and 2009, PA levels in the Brazilian population were stable during free time and household chores, but increased in transportation, resulting in a decrease in the percentage of inactive individuals. CONCLUSION: The continued monitoring and strengthening of VIGITEL are public health priorities, and PA is a key part of it. In the long run, PA evolution may be re-evaluated.

Practice of walking and its association with perceived environment among elderly Brazilians living in a region of low socioeconomic level.

BACKGROUND: The aim of this study was analyze associations between the practice of walking and environmental perception among elderly Brazilians in a region of low socioeconomic level. METHODS: A cross-sectional study was conducted among 385 elderly people aged 60 years and over. To evaluate walking, the International Physical Activity Questionnaire (IPAQ), long version (leisure and transport modules) was used. The environment was evaluated by means of the Neighborhood Environmental Walkability Scale (NEWS) (adapted Brazilian version). For the statistical analysis, multiple logistic regression models were created separately for men and women. The practice of at least 150 minutes a week of walking was the dependent variable, and the variables of environmental perception were the independent variables. All the models were controlled for schooling level and age. RESULTS: The proportion of elderly people active in walking was 56.9% for the men and 26.4% for the women. The perception of the presence of soccer fields (OR = 4.12) and their proximity, within ten minutes' walk from home (OR = 3.43), were associated with the practice of walking among the men. The perception of the presence of public squares (OR = 4.70) and the proximity of primary healthcare units, within ten minutes' walk from home (OR = 3.71), were associated with the practice of walking among the women. An association with adequate perception of vehicle traffic remained at the threshold of significance for the women. CONCLUSION: Accessibility of leisure structures such as football fields and public squares and of health services such as primary healthcare units were important environmental variables associated with the practice of walking among elderly people living in a region of low socioeconomic level in Brazil. These variables need to be taken into consideration when aiming to promote the practice of walking among elderly people living in similar regions.

Lessons learned after 10 years of IPAQ use in Brazil and Colombia.

BACKGROUND: To describe the lessons learned after 10 years of use of the International Physical Activity Questionnaire (IPAQ) in Brazil and Colombia, with special emphasis on recommendations for future research in Latin America using this instrument. METHODS: We present an analytical commentary, based on data from a review of the Latin American literature, as well as expert consultation and the authors' experience in administering IPAQ to over 43,000 individuals in Brazil and Colombia between 1998 and 2008. RESULTS: Validation studies in Latin America suggest that the IPAQ has high reliability and moderate criteria validity in comparison with accelerometers. Cognitive interviews suggested that the occupational and housework sections of the long IPAQ lead to confusion among respondents, and there is evidence that these sections generate overestimated scores of physical activity. Because the short IPAQ considers the 4 physical activity domains altogether, people tend to provide inaccurate answers to it as well. CONCLUSIONS: Use of the leisure-time and transport sections of the long IPAQ is recommended for surveillance and studies aimed at documenting physical activity levels in Latin America. Use of the short IPAQ should be avoided, except for maintaining consistency in surveillance when it has already been used at baseline.

Enrollment in physical education is associated with health-related behavior among high school students.

BACKGROUND: Physical education (PE) plays a critical role in the healthy development of youth; however, the influence of PE classes in helping to provide students with health-related behavior patterns is not clear. This study aims to analyze whether participation in PE classes is associated with health-related behavior among high school students. METHODS: A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors. RESULTS: Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28-30% higher likelihood of reporting lower TV viewing during week days. CONCLUSIONS: Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students.

Methods and participant characteristics of a randomized intervention to promote physical activity and healthy eating among brazilian high school students: the Saude na Boa project.

BACKGROUND: A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project. METHODS: Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n=2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training. RESULTS: The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers' strikes in both sites and lack of involvement of the canteen owners in schools. CONCLUSIONS: The Saude na Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil.

Past and present habitual physical activity and its relationship with bone mineral density in men aged 50 years and older in Brazil.

BACKGROUND: The aim of this study was to determine the relationship between habitual physical activity (HPA) during life and bone mineral density (BMD) in men aged 50 years and older. METHODS: A total of 326 men aged 50 years and older, volunteers living in São Paulo city, Brazil, were studied. BMD was measured in the whole body, femoral neck, Ward's triangle, trochanter, and lumbar spine (L2-L4) with a dual-energy x-ray absorptiometer. The HPA data were collected with questionnaires inquiring about physical exercise and occupational physical activity in the past and during the past 12 months and leisure and locomotor physical activity in the preceding 12 months. The relationship between BMD and HPA was analyzed using multiple linear regression models adjusted for age and body mass index (BMI). RESULTS: Practice of physical exercise in the past 10-20 years and leisure and locomotor physical activity in the preceding 12 months showed a significant positive correlation with BMD of whole body, femoral neck, trochanter, and lumbar spine, and this association was independent of age and BMI. CONCLUSIONS: HPA can contribute to preserving BMD in men aged 50 years and older in Brazil, when it is practiced in the past 10-20 years and even in the present.