Exercise intervention does not reduce the likelihood of VO2max underestimation in older adults with hypertension.

The present study aimed to investigate whether training status would influence the capacity of a verification phase (VER) to confirm maximal oxygen uptake (VO2max) of a previous graded exercise test (GXT) in individuals with hypertension. Twelve older adults with hypertension (8 women) were recruited. Using a within-subject design, participants performed a treadmill GXT to exhaustion followed by a multistage VER both before and after a 12-wkcombined exercise training programme. Individual VO2max, respiratory exchange ratio (RER), maximal heart rate (HRmax), and rating of perceived exertion (RPE) were measured during both GXT and VER tests. Absolute and relative VO2max values were higher in VER than in GXT at baseline, but only absolute VO2max differed between bouts post-intervention (all p < 0.05). Individual VO2max comparisons revealed that 75% of the participants (9/12) achieved a VO2max value that was ≥3% during VER both before (range: +4.9% to +21%) and after the intervention (range: +3.4% to +18.8%), whereas 91.7% (11/12) of the tests would have been validated as a maximal effort if the classic criteria were employed. A 12-wk combined training intervention could not improve the capacity of older adults with hypertension to achieve VO2max during a GXT, as assessed by VER.

Atividade física para gestantes e mulheres no pós-parto: Guia de Atividade Física para a População Brasileira / Physical activity for pregnant and postpartum women: Physical Activity Guidelines for the Brazilian Population

Este artigo tem por objetivo apresentar as recomendações de atividade física para gestantes e mu-lheres no pós-parto desenvolvidas para o Guia de Atividade Física para a População Brasileira. Para isso, utilizou-se uma abordagem de métodos mistos que incluiu quatro etapas: 1) levantamento das diretrizes internacionais mais recentes; 2) revisão narrativa de literatura sobre efeitos da prática de atividade física durante a gestação para a saúde da mulher e do bebê; 3) escuta com gestantes, mu-lheres no pós-parto, profissionais e pesquisadores; 4) consulta pública. As evidências sumarizadas suportam que a prática de atividade física durante a gestação e no período pós-parto é segura, traz be-nefícios à saúde da mãe e do bebê, e reduz os riscos de algumas complicações relacionadas à gestação. Gestantes devem ser incentivadas a realizar pelo menos 150 minutos por semana de atividade física de intensidade moderada. Gestantes com contraindicações devem procurar auxílio de profissionais qualificados. Em alguns casos, a prática de atividade física durante a gestação não é recomendada. Este documento servirá como ferramenta para nortear profissionais de saúde que atuam com ges-tantes e mulheres no pós-parto e irá orientar a população-alvo quanto a prática de atividade física

This manuscript aims to present the recommendations of physical activity for pregnant and postpartum women developed for the Physical Activity Guidelines for the Brazilian Population. A mixed-method ap-proach that included four steps was used: 1) review of the most recent international guidelines for physical activity during pregnancy; 2) narrative literature review on the effects of physical activity during pregnancy on the health of the woman and the baby; 3) consultation with pregnant women, postpartum women, pro-fessionals and researchers; 4) public consultation. The summarized evidence supports that physical activity during pregnancy and in the postpartum is safe, has benefits to the health of the mother and baby, and reduces the risks of some complications related to pregnancy. Pregnancy should be encouraged to do at least 150 min-utes a week of moderate intensity physical activity. Pregnancy women with contraindications should seek help from qualified professionals. In some cases, physical activity during pregnancy is not recommended. This document will be used as a tool to guide health professionals who work with pregnant women and women in the postpartum period. Also, it will inform and guide women during pregnancy and postpartum about the benefits of physical activity

Impact of binge eating during pregnancy on gestational weight gain and postpartum weight retention among women with gestational diabetes mellitus: LINDA-Brasil.

OBJECTIVE: Binge eating (BE) is associated with gestational weight gain, which is a risk factor for gestational diabetes (GDM). Little is known about this association in women with GDM. To evaluate the relationship of BE in pregnancy with gestational weight gain, BE at postpartum and postpartum weight retention in women with GDM. METHOD: Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA-Brasil) is a multicenter cohort study with 1,958 women with GDM. BE was assessed by interview during recruitment in pregnancy and at a phone interview at ~4 months postpartum. Gestational weight gain was classified according to the 2009 Institute of Medicine (IOM) recommendations. Poisson regression with robust variance was used to estimate adjusted relative risks (RR). RESULTS: Prevalence of BE was 31.6% (95% confidence interval [CI] 29.5-33.6%) during pregnancy and 30.0% (95% CI 28.0-32.1%) at postpartum. The risk of exceeding the IOM's recommendation for gestational weight gain was 45% higher (RR 1.45, 95% CI 1.29-1.63) in women who had BE during pregnancy compared to those who did not. The risk of having postpartum weight retention above the 75th percentile was 33% higher (RR 1.33, 95% CI 1.10-1.59) among those with BE compared to those without. DISCUSSION: Among these women with GDM, BE was frequent and was associated with excessive gestational weight gain and weight retention at postpartum. Thus, given the vulnerability of these periods of the life cycle, tracking this eating behavior is important for the management of gestational weight gain and for the prevention of excessive postpartum retention.

Effectiveness of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in Hypertensive Patients: a Systematic Review and Meta-Analysis.

PURPOSE OF REVIEW: The purpose of this meta-analysis is to compare the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) on blood pressure of hypertensive individuals. RECENT FINDINGS: Continuous aerobic training programs are successful in health promotion and are effective in systolic blood pressure (SBP) and diastolic blood pressure (DBP) modulation. However, HIIT seems to be superior to MICT to improvement of cardiorespiratory fitness. PubMed, ScienceDirect, and Google Scholar were searched for randomized clinical trials that compared chronic effects of HIIT and MICT on BP in hypertensive subjects. Pre- and post-intervention changes in maximal oxygen uptake (VO2max) between MICT and HIIT were analyzed. Both interventions presented significant differences in SBP (MICT: mean difference (MD), 3.7 mmHg [95% CI = 2.57, 4.82], p < 0.00001; and HIIT: MD, 5.64 mmHg [95% CI = 1.69, 9.52], p = 0.005) and in DBP (MICT: MD, 2.41 mmHg [95% CI = 1.09, 3.72], p = 0.0003; and HIIT: MD, 4.8 mmHg [95% CI = 2.9, 6.7], p < 0.00001) compared with the control group. No differences were found in the SBP values (MD, 1.13 mmHg [95% CI = - 0.01, 2.27], p = 0.05); however, differences were found between groups in DBP (MD, 1.63 mmHg [95% CI = 0.83, 2.44], p = 0.0001). In the secondary outcome, both interventions increased VO2max in comparison with control groups (MICT: MD, 1.30 ml/kg/min [95% CI = 0.92, 1.68], p < 0.00001; and HIIT: MD, 4.90 ml/kg/min [95% CI = 3.77, 6.04], p < 0.00001), and HIIT promoted greater improvement than MICT (MD, 2.52 ml/kg/min [95% CI = 1.90, 3.13], p < 0.0001). In conclusion, HIIT and MICT promote reduction in SBP in adults with hypertension, and HIIT showed a greater magnitude in DBP reduction. For hypertensive patients, HIIT may be associated with a greater improvement in VO2max than MICT might.

Number of days required to estimate physical activity constructs objectively measured in different age groups: Findings from three Brazilian (Pelotas) population-based birth cohorts.

PURPOSE: The present study aims to estimate the minimum number of accelerometer measurement days needed to estimate habitual physical activity (PA) among 6- (2010), 18- (2011) and 30- (2012) year-old participants, belonging to three population-based Brazilian birth cohorts. METHOD: PA was assessed by triaxial wrist-worn GENEActiv accelerometers and the present analysis is restricted to participants with at least 6 consecutive days of measurement. Accelerometer raw data were analyzed with R-package GGIR. Description of PA measures (overall PA, moderate-to-vigorous PA (MVPA), light PA (LPA)) on weekdays and weekend days were conducted, and statistical differences were tested with chi-squared and Kruskal-Wallis tests. Spearman Brown Formulae was applied to test reliability of different number of days of accelerometer use. RESULTS: Differences between week and weekend days regarding LPA, MVPA and overall PA, were only observed among 30-year-olds. Higher levels of MVPA (p = 0.006) and overall PA (p<0.001) were identified on weekdays. For overall PA, to achieve a reliability coefficient >0.70, two and three days of measurement were needed in adults and children, respectively. For LPA, a reliability coefficient >0.70 was achieved with five days in 6-year-old children, three days in 18-year-old young adults, and four days in 30-year-old adults. Considering MVPA, four days would be necessary to represent a week of measurement among all cohort groups. CONCLUSION: Our results show that four and five measurement days are needed to estimate all habitual PA constructs, for children and adults, respectively. Also, among 30-year-old adults, it is important to make efforts towards weekend days measurement.

Effects of High-Intensity Interval Training in Combat Sports: A Systematic Review with Meta-Analysis.

Vasconcelos, BB, Protzen, GV, Galliano, LM, Kirk, C, and Del Vecchio, FB. Effects of high-intensity interval training in combat sports: A systematic review with meta-analysis. J Strength Cond Res 34(3): 888-900, 2020-Combat sports (CS) are intermittent by nature and high-intensity interval training (HIIT) has been used as a tool to maintain and improve physical fitness among CS athletes. The aim of this study was to perform a systematic review and meta-analysis about chronic effects of HIIT in CS athletes. An electronic search was performed in PubMed, Science Direct, and Google Scholar using the following Boolean criteria: ("CS" OR "martial arts" OR "judo" OR "taekwondo" OR "jiu jitsu" OR "boxing" OR "karate" OR "wrestling" OR "wushu" OR "kung fu") AND ("HIIT" OR "intermittent exercise" OR "sprint interval training" OR "repeated sprint training [RST]"). To be included, the studies needed to be original, involve CS athletes, present HIIT intervention protocol (HIIT, sprint interval training [SIT] or RST), and analyze chronic physiological outcomes. From 2,211 identified studies, after screening and eligibility evaluation, 12 studies were included in this review with meta-analysis. Aerobic (aerobic capacity, heart rate, and maximum oxygen uptake), anaerobic (peak and mean power in single and successive Wingate tests, and blood lactate concentration), and anthropometric outcomes (body mass and body fat percentage) were evaluated. Data of 255 subjects from 12 studies were assessed. Regarding methodological quality, 7 studies obtained 9-10/12 on the TESTEX scale. For the interventions, 5 studies used HIIT, 4 studies used RST protocols, one used SIT protocols, and one used an intermittent protocol that could not be classified. Relating to aerobic power, was found an increase in V[Combining Dot Above]O2max, with a mean difference (MD) of 2.83 ml·kg·min (CI 95% = 0.40-5.25; p < 0.001) for striking and 2.36 ml·kg·min (CI 95% = 1.05-3.66; p < 0.001) for grappling athletes. No differences on anaerobic peak power for striking (MD = 0.67 W; CI 95% = -0.43 to 1.77; p = 0.23) were found, and a statistical improvement for grappling athletes, (MD = 0.51 W; CI 95% = 0.03-0.98; p = 0.04) was found. Seven studies analyzed anthropometric variables, with differences for body mass in striking (MD = -0.93 kg; CI 95% = -1.68 to -0.19; p = 0.01) and no differences for grappling (MD = -0.09 kg; CI 95% = -2.80 to 2.62; p = 0.95). Differences in body fat percentage in striking (MD = 0.50%; CI 95% = 0.30-0.70; p < 0.001) and no differences in grappling (MD = -0.87%; CI 95% = -1.77 to 0.03; p = 0.06) were found. It was concluded that HIIT positively influences maximum oxygen uptake and anaerobic power in combat sport athletes, with a minor impact on body composition.

Relativizing effects of high intensity interval training vs continuous moderate / Relativizando efeitos do treinamento intervalado de alta intensidade vs contínuo moderado

Abstract The production of systematic reviews and meta-analysis increased substantially. In this sense, we highlight those comparing Moderate-Intensity Continuous Training (MICT) and High-Intensity Interval Training (HIIT). It is known that meta-analyses of well-conducted studies are considered as a superior level of scientific evidence; therefore, it is relevant to critically analyze all those articles, especially speaking about the absence of differences between MICT and HIIT reported in previous studies. Widely, analyzing studies included in a meta-analysis frequently is possible to identify a lack of crucial information to the understanding of the exercise intervention, and this can skew readers interpretation and may conduct an equivocate comprehension of the results. In meta-analysis regarding the effects of MICT and HIIT in body composition, the relativization of the full length of training time of each intervention is frequently lacking. Data from previously published meta-analysis was reanalyzed, verifying higher relative reductions of body fat percentage to the HIIT group in comparison to the MICT group when considered the duration of interventions. In this sense, we suggest that all meta-analysis about this subject need not only to provide complete analysis in body composition but also consider analysis relativized of time spent training.

Resumo Verifica-se substancial aumento na produção de revisões sistemáticas e metanálises, inclusive sobre os efeitos do exercício na composição corporal. Destacam-se aqui aqueles comparando Treinamento Contínuo de Intensidade Moderada (MICE) e Treinamento Intervalado de Alta Intensidade (HIIT). Observando que metanálises bem conduzidas apresentam maior nível de evidência científica, torna-se relevante analisar criticamente os trabalhos sobre a temática, a despeito da possível ausência de diferença entre MICE e HIIT previamente relatada. Isto deriva do impacto que protocolos e relatos adequados dos estudos primários exercem no resultado da metanálise. Ao analisar estudos incluídos em metanálises, são identificadas ausências de informações relevantes, o que enviesa a interpretação crítica do leitor, podendo conduzir à interpretação equivocada dos resultados. Observando metanálises sobre os efeitos do MICE e HIIT na composição corporal, questiona-se a carência de relativização do tempo total do treinamento para atingir os resultados. Ao reanalisarmos os dados de metanálise previamente publicada, verificamos maior redução relativa do percentual de gordura no grupo HIIT em comparação ao grupo MICE quando consideradas as durações das intervenções. À vista disto, indica-se que todas as metanálise acerca do tema deveriam concernir não somente análises absolutas da mudança de composição corporal, mas relativizá-las ao tempo treinado.

Intervindo em atividade física, alimentação e estresse em moradores de município de pequeno porte / Intervention on physical activity, diet and stress in people living in a small city

Objetivou-se apresentar o modelo conceitual e desafios de uma intervenção de educação em saúde, incluída por meio do Sistema Único de Saúde. Todos moradores de Dona Francisca, Rio Grande do Sul, de 50-80 anos de idade, atendidos pelos oito agentes comunitários de saúde (ACS) foram considerados elegíveis para a intervenção, que abrangeu: i) encontro individual; ii) contatos motivacionais; iii) encontros educacionais relacionados à atividade física, alimentação e controle de estresse. A intervenção foi conduzida pelos ACS previamente treinados. Foram realizadas três coletas de dados: i) linha de base (2014; n = 649); ii) intermediária (2015; n = 544) e; iii) final (2016; n = 555). Os principais desafios foram relacionados a pactuação dos ACS, baixa participação nos encontros educacionais e coleta de dados, especialmente em áreas rurais. Porém, houve capacitação dos ACS, maior acesso às informações de saúde para a população e coletas de dados que possibilitam traçar o perfil de uma população de município de pequeno porte

The aim of this study is to present the rationale and challenges of a health education intervention, which occurred through the unified health system. All residents of Dona Francisca/Rio Grande do Sul, aged 50-80 years and serviced by community health workers (CHW ) were elegible for the intervention, which consisted of: i) individual meeting; ii) motivational contacts; iii) educational meetings related to physical activity, nutrition and stress control. The intervention was handled by CHW, previously trained. Data were collected for: i) baseline (2014; n = 649); ii) intermediate (2015; n = 544); and iii) final (2016; n = 555) periods. The main challenges were related to CHW performance, low participantion in educational meetings and data collection, particulary among rural areas. However, there was training of CHW, greater access to health information for the population and data collection that make it possible to know the profile of a population of a small city

The "Hypertension Approaches in the Elderly: a Lifestyle study" multicenter, randomized trial (HAEL Study): rationale and methodological protocol.

BACKGROUND: Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. METHODS: Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. DISCUSSION: Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. TRIAL REGISTRATION: NCT03264443 . Registered on 29 August, 2017.

Physical activity level in women with gestational diabetes mellitus: Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA-Brasil) study.

BACKGROUND: The aim of this study was to investigate physical activity and associated factors in women with gestational diabetes mellitus (GDM). METHODS: This cross-sectional study was performed on 2706 women as part of the Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA-Brasil) study, recruited between 2012 and 2016 in Brazil. A structured questionnaire was used to assess physical activity. Descriptive and Poisson regression analyses were used to investigate physical activity and associated factors. RESULTS: Counseling regarding physical activity practices was reported by 47.4% and 34.3% of women before and after a diagnosis of GDM, respectively. During pregnancy, 26% of women were classified as inactive, 39.7% were classified as insufficiently active, and 34.3% were classified as active. Compared with prepregnancy, 63.1% of women reported a decrease in physical activity levels during pregnancy. The prevalence of being inactive during pregnancy was higher among women who did not live with a partner (P = 0.003), had a lower household income (P = 0.01), were employed (P < 0.001), and who had four or more children (P < 0.001). CONCLUSION: Among Brazilian women with GDM, physical activity levels and practices were low, with most women reporting decreased physical activity during pregnancy. A low socioeconomic status was associated with lower physical activity. These findings indicate the need to reinforce the importance of physical activity in the management of GDM in Brazil.

Comparação das respostas fisiológicas durante a prática de exergame e atividades convencionais: uma revisão sistemática com metanálise / Comparison of physiological responses during practices of exergames and conventional activities: a systematic review and meta-analysis

O objetivo do presente trabalho foi realizar revisão sistemática com metanálise dos estudos sobre efeitos fisiológicos da prática de exergames, a fim de compará-las quando realizadas de maneira convencional. As buscas foram realizadas nas bases eletrônicas: PubMed, Science Direct, Google Scholar e a revista Games For Health Journal, utilizando os seguintes descritores ou termos: "health video game" OR "active video game" AND "energy expenditure"; exergam* AND "physical activity"; exergam* AND comparison; exergam* compared to real; exergam* AND "real game"; exergam* AND "real sports". Para serem incluídos, além de serem originais, os artigos também deveriam comparar a realização das atividades convencionais igualmente efetivadas com exergame (EXG). Foram encontrados 2.928 estudos que abordaram a temática. Após avaliação por títulos, 13 artigos foram excluídos por serem duplicatas. No total foram lidos 20 resumos, no entanto, selecionamos apenas sete para entrar na revisão. Além disso, três estudos localizados nas listas de referências foram incluídos. Os estudos que passaram pelos filtros de análise acabaram submetidos à escala PEDro, para mensuração de qualidade metodológica. A metanálise apontou não haver diferença significativa, entre atividades com EXG e atividades convencionais, para frequência cardíaca (p = 0,248), percepção subjetiva de esforço (p = 0,295), gasto energético (p = 0,664) e consumo de oxigênio (p = 0,455). Desta maneira, conclui-se que não há diferença para as variáveis apresentadas em ambas as atividades propostas.

The aim of this study was to perform a systematic review and metanalysis on the physiological effects of exergames practice compared to the same activities performed in a conventional manner. Therefore, a search was made in the databases PubMed, Science Direct, Google Scholar and Games For Health magazine using the following descriptors or terms "health video game" oR "active video game" AND "energy expenditure"; exergam * AND "physical activity"; exergam * AND comparison; exergam * Compared to real; exergam * AND "real game"; exergam * AND "real sports". To be included in the review, studies should be original articles and rely on activities performed with active videogames, namely exergames (EXG), which should be compared with the same conventional activities. An amount of 2928 studies were found. After title evaluation, 13 studies were excluded for duplication, lasting 20 titles. After abstract's evaluation, 7 titles were selected for entering this study. Besides, 3 other studies were found in reference lists and were included.Studies passed by search filters were submitted to PEDro scale for methodological quality evaluation. Metanalysis showed no significant differences for heart rate (p=0.248), rating of perceived exertion (p=0.295), energy expenditure (p=0.664) and oxygen uptake (p=0.455) between EXG and conventional activities. In conclusion, there are no differences between activities with EXG and the same activities realized in a conventional manner on heart rate, rate of perceived exertion, energy expenditure and oxygen consumption.

Depressive Symptoms in Women with Gestational Diabetes Mellitus: The LINDA-Brazil Study.

This study aimed to assess the frequency and severity of depressive symptoms and their relationship with sociodemographic characteristics in women with gestational diabetes mellitus (GDM) who participated in the LINDA-Brazil study. We conducted cross-sectional analyses of 820 women with GDM who were receiving prenatal care in the public health system. We conducted structured interviews to obtain clinical and sociodemographic information and applied the Edinburgh Postnatal Depression Scale (EPDS) to assess depressive symptoms. We classified the presence and severity of depressive symptoms using scores of ≥12 and ≥18, respectively. We used Poisson regression to estimate prevalence ratios (PR). Most of the women lived with a partner (88%), 50% were between 30 and 39 years old, 39% had finished high school, 39% had a family income of 1-2 minimum wages, and 47% were obese before their pregnancies. The presence of depressive symptoms was observed in 31% of the women, and severe depressive symptoms were observed in 10%; 8.3% reported self-harm intent. Lower parity and higher educational levels were associated with lower EPDS score. Depressive symptoms were common and frequently severe among women with GDM, indicating the need to consider this situation when treating such women, especially those who are more socially vulnerable. This trial is registered with NCT02327286, registered on 23 December 2014.

Physical activity levels objectively measured among older adults: a population-based study in a Southern city of Brazil.

BACKGROUND: Low levels of physical activity are currently observed in all age groups around the world. Among older adults physical activity is even lower, potentially influencing quality of life, incidence of diseases and premature mortality. The aim of this study was to describe objectively measured physical activity levels among older adults residents in a Southern city of Brazil. METHODS: A population-based study was carried out including people aged 60+ years living in the urban area of Pelotas. Face-to-face interviews, anthropometric measures and triaxial accelerometry (non-dominant wrist) were used to collect sociodemographic, anthropometric and physical activity, respectively. For descriptive purposes, overall physical activity was expressed as daily averages of acceleration. Time spent in light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) using different bout criteria (non-bouted, and in 1-, 5- and 10-min bouts) were calculated. Crude and adjusted analyses were performed using simple linear regression to examine the association between physical activity and exposure variables. RESULTS: Overall, 971 individuals provided valid accelerometry data. Women spent on average more time on LPA (136.2 vs. 127.6 min per day). Men and women respectively accumulated, in average, 64.5 and 56.7 min per day of non-bouted MVPA, while these daily averages were 14.9 and 9.46 min using 5-min, and 8.1 and 4.5 min using 10-min bout MVPA. In adjusted analyses, men aged 80 years or more spent in average 45 min less LPA per day when compared to men 60-69 years and, among women, this difference was 65 min. Considering time in 5-min MVPA bouts, the youngest age group and those with a better self-perceived health accumulated more MVPA. Specifically among men, socioeconomic status was inversely associated with 5-min bout MVPA. CONCLUSION: The present study showed low levels of physical activity among Brazilian older adults, even lower in more advanced ages, and a different pattern for physical activity intensity between men and women.

Intervenção com atividade física em uma Unidade Básica de Saúde - Projeto UBS+Ativa: Aspectos metodológicos / Intervention with physical activity in one Basic Health Unity - Ubs+Ativa Project: methodological aspects

O Sistema Único de Saúde é o principal meio de acesso à saúde em nível populacional. A prática atividade física regular é reconhecidamente comportamento capaz de prevenir doenças crônicas e interage de forma positiva com outras estratégias comportamentais de promoção da saúde. O objetivo deste estudo é descrever a metodologia do Projeto UBS+Ativa, programa de intervenção com atividade física em Unidade Básica de Saúde (UBS) localizada em Pelotas/RS. A intervenção é baseada em quatro atividades específicas: a) Estudo de linha de base; b) Atividade de divulgação; c) Grupo de atividade física orientada; d) Atendimento ambulatorial. Na linha de base, foram entrevistadas 601 residentes da área de abrangência da UBS. A divulgação do projeto visava recrutar participantes para o grupo de atividade física e para o atendimento ambulatorial individualizado; >2.500 folhetos foram distribuídos. Também, 470 pacientes foram abordados na sala de espera e receberam uma explicação presencial sobre o projeto e a importância da atividade física para a saúde. As aulas coletivas e o atendimento ambulatorial ocorrem três vezes por semana. Tal intervenção tem o potencial para ser ampliados localmente e nacionalmente.

In Brazil, the Unified Health System is the main provider of health care to the population. Practice regular physical activity behavior is admittedly able to prevent chronic diseases and interacts positively with other behavioral health promotion strategies. The aim of this study is to describe the methodological aspects of a physical activity intervention ­ "UBS+ Ativa", taking place in primary health care in Pelotas, a Southern Brazilian city. The intervention was organized into four specific activities: (a) baseline survey; (b) divulgation strategies; (c) group physical activity classes; (d) individual physical activity prescription. In the baseline study, 601 individuals living in the catchment area of the primary health care unit were interviewed. The divulgation of the project was aimed at recruiting participants for the group physical activity classes and for the individual prescription appointments; >2,500 leaflets were distributed. Also, 470 patients were approached in the waiting room and obtained a face-to-face explanation about the project and the importance of physical activity for health. Group classes and individual consultations take place three times per week. This intervention has the potential to be scaled up locally and then nationally.

Intervenções com promoção de atividade física na prevenção primária do diabetes: Metanálise / Intervention with physical activity promotion in primary prevention of diabetes: Meta-analysis

Introdução: Estudos de intervenções com prática de atividade física (AF) e aconselhamento nutricional para indivíduos com risco de desenvolverem diabetes mellitus (DM) têm sido elaborados, mas a síntese de tais estudos ainda é restrita. Objetivo: Reunir e calcular a força de evidência dos achados da última década sobre promoção de AF e prevenção do DM, com base em estudos de intervenção bem delineados e com alta qualidade metodológica com adultos em risco de desenvolver DM. Métodos: Conduziu-se metanálise considerando publicações de 2001 a setembro de 2014. Para pesquisa das referências, foram utilizados os seguintes descritores: diabetes mellitus, intervenção, "atividade física", "exercício físico", organizados adequadamente e em diferentes combinações. Resultados: Foi encontrada redução de 2,13 mmol/L (IC95% = 1,62-2,64; p<0,0001) nos níveis glicêmicos dos sujeitos acompanhados. Conclusão: Intervenções com atividade física exerceram efeitos positivos na prevenção ou retardamento de DM em pessoas com risco de desenvolvê-la.

Introduction: Studies of interventions with physical activity (PA) and nutritional counseling to individuals at risk of developing diabetes mellitus (DM) have been prepared, but the synthesis of such studies is still limited. Objective: To collect and calculate the strength of evidence from the past decade findings on the promotion of PA and prevention of DM, based on well-designed intervention studies with high methodological quality to adults at risk of developing diabetes. Methods: A meta-analysis was conducted considering publications from 2001 to September 2014. To the references search, the following descriptors were used: "diabetes mellitus", "intervention", "physical activity", "physical exercise", organized properly and in different combinations. Results: We found decrease of 2.13mmol/L (95% CI = 1.62 to 2.64; p <0.0001) in blood glucose levels in monitored subjects. Conclusion: Interventions with PA exerted positive effects in the prevention or delay of DM in people at risk of developing this disease.

Bolsas de ensino e pesquisa para a Educação Física no Brasil concedidas pelo CNPq: análise temporal de 2005 a 2014 / Scholarships of teaching and research for Physical Education in Brazil granted by CNPq: a temporal analysis of 2005 to 2014

Este estudo objetivou identificar as verbas por tipo e modalidade de bolsas de ensino e pesquisa concedidas pelo CNPq entre 2005 e 2014 nas grandes áreas de conhecimento, especialmente a de Ciências da Saúde com foco na subárea da Educação Física. As buscas ocorreram no mês de março de 2015 e realizadas no painel de investimentos do CNPq (http://www.cnpq.br/painel-de-investimentos) para informações sobre bolsas e no site da CAPES para identificar os cursos de pós-graduação. Foram investidos R$813.435.000,00 nas diferentes modalidades de bolsa, principalmente produtividade em pesquisa (30,0%). A área de Ciências da Saúde foi a quinta em termos de recebimento de verbas (11,0%). Entre as subáreas das Ciências da Saúde, a Medicina foi a que mais recebeu bolsas de ensino e pesquisa (38%) e a Educação Física ficou em sétimo lugar (4,0%). As subáreas que mais cresceram em investimentos no período analisado foram a Fisioterapia/Terapia Ocupacional (775%) e a Educação Física (738%), sendo esta última a sétima das subáreas em recebimento de bolsas de produtividade. Entretanto, foi a quarta em termos de crescimento de investimentos. Do total de bolsas de ensino e pesquisa, 64,3% foram destinadas a pesquisadores da região Sudeste, 15,4% na região Sul e 14,6% no Nordeste. Em contrapartida, apenas 4,1% para a região Centro-oeste e 1,6% a pesquisadores da região Norte.

The aim of the present study was to evaluate funding of the Brazilian Research Council (CNPq) via scholarships between 2005 and 2014 in Health Sciences and particularly in the sub-area of Physical Education. The search for scholarships was carried out in March, 2015 in the investments panel of the CNPq website (http://www.cnpq.br/painel-de-investimentos), as well as in the CAPES website to identify programs. Total funding was BRL 813,435,000.00; the main type of scholarship was the "research productivity" (30.0%). Health Sciences field placed fifth according to the total amount (11.0%). Within this field, Medicine received the biggest share of scholarships and funding (38%) while Physical Education placed seventh (4.0%). The sub-areas with the highest increases in funding were Physiotherapy/Occupational Therapy (775%) and Physical Education (738%). Physical Education ranked seventh in the receipt of productivity scholarships, but was the fourth in terms of growth in the number of scholarships. Of all scholarships, 64.3% were given to researchers in the Southeast region, 15.4% to South region and 14.6% to Northeast. On the other hand, only 4.1% were awarded to researchers from Center-west region and 1.6% to North region.

Nível de aptidão física de atletas de ginástica rítmica: comparações entre categorias etárias / Fitness level of rhythmic gymnastics athletes: comparisons between age categories

O objetivo do estudo foi avaliar a aptidão física de competidoras de ginástica rítmica (GR), e comparar o desempenho segundo categoria competitiva, considerando maturação e tempo de treinamento. A amostra foi composta por 33 ginastas, sendo 12 pré-infantis, 14 juvenis e 7 adultas, das quais foram coletadas informações sobre maturação, tempo de treinamento e antropometria. Ainda, aplicaram-se testes de i) flexibilidade para extensão de coluna, cintura escapular, flexão e extensão coxo-femoral; ii) equilíbrio estático e dinâmico, iii) potência de membros superiores (PMMSS) e de membros inferiores (PMMII). Em relação às características gerais de treino, as atletas pré-infantis praticam GR há 2,83±1,57 anos, as juvenis há 6,43±2,41 anos e as adultas há 10±3,37 anos, com diferenças entre o primeiro grupo e os demais (p<0,05). Em referência à quantidade de treinos semanais, as pré-infantis treinam 3,25±0,75 vezes por semana, as juvenis 5,07±1,07 dias e as adultas, 4,71±0,76 treinos. Neste contexto, 92% das pré-infantis cumprem entre 2 e 4 horas por treino. Entre as juvenis, 43% treinam entre 2 e 4 horas e 57% fazem mais de 4 horas. Já na categoria adulta, 85% treinam entre 2 e 4 horas e 15% treinam mais de 4 horas. Dentre os principais resultados, destacam-se menores valores da PMMII e equilíbrio na categoria pré-infantil e valores superiores de PMMSS na categoria adulta. O grupo pré-infantil obteve resultados inferiores de equilíbrio e flexibilidade ao ser comparado com as demais categorias. Quanto ao somatotipo, as categorias pré-infantil e juvenil tiveram suas maiores médias encontradas para ectomorfia, enquanto entre adultas, destacou-se o componente mesomórfico.

The aim of this study was to assess physical fitness of competing rhythmic gymnasts and to compare the performance according to competitive category considering maturation and training time. The study comprised 33 gymnasts, including 12 junior, 14 juvenile and 7 senior and information was collected about maturation, training time and anthropometry. In addition, tests were applied regarding i) flexibility of lumbar spine extension, shoulder girdle, hip flexion and extension; ii) static and dynamic balance, iii) lower and upper limbs power. In this context 92% of junior between 2 and 4 hours per session. 43% of juvenile athletes train between 2 and 4 hours and 57% more than 4 hours. In the adult category 85% train between 2 and 4 hours and 15% train more than 4 hours. The main results showed lower values of lower limbs power and balance to the junior category and high values in upper limbs power to the senior category. Regarding the general characteristics of training, junior athletes practice rhythmic gymnastics for 2,83±1,57, juvenile for 6,43±2,41 years and seniors for 10±3,37 years with differences between the first group and the others (p<0,05). About the amount of weekly training, younger athletes train 3,25±0,75, juvenile 5,07±1,07 days and seniors 4,71±0,76 times per week. The junior group showed lower results of balance and flexibility when compared to other categories. Considering somatotype, junior and juvenile categories showed their highest mean values for the ectomorphy while the mesomorphic component was highlighted among adults.

Aplicações do exercício intermitente de alta intensidade na síndrome metabólica / Applications of high-intensity intermittent exercise on metabolic syndrome

Esta revisão de literatura apresenta os efeitos do exercício físico intermitente de alta intensidade (HIIT) em variáveis relacionadas à Síndrome Metabólica (SM). Após contextualização dos critérios de diagnóstico, explicitam-se resultados de intervenções para a SM, bem como as possibilidades de se obter benefícios com o HIIT. Foram recuperados 11 artigos que avaliaram efeitos agudos e 16 que mensuraram efeitos crônicos do exercício. Apontam-se melhoras na composição corporal (incluindo gordura visceral), em variáveis cardiovasculares (destaque para a potência aeróbia máxima) e em componentes metabólicos (principalmente relacionados à glicemia). Quando se compararam diferentes tipos de treinamento, intermitente e contínuo, observou-se indicações favoráveis ao HIIT para os diversos componentes da SM. Em conclusão, a partir deste estudo, observa-se que o HIIT pode ser relevante para a prevenção e tratamento da SM...

This review provides information about the effects of high intensity intermittent training (HIIT) on variables related to the metabolic syndrome (MS). After the diagnoses criteria contextualization, results from exercise interventions on MS are presented, as well as the possibility of achieving benefits with HIIT. Eleven studies that assessed the acute effects and 16 that measured the chronic effects of exercise were recovered. Studies showed improvements in body composition (including visceral fat), cardiovascular variables (especially aerobic power) and metabolic components (mainly related to glycemia). When comparing different types of training, intermittent and continuous, there are favorable indications for the HIIT in most of the MS components. In conclusion, from this study, it appears that HIIT can be relevant for the prevention and treatment of the MS...

Associação entre atividade física, aptidão cardiorrespiratória e biomarcadores inflamatórios em adultos jovens aparentemente saudáveis / Association between physical activity, cardiorespiratory fitness and inflammatory biomarkers in apparently healthy young adults

A inflamação sistêmica crônica de baixa intensidade está relacionada com maior risco de doenças cardiovasculares. Estudos sugerem que a proteína C-reativa, um dos principais biomarcadores inflamatórios, pode estar inversamente relacionada com a prática de atividade física e com a aptidão física. O objetivo deste estudo transversal foi determinar as associações entre os níveis de atividade física e a aptidão cardiorrespiratória, com biomarcadores inflamatórios em homens adultos jovens (18-30 anos) aparentemente saudáveis (N=85). As amostras foram analisadas pelo método ELISA (Enzyme-Linked Immuno Sorbent Assay), usando kits de alta sensibilidade para proteína C-reativa, interleucina 6, interleucina 1? e TNF-?. A prática de atividade física foi mensurada por questionário e acelerometria. O consumo máximo de oxigênio (VO2max) foi estimado por teste incremental em cicloergômetro. Na análise bruta, a média das concentrações de proteína C-reativa da amostra foi de 1,59±1,16 mg/L, e esteve significativamente correlacionada com o VO2max (r=-0,32; p=0,03), mas não com atividade física medida por acelerometria ou questionário. O índice de massa corporal (IMC) e a circunferência abdominal apresentaram correlação significativa com a proteína C-reativa (r=0,37; p<0,001 e r=0,41; p<0,001, respectivamente). Quando incluímos no modelo o IMC e a circunferência da cintura, a aptidão física perdeu a significância. Não houve relação entre atividade física ou aptidão física com os demais marcadores inflamatórios. Conclui-se que nesse grupo de adultos jovens houve relação entre a proteína C-reativa e o VO2max, e que esta associação é explicada pelas modificações no perfil antropométrico decorrentes de altos níveis de aptidão cardiorrespiratória.

Low-intensity chronic systemic inflammation is related to an increased risk of cardiovascular disease. Studies suggest that C-reactive protein, one of the main inflammatory biomarkers, may be inversely related to physical activity levels and physical fitness. The aim of this cross-sectional study was to evaluate the associations between physical activity, fitness and inflammatory biomarkers in apparently healthy men (N=85) aged 18 to 30 years. C-reactive protein, interleukin 6, interleukin 1? and TNF-? were measured using the ELISA method. Physical activity practice was assessed by questionnaire and accelerometry. Maximum oxygen uptake (VO2max) was estimated based on a cycle ergometer incremental test. In the unadjusted analysis, the mean concentration of C-reactive protein in the sample was 1.59±1.16 mg/L, and was inversely correlated with VO2max (r=-0.32, p=0.03), but not with physical activity estimated by accelerometry or questionnaire. Body mass index (BMI) and waist circumference also significantly correlate with C-reactive protein (r=0.37, p<0.001 and r=0.41, p<0.001, respectively). After adjustment for anthropometric characteristics (BMI and waist circumference), the association with fitness was no longer significant. No association was observed between physical activity or fitness levels and the other inflammatory markers. We conclude that in this group of young adults, there was an inverse association between fitness and C-reactive protein, but this association is explained by the influence of fitness on anthropometry.