Is rest-activity rhythm prospectively associated with all-cause mortality in older people regardless of sleep and physical activity level? The 'Como Vai?' Cohort study.

OBJECTIVE: This study aims to test the association of rest-activity rhythm (intradaily variability and interdaily stability) with all-cause mortality in an older adult cohort in Brazil. It also assesses whether the amount of time spent at each intensity level (i.e., physical activity and nocturnal sleep) interferes with this association. METHODS: This cohort study started in 2014 with older adults (≥60 years). We investigated deaths from all causes that occurred until April 2017. Rest-activity rhythm variables were obtained using accelerometry at baseline. Intradaily variability indicates higher rhythm fragmentation, while interdaily stability indicates higher rhythm stability. Cox proportional-hazard models were used to test the associations controlling for confounders. RESULTS: Among the 1451 older adults interviewed in 2014, 965 presented valid accelerometry data. During the follow-up period, 80 individuals died. After adjusting the analysis for sociodemographic, smoking, morbidity score, and number of medicines, an increase of one standard deviation in interdaily stability decreased 26% the risk of death. The adjustment for total sleep time and inactivity did not change this association. On the other hand, the association was no longer significant after adjusting for overall physical activity and moderate to vigorous physical activity. CONCLUSION: Rest-activity rhythm pattern was not associated with mortality when physical activity was considered, possibly because this pattern could be driven by regular exercise. Promoting physical activity remains a relevant strategy to improve population health.

Effects of Regular Exercise During Pregnancy on Early Childhood Neurodevelopment: The Physical Activity for Mothers Enrolled in Longitudinal Analysis Randomized Controlled Trial.

BACKGROUND: The aim of this study was to investigate the effect of exercise during pregnancy on early childhood neurodevelopment (cognitive, motor, and language domains). METHODS: A randomized controlled trial nested into the 2015 Pelotas (Brazil) Birth Cohort was conducted. Healthy pregnant women were enrolled between 16 and 20 weeks of gestation; 424 women and their children (intervention [n = 141]; control [n = 283]) were analyzed. An exercise-based intervention 3 times per week was delivered over 16 weeks. Child neurodevelopment and its domains were assessed at 1, 2, and 4 years. Standardized mean differences and 95% confidence intervals are presented. RESULTS: No effects of exercise during pregnancy on child neurodevelopment and its domains at age 1 year were observed. Compared with the control group, children from women in the exercise group had higher language score at age 2 years (standardized mean differences = 0.23; 95% confidence intervals, 0.02 to 0.44) and higher cognitive score (standardized mean differences = 0.22; 95% confidence intervals, 0.03 to 0.41) at age 4 years. No effects of exercise during pregnancy were observed in the motor domain at 1, 2, and 4 years. CONCLUSIONS: No detrimental effects of exercise during pregnancy on child neurodevelopment were observed. In addition, these findings suggest that exercise during pregnancy can result in small benefits for language and cognitive development.

Physical Activity During Pregnancy and Preterm Birth: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study.

BACKGROUND: Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. METHODS: PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. RESULTS: PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36-0.96) was associated with the outcome. CONCLUSIONS: PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.

Características das instalações e equipamentos para a prática de atividade física em escolas da zona rural de Pelotas, Rio Grande do Sul / Facilities and equipments for physical activity practice in rural schools of Pelotas, Rio Grande do Sul

O objetivo do estudo foi descrever as instalações e equipamentos para atividade física nas escolas da zona rural de Pelotas, Rio Grande do Sul. Trata-se de um estudo transversal, de base escolar, realizado no ano de 2014, em todas as 26 escolas localizadas na zona rural da cidade de Pelotas. Foi utilizado um instrumento com questões relacionadas às políticas de Educação Física e avaliação das estruturas e materiais para a prática de atividade física, elaborado a partir do Physical Activity Resource Assessment (PARA), adaptado para o ambiente escolar. Observou-se que o professor e a disciplina de Educação Física estiveram presentes em todas as escolas. Mesmo com a maior frequência de estruturas como quadras esportivas (34,6% a 65,4%), pracinha/parquinhos (76,9%) e materiais como bolas (50,0% a 84,6%), cones (80,8%), cordas (88,5%), colchonetes (80,8%) e arcos (76,9%), as condições dos atributos foram regulares (7,7% a 46,2%) e ruins (11,5% a 50,0%). Poucas instituições ofereceram instalações e equipamentos em condições adequadas para a prática de atividade física. A ausência de ginásios, quadras cobertas e materiais em melhores condições chama a atenção para a necessidade de investimentos e intervenções nesses espaços

The aim of the study was to describe the facilities and equipment for physical activity practice in rural area schools of Pelotas, Rio Grande do Sul. The design was cross-sectional, school-based, carried out in all the 26 schools located in rural areas of Pelotas Southern, Brazil. We used a survey tool to assess the policies for Physical Education and evaluate the facilities and equipment/materials for physical activity. The instrument was based on the Physical Activity Resource Assessment (PARA), adapted for the school environment. We observed that curricular Physical Education and specific teachers were present in all schools. Despite the high number of facilities, such as courts and fields (34.6% to 65.4%), playgrounds (76.9%) and materials such as balls (50.0% to 84.6%), hoops (88.5%), exercise cones (80.8%) and mats (76.9%), the condition of the facilities and apparatus/equipment were fair (7.7% to 46.2%) or poor (11.5% to 50.0%). Few institutions have provided suitable facilities and equipment for physical activity. The absence of gymnasiums, covered courts and materials in better conditions draws attention to the need for investments and interventions in these spaces

Barreiras à prática de atividades físicas de adolescentes escolares da zona rural do sul do Rio Grande do Sul / Barriers to physical activity in adolescent students from rural area of southern Rio Grande do Sul

O objetivo do presente estudo foi identificar a prevalência de barreiras à prática de atividades físicas e fatores associados em alunos do ensino médio de escolas da zona rural da região sul do Rio Grande do Sul. Foram convidados a participar do estudo todos os alunos matriculados no ensino médio, das 10 escolas compreendidas pela 5ª Coordenadoria Regional de Educação (5ª CRE-RS). O estudo, de delineamento transversal, investigou 510 alunos adolescentes (34% do total da população) que responderam questionário sobre barreiras à prática de atividades físicas e fatores associados. Dos entrevistados, 59,0% eram do sexo feminino, 80,0% tinham entre 15 e 17 anos, 92,3% eram de cor de pele branca e 37,7% estavam cursando o primeiro ano do ensino médio. Mais da metade (53,3%) dos estudantes era suficientemente ativo no lazer e 82,9% encontravam-se na categoria normal de IMC. As barreiras que apresentaram maior prevalência foram: dias de chuva (79,1%), falta de tempo (75,3%) e falta de local adequado para a prática (52,3%). Entre as meninas que relataram oito e nove barreiras, as prevalências de insuficientemente ativas foi, respectivamente de 55,6% e 66,7%, enquanto que, para os meninos que relataram esse mesmo número de barreiras, não houve indivíduos insuficientemente ativos. A única barreira que permaneceu associada a inatividade física no lazer na análise multivariável foi a falta de dinheiro (p=0,03). Conclui-se que mais estudos com adolescentes residentes no meio rural são necessários para se conhecer as necessidades e assim estruturar políticas públicas de incentivo a atividade física.

The aim of the study was to identify the prevalence of barriers to physical activity and associated factors in high school students from rural area of southern Rio Grande do Sul. All students enrolled in high school were invited to participate in the study, ranging from 10 schools for the 5th CRE-RS. Cross-sectional study interviewed 510 adolescent students (34% of the total of the population) who answered a questionnaire about barriers to physical activity and associated factors. Among them, 59.0% were female, 80.0% were between 15 and 17 years, 92.3% were white color and 37.7% were attending the first year of high school. 53.3% of students were active during leisure time and 82.9% were with normal BMI. The more prevalent barriers were: rainy days (79.1%), lack of time (75.3%) and lack of a proper place to practice (52.3%). Among girls who reported eight and nine barriers, the prevalence of insufficient physical activity was respectively 55.6% and 66.7%, whereas for boys who reported the same number of barriers, there were no insufficient active individuals. The only barrier that remained associated with physical inactivity in the multivariate analysis was the lack of money (p = 0.03). We conclude that further studies with adolescents living in rural areas are required to meet the needs and improve public policies to encourage physical activity.