Ten-Year Changes in the Physical Activity and Sedentary Behaviors of Adults: An Analysis of the 2 Cross-Sectional Observation of Cardiovascular Risk Factors in Luxembourg Studies.

BACKGROUND: Monitoring population physical activity (PA) and sedentary behavior over time is important to guide public health actions. The objective of this study was to investigate the changes in PA and sedentary behavior of adult residents in Luxembourg over 10 years. We also investigated variations in change over time across sociodemographic subgroups. METHODS: Two population-based cross-sectional studies of adults living in Luxembourg (Observation of Cardiovascular Risk Factors in Luxembourg [ORISCAV-LUX] [2007-2008] and ORISCAV-LUX 2 [2016-2018]) were considered. Multilevel mixed-effects models were used to investigate changes over time between the studies with regard to self-reported total PA (metabolic equivalent of task-min/week), PA levels (inactive/sufficiently active/highly active), total sitting time, recreational television viewing, and personal computer (PC) use outside of work (in minutes per day). RESULTS: The ORISCAV-LUX study included 1318 participants and the ORISCAV-LUX 2 study involved 1477 participants; 573 adults took part in both studies. The proportion of participants categorized as highly active increased over time by 6.9%. Total PA (761 metabolic equivalent of task-min/wk), television viewing (12 min/d), and PC use outside of work (13 min/d) also increased, whereas the total sitting time decreased by 25 minutes per day. Variations in change over time were observed by sex, country of birth, education, employment status, and perceived financial difficulty. CONCLUSIONS: Over a 10-year period, PA increased and total sitting time decreased in adults living in Luxembourg. With regard to specific sedentary behaviors, television viewing, and PC use outside of work increased. Specific population subgroups will benefit the most from targeted efforts to increase PA and minimize sedentary behavior.

Food consumption scale validation in VAMOS Program: a proposal to assess eating behavior changes in Brazil / Validação da escala de consumo alimentar no Programa VAMOS: uma proposta para avaliar as mudanças no comportamento alimentar no Brasil

Abstract This study aimed to validate the frequency consumption scale (FCS) and establish cut-off points to assess changes in the eating behavior of participants in the VAMOS Program. The study was based on a community intervention conducted in 2019 in 70 Brazilian cities, with 458 adults from Primary Care. The questionnaire consisted of 12 questions about food frequency consumption. The questions were inserted into the analytical workflow, divided into the descriptive analysis, exploratory and confirmatory factor analysis (EFA), item response theory (IRT) modeling, and construction and validity of an applied questionnaire score. EFA indicated a two-factor structure, with three "healthy" (raw vegetables, fruits, and cooked vegetables) and three "unhealthy" (sugary drinks, sweets, and the replacement of meals with snacks) eating items. Items responses' probabilities indicate a daily consumption of two healthy and once or nonweekly consumption of unhealthy items. Finally, the four categories proposed for FCS can respond over time. Therefore, the FCS proposal can be used effectively for program nutrition evaluation. Furthermore, it is possible to attribute behavior change in Brazilian primary care users with six items.

Resumo Este estudo teve como objetivo validar a escala de consumo de frequência (ECF) e estabelecer pontos de corte para avaliar mudanças no comportamento alimentar dos participantes do Programa VAMOS. O estudo baseou-se em uma intervenção comunitária realizada em 2019 em 70 cidades brasileiras, com 458 adultos da Atenção Básica. O questionário era composto por 12 questões sobre o consumo de frequência alimentar. As questões foram inseridas no fluxo de trabalho analítico, divididas em análise descritiva, análise fatorial exploratória e confirmatória (EFA), modelagem da teoria de resposta ao item (TRI) e construção e validade de um escore de questionário aplicado. EFA indicou uma estrutura de dois fatores, com três itens alimentares "saudáveis" (vegetais crus, frutas e vegetais cozidos) e três "não saudáveis" (bebidas açucaradas, doces e a substituição de refeições por lanches). As probabilidades das respostas dos itens indicam um consumo diário de dois itens saudáveis e um consumo único ou não semanal de itens não saudáveis. Por fim, as quatro categorias propostas para o ECF podem fornecer respostas ao longo do tempo. A proposta do ECF pode ser usada efetivamente para avaliação nutricional do programa. Além disso, é possível atribuir a mudança de comportamento em usuários da atenção básica brasileira com seis itens.

Food consumption scale validation in VAMOS Program: a proposal to assess eating behavior changes in Brazil.

This study aimed to validate the frequency consumption scale (FCS) and establish cut-off points to assess changes in the eating behavior of participants in the VAMOS Program. The study was based on a community intervention conducted in 2019 in 70 Brazilian cities, with 458 adults from Primary Care. The questionnaire consisted of 12 questions about food frequency consumption. The questions were inserted into the analytical workflow, divided into the descriptive analysis, exploratory and confirmatory factor analysis (EFA), item response theory (IRT) modeling, and construction and validity of an applied questionnaire score. EFA indicated a two-factor structure, with three "healthy" (raw vegetables, fruits, and cooked vegetables) and three "unhealthy" (sugary drinks, sweets, and the replacement of meals with snacks) eating items. Items responses' probabilities indicate a daily consumption of two healthy and once or nonweekly consumption of unhealthy items. Finally, the four categories proposed for FCS can respond over time. Therefore, the FCS proposal can be used effectively for program nutrition evaluation. Furthermore, it is possible to attribute behavior change in Brazilian primary care users with six items.

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.

Barriers and facilitators of domain-specific physical activity: a systematic review of reviews.

BACKGROUND: Knowing what facilitates and hinders physical activity behaviour across domains (leisure, travel, work or education, and household) is central for the development of actions for more active lifestyles. Thus, the aim of this systematic review of reviews was to summarize the evidence on barriers and facilitators of domain-specific physical activity. METHODS: We included systematic reviews with or without meta-analysis that investigated the association between modifiable barriers and facilitators and levels of domain-specific physical activity. Reviews published until September 2020 were retrieved from PubMed, ISI Web of Science, Scopus, Regional Library of Medicine (BIREME), and PsycNET, and from the reference list of selected articles. Each review was screened by two independent reviewers for eligibility. Data extracted from selected papers included methodological aspects (number of primary studies, study designs, and age groups); physical activity domains and barriers and facilitators investigated; and direction of association. For each pair of barrier/facilitator and domain-specific physical activity, we recorded the number of positive, negative, and null associations reported across reviews. Quality assessment of each systematic review was performed using the AMSTAR-2 tool. RESULTS: Forty-four systematic reviews were selected. The evidence base was largest for leisure-time followed by travel-related physical activity. A very small number of reviews included physical activity in work, educational and domestic settings. Across all physical activity domains, factors related to the built environment were more abundant in the reviews than intra and interpersonal factors. Very consistent positive associations were observed between a range of intrapersonal factors and leisure-time physical activity, as well as moderately consistent evidence of positive association for general social support and support from family members. Evidence of moderate consistency was found for the positive association between transport-related physical activity and positive beliefs about consequences, walkability, and existence of facilities that support active travel. Evidence on barriers and facilitators for physical activity at work, educational, and domestic settings was limited in volume and consistency. CONCLUSIONS: Efforts and resources are required to diversify and strength the evidence base on barriers and facilitators of domain-specific physical activity, as it is still limited and biased towards the leisure domain and built environment factors. TRIAL REGISTRATION: PROSPERO CRD42020209710.

Barreiras e facilitadores para a prática de atividade física em diferentes domínios no Brasil: uma revisão sistemática / Barriers and facilitators for physical activity domains in Brazil: a systematic review

Resumo O objetivo foi revisar sistematicamente as evidências científicas sobre as barreiras e os facilitadores para a prática de atividade física (AF) na população brasileira, considerando os diferentes domínios (lazer, deslocamento, trabalho/estudo e tarefas domésticas). A busca foi conduzida nas bases de dados MEDLINE/PubMed, ISI Web of Science, Scopus, BIREME/LILACS e APA PsycNET, considerando o período de 2010 a 2020. Posteriormente, foi incluída a busca na Revista Brasileira de Atividade Física e Saúde. O processo de seleção consistiu na leitura de títulos e resumos, seguida de textos na íntegra. A avaliação foi realizada por pares e, mediante discrepância, um terceiro revisor era consultado. O domínio do lazer e as barreiras e os facilitadores ambientais foram os mais investigados nos 78 artigos incluídos. Houve consistência nas associações positivas de seis diferentes facilitadores pessoais e sociais para o lazer e um fator ambiental para o deslocamento. Encontrou-se um número reduzido de investigações sobre os domínios de trabalho/estudo e tarefas domésticas, sendo importante o incentivo a futuras investigações acerca das barreiras e dos facilitadores pessoais e sociais relacionados à AF de deslocamento.

Abstract This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

Barriers and facilitators for physical activity domains in Brazil: a systematic review. / Barreiras e facilitadores para a prática de atividade física em diferentes domínios no Brasil: uma revisão sistemática.

This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

O objetivo foi revisar sistematicamente as evidências científicas sobre as barreiras e os facilitadores para a prática de atividade física (AF) na população brasileira, considerando os diferentes domínios (lazer, deslocamento, trabalho/estudo e tarefas domésticas). A busca foi conduzida nas bases de dados MEDLINE/PubMed, ISI Web of Science, Scopus, BIREME/LILACS e APA PsycNET, considerando o período de 2010 a 2020. Posteriormente, foi incluída a busca na Revista Brasileira de Atividade Física e Saúde. O processo de seleção consistiu na leitura de títulos e resumos, seguida de textos na íntegra. A avaliação foi realizada por pares e, mediante discrepância, um terceiro revisor era consultado. O domínio do lazer e as barreiras e os facilitadores ambientais foram os mais investigados nos 78 artigos incluídos. Houve consistência nas associações positivas de seis diferentes facilitadores pessoais e sociais para o lazer e um fator ambiental para o deslocamento. Encontrou-se um número reduzido de investigações sobre os domínios de trabalho/estudo e tarefas domésticas, sendo importante o incentivo a futuras investigações acerca das barreiras e dos facilitadores pessoais e sociais relacionados à AF de deslocamento.

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study

ABSTRACT BACKGROUND: Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed. OBJECTIVE: To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults. DESIGN AND SETTING: Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district. METHODS: The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age. RESULTS: Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001). CONCLUSIONS: To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study.

BACKGROUND: Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed. OBJECTIVE: To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults. DESIGN AND SETTING: Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district. METHODS: The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age. RESULTS: Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001). CONCLUSIONS: To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.

Clustering of Physical Activity and Sedentary Behavior Associated With Body Composition in Brazilian Older Adults.

This study described the clustering patterns of moderate to vigorous physical activity and sedentary time (ST) according to handgrip strength and investigated the association between identified clusters of fat and lean mass in older adults from southern Brazil. Objective measures were used for moderate to vigorous physical activity, ST, and body composition outcomes. Two-step cluster and linear regression analyses were conducted according to handgrip strength. Three clusters were identified: all-day sitters, sitters, and active sitters. The prevalence of clusters in the low-strength group was 58.2%, 22.8%, and 19.0%, respectively, while the prevalence of clusters in the high-strength group was 42.1%, 34.8%, and 23.1%, respectively. All-day sitters had 2.6% more fat mass than active sitters with low strength. High levels of ST characterized all cluster profiles; low strength, lack of moderate to vigorous physical activity, and high ST levels among older adults may indicate a subpopulation at a greater risk of overweight and obesity-related diseases.

[Association between excessive TV viewing time and body mass index among Brazilian adolescents: quantile regression analysis of the National Student Health Survey (PeNSE), 2015]. / Associação entre tempo excessivo frente à TV e índice de massa corporal em adolescentes brasileiros: uma análise de regressão quantílica da PeNSE, 2015.

The study aimed to investigate whether excessive TV viewing time is associated with body mass index (BMI), irrespective of physical activity (PA) and interaction with consumption of ultra-processed foods (UPFs), among Brazilian adolescents. It is a cross-sectional study with data on 13-17-year-old adolescents from the 2015 National Student Health Survey. BMI was the outcome (direct measurement of height and body mass) and exposure was excessive TV viewing time (>2 h/day), daily consumption of UPFs and PA. Quantile regression was used to test associations and interactions. Excessive screen time was associated with higher BMI values (e.g., 25th percentile =0.060 kg/m² versus 95th percentile =0.891 kg/m², p<0.001). After adjusting for PA, the association remained, however, attenuated. The inclusion of UPFs in the model potentiated the association (e.g., 25th percentile =0.062 kg/m² versus 95th percentile =0.956 kg/m², p<0.001). Excessive screen time was associated with BMI percentiles, irrespective of PA - the absence of PA and the presence of UPF consumption affect the upper BMI percentiles more. Actions to reduce excessive TV viewing time, consumption of UPFs and promoting PA are essential to positively impact BMI and its reflexes on the health of Brazilian adolescents.

O objetivo do estudo foi investigar se tempo excessivo frente à TV está associado com índice de massa corporal (IMC), independente da atividade física (AF) e da interação com consumo de alimentos ultraprocessados (AUPs), em adolescentes brasileiros. Estudo transversal com dados de adolescentes de 13-17 anos da Pesquisa Nacional de Saúde do Escolar 2015. IMC foi o desfecho (medida direta da estatura e massa corporal) e as exposições foram tempo excessivo frente à TV (>2 h/dia), consumo diário de AUPs e AF. Regressão quantílica foi usada para testar associações e interações. Tempo excessivo frente à TV foi associado a maiores valores de IMC (ex.: 25º percentil =0,060 kg/m² versus 95º percentil =0,891 kg/m², p<0,001). Após ajuste para AF, a associação se manteve, porém, atenuada. A inclusão de AUPs no modelo potencializou a associação (ex.: 25º percentil =0,062 kg/m² versus 95º percentil =0,956 kg/m², p<0,001). Tempo excessivo frente à TV foi associado a percentis do IMC, independente da AF - ausência da AF e presença do consumo de AUPs afetam mais os percentis superiores do IMC. Ações para reduzir tempo excessivo frente à TV, consumo de AUPs e fomentar AF, são essenciais para impactar positivamente no IMC e seus reflexos na saúde dos adolescentes brasileiros.

Associação entre tempo excessivo frente à TV e índice de massa corporal em adolescentes brasileiros: uma análise de regressão quantílica da PeNSE, 2015 / Association between excessive TV viewing time and body mass index among Brazilian adolescents: quantile regression analysis of the National Student Health Survey (PeNSE), 2015

Resumo O objetivo do estudo foi investigar se tempo excessivo frente à TV está associado com índice de massa corporal (IMC), independente da atividade física (AF) e da interação com consumo de alimentos ultraprocessados (AUPs), em adolescentes brasileiros. Estudo transversal com dados de adolescentes de 13-17 anos da Pesquisa Nacional de Saúde do Escolar 2015. IMC foi o desfecho (medida direta da estatura e massa corporal) e as exposições foram tempo excessivo frente à TV (>2 h/dia), consumo diário de AUPs e AF. Regressão quantílica foi usada para testar associações e interações. Tempo excessivo frente à TV foi associado a maiores valores de IMC (ex.: 25º percentil =0,060 kg/m² versus 95º percentil =0,891 kg/m², p<0,001). Após ajuste para AF, a associação se manteve, porém, atenuada. A inclusão de AUPs no modelo potencializou a associação (ex.: 25º percentil =0,062 kg/m² versus 95º percentil =0,956 kg/m², p<0,001). Tempo excessivo frente à TV foi associado a percentis do IMC, independente da AF - ausência da AF e presença do consumo de AUPs afetam mais os percentis superiores do IMC. Ações para reduzir tempo excessivo frente à TV, consumo de AUPs e fomentar AF, são essenciais para impactar positivamente no IMC e seus reflexos na saúde dos adolescentes brasileiros.

Abstract The study aimed to investigate whether excessive TV viewing time is associated with body mass index (BMI), irrespective of physical activity (PA) and interaction with consumption of ultra-processed foods (UPFs), among Brazilian adolescents. It is a cross-sectional study with data on 13-17-year-old adolescents from the 2015 National Student Health Survey. BMI was the outcome (direct measurement of height and body mass) and exposure was excessive TV viewing time (>2 h/day), daily consumption of UPFs and PA. Quantile regression was used to test associations and interactions. Excessive screen time was associated with higher BMI values (e.g., 25th percentile =0.060 kg/m² versus 95th percentile =0.891 kg/m², p<0.001). After adjusting for PA, the association remained, however, attenuated. The inclusion of UPFs in the model potentiated the association (e.g., 25th percentile =0.062 kg/m² versus 95th percentile =0.956 kg/m², p<0.001). Excessive screen time was associated with BMI percentiles, irrespective of PA - the absence of PA and the presence of UPF consumption affect the upper BMI percentiles more. Actions to reduce excessive TV viewing time, consumption of UPFs and promoting PA are essential to positively impact BMI and its reflexes on the health of Brazilian adolescents.

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study

ABSTRACT BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

Using Multilevel Regression and Poststratification to Estimate Physical Activity Levels from Health Surveys.

BACKGROUND: Large-scale health surveys often consider sociodemographic characteristics and several health indicators influencing physical activity that often vary across subpopulations. Data in a survey for some small subpopulations are often not representative of the larger population. OBJECTIVE: We developed a multilevel regression and poststratification (MRP) model to estimate leisure-time physical activity across Brazilian state capitals and evaluated whether the MRP outperforms single-level regression estimates based on the Brazilian cross-sectional national survey VIGITEL (2018). METHODS: We used various approaches to compare the MRP and single-level model (complete-pooling) estimates, including cross-validation with various subsample proportions tested. RESULTS: MRP consistently had predictions closer to the estimation target than single-level regression estimations. The mean absolute errors were smaller for the MRP estimates than single-level regression estimates with smaller sample sizes. MRP presented substantially smaller uncertainty estimates compared to single-level regression estimates. Overall, the MRP was superior to single-level regression estimates, particularly with smaller sample sizes, yielding smaller errors and more accurate estimates. CONCLUSION: The MRP is a promising strategy to predict subpopulations' physical activity indicators from large surveys. The observations present in this study highlight the need for further research, which could, potentially, incorporate more information in the models to better interpret interactions and types of activities across target populations.

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study.

BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

Multidimensional characteristics of young Brazilian volleyball players: A Bayesian multilevel analysis.

Brazil has been the benchmark for volleyball performance for at least two decades, providing a unique context to examine expertise development. This study examined the variation in body size, functional capacities, motivation for achievement, competitiveness, and deliberate practice of youth volleyball players associated with differences in biological maturity status, chronological age, and accumulated deliberate volleyball practice, adopting a Bayesian multilevel modeling approach. We considered 68 female and 94 male adolescent players (14.2 years, 90% confidence interval: 12.7 to 16.0). Players were grouped by the onset of deliberate volleyball practice as related to biologic maturation milestones [pre-puberty deliberate practice onset (12% of the sample), mid-puberty deliberate practice onset (51% of the sample), and late-puberty deliberate practice onset (37% of the sample). There was substantial variation in body dimensions and functional performance by gender. There was no variation by gender for motivation for deliberate practice and motivation for achievement and competitiveness. The young volleyball players appeared to be highly motivated and committed to deliberate practice, achievement, and competitiveness. Alignment of chronological age, biological maturation, and accumulated training experience allow more in-depth insights into young volleyball players' development, providing sounder support for coaches´ decisions.

Validade e clareza dos conceitos e terminologias do Guia de Atividade Física para a População Brasileira / Validity and Clarity of the Concepts and Terminologies of the Physical Activity Guidelines for the Brazilian Population

Nosso objetivo foi avaliar a validade e a clareza dos conceitos e terminologias adotados na elaboração do Guia de Atividade Física para a População Brasileira (Guia). O Grupo de Trabalho Domínios da Atividade Física (GT Domínios) conduziu a avaliação da validade e da clareza dos conceitos e terminologias relacionados a atividade física (AF), comportamento sedentário, domínios (tempo livre, deslocamento, trabalho ou estudo e tarefas domésticas) e intensidades da AF (leve, moderada e vigorosa), em três etapas: 1- Proposição dos conceitos; 2- Escuta com pesquisadores (dois momen-tos); 3- Consulta pública. Os conceitos propostos pelo GT Domínios foram baseados em guias in-ternacionais, artigos científicos, relatórios nacionais e conhecimentos técnico-científicos-acadêmicos dos integrantes do GT Domínios, discutidos em reuniões (etapa 1). Na escuta com pesquisadores (etapa 2) foram testadas a validade e a clareza dos conceitos em dois momentos. Participaram 70 e 40 pesquisadores vinculados aos outros GT do Guia no primeiro e segundo momentos, respectiva-mente. Em ambas as escutas, todos os conceitos apresentaram índice de concordância para validade e clareza igual ou superior a 80%. As sugestões convergentes indicadas na etapa 2 foram incluídas e novas versões dos conceitos foram disponibilizadas para a terceira etapa (consulta pública) realizada pelo Ministério da Saúde. Foram realizadas 14 sugestões relacionadas aos conceitos que foram aceitas e incorporadas ao texto do Guia, quando pertinentes. Conclui-se que os conceitos e terminologias relacionados a AF propostos pelo GT Domínios para compor o Guia, após a avaliação de pesquisa-dores especialistas e da população consultada, são válidos e claros

We evaluated the validity and clarity of the concepts and terminologies adopted to develop the Physical Activity Guidelines for the Brazilian Population (Guidelines). The Physical Activity Domains Working Group (Domains WG) assessed the validity and clarity of the following concepts: physical activity, seden-tary behavior, PA domains (free time, commuting, work or study, and domestic tasks) and intensities (light, moderate and vigorous). The concepts were evaluated in three stages: 1- Concept proposition; 2- Expert consultation (two steps); 3- Public consultation. The concepts proposed by the Domains WG were based on international guidelines, scientific articles, official documents from the Ministry of Health, and techni-cal-scientific-academic knowledge of the Domains WG members, discussed in a series of meetings (stage 1). In the second stage (expert consultation), validity and clarity of the concepts were tested on two occasions. Seventy and forty researchers working in the other Guidelines WGs contributed to first and second steps, respectively. In both occasions, validity and clarity agreement were equal to or greater than 80% for all concepts. Suggestions provided in step 2 were adopted, and new versions of the concepts were made available for the third step, a public consultation carried out by the Ministry of Health. Fourteen suggestions related to the concepts were made and, when relevant, included in the Guidelines. According to the assessment and suggestions by experts and members of the public, the concepts and terminologies proposed by the Domains WG for the Guidelines are valid and clear

Simultaneity of chronic noncommunicable diseases in 2013 in Brazilian state capital cities: prevalence and demographic profile. / Simultaneidade de doenças crônicas não transmissíveis em 2013 nas capitais brasileiras: prevalência e perfil sociodemográfico.

OBJECTIVE: to describe the prevalence and sociodemographic profile of chronic noncommunicable disease (CNCDs) simultaneity in adults and elderly people resident in Brazilian state capital cities. METHODS: Chronic Noncommunicable Disease Risk and Protection Factor Surveillance System Survey 2013; simultaneity was considered to be two or more CNCDs (diabetes mellitus, dyslipidemia, hypertension, and obesity). RESULTS: of the total 52,929 participants, 13.7% of adult participants and 42.9% of elderly participants had CNCD simultaneity; hypertension and diabetes mellitus simultaneity was greater in adults, while hypertension and obesity simultaneity was greater in the elderly; simultaneity was more prevalent in women, in those between 50 and 59 years old, with partners and up to eight years of schooling; the cities with the lowest and highest prevalence in adults were São Luís and Cuiabá, respectively, while in the elderly, the cities were Belém and Manaus, respectively. CONCLUSION: simultaneity was identified nationwide; prevention measures should be directed especially toward treatment of hypertension.

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.

Simultaneidade de doenças crônicas não transmissíveis em 2013 nas capitais brasileiras: prevalência e perfil sociodemográfico / Simultaneidad de enfermedades crónicas no transmisibles en 2013 en las capitales brasileñas: prevalencia y perfil demográfico / Simultaneity of chronic noncommunicable diseases in 2013 in Brazilian state capital cities: prevalence and demographic profile

Objetivo: descrever a prevalência e o perfil sociodemográfico da simultaneidade de doenças crônicas não transmissíveis (DCNTs) em adultos e idosos das capitais brasileiras. Métodos: Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas não Transmissíveis (Vigitel), realizado em 2013; a simultaneidade considerou duas ou mais DCNTs (diabetes mellitus, dislipidemia, hipertensão e obesidade). Resultados: dos 52.929 participantes, 13,7% dos adultos e 42,9% dos idosos tiveram simultaneidade de DCNT; houve maior agrupamento da hipertensão com diabetes mellitus em adultos, e hipertensão com obesidade em idosos; a simultaneidade foi mais prevalente em mulheres, na idade entre 50 e 59 anos, com companheiro, e de escolaridade até oito anos de estudo; as cidades com menor e maior prevalência em adultos, respectivamente, foram São Luís e Cuiabá, e em idosos, Belém e Manaus. Conclusão: a simultaneidade foi identificada no contexto nacional; medidas de prevenção devem ser direcionadas especialmente ao tratamento da hipertensão.

Objetivo: describir la prevalencia y el perfil sociodemográfico de la simultaneidad de enfermedades crónicas no transmisibles (ECNT) en adultos y ancianos de las capitales brasileñas. Métodos: Sistema de Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas no Transmisibles (Vigitel), realizado en 2013; la simultaneidad consideró dos o más ECNT (diabetes mellitus, dislipidemia, hipertensión y obesidad). Resultados: en 52.929 participantes, 13,7% de los adultos y el 42,9% de los ancianos presentaron simultaneidad de ECNT; hubo mayor agrupamiento de hipertensión con diabetes mellitus en adultos e hipertensión con obesidad en ancianos; la mayor prevalencia fue en mujeres, con edad entre 50 y 59 años, con compañero y escolaridad de hasta ocho años; las ciudades con menor y mayor prevalencia, respectivamente, en adultos fueron São Luís y Cuiabá, y en los ancianos, Belém y Manaus. Conclusión: la simultaneidad se identificó en el contexto nacional, y medidas de prevención deben ser dirigidas especialmente al tratamiento de la hipertensión.

Objective: to describe the prevalence and sociodemographic profile of chronic noncommunicable disease (CNCDs) simultaneity in adults and elderly people resident in Brazilian state capital cities. Methods: Chronic Noncommunicable Disease Risk and Protection Factor Surveillance System Survey 2013; simultaneity was considered to be two or more CNCDs (diabetes mellitus, dyslipidemia, hypertension, and obesity). Results: of the total 52,929 participants, 13.7% of adult participants and 42.9% of elderly participants had CNCD simultaneity; hypertension and diabetes mellitus simultaneity was greater in adults, while hypertension and obesity simultaneity was greater in the elderly; simultaneity was more prevalent in women, in those between 50 and 59 years old, with partners and up to eight years of schooling; the cities with the lowest and highest prevalence in adults were São Luís and Cuiabá, respectively, while in the elderly, the cities were Belém and Manaus, respectively. Conclusion: simultaneity was identified nationwide; prevention measures should be directed especially toward treatment of hypertension.