Impact of cycling and walking on adiposity and healthcare costs among adults: longitudinal study.

Leisure-time physical activity seems relevant to prevent the development of chronic diseases and obesity. However, not much is known about the economic burden of these healthy behaviors, mainly in longitudinal designs. This study aimed to analyze the impact of walking and cycling on leisure-time on adiposity and healthcare costs among adults. This longitudinal study was conducted at a medium-size Brazilian city and included 198 participants with no missing data attended in the Brazilian Unified National Health System. Cycling and walking were assessed by a questionnaire with a face-to-face interview at four time-points (baseline, 6-month, 12-month, and 18-month). Healthcare costs were assessed using medical records. Adiposity markers included waist circumference and body fatness. Over the follow-up period, participants who were more engaged in cycling presented lower body fatness (p-value = 0.028) and healthcare costs (p-value = 0.038). However, in the multivariate model, the impact of cycling on costs was not significant (p-value = 0.507) due to the impact of number of chronic diseases (p-value = 0.001). Cycling on leisure-time is inversely related to adiposity in adults, whereas its role on preventing chronic diseases seems the main pathway linking it to cost mitigation.

Impact of cycling and walking on adiposity and healthcare costs among adults: longitudinal study / Impacto do ciclismo e da caminhada na adiposidade e nos custos de saúde em adultos: estudo longitudinal / Impacto de andar en bicicleta y caminar sobre la adiposidad y los costos de salud en adultos: estudio longitudinal

Abstract: Leisure-time physical activity seems relevant to prevent the development of chronic diseases and obesity. However, not much is known about the economic burden of these healthy behaviors, mainly in longitudinal designs. This study aimed to analyze the impact of walking and cycling on leisure-time on adiposity and healthcare costs among adults. This longitudinal study was conducted at a medium-size Brazilian city and included 198 participants with no missing data attended in the Brazilian Unified National Health System. Cycling and walking were assessed by a questionnaire with a face-to-face interview at four time-points (baseline, 6-month, 12-month, and 18-month). Healthcare costs were assessed using medical records. Adiposity markers included waist circumference and body fatness. Over the follow-up period, participants who were more engaged in cycling presented lower body fatness (p-value = 0.028) and healthcare costs (p-value = 0.038). However, in the multivariate model, the impact of cycling on costs was not significant (p-value = 0.507) due to the impact of number of chronic diseases (p-value = 0.001). Cycling on leisure-time is inversely related to adiposity in adults, whereas its role on preventing chronic diseases seems the main pathway linking it to cost mitigation.

Resumo: A atividade física no lazer parece relevante para prevenir o desenvolvimento de doenças crônicas e obesidade. No entanto, pouco se sabe sobre o impacto econômico destes comportamentos saudáveis, principalmente em estudos longitudinais. O objetivo deste estudo foi analisar o impacto da caminhada e do ciclismo como atividades de lazer na adiposidade e nos custos de saúde em adultos. Este estudo longitudinal foi realizado em uma cidade brasileira de médio porte e incluiu 198 participantes sem dados indisponíveis atendidos no Sistema Único de Saúde brasileiro. A caminhada e o ciclismo foram avaliados por meio de questionário e entrevista presencial em quatro momentos (linha de base, 6 meses, 12 meses e 18 meses). Os custos de saúde foram avaliados por meio de prontuários médicos. Os marcadores de adiposidade incluíram circunferência da cintura e gordura corporal. Durante o período de acompanhamento, os participantes que praticavam mais ciclismo apresentaram menos gordura corporal (p = 0,028) e custos de saúde (p = 0,038). Porém, no modelo multivariado, o impacto do ciclismo nos custos deixou de ser significativo (p = 0,507) devido ao impacto do número de doenças crônicas (p = 0,001). O ciclismo no momento de lazer está inversamente relacionado à adiposidade em adultos, enquanto o seu papel na prevenção de doenças crônicas parece ser o principal aspecto que o liga à redução de custos.

Resumen: La actividad física en el ocio parece relevante para prevenir el desarrollo de enfermedades crónicas y la obesidad. Sin embargo, poco se sabe sobre el impacto económico de estos comportamientos saludables, especialmente en estudios longitudinales. El objetivo de este estudio fue analizar el impacto de caminar y andar en bicicleta como actividades de ocio sobre la adiposidad y los costos de salud en adultos. Este estudio longitudinal se llevó a cabo en una ciudad brasileña de tamaño mediano e incluyó a 198 participantes sin datos indisponibles atendidos en el Sistema Único de Salud brasileño. Se evaluaron los hábitos de caminar y andar en bicicleta mediante un cuestionario y una entrevista cara a cara en cuatro momentos (inicial, 6 meses, 12 meses y 18 meses). Los costos de atención médica se evaluaron utilizando registros médicos. Los marcadores de adiposidad incluyeron la circunferencia de la cintura y la grasa corporal. Durante el período de seguimiento, los participantes que practicaban más ciclismo presentaron menos grasa corporal (p = 0,028) y costos de salud (p = 0,038). Sin embargo, en el modelo multivariado, el impacto del ciclismo en los costos dejó de ser significativo (p = 0,507) debido al impacto del número de enfermedades crónicas (p = 0,001). El hábito de andar en bicicleta en los momentos de ocio está inversamente relacionado con la adiposidad en los adultos, mientras que su papel en la prevención de enfermedades crónicas parece ser el principal aspecto que lo vincula con la reducción de costos.

Changes in leisure physical activity, commuting and television watching in men and women users of the Brazilian National Health System in a middle-sized city: 18-months of follow-up / Mudanças na atividade física de lazer, locomoção e tempo de televisão entre homens e mulheres usuários do Sistema Único de Saúde em uma cidade de médio porte: seguimento de 18 meses

Abstract Given the importance of physical activity for health promotion and for the prevention of chronic non-communicable diseases, the Unified Health System (SUS) has changed its strategy of action in the last decades, trying to adopt preventive activities, seeking better quality of life of the Brazilian population and reduce costs with treatment of diseases. The aim of this study was to investigate changes in physical activity and sedentary behavior patterns in users of the Brazilian National Unified Health System during 18 months and the impact of sex and time on such variables. One hundred and ninety-eight participants (58 men and 140 women) were evaluated. Physical activity level was assessed using the Baecke questionnaire. Men had higher scores in all physical activity variables compared to women: walking (p-value= 0.013), cycling (p-value= 0.001) and commuting (p-value= 0.007), but not for TV watching (p-value= 0.362). After 18 months, in the overall sample, walking score increased 25.9% (95%CI= 10.6 to 41.1), but not cycling (1.5% [95%CI= -2.7 to 5.7]), commuting (14.4% [95%CI= -0.4 to 29.3]) and TV watching (1.6% [95%CI= -5.7 to 9.1]). Men were usually more active than women in active behaviors, but not in TV watching. However, differences over time were similar between sexes.

Resumo Dada a importância da atividade física para promoção da saúde, assim como para a prevenção de doenças crônicas não transmissíveis, o Sistema Único de Saúde (SUS) mudou a estratégia de atuação nas últimas décadas, procurando adotar atividades preventivas, buscando melhorar a qualidade de vida da população brasileira e diminuir gastos com tratamento de doenças. Objetivou-se investigar as mudanças na prática de atividade física e tempo de televisão em usuários do SUS durante um período de 18 meses e o impacto do sexo e tempo nessas variáveis. Foram avaliados 198 participantes (58 homens e 140 mulheres). Nível de atividade física foi mensurado através do questionário de Baecke. Homens apresentaram maiores escores em todas as variáveis de atividade física: caminhada (p-valor 0,013), ciclismo (p-valor 0,001) e locomoção (p-valor 0,007) do que mulheres, mas não para assistir televisão (p-valor= 0,362). Após 18 meses, em toda a amostra, o escore de caminhada aumentou 25,9% (IC95%= 10,6 - 41,1), mas não ciclismo (1,5% [95%CI= -2,7 - 5,7]), locomoção (14,4% [95%CI= -0,4 - 29,3]) e televisão (1,6% [95%CI= -5,7 - 9,1]). Entre usuários do SUS, homens foram usualmente mais ativos que mulheres em comportamentos ativos, mas não ao assistir televisão. Porém, diferenças ao longo do tempo foram similares entre os sexos.

Can participation in sports during childhood influence physical activity in adulthood?

Abstract Aims: The promotion of sports participation during the early years of life is important not only because it promotes health during childhood and adolescence, but also because it has benefits in adulthood. This study was developed to identify the association between sports participation during the early years of life and adulthood, to analyze the non-participation in sports throughout life and to identify the correlates of non-participation in sports. DESIGN: Cross-sectional study. Methods: The sample was composed of 743 adults randomly selected in a medium-size Brazilian city. Non-participation in sports during childhood and adolescence was assessed through specific questions, and non-participation in sports in adulthood was assessed using the second section of Baecke questionnaire. Answering "no" in the three periods assessed (childhood, adolescence and adulthood) was characterized as non-participation in sports throughout life. Chronological age, sex, formal education, BMI, current job and ethnicity were considered covariates. Categorical data were expressed as rates and compared using chi-square test and binary logistic regression. Results: The prevalence of adults not engaged in sports throughout life was 58.5% (95% CI= 55.1 - 62.1). Females (OR = 2.41 [1.71 - 3.38]), those more advanced in age (OR = 3.29 [1.82-5.94]) and/or possessing a lower level of education (OR = 4.47 [2.45 - 8.17]) were associated with the non-engagement in sports. Conclusion: Non-participation in sports during childhood can influence non-participation in sports during adulthood, which is significantly affected by sex, age and education level.

Agressividade no futebol de campo: uma análise quantitativa das partidas da Copa do Mundo de 2010 / Aggressiveness in football: a quantitative analysis of the 2010 World Cup matches

O objetivo foi analisar em jogos de futebol da copa do Mundo de 2010, a ocorrência de faltas violentas e seus determinantes. Foram analisados 16 jogos da fase final dessa competição. Estes jogos foram gravados na íntegra e analisados por dois avaliadores treinados, caso houvesse algum lance capital que gerasse dúvida, um terceiro avaliador auxiliaria na decisão. A descrição dos dados foi feita em forma de taxas/prevalências. A correlação de Spearman foi empregada para analisar o relacionamento entre as variáveis. O teste qui-quadrado analisou a associação e a magnitude das associações foi observada pela Regressão Logística Binária. Ao todo, 18,4% das faltas foram consideradas violentas, e equipes européias foram as mais faltosas. O maior número de faltas ocorreu no segundo tempo; goleiros/zagueiros foram quem mais utilizaram esta infração. O local do campo com mais faltas foi a defesa. Houve associação entre gravidade da falta e ocorrência de cartões (p= 0,001), e correlação entre nível da falta e grau de punição (r= 0.65; p= 0,001). Local do campo parece ser determinante na ocorrência de ações violentas no futebol de alto nível.

The objective was to analyze in matches of soccer World Cup 2010, the occurrence of violent fouls and its determinants. We analyzed 16 finals matches of the World Cup 2010. These matches were recorded and analyzed by two trained evaluators, if there were any doubtful lance, a third evaluator would assist in the decision. Analysis of the data was taken in the form of rates/prevalence. Spearman correlation examined the relationship between variables. Chi-square test analyzed the association and magnitude was observed for Binary Logistic Regression. Altogether, 18.4% of the fouls were classified as violent, and who were more used European teams. The largest number of fouls occurred in the second half; goalkeepers/defenders were more who used this infraction. The location of the field with more fouls was the defense. There was an association between the severity of fouls and occurrence of cards (p= 0.001), and correlation between the level and degree of punishment (r= 0.65, p= 0.001). Location of the field seems to be determinant in the occurrence of violent acts in high-level football.