Impact on the physical activity level of adults at high and very high risk of developing type 2 diabetes mellitus: email follow-up intervention

Aims: The present study aimed to assess the effect of a 24-week intervention on the physical activity level among adults at risk of developing type 2 diabetes mellitus (DM2). Methods: It was included 129 individuals of both sexes who underwent the Preventive Health Check-up at the Albert Einstein Israelita Hospital between January and August 2010 and who were at high and very high risk of developing DM2. The risk of developing DM2 was assessed according to the FINDRISC criteria. All participants were evaluated by the International Physical Activity Questioner (IPAQ). Subjects were followed-up for 24 weeks by a physical education professional through emails during a 6 month period. The IPAQ was sent by email after 3 and 6 months of follow-up. Statistical analysis was performed using the chi-square test with p<0.05 and the Yule Coefficient test. Results: At baseline of the follow-up period, 80.3% of individuals failed to comply with the recommended weekly physical activity. In the end, motivational intervention by e-mail encouraged 74.2% of individuals to comply with the weekly-recommended physical activity and only 1.5% were classified as sedentary. Conclusion: Therefore, the follow-up protocol conducted by periodic and personalized e-mails proved to be effective in promoting physical activity among people at risk of developing metabolic diseases.(AU)

Physical activity as a protective factor for development of non-alcoholic fatty liver in men.

OBJECTIVE: To determine the impact of physical activity on the prevalence of fatty liver, metabolic and cardiovascular disease in adult men. METHODS: This study evaluated 1,399 men (40.7±8.18 years) with body mass index of 26.7kg/m2 (±3.4) who participated in the Protocol of Preventive Health Check-up at Hospital Israelita Albert Einstein from January to October 2011. We conducted tests of serum blood glucose, total cholesterol, LDL, HDL, triglycerides, reactive c-protein, aspartate transaminase, alanine transaminase and gamma-glutamyl transpeptidase. The statistical analysis comprised in the comparison of mean and standard deviation. The analysis of variance was based in two paths of two way ANOVA, Student's t-test, Mann Whitney U test, Wald test and χ2. We considered a significance level at p<0.05 and correlation of univariate Poison with 95% confidence interval. RESULTS: Fatty liver was diagnosed in 37.0% of the sample. Triglyceride levels of active men with fatty liver were 148.2±77.6mg/dL while inactive men with fatty liver had 173.4±15.6mg/dL. The remaining serum levels were normal. Inactive individuals showed higher values than active. In addition, inactive individuals have 10.68 times higher risk of developing fatty liver compared with active. CONCLUSION: Physical activity improves metabolic parameters such as triglycerides, weight control, HDL, which interfere in the development of fatty liver. Physically active individuals had lower fatty liver prevalence regardless of values of body composition and lipid profile, leading the conclusion that physical activity has a protective role against development of fatty liver.

Physical activity as a protective factor for development of non-alcoholic fatty liver in men / Atividade física como fator de proteção para o desenvolvimento de esteatose hepática não alcoólica em homens / Atividade física como fator de proteção para o desenvolvimento de esteatose hepática não alcoólica em homens

Objective To determine the impact of physical activity on the prevalence of fatty liver, metabolic and cardiovascular disease in adult men. Methods This study evaluated 1,399 men (40.7±8.18 years) with body mass index of 26.7kg/m2 (±3.4) who participated in the Protocol of Preventive Health Check-up at Hospital Israelita Albert Einstein from January to October 2011. We conducted tests of serum blood glucose, total cholesterol, LDL, HDL, triglycerides, reactive c-protein, aspartate transaminase, alanine transaminase and gamma-glutamyl transpeptidase. The statistical analysis comprised in the comparison of mean and standard deviation. The analysis of variance was based in two paths of two way ANOVA, Student’s t-test, Mann Whitney U test, Wald test and χ2. We considered a significance level at p<0.05 and correlation of univariate Poison with 95% confidence interval. Results Fatty liver was diagnosed in 37.0% of the sample. Triglyceride levels of active men with fatty liver were 148.2±77.6mg/dL while inactive men with fatty liver had 173.4±15.6mg/dL. The remaining serum levels were normal. Inactive individuals showed higher values than active. In addition, inactive individuals have 10.68 times higher risk of developing fatty liver compared with active. Conclusion Physical activity improves metabolic parameters such as triglycerides, weight control, HDL, which interfere in the development of fatty liver. Physically active individuals had lower fatty liver prevalence regardless of values of body composition and lipid profile, leading the conclusion that physical activity has a protective role against development of fatty liver. .

Objetivo Determinar o impacto do nível de atividade física na prevalência de esteatose hepática, perfil metabólico e comportamento cardiovascular em homens adultos. Métodos Foram avaliados 1.399 homens (40,7±8,18 anos) com índice massa corporal de 26,7kg/m2 (±3,4) pelo protocolo da Revisão Continuada de Saúde do Hospital Israelita Albert Einstein entre janeiro a outubro de 2011. Foram realizadas análise séricas de glicose sanguínea, colesterol total e séries, triglicerídeos, PCR, ALT, AST e Gama GT. A análise estatística utilizada consistiu na comparação de média e desvio padrão. A análise de variância de dois caminhos ANOVA two way, teste t de Student, teste U Mann Whitney, teste de Wald e teste χ2, sendo o nível de significância p<0,05 e correlação univariada de Poison, com intervalo de confiança de 95%. Resultados Os resultados demonstraram que 37,0% da amostra apresentou diagnóstico de esteatose hepática. Homens ativos com esteatose hepática apresentaram níveis de triglicerídeos de 148,2±77,6mg/dL enquanto os inativos com esteatose hepática apresentaram 173,4±15,6mg/dL. Os demais níveis séricos apresentaram-se dentro dos padrões considerados saudáveis, porém os inativos apresentaram todos os valores superiores, em relação aos ativos. Apontou-se que indivíduos inativos apresentam 10,68 vezes maior risco em desenvolver esteatose hepática em relação aos ativos. Conclusão A atividade física melhora os indicadores metabólicos, como triglicérides, controle de peso, HDL, que interferem no desenvolvimento de esteatose hepática, mostrando que indivíduos fisicamente ativos apresentaram menor prevalência de esteatose hepática independentemente dos valores de composição corporal e perfil lipídico, concluindo que a atividade física apresenta papel protetor no desenvolvimento de esteatose hepática. .

Esteatose hepática e estilo de vida ativo: revisão de literatura / Hepatic Steatosis and active lifestyle: Review of Literature

A Doença Hepática Gordurosa Não Alcoólica pode evoluir para a esteatose hepática (EH) sendo derivada do acúmulo de lipídeos nos hepatócitos, quando representa mais de 5% do peso desse órgão. Como a EH promove lesões hepáticas, tem sido considerada como uma das causas mais comuns de doenças hepáticas crônicas nos países desenvolvidos e em desenvolvimento. Considerando a forte associação com o estilo de vida, o objetivo do presente estudo foi apresentar, através de uma revisão na literatura, os principais fatores relacionados ao risco do desenvolvimento de EH e sua associação com o nível de atividade física. Assegura-se que o desenvolvimento da EH esteja relacionado ao estilo de vida, em especial com o histórico de inatividade física e hábitos alimentares pouco saudáveis, fatores associados ao desenvolvimento da síndrome metabólica. A prevalência da EH está associada ao excesso de peso e a obesidade; diabetes melitus do tipo 2 e inatividade fisica, apresentando prevalência entre 10 e 24% dapopulação mundial. A atividade física é considerada como um dos fatores moduladores mais eficazes na prevenção de doenças como a esteatose hepática, e a promoção da saúde. Assim, aumentar o nível de atividade física através das atividades da vida diária e pelo envolvimento em programas de exercícios são comportamentos desejáveis na prevenção de doenças crônicas. O presente estudo permite concluir que a EH como doença metabólica se associa com o ganho de peso e baixo nível de atividade física populacional. Os estudos indicaram que aumentar o nível de atividade física pode colaborar com a diminuição de gordura no fígado e prevenir o aparecimento do quadro de esteatose hepática. Importante frisar que outros hábitos na vida diária poderiam se associar a EH, destacando neste caso, o consumo de bebidas alcoólicas.

The nonalcoholic fatty liver disease, can be progress to hepatic steatosis (HS) or fatty liver that is derived from the accumulation of lipids in hepatocytes, representing more than 5 % by liver weight. As HS promotes liver injury, has been considered as one of the most common causes of chronic liver disease in developed countries and developing countries. The HS has a strong association with the lifestyle, so, the objective of this study was to present the principals risk factors related to the development of HS and the association with the level of physical activity. It ensures that the development of HS is related to lifestyle, especially with the history of physical inactivity and unhealthy eating habits, factors associated with the development of metabolic syndrome. The prevalence of HS is associated with weight gain and obesity, diabetes mellitus type 2 and physical inactivity, with prevalence between 10 and 24% of the world. Physical activity is considered as one of the factors modulating more effective in preventing diseases such as hepatic steatosis, and health promotion. Thus, increasing the level of physical activity through the activities of daily living and involvement in exercise programs are desirable behaviors in the prevention of chronic diseases. The present study shows that the HS as metabolic disease is associatedwith weight gain and low physical activity level population. Studies have indicated that increasing the level of physical activity can help in reducing fat in the liver and prevent the onset of hepatic steatosis frame. Important to note that other habits in daily life could be associated with HS, highlighting this case, the consumption of alcoholic beverages.

The impact of motivational interventions for increasing physical activity.

OBJECTIVE: To assess whether incentives for practicing regular physical activities in fact help raising the frequency of exercising. METHODS: Male and female subjects undergoing two to three assessments in the Check-Up Unit of Hospital Israelita Albert Einstein (HIAE) were evaluated by noting any increase in levels of physical activity, improvements in mean metabolic unit numbers, and the sensitization index. The International Physical Activity Questionnaire was applied to assess the sample. RESULTS: There were 1,879 subjects - 1,559 (83%) males and 320 (17%) females - aged 20 to 76 years (mean age = 45.8 years, standard deviation ± 8.8) who underwent a Continued Health Review at the Center for Preventive Medicine of the HIAE, Check-Up Unit, Jardins. Initially, over half of the sample was insufficiently active (sedentary or poorly active); there were more women than men in this group. After the health review, most subjects increased their level of physical activity; this increase was higher among women. Males encouraged three times to exercising showed better results (increased level of physical activity) as compared to males encouraged twice for exercising. The best results in females were found in the group that went through two evaluations. This result is due to the fact that the sample of females comprising the group that received incentives on three occasions was small. This was also the only group that showed no increase in mean metabolic units. The sensitization index assessment in the overall sample was very satisfactory, as the expected results were achieved. CONCLUSIONS: These results show that motivational interventions are effective for raising the level of physical activity. We concluded that to encourage the practice of regular physical activity through information programs about its health benefits is very important.