Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review.

Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were "High SB UPF Low Sleep", "Low PA High SB Satisfactory Sleep", and "High PA". The main difference in profiles according to sex was that girls' clusters were characterized by high sleep duration, whereas boys' clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.

National policies on physical activity from 64 countries with different economies: a scoping review with thematic analysis.

In 2018, the World Health Organization (WHO) launched a Global Action Plan on Physical Activity (PA), which included 20 policy actions for creating active societies, environments, people and systems. The objective of this scoping review was to summarize the themes/contents of national PA policies/plans conforming to the WHO's proposals and the country's economy. This review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews. A systematic search of electronic databases (Web of Science, Medline/PubMed, LILACS, PsycINFO, Scopus and SPORTDiscus) and 441 government documents/websites from 215 countries/territories was conducted (February 2021). Documents on national-level policies, published in English, Spanish and Portuguese since 2000, were eligible. The information on content and structure was systematically extracted and summarized into dimensions proposed by the WHO: active societies, environments, people and systems. The search identified 888 article references and 586 potentially relevant documents. After the screening, 84 policy documents from 64 countries were eligible. Most documents (n = 46) provided detailed PA policies/plans amid other health topics (e.g. non-communicable diseases, named 'general documents'), and 38 were PA-specific. The content analysis merged 54 visions, 65 missions, 108 principles, 119 objectives, 53 priorities, 105 targets, 126 indicators and 1780 actions/strategies from 38 PA-specific and 46 general documents. Among the PA-specific documents, the active system's dimension was the most contemplated in the principles (n = 43), priorities (n = 51) and action/strategies (n = 530) elements. At the same time, the objectives (n = 39), targets (n = 52) and indicators (n = 58) presented contents more frequently related to the active people dimension. For the general documents, all principles (n = 4), objectives (n = 14) and priorities (n = 7) were related to the dimension of active people, while target (n = 51), indicator (n = 53) and actions/strategies (n = 292) elements presented content related to all dimensions. The increase in countries with national PA policies/plans should be followed by improving the current ones because important dimensions seem to be not considered in these documents. This will facilitate a global PA agenda that considers the complexity and multidimensionality of PA promotion.

A systematic review of the clustering and correlates of physical activity and sedentary behavior among boys and girls.

Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0-19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors' descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex samples, boys, and girls, respectively. While girls were in clusters characterized by "Low PA Low SB" and "Low PA High SB", the majority of boys were in clusters defined by "High PA High SB" and "High PA Low SB". Few associations were found between sociodemographic variables and all cluster types. Boys and girls in "High PA High SB" clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the "High PA Low SB" clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in "High PA Low SB" clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016.

This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016 / Deslocamento ativo entre trabalhadores da região Sul do Brasil: uma análise comparativa entre 2006 e 2016

Abstract This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Resumo O objetivo deste artigo é comparar a prevalência de deslocamento ativo para o trabalho em adultos na região Sul do Brasil entre 2006 e 2016 de acordo com características sociodemográficas e laborais. Os dados do Sistema Brasileiro de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas (VIGITEL) foram comparados em 2006 e 2016 (≥18 anos). Deslocamento ativo para o trabalho, sexo, faixa etária, escolaridade e características laborais foram coletados por inquérito telefônico e analisados nas cidades de Florianópolis, Curitiba e Porto Alegre, utilizando as frequências absolutas e relativas com seus respectivos intervalos de confiança de 95%. O deslocamento ativo aumentou significativamente em 2016 em relação a 2006. Florianópolis apresentou as maiores prevalências nos dois anos analisados. Em todas as capitais houve aumento significativo na prevalência do desfecho, principalmente para mulheres, com ensino médio e apenas em Florianópolis para homens, com baixa escolaridade. A prevalência também aumentou para características laborais em todas as capitais. O deslocamento ativo para o trabalho aumentou expressamente entre os adultos que vivem no Sul do Brasil, com destaque para Florianópolis. Ampliar intervenções nesse contexto é uma necessidade no Brasil.

Implementation of a school-based physical activity intervention for Brazilian adolescents: a mixed-methods evaluation.

The effectiveness of physical activity interventions can be improved through examining the aspects related to their implementation. However, little such evidence has been collected, particularly in low- and middle-income countries. This study aimed to evaluate the implementation of a school-based physical activity intervention with qualitative and quantitative data from different actors (students, teachers and parents) involved in developing the program. The program was conducted in 2017 with three main components: (i) teacher training, (ii) environmental changes and (iii) educational actions. Mixed-method evaluation was performed by an independent evaluation team using a validated indicator matrix for the implementation process, including the self-reported information of students, teachers and parents, as well as interviews with teachers. In the 3 eligible schools, 350 adolescents (51% girls) answered the implementation questionnaire, as did 45 parents (84% mothers), and 47 teachers (70% female). In the qualitative analysis, 18 teachers participated. Categorical analysis found that the intervention was considered feasible by teachers. In general, teachers had a more positive perception of the implementation than did students. The lack of engagement from the school community and parents and the busy schedule of teachers were indicated to be the main difficulties. In conclusion, despite the teachers' motivation, some barriers prevented the successful implementation of the program.

Clustering of Physical Activity, Diet and Sedentary Behavior among Youth from Low-, Middle-, and High-Income Countries: A Scoping Review.

BACKGROUND: The interaction between physical activity (PA), diet, and sedentary behavior (SB) plays an important role on health-related outcomes. This scoping review (Prospero CRD42018094826) aims to identify and appraise clusters of PA, diet, and SB among youth (0-19 years) according to country income. METHODS: Five databases were searched. Fifty-seven articles met the inclusion criteria. RESULTS: Fifty-five cluster types were identified, with greater variety in high-income than lower income countries. The most prevalent profiles were "High SB and consumption of sugar, salt, and beverages (SSB)" (n = 17) and "High PA" (n = 13-5), both of which presented in all income countries. The healthiest profile, "High PA and fruit and vegetables (F&V); Low SB and SSB" (n = 12), was present in upper-middle and high-income countries, while the unhealthiest "Low PA and F&V; High SB and SSB" (n = 6) was present only in high-income countries. CONCLUSIONS: High SB and unhealthy diet (SSB) were more prevalent in clusters, mainly in high-income countries. The results support the need for multi-component actions targeting more than one behavior at the same time.

Clustering of 24-h movement behaviors associated with cardiorespiratory fitness among adolescents: a latent class analysis.

This study aimed to examine the clustering of 24-h movement behaviors (moderate to vigorous physical activity, screen time, and sleep duration) and their association with cardiorespiratory fitness among adolescents. We evaluated 561 adolescents (52.1% girls; mean age, 13.0 ± 1.0 years) from Florianópolis, Brazil. A 20-m shuttle run was used to assess cardiorespiratory fitness, while a questionnaire was used to measure 24-h movement behaviors. A latent class analysis was performed to identify the clustering of 24-h movement behaviors, while linear Bayesian mixed-effect regression models were applied to identify their association with cardiorespiratory fitness. Two classes were identified: unhealthy (10.4%), characterized as a high probability of practicing less than 300 min/week of moderate to vigorous physical activity, spending more than 4 h/day in front of screens, and sleeping less than 8 h/day; and healthy (89.6%), characterized by a high probability of practicing more than 420 min/week of moderate to vigorous physical activity, spending less than 2 h/day in front of screens, and sleeping 8-10 h/day. Adolescents in the healthy class had a higher cardiorespiratory fitness level than those in the unhealthy class. Most adolescents were grouped in the healthy class and had higher cardiorespiratory fitness levels than those in the unhealthy class. These results suggest that families and professionals should work toward creating healthier lifestyles for adolescents by increasing opportunities to practice moderate to vigorous physical activity, reduce screen time, and favor healthy sleep to increase their cardiorespiratory fitness levels. What is Known: • Moderate to vigorous physical activity, screen time, and sleep duration are positively, negatively, and inconsistently associated with cardiorespiratory fitness, respectively, when analyzed separately. • Little is known about the clustering of 24-h movement behaviors and how they are associated with cardiorespiratory fitness levels in adolescents. What is New: • The 24-h movement behaviors clustered into almost opposite classes among adolescents (healthy and unhealthy classes). • Adolescents in the healthy class had greater cardiorespiratory fitness levels than those in the unhealthy class.

Sedentary behavior in children and adolescents: an update of the systematic review of the Brazil's Report Card / Comportamento sedentário em crianças e adolescentes brasileiros: uma atualização da revisão sistemática do Report Card Brasil

Abstract This review updated data on sedentary behavior in Brazilian children and adolescents for the Brazil's Report Card 4.0. The searching was carried out in eight databases (PubMed, Scopus, Web of Science, LILACS, SPORTDiscus, BIREME, Scielo, and Google Scholar), based on the the following criteria: original research; samples including Brazilian children and adolescents; to be a observational survey with the prevalence of at least one component of sedentary behavior. In this updated review were included 118 studies (corresponding to 159 papers), being 71 studies (104 papers) previously reviewed in the Report Card 3.0 and 47 studies (55 papers) found in update from 2018 to 2019. Screen time (34.7%) and TV viewing (28.2%) remains the most investigated components, however, two studies investigated cell phone use, and there was an increase in other types of sedentary behavior such as sitting time (from 9% to 25.6%). We found only four studies involving pre-scholars, but four of them covered almost all age groups. Self-reported questionnaire was the instrument more used; however, increased the studies using accelerometers (from 2 to 8 studies). The cut-off point more frequent was 2 hours/day (47.5%), but the use of other measures doubled. Almost 70% of the studies reported that less than 50% (general range: 9.4% to 97.7%) of individuals had < 2 hours/day of sedentary behavior. The updated review found few studies with prescholars and children; using validated instruments; using accelerometers, with standardization of cutoff points, and prevalences very close to what was observed in the previous review.

Resumo Este revisão atualiza dados de comportamento sedentário em crianças e adolescentes brasileiros para o Report Card Brasil 4.0. A busca foi realizada em oito bases de dados (PubMed, Scopus, Web of Science, LILACS, SPORTDiscus, BIREME, Scielo, and Google Scholar) usando os seguintes critérios: artigos originais; amostras incluindo crianças e adolescentes; estudos observacionais que estimaram a prevalência de pelo menos um componente do CS. Nesta atualização foram incluídos 118 estudos (com publicação de 159 artigos), sendo 71 (104 artigos) revisados anteriormente no Report Card 3.0 e 47 estudos (55 artigos) encontrados na atualização de 2018 a 2019. O tempo de tela (34,7%) e de TV (28,2%) continuam sendo os componentes mais investigados, entretanto, dois estudos investigaram o uso de celular e houve aumento em outros comportamentos sedentários, como o tempo sentado (de 9% para 25,6%). Foram encontrados somente quatro estudos com pré-escolares, mas quatro deles cobriam quase todas as idades. O questionário foi o instrumento mais utilizado; no entanto, aumentou o número de estudos usando acelerômetros (de 2 para 8). O ponto de corte mais frequente foi 2 horas/dia (47,5%), mas o uso de outros medidas duplicou. Quase 70% dos estudos relatou que menos de 50% (variação geral: 9,4% a 97,7%) dos adolescentes atendem às recomendações (<2 horas / dia) de comportamento sedentário. A revisão atualizada mostra ainda poucos estudos com pré-escolares e crianças, com o uso de instrumentos validados, com o uso de acelerômetros, com padronização de pontos de corte, e prevalências muito próximas do observado na revisão anterior.

Clustering of screen time behaviours in adolescents and its association with waist circumference and cardiorespiratory fitness.

OBJECTIVES: To identify the association of clusters of screen time (ST) behaviours with waist circumference (WC) and cardiorespiratory fitness (CRF) among adolescents. DESIGN: Cross-sectional study of 574 adolescents (53% girls, 13 years), conducted in 2017. METHODS: Waist circumference was measured, a shuttle run was performed to assess CRF, and a questionnaire was applied. Sex, age, socioeconomic status was reported, and daily duration of ST indicators for television viewing, computer use, videogame playing, and cellphone use, in weekdays and weekend days. Latent class analysis was performed to identify typologies of ST behaviours. Mixed-effects linear regressions were used to test the association of ST clusters with WC and CRF. RESULTS: Participants' WC was 66.9±8cm and CRF was 39.5±4mlO2/kg/min. Four clusters were identified: "Low ST" (25%); "High ST" (20%); "Gamers" (17%); and "High cellphone" (39%). No significant associations were found between ST clusters and WC. Maximum oxygen uptake was higher in those in the "Low ST" cluster compared to the other clusters. No significant interactions for sex were observed. CONCLUSIONS: Typologies of ST behaviours do not seem to be related to WC; however, those in the Low ST cluster had higher CRF compared to their peers in the other clusters, suggesting that total ST may be more important for CRF than specific indicators.

Sociodemographic, biological, and psychosocial correlates of light- and moderate-to-vigorous-intensity physical activity during school time, recesses, and physical education classes.

BACKGROUND: Identifying factors associated with physical activity (PA) is useful in planning interventions and policies. The aim of this study was to identify sociodemographic, biological, and psychosocial factors associated with PA performed in school settings. METHODS: Data collected for the present study included gender, age, socioeconomic status, body fat percentage, aerobic fitness, self-efficacy, attitudes, peer and parental support, and perception of school environment. Dependent variables were light-intensity PA (LPA) and moderate-to-vigorous-intensity PA (MVPA) performed during school time, recesses, and physical education (PE) classes. Multiple regression analyses were performed. RESULTS: Participating adolescents (n = 567, 53% female, 12.9 ± 5.3 years) spent 5% of school time in MVPA and 27% in LPA, 15% of recesses in MVPA and 44% in LPA, and 16% of PE classes in MVPA and 41% in LPA. Boys engaged in more MVPA in all categories. Age was inversely related with MVPA and LPA in all periods, whereas body fat percentage was inversely related with MVPA in school time and PE classes. Attitude was inversely related with MVPA in all periods and with LPA in recesses. Considering PA to be good and enjoyable was positively associated with MVPA in school time. CONCLUSION: Adolescents spent little time in PA during school. Future interventions should implement enjoyable activities at school.

Effect of a Multicomponent Intervention on Lifestyle Factors among Brazilian Adolescents from Low Human Development Index Areas: A Cluster-Randomized Controlled Trial.

Promoting healthy lifestyle factors (e.g., physical activity, healthy eating, less screen time) among young people is a relevant and challenging step toward reducing non-communicable diseases. This study aimed to evaluate the effect of a multicomponent intervention on lifestyle factors among adolescents from schools in low Human Development Index (HDI < 0.500) areas. The Fortaleça sua Saúde program was conducted with 548 adolescents aged 11⁻18 years old in the intervention group and 537 in the control group. The four-month intervention included strategies focused on training teachers, new opportunities for physical activity in the school environment, and health education strategies for the school community (including parents). Moderate- to-vigorous physical activity level (≥420 min/week), TV watching and computer use/gaming (<2 h/day), daily consumption of fruit juice, fruit, vegetables, soft drinks, savory foods and sweets, and current alcohol and tobacco use were measured before and after intervention. McNemar's test and logistic regression (odds ratio [OR] and a 95% confidence interval [95% CI]) were used, considering p < 0.05. In the intervention schools, a significant increase occurred in the number of adolescents who met physical activity guidelines (5.3%; 95% CI = 0.8; 9.8) and who reported using computer for <2 h a day (8.6%; 95% CI = 3.8; 13.4) after intervention. No changes were observed in the control schools. At the end of the intervention, adolescents from intervention schools were more likely to practice physical activity at recommended levels (OR = 1.44; 95% CI = 1.00; 2.08) than adolescents from control schools. No significant change was observed for the other lifestyle factors. In conclusion, this multicomponent intervention was effective in promoting physical activity among adolescents from vulnerable areas. However, other lifestyle factors showed no significant change after intervention. This study is registered at Clinicaltrials.gov NCT02439827.

School-Based Intervention on Cardiorespiratory Fitness in Brazilian Students: A Nonrandomized Controlled Trial.

BACKGROUND: In response to the worldwide increasing prevalence of low cardiorespiratory fitness (CRF), several interventions have been developed. The aim of this study was to examine the effect of a school-based intervention on CRF in Brazilian students. METHODS: A nonrandomised controlled design tested 432 students (intervention group: n = 247) from 6th to 9th grade recruited from two public secondary schools in Florianopolis, in 2015. The intervention entitled "MEXA-SE" (move yourself), applied over 13 weeks, included four components: (1) increases in physical activity during Physical Education classes; (2) active recess; (3) educational sessions; and (4) educational materials. CRF (20-m shuttle run test) was the primary outcome. RESULTS: The effect size of the intervention on CRF was 0.15 (CI 95% = -0.04; 0.34). In the within-group comparisons, VO2max decreased significantly from baseline to follow-up in the control group but remained constant in the intervention group. After adjustment variables, differences between intervention and control group were not statistically significant (p > 0.05). CONCLUSION: The "MEXA-SE" intervention did not have an effect on adolescents' CRF. However, maintenance of VO2max in intervention group and a reduction within control group demonstrates that this intervention may be beneficial for long-term CRF and, possibly, the increased intervention time could result in a better effect.

Are adolescents really being sedentary or inactive when at school? An analysis of sedentary behaviour and physical activity bouts.

This study analysed physical activity (PA) and sedentary behaviour (SB) performed in bouts during schooltime. Adolescents of two schools answered a questionnaire, had their height and weight measured and wore accelerometers during schooltime. Moderate-to-vigorous intensity PA was estimated in bouts of 2, 5 and 10 min, and SB in bouts of 5, 10, 30 and 60 min. Body mass index was calculated, and adolescents were classified as overweight or normal weight. Frequency, duration and volume of PA and SB were calculated for the whole sample and for those who performed at least one bout weekly. PA and SB differences between gender and weight status were tested using Mann-Whitney and t tests. A total of 415 adolescents (54% girls, 12.3 ± 1.3 years old, 34.6% overweight) performed 0.1 (± 0.2), 0.2 (± 0.5) and 0.4 (± 0.6) bouts of 10, 5 and 2 min of PA, and 10.6 (± 2.0), 6.0 (± 1.3), 1.1 (± 0.9) and 0.4 (± 0.5) bouts/day of 5, 10, 30 and 60 min of SB, respectively. Boys accumulated less SB and more PA in bouts. No differences were found for weight status.Conclusion: Adolescents hardly engaged in bouted PA and accumulated more SB in smaller bouts during schooltime. Bouted PA and SB were not associated with weight status. What is Known: • Adolescents are not engaging in enough PA and are accumulating large volumes of SB, which might negatively impact their health. • Schools play an important role in daily overall PA, with opportunities such as PE classes and recesses. But most classes are still undertaken in seated positions. What is New: • Adolescents hardly engage in bouted (> 10 m) PA when at school., and most SB is accumulated in short bouts (≤ 10m). • Weight status was not associated with bouted PA or SB at school.

Community and environment for physical activity among young people: a systematic review of the Report Card Brazil 2018 / Ambiente comunitário para atividade física de jovens: uma revisão sistemática do Report Card Brasil 2018

Abstract The aim of this study was to identify evidence about the prevalence of the community and environment indicators related to physical activity (PA) among young Brazilian people. A systematic review was carried out using eight databases (PubMed, Scopus, Web of Science, LILACS, SPORTDiscus, BIREME, Scielo, and Google Scholar) with descriptors in Portuguese and English. Community and environment Indicators included access, presence, proximity, quality, safety and pollution of/in spaces, facilities, programs available for PA among young people (up to 18 years-old), which may be measured subjectively and/or objectively. A total of 23 documents were included, representing 15 different studies. There were more studies in the South region (n=8), followed by the Northeast (n=3) and Southeast (n=3). Self-reported instruments were more frequently used (n=15). The studies reported prevalence of perception (positive and/or barrier) for access to facilities, programs and/or parks (n=13); presence of sidewalks and bicycle lanes (n=4); proximity to residence (n=5); quality (n=5); safety from crime and traffic (n=14) and pollution (n=6); number of spaces and/or facilities around the residence (n=1); and observation of adolescents using public spaces for PA (n=3). The prevalence rates showed high variability according to environmental indicator. No studies are available for the North and Midwest of the country. Distinct environmental measures were used in self-reported studies, impairing data comparability. To date, no studies have been identified that provide information about the prevalence of combined environmental measures (perceived and objective).

Resumo Objetivou-se identificar evidências das prevalências de indicadores do ambiente comunitário relacionado a atividade física (AF) de jovens brasileiros. A revisão sistemática utilizou-se de oito bases de dados (PubMed, Scopus, Web of Science, LILACS, SPORTDiscus, BIREME, Scielo, and Google Scholar), com descritores em Português e Inglês. As variáveis de ambiente e comunidade incluem acesso, presença, proximidade, qualidade, segurança e poluição de/em espaços, estruturas, programas disponíveis para AF. Foram extraídos os dados de prevalência de jovens (maiores de 18 anos), que podem ser medidos subjetivamente e/ou objetivamente. No total, 23 documentos foram incluídos (n=2; relatórios nacionais), sendo 15 estudos diferentes. Houve mais estudos na região Sul (n=8), seguido do Nordeste (n=3) e Sudeste (n=3). O uso de instrumento auto relatado foi mais utilizado (n=15). Os estudos reportaram prevalências de percepção (positiva e/ou barreira) para acesso a estruturas, programas e/ou parques (n=13); presença de calçadas e ciclovias (n=4); proximidade com a residência (n=5); qualidade (n=5); segurança para crimes e trânsito (n=14) e poluição (n=6); quantidade de espaços e/ou estruturas no entorno da residência (n=1); e observação de adolescentes utilizando espaços públicos para AF (n=3). As taxas de prevalência apresentaram alta variabilidade de acordo com os indicadores do ambiente. Estudos na região Norte e Centro-oeste do país são inexistentes. As medidas de ambiente são distintas nos estudos com auto relato, o que dificulta a comparabilidade dos dados. Até o momento, não foi identificado estudos que forneçam informações sobre prevalências de medidas do ambiente utilizadas de maneira combinada (percebida e objetiva).

Nutritional status of children from lower Amazonas: agreement between three classification criteria / Fatores sociodemográficos e excesso de peso em crianças participantes de programa governamental de distribuição de leite fortificado

INTRODUCTION: The knowledge of adequate methods to monitor growth and nutritional status during childhood and adolescence makes possible an early diagnosis of possible problems, such as malnutrition, overweight or obesity in adult life. OBJECTIVE: To determine the agreement between three methods of nutritional assessment status of children 2 to 6 years old from Lower Amazonas region, Brazil. METHODS: Exploratory, epidemiological, and cross-sectional school-based study conducted in 2014 with children of Child Education in the city of Parintins. We assessed the nutritional status, body mass index, according to three criteria: Conde and Monteiro, Cole et al, and World Health Organization (WHO). We used the Kappa coefficient to investigate the agreement between three criteria. RESULTS: Participants were 1.387 children (714 boys) with a mean age of 5 years. The boys had a higher prevalence of overweight than girls by the WHO classification, but higher proportion of girls with low weight, according to the national criteria. The best levels of agreement were for females and national protocol showed good agreement with the international use of protocols, highlighting proposed by the WHO. CONCLUSION: We concluded that there was agreement among the criteria for assessing the nutritional status of children in the Lower Amazonas.

INTRODUÇÃO: Estudos anteriores mostraram a efetividade do programa VIVALEITE para o ganho de peso de crianças menores de dois anos. Como o programa é efetivo, é possível que crianças ingressantes com peso próximo ao limite considerado adequado para idade o ultrapassem no decorrer de sua participação OBJETIVO: Analisar a associação entre fatores sociodemográficos e excesso de peso em participantes do programa VIVALEITE. MÉTODO: Estudo de coorte com dados de 1.039 crianças de famílias de baixa renda do interior do Estado de São Paulo, ingressantes no programa com seis meses de idade e peso próximo ao limite superior de adequação, entre janeiro/2003 e setembro/2008. Investigou-se a proporção de crianças que ficam com excesso de peso durante a participação no programa e associações com as condições sociodemográficas de cada criança (amamentação aos seis meses, sexo, peso ao nascer) e dos respectivos responsáveis (condição conjugal, idade, situação de trabalho, escolaridade). A modelagem foi feita por meio de regressão logística multinível das variáveis socioeconômicas e o conjunto das idades de pesagem. O processamento foi feito com o pacote estatístico Stata 10.1. RESULTADOS: Conforme análise multinível, a categoria sim da variável aleitamento materno aos seis meses (OR=0,29, p=0,001) e a categoria trabalha da variável situação de trabalho materno (OR=0,36, p=0,012) foram associadas significantemente ao excesso de peso das crianças. As demais variáveis não foram associadas estatisticamente a excesso de peso. CONCLUSÃO: Não amamentação aos seis meses e ausência de trabalho materno são fatores sociodemográficos positivamente associados ao excesso de peso das crianças participantes do programa.

Exposure to simultaneous sedentary behavior domains and sociodemographic factorsassociated in public servants / Exposição a simultâneos domínios do comportamentosedentário e fatores sociodemográficos associados em servidores públicos

Abstract Exposure to sedentary behavior may contribute to health problems. This study aimed to estimate the prevalence of exposure to simultaneous sedentary behavior domains and verify associated sociodemographic characteristics among technical and administrative servers of a Brazilian university. This is a cross-sectional epidemiological study carried out with 623 technical and administrative servers. Sedentary behavior was identified through a questionnaire in the following domains: commuting (active / passive), sitting time at work, daily time spent watching television and computer use (≥3 hours / day). Sociodemographic variables were age, sex and educational level. The prevalence of servers that had one, two, three and four simultaneous sedentary behavior was 28.4%, 43.2%, 22.5% and 4.3%, respectively. Women were more likely to have three sedentary behavior simultaneously (OR = 1.61, CI 95% = 1.02, 2.56). Servers with 9-11 years of schooling were less exposed to two (OR = 0.27, CI 95% = 0.17, 0.44), three (OR = 0.39, CI 95% = 0.23, 0.66) and four (OR = 0.22, CI 95% = 0.07; 0.69) sedentary behavior simultaneously and those over 12 years of schooling were less likely of having two (OR = 0.22, CI 95% = 0.10; 0.49) and three (OR = 0.15, CI 95% = 0.05, 0.46) sedentary behavior simultaneously. More than half of servers have two sedentary behavior during the week. Having sedentary behavior in more than one domain simultaneously was associated with sex and educational level.

Resumo A exposição a comportamentos sedentários podem contribuir para diversos agravos a saúde. Este estudo teve como objetivo estimar a prevalência de exposição a simultâneos domínios do comportamento sedentário e verificar que características sociodemográficas estão associadas, em servidores técnico-administrativos de uma universidade federal brasileira. Trata-se de um estudo epidemiológico transversal realizado com 623 servidores técnico-administrativos. O comportamento sedentário foi identificado por meio de questionário nos domínios: deslocamento (ativo/passivo), tempo sentado no trabalho, tempo de assistir televisão e utilização o computador por dia (≥ três horas/dia). As variáveis sociodemográficas investigadas foram: idade, sexo e escolaridade. A prevalência de servidores que apresentaram um, dois, três e quatro comportamentos sedentários simultaneamente foi de 28,4%, 43,2%, 22,5% e 4,3%, respectivamente. As mulheres apresentaram maior chance de ter três comportamentos sedentários simultaneamente (RC: 1,61; IC95%: 1,02; 2,56). Os servidores com 9 a 11 anos de escolaridade estiveram menos expostos a dois (RC: 0,27; IC95%: 0,17; 0,44), três (RC: 0,39; IC95%: 0,23; 0,66) e quatro (RC: 0,22; IC95%: 0,07; 0,69) comportamentos sedentários simultaneamente e aqueles com 12 anos ou mais de escolaridade tiveram menor chance de ter dois (RC: 0,22; IC95%: 0,10; 0,49) e três (RC: 0,15; IC95%: 0,05; 0,46) comportamentos sedentários. Mais da metade dos servidores apresentaram comportamentos sedentários em dois domínios, durante a semana. O comportamento sedentário em mais de um domínio simultaneamente foi associado ao sexo e ao nível educacional.

Orientações para utilização de acelerômetros no Brasil / Instructions for accelerometer use in Brazil

O objetivo do presente estudo foi apresentar um conjunto de orientações para a utilização de acelerômetros no Brasil. O método consistiu na revisão e síntese de artigos que utilizaram acelerômetros como instrumento de medida objetiva da atividade física. Com base nesses estudos, buscou-se apresentar orientações para as fases pré-coleta (seleção do acelerômetro; testagem da calibração dos acelerômetros, atualização de firmware; estudo piloto; e definição de protocolo), coleta (distribuição dos acelerômetros; contato com participantes; e devolução dos acelerômetros) e pós-coleta (processamento; transformação e interpretação dos dados; e comparabilidade dos dados) do uso de acelerômetros. São descritos procedimentos para facilitar as tomadas de decisões relacionadas ao uso desses dispositivos, bem como para obtenção de dados de acelerometria válidos e reprodutíveis. As orientações são uma iniciativa de pesquisadores da área a fim de proporcionar um avanço metodológico nas medidas objetivas da atividade física. A adoção das orientações pode facilitar a padronização dos procedimentos empregados e a comparabilidade de resultados entre estudos com acelerômetros no Brasil.

The aim of this study was to develop instructions for using accelerometers to measure physical activity in Brazil. This manuscript is a review and synthesis of scientific papers that have used accelerometers for objective physical activity assessment in different age groups as well as studies providing directions for using activity monitors in large-scale studies. In this study, we present instructions for the pre-data collection (selection of monitor; unit calibration, firmware update, pilot study, protocol definition), data collection (monitor distribution, contacting participants, monitor return) and post-data collection (data processing, transformation and interpretation) phases. We describe procedures for facilitating decision making related to using accelerometers, as well as for obtaining valid and reliable accelerometer physical activity data. This set of instructions is an initiative of a group of physical activity researchers with the purpose of contributing to methodologically advance the field of objective physical activity measurement in Brazil. The current set of instructions intend to facilitate the standardization of procedures for collecting physical activity data with accelerometers in Brazil and, thus, for ascertaining future comparability of data collected in different studies.

Association between cardiorespiratory fitness and body fat in girls / Relação entre aptidão cardiorrespiratória e adiposidade corporal em meninas

Abstract Objective: To estimate the prevalence of low cardiorespiratory fitness and its association with excess body fat, considering the sexual maturation and economic level in female adolescents. Methods: Cross-sectional, epidemiological study of 1223 adolescents (10-17 years) from the public school system of Cascavel, PR, Brazil, in 2006. We analyzed the self-assessed sexual maturation level (prepubertal, pubertal and post-pubertal), the economic level (high and low) through a questionnaire and body fat (normal and high) through triceps and subscapular skinfolds. The 20-meter back-and-forth test was applied to estimate maximum oxygen consumption. Cardiorespiratory fitness was assessed according to reference criteria and considered low when the minimum health criterion for age and sex was not met. Chi-square test and logistic regression were applied, with a significance level of 5%. Results: The prevalence of low cardiorespiratory fitness was 51.3%, being associated with all study variables (p<0.001). At the crude analysis, adolescents with high body fat were associated with low cardiorespiratory fitness, when compared to those with normal body fat (OR=2.76; 95%CI: 2.17-3.52). After adjustment by sexual maturation, this association remained valid and showed an effect that was 1.8-fold higher (95%CI: 1.39-2.46) and after adjusting by economic level, the effect was 1.9-fold higher (95%CI: 1.45-2.61). Conclusions: Approximately half of the assessed girls showed unsatisfactory levels of cardiorespiratory fitness for health, which was associated with high body fat, regardless of sexual maturation level and economic level. Effective public health measures are needed, with particular attention to high-risk groups.

Resumo Objetivo: Estimar a prevalência de aptidão cardiorrespiratória baixa e sua associação com excesso de adiposidade corporal, considerando a maturação sexual e o nível econômico, em adolescentes do sexo feminino. Métodos: Estudo epidemiológico transversal com 1.223 adolescentes (10-17 anos) da rede pública de ensino de Cascavel, PR, Brasil, em 2006. Analisou-se a maturação sexual (pré-púbere, púbere e pós-púbere) autoavaliada, o nível econômico (NE) (alto e baixo) por questionário e a adiposidade corporal (normal e elevada) por dobras cutâneas do tríceps e subescapular. Aplicou-se o teste de vaivém de 20 metros para estimar o consumo máximo de oxigênio. A aptidão cardiorrespiratória foi avaliada por critérios referenciados e considerada baixa quando não atingido o critério mínimo para a saúde segundo idade e sexo. Foram aplicados o teste de qui-quadrado e a regressão logística, com nível de significância de 5%. Resultados: A prevalência de aptidão cardiorrespiratória baixa foi de 51,3% que se associou a todas as variáveis do estudo (p<0,001). Na análise bruta, as adolescentes com adiposidade corporal elevada associaram-se à aptidão cardiorrespiratória baixa, quando comparada com aquelas com adiposidade normal (RC=2,76; IC95% 2,17-3,52). Após ajuste pela maturação sexual, essa associação se manteve e mostrou efeito 1,8 vez maior (IC95% 1,39-2,46) e, após ajuste pelo NE, o efeito foi 1,9 vezes maior (IC95% 1,45-2,61). Conclusões: Aproximadamente metade dos avaliados apresentou níveis insatisfatórios de aptidão cardiorrespiratória para a saúde, o que se associou à adiposidade corporal elevada, independentemente da maturação sexual e NE. Medidas efetivas de saúde pública são necessárias, com especial atenção para grupos de maior risco.

Stages of Behavior Change for physical activity and associated factors among technical-administrative servers of a federal university / Estágios de Mudança de Comportamento para a atividade física e fatores associados em servidores técnico-administrativos de uma universidade federal

Abstract The benefits that the regular practice of physical activity (PA) provides to health and its importance in preventing and fighting chronic diseases. The aim of this study was to identify the Stages of Behavior Change (SBC) for PA among technical-administrative servers and its association with sociodemographic and health risk factors. This cross-sectional study investigated 622 technical-administrative servers (337 women) from a Brazilian federal university. SBC for PA, sociodemographic information (gender, age, marital status and educational level) and health risk factors (inadequate eating habits, excessive alcohol consumption, smoking, commuting and PA at work) were collected through questionnaires. Multinomial regression with adjustment for the hierarchical level was applied and significance level of 5% was adopted. The distribution of technical-administrative servers in SBC for PA identified prevalence of 9.1% and 6.5% in the pre-contemplation stage, 24.6% and 33.5% in contemplation, 33.3% and 22 6% in preparation, 5.6% and 12.2% in action and 27.4% and 25.2% in maintenance stages between men and women, respectively. Lower odds ratio of being in the preparation stage was identified among women (OR=0.62; CI95%=0.41; 0.93) while those with inadequate eating habits were more odds to be in the “pre-contemplation + contemplation” (OR=2.77; CI95%=1.85; 4.15) and preparation stages (OR=1.75; CI95%=1.12; 2.70). Over 60% of technical-administrative servers are insufficiently active (pre-contemplation, contemplation and preparation stages) and factors associated with SBC were female sex and inadequate eating habits.

Resumo Os benefícios que a atividade física (AF) regular proporciona à saúde e a sua importância para prevenir e combater doenças crônicas não transmissíveis. Objetivou-se identificar os Estágios de Mudança de Comportamento (EMC) para a AF em servidores técnico-administrativos e sua associação com fatores sociodemográficos e de risco a saúde. Este estudo transversal investigou 622 servidores (337 mulheres) técnico-administrativos de uma universidade federal brasileira. Foram coletados os EMC para a AF, informações sociodemográficas (sexo, idade, estado civil e escolaridade) e fatores de risco à saúde (hábitos alimentares inadequados, consumo excessivo de álcool, tabagismo, forma de deslocamento e AF no trabalho) por meio de questionários. Aplicou-se a regressão multinomial com ajuste por nível hierárquico e adotou-se nível de significância de 5%. A distribuição dos servidores nos EMC para a AF identificou prevalência de 9,1% e 6,5% no estágio de pré-contemplação, 24,6% e 33,5% de contemplação, 33,3% e 22,6% de preparação, 5,6% e 12,2% de ação e 27,4% e 25,2% de manutenção entre homens e mulheres, respectivamente. Menor chance de estar no estágio de preparação foi identificada entre as mulheres (RC: 0,62; IC95%: 0,41; 0,93) enquanto aqueles com hábitos alimentares inadequados apresentaram maior chance de estar nos estágios de pré-contemplação + contemplação (RC: 2,77; IC95%: 1,85; 4,15) e preparação (RC: 1,75; IC95%: 1,12; 2,70). Mais de 60% dos servidores da instituição são insuficientemente ativos (estágios de pré-contemplação, contemplação e preparação) e os fatores associados aos EMC foram o sexo feminino e os hábitos alimentares inadequados.