Effects of linear periodized and non-periodized combined training on body image perception of adults with obesity: A randomized clinical trial.

OBJECTIVE: Verify the effect of non-periodized and linear periodized combined training on body image perception and body dissatisfaction in adults with obesity. DESIGN: A randomized clinical trial on the effect of two types of combined training periodization was carried out on people with grade I and II obesity. SETTING: Participants were allocated into three groups: non-periodized periodization group, linear periodization group, and control group, with 23 participants in each. SUBJECTS: Adults with obesity, with a body mass index between 30 kg/m² and 40 kg/m². INTERVENTIONS: The intervention lasted 16 weeks (separated into three mesocycles of 4 weeks and 1 week of familiarization), in 3 weekly sessions of 1 hour each, composed of aerobic (30 min) and muscle strength exercises (six exercises) in the same session. The group with non-periodized model maintained uniform intensity, volume, and workload throughout the mesocycles. The group with the linear periodization model started with low initial intensity, subsequently introducing a gradual increase of intensity in the mesocycles. MAIN MEASURES: Body image perception (current and ideal silhouette) and body dissatisfaction were assessed using the Stunkard silhouette scale. RESULTS: The perception of the current silhouette increased only in the control group (Δ = 1.16; p = 0.04). There was a significant reduction in the ideal silhouette over time (p = 0.001), especially in non-periodized group (Δ = -1.26). Body dissatisfaction increased significantly only over time (p = 0.001), especially for control group (Δ = 1.47). CONCLUSIONS: Regardless of periodization, combined training effectively maintained the perception of the current silhouette and reduced the ideal silhouette in adults with obesity. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (RBR-3c7rt3).

Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults.

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.

Effects of Nonperiodized and Linear Periodized Combined Training on Health-Related Physical Fitness in Adults With Obesity: A Randomized Controlled Trial.

ABSTRACT: Streb, AR, Passos da Silva, R, Leonel, LdS, Possamai, LT, Gerage, AM, Turnes, T, and Del Duca, GF. Effects of nonperiodized and linear periodized combined training on health-related physical fitness in adults with obesity: a randomized controlled trial. J Strength Cond Res 36(9): 2628-2634, 2022-The aim of this randomized controlled trial study was to compare the effects of 16 weeks of linear periodized and nonperiodized combined training (CT) in cardiorespiratory fitness, muscle strength, and body composition indicators of adults with obesity. Thirty-four obese adults of both sexes (36.6 ± 4.4 years; body mass index, 32.9 ± 2.7 kg·m -2 ) were divided into nonperiodized (NG; n = 8), linear periodized (PG; n = 11), and control (CG; n = 15) groups. The NG and PG groups performed 3 weekly sessions of CT over 16 weeks in different ways. Anthropometric measures, maximal strength for leg press and barbell bench press, maximal oxygen uptake (V̇ o2 max), and ventilatory thresholds were determined before and after intervention. The generalized estimation equation was used, with the applied level of significance for the interaction of 0.10 and the isolated effect of time or group or both of 0.05. Significant and similar increases were observed in the 1-repetition maximum test for bench press (NG: 48.8 ± 5.7 to 55.0 ± 6.1 kg; PG: 48.7 ± 5.7 to 53.8 ± 5.9 kg; p = 0.001) and leg press (NG: 235.2 ± 18.7 to 268.3 ± 19.7 kg; PG: 223.1 ± 25.3 to 253.3 ± 23.1 kg; p = 0.05) in trained groups. Relative V̇ o2 max improved only in PG (27.8 ± 1.3 to 32.0 ± 1.4 mL·kg·min -1 ; p = 0.05), while ventilatory thresholds improved in NG and CG ( p = 0.004 and p = 0.06). There was an increase in body mass in CG (97.6 ± 3.4 to 99.1 ± 2.9 kg) and NG (92.5 ± 5.4 to 93.5 ± 5.4 kg; p = 0.05). Combined training improved maximal upper-body and lower-body strength, regardless of periodization. However, for improvement in V̇ o2 max, linear periodization may be superior to nonperiodization in obese adults.

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.

Is the availability of open public spaces associated with leisure-time physical activity in Brazilian adults?

This study aims to analyse the association between perceived presence of public spaces near residences and practice of physical activity during leisure time by adults in the state capitals of Brazil, based on sociodemographic characteristics. Participants were individuals aged ≥18 years living in the 27 state capitals of Brazil (n = 52 929, 53.9% female) who responded to a national survey called VIGITEL in 2013. Physical activity during leisure time (≥1 time/week), perception of space, population and sociodemographic variables (sex, age, years of study and geographic region) were self-reported. The adjusted binary logistic regression analysis was used. Among adults, the prevalence of physical activity during leisure was 45.1% (95% CI [44.2; 46.0]), and 71.1% (95% CI [70.2, 71.8]) perceived public space near their residence. A direct association between perceiving public space and physical activity ([OR] = 1.43; 95% CI [1.32; 1.55]) was observed. No significant difference was observed in the population groups (men and women, younger and older adults, and those with more and fewer years of study). Thus, even with the possible regional differences in Brazilian state capitals, the presence of public spaces increases the practice of physical activity during leisure time, independent of sociodemographic variables.

Moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults.

OBJECTIVE: To investigate the moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults. METHODS: Secondary analysis of the survey "Lifestyle and leisure habits of industry workers" (n=46,981), conducted in 24 Brazilian states (2006-2008). Self-reported information was collected with a previously tested questionnaire. Crude and adjusted logistic regression models were applied to analyze the association between sociodemographic variables (sex, age, marital status, number of children, education, country area and company size) and active commuting to work in different strata of gross family income. To test the moderating effect, an interaction analysis was applied. RESULTS: The proportion of active commuters among low-, medium- and high-income workers was 40.7% (95%CI:40.0%;41.5%), 27.0% (95%CI:26.3;27.6%) and 11.1%, (95%CI:10.5%;11.7%), respectively. The moderating effect of gross family income was confirmed. Men were more likely (OR:1.22 95%CI:1.12;1.32) to commute actively than women among low-income individuals. Active commuting was less likely among older workers in low-(OR30-39:0.90 95%CI: 0.83;0.98; OR≥40: 0.76 95%CI: 0.68;0.85) and medium-income strata (OR30-39:0.87 95%CI:0.80;0.95; OR≥40:0.84 95%CI:0.76;0.93) and among married individuals in high-income strata (OR:0.72 95%IC:0.61;0.84). Adults with lower education (ORhigh:10.80 95%CI:8.47;13.77), working in the south (ORhigh:1.93 95%CI:1.53;2.44) and in small companies (ORlow:2.50 95%CI:2.28;2.74) were more likely to commute actively; however, the magnitude of these associations differed at each income strata. CONCLUSION: There was an inverse association between gross family income and active commuting. Gross family income acts as a moderator of the association between demographic indicators and active commuting.

Gender differences in the clustering patterns of risk behaviours associated with non-communicable diseases in Brazilian adolescents.

OBJECTIVE: The aim of this study is to investigate gender differences in the clustering of risk behaviours associated with chronic non-communicable diseases in Brazilian adolescents. METHODS: A cross-sectional survey was conducted in 2011 comprising 6529 adolescents aged 15-19years from Santa Catarina State, Brazil. Excessive screen-time, insufficient moderate to vigorous physical activity (MVPA), low fruit/vegetable intake and consumption of alcohol were investigated. Poisson regression was performed in the analysis of sociodemographic factors associated with the clustering of three or more risk behaviours. RESULTS: Girls presented with higher insufficient MVPA (76.3%), while boys presented with lower fruit or vegetable intake (53.0%) and greater consumption of alcohol (40.8%). A total of 21.2% of the teenagers had one risk behaviour, 37.3% had two, 28.5% had three, and 8.0% had all of the measured risk behaviours. Adolescents who did not work and boys who lived in urban areas exhibited more risk behaviours, whereas girls aged 17-19years old and boys who had mothers with ≥12years of study exhibited fewer risk behaviours. CONCLUSION: There was a difference between genders for individual risk behaviours, and a high degree of clustering in both genders. Prevention programs could focus on these behaviours in order to reduce negative health outcomes in adolescents.

Effect of Combined Physical Exercise Training in Reducing Cardiovascular Risk Among Adults with Obesity: A Randomized Clinical Trial.

It is necessary to understand the relationship between different models of exercise periodization and the reduction of cardiovascular risk in adults with obesity. The aim of this study was to verify the effect of two periodization models of combined training on the cardiovascular risk of adults with obesity of both sexes. A randomized clinical trial was conducted with adults of both sexes with obesity. They were divided into three groups: control group (CG), non-periodized combined training group (NG), and combined training group with linear periodization (PG). The NG and PG groups underwent physical exercise training regimen for 16 weeks, in three weekly sessions of 60 min each, with the volume and intensity equalized. Cardiovascular risk was measured by the overall Framingham risk score (FRS). Generalized estimation equations and individual responsiveness analyses were used, stratified by sex. A statistically significant reduction in FRS was observed only in men of the NG (pre: 2.50 ± 0.56; post: 0.50 ± 1.02; p-value = 0.001). There was no statistically significant intervention effect on the women's cardiovascular risk. It was found that, regardless of sex, subjects in the control group mostly presented results of increased cardiovascular risk. In contrast, those belonging to the exercise groups, if not reduced, at least stabilized the chances of suffering a cardiovascular event in the next ten years after 16 weeks of combined training. Sixteen weeks of non-periodized combined training were sufficient to reduce cardiovascular risk in men with obesity. Both periodization models were important to stabilize the risk of developing a cardiovascular disease in the next 10 years.

Prevalence and sociodemographic correlates of all domains of physical activity in Brazilian adults.

OBJECTIVE: To estimate the prevalence and sociodemographic indicators associated with physical inactivity in leisure, commuting, work, and household in adults in Florianopolis, Brazil. METHODS: Population-based cross-sectional study was conducted from September 2009 to January 2010, with adults between 20 to 59 years of age (n=1720). Sociodemographic indicators and physical inactivity in each domain were assessed by a validated questionnaire, applied through face-to-face interviews. RESULTS: The prevalence of physical inactivity in each domain was: leisure (52.5%); commuting (50.4%); work (80.9%); and household (57.6%). Women were 27% more inactive in leisure, while men were significantly more inactive at commuting and household (p<0.001). Older adults were more inactive in leisure (p=0.04) and commuting (p=0.05). Physical inactivity in leisure was higher in black adults and those who living with a partner and with lower educational level and lower income. In commuting, those living with a partner and who had higher income were more inactive. Physical inactivity at work was higher in white or brown adults, who had higher educational level and higher income. Physical inactivity in household was found to be higher in adults with higher educational level and higher income. CONCLUSIONS: Sociodemographic indicators presented different associations with physical inactivity in each domain.

Clustering of unhealthy behaviors in a Brazilian population of industrial workers.

OBJECTIVE: To analyze the clustering of four unhealthy behaviors (tobacco use, excessive alcohol consumption, physical inactivity and low consumption of fruits and vegetables) and their association with sociodemographic factors among adult industrial workers in Brazil. METHODS: Data from 23 Brazilian states and the Federal District were collected via questionnaire from 2006 to 2008. Clustering of risk behaviors was identified using the ratio between the observed and expected percentages of each combination of unhealthy behaviors. RESULTS: Among the 44,477 workers surveyed, 18.0% of men and 11.4% of women accumulated three or four unhealthy behaviors. The most frequent combination was physical inactivity and low consumption of fruits and vegetables. The concurrent presence of all four behaviors was 86% higher in men and 148% higher in women than would be predicted if the frequency of these behaviors were independent. Presence of one or more negative behaviors was more frequent in men, younger individuals and in those with lower levels of education and family income than subjects without these characteristics. CONCLUSIONS: There was a strong tendency for unhealthy behaviors to assume combinatorial patterns, mainly in men, people with less education, income, and age, suggesting important disparities.

Sex differences in the association between educational level and specific domains of physical activity: a Brazilian cross-national survey.

OBJECTIVE: To identify the association between educational level and physical activity (PA) in specific domains according to sex, among residents of 26 Brazilian state capitals and the Federal District. METHODS: This is a cross-national survey, with data obtained from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL), in 2017, conducted with individuals ≥ 18 years old (n = 53,034). The education level (classified as ≤ 4 years, 5 to 8 years, 9 to 11 years, and ≥ 12 years of education) and PA of participants (meeting PA recommendations and performing this active behaviour) in the commuting, domestic, leisure, and work domains were self-reported. Binary logistic regression was used to analyze the data obtained from the survey. RESULTS: Males and females with higher education were less likely to meet PA recommendations (males: OR = 0.68 [95% CI 0.52-0.91]; females: OR = 0.41 [0.34-0.48]) and perform the active behaviour (males: OR = 0.73 [0.57-0.93]; females: OR = 0.27 [0.23-0.32]) in the domestic domain. In the work domain, the two outcomes were associated with education only for males, indicating that those with more years of education had less chance of meeting PA recommendations (OR9 to 11 years = 0.61 [0.46-0.83]; OR≥12 years = 0.21 [0.15-0.30]) and performing it (OR9 to 11 years = 0.64 [0.49-0.84]; OR≥12 years = 0.25 [0.18-0.34]). However, more years of education seemed to positively influence meeting PA recommendations (males: OR9-11 years = 2.26 [1.79-2.87]; OR≥12 years = 2.91 [2.28-3.72]; females: OR5-8 years = 1.26 [1.04-1.54]; OR9-11 years = 1.81 [1.52-2.16]; OR≥12 years = 2.69 [2.25-3.22]) and practicing this behaviour (males: OR5-8 years = 1.29 [1.01-1.63]; OR9-11 years = 2.54 [2.04-3.17]; OR≥12 years = 3.31 [2.64-4.16]; females: OR5-8 years = 1.23 [1.03-1.46]; OR9-11 years = 1.75 [1.51-2.01]; OR≥12 years = 2.94 [2.53-3.40]) in leisure time for both sexes. CONCLUSION: Education level appears to be an important determinant in the relationship with PA in its different domains, especially in the leisure and domestic domains, for both sexes.

RéSUMé: OBJECTIF: Identifier l'association entre le statut éducatif et l'activité physique (AP) dans des domaines spécifiques, selon le sexe, chez les résidents des capitales du Brésil et du District Fédéral. MéTHODES: Il s'agit d'une enquête transnationale dérivée de la surveillance téléphonique des facteurs de risque et de protection pour les maladies chroniques (VIGITEL), menée en 2017, auprès de personnes âgées de ≥ 18 ans (n = 53 034). Le niveau d'éducation (≤ 4 ans, 5 à 8, 9 à 11 et ≥ 12 ans d'étude) et l'AP des participants (respecter les recommandations d'activité physique et adopter ce comportement actif) dans les domaines des déplacements domicile-travail, domestique, des loisirs et du travail ont été autodéclarés. Une régression logistique binaire a été utilisée. RéSULTATS: Les hommes et les femmes ayant fait des études supérieures étaient moins susceptibles de respecter les recommandations de l'AP (hommes : RC = 0,68 [IC95% 0,52­0,91]; femmes : RC = 0,41 [0,34­0,48]) et d'adopter un comportement actif (hommes : RC = 0,73 [0,57­0,93]; femmes : RC = 0,27 [0,23­0,32]) dans le domaine domestique. Dans le domaine du travail, les deux résultats n'étaient associés à l'éducation que pour les hommes, indiquant que ceux qui avaient plus d'années d'éducation avaient moins de chances de respecter les recommandations de l'AP (RC9 a 11 ans = 0,61 [0,46­0,83]; RC≥12 ans = 0,21 [0,15­0,30]) et de les exécuter (RC9 a 11 ans = 0,64 [0,49­0,84]; RC≥12 ans = 0,25 [0,18­0,34]). Cependant, plus d'années d'éducation semblent influencer positivement le respect des recommandations de l'AP (hommes : RC9 a 11 ans = 2,26 [1,79­2,87]; RC≥12 ans = 2,91 [2,28­3,72]; femmes : RC5 a 8 ans = 1,26 [1,04­1,54]; RC9 a 11 ans = 1,81 [1,52­2,16]; RC≥12 ans = 2,69 [2,25­3,22]) et la pratique de ce comportement (hommes : RC5 a 8 years = 1,29 [1,01­1,63]; RC9 a 11 ans = 2,54 [2,04­3,17]; RC≥12 ans = 3,31 [2,64­4,16]; femmes : RC5 a 8 ans = 1,23 [1,03­1,46]; RC9 a 11 ans = 1,75 [1,51­2,01]; RC≥12 ans = 2,94 [2,53­3,40]) pendant les loisirs pour les deux sexes. CONCLUSION: Le niveau d'éducation semble un déterminant important de la relation avec l'AP dans ses différents domaines, notamment dans les domaines des loisirs et domestique, pour les deux sexes.

Effects of linear periodization of combined training on quality of life of adults with obesity: a blind randomized controlled trial.

This study aimed to compare the effect of 16-weeks of combining aerobic and strength training with a linear increase or fixed intensity on the health-related quality of life (HRQoL) of obese adults. This single-blinded clinical trial involved adults with obesity (BMI ≥ 30 kg/m2), randomized into control (CG), fixed intensity (FG), or linear increase (LG) groups. The FG and LG performed 16 weeks of combined (aerobic + strength) training for 60 min, three times a week. The FG performed aerobic exercises between 50 and 59% of the heart rate reserve (HRres) and strength at 10-12 maximum repetitions (RM). The LG started with 40-49% of HRres and 12-14 RM and progressively increased the intensity (50-59% and 10-12 RM; 60-69% and 8-10 RM). The HRQoL was assessed using the SF-36 questionnaire. Generalized estimation equations and mean differences (∆) were used. Of the 69 participants (23 per group), 36 completed the intervention (CG = 13, FG = 9, and LG = 14). A significant difference was observed in the time of the physical function, with superiority in the training groups (CG: ∆ = 1.2 vs. FG and LG, respectively: ∆ = 10.0). The mental health component and mental health domain showed significant differences for the FG (∆ = 30.2 and ∆ = 23.1, respectively). In conclusion, the combined training improved physical functioning. Specifically, fixed-intensity training effectively enhanced mental health indicators.Trial Registration: This study is registered at www.ensaiosclinicos.gov.br/ (No. RBR-3c7rt3), Date of registration: 07/02/2018.

Effects of Combined Training With Linear Periodization and Non-Periodization on Sleep Quality of Adults With Obesity.

Background: Combined exercise training has proven effective in preventing and treating sleep disorders among obese adults. However, structured progression of intensity in sleep parameters remains poorly investigated within this population. Purpose: To verify the effects of non-periodized and linear periodization combined training on the sleep quality of obese adults. Methods: This was a randomized controlled trial involving adults with body mass index ≥ 30 kg/m2, allocated to 3 groups: control (CG; n = 13), non-periodized training (NG; n = 9), and with linear periodization (PG; n = 13). Groups PG and NG trained for 16 weeks in 3 weekly sessions lasting of 60 minutes. The NG trained in 50-59% heart rate reserve (HRR) e 2 × 10-12 repetition maximum (RM) and the PG with progression in 3 mesocycles: 40-49%;50-59%; 60-69% HRR e 2x12-14; 2x10-12; 2 × 8-10 RM, with the total volume equated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. For statistics, we used Generalized Estimation Equations considering p ≤ 0.05. Results: Sleep latency was reduced in both training groups after intervention (NG-Δ = -25.56 minutes p = .028; PG-Δ = -22.23 minutes p = .035), while significant improvements in sleep efficiency were found only in the NG (Δ = 20.67%; p = .042). Conclusion: Despite the NG's apparent superiority, which model has the best sleep effects on obese adults cannot be stated. Hence, caution is needed while extrapolating the results.

Combined relationship of physical inactivity and sedentary behaviour with the prevalence of noncommunicable chronic diseases: data from 52,675 Brazilian adults and elderly.

This paper aims to verify the association between the combined relationship of physical inactivity and sedentary behaviour (SB) at leisure-time and the prevalence of noncommunicable chronic diseases (NCDs) in Brazilian adults and elderly. This is a cross-sectional study, derived from the VIGITEL system, with individuals ≥18 years old (n = 52,675). The presence of NCDs (diabetes, hypertension, and obesity) and the independent variables were defined by self-report. Binary logistic regression was used. While adults with the presence of, at least, one risky behaviour had a higher odds to have obesity (OR active + high SB: 1.25; 95%CI: 1.01;1.54; OR inactive + low SB: 1.47; 95%CI: 1.25;1.73; OR inactive + high SB: 1.77; 95%CI: 1.47;2.12), the elderly had an increased risk for this outcome only when classified as inactive (OR inactive + low SB: 1.43; 95%CI: 1.17;1.75; OR inactive + high SB: 1.87; 95%CI: 1.47;2.38). Inactive adults with low SB were more likely to have diabetes (OR inactive + low SB: 1.31; 95%CI: 1.00;1.71) and hypertension (OR inactive + low SB: 1.26; 95%CI: 1.08;1.46), while physical inactivity was again more strongly associated with these outcomes in the elderly, for diabetes (OR inactive + low SB: 1.23; 95%CI: 1.02;1.48; OR inactive + high SB: 1.75; 95%CI: 1.39;2.19), and hypertension (OR inactive + low SB: 1.22; 95%CI: 1.05;1.41; OR inactive + high SB: 1.60; 95%CI: 1.33;1.94) Both leisure-time behaviours carry a high risk of the prevalence of different NCDs, however, physical inactivity, isolated or combined, showed a greater association with the evaluated outcomes.HighlightsThis cross-national survey included representative sample of people ≥18 years old.Adults with at least one evident risky behavior had a higher chance of obesity.Inactive adults with low sedentary behavior had higher chances for diabetes and hypertension.Physical inactivity was more strongly associated with all diseases in the elderly.

Association between simultaneity of health-risk behaviours and self-rated health in Brazilian adolescents.

INTRODUCTION: This study examined the association between simultaneity of four health-risk behaviours, namely, low levels of moderate-to-vigorous physical activity (insufficient MVPA: <420 min/week), tobacco use, alcohol consumption, and excessive television (TV)-(>2 h/d of TV viewing) and self-rated health (SRH) in Brazilian adolescents. METHODS: We used data of 100,551 adolescents from the National School Health Survey, a national cross-sectional study carried out in 2015. Association between simultaneity of health risk behaviours (i.e. the ratio between observed and expected prevalence rates) and SRH was examined using logistic regression models. RESULTS: The majority of the participants were female (51.9%) and 14 years of age (50.6%), and 26% of the participants' SRH ranged from 'average' to 'extremely poor'. Those who engaged in the following combinations of health-risk behaviours had higher odds of worse SRH than their healthier counterparts: insufficient MVPA and tobacco use (odds ratio-OR: 2.0, 95% confidence interval [CI]: 1.4 to 3.0); insufficient MVPA and alcohol consumption (OR: 1.6, 95%CI: 1.3 to 1.9); insufficient MVPA and >2 h/day of TV viewing (OR: 1.3, 95%CI: 1.1 to 1.6); insufficient MVPA, tobacco use and alcohol consumption (OR: 2.1, 95%CI: 1.7, to 2.7); and insufficient MVPA, alcohol consumption and >2 h/day of TV viewing (OR: 1.6, 95%CI: 1.4 to 2.0). CONCLUSIONS: Insufficient MVPA, alcohol consumption, and other health-risk behaviours were associated with worse SRH in Brazilian adolescents.

Effects of Non-periodized and Linear Periodized Combined Exercise Training on Insulin Resistance Indicators in Adults with Obesity: A Randomized Controlled Trial.

BACKGROUND: The aim was to verify the effect of non-periodized and linear periodized combined (aerobic plus resistance) exercise training on insulin resistance markers in adults with obesity. METHODS: A blinded randomized control trial was conducted with three groups of individuals with obesity (BMI, 30-39.9 kg/m2): control group (CG, n = 23), non-periodized group (NG, n = 23), and linear periodized group (PG, n = 23). The NG and PG performed aerobic and resistance exercises in the same session in aerobic-resistance order for 16 weeks. Both intervention groups trained three sessions weekly, with a total duration of 60 min each. The aerobic training of the NG had a duration of 30 min always between 50% and 59% of the reserve heart rate (HRres), while resistance exercise was comprised of 6 exercises, performed always in 2 × 10-12 maximum repetitions (MRs). The PG progressed the aerobic and resistance training from 40%-49% to 60%-69% (HRres) and from 2 × 12-14 to 2 × 8-10 RM, respectively, along the intervention period. The evaluated indicators of insulin resistance included fasting glucose, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) collected pre- and post-intervention. The analyses to verify the exercise training effect were performed using generalized estimating equations. RESULTS: After 16 weeks of training, per protocol analysis (n = 39) showed significant reductions in HOMA-IR only in the training groups (NG: Δ = - 1.6, PG: Δ = - 0.6; p = 0.094). Intention-to-treat analysis demonstrated significant reductions in fasting insulin levels (NG: Δ = - 1.4, PG: Δ = - 1.0; p = 0.004) and HOMA-IR (NG: Δ = - 5.5, PG: Δ = - 3.8; p = 0.002). CONCLUSION: Periodized and non-periodized combined exercise training similarly reduces insulin resistance markers in adults with obesity. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-3c7rt3. Registered 07 February 2019- https://ensaiosclinicos.gov.br/trial/5970/1 .

Association between characteristics of physical activity in leisure time and obesity in Brazilians adults and elderly.

OBJECTIVE: To verify the association of obesity with volume, intensity and types of physical activity in leisure time among Brazilian adults and elderly. STUDY DESIGN: Cross-sectional study, with a secondary analysis of data from "Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey". METHODS: The target population comprised adults aged ≥18 years. The outcome was obesity (BMI≥30.0 ​​kg/m²) and the exposures were the volume, intensity, and main type of physical activity in leisure time. Binary logistic regression was used and the results were expressed as odds ratio (OR) and 95% confidence intervals (CI95%), with a significance level of 5%. RESULTS: Compared to inactive, the highest volume of leisure time physical activity (≥300min/week) had a lower occurrence of obesity in adults (OR=0.76; CI95%: 0.63, 0.92; p=0.001) and elderly (OR=0.62; CI95%: 0.46, 0.82; p=0.001). In adults, vigorous activities (OR=0.65; CI95%: 0.55, 0.78; p<0.001) and, in the elderly, light/moderate activities (OR=0.75; CI95%: 0.62, 0.89; p<0.001) and vigorous (OR=0.54; CI95%: 0.37, 0.78; p<0.001) presented protective effect for obesity. Among the types of physical activity, running was the most strongly associated with a lower occurrence of obesity in adults (OR=0.54; CI95%: 0.32, 0.92; p=0.024) and elderly (OR=0.27; CI95%: 0.10, 0.69; p=0.006). In adults, strength training (p<0.001), gymnastics (p=0.032) and sports (p=0.013) and in elderly, walking (p=0.001) and sports (p=0.003) also had protective effect. CONCLUSION: A greater volume, vigorous intensity and physical activities of a structuring character and intensity progression, such as running, were associated with the lower occurrence of obesity.

Phase angle associated with different indicators of health-related physical fitness in adults with obesity.

In obese populations, the exacerbated increase in adipose tissue results in a significant reduction of health-related physical fitness and can affect the phase angle (PhA), a promising health indicator of cell health and integrity. The aim of this study was to investigate the association of PhA with health-related physical fitness indicators in obese adults. This cross-sectional study had a non-probabilistic sample and was conducted from April to June 2018. The PhA was obtained by a bioelectrical impedance analysis, and the health-related physical fitness indicators evaluated were percentage of body fat (%BF), lower- and upper-body maximal strength, cardiorespiratory fitness (relative V̇O2peak), and flexibility. Pearson and Spearman´s linear correlations, crude and adjusted linear regression analyses were performed. A total of 69 obese adults (60.8% female; BMI = 33.5 ± 2.8 kg/m2) with a mean age of 34.6 ± 7.1 years were studied. The PhA means were 5.8 (±0.6º) and had an inverse correlation with %BF (r=-0.74; p<0.001) and positive correlation with V̇O2peak (r=0.50; p<0.001), lower- and upper-body maximal strength (r=0.65; r=0.70; p<0.001, respectively). After adjustment, %BF (ß=-0.065, adjusted R2=0.53; p<0.001), lower- and upper-body maximal strength (ß=0.004; adjusted R2=0.46; p<0.001, and ß=0.024; adjusted R2=0.50; p<0.001, respectively) were predictors of PhA. Our results suggest the favorable role of PhA as a clinically viable tool to screen and identify the physical fitness variables and functional status of obese adults.

Comparison of linear periodized and non-periodized combined training in health markers and physical fitness of adults with obesity: Clinical trial protocol.

The literature discusses that combined training, aerobic more resistance exercises in the same session, is a suitable strategy for people with obesity and that exercise periodization leads to positive health outcomes; however, the implication of different periodizations of combined training for health outcomes in obese adults requires further investigation. The aim of the study will be to describe the methodology used to compare the effect of linear periodized and non-periodized combined training on health markers and health-related physical fitness in adults with obesity. This is a blinded randomized controlled clinical trial investigating adults with obesity in the age group 20-50 years. The sample will be non-probabilistic, and participants will be allocated randomly into one of three groups: control group (CG), non-periodized group (NG), and periodized group (PG). The intervention will occur in 60-min sessions, 3 days a week for 16 weeks, with 1 week dedicated to familiarization with the training and 15 weeks of combined training (aerobic followed by resistance in the same session). The PG group will perform three mesocycles of 5 weeks each, progressing in intensity throughout the intervention [aerobic: from 40-49% to 60-69% of heart rate reserve (HRR); strength: from 12 to 14 maximum repetitions (MR) to 8 to 10MR]; the NG group will maintain the same relative intensity throughout the study (aerobic: 50-59% of HRR; strength: 2 sets of 10-12 MR). Participants in the CG group will maintain their usual activities without the proposed intervention. Pre- and post-intervention assessments will be performed for biochemical markers, body composition, cardiovascular parameters, cardiorespiratory fitness, maximum upper and lower limb strength, flexibility, and subjective health-related parameters. This project was approved by the Committee of Ethics and Research with Human Beings of the institution of origin (protocol 2,448,674) and registered in the Brazilian Registry of Clinical Trials (RBR-3c7rt3).