Correlates of metabolic syndrome among young Brazilian adolescents population.

BACKGROUND: Findings available in literature indicate that metabolic syndrome (MetS) diagnosed in young ages tends to remain in adulthood. The aim of the study was to identify demographic, nutritional, anthropometric and behavioral correlates of MetS in a sample of adolescents from Dourados, Mato Grosso do Sul, Brazil. METHODOLOGY: This is a cross-sectional school-based study involving 274 participants aged 12-18 years (186 girls and 88 boys). Anthropometric measurements were performed and a questionnaire with structured questions was applied for data collection. MetS was identified according to criteria proposed by the International Diabetes Federation. Data were statistically treated using bivariate analysis and hierarchical multiple regression. RESULTS: The proportion of adolescents identified with MetS was equivalent to 4.7% [95% CI (3.6-6.0)]. Multivariate analysis showed that older age (OR = 1.22 [1.04-1.73]) and higher economic class (OR = 1.25 [1.07-1.96]) were significantly associated with MetS. Among behavioral factors, longer recreational screen time (OR = 1.26 [1.05-1.94]) and low fruits/vegetables intake (OR = 1.49 [1.23-2.41]) were independently associated with MetS. Likewise, excess body weight (OR = 1.52 [1.24-2.41]) was significantly associated with the outcome. CONCLUSION: The high proportion of adolescents with MetS and the identification of their correlates reinforce the need for early life style intervention and awareness programs in this population group.

Performance of anthropometric indicators as predictors of metabolic syndrome in Brazilian adolescents.

BACKGROUND: It is not clear which is the best anthropometric indicator to predict metabolic syndrome (MetS) in adolescents. Our objective was to identify the predictive power, with respective cut-off points, of anthropometric indicators associated with the quantity and distribution of body fat for the presence of MetS and to determine the strength of the association between the proposed cut-off points and MetS in adolescents. METHODS: The sample consisted of 1035 adolescents (565 girls and 470 boys) aged between 12 and 20 years. Four anthropometric indicators were considered: waist circumference (WC), body mass index (BMI), waist-height ratio (WHtR), and conicity index (C-Index). MetS was defined according to the criteria of the International Diabetes Federation. Predictive performance was described through analysis of Receiver Operating Characteristic (ROC) curves with a 95% confidence interval. The most accurate cut-off points were identified through sensitivity, specificity and Area Under the Curve (AUC) values. RESULTS: The four anthropometric indicators presented significant AUCs close to 0.70. At younger ages (12-15 years) the girls presented a statistically greater capacity to discriminate MetS; however, at more advanced ages (16-20 years) both sexes presented similar AUCs. Among the anthropometric indicators investigated, regardless of sex and age, the WHtR showed the highest discriminant value for MetS, while the C-Index demonstrated a significantly lower capacity to predict MetS. The AUCs equivalent to WC and BMI did not differ statistically. The proposed cut-off points for WHtR (12-15 years = 0.46, 16-20 years = 0.48) presented the highest values of sensitivity and specificity, between 60% and 70%, respectively. CONCLUSION: Considering that the best AUC was found for WHtR, we suggest the use of this anthropometric indicator, with the cut-off points presented herein, for the prediction of MetS in adolescents with characteristics similar to the study sample.

[Health-related quality of life in Latin American adolescents]. / Calidad de vida relacionada con la salud de adolescentes latinoamericanos.

OBJECTIVE: The objective of the present study was to find out if there are differences in terms of sex, age, or country of origin for the components of health-related quality of life (HRQL) in samples of adolescents from three cities-in Argentina, Brazil, and Chile, respectively-using data collected through an internationally recognized and validated survey questionnaire, KIDSCREEN-52. METHODS: The KIDSCREEN-52 questionnaire was administered to 1 357 adolescents between 12 and 17 years of age (48.6% of them male) in selected samples in the three countries. Univariate analysis of variation (ANCOVA) was used. Not only sex and age differences, but also differences for each component of HRQL, were found between the three country groups. RESULTS: The data showed significant differences between the three countries for each of the specific components of HRQL. Males scored significantly higher than females in the following components: Physical Well-being (P < 0.001), Psychological Well-being (P = 0.019), Moods and Emotions (P < 0.001), Self-perception (P = 0.001), Autonomy (P < 0.001), and Parent Relations and Home Life (P = 0.008). Furthermore, the average scores for Physical Well-being (P = 0.001), Psychological Well-being (P = 0.001), Self-Perception (P = 0.038), Autonomy (P = 0.001), Parent Relations and Home Life (P = 0.001), School Environment (P = 0.001), and Financial Resources (P = 0.022) showed a significantly declining trend with each advancing year, while average scores for the component Social Acceptance (Bullying) increased significantly with age (P < 0.001). CONCLUSIONS: The evidence suggests that interventions in disease prevention and health promotion should be developed for specific target groups, using appropriate actions depending on the sex and age of the adolescents.

[Eating habit and metabolic syndrome in a sample of Brazilian adults]. / Hábito alimentar e síndrome metabólica em uma amostra de adultos brasileiros.

The objective was to analyze indicators related to eating habits and their association with metabolic syndrome (MetS) in a representative sample of adults in a community from State of São Paulo, Brazil. The sample was comprised of 1,112 participants aged ≥ 20 years. Data from sociodemographic issues, indicators regarding eating habits, anthropometric measures, resting arterial pressure, blood glucose and plasma lipids were registered. MetS was assessed according to the NCEP-ATP III criteria. The results showed that adequate consumption of fruits and vegetables was reported by less than 10% of the individuals. Regular consumption of fatty foods (5 days/week) was reported by 54.2% and sugar-added products and soft drinks by 3 8.6% of the interviewees. Gender, age, schooling, socioeconomic level and nutritional status influenced significantly the eating habits. Prevalence of MetS was approximately 24%, significantly higher in men (27.8% vs 20.3%; p = 0.005). Risk to identify MetS in individuals who reported not consuming regularly fruits and vegetables was approximately two times higher than their peers who reported adequate intake (women: OR = 1.93; 95% CI 1.51 - 2.38; men: OR = 2.04; 95% CI 1.63 - 2.40). Exposure risk for MetS was progressively higher according to reported higher consumption of fatty foods, sugar-added products and soft drinks. The findings suggest interventions in order to emphasize healthy eating habits, which could help to minimize risk of MetS.

Prevalence and Correlates of Health Risk Behaviors among University Students from a State in the Southern Region of Brazil.

BACKGROUND: Surveys conducted in different regions of the world show that the prevalence rates of health risk behaviors (HRBs) in university students are sometimes higher than those found in non-university populations. This study aims to identify the prevalence rates and demographic and academic environment correlates associated with HRBs among Brazilian university students. METHODS: In a cross-sectional epidemiological study, a random sample of 5310 university students answered an online questionnaire, with demographic (sex, age, skin color, marital status, and paid work) and academic setting information (housing type, size of campus, year, and shift of study), as well as items clustered in four HRB domains: personal safety and violence, sexual behavior and contraception, addictive substance use, eating habits, physical activity, and sleep. The data were analyzed statistically using bivariate analysis and hierarchical multiple regression. RESULTS: The highest prevalence rates occurred in HRBs clustered in the domain of eating habits, physical activity, and sleep (>60%), while HRBs for personal security and violence were less prevalent (<15%). From 15% to 35% of university students assumed HRBs regarding addictive substance use, and approximately 50% reported risky sexual behavior. The university students most susceptible to HRBs were men, aged ≥ 22 years, living far from their family, studying on larger campuses, attending night classes, and with two or more years of study at the university. CONCLUSION: The findings suggest that policies and interventions in the university context aimed at students' readiness to engage in a healthy lifestyle should target specific correlates associated with HRBs.

Footwork Pro System Reproducibility of Static and Dynamic Plantar Pressure Indicators.

Objective: The purpose of this study was to identify the reproducibility of the Footwork Pro plate in the measurement of static and dynamic plantar pressure in healthy adults. Methods: We performed a reliability study using a test-retest design. The sample consisted of 49 healthy adults of both sexes, aged 18 to 64. Participants were assessed on the following 2 different occasions: the initial moment and 7 days later. Measurements for the static and dynamic plantar pressure were performed. We used the Student t test for paired data, the concordance correlation coefficient, and bias to estimate reliability. Results: Plantar pressure values for the static condition (peak plantar pressure, plantar surface contact area, and body mass distribution) and dynamic condition (peak plantar pressure, plantar surface contact area, and contact time) between the first and second measurements did not present statistically significant differences. The concordance correlation coefficients were ≤0.90, and the biases were of low magnitude. Conclusion: The findings showed that the Footwork Pro system offered clinically acceptable reproducibility to identify static and dynamic plantar pressure and thus may be a reliable tool for this purpose.

Independent and combined effects of lifestyle behaviors on adolescent health-related quality of life.

OBJECTIVE: To investigate the independent and combined effects of lifestyle behaviors, including physical activity, sedentary behavior, sleep duration and food intake, in the health-related quality of life (HRQoL) of Brazilian adolescents. METHODS: Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect lifestyle behaviors data. Perception of the HRQoL was identified using the Kidscreen-27. The study used covariance analysis and linear regression models for statistical analysis. RESULTS: Adolescents who reported ≤ 2 hours/day of screen-based sedentary behavior and sleep duration equivalent to 8-10 hours/night presented significantly higher HRQoL. Adolescents who reported joint adherence ≥ 3 healthy lifestyle behaviors demonstrated approximately two [OR=2.12] to three times [OR=3.04] more chance of presenting higher perceptions of HRQoL. CONCLUSION: Although healthy lifestyle behaviors had a positive independent effect on HRQoL, joint adherence to healthy behaviors enhances the cumulative effect.

Health-promoting domains and lifestyle of a sample of Brazilian adolescents.

BACKGROUND: Reports indicate that the health habits of adults are strongly linked to the behaviors incorporated in adolescence. Therefore, it is essential to monitor the lifestyle of adolescents to promote their present and future health. This study aimed to identify differences in health-promoting domains according to demographic data and lifestyle behaviors, including physical activity, sedentary behavior, sleep duration, and food intake, in a sample of Brazilian adolescents. MATERIALS AND METHODS: Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect demographic data and lifestyle behaviors. To examine the health-promoting domains the Adolescent Health Promotion Scale (AHPS) was used. Data were analyzed using multivariate analysis. RESULTS: Scores attributed to each of the health-promoting domains showed substantial variations according to sex, age, year of study, parents' schooling, and family economic class. After adjustment for covariables, the adolescent who presented significantly higher scores equivalent to the overall index of health promotion reported being more physically active (F = 4.848; P = 0.009), sleeping 6-8 hours/night (F = 2.328; P = 0.046), consuming fruit/vegetable more frequently (F = 3.168; P = 0.024), while sedentary behavior and intake of sweetened products/soft drinks have not shown any significant effect. CONCLUSION: The findings confirmed the consistent positive influence of health-promoting domains assessed by AHPS on healthy lifestyle behaviors, suggesting in the intervention programs aimed at adopting healthy lifestyle approaches it is important enough to contemplate actions aimed at all the areas of health promotion with characteristics aimed at nutrition behavior, social support, health responsibility, life appreciation, exercise behavior, and stress management.

Adherence to Combined Healthy Movement Behavior Guidelines among Adolescents: Effects on Cardiometabolic Health Markers.

BACKGROUND: The combined movement behavior guidelines for adolescents recommend ≥60 min of moderate to vigorous physical activity, ≤2 h of screen time, and 8-10 h of sleep. Considering that the information available on this topic in the young Latin American population is rare, this study aimed to identify the proportion of a sample of Brazilian adolescents meeting individual guidelines as well as the combination of the three healthy movement behavior guidelines. In addition, another objective of the study was to examine the effects of compliance with these guidelines on cardiometabolic health markers. METHODS: This is a cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire with structured questions was applied to collect data on physical activity, screen time, and sleep duration. Cardiometabolic health was assessed by the calculation of a continuous risk score, including twelve markers related to body fat, blood pressure, plasma lipids and lipoproteins, glycemia, and insulin. RESULTS: Only 4.8% (4.3-5.4) of the adolescents met the three healthy movement behavior guidelines, while 9.3% (8.4-10.4) of the sample did not meet any of the guidelines. No significant difference between sexes was found in the simultaneous compliance of the three movement guidelines. Adolescents who did not meet any of the movement guidelines were twice as likely to have higher cardiometabolic risk (OR = 2.05 (1.41-3.17)) than their peers who met all three guidelines. CONCLUSIONS: Considering the high proportion of adolescents who did not meet the movement behavior guidelines and the negative effects on cardiometabolic health, it is suggested that future policies and interventions should consider an integrated and holistic approach aimed at simultaneous actions of maximizing physical activity, minimizing screen time, and ensuring sufficient sleep duration.

Effects of social and environmental determinants on overweight and obesity among Brazilian schoolchildren from a developing region.

OBJECTIVE: To identify the social and environmental determinants most strongly associated with overweight and obesity in Brazilian schoolchildren from a developing region. METHODS: Data were collected from a community-based survey of schoolchildren from the Valley of Jequitinhonha, Minas Gerais, Brazil. The sample was composed of 5 100 school children aged 6-18 years. Overweight and obesity were defined by body mass index based on the current method recommended by the World Health Organization in 2007. Social and environmental determinants were collected by using a structured questionnaire. RESULTS: The prevalence of overweight and obesity was 11.1% and 2.7% in girls and 8.2% and 1.5% in boys, respectively. The chance of overweight was higher in schoolchildren who engaged in remunerated work (odds ratio [OR] = 2.19, 95% confidence interval [CI] 1.30- 3.26), whose parents had higher education levels (OR = 1.52, 95% CI 1.12-2.07), who had two or fewer siblings (OR = 1.74, 95% CI 1.21-2.49), and who were in a high economic class (OR = 1.93, 95% CI 1.32-2.85). Schoolchildren who traveled by car to school (OR = 1.50, 95% CI 1.14-1.91), lived < 5 km from school (OR = 1.64, 95% CI 1.06-2.39), and consumed foods sold in the school cafeteria (OR = 1.56, 95% CI 1.19-2.16) presented high odds of being overweight. CONCLUSIONS: The background from a particular region of a country should be considered when implementing preventive measures regarding overweight and obesity, especially for very poor, developing regions like the Valley of Jequitinhonha. Measures taken should consider a multilevel intervention that includes the family, school, and physical environment.

Exercise and fruit/vegetable intake, and their associations with body weight status in university students.

INTRODUCTION: Background: evidence suggests that exposure to risk factors related to excess body weight is more frequent in the second and third decades of life. Thus, one of the most propitious environments for the acquisition of habits that can inhibit overweight is the university. Objective: to identify the frequency of aerobic and strength exercises and of fruit/vegetable intake in university students, and subsequently establish associations between both health behaviors and excess body weight. Methods: the sample was comprised of 5,310 university students. An online questionnaire was used to collect the frequency of exercises and fruit/vegetable intake. The body mass index was used to define body weight status. The data were analyzed statistically by employing a bivariate analysis and binary logistic regression. Results: the practice of aerobic and strength exercises was reported by 80.4 % and 51.6 % of the sample, respectively. Only 13 % of the surveyed university students had an adequate fruit/vegetable intake. The proportion of excess body weight was 39.1 %, the condition being significantly higher in men. The risk for excess body weight identified in the university students who reported not consuming fruits/vegetables daily was two to three times higher than in their peers who reported an adequate intake (women: OR = 2.92 [95 % CI 2.07-4.12]; men: OR = 1.98 [95 % CI 1.41-3.02]). Exposure to the risk for excess body weight was progressively lower as the reported frequency of aerobic exercise became higher. Conclusion: these findings suggest the need to promote initiatives aimed at the preparation and implementation of health education and promotion programs in the university context, through actions of guidance about exercise and food intake that may help to minimize the risks of onset and development of excess body weight.

INTRODUCCIÓN: Antecedentes: las evidencias sugieren que la exposición a factores de riesgo relacionados con el exceso de peso se produce con mayor frecuencia en la segunda y tercera décadas de la vida. Por lo tanto, uno de los entornos más propicios para la adquisición de hábitos que puedan inhibir el sobrepeso es la universidad. Objetivos: identificar la frecuencia de los ejercicios aeróbicos y de fuerza y del consumo de frutas/verduras en estudiantes universitarios, y posteriormente establecer asociaciones entre los dos comportamientos de salud y el exceso de peso. Métodos: la muestra estaba compuesta de 5310 estudiantes universitarios. Las frecuencias de los ejercicios físicos y del consumo de frutas/verduras se recopilaron mediante la aplicación de un cuestionario online. El exceso de peso se estableció a partir del índice de masa corporal. Los datos se analizaron estadísticamente empleando análisis bivariados y de regresión logística binaria. Resultados: la práctica de ejercicios aeróbicos y de fuerza fue relatada por el 80,4 % y el 51,6 % de la muestra, respectivamente. Solamente el 13 % de los estudiantes universitarios presentaron un consumo adecuado de frutas/verduras. La proporción del exceso de peso fue equivalente al 39,1 %, siendo dicha proporción significativamente más elevada en los hombres. El riesgo de padecer exceso de peso identificado en los estudiantes universitarios que relataron no consumir frutas/verduras diariamente fue de dos a tres veces mayor que el de sus pares que refirieron un consumo adecuado (mujeres: OR = 2,92; IC 95 %, 2,07-4,12; hombres: OR = 1,98; IC 95 %, 1,41-3,02). La exposición al riesgo del exceso de peso fue progresivamente menor conforme mayor era la frecuencia reportada de ejercicios aeróbicos. Conclusión: los hallazgos sugieren la necesidad de promover iniciativas dirigidas al diseño e implementación de programas de educación y promoción de la salud en el contexto universitario a través de acciones de orientación sobre ejercicio físico y consumo de alimentos que puedan ayudar a minimizar los riesgos de aparición y desarrollo del exceso de peso.

Physical growth of schoolchildren from the Jequitinhonha Valley, Minas Gerais, Brazil: Comparison with the CDC-2000 reference using the LMS method.

OBJECTIVE: To analyse the physical growth of a representative school population sample from the Jequitinhonha Valley, Minas Gerais, Brazil, in comparison with the reference proposed by the Centre for Disease Control and Prevention (CDC-2000). METHODS: The sample was composed of 5100 individuals (2730 girls and 2370 boys), aged 6-18 years. Body weight-for-age and height-for-age percentiles were obtained using the LMS method. Statistical and graphical comparisons were made with the corresponding percentiles of the CDC-2000 reference, estimated using the same method. RESULTS: Overall, the calculated values of the L (asymmetry) and the S (variability) parameters were quite similar to the CDC-2000 reference values. However, M (median) was substantially different from the reference used in the study, mainly in schoolchildren over 12-13 years of age of both genders. The magnitude of the deficits of height-for-age and body weight-for-age observed in the schoolchildren from the Jequitinhonha Valley, Minas Gerais, Brazil, varied from 4 to 6 cm and from 3 to 6 kg, respectively. CONCLUSION: The body weight-for-age and height-for-age percentiles of schoolchildren population in the Jequitinhonha Valley, Minas Gerais, Brazil differed substantially from those referenced.

Psychometric Properties of the Brazilian Version of the Adolescent Health Promotion Scale (AHPS). / Propriedades Psicométricas da Versão Brasileira da Adolescent Health Promotion Scale (AHPS).

This study aimed to translate into Portuguese, perform the cross-cultural adaptation and verify the psychometric properties of the Adolescent Health Promotion Scale (AHPS) for use in Brazilian adolescents. The original version was translated following international recommendations. The final version of the translated scale was administered to a sample of 1,949 adolescents of both genders aged 12-18 years. An exploratory factor analysis and then a confirmatory factor analysis were completed to identify the baseline psychometric properties. After minor changes identified in the translation process, the committee of experts considered that the Portuguese version of the AHPS showed semantic, idiomatic, cultural and conceptual equivalence. The factor analysis confirmed the structure of six subscales originally proposed, by statistical indicators equivalent to χ2/df=1.83, CFI=0.948, GFI=0.969, AGFI=0.956 and RMSR=0.052. Factor validity and reliability were confirmed by suitable factor loadings and desirable realms of composite reliability (>0.7) average variance extracted (>0.5). In conclusion, translation, cross-cultural adaptation and psychometric properties of the AHPS were satisfactory, thus enabling its application in future Brazilian studies.

Os objetivos do estudo foram traduzir para o idioma português, realizar adaptação transcultural e verificar propriedades psicométricas da Adolescent Health Promotion Scale (AHPS) para uso em adolescentes brasileiros. Versão original foi traduzida de acordo com recomendações internacionais. Versão final da escala traduzida foi administrada em uma amostra de 1.949 adolescentes de ambos os sexos com idade entre 12 e 18 anos. Para identificar as propriedades psicométricas iniciais foi realizada análise fatorial exploratória e, na sequência, análise fatorial confirmatória. Após discretas modificações apontadas no processo de tradução, comitê de juízes considerou que a versão para o idioma português da AHPS apresentou equivalências semântica, idiomática, cultural e conceitual. Análise fatorial confirmou estrutura de seis subescalas originalmente proposta, mediante indicadores estatísticos equivalentes a χ2 /gl=1,83, CFI=0,948, GFI=0,969, AGFI=0,956 e RMSR=0,052. Validade fatorial e confiabilidade foram confirmadas mediante adequadas cargas fatoriais e desejáveis dimensões de confiabilidade composta (>0,7) e variância média extraída (>0,5). Concluindo, tradução, adaptação transcultural e propriedades psicométricas da AHPS foram satisfatórias, o que viabiliza sua aplicação em futuros estudos no Brasil.

Determinants of lifestyle associated with metabolic syndrome in Brazilian adolescents.

INTRODUCTION: Background: metabolic syndrome (MetS) has been diagnosed in adolescents. However, it remains uncertain which determinants of lifestyle are independently associated with its occurrence. Objective: to verify the association between lifestyle determinants (physical activity, sedentary behavior and food consumption) and MetS, by controlling demographic indicators and anthropometric nutritional status in a sample of adolescents from the southern region of Brazil. Subjects and methods: a school-based cross-sectional study involving 1,035 adolescents (565 girls and 470 boys) aged 12 to 20 years. Anthropometric measurements were performed and a questionnaire was applied with structured questions. MetS was identified according to criteria proposed by the International Diabetes Federation. The data were treated using bivariate analysis and hierarchical multiple regression. Results: the overall prevalence of MetS was equivalent to 4.5% (95% CI: 3.8 to 5.4). Multivariate analysis showed a significant association between MetS and age (OR = 1.34 [95% CI, 1.09 to 1.80]) and economic class (OR = 1.35 [95% CI: 1.08 to 1.86]). Among the determinants of lifestyle, high recreational screen time (OR = 1.32 [95% CI: 1.07 to 1.94]) and low fruit/vegetable intake (OR = 1.23 [95% CI: 1.01 to 1.87]) were independently associated with MetS. Likewise, obesity (OR = 1.62 [95% CI: 1.28 to 2.47]) was significantly associated with the outcome. Conclusion: in view of the significant association with MetS, intervention strategies should be designed to reduce recreational screen time and encourage fruit/vegetable consumption, especially among older adolescents, with a high economic class and obesity status.

INTRODUCCIÓN: Introducción: el síndrome metabólico (SMet) se ha diagnosticado en adolescentes, sin embargo, sigue siendo incierto qué determinantes del estilo de vida se pueden asociar de forma independiente con su ocurrencia. Objetivo: verificar la asociación entre determinantes del estilo de vida (actividad física, comportamiento sedentario y consumo de alimentos) y SMet mediante el control de indicadores demográficos y el estado nutricional antropométrico en una muestra de adolescentes de la región sur de Brasil. Sujetos y métodos: estudio transversal con 1.035 adolescentes (565 chicas y 470 chicos) de 12 a 20 años. Se midieron valores antropométricos y se aplicó un cuestionario con preguntas estructuradas. El SMet se identificó de acuerdo con los criterios propuestos por la International Diabetes Federation. Los datos fueron tratados mediante análisis bivariado y regresión múltiple jerarquizada. Resultados: la prevalencia general de SMet fue del 4,5% [IC 95%: 3,8-5,4]. El análisis multivariado mostró una asociación significativa entre SMet y edad (OR = 1,34 [IC 95%: 1,09-1,80]) y clase económica (OR = 1,35 [IC 95%: 1,08-1,86]). Entre los determinantes del estilo de vida, el alto tiempo de pantalla en actividad recreativa (OR = 1,32 [IC 95%: 1,07-1,94]) y la baja ingesta de frutas/vegetales (OR = 1,23 [IC 95%: 1,01-1,87]) se asociaron de forma independiente con el SMet. Del mismo modo, la obesidad (OR = 1,62 [IC 95%: 1,28-2,47]) se asoció significativamente con el SMet. Conclusión: en vista de la asociación significativa con el SMet, las estrategias de intervención deben diseñarse para reducir el tiempo de pantalla recreativo y fomentar el consumo de frutas y verduras, especialmente entre los adolescentes mayores, de clase económica más alta y obesos.

Use of different segmental multi-frequency bioelectrical impedance devices for analysis of body composition in young adults: comparison with bioelectrical spectroscopy.

INTRODUCTION: Introduction: recently there have been several new versions of equipment based on the principles of bioelectrical impedance (BIA). Therefore, it is important to know the agreement between data produced by different commercially available equipment. Objective: to verify the agreement between fat-free mass (FFM), fat mass (FM), and body fat percentage (BF%) estimated using different segmental multi-frequency BIA (Tanita® MC-980U and InBody 770®) and whole-body spectral techniques (Xitron 4200). Methods: the sample consisted of 117 adults of both sexes, aged between 18 and 28 years. Methodological procedures followed specific guidelines for each equipment model. Agreement was analyzed by the t-test for paired data, concordance correlation coefficient (CCC), and Bland-Altman plot. Results: mean estimates of FFM, FM, and BF% produced by the Tanita® MC-980U and InBody 770® devices did not present statistical differences compared to the Xitron 4200® reference device. CCC values for FFM demonstrated magnitudes between 0.904 and 0.931, representing clinically acceptable strength of agreement, while for FM and BF% the strength of agreements was weak (< 0.90). Regarding the FFM, the bias showed underestimates of -0.98 kg to -1.69 kg, with limits of agreement between -7.32 kg and 3.94 kg. In the case of FM and BF%, overestimations were observed that reached values of 1.01 kg and 0.71%, with limits of agreement of -1.91 kg to 3.93 kg and -3.86% to 5.28%, respectively. Conclusion: FFM, FM, and BF% estimated by the Tanita® MC-980U and InBody 770® devices were not individually comparable with estimates produced by the Xitron 4200® reference device; therefore, its replacement for diagnostic purposes and inter- or intra-subject comparisons is not recommended.

INTRODUCCIÓN: Introducción: recientemente han surgido varias versiones de equipamiento que se basan en los principios de bioimpedancia eléctrica (BIA). Por lo tanto, es importante conocer la concordancia entre datos producidos por diferentes equipamientos disponibles comercialmente. Objetivos: verificar la concordancia entre masa libre de grasa (MLG), masa grasa (MG) y porcentaje de grasa (%Grasa) estimadas por diferentes equipamientos de BIA por técnica segmentar de multifrecuencia (Tanita® MC-980U e InBody 770®) y espectral de cuerpo entero (Xitron 4200®). Métodos: muestra constituida por 117 adultos de ambos sexos con edad entre 18 y 28 años. Los procedimientos metodológicos han seguido las directrices específicas de cada modelo de equipamiento. La concordancia se analizó mediante el test t para datos pareados, coeficiente de correlación de concordancia (CCC) y trazado Bland-Altman. Resultados: las estimaciones medias de MLG, MG y %Grasa producidas por los equipamientos Tanita® MC-980U e InBody 770® no presentaron diferencias estadísticas en comparación con el equipamiento de referencia Xitron 4200®. Los valores de CCC para MLG presentaron magnitudes entre 0,904 y 0,931, lo que representa una fuerza de concordancia clínicamente aceptable, mientras que para MG y %Grasa la fuerza de concordancia fue débil (< 0,90). Con respecto al MLG, los sesgos apuntaron subestimaciones de -0,98 kg a -1,69 kg, con límites de concordancia entre -7,32 kg y 3,94 kg. En el caso de la MG y del %Grasa, se observaron sobreestimaciones que alcanzaron valores de 1,01 kg y 0,71%, con límites de concordancia de -1,91 kg a 3,93 kg y -3,86% a 5,28%, respectivamente. Conclusión: la MLG, la MG y el %Grasa estimados por los equipamientos Tanita® MC-980U e InBody 770® no fueron comparables individualmente con estimaciones producidas por el equipamiento de referencia Xitron 4200®. Por lo tanto, no se aconseja su sustitución para efecto de diagnóstico y comparaciones inter o intraindividuos.

The influence of gender and age on foot structure and plantar pressure in asymptomatic adults / Influência de sexo e idade na estrutura do pé e pressão plantar em adultos assintomáticos

Abstract The aim of the study was identify the influence of gender and age of healthy adults on the foot structure and the plantar pressure during gait. Sample comprising 608 women and men participants. To identify the structure of the foot, anthropometric measurements of both the total and the truncated length of the foot, the width of the forefoot, and the heights of the back and navicular were taken. Peak pressure and plantar contact area in three foot-masks (forefoot, middle foot, and hindfoot) were considered markers of plantar pressure. The data were analyzed by two-way variance analysis. No significant influence of age on the foot structure dimensions was identified; however, women presented measures equivalent to the five significantly smaller anthropometric markers. As for the peak plantar pressure, both males and females showed statistically similar values, but significant differences were observed for age. As to the plantar contact area, while age did not have significant influence, men showed significantly higher values in the three foot-masks. The findings suggest that gender influences the foot structure and the plantar contact area, while age influences the peak of plantar pressure.

Resumo O objetivo do estudo foi identificar a influência de sexo e idade na estrutura do pé e na pressão plantar durante a marcha de adultos saudáveis. Amostra constituída por 608 participantes de ambos os sexos. Para identificar a estrutura do pé, foram realizadas medidas antropométricas equivalentes ao comprimento total e truncado do pé, à largura do antepé, às alturas do dorso e do navicular. Pico de pressão e área de contato plantar em três máscaras podais (antepé, médio pé e retropé) foram considerados marcadores de pressão plantar. Os dados foram analisados mediante análise de variância two-way. Não foi identificada influência significativa da idade nas dimensões da estrutura do pé; contudo, mulheres apresentaram medidas equivalentes aos cinco marcadores antropométricos significativamente menores. Quanto ao pico de pressão plantar, ambos os sexos apresentaram valores estatisticamente similares, porém diferenças significativas foram observadas com relação à idade. No caso da área de contato plantar, enquanto a idade não demonstrou influência significativa, os homens apresentaram valores significativamente maiores nas três máscaras podais. Os achados sugerem que o sexo exerce influência na estrutura do pé e na área de contato plantar, enquanto o pico de pressão plantar é influenciado pela idade.

Socio-demographic correlates of physical activity among European older people.

From a public health perspective, identifying factors related to attaining the physical activity (PA) recommendations is important in order to identify subgroups for intervention programs. The aim of this study is to identify the socio-demographic correlates of attaining the recommended levels of PA in the older European population. Using data from the European Social Survey round 6, PA and socio-demographic characteristics were collected from 10,148 participants (4556 men, 5592 women), aged 65 years and over, from 28 countries in 2012. PA was accessed using the question "On how many of the last seven days did you walk quickly, do sports, or other PA for 30 min or longer?" and meeting PA guidelines was assessed using World Health Organization criteria. Overall, 59.7% of the participants attained the PA-recommended levels. The likelihood of attaining PA recommendations was higher among older people with higher education levels (p < 0.05; p < 0.01; p < 0.001). Men who lived in a town or small city (p < 0.05) and lived in a rural area (p < 0.001) were more likely to attain the PA recommendations. Women who lived with a partner were more likely to attain the PA recommendations (p < 0.001). Promotion of PA is critical to health among older people; therefore, intervention programs must consider these socio-demographic factors when planning an increase in PA.

Independent and combined effects of lifestyle behaviors on adolescent health-related quality of life / Efectos individuales y combinados de conductas del estilo de vida en la calidad de vida relacionada a la salud de adolescentes / Efeitos individual e combinado de condutas do estilo de vida na qualidade de vida relacionada à saúde de adolescentes

ABSTRACT Objective: To investigate the independent and combined effects of lifestyle behaviors, including physical activity, sedentary behavior, sleep duration and food intake, in the health-related quality of life (HRQoL) of Brazilian adolescents. Methods: Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect lifestyle behaviors data. Perception of the HRQoL was identified using the Kidscreen-27. The study used covariance analysis and linear regression models for statistical analysis. Results: Adolescents who reported ≤ 2 hours/day of screen-based sedentary behavior and sleep duration equivalent to 8-10 hours/night presented significantly higher HRQoL. Adolescents who reported joint adherence ≥ 3 healthy lifestyle behaviors demonstrated approximately two [OR=2.12] to three times [OR=3.04] more chance of presenting higher perceptions of HRQoL. Conclusion: Although healthy lifestyle behaviors had a positive independent effect on HRQoL, joint adherence to healthy behaviors enhances the cumulative effect.

RESUMEN Objetivo: Investigar los efectos individuales y combinados de conductas del estilo de vida, incluyendo actividad física, conducta sedentaria, sueño y ingestión de alimentos, en la calidad de vida relacionada a la salud (CVRS) de adolescentes brasileños. Métodos: Estudio observacional de base escolar, con participación de 306 adolescentes de 14 a 18 años. Fue aplicada encuesta con cuestiones estructuradas para recoger datos de conductas del estilo de vida. Percepción de la CVRS fue identificada por medio del Kidscreen-27. Análisis de covarianza y modelos de regresión linear fueron usados para análisis estadístico. Resultados: Adolescentes que apuntaron ≤ 2 horas/día de conducta sedentaria basado en pantalla y duración de sueño entre 8-10 horas/noche tuvieron CVRS significativamente más elevada. Adolescentes que relataron adherencia conjunta ≥ 3 conductas saludables del estilo de vida demostraron aproximadamente de dos [OR=2,12] a tres veces [OR=3,04] más chance de presentar percepciones más elevadas de CVRS. Conclusión: Aunque conductas saludables del estilo de vida resulten en efecto individual positivo sobre la CVRS, adherencia conjunta de conductas saludables potencializa el efecto acumulativo.

RESUMO Objetivo: Investigar os efeitos individual e combinado de condutas do estilo de vida, incluindo atividade física, comportamento sedentário, sono e consumo alimentar, na qualidade de vida relacionada à saúde (QVRS) de adolescentes brasileiros. Métodos: Estudo observacional de base escolar, com participação de 306 adolescentes de 14 a 18 anos. Foi aplicado questionário com questões estruturadas para levantar dados de condutas do estilo de vida. Percepção da QVRS foi identificada por meio do Kidscreen-27. Análise de covariância e modelos de regressão linear foram usados para análise estatística. Resultados: Adolescentes que apontaram ≤ 2 horas/dia de comportamento sedentário baseado em tela e duração de sono entre 8-10 horas/noite apresentaram QVRS significativamente mais elevada. Adolescentes que relataram adesão conjunta ≥ 3 condutas saudáveis do estilo de vida demonstraram aproximadamente de duas [OR=2,12] a três vezes [OR=3,04] mais chance de apresentarem percepções mais elevadas de QVRS. Conclusão: Embora condutas saudáveis do estilo de vida apresentaram efeito individual positivo sobre a QVRS, adesão conjunta de condutas saudáveis potencializaram o efeito cumulativo.

Clustering of Excess Body Weight-Related Behaviors in a Sample of Brazilian Adolescents.

The aim of the study was to identify the existence of clusters in multiple lifestyle behaviors, including consumption of fruits/vegetables, sugary products/soft drinks, physical activity and sedentary behavior. The association between identified clusters and excess body weight in a sample of adolescents from Dourados, Brazil, was examined. This is a cross-sectional school-based study involving 578 participants aged 12⁻18 of both sexes. Anthropometric measurements were performed and a questionnaire was applied with structured questions to collect data. Excess body weight was identified through body mass index. Cluster analysis was performed to identify sex-specific clusters of multiple lifestyle behaviors. Analysis of covariance and logistic regression were used to analyze associations between clusters and excess body weight. Six clusters were identified in both sexes. Girls and boys in the cluster characterized by greater time spent in sedentary behavior were 53% (OR = 1.53 [1.06⁻2.26]) and 63% (OR = 1.63 [1.12⁻2.35]) more likely to present excess body weight compared to their peers in the reference cluster. In the case of adolescents in the cluster characterized by high consumption of sugary products/soft drinks, girls were 47% more likely to be overweight (OR = 1.47 [1.05⁻2.13]) and boys were 51% more likely (OR = 1.51 [1.05⁻2.16]). High consumption of fruits/vegetables, low consumption of sugary products/soft drinks and less sedentary behavior was considered the most effective combination for the maintenance of a healthy weight.

Physical activity and health: a historical and conceptual approach / A relação entre atividade física e saúde: uma abordagem histórica e conceitual

This theoretical essay reflects on physical activity (PA) and health and the development of this study area, particularly in Brazil. A historical review is presented based on major research themes in the area since the 1950s and the evolution of PA recommendations for health. Crucial conceptual and operational definitions in the area that have gone through recent updates are addressed. The pa-per highlights relevant institutions and documents, as well as reflects on future perspectives and challenges in the field. Finally, this essay highlights the need to reduce the gap between the robust scientific knowledge already produced about the health benefits of PA and the real action in the field, especially in the primary health care setting

A partir de uma abordagem histórica, conceitual, crítica e didática, este ensaio teórico propõe uma reflexão sobre a relação entre atividade física (AF) e saúde e o desenvolvimento desta área de estudo, com um olhar especial sobre o Brasil. Apresenta-se revisão histórica a partir de grandes temas de pesquisa na área desde os anos 1950 e da evolução das recomendações de AF para a saúde. São abordadas definições conceituais e operacionais que passaram por atualizações recentes e que são cruciais na área. Faz-se destaque a instituições e documentos relevantes, além de reflexões sobre perspectivas e desafios futuros para a área. Por fim, destaca a necessidade da redução na distância entre a solidez do conhecimento já produzido sobre os benefícios da AF para a saúde e os desejados avanços no contexto da promoção da saúde, em especial na atenção primária à saúde