How many steps/day are enough? For adults.

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day.

How many steps/day are enough? For older adults and special populations.

Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26) and 2,215 steps/day (or an effect size of 0.67), respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute) in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs), and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding) value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7,100 steps/day if averaged over a week. Measured directly and including these background activities, the evidence suggests that 30 minutes of daily MVPA accumulated in addition to habitual daily activities in healthy older adults is equivalent to taking approximately 7,000-10,000 steps/day. Those living with disability and/or chronic illness (that limits mobility and or/physical endurance) display lower levels of background daily activity, and this will affect whole-day estimates of recommended physical activity.

Health-related factors correlate with behavior trends in physical activity level in old age: longitudinal results from a population in São Paulo, Brazil.

BACKGROUND: Physical inactivity in leisure time is common among elderly in Brazil and this finding is particularly alarming considering that this population is greatly affected by chronic diseases. The identification of health factors that influence physical activity level (PAL) will help in the development of strategies for increasing PAL older adults. The current research aimed to identify variables that independently affect behavior trends in PAL over the course of two years among elderly. METHODS: A survey entitled the Epidoso Project ("Epidemiology of aging") studied 1,667 community-based older individuals in São Paulo city, Brazil over the course of two years. Physical activity level was determined through questions about frequency and duration of physical activities. Body Mass Index was calculated; functional capacity was assessed through the ADL (activities of daily living) scale; cognition was assessed by Mini-Mental State Examination; and mental health was assessed through the Dysthymia Screening. Experiences of falls and fractures were also assessed. Subjects were divided into three groups according to their self-report of Physical Activity Level: a--Regularly Active; b--Insufficiently Active and c--Physically Inactive. Behavior trends in PAL were also measured after two years. Multivariate regression model methodology was used to test associations longitudinally. RESULTS: Results from the final model demonstrated that the risk of a not favorable behavior trend in PAL, which included the group who remained physically inactive and the group that displayed decreased PAL, in this cohort of older adults was significantly increased if the individual was female (OR = 2.50; 95% CI = 1.60-3.89; P < 0.01), older (80 y vs. 65 y, OR = 6.29, 95% CI = 2.69-14.67; P < 0.01), dependent on help from others for activities in the ADL scale (moderate-severe = 4-7+ vs. 0 ADLs) (OR = 2.25, 95% CI = 1.20-4.21; P < 0.011) or had experienced a history of falls with consequences (OR = 6.88, 95% CI = 0.91-52.01; P < 0.062). CONCLUSIONS: Age, gender, ADL scores and falls were associated with a not favorable behavior trend in PAL. Promotion programs should target these factors, reducing barriers to achieve desired changes in PAL.

[Effects of the government's healthy living program on metabolic markers and physical capacity in Chilean women]. / Efectos del programa gubernamental vida sana en marcadores metabólicos y capacidad física en mujeres Chilenas.

OBJECTIVE: To determine the effects of the government's healthy living plan on metabolic markers and physical capacity in sedentary women from Villa Alemana, Chile. MATERIALS AND METHODS: 63 women who participated in the study (41.2±11.2 years) underwent 12 months of multi- and interdisciplinary intervention (doctor, nutritionist, psychologist and physical education teacher) of 180 minutes of physical activity per week. Mean and standard deviation were used for statistical analysis, while the t-test of related samples was used to determine the effects of the program. The level of significance was estimated with a value of p<0.05. RESULTS: There was a decrease in total cholesterol (p=0.003) and LDL cholesterol (p=0.048), improvement in the 6-minute test (p=0.000) and number of squats in thirty seconds (p=0.000) with a positive effect on delta recovery heart rate (p=0.001). CONCLUSIONS: The government's strategy resulted in a decrease of cardiovascular risk due to improved metabolic markers and women's physical capacity.

OBJETIVO: Determinar los efectos del plan gubernamental vida sana en marcadores metabólicos plasmáticos y capacidad física en mujeres sedentarias de Villa Alemana. MÉTODOS: Participaron 63 mujeres (41,2 ± 11,2 años) que fueron sometidas a 12 meses de intervención multi e inter-disciplinaria (médico, nutricionista, psicólogo(a) y profesor de educación física) (180 minutos de ejercicio por semana). En el análisis estadístico descriptivo se utilizaron la media y desviación estándar, la prueba T de muestras relacionadas se usó para determinar los efectos del programa, el nivel de significancia se estimó con un valor p<0,05. RESULTADOS: Se apreció una disminución en el colesterol total (p=0,003) y colesterol LDL (p=0,048), mejora en el test de 6 minutos (p=0,000) y número de sentadillas en treinta segundos (p=0,000) con un efecto positivo en el delta de recuperación de la frecuencia cardíaca (p=0,001). CONCLUSIÓN: La estrategia gubernamental produjo una disminución en el riesgo cardiovascular debido a una mejora en los marcadores metabólicos y capacidad física de las mujeres.

Physical activity in adults from two Brazilian areas: similarities and differences.

Lack of comparability has been a major limitation in studies on physical activity, due to the utilization of different methodological instruments and inconsistent cut-off points. This study aims to compare the levels of physical activity in adults from two Brazilian areas: (a) São Paulo, the richest State in the country; (b) Pelotas, a medium-sized southern Brazilian city. Both sites used cross-sectional population-based designs, with multiple-stage sampling strategies. Level of physical activity was assessed with the short version of the International Physical Activity Questionnaire. Prevalence of sedentary lifestyle was three times higher in Pelotas than in São Paulo. On the other hand, the proportion of very active subjects was significantly higher in Pelotas. The proportion of insufficiently active individuals (sedentary + irregularly active) was almost identical between the sites. Socioeconomic status was inversely related to level of physical activity in both sites. Among the insufficiently active subjects, those living in São Paulo are at least engaged in a limited amount of activity. On the other hand, among sufficiently active people, those living in Pelotas are more active.

What is Causing the Worldwide Rise in Body Weight?

The worldwide rise in body weight has reached epidemic proportions and this has serious public health consequences. Despite the universal recognition of this problem, its causes are still debated: some attribute it to excess caloric intake; others blame a lack of physical activity (PA); some implicate specific changes to micro- and macro-nutrients. During the past century, government health agencies have developed guidance on healthy eating. These, along with advances in agriculture and food manufacturing, have largely eliminated nutrient deficiencies and helped reduce the consumption of fat. Over the past 60 years, however, technological advances and shifts in the types of occupations prominent in industrialised as well as developing countries have resulted in well-documented decreases in energy expenditure. Energy intake must be balanced with energy expenditure in order to prevent weight gain, and there is increasing evidence that this balance must be at a relatively high level of energy flux. A programme that was started in São Paulo in 1996 known as 'Agita' has sought to motivate populations to engage in small amounts of physical exercise daily to tackle growing obesity levels. This multi-agency initiative is one example of how to successfully increase exercise within a community and scale both within (e.g. all states in Brazil) and across many nations. Reducing caloric intake in whole populations is challenging especially at relatively low levels of energy expenditure, and evidence suggests that there is a critical energy flux threshold for regulating intake to achieve energy balance. Increasing PA, however, may be more achievable than reducing intake. Activity raises caloric expenditure and can offset excess intake. The implementation of programmes to achieve greater PA is therefore vital if the worldwide rise in body weight is to be halted, while we also need to implement programmes to help people eat smarter.

Efectos del programa gubernamental vida sana en marcadores metabólicos y capacidad física en mujeres Chilenas / Effects of the government's healthy living program on metabolic markers and physical capacity in Chilean women

RESUMEN Objetivo Determinar los efectos del plan gubernamental vida sana en marcadores metabólicos plasmáticos y capacidad física en mujeres sedentarias de Villa Alemana. Métodos Participaron 63 mujeres (41,2 ± 11,2 años) que fueron sometidas a 12 meses de intervención multi e inter-disciplinaria (médico, nutricionista, psicólogo(a) y profesor de educación física) (180 minutos de ejercicio por semana). En el análisis estadístico descriptivo se utilizaron la media y desviación estándar, la prueba T de muestras relacionadas se usó para determinar los efectos del programa, el nivel de significancia se estimó con un valor p<0,05. Resultados Se apreció una disminución en el colesterol total (p=0,003) y colesterol LDL (p=0,048), mejora en el test de 6 minutos (p=0,000) y número de sentadillas en treinta segundos (p=0,000) con un efecto positivo en el delta de recuperación de la frecuencia cardíaca (p=0,001). Conclusión La estrategia gubernamental produjo una disminución en el riesgo cardiovascular debido a una mejora en los marcadores metabólicos y capacidad física de las mujeres.(AU)

ABSTRACT Objective To determine the effects of the government's healthy living plan on metabolic markers and physical capacity in sedentary women from Villa Alemana, Chile. Materials and Methods 63 women who participated in the study (41.2±11.2 years) underwent 12 months of multi- and interdisciplinary intervention (doctor, nutritionist, psychologist and physical education teacher) of 180 minutes of physical activity per week. Mean and standard deviation were used for statistical analysis, while the t-test of related samples was used to determine the effects of the program. The level of significance was estimated with a value of p<0.05. Results There was a decrease in total cholesterol (p=0.003) and LDL cholesterol (p=0.048), improvement in the 6-minute test (p=0.000) and number of squats in thirty seconds (p=0.000) with a positive effect on delta recovery heart rate (p=0.001). Conclusions The government's strategy resulted in a decrease of cardiovascular risk due to improved metabolic markers and women's physical capacity.(AU)

Time trends in physical activity in the state of São Paulo, Brazil: 2002-2008.

PURPOSE: To document time trends in physical activity in the state of São Paulo, Brazil (2002-2008). In addition, we discuss the role of Agita São Paulo at explaining such trends. METHODS: Cross-sectional surveys were carried out in 2002, 2003, 2006, and 2008 in the state of São Paulo, Brazil, using comparable sampling approaches and similar sample sizes. In all surveys, physical activity was measured using the short version of the International Physical Activity Questionnaire. Separate weekly scores of walking and moderate- and vigorous-intensity physical activities were generated; cutoff points of 0 and 150 min·wk were used. Also, we created a total physical activity score by summing these three types of activity. We used logistic regression models for adjusting time trends for the different sociodemographic compositions of the samples. RESULTS: The prevalence of no physical activity decreased from 9.6% in 2002 to 2.7% in 2008, whereas the proportion of subjects below the 150-min threshold decreased from 43.7% in 2002 to 11.6% in 2008. These trends were mainly explained by increases in walking and moderate-intensity physical activity. Increases in physical activity were slightly greater among females than among males. Logistic regression models confirmed that these trends were not due to the different compositions of the samples. CONCLUSIONS: Physical activity levels are increasing in the state of São Paulo, Brazil. Considering that the few data available in Brazil using the same instrument indicate exactly the opposite trend and that Agita São Paulo primarily incentives the involvement in moderate-intensity physical activity and walking, it seems that at least part of the trends described here are explained by the Agita São Paulo program.

A prática de exercícios físicos em pacientes com transtornos alimentares: [revisão] / Physical exercises in patients with eating disorders: [review]

CONTEXTO: Diferentes estudos discutem a relação da prática excessiva de exercícios físicos com transtornos alimentares como estratégia para perda de peso. OBJETIVO: Revisar a literatura sobre a prática de exercícios físicos em pacientes com transtornos alimentares, discutindo definições, critérios diagnósticos e propostas terapêuticas. MÉTODOS: Levantamento bibliográfico foi realizado por meio de MedLine, LiLacs e Cochrane Library, com os termos "transtornos alimentares", "anorexia", "bulimia", "exercício físico excessivo", "atividade física", "exercício obrigatório", "exercício compulsivo" e "exercício excessivo". RESULTADOS: Dos 80 artigos encontrados, foram selecionados 12 que incluíam a investigação de um padrão de atividade física considerado excessivo em indivíduos acima dos 18 anos e uso de algum instrumento de avaliação para essa finalidade. A prática de exercícios físicos em pacientes com transtornos do comportamento alimentar é revisada. CONCLUSÃO: Não há consenso sobre critérios diagnósticos e instrumentos para considerar o exercício físico como inadequado ou excessivo e seu uso como recurso para perder peso. Por outro lado, a prática de exercícios físicos durante o tratamento de pacientes com transtornos alimentares pode ser benéfica desde que orientada e supervisionada.

BACKGROUND: Several studies discuss the relationship between excessive physical exercises and eating disorder patient as a strategy to lose weight. OBJECTIVE: Review the literature concerning physical exercises in eating disorder patients including definitions, diagnostic criteria and therapeutic proposals. METHODS: A literature review was done through MedLine, LILACS and Cochrane databases using the terms "eating disorders", "anorexia nervosa", "bulimia nervosa", "physical activity", "obligatory exercise", "compulsive exercise" and "excessive exercise". RESULTS: 12 articles in a sampling of 80 were selected. These articles include the investigation of a physical pattern that was considered excessive in adults over 18 and the use of evaluation instruments. The practice of physical exercises in patients with disturbed eating behaviors is revised. DISCUSSION: There is no consensus in literature about diagnostic criteria and instruments to consider the physical exercise as inadequate or excessive and its use as a way to lose weight. On the other hand the practice of physical exercises along the treatment of eating disorder patients could be beneficial if oriented and supervised.

A descriptive epidemiology of leisure-time physical activity in Brazil, 1996-1997.

OBJECTIVES: To describe the prevalence, frequency, type, motivation for, and demographic and socioeconomic distribution of leisure-time physical activity (LTPA) among adults in Brazil. METHODS: The data source for our study was the Brazilian Living Standards Measurement Survey (LSMS) (Pesquisa sobre Padrões de Vida), which was conducted in 1996 and 1997. This survey studied a multistage stratified probabilistic sample of 4 893 households, which included 11 033 persons who were 20 years of age or older. The surveyed households were selected in the two most populous Brazilian regions, the Northeast and the Southeast, where in total 70% of all Brazilians live. The selected persons responded to a series of questions concerning their leisure-time physical activities. RESULTS: Only 13% of the Brazilians surveyed reported performing at least a minimum of 30 minutes of LTPA on one or more days of the week, and only 3.3% reported doing the recommended minimum of 30 minutes on 5 or more days of the week. In younger age groups, men were more active than were women. However, this difference sharply decreased with increasing age, and by the age range of 40 to 45 years the prevalence of LTPA was similarly low in both genders. Men reported engaging in more team sports, and women reported more walking/jogging activities, but walking/jogging was relatively more common in both genders when physical activity was performed on 5 or more days of the week. Recreation was by far the leading reason given by men to engage in LTPA, while recreation, health concerns, and even esthetic concerns were all relevant for women. In both genders, health concerns tended to be relatively more important for those exercising more days of the week. Also in both genders, increasing age was associated with more frequent LTPA, more walking/jogging than team sports, and more health concerns reasons than reasons related to recreation. Among both men and women there was a strong association between LTPA and socioeconomic status, measured either by income or schooling, independent of age, region, and urban or rural place of residence. CONCLUSIONS: The prevalence of adult LTPA in Brazil was much lower than the levels that have been reported for developed countries. However, the demographic and social distribution of LTPA in Brazil followed a pattern similar to the one usually observed in developed nations, where men tend to be more active than women, increasing age limits LTPA, and higher socioeconomic status is associated with more LTPA. Our data will provide a baseline to evaluate the impact on LTPA of "Agita Brasil" ("Move, Brazil"), an initiative to encourage physical activity that was implemented in the country after 1997.

Auto-estima e imagem corporal de gestantes de acordo com o nível de atividade física / Self-esteem and body image in pregnant women according to physical activity level

Objetivo: comparar a auto-estima e a imagem corporal de gestantes ativas e irregularmente ativas em duas comunidades. Métodos: participaram da amostra 20 gestantes alunas de academias e 11 gestantes pacientes de programa de pré-natal não envolvidas com atividade física estruturada, com faixa etária de 22 a 42 anos com 27,2 ± 1,5 semanas de gestação. A amostra foi dividida de acordo com a classifi cação do Questionário Internacional de Nível de Atividade Física (IPAQ). A auto-estima foi avaliada com a Escala Janis-Field de inadequação dos sentimentos para avaliação da auto-estima e a imagem corporal com o questionário de imagem corporal (BSQ). As comparações foram feitas por meio de análise de variância paramétrica e não-paramétrica. O nível de signifi cância adotado foi de p<0,05. Resultados: houve diferença signifi cativa apenas entre as gestantes inseridas no programa de atividade física das academias: em uma escala de 0 a 100, as classifi cadas em ativas apresentaram uma auto-estima signifi cativamente alta (77,1) em relação às irregularmente ativas (68,0). Quanto à imagem corporal não houve diferença estatística signifi cativa. Conclusão: as gestantes consideradas ativas possuem uma auto-estima melhor em relação as gestantes irregularmente ativas quando participantes de um programa de atividade física estruturado, sendo que esta associação não foi encontrada em gestantes não envolvidas nesse tipo de programa. A imagem corporal não teve associação com o nível de atividade física.

Purpose: to compare self-esteem and body image of active and insuffi ciently active pregnant women (PW) in two communities. Methods: sample consisted of 20 PW participants of physical activity program of fi tness centers and 11 PW not involved in structured physical activity. They were 29.8 ± 4.54 years old, and 27.2 ± 1.5 weeks of gestation. The sample was divided according to physical activity level using the International Physical Activity Questionnaire (IPAQ). The participants had answered Janis-Field scale feelings for evaluation of self-esteem and to the Body Shape Questionnaire to analyze body perception. Statistical analyze used was analysis of variance parametric and no parametric. Signifi cance level was p<.05. Results: we found signifi cant difference in PW from fi tness centers: in a scale from 0 to 100, the PW classifi ed in active had presented self-esteem signifi cantly high (77.1) in relation to the irregularly active (68.0). There is no statistic difference in body image. Conclusion: the PW considered active have better self-esteem in relation irregularly active when participant of a physical activity program. In fact, this association was not found in PW who were not involved in this type of physical activity program.

Comparação dos efeitos do alongamento e do flexionamento, ambos passivos, sobre os níveis de flexibilidade, capacidade funcional e qualidade de vida do idoso / Comparison of the effects of stretching and inflecting, both passive, on the levels of flexibility, functional capacity and quality of life of the elderly

Este trabalho teve como objetivo verificar a influencia da flexibilidade na autonomia e na qualidade de vida de 69 idosas, com média de idade de 65,33. Esta pesquisa foi realizada na Zona Oeste Jacarepaguá mais especificamente nos bairros da Freguesia e Pechincha. Neste estudo foi aplicado o teste de Goniometria, para verificar a flexibilidade angular. Para avaliar a autonomia, foi utilizada abateria de testes práticos de autonomia de (Pereira4). E para avaliar a qualidade de vida, foi aplicado o WHOQ-100 da OMS1O. Analisando o % entre o pré e o pós-teste com a aplicação do teste t de Student, ambos os grupos apresentaram melhora na flexibilidade, com o grupo de flexionamento obtendo valores significativos no movimento de flexão horizontal do ombro e o grupo de alongamento nos movimentos de abdução do ombro e extensão do quadril. Os resultados da autonomia não apresentaram melhoras significativas na bateria de teste e sim melhora no tempo de execução de cada teste. No questionário de qualidade de vida, houve melhoras em ambos os grupos nos domínios psicológico e nível de independência, não sendo detectados resultados significativos na avaliação dos resultados dos %. Foram obtidas médias das variações percentuais dos movimentos no pós-teste de 95,42% para o grupo de flexionamento e de 87,09% para o de alongamento. Na bateria de testes de autonomia, o grupo de flexionamento apresentou um resultado de 6,16% e o de alongamento, 6,52%. Na qualidade de vida, o domínio do grupo de flexionamento apresentou 12,49%; e o grupo de alongamento 12,55%.

The purpose of this assignment was to verify the influence flexibility had on autonomy and quality of life for 69 elderly women averaging 65,33 years of age. The research was performed in the West Zone namely in Jacarepaguá and more specifically in the Freguesia and Pechincha quarters. For this study, the Goniometric test was applied in order to verify angular flexibility. To evaluate autonomy, the Pereira4 practical autonomy test battery was employed. For evaluating quality oflife, the OMS WHOK-10010 was used. Analyzing the (delta)% found between pre-and-post tests employing Student’s “t” test, both groups showed improvement in flexibility; the bending group obtained meaningful values for the horizontal shoulder flexing movement, while the stretching group obtained those results for shoulder abduction and hip extension movements. The results obtained for autonomy did not show meaningful improvement in the test battery; however it did so for the time demanded for performing each test. In the questionnaire dealing with quality of life, both groups showed improvement in the psychological and independence level domains; no meaningful results were detected in the evaluation of (delta)%. Average percentage variations obtained for movements in the post-test were 95,42% for the bending group and 87,09% for the stretching group. In the autonomy test battery, the bending group showed 6,16% and the stretching group, 6,52%. Regarding quality of life, the bending group domain showed 12,49% and the stretching group domain, 12,55%.

Dislipidemias e a promoção da atividade física: uma revisão na perspectiva de mensagens de inclusão / Dislipidemia and physical activity: a review inclusive message perspective

As alterações no metabolismo dos lipídeos são uma das conseqüências negativas mais importantes do sedentarismo. O propósito deste artigo é rever os estudos mais significantes que analisaram a relação entre atividade/inatividade física no perfil lipídico. Considerando a ineficácia das intervenções anteriores que procuraram usar atividade física na prevenção e tratamento, especial atenção foi dedicada à informação científica que levou em conta práticas modernas, particularmente as que permitam uma maior aderência, essencial em programas de saúde pública. A revisão presente aborda as causas e os efeitos deletérios do sedentarismo na mobilização de lipídeos, o papel da atividade física moderada e acumulada, a eficácia de propostas de estilo de vida ativo, comparação de efeitos entre programas de condicionamento (fitness) com os estilo de vida (atividade física), as recomendações preventivas e terapêuticas, assim como recentes aspectos da relação entre dislipidemias e declínio na função cognitiva. Os estudos aqui sumarizados apontam que programas de atividade física são fundamentais na prevenção e no tratamento das dislipidemias, sendo que as evidências científicas do impacto positivo dos protocolos inclusivos de atividade física, que enfatizam as vantagens da intensidade moderada e da forma acumulada, podem em muito beneficiar a adesão e manutenção de pessoas em padrões regulares de atividade.

Changes in lipides metabolism has been one of the utmost negative consequences of sedentariness. The purpose of this paper was to review the most significant studies that have analyzed the relationship of physical activity/inactivity and lipids profiling. Considering the ineffective impact of former interventions in promoting physical activity as prevention or treatment tool, special attention was dedicated to the scientific information that took into account modern practices, particularly the ones which permitted a higher long term adherence, essential for public health programs. Present review comprised the harmful effects of sedentarism, the role of moderate physical activity, the role of accumulation approach, the effectiveness of active life style, comparing fitness to active living programs, the recommendations for prevention and treatment; and recent issues on the relationship between dislipidemias and declining in cognitive function. Summary of the review articles confirms that physical activity programs are fundamental in dislipidemia prevention and treatment. Scientific evidences showed the positive impact of inclusive physical activity protocols, particularly when emphasizing the advantages of moderate intensity and accumulated mode, increasing adherence and sustained physical activity.

Physical activity in adults from two Brazilian areas: similarities and differences

A incomparabilidade sempre foi uma limitacão entre os estudos sobre atividade física, em funcão da utilizacão de vários instrumentos e pontos de corte inconsistentes. Comparou-se o nível de atividade física de adultos do Estado de São Paulo e da cidade de Pelotas, Rio Grande do Sul, no Brasil. Ambos os centros usaram delineamento transversal de base populacional, com amostragem em múltiplos estágios. A prática de atividade física foi avaliada com a versão curta do Questionário Internacional de Atividade Física. A prevalência de sedentarismo foi três vezes maior em Pelotas do que em São Paulo. Já a proporcão de pessoas muito ativas foi significativamente maior em Pelotas. A prevalência de atividade física insuficiente (sedentários + irregularmente ativos) foi similar em ambos os centros. O nível sócio-econômico associou-se inversamente com o nível de atividade física nos dois centros. Entre as pessoas insuficientemente ativas, as de São Paulo estão ao menos praticando uma pequena quantidade de atividade física. Já entre os suficientemente ativos, as pessoas de Pelotas têm maior nível de atividade física.

Efeito de um programa de atividade física na aptidäo f1sica e na auto-percepçäo da aptidäo física em mulheres acima de 50 anos de idade / Effect of a physical fitness of women over 50 years-old

O objeto desse estudo foi verificar o efeito de um programa de atividade física na aptidäo física e na auto-percepçäo da aptidäo física em mulheres acima de 50 anos. Participaram do programa de 22 semanas, 2 vezes/semana, 1h/aula, 35 mulheres divididas em:experimental (GE), n=20,50 a 75 anos; e controle (GC), n= 15,50 a 83 anos. Foram analisadas as variáveis: adiposidade, índice de massa corporal IMC), força dos membros superiores e inferiores (MMII), flexibilidade do tronco, mobilidade (VA); agilidade e a endurance cardiorrespiratória(ECR). A auto-percepçäo (AP) foi avaliada de forma quantitativa: nota de 0(pior) a 10(melhor); e qualitativa: pior, igual ou melhor que seus pares. Análises estatísticas utilizadas: "teste t de student" e delta percentual na aptidäo física pré e pós programa; coeficiente de correlaçäo linear de Pearson para AP quantitativo e qui-quadrado e kappa para AP qualitativo com p menor que 0,05. Os resultados mostraram incremento significativo no GE nas variáveis VA, força dos MMII e agilidade, e manutençäo das demais variáveis da aptidäo física. Houve modelaçäo das variáveis e alta na AP quantitativa com a aptidäo física mensurada nas variáveis adiposidade, IMC, VA, agilidade e ECR. Na AP qualitativa houve concordância significativa na adiposidade do GE. Portanto podemos concluir que: a)a prática de atividade física teve bom efeito na manutençäo e/ou incremento das variáveis da aptidäo física; b)a AP quantitativa teve melhor relaçäo com o nível de aptidäo física do que AP qualitativa; c)sugere-se realizaçäo de novos estudos para consolidar a importância da AP, já que esta vem se apresentando como ótimo preditor do nível de aptidäo física em indivíduos mais velhos.(au)

Padrão da prescrição de atividade física realizada por médicos ortopedistas brasileiros / Pattern of physical activity prescription realized by brazilian orthopedic surgeons

Objetivo: avaliar a prescrição de atividade física realizada por ortopedistas brasileiros. Metodologia: 521 ortopedistas responderam um questionário sobre prescrição de atividade física. Os parâmetros prescritos de freqüência, duração e intensidade considerados corretos foram: realizar pelo menos 30 minutos contínuos ou acumulados de atividade moderada na maioria dos dias da semana. Utilizada análise estatística descritiva. Resultados: 86,4% prescrevem atividade física para a maioria dos pacientes, sendo caminhada (97,5%) e natação/hidroginástica (96,5%) as mais prescritas. Cerca de 60% prescrevem musculação, atividades cotidianas e corrida/jogging. Caminhada apresentou os maiores índices de acerto da freqüência (18,9%), duração (62,4%) e intensidade (44,1%). As porcentagens de acerto desses parâmetros para todas as atividades prescritas foram: 8,8%, 40,3% e 35,3%. A prescrição de atividades cotidianas foi a mais vaga, com pelo menos 50% sem a definição de freqüência e duração, 40% sem intensidade definida. A maioria prescreve verbalmente e poucos usam receituário. Musculação é mais prescrita para reabilitação. Caminhada e atividades cotidianas são prescritas principalmente para prevenção de doenças. Conclusões: o ortopedista brasileiro prescreve atividade física para a maioria dos pacientes como prevenção e tratamento de doenças, geralmente de forma verbal (diminuindo sua eficácia) e pouco condizentes com a recomendação atual para promoção da saúde.

Objective: to evaluate physical activity prescription performed by Brazilian orthopedic. Methodology: 521 orthopedic answered a questionnaire on physical activity prescription. The prescribed parameter of frequency, duration, and intensity of physical activity considered appropriate was: at least 30 continuous or accumulated minutes of moderate activity accomplished on most days of the week. Descriptive statistical analysis was applied to it. Results: 86.4% of the orthopedists prescribe physical activity for the majority of the patients. Walking (97.5%) and swimming/water aerobics (96.5%) are the most prescribed activities. Nearly 60% of them prescribe weight lifting, daily activities, and jogging. Walking had the highest rate of appropriateness on frequency (18.9%), duration (62.4%) and intensity (44.1%). Whereas for all prescribed activities the rate of appropriateness o those parameters were 8.8%, 40.3% and 35.3%. Daily activities had the most imprecise prescription, at least 50% did not define frequency and duration, and 40% lacked defined intensity. Most physicians prescribe verbally, and few of them use dispensatories. Weight lifting is mostly prescribed for rehabilitation, while walking and daily activities are mainly prescribed for prevention of diseases. Conclusions: the Brazilian orthopedic prescribes physical activity for the majority of patients as prevention and treatment of diseases, usually through a verbal mean (which lessens its efficacy) and not consistent with the current recommendation for health promotion.

A descriptive epidemiology of leisure-time physical activity in Brazil, 1996­-1997

OBJECTIVES: To describe the prevalence, frequency, type, motivation for, and demographic and socioeconomic distribution of leisure-time physical activity (LTPA) among adults in Brazil. METHODS: The data source for our study was the Brazilian Living Standards Measurement Survey (LSMS) (Pesquisa sobre Padröes de Vida), which was conducted in 1996 and 1997. This survey studied a multistage stratified probabilistic sample of 4 893 households, which included 11 033 persons who were 20 years of age or older. The surveyed households were selected in the two most populous Brazilian regions, the Northeast and the Southeast, where in total 70 percent of all Brazilians live. The selected persons responded to a series of questions concerning their leisure-time physical activities. RESULTS: Only 13 percent of the Brazilians surveyed reported performing at least a minimum of 30 minutes of LTPA on one or more days of the week, and only 3.3 percent reported doing the recommended minimum of 30 minutes on 5 or more days of the week. In younger age groups, men were more active than were women. However, this difference sharply decreased with increasing age, and by the age range of 40 to 45 years the prevalence of LTPA was similarly low in both genders. Men reported engaging in more team sports, and women reported more walking/jogging activities, but walking/jogging was relatively more common in both genders when physical activity was performed on 5 or more days of the week. Recreation was by far the leading reason given by men to engage in LTPA, while recreation, health concerns, and even esthetic concerns were all relevant for women. In both genders, health concerns tended to be relatively more important for those exercising more days of the week. Also in both genders, increasing age was associated with more frequent LTPA, more walking/jogging than team sports, and more health concerns reasons than reasons related to recreation. Among both men and women there was a strong association between LTPA and socioeconomic status, measured either by income or schooling, independent of age, region, and urban or rural place of residence. CONCLUSIONS: The prevalence of adult LTPA in Brazil was much lower than the levels that have been reported for developed countries. However, the demographic and social distribution of LTPA in Brazil...

Teste específico para mensurar agilidade em futebolistas e sua correlaçäo com o desempenho no passe em situaçäo real de jogo / Specific test for measurement of agility among soccer players and its correlation with development of passes at a real game situation

O presente estudo tem como primeiro objetivo propor um teste específico que avalie agilidade em futebolistas, verificando sua reprodutibilidade, e como segundo determinar a correlaçao entre agilidade e o desempenho dos passes em situaçao real de jogo em futebolistas. Foram utilizados 17 e 11 atletas (respectivamente para os objetivos) da equipe profissional de Sao Caetano do Sul, que disputou o torneio estadual (Sao Paulo) da divisao intermediária, (1992), com idade variando de 20 a 34 anos. O teste de agilidade (Shuttle Run - SR) foi realizado segundo a padronizaçao do CELAFISCS e o teste de agilidade com bola (SRB), específico para futebolistas, foi padronizado com as mesmas medidas do SR tradicional. O desempenho dos passes foi calculado utilizando a observaçao em três jogos (uma derrota, uma vitória e um empate). Os passes foram classificados em Bom (B), Errado (E) e Normal (N). Os atletas que participaram deste estudo (no segundo objetivo) jogaram 3 jogos totalizando 94 por cento do tempo total dessas partidas. Para a análise dos dados foi utilizada a correlaçao de Pearson com um nível de significância de P< O,05 e P< O,01, respectivamente. Foi observada uma correlaçao moderada entre o SR e o SRB (O,57 - O,59; p < O,05); e alto coeficiente de reprodutibilidade (O,77; p < O,05); para o novo teste (SRB). O novo teste também apresentou altos coeficientes de correlaçao com passes bons (0,89) e errados (0,67) que foram significantes (p<.01). De acordo com esses resultados, os autores concluíram que o novo teste de medida de agilidade em futebol parece ser bem promissor e um bom revelador de performance em passes bons e errados durante um jogo de futebol.

Consumo alimentar, atividade física e percepçäo da aparência corporal em adolescentes / Consumption of food, physical activity and perception of body aspect on adolescent

Para conhecer os padröes de consumo alimentar, os estágio de comportamento relativos à atividade física e as características antropométricas em uma populaçäo de adolescentes segundo a auto-percepçäo da aparência corporal foram avaliadas 28 adolescentes do sexo feminino de 14 a 17 anos de idade (x = 16,16 ñ 0,83) agrupadas de acordo com a auto-avaliaçäo da aparência coprporal em : G1- gorda, G2- peso normal e, G3- magra. Para estabelecer o consumo alimentar diário utilizou-se o registro alimentar de quatro dias. As variáveis antropométricas medidas foram peso, estatura, adiposidade mediante a média de sete dobras cutâneas e o índice de massa corporal. A maturaçäo sexual foi estabelecida por auto-avaliaçäo de acordo com os estágios de Tanner (pêlos públicos x = 5,5 ñ 0,9 e mamas x = 5,0 ñ 0,5). A análise estatística utilizada foi Anova Oneway, com post-hoc Scheffé. O nível de significância adotado foi p < .01. O grupo ''gorda'' apresentou valores maiores porém näo significantes de peso, estatura e IMC e valores significativamente mais altos de adiposidade que os demais grupos. O consumo de energia foi menor no grupo ''gorda'' em relaçäo aos demais e no ''normal'' em relaçäo ao ''magra''. Outro fator da ingestäo do grupo ''gorda'' é o resultado apresentado na auto-avaliaçäo do peso corporal, que pode estar interferindo na reduçäo da ingestäo alimentar das adolescentes objetivando controlar o peso considerado alto. No comportamento relativo à atividade física, a maioria das adolescentes näo parece ser ativa já que se encontram no estágio pré contemplativo