Felipe Fossati Reichert

The Role of Perceived Personal Barriers to Engagement in Leisure-Time Physical Activity

OBJECTIVES We sought to identify perceived personal barriers to physical activity and examine the potential association between these barriers and sociodemographic and behavioral variables, including participation in leisure-time physical activity. METHODS In 2003, we conducted a population-based study in Pelotas, Brazil. Participants aged 20 years and older were selected according to a multistage sampling strategy. Participants responded to both the International Physical Activity Questionnaire and a standardized questionnaire investigating 8 perceived personal barriers. RESULTS Only 26.8% of participants achieved 150 minutes per week of leisure-time physical activity. Lack of money (40.3%) and feeling too tired (38.1%) were the most frequently reported barriers to physical activity. A dose-response group association was observed between number of perceived barriers and level of physical activity. In the multivariable analysis, lack of time, dislike of exercising, feeling too tired, lack of company, and lack of money were associated with physical inactivity. CONCLUSION Detection of the determinants of physical inactivity, a growing epidemic, should be a public health priority. Brazil is a middle-income (developing) country. The prevalence of most of the personal barriers studied was higher in this population than those levels observed in high-income (developed) countries. Perceiving 5 of the 8 barriers investigated was inversely associated with leisure-time physical activity level.

Gender differences in leisure-time physical activity

Summary.Objectives:To explore the association between gender and leisure-time physical activity in a population-based sample of adults living in Brazil. To study a variety of variables possibly associated with physical activity levels.Methods:A multistage sampling of households was undertaken in Pelotas, a medium-sized Southern Brazilian city. Leisure-time physical activity was measured using the long version of the International Physical Activity Questionnaire. Data on potential predictors of leisure-time physical activity behavior were collected using a standardized questionnaire. 1 344 men and 1 756 women were interviewed. Several definitions of moderate and vigorous-intensity physical activity were used.Results:Regardless of the guideline used, males were more active than women. Socioeconomic level was positively associated with leisure-time physical activity in both genders. A positive dose-response between age and inactivity was found in men, but not among women.Conclusions:Because men and women have different levels of physical activity, and the variables associated with activity levels are not consistent across the genders, interventions promoting physical activity should take these differences into account.Zusammenfassung.Geschlechterbedingte Unterschiede bei körperlichen Aktivitäten in der FreizeitZiel:Die Beziehung zwischen Geschlecht und körperlichen Freizeitktivitäten in einer bevölkerungsbasierten Stichprobe von in Brasilien lebenden Erwachsenen zu untersuchen.Methoden:Ein mehrstufiges Sampling von Haushalten wurde in Pelotas durchgeführt, einer mittelgrossen südbrasilianischen Stadt. Körperliche Freizeitaktivitäten wurden anhand der Langversion des Fragebogens zur Erhebung gesundheitsrelevanter körperlicher Aktivität (IPAC) gemessen. Daten zu potentiellen Prädiktoren des Verhaltens im Bereich der körperlichen Freizeitaktivitäten wurden mittels eines standardisierten Frage-bogens erhoben. Es wurden 1 344 Männer und 1 756 Frauen befragt. Verschiedene Definitionen körperlicher Aktivität von moderater bzw. starker Intensität kamen zur Anwendung.Ergebnisse:Unabhängig der verwendeten Richtlinien waren Männer aktiver als Frauen. Der sozioökonomische Status war negativ assoziiert mit körperlichen Freizeitaktivitäten bei beiden Geschlechtern. Eine positive Dosis-Wirkungs-Beziehung zwischen Alter und Inaktivität konnte bei Männern festgestellt werden, jedoch nicht bei Frauen.Schlussfolgerungen:Da Männer und Frauen ein unterschiedliches Mass an körperlicher Aktivität aufweisen und die Variablen, die mit körperlicher Betätigung assoziiert sind, zwischen den Geschlechtern nicht einheitlich sind, sollten Interventionen zur Förderung körperlicher Aktivität diese Unterschiede berücksichtigen.Résumé.Pratique de l’activité physique durant les loisirsdifférences entre les sexesObjectifs:Etudier l’association entre le genre et la pratique de l’activité physique durant les loisirs dans un échantillon populationnel d’adultes vivant au Brésil. Etudier différentes variables qui pourraient être associées avec les niveaux d’activité physique.Méthodes:Un échantillonnage en grappe des ménages a été effectué à Pelotas, un ville de taille moyenne au sud du Brésil. L’activité physique pratiquée durant les loisirs a été mesurée au moyen de la version longue du «Questionnaire International d’Activité Physique». Les variables prédictrices de la pratique de l’activité physique durant les loisirs ont été collectées au moyen d’un questionnaire standardisé. 1 344 hommes et 1 756 femmes ont été interviewés. Diverses définitions actuelles des niveaux d’activité physique recommandés (modérée/intense) ont été utilisées.Résultats:Indépendamment des recommandations utilisées comme critères, les hommes étaient plus actifs que les femmes. Le niveau socio-économique était associé négativement avec la pratique d’une activité physique pendant les loisirs pour les deux sexes. Une dose-réponse positive entre l’âge et la sédentarité a été identifiée chez les hommes mais pas chez les femmes.Conclusions:Les hommes et les femmes ont des niveaux de pratique de l’activité physique différents. Les variables associées à cette pratique varient également entre les sexes. Les interventions de promotion de l’activité physique devraient donc tenir compte de ces spécificités.

Evolução da pesquisa epidemiológica em atividade física no Brasil: revisão sistemática

OBJECTIVE To describe the evolution of the epidemiological research on physical activity in Brazil. METHODS A systematic review of the literature was carried out in electronic databases (Medline/PubMed, Lilacs, Ovid, Science Direct, BioMed Central and High Wire), non-indexed Brazilian journals, query by specific authors, and contact with other researchers. The inclusion criteria were: the sample should be representative of a defined population; sample size equal to or greater than 500 individuals; data collection in Brazil; measurement of physical activity; and report of data on this variable. RESULTS A total of 42 studies were reviewed. The first study was published in 1990, and there has been a clear growth in the number of publications since 2000. Great regional disparities were seen and most studies were carried out in the Southeast and South regions. Almost all studies (93%) used questionnaires but operational definitions of sedentary lifestyle and questionnaires used varied markedly across studies preventing result comparisons. CONCLUSIONS Although the literature on physical activity in Brazil has quantitatively increased, methodological limitations make it difficult to compare study results. Therefore, standardization of instruments and definitions is essential for the improvement of scientific knowledge in the area.

Sleep patterns and television viewing in relation to obesity and blood pressure: evidence from an adolescent Brazilian birth cohort.

Background:Disruption of circadian rhythms has been associated with obesity in children and adolescents, and with hypertension in adults, in industrialized populations.Objective:We examined cross-sectional associations between sleep duration or television viewing and obesity and blood pressure in Brazilian adolescents.Design:The sample consisted of 4452 adolescents aged 10–12 years participating in a prospective birth cohort study in Pelotas, Brazil. Sleep duration and television viewing were determined through questionnaires. Obesity was assessed using international cut-offs for body mass index (BMI), and body fatness by skinfold thicknesses. Blood pressure was measured using a validated monitor.Results:Short sleep duration was associated with increased BMI, skinfolds, systolic blood pressure, activity levels and television viewing. Each hour of sleep reduced BMI by 0.16 kg/m2 (s.e. 0.04), and was associated with odds ratio for obesity of 0.86 (s.e. 0.04), both P<0.001. Television viewing was associated with increased BMI and skinfolds, and increased blood pressure. The effects of sleep duration and television viewing on obesity were independent of one another. Their associations with blood pressure were mediated by body fatness.Conclusions:Both short sleep duration and increased television viewing were associated with greater body fatness, obesity and higher blood pressure, independently of physical activity level. These associations were independent of maternal BMI, identified in other studies as the strongest predictor of childhood obesity. Our study shows that behavioural factors associated with metabolic risk in industrialized populations exert similar deleterious effects in a population undergoing nutritional transition and suggest options for public health interventions.

Early determinants of physical activity in adolescence: prospective birth cohort study

Abstract Objective To examine the effects of early social, anthropometric, and behavioural variables on physical activity in adolescence. Design Prospective birth cohort study. Setting Pelotas, southern Brazil. Participants 4453 adolescents aged 10-12 years participating in the Pelotas 1993 birth cohort study (follow-up rate 87.5%). Main outcome measures Sedentary lifestyle (< 300 minutes of physical activity per week) and median physical activity score (minutes per week). Results The prevalence of a sedentary lifestyle at age 10-12 years was 58.2% (95% confidence interval 56.7% to 59.7%). Risk factors for a sedentary lifestyle in adolescence were female sex, high family income at birth, high maternal education at birth, and low birth order. Weight gain variables at ages 0-1, 1-4, and 4-11 years and overweight at age 1 or 4 years were not significant predictors of physical activity. Levels of physical activity at age 4 years, based on maternal report, were inversely related to a sedentary lifestyle at age 10-12 years. Conclusions Physical activity in adolescence does not seem to be programmed by physiological factors in infancy. A positive association between birth order and activity may be due to greater intensity of play in childhood and adolescence. Tracking of physical activity from age 4 to 10-12 years, however, suggests that genetic factors or early habit formation may be important.

Physical activity as a predictor of adolescent body fatness: a systematic review

Adolescent obesity has increased dramatically in several countries in recent decades; however, the contribution of physical activity level to adolescent adiposity requires clarification. This article investigates the effect of physical activity on subsequent levels of adiposity in adolescence. The methodological aspects of the studies included in this article, particularly in terms of measurement accuracy for both exposure (physical activity) and outcome (adiposity) variables, are also evaluated. Systematic searches of the literature were undertaken using online databases, including PubMed/MEDLINE, examination of citations and contacting of authors. The online databases were searched from their earliest records until 2007. Only longitudinal studies with 50 or more adolescents were included. Two independent reviewers assessed the quality of the studies using the Downs and Black checklist. Thirteen observational, five experimental and six quasi-experimental studies (without a control group) were identified. Almost all studies were carried out in high-income settings and showed protective effects of physical activity for both prevention and treatment of adolescent obesity. However, experimental studies undertaken with obese adolescents at baseline usually combined physical activity with dietary changes, making it difficult to assess the effect of physical activity itself on the treatment of obesity. Physical activity estimated from questionnaires and body mass index (BMI) were the most frequently used measures. Despite the feasibility of using these approaches in epidemiological studies, significant limitations are evident. Questionnaires are subjective and adolescents may not report physical activity level accurately. Furthermore, BMI is not an accurate measure of fatness for adolescents, as it is also associated with lean mass, hence bias may arise from its longitudinal association with physical activity level. Despite the majority of studies reviewed showing protective effects of physical activity on adiposity, particularly in individuals who are obese at baseline, the current literature on this issue is sparse and several methodological drawbacks are evident. The main limitations relate to a lack of validity in the measurements of both physical activity and body composition. Further studies are needed in order to generate evidence-based recommendations for the quantity and quality of adolescent physical activity required to prevent or treat adolescent obesity.

Prevalence of metabolic syndrome in adolescents: a systematic review.

The present study aimed to review the literature on the prevalence of metabolic syndrome and its components in adolescents (10-19 years old). The search was conducted in online databases (MEDLINE and SciELO), references from retrieved articles, and contacts with authors. Only original articles using either the criteria of the World Health Organization (WHO) or the National Cholesterol Education Programs Adult Treatment Panel III (NCEP ATP-III) were considered. Sixteen studies met the inclusion criteria. Eight studies were undertaken in low to medium-income countries, but none of them in Brazil. Prevalence of metabolic syndrome in studies using the NCEP-ATP III criteria ranged from 4.2% to 15.4%. Prevalence in studies using the WHO criteria was slightly higher: 4.5% to 38.7%. High triglyceride level was the most frequent component of the metabolic syndrome, with prevalence ranging from 4.9% to 75.0%, while high blood glucose showed the lowest prevalence. In conclusion, although there are few available studies, metabolic syndrome in adolescents is a highly prevalent health issue. The exact prevalence of metabolic syndrome in Brazilian adolescents is unknown.

Prevalência de fatores de risco cardiovascular em adolescentes

The aim of this study was to determine the prevalence of cardiovascular risk factors in adolescents and to verify its association with age and gender. 644 high school students from public schools in the city of Londrina, Parana State, Brazil, participated in the study. A two-step sampling process was used. Behavioral risk factors (physical inactivity, inadequate consumption of fruits and vegetables, and smoking) and biological risk factors (overweight and high blood pressure) were investigated. Nearly 90% of adolescents showed at least one risk factor. Inadequate consumption of fruits (56.7%) and vegetables (43.9%) and physical inactivity (39.2%) were the most prevalent risk factors. Prevalence rates for high blood pressure and overweight were 18.6 and 12.7%, respectively. Cardiovascular risk factors were more frequent among boys (PR = 1.20; 95%CI = 1.01-1.42). In conclusion, cardiovascular risk factors are a prevalent health issue among students in the city of Londrina.

Prevalência de inatividade física e fatores associados em adolescentes

OBJETIVO: Estimar a prevalencia de inatividade fisica em adolescentes (14 a 18 anos) da cidade de Maringa/PR e explorar sua associacao com variaveis demograficas, socioeconomicas, comportamental e indicadores de estado nutricional. METODOS: Estudo transversal com uma amostra representativa de escolares do ensino medio da cidade incluindo 991 (54,5% mocas) de 12 colegios publicos e privados selecionados por meio de amostragem em multiplos estagios. O nivel de atividade fisica habitual foi verificado por meio do IPAQ modificado para adolescentes, usando como referencia a ultima semana. A inatividade fisica foi definida 4 h/dia), estado nutricional e obesidade abdominal. RESULTADOS: A prevalencia de inatividade fisica em adolescentes foi de 56,9% (mocas= 57,9%, rapazes= 55,7%, p=0,46). Os fatores de risco associados a inatividade fisica foram pertencer ao nivel socioeconomico mais baixo, estudar em escolas publicas e ser obeso. CONCLUSAO: Encontramos uma alta prevalencia de inatividade fisica no estudo. Faz-se urgentemente necessario o desenvolvimento de estrategias, que visem o aumento da atividade fisica, o que pode ser obtido por meio de desenvolvimento de conteudos escolares que promovam estilos de vida saudavel.

Associations of Birth Order With Early Growth and Adolescent Height, Body Composition, and Blood Pressure: Prospective Birth Cohort From Brazil

Birth weight has been inversely associated with later blood pressure. Firstborns tend to have lower birth weight than their later-born peers, but the long-term consequences remain unclear. The study objective was to investigate differences between firstborn and later-born individuals in early growth patterns, body composition, and blood pressure in Brazilian adolescents. The authors studied 453 adolescents aged 13.3 years from the prospective 1993 Pelotas Birth Cohort. Anthropometry, blood pressure, physical activity by accelerometry, and body composition by deuterium were measured. Firstborns (n = 143) had significantly lower birth weight than later borns (n = 310). At 4 years, firstborns had significantly greater weight and height, indicating a substantial overshoot in catch-up growth. In adolescence, firstborns had significantly greater height and blood pressure and a lower activity level. The difference in systolic blood pressure could be attributed to variability in early growth and that in diastolic blood pressure to reduced physical activity. The magnitude of increased blood pressure is clinically significant; hence, birth order is an important developmental predictor of cardiovascular risk in this population. Firstborns may be more sensitive to environmental factors that promote catch-up growth, and this information could potentially be used in nutritional management to prevent catch-up “overshoot.”