Leandro Martin Totaro Garcia

All-Cause Mortality Attributable to Sitting Time: Analysis of 54 Countries Worldwide

INTRODUCTION Recent studies have shown that sitting time is associated with increased risk of all-cause mortality, independent of moderate to vigorous physical activity. Less is known about the population-attributable fraction for all-cause mortality associated with sitting time, and the gains in life expectancy related to the elimination of this risk factor. METHODS In November 2015, data were gathered from one published meta-analysis, 54 adult surveys on sitting time distribution (from 2002 to 2011), in conjunction with national statistics on population size, life table, and overall deaths. Population-attributable fraction for all-cause mortality associated with sitting time >3 hours/day was estimated for each country, WHO regions, and worldwide. Gains in life expectancy related to the elimination of sitting time >3 hours/day was estimated using life table analysis. RESULTS Sitting time was responsible for 3.8% of all-cause mortality (about 433,000 deaths/year) among those 54 countries. All-cause mortality due to sitting time was higher in the countries from the Western Pacific region, followed by European, Eastern Mediterranean, American, and Southeast Asian countries. Eliminating sitting time would increase life expectancy by 0.20 years in those countries. CONCLUSIONS Assuming that the effect of sitting time on all-cause mortality risk is independent of physical activity, reducing sitting time plays an important role in active lifestyle promotion, which is an important aspect of premature mortality prevention worldwide.

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

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

Predictors and health consequences of screen-time change during adolescence--1993 Pelotas (Brazil) birth cohort study.

Purpose To investigate screen-time change from early to mid adolescence, its predictors, and its influence on body fat, blood pressure, and leisure-time physical activity. Methods We used data from a longitudinal prospective study, conducted among participants of the 1993 Pelotas (Brazil) Birth Cohort Study. At baseline, adolescents were, on average, 11 years old. They were later visited at age 15 years. Screen time was self-reported, accounting for the time spent watching television, playing video games, and using the computer. Several predictors were examined. The effect of screen-time change on some health outcomes was also analyzed. Results Screen time increased on average 60 min/d from 11 to 15 years of age, for the 4,218 adolescents studied. The groups that presented the highest increases in screen time were male, wealthiest, those whose mothers had higher education, and adolescents with a history of school failure. There were positive associations between screen-time change and body mass index, skinfold thickness, waist circumference, and leisure-time physical activity at 15 years of age. Conclusions Screen time increased from early to mid adolescence. This increment was higher among boys and the wealthiest adolescents. Increases in screen time affected body composition, with negative implications on adiposity.

Insatisfação com o peso corporal e fatores associados em adolescentes

Objective: To assess the prevalence of body weight dissatisfaction among adolescents and the associated factors. Methods: Population-based cross-sectional study covering a sample of students with ages from 15 to 19 years, attending public high schools in Santa Catarina, Brazil, in the year 2002. The outcome of the study was body weight satisfaction, assessed by the question: “Are you satisfied with your body weight?” The variables analyzed were gender, age, family income, home neighborhood, nutritional status, time of television viewing per week, smoking and self-rated health. Some feeding behaviors were also investigated: taking weight loss medication, vomiting after meals, and having at least three meals per day. A multinomial regression model was used in the crude and adjusted analyses. Results: Among the adolescents evaluated (n=5,028), 16.7% (95%CI: 15.7-17.7) were unsatisfied and would like to gain weight, and 36.2% (95%CI: 34.9-37.5) would like to reduce it. Frequent behaviors among those who wanted to reduce their body weight included: taking weight loss medication,

Autoavaliação de saúde e fatores associados em adolescentes do Estado de Santa Catarina, Brasil

OBJECTIVE: To identify the prevalence and factors associated with negative self-rated health among adolescents in the State of Santa Catarina, Brazil. METHODS: A cross-sectional investigation was conducted with a representative sample of 5,028 adolescents who were attending public highschools. The negative self-rated health was analyzed in relation to the following variables: gender, income, physical activity practice, smoking, alcohol consumption, drug use and self-rated stress. The binary logistic regression was carried out to test associations. RESULTS: The prevalence of negative self-rated health was higher among girls (17.6%) in comparison to boys (9.6%; p<0.0001). Higher values of Odds Ratio (OR) were associated with female gender (OR 1.99; 95%CI 1.66-2.38), lower socioeconomic status (OR 1.54; 95%CI 1.08-2.20), smoking (OR 2.00; 95%CI 1.35-2.94), and negative self-rated stress (OR 3.36; 95%CI 2.74-4.12). CONCLUSIONS: Female adolescents, those with lower socioeconomic status, smokers and those who negatively perceived stress presented higher levels of negative self-rated health.

Um pouco de história, desenvolvimentos recentes e perspectivas para a pesquisa em atividade física e saúde no Brasil

As grandes transformacoes mundiais das ultimas decadas provocaram mudancas sociais e na saude, individual e coletiva, jamais imaginadas. O perfil dos problemas de saude atuais faz com que a promocao de estilos de vida saudaveis (e ativos fisicamente) seja valorizada e colocada como uma das prioridades em saude publica no planeta. A Educacao Fisica Brasileira esta atenta a essas evolucoes nas ciencias e nas praticas que envolvem a atividade fisica relacionada a saude, e precisa responder aos anseios da sociedade em termos de formacao profissional competente e producao cientifica de qualidade nesta area. Este artigo discute desenvolvimentos recentes e perspectivas na pesquisa em atividade fisica e saude, com repercussoes para a Educacao Fisica no Brasil.

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

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

Which social support and psychological factors are associated to active commuting to school

OBJECTIVE The aim of this study was to investigate the association between self-efficacy, enjoyment, and volitional control with active commuting, as well as to analyze the impact of social support from parents, friends, and teachers with active commuting to school. METHODS Participants in this cross-sectional study were 625 students (male: 46.3%) aged 10 to 15years from Porto, Portugal (2010/2011). A questionnaire was used to assess active commuting to/from school (walk/cycle), self-efficacy, enjoyment, volitional control and social support. Binary logistic regression was performed to identify significant associations between targeted variables and active commuting. RESULTS The results show positive associations in crude analyses for all variables, except for enjoyment for walk/cycle to school. In the adjusted model, higher likelihood of active commuting was found among students who reported having higher self-efficacy (OR=2.10; CI95%: 1.07; 4.11) to walk/cycle to school as well as among adolescents who reported being encouraged by their parents (OR=3.66; CI95%: 1.55; 8.69), and having the partnership of friends in active journeys (OR=4.31; CI95%: 1.79; 10.37). CONCLUSION Self-efficacy, encouragement from parents and companionship from friends were important indicators of active commuting to school among Portuguese adolescents. These findings provide support for further research to identify and understand factors that predict and explain the active commuting.

Aedes ægypti control in urban areas: A systemic approach to a complex dynamic

Author summary The available strategy for controlling the diseases transmitted by Aedes ægypti (dengue fever, Zika, and chikungunya) relies on continued community participation. Despite slogans emphasizing how easy it should be, no country has achieved it since the seventies. To better investigate potentially sustainable interventions, we developed a systemic model based on a multidisciplinary approach, integrating as deeply as possible specialized knowledge and field experience. The resulting model is composed of 4 external and 8 internal subsystems and 31 relationships, consistent with the literature and checked over multiple iterations with specialists of the many areas. We analyzed the model and the main feedback loops responsible for the system’s stability, searching for possible interventions that could shift the existing balance. We suggest the introduction of 1 more player, the local primary health care structure, with the potential to change the undesired equilibrium. The health agents in the areas are the first to detect disease cases, and they could stimulate individuals to inform about potential mosquitoes’ breeding sites and bring timely information to the vector-control program. Triggering such an action could introduce changes in peoples attitude through a positive feedback loop in the desired direction.

Effects of a new walking and cycling route on leisure-time physical activity of Brazilian adults: A longitudinal quasi-experiment

The primary aim of this study was to evaluate the effects of a new walking and cycling route on leisure-time physical activity (PA) (walking and moderate-to-vigorous PA) of adults. Furthermore, we also investigated the use, intention to use and barriers to use the new route for leisure-time PA. A longitudinal quasi-experiment was carried out. Three exposure groups were defined, based on the distance from home to the new route: 0-500m, 501-1000m and 1001-1500m. Telephone-based interviews were carried out in 2009 and 2012. Those living around the new walking and cycling route increased their leisure-time walking by 15min/week on average. Those residing up to 500m from the route increased leisure-time walking by 30min/week and walking plus moderate-to-vigorous PA by 50min/week. The proportion of people who started walking or practicing moderate-to-vigorous PA during leisure time and who reported intention to use the new route was higher among those living closer to it. Perceived distance was the most prevalent barrier to use the new route.