Mario Renato Azevedo

Adolescent physical activity and health : A systematic review

AbstractPhysical activity in adolescence may contribute to the development of healthy adult lifestyles, helping reduce chronic disease incidence. However, definition of the optimal amount of physical activity in adolescence requires addressing a number of scientifIc challenges. This article reviews the evidence on short- and long-term health effects of adolescent physical activity. Systematic reviews of the literature were undertaken using a reference period between 2000 and 2004, based primarily on the MEDLINE/PubMed database. Relevant studies were identifIed by examination of titles, abstracts and full papers, according to inclusion criteria defined a priori. A conceptual framework is proposed to outline how adolescent physical activity may contribute to adult health, including the following pathways: (i) pathway A — tracking of physical activity from adolescence to adulthood; (ii) pathway B — direct influence of adolescent physical activity on adult morbidity; (iii) pathway C — role of physical activity in treating adolescent morbidity; and (iv) pathway D — short-term benefits of physical activity in adolescence on health. The literature reviews showed consistent evidence supporting pathway ‘A’, although the magnitude of the association appears to be moderate. Thus, there is an indirect effect on all health benefits resulting from adult physical activity. drawing recommendations. Finally, although studies on physical fitness are of interest for understanding the relationships between fitness and health, guidelines should focus on PA rather than fitness.Definition of adolescent PA guidelines is beyond the scope of this article, but our conceptual framework, and the recognition that domains of PA are different from those of adults may help governmental and non-governmental agencies involved in creating these guidelines.

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.

Conhecimento de adultos sobre o papel da atividade física na prevenção e tratamento de diabetes e hipertensão: estudo de base populacional no Sul do Brasil

The aim of this study was to evaluate public knowledge on the role of physical activity in the prevention and treatment of diabetes and hypertension, and the factors associated with such knowledge. A population-based cross-sectional study was conducted in Pelotas, southern Brazil, including 972 adults aged 20 to 69 years, selected with a clustering protocol. Knowledge on the preventive and curative benefits of physical activity was higher for hypertension (87.2%) than for diabetes (47.2%). Women were more knowledgeable on the role of physical activity in preventing diabetes (PR: 1.16; 95%CI: 1.03-1.31). In terms of treatment, greater knowledge was associated with female gender, current physical activity, obesity, subjects, and higher socioeconomic status. For prevention of hypertension, greater knowledge was observed in individuals with higher socioeconomic status (PR: 1.23; 95%CI: 1.11-1.36). For treatment of hypertension, physically active and obese subjects showed greater knowledge. Subjects were generally more knowledgeable on the curative role of physical activity than on its preventive benefits. Public health efforts should aim to raise public awareness on the preventive effects of physical activity against diabetes, hypertension, and other chronic non-communicable diseases.

Physical activity interventions in Latin America: expanding and classifying the evidence.

Context Systematic reviews of public health interventions are useful for identifying effective strategies for informing policy and practice. The goals of this review were to (1) update a previous systematic review of physical activity interventions in Latin America which found that only school-based physical education had sufficient evidence to recommend widespread adoption; (2) assess the reporting of external validity elements; and (3) develop and apply an evidence typology for classifying interventions. Evidence acquisition In 2010–2011, community-level, physical activity intervention studies from Latin America were identified, categorized, and screened based on the peer-reviewed literature or Brazilian theses published between 2006 and 2010. Articles meeting inclusion criteria were evaluated using U.S. Community Guide methods. External validity reporting was assessed among a subset of articles reviewed to date. An evidence rating typology was developed and applied to classify interventions along a continuum based on evidence about their effectiveness in the U.S. context, reach, adoption, implementation, institutionalization, and benefits and costs. Evidence synthesis Thirteen articles published between 2006 and 2010 met inclusion criteria and were abstracted systematically, yet when combined with evidence from articles from the previous systematic review, no additional interventions could be recommended for practice. Moreover, the reporting of external validity elements was low among a subset of 19 studies published to date (median=21% of elements reported). By applying the expanded evidence rating typology, one intervention was classified as evidence-based, seven as promising, and one as emerging. Conclusions Several physical activity interventions have been identified as promising for future research and implementation in Latin America. Enhanced reporting of external validity elements will inform the translation of research into practice.

Factors associated with fruit and vegetable intake among adults in a southern Brazilian city

The study aimed to describe the frequency of fruit and vegetable intake among adults (20-69 years of age) and to identify associated factors. This population-based study in 2006 included 972 adults in Pelotas, Southern Brazil. Consumption of fruits and vegetables was evaluated with three questions on habitual food intake during the year prior to the interview. The outcome variable was regular consumption of fruits and vegetables. Only one in five adults (20.9%) reported consuming fruits and vegetables regularly. Female gender, age 60 years or older, higher socioeconomic status, former smoking, and physical activity were associated with the outcome variable. According to the results, fruit and vegetable intake among adults fails to meet current Ministry of Health recommendations, particularly among male, young, poor, and physically inactive adults. Interventions to encourage healthy diet are urgently needed.

Tabagismo e consumo de álcool em estudantes universitários: prevalência e fatores associados

The study aimed to estimate the prevalence of smoking and alcohol intake among university students from the Federal University of Pelotas, Brazil (UFPel), as well as to investigate factors associated with both habits. The sample included 485 students who were admitted to the university in 2008. Students were sampled randomly across all schools of the UFPel campus, and answered a pre-tested questionnaire, which was administered in the classroom by a member of the research team. Of the individuals interviewed, 53.9% were females and 42.3% were under 20 years. Regarding alcohol intake, 75% used alcohol once a month or less frequently, and the prevalence of risk for abusive alcohol intake was 6.2%. Regarding smoking, 10.2% reported smoking regularly or on weekends. More than 90% of those who smoked or used alcohol started before entering the university. Smoking was directly related to age and inversely related to self-rated health. In terms of alcohol intake, those who lived with friends were more likely to use it. Our data suggest the need for implementing strategies to promote healthy lifestyles among university students. However, the fact that more than 90% of individuals started to smoke or drink before entering the university suggests that interventions should target adolescents as a whole, and not only those who are university students, because onset of smoking and alcohol intake seems to occur at earlier ages.

Prevalência e fatores associados a sintomas depressivos em adultos do sul do Brasil: estudo transversal de base populacional

To identify the prevalence of depressive symptoms and examine associated factors in a Southern Brazilian adult population, a cross-sectional population-based study was carried out, including 972 subjects, men and women, aged 20 to 69 years, living in the urban area of Pelotas, Rio Grande do Sul. The sampling strategy relied on the census tracts of the city as primary sampling units and households as the secondary units. The questionnaire included socio-demographic, behavioral and nutritional variables. The prevalence of sadness, anxiety, loss of energy, lack of will to do things, thinking about the past, and wishing to stay at home were 29.4%, 57.6%, 37.4%, 40.4%, 33.8%, and 54.3%, respectively. Female gender, older ages, smokers and obese individuals showed association with depressive symptoms. Population-based studies using longitudinal designs may help to clarify the relationship between biopsychosocial variables and depressive symptoms.

Risk factors for chronic non-communicable diseases and the CARMEN Initiative: a population-based study in the South of Brazil

A Iniciativa CARMEN e uma estrategia da Organizacao Pan-Americana da Saude e da Organizacao Mundial da Saude de combate as doencas cronicas nao-transmissiveis, que preve intervencoes populacionais para a reducao simultânea de seus fatores de risco. Pretende-se fornecer uma linha de base para intervencoes da Iniciativa CARMEN valendo-se de um estudo de base populacional com 3.100 adultos (> 20 anos), moradores de Pelotas, Rio Grande do Sul. Os fatores estudados foram: tabagismo, sedentarismo, diabetes mellitus, hipertensao arterial sistemica e excesso de peso, sendo descritos acumulados, isoladamente e em combinacoes. O sedentarismo foi o fator de risco mais prevalente (73,2%), seguido do excesso de peso (48,1%). As mulheres foram mais sedentarias e mais magras que os homens. Mais da metade da populacao apresenta dois ou tres fatores de risco (53,4%). A combinacao de sedentarismo e excesso de peso ocorreu em 34,7% da amostra; e sedentarismo, excesso de peso e hipertensao, em 10,8%. O acumulo de fatores de risco para doencas cronicas nao-transmissiveis e frequente na populacao estudada e a identificacao das suas combinacoes mais prevalentes e de grande relevância para o planejamento de intervencoes futuras.The CARMEN Initiative is a strategy of the Pan American Health Organization and the World Health Organization that proposes population-based interventions to reduce risk factors for chronic non-communicable diseases (CNCD) by approaching them simultaneously. The present study aims to provide a baseline for further interventions by the CARMEN Initiative based on a cross-sectional population-based study of 3,100 adults (>20 years old) in Pelotas, a city in the South of Brazil. Prevalence of smoking, physical inactivity, diabetes mellitus, hypertension, and excess weight were studied and presented separately and aggregated in various combinations. The most frequent risk factor was physical inactivity (73.2%), followed by excess weight (48.1%). Women were less active and thinner than men. More than half of the sample showed two or three risk factors (53.4%). The combination of physical inactivity and excess weight was observed in 34.7% of the sample, while 10.8% presented physical inactivity, excess weight, and hypertension concurrently. The accumulation of risk factors for CNCD is frequent in the study population and the identification of the most common combinations is essential for planning future interventions.

Association between health risk behaviors in parents and adolescents in a rural area in southern Brazil

This article aimed to assess the association between health risk behaviors in parents and adolescents in a rural area. The sample included 377 schoolchildren 10 to 18 years of age and 338 parents. The following variables were analyzed: level of leisure-time and commuting physical activity, inadequate eating habits, overweight/obesity, smoking, and alcohol consumption. Prevalence rates for smoking and alcohol consumption by adolescents in the previous 30 days were 6.7% and 27%, respectively. Forty-five percent of adolescents failed to reach the target physical activity score. Adherence to steps to healthy eating was low. Physical activity in adolescents was positively associated with that of parents, and adolescent drinking was associated with maternal alcohol consumption. There was no significant association for other behaviors. In the analysis stratified by gender, level of physical exercise in female adolescents was associated with that of fathers. Parental health risk behaviors were associated with the behaviors in the adolescent children in this rural area.