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Madalosso MM, Martins NNF, Medeiros BM, Rocha LL, Mendes LL, Schaan BD, Cureau FV. Consumption of ultra-processed foods and cardiometabolic risk factors in Brazilian adolescents: results from ERICA. Eur J Clin Nutr 2023; 77:1084-1092. [PMID: 37612385 DOI: 10.1038/s41430-023-01329-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION The consumption of ultra-processed foods (UPF) has increased over the past few decades. However, few studies have investigated the association between UPF consumption and cardiometabolic risk factors in adolescents from developing countries. OBJECTIVE To evaluate the association between UPF consumption and cardiometabolic risk factors in Brazilian adolescents. METHODS This study included students aged 12-17 years who participated in the ERICA. Food consumption was assessed using a 24-h food recall, and the foods were classified based on their degree of processing, utilizing the NOVA classification. Participants' blood samples were collected after an overnight fast and exams were performed (triglycerides, total cholesterol, HDL-c, LDL-c, fasting glucose, insulin, and HbA1c). Overweight/obesity and blood pressure were also investigated. Associations were evaluated using Poisson regression models. RESULTS The analysis included a total of 36,952 adolescents. The energy consumption from UPF was 30.7% (95%CI: 29.7-31.6) per day. Adolescents with high UPF consumption, defined as the top tertile (≥38.7% per day), were observed to have higher intake of sodium, saturated and trans-fat, while having lower intake of proteins, fibers, polyunsaturated fats, vitamins and minerals. After adjusting for potential confounders, it was observed that higher UPF consumption was directly associated with high LDL-c (PR = 1.012; 95%CI: 1.005-1.029) and inversely with low HDL-c (PR = 0.972; 95%CI: 0.952-0.993). No associations were found between UPF consumption and other cardiometabolic risk factors. CONCLUSION Brazilian adolescents have presented a high consumption of UPF, which is associated to poor diet quality and can contribute to elevated LDL-c levels.
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Affiliation(s)
- Mariana Migliavacca Madalosso
- Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Nina Nayara Ferreira Martins
- Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Luana Lara Rocha
- Graduate Program in Public Health, Universidade Federal de Minas Gerais, School of Medicine, Belo Horizonte, MG, Brazil
| | - Larissa Loures Mendes
- Department of Nutrition, Universidade Federal de Minas Gerais, School of Nursing, Belo Horizonte, MG, Brazil
| | - Beatriz D Schaan
- Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Felipe Vogt Cureau
- Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Graduate Program in Physical Education, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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De Moraes ACF, Medeiros-Oliveira VC, Burford K, Schaan BD, Bloch K, de Carvalho KMB, Cureau FV, Nascimento-Ferreira MV. Association Between Sleep Time and Pro- and Anti-Inflammatory Biomarkers Is Mediated by Abdominal Obesity Among Adolescents. J Phys Act Health 2023; 20:926-933. [PMID: 37295784 DOI: 10.1123/jpah.2022-0468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Movement behaviors and abdominal obesity are associated with higher inflammatory biomarkers. However, the role of waist circumference as a mediating factor is still unknown. Thus, our aims were to (1) test the associations between 24-hour movement behavior variables (physical activity, sedentary behavior, and sleep), abdominal obesity, and pro- and anti-inflammatory biomarkers; and (2) investigate whether abdominal obesity had a mediating effect between the investigated associations. METHODS This multicenter cross-sectional study included 3591 adolescents (aged 12-17 y) from 4 Brazilian cities. Waist circumference (in centimeters; at half the distance between the iliac crest and at the lower costal margin), 24-hour movement behaviors (validated questionnaire), high-sensitive C-reactive protein, and adiponectin (serum plasma) were evaluated. We used multiple mediation regression models (95% confidence interval) to determine if waist circumference mediated the association between 24-hour movement behaviors and pro- and anti-inflammatory biomarkers. RESULTS The results revealed that screen time and moderate to vigorous physical activity were not associated with pro- or anti-inflammatory biomarkers. However, sleep duration (in hours per day) was negatively associated with pro- (C-reactive protein, β = -0.08; 95% confidence interval, -0.38 to -0.02) and anti- (adiponectin, β = -0.31; 95% confidence interval, -2.13 to -0.12) inflammatory biomarkers. Our results also showed that waist circumference mediated the association between sleep duration and high-sensitive C-reactive protein (2.7%), and adiponectin (2.8%). CONCLUSION Sleep duration was inversely associated with pro- and anti-inflammatory biomarkers, and these relations were mediated by abdominal obesity. Therefore, adolescents having healthy sleep can have implications for reducing waist circumference and inflammatory indicators.
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Affiliation(s)
- Augusto César Ferreira De Moraes
- The University of Texas Health Science Center at Houston School of Public Health Austin Campus, Department of Epidemiology, Human Genetics, and Environmental Science, Michael & Susan Dell Center for Healthy Living, Austin, TX,USA
- Department of Epidemiology, Graduate Program in Public Health and Graduate Program in Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, SP,Brazil
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
| | - Vanessa Cassia Medeiros-Oliveira
- Department of Epidemiology, Graduate Program in Public Health and Graduate Program in Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, SP,Brazil
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
| | - Katie Burford
- The University of Texas Health Science Center at Houston School of Public Health Austin Campus, Department of Epidemiology, Human Genetics, and Environmental Science, Michael & Susan Dell Center for Healthy Living, Austin, TX,USA
| | - Beatriz D Schaan
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS,Brazil
- Faculty of Medicine, Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
| | - Katia Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ,Brazil
| | | | - Felipe Vogt Cureau
- Graduate Program in Cardiology and Cardiovascular Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS,Brazil
| | - Marcus Vinicius Nascimento-Ferreira
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP,Brazil
- HEALth, pHYsical activity and Behavior ReseArch (HEALTHY-BRA) group, Federal University of Tocantins, Campus Miracema, Miracema, TO,Brazil
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The relationship between ultra-processed food consumption and internalising symptoms among adolescents from São Paulo city, Southeast Brazil. Public Health Nutr 2022; 25:2498-2506. [PMID: 34610854 PMCID: PMC9991766 DOI: 10.1017/s1368980021004195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the association between ultra-processed food (UPF) consumption and internalising symptoms (IS) among adolescents. DESIGN It is a cross-sectional study. Paper-pencil survey was completed in classroom with information on UPF consumption, IS and selected covariates. IS were assessed with the Internalizing Symptoms sub-scale from the Social Behaviour Questionnaire (IS-SBQ). UPF was evaluated with a FFQ extracted from the Brazilian National School Health Survey. Crude and adjusted association between UPF and IS was investigated with structural equation models. SETTING São Paulo, SP, Brazil. PARTICIPANTS A total of 2680 students, Mage = 14·85; (95 % CI 14·81, 14·88). RESULTS UPF consumption was associated with higher scores in IS in the crude (β = 0·14; P < 0·001) and adjusted (β = 0·12; P < 0·001) models. The higher the consumption of UPF, the higher is the IS score. The following variables were associated with a lower risk of UPF consumption: male sex, public school and having more meals with parents. The change in the magnitude of the standardised score was almost negligible, but the model was significantly improved with the inclusion of covariates. CONCLUSIONS Our results provide evidence about the positive association between UPF consumption and IS among adolescents. The association, despite its low magnitude, remained significant after adjusting for potential confounders. These results are relevant considering the increase in UPF consumption worldwide and in low- and middle-income countries. Also, our study emphasises the importance of a healthy diet with a reduction in UPF consumption among adolescents.
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Schaan CW, Schaan BD, Cureau FV. Prevalence and correlates of meeting physical activity, screen time and sleep duration guidelines among Brazilian adolescents: findings from ERICA. Appl Physiol Nutr Metab 2022; 47:690-698. [PMID: 35395163 DOI: 10.1139/apnm-2021-0447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The prevalence of meeting movement guidelines is low in developed countries; however there is a lack of data among medium-income countries, including Brazil. We evaluated the prevalence and correlates of meeting physical activity, screen time, and sleep guidelines in Brazilian adolescents. Employing a cross-sectional design, Brazilian adolescents (aged 12-17) were surveyed about their physical activity levels, sleep, and screen time. The data was collected at schools through a self-administered questionnaire using a Personal Digital Assistant for entering the data. Poisson regression models were used to examine the associations between correlates (sex, age, socioeconomic status, region, skin colour and shift of school) and meeting movement guidelines. A total of 58,535 adolescents were included. Although only 8.7% of adolescents met all three movement guidelines, the prevalence of those who met physical activity, screen time and sleep duration guidelines was 46.4%, 42.5% and 40%, respectively. Moreover, male sex, age 14-15 years old, non-white skin colour, afternoon shift of school and living in the Northern and Northeastern regions were associated with a higher prevalence of meeting all movement guidelines. The prevalence of adolescents who met all three movement guidelines was low among Brazilian adolescents. Adolescents living in less developed regions show greater adherence to movement guidelines, suggesting a possible impact of the urbanization process on these behaviours. Novelty bullets: - The prevalence of Brazilian adolescents whom met all three movement behaviours guidelines was around 9%. - Among all adolescents, 40% met only one movement guideline.
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Affiliation(s)
- Camila Wohlgemuth Schaan
- Universidade Federal do Rio Grande do Sul, Graduate Program in Endocrinology, Porto Alegre, Brazil;
| | - Beatriz D Schaan
- HCPA, 37895, Endocrine Division, Porto Alegre, RS, Brazil.,UFRGS, 28124, Graduate Program in Endocrinology, Porto Alegre, RS, Brazil;
| | - Felipe Vogt Cureau
- Universidade Federal do Rio Grande do Sul, 28124, Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Porto Alegre, RS, Brazil;
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Christofaro DGD, Tebar WR, Saraiva BTC, da Silva GCR, Dos Santos AB, Mielke GI, Ritti-Dias RM, Mota J. Comparison of bone mineral density according to domains of sedentary behavior in children and adolescents. BMC Pediatr 2022; 22:72. [PMID: 35105341 PMCID: PMC8805312 DOI: 10.1186/s12887-022-03135-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Somatic maturation and the age at onset of puberty are closely related to bone mineral density (BMD), and are potential confounders of the associations between physical activity, sedentary behavior (SB) and BMD in adolescents. Thus the aim was compare BMD at different anatomical sites according to different domains of SB. METHODS The sample consisted of 88 young people (54 boys and 34 girls; 9.5 ± 1.5 years). The self-reported SB was measured by the time spent on TV, computer, video game and smartphone. BMD at each location and throughout the body was assessed by DEXA. Physical activity was assessed by a questionnaire. The comparison of the different types of BMD sites according to the SB levels for each screen device and the total SB were analyzed by Covariance Analysis (ANCOVA). RESULTS Whole-body BMD was higher in young people with low total SB (Total BMD = 0.957 ± 0.042) than in those with moderate (Total BMD = 0.921 ± 0.053) and high SB (Total BMD = 0.929 ± 0.051) (p-value = 0.011). Children and adolescents with low total SB had higher BMD legs (0.965 ± 0.056) than young people with high total SB (BMD legs = 0.877 ± 0.209), but this relationship was attenuated when the analyzes were adjusted for physical activity (p-value = 0.068). CONCLUSION Adolescents with high sedentary behavior tend to have lower whole body bone mineral density than those with low sedentary behavior.
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Affiliation(s)
- Diego Giulliano Destro Christofaro
- School of Technology and Sciences, Presidente Prudente, São Paulo State University (Unesp), Roberto Simonsen street, number 305, Presidente Prudente, Sao Paulo, 19.060-900, Brazil.
| | - William Rodrigues Tebar
- School of Technology and Sciences, Presidente Prudente, São Paulo State University (Unesp), Roberto Simonsen street, number 305, Presidente Prudente, Sao Paulo, 19.060-900, Brazil
| | - Bruna Thamyres Ciccotti Saraiva
- School of Technology and Sciences, Presidente Prudente, São Paulo State University (Unesp), Roberto Simonsen street, number 305, Presidente Prudente, Sao Paulo, 19.060-900, Brazil
| | - Gabriela Caroline Rodrigues da Silva
- School of Technology and Sciences, Presidente Prudente, São Paulo State University (Unesp), Roberto Simonsen street, number 305, Presidente Prudente, Sao Paulo, 19.060-900, Brazil
| | - Amanda Barbosa Dos Santos
- School of Technology and Sciences, Presidente Prudente, São Paulo State University (Unesp), Roberto Simonsen street, number 305, Presidente Prudente, Sao Paulo, 19.060-900, Brazil
| | - Gregore Iven Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | | | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
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da Costa L, Lemes IR, Tebar WR, Oliveira CB, Guerra PH, Soidán JLG, Mota J, Christofaro D. Sedentary behavior is associated with musculoskeletal pain in adolescents: A cross sectional study. Braz J Phys Ther 2022; 26:100452. [PMID: 36257097 PMCID: PMC9579307 DOI: 10.1016/j.bjpt.2022.100452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/31/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND High prevalence of back pain has been observed in adolescents. Sedentary behavior (SB) is considered a risk factor for musculoskeletal pain. The association between back pain and SB in the pediatric/adolescent population is not well established. OBJECTIVE To investigate the association between SB and low back and neck pain in adolescents according to sex. METHODS This is a cross-sectional study with children and adolescents aged 10-17 years, randomly recruited from public and private schools in Presidente Prudente, Brazil. All students enrolled in the selected schools were eligible to participate. SB was evaluated by adding the number of hours of use of screen devices, such as television, computer, video game, and smartphone/tablet. To assess neck and low back pain, the Nordic Musculoskeletal Questionnaire was used. Physical activity and socioeconomic status were assessed by the Baecke Questionnaire and the Brazilian Criteria for Economic Classification (ABEP), respectively. Odds ratio (OR) from Binary Logistic Regression in the unadjusted and adjusted model (physical activity, abdominal obesity, and socioeconomic status) showed the relationship between musculoskeletal pain and SB. RESULTS A total of 1011 adolescents (557 girls) with a mean ± standard deviation age of 13.2±2.4 years were included. Moderate (OR = 1.80; 95%CI: 1.00, 3.23) and high (OR = 1.91; 95%CI: 1.02, 3.53) SB were associated with neck pain in girls. In boys, moderate SB [OR = 2.75; 95%CI: 1.31, 5.78) were associated with neck pain. Moderate (OR = 2.73; 95%CI: 1.45, 5.02) and high (OR = 2.49; 95%CI: 1.30, 4.76) SB were associated with low back pain only in girls. CONCLUSION Moderate and high SB were associated with neck pain in girls and boys, while moderate and high SB were associated with low back pain only in girls.
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Affiliation(s)
- Lucas da Costa
- Department of Physical Education, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Presidente Prudente, SP, Brazil,Corresponding author at: Universidade Estadual Paulista Julio de Mesquita Filho, Rua Roberto Símonsen, 305, Centro Educacional, CEP: 19060-900, Presidente Prudente, SP, Brazil.
| | - Italo Ribeiro Lemes
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil,Applied Physiology & Nutrition Research Group, Universidade de São Paulo, São Paulo, SP, Brazil
| | - William R. Tebar
- Department of Physical Education, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Presidente Prudente, SP, Brazil
| | - Crystian B. Oliveira
- Faculdade de Medicina, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP, Brazil
| | | | - José Luiz G. Soidán
- Facultade de Ciencias da Educación e do Deporte, Universida de Vigo, Pontevedra, Galiza, Espanã
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, North region, Portugal
| | - Diego.G.D. Christofaro
- Department of Physical Education, Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Presidente Prudente, SP, Brazil
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Parajára MDC, Andrade ACDS, Xavier CC, Proietti FA, Meireles AL. Associations of the perceived neighborhood environment and screen time in adolescents living in a medium-sized city in Brazil: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:963-975. [PMID: 31846351 DOI: 10.1080/09603123.2019.1703912] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/07/2019] [Indexed: 06/10/2023]
Abstract
Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015-2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11-17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.
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Affiliation(s)
- Magda Do Carmo Parajára
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Amanda Cristina De Souza Andrade
- Department of Public Health, Federal University of Mato Grosso, Cuiabá, Brazil
- Belo Horizonte Observatory for Urban Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Fernando Augusto Proietti
- Faculty of Health and Human Ecology, Vespasiano, Brazil
- René Rachou Institute - Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Adriana Lúcia Meireles
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
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School environment and physical activity in adolescents from São Paulo city. Sci Rep 2021; 11:18118. [PMID: 34518611 PMCID: PMC8438037 DOI: 10.1038/s41598-021-97671-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/23/2021] [Indexed: 11/08/2022] Open
Abstract
We examined the association of physical activity (PA) facilities and access to school with total PA and domain-specific PA in adolescents. We enrolled 2610 adolescents (mean: 14.9 years) from Sao Paulo city. The number and presence of sports courts, swimming pools, locker rooms, running/athletics tracks, entrance accessible for student cyclists, bike racks, speed limit signal around the school, and pedestrian crossing were assessed in each school. All participants responded to a questionnaire about frequency and duration of physical education classes, leisure time, and active commuting. Total PA was obtained by adding up all PA domains. Presence of three or more (OR: 1.62; 95% CI: 1.15 to 2.30) sports courts, swimming pool available in usable conditions (OR: 1.45; 95% CI: 1.01 to 2.10), running/athletics tracks (OR: 2.35; 95% CI: 1.07 to 5.18), and bike racks (OR: 1.38; 95% CI: 1.07 to 1.78) were positively associated with total PA. Number of sports courts, swimming pool available in usable conditions, speed limit signals around the school, and pedestrian crossings were positively associated with physical education classes. The bike racks, speed limit signs around the school, and pedestrian crossings were positively associated with active commuting. School environment was associated with increased PA. Our findings should be considered in future epidemiologic studies and for educational and health policy makers.
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The adherence to school meals is associated with a lower occurrence of obesity among Brazilian adolescents. Prev Med 2021; 150:106709. [PMID: 34181943 DOI: 10.1016/j.ypmed.2021.106709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/23/2022]
Abstract
This study aimed to verify the association between adherence to meals from the Brazilian National School Feeding Program (PNAE) and obesity indicators among adolescents. Data from 12,373 students attending public schools from the 2015 National Survey of School Health were used. Adherence to school meals was assessed using a self-administered questionnaire and classified as null (zero/rarely), low (1-2×/week), moderate (3-4×/week), and high (5×/week). Weight and height were measured and classified based on the World Health Organization's reference for Z-scores of body mass index (BMI) for age, overweight (≥ + 1 Z-score) and obesity (≥ + 2 Z-score). Linear and Poisson regression models adjusted for potential confounding factors (gender, race/ethnicity, age, region, goods score, maternal education, living with parents, eating outside of school profile and physical activity) were performed to assess the association between adherence to school meals and the indicators (Z-score, overweight and obesity). The prevalence of high adherence was 21.6% and obesity, 8%. An inverse and dose-response association were observed between adherence to the PNAE meals and obesity indicators. Adolescents with high adherence to school meals (5×/week) had a 0.10 lower BMI Z-score (coefficient = -0.10, CI -0.17;-0.03), 11% less prevalence of overweight (PR = 0.89, CI 0.80;0.99) and 24% less prevalence of obesity (PR = 0.76, CI 0.62;0.93) than those with a lower adherence (<5×/week). Our results showed that the adherence to PNAE meals may contribute to obesity prevention in Brazil.
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dos Santos AE, Araujo RHDO, Couto JO, da Silva DRP, Silva RJDS. Daily physical activity, human development index and insomnia in a representative sample of Brazilian adolescents: a cross-sectional analysis. SAO PAULO MED J 2021; 139:481-488. [PMID: 34378737 PMCID: PMC9632537 DOI: 10.1590/1516-3180.2020.0745.r1.0604221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/05/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Although there is a growing body of research pointing towards the need to investigate how different movement behaviors, such as physical activity and sleep, influence each other, the joint relationship between these factors and insomnia has been little explored among adolescents in developing countries. OBJECTIVES To investigate the association between daily physical activity and insomnia in a national sample of Brazilian adolescents, according to the Human Development Index (HDI) of each Brazilian region. DESIGN AND SETTINGS Cross-sectional study on 102,072 Brazilian students aged 11 to 19 years, selected from all regions of the country. METHODS Information on insomnia and physical activity was self-reported by adolescents. RESULTS Our analyses revealed that girls who accumulated at least 60 minutes/day of physical activity on up to three days/week were less prone to present insomnia. This pattern of association was maintained only for those who lived in high HDI regions (odds ratio, 0.87; 95% confidence interval, 0.75-0.99). For boys, there was a positive association between the number of active days and protection against insomnia, especially for those who lived in high HDI regions. CONCLUSION Even amounts of physical activity that were lower than the weekly guidelines, were associated with better sleep quality for Brazilian adolescents, especially girls, and even for those who lived in regions with greater social and economic vulnerability.
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Affiliation(s)
- Antônio Evaldo dos Santos
- MSc. Physical Education Professional, Department of Physical Education, Universidade Federal de Sergipe (UFS), São Cristóvão (SE), Brazil.
| | | | - Josiene Oliveira Couto
- MSc. Physical Education Professional, Department of Physical Education, Universidade Federal de Sergipe (UFS), São Cristóvão (SE), Brazil.
| | - Danilo Rodrigues Pereira da Silva
- PhD. Physical Education Professional, Department of Physical Education, Universidade Federal de Sergipe (UFS), São Cristóvão (SE), Brazil.
| | - Roberto Jerônimo dos Santos Silva
- PhD. Physical Education Professional, Department of Physical Education, Universidade Federal de Sergipe (UFS), São Cristóvão (SE), Brazil.
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Morais LDC, Paravidino VB, Mediano MFF, Benthroldo R, Gonçalves TR, Sgambato MR, de Souza BDSN, Junior EV, Marques ES, Pereira RA, Sichieri R, Cunha DB. Effectiveness of a school-based randomized controlled trial aimed at increasing physical activity time in adolescents. Eur J Public Health 2021; 31:367-372. [PMID: 33846735 DOI: 10.1093/eurpub/ckab025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of obesity prevention educational activities, isolated or combined with the modification of the school environment on total physical activity time. METHODS This is a school-based randomized controlled trial, conducted with 2511 students from fifth and sixth-grade in Brazil, that employed a parallel, three-group experimental arms: control group (CG), PAAPPAS group (PG) and PAAPPAS-environment group (PEG). During the 2016 school year, the PG received educational activities in the classroom, providing a general basis for a healthy lifestyle. The PEG received the same educational activities and also modifications in the school environment to stimulate physical activity practice during one month. Physical activity was evaluated through a validated physical activity questionnaire. Intention-to-treat analysis was performed to evaluate the rate of change of physical activity time between groups using PROC GENMOD procedure. All analyses were performed using SAS. RESULTS Total physical activity time increased by 22% in PEG compared with CG (P = 0.003). No difference was observed between PEG and PG (Δ = 60.20 vs. 36.37, respectively; P = 0.27) and between PG and CG (Δ = 36.37 vs. 9.70, respectively; P = 0.23). The proportion of individuals who attended at least 150 min week-1 of physical activity increased in PEG compared with PG (P = 0.04); however, no difference was observed between PEG and CG (P = 0.19) and between PG and CG (P = 0.26). For 300 min week-1, no difference was observed between groups. CONCLUSION A school-based multi-component intervention including modification of the school environment was effective for increasing physical activity time among adolescents.
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Affiliation(s)
- Lidiane da C Morais
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Physical Education and Sports, Naval Academy, Brazilian Navy, Rio de Janeiro, Brazil
| | - Mauro F F Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Raycauan Benthroldo
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatiana R Gonçalves
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michele R Sgambato
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Eliseu V Junior
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Emanuele S Marques
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosângela A Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana B Cunha
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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12
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Silva RMA, Andrade ACDS, Caiaffa WT, Bezerra VM. Co-occurrence of health risk behaviors and the family context among Brazilian adolescents, National Survey of School Health (2015). REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210023. [PMID: 33950141 DOI: 10.1590/1980-549720210023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the association between the co-occurrence of risk behaviors (RB) and the family context in Brazilian adolescents. METHODS Cross-sectional study on 101,534 students from the 9th grade of elementary school in the National Survey of School Health - PeNSE 2015. The co-occurrence of RB was estimated by the sum of the presence of sedentary behavior, low fruit consumption, regular consumption of alcohol and tobacco. Prevalence was assessed using the Venn diagram and multivariate analysis by the ordinal logistic regression model of partial proportional odds. RESULTS 8.8% of the adolescents did not have RB; 34.5% had one; 42.7% had two; and 14.1%, three or four. The most prevalent combinations were between sedentary behavior and low fruit consumption (33.8%); sedentary behavior with low fruit consumption and regular consumption of alcohol (9.5%). Those who were more likely to present co-occurrence had mothers with higher education level in all models, did not live with their fathers [0, 1 and 2 vs. 3: (OR = 1.21; 95%CI 1.07-1.37)], had parents who sometimes, never or rarely understood their problems and concerns [0, 1 and 2 vs. 3: (OR = 1.62; 95%CI 1.49-1.76)] and monitored their homework [0, 1 and 2 vs. 3: (OR = 1.77; 95%CI 1.62-1.93)]; and had meals with parents or guardians <4 days/week for the three models. CONCLUSION Health RB tend to cluster among Brazilian adolescents and are related to characteristics of the family context. These findings point to the need for health promotion actions focusing on simultaneity and not in isolation.
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Affiliation(s)
| | - Amanda Cristina de Souza Andrade
- Universidade Federal de Mato Grosso - Cuiabá (MT), Brasil.,Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | | | - Vanessa Moraes Bezerra
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia - Vitória da Conquista (BA), Brasil
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13
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Association between different contexts of physical activity and anxiety-induced sleep disturbance among 100,648 Brazilian adolescents: Brazilian school-based health survey. Psychiatry Res 2020; 293:113367. [PMID: 32777618 DOI: 10.1016/j.psychres.2020.113367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/28/2020] [Accepted: 08/02/2020] [Indexed: 11/24/2022]
Abstract
Physical activity (PA) practice can be a protective factor for anxiety-induced sleep disturbance (AISD), however the association between different contexts of PA and anxiety-induced sleep disturbance is not clear. We aimed to analyze the association between different contexts of PA and AISD. Data from the Brazilian School-based Health Survey [n=100,648; age: 14.3y (range:11-18 years)], conducted in 2015, were used. Higher PA during transport was associated with higher AISD. PA during physical education classes presented lower odds for AISD. PA practiced outside school was associated with reduced AISD among boys. The association between PA and AISD seems to be context-dependent.
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Ferrari G, Rezende LFM, Wagner GA, Florindo AA, Peres MFT. Physical activity patterns in a representative sample of adolescents from the largest city in Latin America: a cross-sectional study in Sao Paulo. BMJ Open 2020; 10:e037290. [PMID: 32878760 PMCID: PMC7470644 DOI: 10.1136/bmjopen-2020-037290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES We examined the patterns of total and domain-specific physical activity (PA) by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo city, Brazil. DESIGN Cross-sectional study. PARTICIPANTS We included a representative sample of 2682 (52.2% boys) adolescents aged 14-15 years from public and private schools in Sao Paulo, 2017. Socioeconomic status was assessed using a wealth index derived from principal component analysis. Descriptive analyses evaluated differences in total and domain-specific PA by sex, socioeconomic status and maternal education level. OUTCOME MEASURES We collected data on the frequency and duration that adolescents spent in each PA domain (active transportation, leisure PA and physical education classes) through a self-report questionnaire. RESULTS On average, adolescents spent 197.7 min/week (95% CI 190.6-204.8) in total PA. The proportion of adolescents achieving at least 60 min/day (≥420 min/week) was 12.7% (95% CI 11.4-14.1), with a higher prevalence in boys (18.3%) and in those with higher socioeconomic status (17.4%). Similar patterns were observed for leisure PA and physical education classes. Active transportation was higher in girls (46.0 min/week; 95% CI 42.6-49.6) than in boys (43.4 min/week, 95% CI 39.9-46.6). Boys and adolescents with higher socioeconomic status and higher maternal education level had higher levels of total PA. CONCLUSIONS We found a variation in patterns of total and domain-specific PA by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo. Initiatives for promoting PA in adolescents should take these findings into account.
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Affiliation(s)
- Gerson Ferrari
- Facultad de Ciencias Médicas, Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago de Chile, Chile
| | - Leandro F M Rezende
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brazil
| | - Gabriela Arantes Wagner
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brazil
| | - Alex A Florindo
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo, Brazil
- Graduate Program in Nutrition in Public Health, Department of Nutrition, School ofPublic Health, University of Sao Paulo, São Paulo, SP, Brazil
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Brandao JM, Sichieri R, Ribas SA, Verly-Jr E, Pereira RA, Castro IRRD, Hassan BK, Oliveira ASDD, Marques ES, Cunha DB. Treatment of Childhood Obesity Based on Brazilian Dietary Guidelines Plus Energy Restriction (PAPPAS HUPE Study): Protocol for a Randomized Clinical Trial. JMIR Res Protoc 2020; 9:e16170. [PMID: 32502969 PMCID: PMC7308900 DOI: 10.2196/16170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 11/24/2022] Open
Abstract
Background The Food Guide for the Brazilian Population relies on natural or minimally processed foods mainly of plant origin such as beans and rice with low oil, salt, and sugar content and limited consumption of ultraprocessed foods. Reduction of ultraprocessed foods improves diet quality and energy consumption. Objective The goal of this study is to evaluate the effectiveness of an intervention for the treatment of obesity in children, with counseling based on the Brazilian Food Guide plus control of total energy intake. Methods A parallel, randomized clinical trial will include children aged 7 to 12 years. Randomization will be performed in blocks of 10 individuals using computer-generated random sequence numbers. Both the control and intervention groups will participate in 6 standardized educational activities based on the 10 steps of the Brazilian Food Guide. These activities will be conducted at the University Hospital Toy Library, located in the pediatric outpatient clinic. For the intervention group, in addition to the educational activities, an individualized food plan based on the nutritional recommendations of the Brazilian Society of Pediatrics will be prescribed and discussed with the mothers and fathers. The primary outcome of the study will be variations in body mass index, and secondary outcomes will include analysis of insulin resistance, blood pressure, body fat percentage, and waist and neck circumference. Results This project was funded by the National Council for Scientific and Technological Development in December 2017 (grant no 408333/2017-0). Recruitment began in August 2018 and by September 2019, we had enrolled the 101 participants. In addition to the patients referred by the national system of regulation, recruitment was made by medical outpatient referral and external indication. This is an ongoing study. We expect the results to be published in November 2020. Conclusions At the end of the project, in case of a positive result, a protocol for the treatment of obesity based on the Brazilian Food Guide will be proposed to the Unified Health System. A successful method to reduce childhood obesity is expected. Trial Registration Brazilian Registry of Clinical Trials RBR-3st5sn; http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn International Registered Report Identifier (IRRID) DERR1-10.2196/16170
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Affiliation(s)
- Joana Maia Brandao
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Simone Augusta Ribas
- Department of Nutrition and Public Health, School of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eliseu Verly-Jr
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosangela Alves Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Bruna Kulik Hassan
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Emanuele Souza Marques
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Dos Santos AE, Araujo RHDO, Nascimento VMSD, Couto JDO, Silva RJDS. Associations between specific physical activity domains and social isolation in 102,072 Brazilian adolescents: Data from the 2015 National School-Based Health Survey. J Health Psychol 2020; 26:2626-2635. [PMID: 32493064 DOI: 10.1177/1359105320922298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study investigated the association among loneliness, number of friends, and participation in physical education classes, leisure-time physical activities, and active commuting. Data from 102,072 adolescents participating in the National School-based Health Survey aged 11-19 years were analyzed. Information about the study variables was self-reported through a questionnaire. Adolescents more active in physical education classes and leisure were less likely of having social isolation. Those more active in commuting were more likely of having social isolation. Interventions aimed at addressing social isolation in adolescence can prioritize school and leisure-time physical activities.
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Werneck AO, Vancampfort D, Oyeyemi AL, Stubbs B, Silva DR. Joint association of ultra-processed food and sedentary behavior with anxiety-induced sleep disturbance among Brazilian adolescents. J Affect Disord 2020; 266:135-142. [PMID: 32056867 DOI: 10.1016/j.jad.2020.01.104] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/26/2019] [Accepted: 01/20/2020] [Indexed: 11/15/2022]
Abstract
AIMS We analyzed the joint association of high ultra-processed food ingestion and sedentary behavior (SB) with anxiety-induced sleep disturbance among Brazilian adolescents. METHODS Data from the Brazilian Scholar Health Survey, a nationally representative survey of 9th grade adolescents [mean: 14.28 years (range: 11-18 years)] conducted in 2015 (n = 100,648) were used. Self-reported anxiety-induced sleep disturbance, SB (TV viewing and total sitting time), and frequency of ingestion of different ultra-processed foods were collected. Age, ethnicity, type of city (capital or interior), region of the country, and habitual physical activity (global scholar survey questionnaire) were covariates. Logistic regression analyses were conducted to assess the associations. RESULTS High ultra-processed food ingestion plus low SB [boys:OR:1.44(99%CI:1.16-1.79), girls:OR:1.41(99%CI:1.22-1.63)] were risk factors for anxiety-induced sleep disturbance. The highest risk of anxiety-induced sleep disturbance was observed among those who joint high ultra-processed food ingestion with high SB [boys:OR:1.85(99%CI:1.46-2.35), girls:OR:1.62(99%CI:1.39-1.89)]. In addition, the interaction of high ultra-processed food ingestion with TV-viewing substantially increased the odds of anxiety-induced sleep disturbance [boys:OR:2.03(99%CI:1.61-2.56), girls:OR:2.04(99%CI:1.76-2.36)]. CONCLUSIONS Both the high consumption of ultra-processed foods and SB (especially TV-viewing) appear to be independently associated with anxiety-induced sleep disturbance in both sexes. However, the co-occurrence of both negative lifestyle behaviors is associated with a substantial increase in the risk of anxiety-induced sleep disturbance. Future longitudinal research is required to confirm/refute our findings and explore potential mechanisms.
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Affiliation(s)
- André O Werneck
- Department of Physical Education, Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Rua Roberto Símonsen, 305, 19060-900 Presidente Prudente, São Paulo,Brazil.
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Adewale L Oyeyemi
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom and South London and Maudsley NHS Foundation Trust, London, UK
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
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Agathão BT, Lopes CS, Cunha DB, Sichieri R. Gender differences in the impact of sleep duration on common mental disorders in school students. BMC Public Health 2020; 20:148. [PMID: 32005216 PMCID: PMC6995133 DOI: 10.1186/s12889-020-8260-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 01/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Common mental disorders (CMD) in children and adolescents can be initial and non-specific manifestations of more serious mental diseases and often persist into adulthood. Therefore, early detection is important, as is the identification of the factors that impact development. Insufficient sleep represents one of the most common and potentially remediable risks to mental health in children and adolescents for whom chronic sleep loss has become normal. This study aims to investigate the influence of sleep duration on CMD in schoolchildren and adolescents. METHODS The data for this longitudinal study were derived from the community trial Parents, Students, Community Health Agents and Teachers for Healthy Eating (PAAPAS) in 2016 (N = 2743), with fifth and sixth graders from 18 public schools of Duque de Caxias, Rio de Janeiro, Brazil. CMD were assessed by the General Health Questionnaire (GHQ-12) at baseline and at a 9-month follow-up. Sleep duration was evaluated at baseline and was categorized as short, adequate or long according to age group. The effect of sleep duration on common mental disorders was analysed by sex using linear mixed-effects models. RESULTS At baseline, the frequency of CMD was 33.2% and was higher in boys than in girls and higher among students with short sleep duration. There was an increase in the CMD score over time among girls with short sleep duration (p < 0.01). Among boys, a similar trajectory of the CMD score was observed in the subgroups with short and long sleep duration, but there was a significant reduction in the subgroup with long sleep duration (p = 0.05). CONCLUSION Changes in common mental disorder patterns differ according to sex, and short sleep duration seems to be problematic for students' mental health. The promotion of health strategies that involve the family and school environment, such as later school hours, could help change this scenario.
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Affiliation(s)
- Beatriz Tosé Agathão
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro (UERJ), 524 São Francisco Xavier St., Maracanã, Rio de Janeiro, 20550-900, Brazil.
| | - Claudia Souza Lopes
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro (UERJ), 524 São Francisco Xavier St., Maracanã, Rio de Janeiro, 20550-900, Brazil
| | - Diana Barbosa Cunha
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro (UERJ), 524 São Francisco Xavier St., Maracanã, Rio de Janeiro, 20550-900, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro (UERJ), 524 São Francisco Xavier St., Maracanã, Rio de Janeiro, 20550-900, Brazil
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Schaan CW, Cureau FV, Salvo D, Kohl HW, Schaan BD. Unhealthy snack intake modifies the association between screen-based sedentary time and metabolic syndrome in Brazilian adolescents. Int J Behav Nutr Phys Act 2019; 16:115. [PMID: 31775773 PMCID: PMC6882160 DOI: 10.1186/s12966-019-0880-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/08/2019] [Indexed: 12/20/2022] Open
Abstract
Background Excessive screen time has been associated with metabolic syndrome (MetS) among adolescents; however, snack intake in front of screens may play a role in this association. Therefore, our objective was to investigate the association between screen-based sedentary time with MetS and whether this association is modified by unhealthy snack intake in front of screens. Methods This study was a nationwide, cross-sectional, school-based survey in Brazil including adolescents aged 12 to 17 years. The frequency of snack consumption in front of screen and screen-based sedentary time (TV view, computers and videogames use) were self-reported. Thereafter, screen time was categorized (≤2, 3–5 and ≥ 6 h/day); snack consumption in front of screens was dichotomized. Metabolic syndrome diagnosis was defined based on the International Diabetes Federation criteria. Associations between screen time and MetS were investigated using logistic regression in overall sample and after stratification by snack intake in front of screens. Results A total of 33,900 adolescents were included in the analysis. The final adjusted model, which included sociodemographic data, physical activity, and energy intake, showed that adolescents who spent ≥6 h/day in front of screens had an increased odds ratio for MetS (OR = 1.68, 95%CI: 1.03–2.74). However, after stratifying the sample according to reported snack intake, the association between higher screen-based sedentary time and MetS remained significant only for adolescents who reported consumption of snacks in front of screens. Conclusion Longer screen-based sedentary times were directly associated with MetS. However, this association seems to be modified by reported snack intake in front of screens.
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Affiliation(s)
- Camila Wohlgemuth Schaan
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre. Hospital de Clínicas de Porto Alegre, St. Ramiro Barcelos 2350/21, 90035-003, Porto Alegre, RS, Brazil.
| | - Felipe Vogt Cureau
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre. Hospital de Clínicas de Porto Alegre, St. Ramiro Barcelos 2350/21, 90035-003, Porto Alegre, RS, Brazil
| | - Deborah Salvo
- Washington University in St. Louis, Brown School, Prevention Research Center in St. Louis, Saint Louis, MO, USA
| | - Harold W Kohl
- University of Texas Health Science Center at Houston, School of Public Health, Michael and Susan Dell Center for Healthy Living and University of Texas at Austin, Department of Kinesiology and Health Education, Austin, TX, USA
| | - Beatriz D Schaan
- Post-graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre. Hospital de Clínicas de Porto Alegre, St. Ramiro Barcelos 2350/21, 90035-003, Porto Alegre, RS, Brazil
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20
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Co-occurrence and clustering of the four major non-communicable disease risk factors in Brazilian adolescents: Analysis of a national school-based survey. PLoS One 2019; 14:e0219370. [PMID: 31269084 PMCID: PMC6609030 DOI: 10.1371/journal.pone.0219370] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 06/22/2019] [Indexed: 01/09/2023] Open
Abstract
Background The major non-communicable chronic diseases (NCD) are associated with a small group of modifiable lifestyle-related risk factors, including smoking, insufficient physical activity, unhealthy eating, and alcohol abuse. In this study, we evaluated the co-occurrence and clustering of the major NCD risk factors among Brazilian adolescents. Methods This cross-sectional study analyzed data of 101,607 adolescents from the Brazilian National Survey of School Health (PeNSE) 2015. The risk factors included were: regular consumption of ultra-processed foods, irregular consumption of fruits and vegetables, insufficient physical activity, smoking, and alcohol consumption. Clustering was defined through the ratio between observed and expected prevalences of combination of risk factors greater than 1. Expected prevalence of the co-occurrence of risk factors was calculated from the joint probability of the behaviors. Additionally, we examined the presence of at least four risk factors according to socioeconomic characteristics. Results Of the 32 combinations of risk factors, 13 corresponded to clustering. We observed a strong correlation between alcohol consumption and smoking, which were found together in 8 of the 13 clusters identified. The most frequent combinations of risk factors involved unhealthy eating and insufficient physical activity. Only 2.9% of the adolescents did not present any risk behaviors, while 38.0%, 32.9%, 9.4% and 1.8% accumulated two, three, four and five risk factors, respectively. The accumulation of risk factors was higher in girls, older adolescents, those who did not live with both parents, children of less-educated mothers, students attending public school, and residents of cities in more developed urban areas of the country. Conclusions The main risk factors for NCD are frequent and not randomly distributed among Brazilian adolescents. Our results provide information for policymakers to target specific groups and joint behavioral risk factors for health improvement in adolescents.
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Werneck AO, Collings PJ, Barboza LL, Stubbs B, Silva DR. Associations of sedentary behaviors and physical activity with social isolation in 100,839 school students: The Brazilian Scholar Health Survey. Gen Hosp Psychiatry 2019; 59:7-13. [PMID: 31054464 DOI: 10.1016/j.genhosppsych.2019.04.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine the relationship between physical activity, sedentary behaviors, and social isolation in a representative sample of Brazilian adolescents. METHOD Cross sectional analyses using data from the Brazilian Scholar Health Survey conducted in 2015. The sample included 100,839 adolescents (mean age: 14.3 y, 51.4% Female) from 3040 schools. Information about social isolation (number of close friends and perceived loneliness), physical activity (International Physical Activity Questionnaire) and sedentary behaviors (total sitting time and TV viewing) were self-reported. Chronological age, race and type of city (state capital or other) were co-variables. Logistic regression models were used to analyze the data (results are presented as odds ratios (OR) with 95% confidence intervals). RESULTS Physical activity was associated with lower odds of both social isolation indicators in boys, and with lower likelihood of having few friends in girls. Greater sitting time was associated with higher likelihood of social isolation, as was low (<1 h/d) [boys: OR: 1.54 (95% CI: 1.33 to 1.77); girls: OR: 1.31 (95% CI: 1.17 to 1.48] and high TV viewing (≥8 h/d) [boys: OR: 1.75 (95% CI: 1.47 to 2.09)]; girls: OR: 1.58 (95% CI: 1.37 to 1.82)]. More than 300 min/week of physical activity was sufficient to eliminate the association of high TV viewing and high sitting time with markers of social isolation in boys. CONCLUSION Physical activity is associated with a lower prevalence of social isolation, especially among boys. Both high and low amounts of TV viewing increase the likelihood of social isolation. Physical activity reduced the association between TV viewing and sitting with social isolation among boys.
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Affiliation(s)
- André O Werneck
- Department of Physical Education, São Paulo State University (UNESP), Presidente Prudente, Brazil.
| | - Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK; Department of Health Sciences, University of York, UK
| | - Luciana L Barboza
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Sergipe, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Danilo R Silva
- Department of Health Sciences, University of York, UK; Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Sergipe, Brazil
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Silva FG, Oliveira CB, Hisamatsu TM, Negrão Filho RF, Rodrigues CRD, Franco MR, Pinto RZ. Critical evaluation of physical activity questionnaires translated to Brazilian-Portuguese: a systematic review on cross-cultural adaptation and measurements properties. Braz J Phys Ther 2019; 24:187-218. [PMID: 31085135 DOI: 10.1016/j.bjpt.2019.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 04/13/2019] [Accepted: 04/18/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The number of questionnaires that measures physical activity levels has increased considerably. For Brazilian population it becomes a challenge, due to the need of a rigorous translation, adaptation and testing of measurement properties. OBJECTIVE Evaluate the methodological quality and criteria of physical activity questionnaires translated to Brazilian-Portuguese. METHODS Methodological quality and quality criteria was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. RESULTS Sixty-nine studies were included, the most frequent questionnaires investigated were the International Physical Activity Questionnaire (n=16) and the Baecke Physical Activity Questionnaire (n=12). Translation (n=13), reliability (n=37) and construct validity (n=44) were the measurement properties commonly investigated. For reliability, most studies were rated as 'adequate' for methodological quality. The Intraclass Correlation Coefficient of the questionnaires ranged from 0.20 to 1.0. For construct validity, 31 analyses showed 'inadequate' methodological quality, due to poor description of the comparator instrument. High level of evidence on reliability were found for Baecke Physical Activity Questionnaire, Self-administered Physical Activity Checklist and Physical Activity Questionnaire of the Surveillance System of Risk Factors and Protection for Chronic Diseases; on construct validity for Self-administered Physical Activity Checklist, Physical activity Questionnaire for Adolescents, Physical activity Questionnaire for Older Children and Saúde naBoa Questionnaire. CONCLUSION Most questionnaires showed poor methodological quality and measurement properties. The Baecke Physical Activity Questionnaire and Self-administred Physical Activity Checklist showed better scorings for methodological quality and quality criteria. Further high methodological quality studies are still warranted.
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Affiliation(s)
- Fernanda Gonçalves Silva
- Department of Physical Therapy, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | - Crystian Bitencourt Oliveira
- Department of Physical Therapy, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | - Thalysi Mayumi Hisamatsu
- Department of Physical Therapy, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | - Ruben Faria Negrão Filho
- Department of Physical Therapy, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | - Caio Russo Dutra Rodrigues
- Department of Physical Therapy, Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | - Marcia Rodrigues Franco
- Centro Universitário UNA, Contagem, MG, Brazil; Regional Public Hospital of Betim, Betim, MG, Brazil
| | - Rafael Zambelli Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Silva DAS, Chaput JP, Tremblay MS. Participation frequency in physical education classes and physical activity and sitting time in Brazilian adolescents. PLoS One 2019; 14:e0213785. [PMID: 30865705 PMCID: PMC6415839 DOI: 10.1371/journal.pone.0213785] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/28/2019] [Indexed: 12/01/2022] Open
Abstract
Introduction To examine the association between participation frequency per week in physical education (PE) classes and physical activity (PA) and sitting time levels in adolescents according to the economic development level of the region of residence. Methods A cross-sectional study with a sample representative of Brazil was carried out with 12,220 students aged 11–19 years. Participation frequency per week in PE classes, moderate-to-vigorous PA (MVPA), PA during PE classes, active commuting, PA outside of school hours, total accumulated PA, time sitting in front of the TV and total sitting time were assessed by using a self-administered questionnaire. Results Adolescents who reported having PE classes were more likely to meet MVPA recommendations (1–2 PE class/week–OR: 1.3, 95%CI: 1.1–1.5; ≥3 PE class/week–OR: 2.0, 95%CI: 1.7–2.5), spent more time in PA outside of school hours (1–2 PE class/week–OR: 1.6, 95%CI: 1.4–1.9; ≥3 PE class/week–OR: 2.0, 95%CI: 1.5–2.6), and accumulated more PA (1–2 PE class/week–OR: 1.9, 95%CI: 1.6–2.2; ≥3 PE class/week–OR: 6.0, 95%CI: 4.0–8.9) than students who reported not taking PE classes. Boys from regions with higher Human Development Index (HDI) who took ≥3 PE classes/week were more likely to have higher levels of active commuting (OR: 1.4, 95%CI: 1.1–1.9) and less likely of getting in front of TV (OR: 0.7, 95%CI: 0.5–0.9). Adolescents from regions with higher HDI were more likely to have more time spent in PA during PE classes (Male–OR: 2.7, 95%CI: 2.4–3.1; Female–OR = 3.2, 95%CI: 2.8–3.7). Conclusions Having PE classes is associated with a higher level of PA in both sexes and in both regions and lower level of sitting time in boys from regions with higher HDI.
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Affiliation(s)
- Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
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Werneck AO, Vancampfort D, Oyeyemi AL, Stubbs B, Silva DR. Associations between TV viewing, sitting time, physical activity and insomnia among 100,839 Brazilian adolescents. Psychiatry Res 2018; 269:700-706. [PMID: 30273895 DOI: 10.1016/j.psychres.2018.08.101] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/10/2018] [Accepted: 08/24/2018] [Indexed: 12/27/2022]
Abstract
Our aim was to examine the relationship between insomnia and levels of physical activity (PA) and time spent sitting and TV viewing among Brazilian adolescents. Data from the Brazilian Scholar Health Survey, a nationally representative survey of 9th grade adolescents [mean: 14.28 years (range: 11-18 years)] conducted in 2015 (n = 100,839) were used. Self-reported insomnia, TV viewing, sitting time and total PA (adapted International PA Questionnaire) were collected. Chronological age, race, type of city (capital or interior) country region, goodies ingestion and ultra-processed foods ingestion were covariates. Logistic regression analyses were conducted to assess the associations. A higher sitting time and TV viewing (≥8 h/day) was associated with a higher risk of insomnia among boys [sitting time: OR = 2.39 (95%CI = 1.88-3.04); TV:OR = 2.49(95%CI = 1.92-3.22) and girls [sitting time: OR = 2.17(95%CI = 1.84-2.57; TV:OR = 1.72(95%CI = 1.44-2.04)]. More than 4 h of sitting time per day was associated with higher risk of insomnia in adolescents who comply [boys: OR = 1.43(95%CI = 1.19-1.73); girls: OR = 1.66(95%CI = 1.41-1.94)] and who do not comply with the 300 min/week of physical activity recommendation [boys = OR = 1.35(95%CI = 1.13-1.60); girls: OR = 1.38(95%CI = 1.20-1.57)]. Our data suggest that higher levels of TV viewing or sitting are associated with sleep difficulties in this large cohort of adolescents, irrespective of their physical activity behavior.
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Affiliation(s)
- André O Werneck
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina, Rodovia Celso Garcia Cid, km 380, 86057-970 Londrina, Parana, Brazil.
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Adewale L Oyeyemi
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Danilo R Silva
- Departament of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
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Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE To evaluate the association between back pain and health-related quality of life (HRQoL) among adolescents. SUMMARY OF BACKGROUND DATA The prevalence of back pain has been increasing not only in the adult population but also among children and adolescents. The better knowledge about the association between back pain and health-related quality of life could facilitate the implementation of new intervention strategies on prevention and treatment of back pain. METHODS A sample of 350 students from the fifth to ninth grades of one public school in Niterói, Rio de Janeiro, Brazil. Anthropometric measures and information regarding sociodemographic, lifestyle, frequency and intensity of neck (NP), thoracic (TP), and low back pain in the previous month were collected using a personal digital assistant. HRQoL was assessed by KIDSCREEN-27. Multiple linear regression analyses were performed to investigate the association between back pain and HRQoL by sex. RESULTS The mean age of participants was 12.7 (±1.6) years. Frequency of NP, TP, and low back pain was 34.3, 27.1, and 13.1%, respectively. The mean intensity of pain was 2.3 (±0.2) for neck, 2.0 (±0.2) for thoracic, and 1.3 (±0.1) for low back pain. The presence of two/three painful sites was reported by 21.7% of the adolescents. The frequency and severity of neck pain were inversely associated with global HRQoL in both the sexes. There is a strong inverse association between the number of painful sites and global HRQoL and domains. CONCLUSION The presence and intensity of cervical pain and the number of painful regions were associated with lower HRQoL in adolescents, which is worrying due to the important relationship between back pain in the adolescence and in the adulthood. LEVEL OF EVIDENCE 3.
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Cureau FV, Sparrenberger K, Bloch KV, Ekelund U, Schaan BD. Associations of multiple unhealthy lifestyle behaviors with overweight/obesity and abdominal obesity among Brazilian adolescents: A country-wide survey. Nutr Metab Cardiovasc Dis 2018; 28:765-774. [PMID: 29843935 DOI: 10.1016/j.numecd.2018.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Physical inactivity, unhealthy diet, smoking and heavy drinking are four key unhealthy lifestyle behaviors (ULB) that may influence body weight and obesity development. More recently, sedentary time has been recognized as another potentially emerging ULB related to obesity. We therefore investigated the association of multiple ULB with overweight/obesity and abdominal obesity among Brazilian adolescents. METHODS AND RESULTS This cross-sectional study involved 62,063 students (12-17 years). Physical inactivity, high screen time, low fiber intake, binge drinking and smoking were self-reported and combined to a ULB risk score, ranging from zero to five. Participants were classified as overweight/obese or with abdominal obesity using sex and age-specific cut-off points for BMI and waist circumference, respectively. Poisson regression models were used to examine the associations between ULB with overweight/obesity and abdominal obesity, adjusted for socio-demographic variables. Overall, 2.3%, 18.9%, 43.9%, 32.3% and 2.6% of participants reported zero, one, two, three and four/five ULB, respectively. Higher ULB risk score was associated with overweight/obesity and abdominal obesity in a dose-response gradient. Among 32 possible combinations of ULB, the three most prevalent combinations (physical inactivity + low fiber intake; high screen time + low fiber intake; physical inactivity + high screen time + low fiber intake) were positively associated with general and abdominal obesity. CONCLUSIONS Our findings suggest a synergistic relationship between ULB and general and abdominal obesity. Preventive efforts targeting combined ULB should be sought to reduce the prevalence of general and abdominal obesity in Brazilian youth.
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Affiliation(s)
- F V Cureau
- Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Science and Technology for Health Technology Assessment, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - K Sparrenberger
- Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - K V Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - U Ekelund
- Department of Sports Medicine, Norwegian School of Sports Science, Oslo, Norway
| | - B D Schaan
- Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Regional Socioeconomic Inequalities in Physical Activity and Sedentary Behavior Among Brazilian Adolescents. J Phys Act Health 2018; 15:338-344. [DOI: 10.1123/jpah.2017-0338] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: This study aims to describe the regional prevalence and patterns of physical activity (PA) and sedentary behavior among Brazilian adolescents. Methods: Data from the Brazilian Scholar Health Survey, a nationally representative survey of ninth-grade adolescents [mean age: 14.29 y (14.27–14.29)] conducted in 2015 (n = 101,445), were used. Outcomes were television viewing, sitting time (ST), total PA, and active traveling collected via self-administered questionnaire. Information on frequency of physical education classes and type of school was collected from the school’s director. Frequencies with 95% confidence intervals were used to determine the prevalence and patterns of outcomes. Results: Higher prevalence of PA (≥300 min/wk) and ST (>4 h/d) was found in Midwest (PA = 38.0%; ST = 44.5%), South (PA = 37.6%; ST = 50.1%), and Southeast (PA = 36.1%; ST = 49.3%) compared with Northeast (PA = 29.7%; ST = 36.9%) and North (PA = 34.4%; ST = 34.8%) regions of Brazil. ST was higher among adolescents from private schools (51.5%) than public schools (42.9%), whereas active traveling was greater among students of public schools than private schools (62.0% vs 34.4%). Most inequalities in outcomes between capital and interior cities were in the poorest regions. Conclusions: The results indicate that national plans targeting regional inequalities are needed to improve PA and to reduce sedentary behavior among Brazilian adolescents.
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Costa CDS, Flores TR, Wendt A, Neves RG, Assunção MCF, Santos IS. Comportamento sedentário e consumo de alimentos ultraprocessados entre adolescentes brasileiros: Pesquisa Nacional de Saúde do Escolar (PeNSE), 2015. CAD SAUDE PUBLICA 2018. [DOI: 10.1590/0102-311x00021017] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Estudo transversal com o objetivo de investigar a associação entre comportamento sedentário e consumo de alimentos ultraprocessados (AUP) em adolescentes brasileiros. Foram utilizados dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) realizada em 2015. O consumo diário de pelo menos um grupo de AUP representou o desfecho, e a exposição principal foi o tempo diário de comportamento sedentário (horas em atividades sentado, excluído o tempo dispendido na escola). Foram calculadas prevalências, razões de prevalências e intervalos de 95% de confiança (IC95%). As análises foram ajustadas para sexo, idade, cor da pele, escolaridade materna, índice de bens, região geográfica e dependência administrativa da escola. Cerca de 40% dos escolares reportaram consumo diário de pelo menos um grupo de AUP (39,7%; IC95%: 39,2-40,3) e 68,1% (IC95%: 67,7-68,7) referiram > 2 horas/dia de comportamento sedentário. Entre os escolares com comportamento sedentário > 2 horas/dia, a prevalência de consumo diário de AUP foi de 42,8% (IC95%: 42,1-43,6%), maior do que entre os sem comportamento sedentário (29,8%; IC95%: 29,0-30,5%). Quanto maior o tempo de comportamento sedentário, maior a prevalência de consumo de AUP (valor de p para tendência linear < 0,001). Estratégias que promovam a alimentação saudável e a diminuição de comportamentos sedentários, bem como regulamentações da publicidade de AUP, tornam-se necessárias a fim de evitar que estilos de vida não saudáveis perdurem à idade adulta.
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Cunha DB, Verly Junior E, Paravidino VB, Araújo MC, Mediano MFF, Sgambato MR, de Souza BDSN, Marques ES, Baltar VT, de Oliveira ASD, da Silva ACF, Pérez-Cueto FJ, Pereira RA, Sichieri R. Design of a school randomized trial for nudging students towards healthy diet and physical activity to prevent obesity: PAAPAS Nudge study protocol. Medicine (Baltimore) 2017; 96:e8898. [PMID: 29390278 PMCID: PMC5815690 DOI: 10.1097/md.0000000000008898] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of nudge activities at school on the students' body mass index (BMI). DESIGN School-based factorial randomized community trial. SETTING Eighteen public schools in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. PARTICIPANTS AND INTERVENTION The 18 schools will be randomized into 4 group arms: group 1-control (without any activity); group 2-will receive educational activities in the classroom; group 3-will receive changes in the school environment (nudge strategies); group 4-will receive educational activities and changes in the school environment. Activities will occur during the 2018 school-year. MAIN OUTCOME MEASURE(S) The primary (BMI) and secondary (body fat percentage) outcomes will be assessed at baseline and after the study using a portable electronic scale with a segmental body composition monitor. The height will be measured by a portable stadiometer. ANALYSIS Statistical analyses for each outcome will be conducted through linear mixed models that took into account the missing data and cluster effect of the schools.
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Affiliation(s)
- Diana Barbosa Cunha
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro
| | - Eliseu Verly Junior
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro
| | - Vitor Barreto Paravidino
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro
- Department of Physical Education and Sports, Naval Academy, Brazilian Navy
| | - Marina Campos Araújo
- Department of Epidemiology and Quantitative Methods, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Ministry of Health
| | | | | | | | - Emanuele Souza Marques
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro
| | - Valéria Troncoso Baltar
- Department of Epidemiology and Biostatistics, Institute of Collective Health, Fluminense Federal University, Niterói
| | | | | | | | - Rosangela Alves Pereira
- Department of Social and Applied Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro
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Maia EG, Mendes LL, Pimenta AM, Levy RB, Claro RM. Cluster of risk and protective factors for obesity among Brazilian adolescents. Int J Public Health 2017; 63:481-490. [PMID: 29143071 DOI: 10.1007/s00038-017-1053-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/17/2017] [Accepted: 11/06/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aims to identify and analyze clusters formed by risk and protective factors for obesity among Brazilian adolescents. METHODS Cross-sectional data collected in a national representative sample of adolescents by the Brazilian National School Health Survey of 2012 were used (n = 109,104). Cluster analysis was applied to identify clusters involving dietary intake, eating behavior, physical activity and sedentary behaviors. Logistic regression was employed to contextualize the clusters according to students' sociodemographics and schools' characteristics. RESULTS Two clusters were identified. Cluster 1 was predominantly characterized by the low frequency of both risk and protective factors for obesity; Cluster 2 was characterized by high frequency of both of these factors. None was essentially healthy or unhealthy. Adolescents from less developed regions and with mothers with lower education level were associated to Cluster 1. CONCLUSIONS The identification of two mixed clusters indicate wide spread obesity risk among scholars in the country. The association between the clusters and sociodemographic characteristics of the population allows a greater refinement of health promotion and obesity prevention and combat actions in Brazil.
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Affiliation(s)
- Emanuella Gomes Maia
- Graduate Program in Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Larissa Loures Mendes
- Nutrition Department, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Adriano Marçal Pimenta
- Department of Maternal Child Nursing and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Rafael Moreira Claro
- Nutrition Department, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Ferreira NL, Claro RM, Mingoti SA, Lopes ACS. Coexistence of risk behaviors for being overweight among Brazilian adolescents. Prev Med 2017; 100:135-142. [PMID: 28412185 DOI: 10.1016/j.ypmed.2017.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 04/05/2017] [Accepted: 04/09/2017] [Indexed: 11/16/2022]
Abstract
This study aimed to evaluate the magnitude of and the factors associated with the coexistence of risk behaviors for being overweight among Brazilian adolescents. This is a cross-sectional study with a representative sample of adolescents (mostly aged 13-15years) enrolled from public and private schools of Brazil in 2012. The co-occurring sedentary behavior and inadequate food consumption (regular intake of sugary and fried foods, and irregular consumption of fruits and vegetables-FV) was estimated using a Venn diagram. Sociodemographic, familial, and behavioral factors associated with the number of risk behaviors for being overweight were identified using an ordinal logistic regression analysis. Sedentary behavior was observed in 62.0% of adolescents. Regular intake of sugary or fried food was observed in 55.3% and 23.5% of adolescents, respectively, with 51.9% having an inadequate intake of FV. At least one risk behavior was reported in >90.0% of adolescents; 6.1% reported all 4. Being female, having a higher maternal education level, attending private school, not having breakfast or meals with parents regularly, eat watching television, and not practicing weekly leisure time physical activity were associated with an increased chance of having multiple risk behaviors. This study observed a high prevalence of coexisting of risk behaviors, which was associated with sociodemographic, familial, and behavioral factors. These findings may contribute to a clearer understanding of the associations between different behaviors among adolescents, and may be used to improve public health surveillance and to develop strategies that address multiple behaviors, in order to prevent overweight among adolescents.
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Affiliation(s)
- Nathália Luíza Ferreira
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN), Av. Alfredo Balena, 190, room 316, Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil
| | - Rafael Moreira Claro
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN), Av. Alfredo Balena, 190, room 316, Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil; Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN), Av. Alfredo Balena, 190, room 322, Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil
| | - Sueli Aparecida Mingoti
- Department of Statistics, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, room 4054, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Aline Cristine Souza Lopes
- Department of Nutrition, Universidade Federal de Minas Gerais, Research Group in Nutrition Interventions (GIN), Av. Alfredo Balena, 190, room 316, Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil.
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Ramos DDO, Daly M, Seidl-de-Moura ML, Jomar RT, Nadanovsky P. Inconsistent reports of risk behavior among Brazilian middle school students: National School Based Survey of Adolescent Health (PeNSE 2009/2012). CAD SAUDE PUBLICA 2017; 33:e00145815. [PMID: 28538791 DOI: 10.1590/0102-311x00145815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 06/13/2016] [Indexed: 11/22/2022] Open
Abstract
This study assessed the consistency of self-reports of risk behavior (overall and within four specific domains: alcohol use, tobacco use, drug use, and sexual activity) in two editions of the Brazilian National School Based Survey of Adolescent Health (PeNSE): 2009 and 2012. The overall proportion of cases with at least one inconsistent response in the two editions was 11.7% (2.7% on the alcohol items, 2.1% for drug use, 4.3% for cigarette use, 3% for sexual activity) and 22.7% (12.8% on alcohol items, 2.5% for drug use, 4.3% for cigarette use, 4.1% for sexual activity), respectively. Such inconsistency was more prevalent among males, delayed students, those who reported having experimented with drugs, and those who did not have a cellphone. Because inconsistent responses were more prevalent among the students who claimed to have engaged in risky activities, removing inconsistent responders affected the estimated prevalence of all risk behaviors in both editions of the survey. This study supports the importance of performing consistency checks of self-report surveys, following the growing body of literature on this topic.
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Affiliation(s)
| | | | | | - Rafael Tavares Jomar
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Paulo Nadanovsky
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Vojciechowski AS, Natal JZ, Gomes ARS, Rodrigues EV, Villegas ILP, Korelo RIG. Effects of exergame training on the health promotion of young adults. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.001.ao06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Training with exergames has been prescribed for health problems prevention, however, little is known about its influence on the self-perception of the physical condition and on the physical and motor skills (PMS). Objective: To investigate the effects of exergames (EXG) on the self-perception of the physical condition, level of physical activity and PMS in healthy young adults. Methods: Forty young adults, of both genders, were allocated by convenience into Control Group (CG, n = 20, 21.85 ± 0.62 years old), the individuals did not perform the physical training with exergames, and Intervention Group (IG, n = 20, 23.10 ± 0.61 years old), the subjects practiced exergames training (XBOX360 Kinect ®), in pairs, twice a week, for 12 weeks. Anthropometric measurements; self-perceived physical condition (International Fitness Scale-IFIS); International Physical Activity Questionnaire (IPAQ) and PMS (flexibility; abdominal endurance; upper limb strength and endurance, agility and velocity) were evaluated. Results: The IG presented better self-perception of the physical condition; increased physical activity level in the leisure domain and enhanced PMS after 12 weeks of intervention, compared to the CG. Conclusion: The EXG was efficient to improve skeletal muscle function, to contribute to physical exercise adherence and to promote physical health in active young adults.
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de Rezende LFM, Azeredo CM, Silva KS, Claro RM, França-Junior I, Peres MFT, Luiz ODC, Levy RB, Eluf-Neto J. The Role of School Environment in Physical Activity among Brazilian Adolescents. PLoS One 2015; 10:e0131342. [PMID: 26098906 PMCID: PMC4476687 DOI: 10.1371/journal.pone.0131342] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/01/2015] [Indexed: 11/19/2022] Open
Abstract
Objective To analyze the association of physical activity facilities and extracurricular sports activities in schools with physical activity among adolescents. Methodology/Principal Findings We used data collected for the National Survey of School Health in 2012. The national representative sample comprised 109,104 Brazilian students from 2,842 schools. We calculated the prevalence of participation in physical education classes, leisure-time physical activity, and total physical activity level. We also evaluated the following physical activity facilities: sports courts, running/athletics tracks, schoolyard with teacher-directed physical activities, swimming pools, locker rooms; and the offer of extracurricular sports activities. Schools with at least one physical activity facility had increased odds of participation in physical education (OR 1.59; 95% CI 1.20 to 2.10). However, in order to increase leisure-time physical activity (OR1.14; 95% CI 1.03 to 1.26) and total physical activity level (OR 1.15; 95% CI 1.06 to 1.24) at least four and two facilities, respectively, were necessary. Extracurricular sports activities in schools were positively associated with leisure-time physical activity and physical activity level. The number of sports courts and swimming pool in a school were associated with participation in physical education classes. Availability of sports courts, running/athletics tracks, and swimming pool in schools were associated with leisure-time physical activity. Total physical activity was associated with schools with sports courts, schoolyard with teacher-directed physical activities, and swimming pool. Conclusions School-level characteristics have important potential to increase the possibility of engagement in physical activity in and out of school, and therefore have a fundamental role in promoting these practices.
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Affiliation(s)
| | - Catarina Machado Azeredo
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, São Paulo, Brasil
- Universidade Federal de Uberlândia, Faculdade de Medicina, Minas Gerais, Brazil
| | - Kelly Samara Silva
- Universidade Federal de Santa Catarina, Centro de Desportos, Santa Catarina, Brazil
| | - Rafael Moreira Claro
- Universidade Federal de Minas Gerais, Departamento de Nutrição, Minas Gerais, Brazil
| | - Ivan França-Junior
- Faculdade de Saúde Pública da Universidade de São Paulo, Departamento de Saúde Materno-Infantil, São Paulo, Brazil
| | | | - Olinda do Carmo Luiz
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, São Paulo, Brasil
| | - Renata Bertazzi Levy
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, São Paulo, Brasil
| | - José Eluf-Neto
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, São Paulo, Brasil
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