Effect of Combined Physical Exercise Training in Reducing Cardiovascular Risk Among Adults with Obesity: A Randomized Clinical Trial

It is necessary to understand the relationship between different models of exercise periodization and the reduction of cardiovascular risk in adults with obesity. The aim of this study was to verify the effect of two periodization models of combined training on the cardiovascular risk of adults with obesity of both sexes. A randomized clinical trial was conducted with adults of both sexes with obesity. They were divided into three groups: control group (CG), non-periodized combined training group (NG), and combined training group with linear periodization (PG). The NG and PG groups underwent physical exercise training regimen for 16 weeks, in three weekly sessions of 60 min each, with the volume and intensity equalized. Cardiovascular risk was measured by the overall Framingham risk score (FRS). Generalized estimation equations and individual responsiveness analyses were used, stratified by sex. A statistically significant reduction in FRS was observed only in men of the NG (pre: 2.50 ± 0.56; post: 0.50 ± 1.02; p-value = 0.001). There was no statistically significant intervention effect on the women's cardiovascular risk. It was found that, regardless of sex, subjects in the control group mostly presented results of increased cardiovascular risk. In contrast, those belonging to the exercise groups, if not reduced, at least stabilized the chances of suffering a cardiovascular event in the next ten years after 16 weeks of combined training. Sixteen weeks of non-periodized combined training were sufficient to reduce cardiovascular risk in men with obesity. Both periodization models were important to stabilize the risk of developing a cardiovascular disease in the next 10 years.

Effects of linear periodized and non-periodized combined training on body image perception of adults with obesity: A randomized clinical trial

OBJECTIVE

Verify the effect of non-periodized and linear periodized combined training on body image perception and body dissatisfaction in adults with obesity.

DESIGN

A randomized clinical trial on the effect of two types of combined training periodization was carried out on people with grade I and II obesity.

SETTING

Participants were allocated into three groups: non-periodized periodization group, linear periodization group, and control group, with 23 participants in each.

SUBJECTS

Adults with obesity, with a body mass index between 30 kg/m² and 40 kg/m².

INTERVENTIONS

The intervention lasted 16 weeks (separated into three mesocycles of 4 weeks and 1 week of familiarization), in 3 weekly sessions of 1 hour each, composed of aerobic (30 min) and muscle strength exercises (six exercises) in the same session. The group with non-periodized model maintained uniform intensity, volume, and workload throughout the mesocycles. The group with the linear periodization model started with low initial intensity, subsequently introducing a gradual increase of intensity in the mesocycles.

MAIN MEASURES

Body image perception (current and ideal silhouette) and body dissatisfaction were assessed using the Stunkard silhouette scale.

RESULTS

The perception of the current silhouette increased only in the control group (Δ = 1.16; p = 0.04). There was a significant reduction in the ideal silhouette over time (p = 0.001), especially in non-periodized group (Δ = -1.26). Body dissatisfaction increased significantly only over time (p = 0.001), especially for control group (Δ = 1.47).

CONCLUSIONS

Regardless of periodization, combined training effectively maintained the perception of the current silhouette and reduced the ideal silhouette in adults with obesity.

TRIAL REGISTRATION

Brazilian Registry of Clinical Trials (RBR-3c7rt3).

Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.

Association between simultaneity of health-risk behaviours and self-rated health in Brazilian adolescents

Introduction

This study examined the association between simultaneity of four health-risk behaviours, namely, low levels of moderate-to-vigorous physical activity (insufficient MVPA: <420 min/week), tobacco use, alcohol consumption, and excessive television (TV)–(>2 h/d of TV viewing) and self-rated health (SRH) in Brazilian adolescents.

Methods

We used data of 100,551 adolescents from the National School Health Survey, a national cross-sectional study carried out in 2015. Association between simultaneity of health risk behaviours (i.e. the ratio between observed and expected prevalence rates) and SRH was examined using logistic regression models.

Results

The majority of the participants were female (51.9%) and 14 years of age (50.6%), and 26% of the participants’ SRH ranged from ’average’ to ’extremely poor’. Those who engaged in the following combinations of health-risk behaviours had higher odds of worse SRH than their healthier counterparts: insufficient MVPA and tobacco use (odds ratio—OR: 2.0, 95% confidence interval [CI]: 1.4 to 3.0); insufficient MVPA and alcohol consumption (OR: 1.6, 95%CI: 1.3 to 1.9); insufficient MVPA and >2 h/day of TV viewing (OR: 1.3, 95%CI: 1.1 to 1.6); insufficient MVPA, tobacco use and alcohol consumption (OR: 2.1, 95%CI: 1.7, to 2.7); and insufficient MVPA, alcohol consumption and >2 h/day of TV viewing (OR: 1.6, 95%CI: 1.4 to 2.0).

Conclusions

Insufficient MVPA, alcohol consumption, and other health-risk behaviours were associated with worse SRH in Brazilian adolescents.

Leisure-time physical activities and their association with active behavior in other domains and sociodemographic aspects: a population-based study with adults residing in the Brazilian state capitals and the Federal District

This study aimed to identify the types of leisure-time physical activity (LTPA) most practiced and their association with active behavior in other domains and the sociodemographic aspects in Brazilian adults (≥ 18 years old). It was a cross-sectional study, using data from a population-based system (Vigitel, 2017). Binary logistic regression was used. In the 29,323 LTPA practitioners (51.3% men), the five types of activities most performed were: walking (36.6%), weight training (17.7%), soccer (11.7%), jogging (8.3%), and aerobics (6.7%). The LTPA that had the greatest associations with sociodemographic variables were soccer, walking, and aerobics, all with p-value ≤ 0.01. When considering the other domains of physical activity, participants who reported doing household physical activity were more likely to walk and less likely to practice weight training, soccer and aerobics. Those who did active commuting had more of a chance to walking and less of a chance to weight train, while individuals who practiced occupational physical activity were less likely to walk and more likely to play soccer. Important differences in sociodemographic aspects and active behavior in the other domains were found according to the LTPA type.

Sex differences in the association between educational level and specific domains of physical activity: a Brazilian cross-national survey

Objective

Methods

Results

Conclusion

Supplementary Information

Socioeconomic inequalities in the consumption of minimally processed and ultra-processed foods in Brazilian adolescents

In this study, we evaluated socioeconomic inequalities in the consumption of in natura/minimally processed and ultra-processed foods among adolescents. We used data from the Brazilian National Survey of School Health (PeNSE), 2015. According to the self-reported consumption of beans, vegetables and fruits, a score of in natura/minimally processed foods was generated (0-21 points). Sodas, sweets, instant noodles, and ultra-processed meat were used for the score of ultra-processed foods (0-21 points). Equality indicators were gender, maternal education, and socioeconomic level. Absolute difference, ratios, concentration index and slope index of inequality were calculated. Adolescents (n=101,689, 51% girls, 14.2 years) reported a mean score of 9.97 and 11.46 for ultra-processed foods and in natura/minimally processed foods, respectively. Absolute and relative differences between adolescents with the highest and lowest socioeconomic level, there were differences of 2.64 points and 33% for consumption of in natura/minimally processed foods; and 1.48 points and 15% for ultra-processed foods. Adolescents from higher socioeconomic level ate more in natura/minimally processed foods and ultra-processed foods.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016

This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Effects of Combined Training With Linear Periodization and Non-Periodization on Sleep Quality of Adults With Obesity

Background: Combined exercise training has proven effective in preventing and treating sleep disorders among obese adults. However, structured progression of intensity in sleep parameters remains poorly investigated within this population. Purpose: To verify the effects of non-periodized and linear periodization combined training on the sleep quality of obese adults. Methods: This was a randomized controlled trial involving adults with body mass index ≥ 30 kg/m2, allocated to 3 groups: control (CG; n = 13), non-periodized training (NG; n = 9), and with linear periodization (PG; n = 13). Groups PG and NG trained for 16 weeks in 3 weekly sessions lasting of 60 minutes. The NG trained in 50-59% heart rate reserve (HRR) e 2 × 10-12 repetition maximum (RM) and the PG with progression in 3 mesocycles: 40-49%;50-59%; 60-69% HRR e 2x12-14; 2x10-12; 2 × 8-10 RM, with the total volume equated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. For statistics, we used Generalized Estimation Equations considering p ≤ 0.05. Results: Sleep latency was reduced in both training groups after intervention (NG-Δ = -25.56 minutes p = .028; PG-Δ = -22.23 minutes p = .035), while significant improvements in sleep efficiency were found only in the NG (Δ = 20.67%; p = .042). Conclusion: Despite the NG's apparent superiority, which model has the best sleep effects on obese adults cannot be stated. Hence, caution is needed while extrapolating the results.

Effects of linear periodization of combined training on quality of life of adults with obesity: a blind randomized controlled trial

This study aimed to compare the effect of 16-weeks of combining aerobic and strength training with a linear increase or fixed intensity on the health-related quality of life (HRQoL) of obese adults. This single-blinded clinical trial involved adults with obesity (BMI ≥ 30 kg/m²), randomized into control (CG), fixed intensity (FG), or linear increase (LG) groups. The FG and LG performed 16 weeks of combined (aerobic + strength) training for 60 min, three times a week. The FG performed aerobic exercises between 50 and 59% of the heart rate reserve (HRres) and strength at 10–12 maximum repetitions (RM). The LG started with 40–49% of HRres and 12–14 RM and progressively increased the intensity (50–59% and 10–12 RM; 60–69% and 8–10 RM). The HRQoL was assessed using the SF-36 questionnaire. Generalized estimation equations and mean differences (∆) were used. Of the 69 participants (23 per group), 36 completed the intervention (CG = 13, FG = 9, and LG = 14). A significant difference was observed in the time of the physical function, with superiority in the training groups (CG: ∆ = 1.2 vs. FG and LG, respectively: ∆ = 10.0). The mental health component and mental health domain showed significant differences for the FG (∆ = 30.2 and ∆ = 23.1, respectively). In conclusion, the combined training improved physical functioning. Specifically, fixed-intensity training effectively enhanced mental health indicators.

Trial Registration: This study is registered at www.ensaiosclinicos.gov.br/ (No. RBR-3c7rt3), Date of registration: 07/02/2018.

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study

BACKGROUND

Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed.

OBJECTIVE

To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults.

DESIGN AND SETTING

Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district.

METHODS

The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age.

RESULTS

Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001).

CONCLUSIONS

To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.

Effects of Non-periodized and Linear Periodized Combined Exercise Training on Insulin Resistance Indicators in Adults with Obesity: A Randomized Controlled Trial

BACKGROUND

The aim was to verify the effect of non-periodized and linear periodized combined (aerobic plus resistance) exercise training on insulin resistance markers in adults with obesity.

METHODS

A blinded randomized control trial was conducted with three groups of individuals with obesity (BMI, 30-39.9 kg/m²): control group (CG, n = 23), non-periodized group (NG, n = 23), and linear periodized group (PG, n = 23). The NG and PG performed aerobic and resistance exercises in the same session in aerobic-resistance order for 16 weeks. Both intervention groups trained three sessions weekly, with a total duration of 60 min each. The aerobic training of the NG had a duration of 30 min always between 50% and 59% of the reserve heart rate (HRres), while resistance exercise was comprised of 6 exercises, performed always in 2 × 10-12 maximum repetitions (MRs). The PG progressed the aerobic and resistance training from 40%-49% to 60%-69% (HRres) and from 2 × 12-14 to 2 × 8-10 RM, respectively, along the intervention period. The evaluated indicators of insulin resistance included fasting glucose, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) collected pre- and post-intervention. The analyses to verify the exercise training effect were performed using generalized estimating equations.

RESULTS

After 16 weeks of training, per protocol analysis (n = 39) showed significant reductions in HOMA-IR only in the training groups (NG: Δ = - 1.6, PG: Δ = - 0.6; p = 0.094). Intention-to-treat analysis demonstrated significant reductions in fasting insulin levels (NG: Δ = - 1.4, PG: Δ = - 1.0; p = 0.004) and HOMA-IR (NG: Δ = - 5.5, PG: Δ = - 3.8; p = 0.002).

CONCLUSION

Periodized and non-periodized combined exercise training similarly reduces insulin resistance markers in adults with obesity.

TRIAL REGISTRATION

Brazilian Registry of Clinical Trials, RBR-3c7rt3. Registered 07 February 2019- https://ensaiosclinicos.gov.br/trial/5970/1 .

Combined relationship of physical inactivity and sedentary behaviour with the prevalence of noncommunicable chronic diseases: data from 52,675 Brazilian adults and elderly

This paper aims to verify the association between the combined relationship of physical inactivity and sedentary behaviour (SB) at leisure-time and the prevalence of noncommunicable chronic diseases (NCDs) in Brazilian adults and elderly. This is a cross-sectional study, derived from the VIGITEL system, with individuals ≥18 years old (n = 52,675). The presence of NCDs (diabetes, hypertension, and obesity) and the independent variables were defined by self-report. Binary logistic regression was used. While adults with the presence of, at least, one risky behaviour had a higher odds to have obesity (OR _{active + high SB}: 1.25; 95%CI: 1.01;1.54; OR _{inactive + low SB}: 1.47; 95%CI: 1.25;1.73; OR _{inactive + high SB}: 1.77; 95%CI: 1.47;2.12), the elderly had an increased risk for this outcome only when classified as inactive (OR _{inactive + low SB}: 1.43; 95%CI: 1.17;1.75; OR _{inactive + high SB}: 1.87; 95%CI: 1.47;2.38). Inactive adults with low SB were more likely to have diabetes (OR _{inactive + low SB}: 1.31; 95%CI: 1.00;1.71) and hypertension (OR _{inactive + low SB}: 1.26; 95%CI: 1.08;1.46), while physical inactivity was again more strongly associated with these outcomes in the elderly, for diabetes (OR _{inactive + low SB}: 1.23; 95%CI: 1.02;1.48; OR _{inactive + high SB}: 1.75; 95%CI: 1.39;2.19), and hypertension (OR _{inactive + low SB}: 1.22; 95%CI: 1.05;1.41; OR _{inactive + high SB}: 1.60; 95%CI: 1.33;1.94) Both leisure-time behaviours carry a high risk of the prevalence of different NCDs, however, physical inactivity, isolated or combined, showed a greater association with the evaluated outcomes.Highlights This cross-national survey included representative sample of people ≥18 years old.Adults with at least one evident risky behavior had a higher chance of obesity.Inactive adults with low sedentary behavior had higher chances for diabetes and hypertension.Physical inactivity was more strongly associated with all diseases in the elderly.

Quality of life and its relationship with different anthropometric indicators in adults with obesity

Abtract Introduction: Obesity compromises the quality of life. However, few studies have investigated the influence of different anthropometric indicators on the quality of life of this population. Objective: We aimed to correlate the physical and mental components of quality of life and verify its association with different anthropometric indicators in adults with obesity. Methods: A cross-sectional study was conducted in adults with obesity [body mass index (BMI) ≥ 30 kg/m²]. The quality of life was investigated using the SF-36 questionnaire, with scores ranging from 0 (worst-case scenario) to 100 (best scenario for the outcome). The anthropometric indicators used were BMI, waist circumference, waist/height ratio (WHR), and lean and fat body mass. For analysis, Spearman’s correlation and crude and adjusted linear regression for sociodemographic variables were used. Results: A total of 75 subjects (nfemales = 47; µage= 34.8 ± 7.1 years) were included, and their means of the physical and mental components were 64.5 ± 15.9 and 50.8 ± 21.3 points, respectively. The social functioning domain presented a strong positive correlation (r = 0.760) with the mental health domain, and eight moderate correlations (0.400 ≤ r ≥ 0.699) were found between the different domains of the questionnaire. The functional capacity domain and the physical component presented a moderate negative correlation with the WHR (r = -0.402 and r = -0.407, respectively). After adjustment, the WHR was inversely associated with the physical component (β = -1.197; p = 0.002). Conclusion: In adults with obesity, important correlations were observed between the physical and mental components of quality of life, and the waist/height ratio was the only anthropometric indicator correlated and associated with the physical component of the outcome.

[Association between the practice of physical activity of different types and the use of insulin in adult and elderly diabetics in Brazil]

The scope of this paper was to verify the association between the practice of physical activity of different types and the use of insulin in adults and the elderly. This is a cross-sectional population-based study with data from the survey entitled Surveillance of risk factors and protection for chronic diseases by telephone (VIGITEL 2013). The sample consisted of individuals aged ≥18 years, living in the 27 Brazilian capitals and diagnosed with diabetes. The practice of physical activity in commuting, the home, leisure, work and the use of insulin were self-reported. Binary logistic regression was used in crude and adjusted analyses for sociodemographic factors. Of the 4,593 subjects with diabetes, insulin use was reported by 16.2% and 25.5% of adults and the elderly, respectively. The practice of physical activity in the home (OR: 0.61, 95%CI: 0.40; 0.94) and at work (OR: 0.38, 95%CI: 0.18; 0.78) were associated with the lowest use of insulin among the elderly. There was a tendency to reduce insulin use as the number of physically active domains increased among the elderly (p = 0.003). The conclusion drawn was that physical activity practiced alone or in a cumulative way in different domains was associated with lower insulin use among the elderly.

Effects of Nonperiodized and Linear Periodized Combined Training on Health-Related Physical Fitness in Adults With Obesity: A Randomized Controlled Trial

Streb, AR, Passos da Silva, R, Leonel, LdS, Possamai, LT, Gerage da Silva, AM, Turnes, T, and Del Duca, GF. Effects of nonperiodized and linear periodized combined training on health-related physical fitness in adults with obesity: a randomized controlled trial. J Strength Cond Res XX(X): 000-000, 2020-The aim of this randomized controlled trial study was to compare the effects of 16 weeks of linear periodized and nonperiodized combined training (CT) on cardiorespiratory fitness, muscle strength, and body composition indicators of adults with obesity. Thirty-four obese adults of both sexes (36.6 ± 4.4 years; body mass index, 32.9 ± 2.7 kg·m) were divided into nonperiodized (NG; n = 8), linear periodized (PG; n = 11), and control (CG; n = 15) groups. The NG and PG groups performed 3 weekly sessions of CT over 16 weeks in different ways. Anthropometric measures, maximal strength for leg press and barbell bench press, maximal oxygen uptake (V[Combining Dot Above]O2max), and ventilatory thresholds were determined before and after the intervention. The generalized estimation equation was used, adopting the level of significance for the interaction of 0.10, and 0.05 for the isolated effect of time or group or both. Significant and similar increases were observed in the 1-repetition maximum test for bench press (NG: 48.8 ± 5.7 to 55.0 ± 6.1 kg; PG: 48.7 ± 5.7 to 53.8 ± 5.9 kg; p = 0.001) and leg press (NG: 235.2 ± 18.7 to 268.3 ± 19.7 kg; PG: 223.1 ± 25.3 to 253.3 ± 23.1 kg; p = 0.05) in trained groups. Relative V[Combining Dot Above]O2max improved only in PG (27.8 ± 1.3 to 32.0 ± 1.4 mL·kg·min; p = 0.05), whereas ventilatory thresholds improved in NG and CG (p = 0.004 and p = 0.06). There was an increase in body mass in CG (97.6 ± 3.4 to 99.1 ± 2.9 kg) and NG (92.5 ± 5.4 to 93.5 ± 5.4 kg; p = 0.05). Combined training improved maximal upper- and lower-body strength regardless of periodization. However, for improvements in V[Combining Dot Above]O2max, linear periodization may be superior than nonperiodization in obese adults.

[Simultaneity of risk behaviors for obesity in adults in the capitals of Brazil]

The scope of this study was to verify the association between risk behaviors and obesity in adults (18 to 59 years of age) in Brazilian capitals. It involved a cross-sectional population-based study conducted by telephone interview. The self-reported variables were obesity, defined by weight and height (BMI ≥ 30 kg/m²) and risk behaviors: physical inactivity (≤ 149 minutes/week), excess sedentarism (≥ 4 hours/day), frequent consumption of sweets (≥ 5 days/week) and meat with fat and/or chicken with skin (≥ 1 day/week). The simultaneity of risk behaviors was analyzed for reasons of observed and expected prevalence. The Poisson and multinomial logistic regressions were used in crude analyses and adjusted for sociodemographic factors. Among the 35,448 adults, the simultaneous consumption of meat with fat, excess sedentarism and physical inactivity (PR: 1.94, 95% CI: 1.45, 2.60), as well as the presence of the four risk behaviors (PR: 1.72, 95% CI: 1.16, 2.53) were associated with obesity in men. In women, the simultaneous consumption of sweets and meat with fat (PR: 1.77, 95% CI: 1.19, 2.66) was also associated with the outcome. In both sexes, there was an increase in the tendency of obesity according to the sum total of risk behaviors.

Phase angle associated with different indicators of health-related physical fitness in adults with obesity

In obese populations, the exacerbated increase in adipose tissue results in a significant reduction of health-related physical fitness and can affect the phase angle (PhA), a promising health indicator of cell health and integrity. The aim of this study was to investigate the association of PhA with health-related physical fitness indicators in obese adults. This cross-sectional study had a non-probabilistic sample and was conducted from April to June 2018. The PhA was obtained by a bioelectrical impedance analysis, and the health-related physical fitness indicators evaluated were percentage of body fat (%BF), lower- and upper-body maximal strength, cardiorespiratory fitness (relative V̇O2peak), and flexibility. Pearson and Spearman´s linear correlations, crude and adjusted linear regression analyses were performed. A total of 69 obese adults (60.8% female; BMI = 33.5 ± 2.8 kg/m²) with a mean age of 34.6 ± 7.1 years were studied. The PhA means were 5.8 (±0.6º) and had an inverse correlation with %BF (r=-0.74; p<0.001) and positive correlation with V̇O2peak (r=0.50; p<0.001), lower- and upper-body maximal strength (r=0.65; r=0.70; p<0.001, respectively). After adjustment, %BF (β=-0.065, adjusted R²=0.53; p<0.001), lower- and upper-body maximal strength (β=0.004; adjusted R²=0.46; p<0.001, and β=0.024; adjusted R²=0.50; p<0.001, respectively) were predictors of PhA. Our results suggest the favorable role of PhA as a clinically viable tool to screen and identify the physical fitness variables and functional status of obese adults.

Anthropometric indicators associated with blood pressure elevation in adults with obesity

The aim of the study was to investigate the association between different anthropometric indicators and high blood pressure in adults with obesity.This is a cross-sectional study with a non-probabilistic sample of adults with obesity. Systolic and diastolic blood pressure were measured using automated equipment (OMRON, model 742 HEM). The anthropometric indicators used were body mass index (BMI), relative fat mass (RFM), waist circumference (WC), waist-to-stature ratio (WSR) and waist-hip ratio (WHR). The data were analyzed by crude and adjusted (sex and age) linear regression, adopting a level of significance p <0.05. Among the 63 adults with obesity evaluated (38 woman; 35.27±7.02 years; BMI: 33.46±2.89 kg m-2; RFM: 39.98±6.70; WC: 109.38±10.15 cm; WSR: 0.64±0.05; WHR: 0.93±0.01), it was observed that the increase in systolic blood pressure was directly associated with the indicators RFM (p=0.011; Cohen’s F²= 0.42), WC (p=0.003; Cohen’s F²= 0.49), WSR (p=0.010; Cohen’s F²= 0.42) e WHR (p=0.001; Cohen’s F²= 0.52), but not to BMI (p=0.100). The elevation of diastolic blood pressure was directly associated with all the anthropometric indicators analyzed: BMI (p=0.040; Cohen’s F²= 0.14), RFM (p= 0.006; Cohen’s F²= 0.21), WC (p=0.002; Cohen’s F²= 0.26),WSR (p=0.004 Cohen’s F²=0.23) and WHR (p=0.012; Cohen’s F²=0.19). It was concluded blood pressure elevation was directly associated with the anthropometric indicators investigated and, among them, the WHR and the WC presented the best predictive capacity for systolic blood pressure and diastolic blood pressure elevations, respectively

Physical inactivity, television time and chronic diseases in Brazilian adults and older adults

This study aimed to investigate the association between simultaneity of leisure-time physical inactivity and high television time with the presence of chronic diseases in adults and older adults in Brazil. We analyzed secondary data from Vigitel 2013 database, a cross-sectional national survey. It was included 37 947 adults (18-59 years) and 14 982 older adults (≥60 years) living in Brazilian state capitals. The association was between simultaneity of risk behaviors considering leisure-time physical inactivity (<10 min/day) and high television time (≥2 h/day), with the presence of chronic diseases (diabetes, dyslipidemia, hypertension and obesity), measured according to the age group. We performed a binary logistic regression, crude and adjusted analysis, using weighted to reflect population estimates. In adults, there was an association between leisure-time physical inactivity and television time with the presence of diseases. In practice, the simultaneity of risk behaviors when compared with those without risk behavior had higher odds for diabetes (OR = 1.83), dyslipidemia (OR = 1.17), hypertension (OR = 1.54) and obesity (OR = 1.60). In older adults, the simultaneity was associated with diabetes (OR = 1.61), hypertension (OR = 1.33) and obesity (OR = 1.81). We concluded that for adults and older adults the simultaneity of leisure-time physical inactivity and high television time increased the odds for the presence of chronic disease, especially for diabetes and obesity.

Attitudes towards body weight dissatisfaction associated with adolescents’ perceived health and sleep (PeNSE 2015)

Abstract This study aimed to investigate whether attitudes towards body weight dissatisfaction is associated with perceived health and impairments in sleep among a national population-based sample of Brazilian adolescents. This is a cross-sectional data from the 2015 National School-Based Health Survey (PeNSE). A total of 100.182 students (70.8% were between 14 to 15) in ninth-grade, enrolled in public and private schools were eligible for data analysis. Variables were measured using a questionnaire and binary logistic regression was used. There was association between attitudes towards body weight dissatisfaction and perceived health (not controlling weight = OR: 2.19, 95%CI: 2.00-2.40; trying to lose = OR: 1.90, 95%CI: 1.75-2.05; gain = OR: 2.22, 95%CI: 2.01-2.46; maintain = OR: 1.81, 95%CI: 1.54-2.14). Adolescents were also more likely to present impairments in sleep (not controlling weight = OR: 1.21, 95%CI: 1.11-1.32; trying to lose = OR: 1.16, 95%CI: 1.08-1.25; gain = OR: 1.43, 95%CI: 1.28-1.61; maintain = OR: 1.43, 95%CI: 1.22-2.68). Dissatisfaction is an additional concern in the daily life of adolescents, which is associated to depreciation of the quality of sleep and decrement of psychological well-being.

Simultaneity of chronic noncommunicable diseases in 2013 in Brazilian state capital cities: prevalence and demographic profile

OBJECTIVE

to describe the prevalence and sociodemographic profile of chronic noncommunicable disease (CNCDs) simultaneity in adults and elderly people resident in Brazilian state capital cities.

METHODS

Chronic Noncommunicable Disease Risk and Protection Factor Surveillance System Survey 2013; simultaneity was considered to be two or more CNCDs (diabetes mellitus, dyslipidemia, hypertension, and obesity).

RESULTS

of the total 52,929 participants, 13.7% of adult participants and 42.9% of elderly participants had CNCD simultaneity; hypertension and diabetes mellitus simultaneity was greater in adults, while hypertension and obesity simultaneity was greater in the elderly; simultaneity was more prevalent in women, in those between 50 and 59 years old, with partners and up to eight years of schooling; the cities with the lowest and highest prevalence in adults were São Luís and Cuiabá, respectively, while in the elderly, the cities were Belém and Manaus, respectively.

CONCLUSION

simultaneity was identified nationwide; prevention measures should be directed especially toward treatment of hypertension.

Is the availability of open public spaces associated with leisure-time physical activity in Brazilian adults?

This study aims to analyse the association between perceived presence of public spaces near residences and practice of physical activity during leisure time by adults in the state capitals of Brazil, based on sociodemographic characteristics. Participants were individuals aged ≥18 years living in the 27 state capitals of Brazil (n = 52 929, 53.9% female) who responded to a national survey called VIGITEL in 2013. Physical activity during leisure time (≥1 time/week), perception of space, population and sociodemographic variables (sex, age, years of study and geographic region) were self-reported. The adjusted binary logistic regression analysis was used. Among adults, the prevalence of physical activity during leisure was 45.1% (95% CI [44.2; 46.0]), and 71.1% (95% CI [70.2, 71.8]) perceived public space near their residence. A direct association between perceiving public space and physical activity ([OR] = 1.43; 95% CI [1.32; 1.55]) was observed. No significant difference was observed in the population groups (men and women, younger and older adults, and those with more and fewer years of study). Thus, even with the possible regional differences in Brazilian state capitals, the presence of public spaces increases the practice of physical activity during leisure time, independent of sociodemographic variables.

Chronic noncommunicable diseases multimorbidity and its association with physical activity and television time in a representative Brazilian population

Lifestyle behaviors need to be more explored within the context of chronic noncommunicable disease (NCD) multimorbidity. This study aimed to investigate the association of multimorbidity with physical activity and sedentary behavior in a representative Brazilian population (n = 52,929). A cross-sectional survey (VIGITEL in the Portuguese acronym) was conducted in 2013 in the 27 Brazilian federal units. Multimorbidity is defined as the presence of two or more NCDs, that is, the outcome variable; and physical activity (commuting, domestic chores, leisure, and work domains) and sedentary behavior (television time < 2 hours/day and ≥ 2 hours/day) were the exposure variables. Poisson and multinomial logistic regressions (odds ratio - OR) stratified by age and their respective 95% confidence intervals were used, adopting a significance level of 5%. Among 37,947 adults, the presence of three chronic diseases was less frequent in subjects active in the work domain (OR = 0.60) and more frequent among those with longer daily television time (OR = 1.25). The presence of four diseases was less frequent in subjects active in the commuting (OR = 0.52) and work (OR = 0.42) domains. Among 14,982 older adults, the presence of two, three, and four chronic diseases was consistently more frequent in those with longer daily television time (OR = 1.33; 1.55 and 1.93, respectively). Finally, interactions between total physical activity level and daily television time were statistically significant in the multimorbidity in both age groups. Physical activity and sedentary behavior are associated with multimorbidity and should be considered independent factors for health promotion and for the treatment of patients with multimorbidity.

Change in overweight and obesity over a decade according to sociodemographic factors in Brazilian adolescents

The aims were to examine changes in the prevalence of overweight and obesity among students from 2001 to 2011, and to verify if these changes differ according to age group, area of residence, and family income. We analyzed two cross-sectional surveys conducted in 2001 and 2011 with brazilian adolescents. Sociodemographic and anthropometric characteristics were self-reported using a questionnaire. Multinomial logistic regression was used to analyze changes in overweight and obesity between the two surveys. The nutritional status was the outcome of the present study and the surveys (2001 and 2011) were the exposure. The odds of being overweight and obese were higher among boys and girls in urban areas in the 2011 survey compared to the 2001. Boys and girls with higher income were also more likely to present overweight and obesity in the second survey compared to the first. An increase of overweight and obesity was observed over a decade. We suggest that future interventions consider the area of residence and the family income to strengthen the effectiveness of actions developed to prevent and control these indicators among adolescents.

Comparison of linear periodized and non-periodized combined training in health markers and physical fitness of adults with obesity: Clinical trial protocol

The literature discusses that combined training, aerobic more resistance exercises in the same session, is a suitable strategy for people with obesity and that exercise periodization leads to positive health outcomes; however, the implication of different periodizations of combined training for health outcomes in obese adults requires further investigation. The aim of the study will be to describe the methodology used to compare the effect of linear periodized and non-periodized combined training on health markers and health-related physical fitness in adults with obesity. This is a blinded randomized controlled clinical trial investigating adults with obesity in the age group 20–50 years. The sample will be non-probabilistic, and participants will be allocated randomly into one of three groups: control group (CG), non-periodized group (NG), and periodized group (PG). The intervention will occur in 60-min sessions, 3 days a week for 16 weeks, with 1 week dedicated to familiarization with the training and 15 weeks of combined training (aerobic followed by resistance in the same session). The PG group will perform three mesocycles of 5 weeks each, progressing in intensity throughout the intervention [aerobic: from 40-49% to 60–69% of heart rate reserve (HRR); strength: from 12 to 14 maximum repetitions (MR) to 8 to 10MR]; the NG group will maintain the same relative intensity throughout the study (aerobic: 50–59% of HRR; strength: 2 sets of 10–12 MR). Participants in the CG group will maintain their usual activities without the proposed intervention. Pre- and post-intervention assessments will be performed for biochemical markers, body composition, cardiovascular parameters, cardiorespiratory fitness, maximum upper and lower limb strength, flexibility, and subjective health-related parameters. This project was approved by the Committee of Ethics and Research with Human Beings of the institution of origin (protocol 2,448,674) and registered in the Brazilian Registry of Clinical Trials (RBR-3c7rt3).

Índice de Massa Corporal como preditor de multimorbidade na população brasileira

Overweight is a health risk indicator, but little is known about its influence on the chronic non-communicable diseases (NCD) multimorbidity. The aim of this study was to identify the predictive values   and sociodemographic factors associated with Body Mass Index (BMI) as a determinant of the occurrence of NCD multimorbidity in Brazilian men and women. Data from the “Surveillance of risk and protection factors for chronic diseases by telephone survey” - 2013 national survey were used. The population was composed of ≥18 year-old individuals and those living in house with a fixed telephone line in the 27 Brazilian’s capitals. The outcome variables were BMI and its respective predictive value for the occurrence of multimorbidity (≥2 NCDs). The exposure was age, marital status and educational level. Inferential statistics included the construction of Receiver Operating Characteristic curves (cutoff point defined by sensibility [Se] and specificity [Sp]) and the association by Poisson Regression, stratified by sex. The values with the best predictive capacity for multimorbidity were 26.7 kg/m² (Se = 60.9%, Sp = 60.2%) for men and 25.7 kg/m² (Se = 61.8%, Sp = 61.1%) for women. The predictive multimorbidity value followed the progress of age groups up to 55 to 64 years for both groups. Women with higher educational level showed an inverse association for the presence of the outcome. BMI can be considered a predictor of the occurrence of multimorbidity, and sociodemographic profile associated with this predictive value was advancement age and inversely associated with educational level in women.

Quality of life and functional capacity during the treatment of hematologic neoplasms

Abstract Introduction: Cancer is a serious pathology with a high incidence and complex diagnoses. Emotional and environmental factors, the deleterious effects of these, and lifestyle affect different outcomes. Objective: Investigate the association between quality of life and functional capacity during treatment for hematologic cancer. Methods: A cross-sectional study with intentional sampling of patients of both sexes with hematologic neoplasms, interviewed in 2016. Quality of life (QF) was measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. For the definition of functional capacity in basic and instrumental activities of daily life, the Katz Index and the Lawton Scale, respectively, were used. Data were analyzed by correlations and comparisons of means tests. Results: The 52 participants presented an average QF score of approximately 60.6. Among the functional scales, the worst result was in role functioning (46.8), while for symptoms, it was fatigue (48.1). The results of more expressive QF indicators were the strong correlation between role functioning and fatigue (r = -0.60), and a moderate correlation between social functioning and financial difficulties (r = -0.45). There was still an association between role functioning and functional incapacity in daily activities (p = 0.017). Fatigue was associated with incapacity for basic activities (p = 0.018), while insomnia was correlated with instrumental activities (p = 0.032). Conclusion: The association between lower QF scores and functional incapacity reflects the damaging effect of hematologic neoplasms on daily activities.

Moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults

OBJECTIVE

To investigate the moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults.

METHODS

Secondary analysis of the survey "Lifestyle and leisure habits of industry workers" (n=46,981), conducted in 24 Brazilian states (2006-2008). Self-reported information was collected with a previously tested questionnaire. Crude and adjusted logistic regression models were applied to analyze the association between sociodemographic variables (sex, age, marital status, number of children, education, country area and company size) and active commuting to work in different strata of gross family income. To test the moderating effect, an interaction analysis was applied.

RESULTS

The proportion of active commuters among low-, medium- and high-income workers was 40.7% (95%CI:40.0%;41.5%), 27.0% (95%CI:26.3;27.6%) and 11.1%, (95%CI:10.5%;11.7%), respectively. The moderating effect of gross family income was confirmed. Men were more likely (OR:1.22 95%CI:1.12;1.32) to commute actively than women among low-income individuals. Active commuting was less likely among older workers in low-(OR30-39:0.90 95%CI: 0.83;0.98; OR≥40: 0.76 95%CI: 0.68;0.85) and medium-income strata (OR30-39:0.87 95%CI:0.80;0.95; OR≥40:0.84 95%CI:0.76;0.93) and among married individuals in high-income strata (OR:0.72 95%IC:0.61;0.84). Adults with lower education (ORhigh:10.80 95%CI:8.47;13.77), working in the south (ORhigh:1.93 95%CI:1.53;2.44) and in small companies (ORlow:2.50 95%CI:2.28;2.74) were more likely to commute actively; however, the magnitude of these associations differed at each income strata.

CONCLUSION

There was an inverse association between gross family income and active commuting. Gross family income acts as a moderator of the association between demographic indicators and active commuting.