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  • Author: Danilo R. Silva x
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Luciana L.S. Barboza, Larissa Gandarela, Josefa Graziele S. Santana, Ellen Caroline M. Silva, Elondark S. Machado, Roberto Jerônimo S. Silva, Thayse N. Gomes, and Danilo R. Silva

Introduction: The authors’ objective was to identify the minimum number of days required to measure sedentary behavior and physical activity in children during school hours. Methods: Fifty-three children from four classes of the second year of elementary school in a public school in Brazil were selected. Sedentary behavior and physical activity were evaluated using activPAL in the thigh and ActiGraph GT3X on the hip. The devices were used for 4 days during the 4 hr of school. Intraclass correlation coefficient (ICC) and Bland–Altman plots were used for statistical analysis (p < .05). Results: For sedentary/stationary behavior indicators, 1 day showed good agreement with 4 days (sitting time, ICC = .89; bias [limits of agreement 95%, LA95%] = 1.6 [45.1 to −41.9], standing time, ICC = .93; bias [LA95%] 1.1 [30.2 to −28.0], and stationary behavior, ICC = .56; bias [LA95%] = 0.2 [37.2 to −36.7]). However, 2 days were necessary for good agreement, with 4 days for physical activity indicators (walking time, ICC = .91; bias [LA95%] = 1.1 [12.0 to −9.7], light physical activity, ICC = .97; bias [LA95%] = 0.3 [7.6 to −7.0], moderate physical activity, ICC = .93; bias [LA95%] = 0.3 [2.3 to −1.6], and vigorous physical activity, ICC = .93; bias [LA95%] = 0.3 [3.1 to −2.5]). Conclusion: Therefore, 1 evaluation day seems enough to obtain representative data of school sedentary/stationary behavior, while 2 days are necessary for the evaluation of physical activity indicators during school hours.

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Danilo R. Silva, Cláudia S. Minderico, Pedro B. Júdice, André O. Werneck, David Ohara, Edilson S. Cyrino, and Luís B. Sardinha

Background: This investigation aimed to analyze the agreement between the GT3X accelerometer and the ActivPAL inclinometer for estimating and detecting changes in sedentary behavior of different contexts among adolescents. Methods: Secondary data from an intervention using standing desks in the classroom conducted within 2 sixth-grade classes (intervention [n = 22] and control [n = 27]) were used. The intervention took place over 16 weeks, with activity assessments (ActivPAL and GT3X) being performed 7 days before and in the last week of the intervention. Baseline information from both groups was considered for cross-sectional analysis (209 valid days), while data from 20 participants (intervention group) were used for longitudinal analysis. Results: The authors observed that GT3X overestimated sedentary time at school (16.8%), after school (13.5%), and during weekends (7.3%) compared with ActivPAL (P < .05). Outside the school (after school [r = −.188] and on weekends [r = −.260]), there was a trend to higher overestimation among adolescents with less sedentary behavior. Longitudinally, the GT3X was unable to detect changes resulting from an intervention in school hours (ActivPAL = −34.7 min·9 h−1 vs GT3X = +6.7 min·9 h−1; P < .05). Conclusions: The authors conclude that GT3X (cut-point of <100 counts·min−1) overestimated sedentary time of free-living activities and did not detect changes resulting from a classroom standing desk intervention in adolescents.

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Luciana L.S. Barboza, Heike Schmitz, Julian Tejada, Ellen Caroline M. Silva, Advanusia S.S. Oliveira, Luís B. Sardinha, and Danilo R. Silva

Background: To evaluate the effects of the introduction of physically active lessons on movement behaviors, cognitive, and academic performance in schoolchildren. Methods: This was a cluster-controlled trial. A total of 61 students from the second year of elementary school in a public school in Brazil made up 2 intervention classes (n = 34) with the introduction of physically active lessons and 2 control classes (n = 27). Sedentary behavior, physical activity, cognitive, and academic performance were evaluated in 3 moments, which were compared using models of generalized estimating equations. Results: The intervention was effective for reducing the standing time between the baseline and 3 months while increasing the walking time between baseline and 3 months and baseline and 9 months. There was a reduction in time in stationary activities and increased time in light physical activities between all moments. The intervention group increased their performance in the go/no go test, showing a smaller number of errors between the baseline and 3 months and baseline and 9 months, and a reduction in the test time between baseline and 3 months. No impact on students’ academic performance was observed. Conclusion: Physically active lessons improve movement behaviors and cognitive functions among elementary schoolchildren.

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André O. Werneck, Edilson S. Cyrino, Paul J. Collings, Enio R.V. Ronque, Célia L. Szwarcwald, Luís B. Sardinha, and Danilo R. Silva

Background: This study describes the levels and patterns of television (TV) viewing in Brazilian adults and investigates associations of TV viewing with hypertension, type 2 diabetes, and heart disease. Methods: Data from the Brazilian Health Survey, a nationally representative survey that was conducted in 2013 (N = 60,202 men and women aged ≥18 y), were used. Information regarding TV viewing, physician diagnoses of type 2 diabetes, hypertension, and heart disease was collected via interview-administered questionnaire. Data on covariables (including chronological age, educational status, skin color, sodium consumption, sugar consumption, tobacco smoking, alcohol consumption, and leisure-time physical activity) were also self-reported. Logistic regression models and population attributable fractions were used for the etiological analyses. Results: The prevalence (95% confidence interval) of >4 hours per day of TV viewing was 12.7% (12.0–13.4) in men and 17.5% (16.8–18.3) in women. Men and women being younger or older, moderately educated, living alone, smoking tobacco, and drinking alcohol were associated with higher reported TV viewing time. Odds ratios (95% confidence interval) revealed that >4 hours per day of TV viewing was associated with type 2 diabetes [male: 1.64 (1.23–2.17) and female: 1.33 (1.09–1.63)], hypertension [male: 1.36 (1.14–1.63) and female: 1.20 (1.05–1.37)], and heart disease [male: 1.96 (1.43–2.69) and female: 1.30 (1.00–1.68)]. Exceeding 4 hours per day of TV viewing was responsible for 6.8% of type 2 diabetes, 3.7% of hypertension, and 7.5% of heart disease cases. Conclusions: Independent of covariates, >4 hours per day of TV viewing was associated with type 2 diabetes, hypertension, and heart disease. High volumes of TV viewing are prevalent and appear to contribute to chronic disease burden.

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André O. Werneck, Adewale L. Oyeyemi, Rômulo A. Fernandes, Marcelo Romanzini, Enio R.V. Ronque, Edilson S. Cyrino, Luís B. Sardinha, and Danilo R. Silva

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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Alex S. Ribeiro, Luiz C. Pereira, Danilo R.P. Silva, Leandro dos Santos, Brad J. Schoenfeld, Denilson C. Teixeira, Edilson S. Cyrino, and Dartagnan P. Guedes

The purpose of the study was to clarify the independent association between sedentary behavior and physical activity with multiple chronic diseases and medicine intake in older individuals. Sedentary behavior and physical activity were measured by questionnaires. Diseases and medication use were self-reported. Poisson’s regression was adopted for main analysis, through crude and adjusted prevalence ratio and confidence interval of 95%. For men, sedentary time >4 hr/day presented a 76% higher prevalence of ≥2 chronic diseases, while physical inactivity increases the likelihood of using ≥2 medicines in 95%. For women, sedentary behavior >4 hr/day presented an 82% and 43% greater prevalence for ≥2 chronic diseases and the intake of ≥2 medicines, respectively. Sedentary behavior represents an independent associated factor of multiple chronic diseases in older men and women. In addition, inactivity for men and sedentarism for women are associated with the amount of medicine intake.

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André O. Werneck, Luciana L. Barboza, Raphael H.O. Araújo, Adewale L. Oyeyemi, Giseli N. Damacena, Célia L. Szwarcwald, and Danilo R. Silva

Background: The authors analyzed time trends and sociodemographic inequalities in different physical activity and sedentary behavior domains between 2003 and 2019. Methods: A secondary analysis of data from 5 cross-sectional Brazilian epidemiological surveys (World Health Survey—2003, National Household Sample Survey—2008/2015, and Brazilian Health Survey—2013/2019) conducted among a nationally representative sample of Brazilian adults. The authors used data on different domains of physical activity (leisure, commute, total transport, and total physical activity) and sedentary behavior (TV viewing and other types of screens) that were available in the different surveys. Gender, age group, country region, ethnicity, type of area and city, and quintiles of income and educational achievement were used as sociodemographic correlates. Results: The prevalence of leisure-time physical activity increased over time (2008: 7.0% vs 2019: 26.5%). There was also an increased trend of social inequality in leisure-time physical activity. A trend of reduction was observed for active commuting (2008: 35.0% vs 2019: 21.8%), while total transport physical activity was stable (2013: 49.5% vs 2019: 49.6%). Directions of findings were opposite for sedentary behavior, with reduced trend for >3 hours per day of TV viewing (2008: 34.8% vs 2019: 21.8%) and increased trend for >3 hours per day of other types of screen time (2008: 6.4% vs 2019: 22.2%). Conclusion: A positive trend exists in leisure-time physical activity, but there was also an increase in social inequalities for physical activity in Brazil.