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  • Author: Felipe Fossati Reichert x
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Felipe Vogt Cureau, Paola Duarte, Daniela Lopes dos Santos and Felipe Fossati Reichert

Background:

Few studies have investigated the prevalence and correlates of risk factors for noncommunicable diseases among Brazilian adolescents. We evaluated the clustering of risk factors and their associations with sociodemographic variables.

Methods:

We used a cross-sectional study carried out in 2011 comprising 1132 students aged 14–19 years from Santa Maria, Brazil. The cluster index was created as the sum of the risk factors. For the correlates analysis, a multinomial logistic regression was used. Furthermore, the observed/expected ratio was calculated.

Results:

Prevalence of individual risk factors studied was as follows: 85.8% unhealthy diets, 53.5% physical inactivity, 31.3% elevated blood pressure, 23.9% overweight, 22.3% excessive drinking alcohol, and 8.6% smoking. Only 2.8% of the adolescents did not present any risk factor, while 21.7%, 40.9%, 23.1%, and 11.5% presented 1, 2, 3, and 4 or more risk factors, respectively. The most prevalent combination was between unhealthy diets and physical inactivity (observed/expected ratio =1.32; 95% CI: 1.16–1.49). Clustering of risk factors was directly associated with age and inversely associated with socioeconomic status.

Conclusions:

Clustering of risk factors for noncommunicable diseases is high in Brazilian adolescents. Preventive strategies are more likely to be successful if focusing on multiple risk factors, instead of a single one.

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Renata Moraes Bielemann, Andreia Morales Cascaes, Felipe Fossati Reichert, Marlos R. Domingues and Denise Petrucci Gigante

Background:

The aim of this study was to assess physical activity (PA) patterns (intensity and prevalence) in children according to demographic, socioeconomic, and familiar characteristics.

Methods:

In 2010, a cross-sectional study of 239 children aged 4–11 was conducted, in Pelotas, Southern Brazil. PA was measured by accelerometry and classified in different intensities. Insufficient physical activity was defined as less than 60 min/day of moderate-to-vigorous PA. Descriptive analyses of accelerometry-related variables were presented. Multivariate Poisson regression models were used to estimate the association between physical insufficient PA and covariates.

Results:

For both sexes, around 65% of the registered time was spent in sedentary activities and less than 20 min/day in vigorous activity. Age and economic status were inversely associated to PA in all categories of PA. Moderate and vigorous activities means were higher in boys than in girls. The prevalence of insufficient PA was 34.5% in girls and 19.5% in boys.

Conclusions:

We found important differences in physical activity patterns according to sex and economic status, as well as a significant decline in time spent in moderate-to-vigorous PA with increasing age. Understanding the relationship between these sociodemographic factors is important to tackle low levels of PA.

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Rafaela Costa Martins, Felipe Fossati Reichert, Renata Moraes Bielemann and Pedro C. Hallal

Background:

To evaluate the 1-year stability of objectively measured physical activity among young adults living in South Brazil, as well as assessing the influences of temperature, humidity and precipitation on physical activity.

Methods:

A longitudinal study was conducted over 12 consecutive months (October 2012 to September 2013). Sixteen participants (8 men) used GT3X+ accelerometers 1 week per month for the entire year. Climate variables were obtained from an official climate information provider.

Results:

Physical activity was remarkably stable over the year—the proportion of the day spent in moderate-to-vigorous intensity physical activity (MVPA) was around 5% in every month. Average temperature (ρ = –0.64; P = .007), humidity (ρ = –0.68; P = .004) and rain (ρ = –0.67; P = .004) were inversely correlated to MVPA in the Summer. Rain was also inversely correlated to MVPA in the Spring (ρ = –0.54; P = .03).

Conclusions:

Objectively measured physical activity was stable over a 1-year period. Climate variables consistently influenced physical activity practice in the Summer, but not in the other seasons.

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Carla Cristiane Silva, Maurizio Bertollo, Felipe Fossati Reichert, Daniel Alexandre Boullosa and Fábio Yuzo Nakamura

Purpose:

To examine which body position and indices present better reliability of heart rate variability (HRV) measures in children and to compare the HRV analyzed in different body positions between sexes.

Method:

Twenty eutrophic prepubertal children of each sex participated in the study. The RR intervals were recorded using a portable heart rate monitor twice a day for 7 min in the supine, sitting, and standing positions. The reproducibility was analyzed using the intraclass correlation coefficient (ICC; two way mixed) and within-subject coefficient of variation (CV).Two-way ANOVA with repeated measures was used to compare the sexes.

Results:

High levels of reproducibility were indicated by higher ICC in the root-mean-square difference of successive normal RR intervals (RMSSD: 0.93 and 0.94) and Poincaré plot of the short-term RR interval variability (SD1: 0.92 and 0.94) parameters for boys and girls, respectively, in the supine position. The ICCs were lower in the sitting and standing positions for all HRV indices. In addition, the girls presented significantly higher values than the boys for SDNN and absolute high frequency (HF; p < .05) in the supine position.

Conclusions:

The supine position is the most reproducible for the HRV indices in both sexes, especially the vagal related indices.

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Felipe Fossati Reichert, Jonathan Charles Kingdom Wells, Ulf Ekelund, Ana Maria Baptista Menezes, Cesar Gomes Victora and Pedro C. Hallal

Background:

Physical activity may influence both fat and lean body mass. This study investigated the association between physical activity in children between the ages of 11 and 13 years and both fat and lean mass.

Methods:

A subsample of the 1993 Pelotas (Brazil) Birth Cohort was visited in 2004–2005 and 2006–2007. Physical activity was estimated through standardized questionnaires. Body composition (ie, fat and lean mass) was measured using deuterium dilution. Those with moderate-to-vigorous activity greater than 420 min/wk were classified as active, and physical activity trajectory was defined as being above or below the cutoff at each visit.

Results:

Four hundred eighty-eight adolescents (51.8% boys) were evaluated. The mean difference in fat mass in boys and girls who reported ≥ 420 min/wk of physical activity in both visits compared with those who were consistently inactive was –4.8 kg (P ≤ .001). There was an inverse association between physical activity and fat mass among boys in both crude and confounder-adjusted analyses, whereas for girls, the association was evident only in the crude analysis. There was no significant association between physical activity and lean mass.

Conclusion:

Physical activity may contribute to tackling the growing epidemic of adolescent obesity in low- and middle-income countries.

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Felipe Fossati Reichert, Ana Maria Batista Menezes, Jonathan Charles Kingdom Wells, Ulf Ekelund, Fabiane Machado Rodrigues and Pedro Curi Hallal

Background:

Prospective studies on physical activity (PA), diet, and body composition in adolescents are lacking, particularly outside high-income countries.

Goals:

To describe the methods used to assess these variables in the 1993 Pelotas (Brazil) Birth Cohort and to discuss the fieldwork challenges faced and alternatives to overcome them.

Methods:

In 2006–07 a subsample of the 1993 Pelotas cohort was revisited. PA was estimated using questionnaires, a combined heart-rate and motion sensor (Acti-Heart), and the ActiGraph GT1M accelerometer. Diet was investigated by questionnaire. Total body water was determined by stable isotopes. Thirty individuals had their total energy expenditure assessed by doubly labeled water. All data were collected at participants’ home.

Results:

The logistics of the fieldwork and the difficulties in undertaking the study and alternatives to overcome them are presented. Preliminary analyses show that 511 individuals were traced (response rate = 90.0%). Compliance of both adolescents and their families for the motion sensors and body-composition measurements was excellent.

Conclusions:

The authors conclude that it is feasible to carry out high-quality studies on PA in developing countries. They hope the article will be useful to other researchers interested in carrying out similar studies.

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Pedro Curi Hallal, Felipe Fossati Reichert, Fernando Vinholes Siqueira, Samuel Carvalho Dumith, Juliano Peixoto Bastos, Marcelo Cozzensa da Silva, Marlos Rodrigues Domingues, Mario Renato Azevedo and Ulf Ekelund

Objectives:

The objective of this study was to evaluate physical activity (PA) levels in adults and their association with sex, age, and education level across categories of body mass index (BMI).

Methods:

We conducted a population-based, cross-sectional study including 3100 individuals age ≥20 years living in Pelotas, Brazil. PA was assessed using the leisure-time section of the long International Physical Activity Questionnaire. “No PA” was defined as zero minutes of activity/week; “insuffcient PA” was defined as <150 minutes of activity/week; “high PA” was defined as ≥500 minutes of activity/week. BMI was categorized into normal (<25 kg/m2), overweight (25–29.9 kg/m2), and obesity (≥30 kg/m2).

Results:

The prevalence of insufficient PA was 71.6% among normal BMI subjects, 71.3% among overweight individuals, and 73.7% among obese ones (P = .67). No PA and high PA were also not associated with BMI. The associations between sex, age, and education level and PA levels tended to be stronger among normal-weight individuals compared with overweight and obese individuals. Among the obese, most associations were not significant. Among normal-weight individuals, higher PA levels were observed in men, young adults, and those with higher education.

Conclusions:

Variables associated with leisure-time PA differed between normal-weight, overweight, and obese individuals. Studies on PA correlates might benefit from stratifying by BMI.

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Pedro C. Hallal, Samuel Carvalho Dumith, Felipe Fossati Reichert, Ana M.B. Menezes, Cora L. Araújo, Jonathan C.K. Wells, Ulf Ekelund and Cesar G. Victora

Objectives:

To explore cross-sectional and longitudinal associations between self-reported and accelerometry-based physical activity (PA) and blood pressure (BP) between 11 and 14 years of age.

Methods:

Prospective birth cohort study in Pelotas, Brazil. Participants were 427 cohort members who were followed up with at 11, 12, and 14 years of age, and had questionnaire data on PA and BP at 11 and 14 years, as well as accelerometry and questionnaire data on PA at 12 years. Outcome measures were continuous systolic and diastolic BP at 14 years, and change in BP from 11 to 14 years.

Results:

PA was unrelated to systolic BP in any analyses. PA measured by accelerometry at 12 years, but not questionnaire-derived PA, was inversely associated with diastolic BP at 14 years of age in fully adjusted models. Those who exceeded the 300-minutes PA threshold at all 3 visits had a 2.6 mmHg lower mean increase in DBP from 11 to 14 years compared with those classified below the threshold in all visits.

Conclusions:

Accelerometry-based PA was longitudinally inversely associated with diastolic BP. This finding was not evident when analyzing self-reported PA at a given age, suggesting a possible underestimation of the association when using subjective data.