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Relevance of Life Course Epidemiology for Research on Physical Activity and Sedentary Behavior
Gregore Iven Mielke
Ten-Year Trends in Total Physical Activity Practice in Brazilian Adults: 2002-2012
Pedro C. Hallal, Kelly Cordeira, Alan G. Knuth, Grégore Iven Mielke, and Cesar G. Victora
Background:
One-third of adults worldwide are physically inactive causing over 5.3 million deaths annually. Despite a growing focus on physical activity and health, population-based data on physical activity trends in low- and middle-income countries are still limited. To help fill the gap, this study provides trend data over a 10-year period in Pelotas, a southern Brazilian city.
Methods:
The short version of the International Physical Activity Questionnaire was used to assess the prevalence of physical inactivity in 2002 (n = 3119), 2007 (n = 2969), and 2012 (n = 2868). Levels of inactivity and trends were assessed according to sex, age, schooling, and socioeconomic position (SEP).
Results:
The prevalence of physical inactivity rose from 41.1% (95% CI: 37.4–44.9) in 2002 and 52.0% (95% CI: 49.1–53.8) in 2007 to 54.4% (95% CI: 51.8–56.9) in 2012 (P < .001). Physical inactivity significantly increased in all subgroups except in the highest SEP and 70+ year age subgroups.
Conclusions:
After a sharp increase in the prevalence of physical inactivity from 2002–2007, levels plateaued from 2007–2012. However, it is important to stress that current levels are still unacceptably high, and that efforts must be intensified to reverse the trend.
Life Course Epidemiology Applied to Physical Activity Research
Gregore Iven Mielke, Ding Ding, Tracy Kolbe-Alexander, Esther van Sluijs, and Pedro C. Hallal
Maternal Physical Activity Patterns in the 2015 Pelotas Birth Cohort: From Preconception to Postpartum
Luciana Tornquist, Debora Tornquist, Gregore Iven Mielke, Mariângela Freitas da Silveira, Pedro Curi Hallal, and Marlos Rodrigues Domingues
Background: Motherhood has been associated with reduced leisure-time physical activity (LTPA) levels. We aim to assess maternal LTPA patterns from preconception to 4 years postpartum. Methods: The study was developed with mothers from the Pelotas 2015 Birth Cohort, Southern Brazil (n = 4273). LTPA data were self-reported for preconception, antenatal, and 3, 12, 24, and 48 months postpartum. Information on LTPA referring to preconception (3 mo before pregnancy) and each gestational trimester was retrospectively collected in perinatal. The prevalence of active mothers was calculated according to recommendations (≥150 min/wk). We described changes in LTPA between follow-ups and estimated the probability of mothers being active according to previous LTPA. We used group-based trajectory analysis to identify patterns of LTPA throughout the follow-ups. Results: The prevalence of active mothers during leisure time decreased in pregnancy and postpartum compared with preconception. At 12 months postpartum, LTPA levels rose again, but at 48 months, the rates of active mothers still had not returned to preconception levels. Prior LTPA engagement was an important determinant of the maintenance of LTPA. Trajectory analysis identified 4 patterns of maternal LTPA, and ∼80% of mothers were allocated to the “always inactive” group. Higher education and income, working outside the home, multiple births, and participating in the PAMELA study intervention were associated with a higher probability of mothers not being included in this predominantly inactive group. Conclusions: Motherhood is associated with declining rates of women meeting physical activity recommendations during pregnancy and early postpartum.
Social Support and Leisure-Time Physical Activity Among the Elderly: A Population-Based Study
Andrea Wendt Böhm, Grégore Iven Mielke, Maurício Feijó da Cruz, Virgílio Viana Ramires, and Fernando C. Wehrmeister
Background:
Physical inactivity in elderly is a public health problem. The purpose of this study is to describe and test the association between social support and leisure-time physical activity among the elderly.
Methods:
A cross-sectional, population-based study with 1,285 subjects (60+ years old) living in a city in southern Brazil was carried out in 2014. Physical activity practice was measured using the International Physical Activity Questionnaire [leisure domain: at least 150 minutes per week of walking + moderate physical activity + 2(vigorous physical activity)], while social support was measured using the Physical Activity Social Support Scale.
Results:
The prevalence of elderly who reached the recommendations of leisure-time physical activity was 18.4%. The elderly persons who had the company of family or friends to walk had a 2.45 times higher prevalence of reaching the recommendations of physical activity in leisure than those who did not. Those who had company of friends to practice moderate-to-vigorous physical activity (MVPA) were 3.23 times more likely to reach physical activity recommendations than their counterparts. The least common social support was the joint practice for walking and for MVPA.
Conclusions:
Strategies that incentivize family members and friends to provide social support to the elderly for physical activity focusing on joint practice must be encouraged.
Association Between Knowledge and Practice in the Field of Physical Activity and Health: A Population-Based Study
Thiago T. Borges, Pedro C. Hallal, Inacio Crochemore Mohnsam da Silva, Grégore Iven Mielke, Airton J. Rombaldi, and Fernando C. Barros
Background:
The aim of the current study was to evaluate the association between knowledge about physical activity (PA) recommendations (in terms of duration and frequency) and physical activity practice in a population-based sample of adults and adolescents.
Methods:
Crosssectional survey, conducted in Pelotas, Brazil. Participants (10+ years) were included in the sample and reported their perception about the minimum number of days and duration of PA to achieve health benefits. Those who reported PA practice ≥ 150 min/wk (adults) and ≥ 300 min/wk (adolescents) were considered active.
Results:
The sample included 1696 adults and 399 adolescents. More than one-third (38.6%) of the adult population reported that < 150 minutes of PA per week would be sufficient to obtain health benefits. Moreover, 76.1% of the adolescents reported that < 300 minutes per week were sufficient to obtain health benefits. Among adolescents, those who were active tended to report that higher amounts of PA were needed to obtain health benefits.
Conclusions:
Despite global recognition of the role of PA for improving health, knowledge about the minimum frequency and duration for achieving health benefits is still low in Brazil, particularly among adolescents.
Physical Activity During Pregnancy and Preterm Birth: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study
Werner de Andrade Müller, Grégore Iven Mielke, Inácio Crochemore M. da Silva, Mariangela F. Silveira, and Marlos Rodrigues Domingues
Background: Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. Methods: PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. Results: PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36–0.96) was associated with the outcome. Conclusions: PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.
Longitudinal Associations Between Device-Measured Physical Activity and Early Childhood Neurodevelopment
Otávio Amaral de Andrade Leão, Gregore Iven Mielke, Pedro Curi Hallal, John Cairney, Jorge Mota, Marlos Rodrigues Domingues, Joseph Murray, and Andréa Dâmaso Bertoldi
Background: The aim of this study was to investigate longitudinal associations between physical activity and early childhood neurodevelopment. Methods: Data from 1673 children from the 2015 Pelotas (Brazil) birth cohort study were analyzed. Physical activity was measured using accelerometers on the wrist at ages 1, 2, and 4 years. Neurodevelopment was measured using the Battelle Development Inventory at age 4 years. Linear regression models were used to test trajectories and cumulative associations of physical activity with child neurodevelopment. Results: Of the 3 physical activity trajectories observed, children in the medium (β = 1.17; 95% confidence interval, 0.25 to 2.10) and high (β = 2.22; 95% confidence interval, 0.61 to 3.82) trajectories showed higher neurodevelopment scores than children in the lower activity trajectory. Cumulative analyses showed that children in the highest tertile of physical activity in all follow-ups presented a mean neurodevelopment score 4.57 (95% confidence interval, 2.63 to 6.51) higher than children in the lowest tertile in all follow-ups. All analyses showed a dose–response characteristic of association, with higher physical activity indicating higher neurodevelopment scores. Conclusions: Physical activity may be an important predictor of neurodevelopment through early childhood.
Trends in Leisure-Time Physical Activity in a Southern Brazilian City: 2003-2010
Inacio Crochemore Mohnsam da Silva, Alan Goularte Knuth, Grégore Iven Mielke, Mario Renato Azevedo, Helen Gonçalves, and Pedro Curi Hallal
Background:
Most of physical activity surveillance data are derived from high-income countries. The aim of the current study was to report time trends in leisure-time physical activity.
Methods:
Population-based surveys were conducted in the city of Pelotas, Brazil in 2003 and 2010, including individuals aged 20+ years. Physical activity was assessed using the leisure-time section of the long version of the IPAQ. A cut-off point of 150 min/wk was used in the analyses. Methodologies were virtually identical in both surveys.
Results:
In 2003, 26.8% (95% CI 24.3; 29.2) of the participants were classified as active in leisuretime, as compared with 24.4% (95% CI 22.6; 26.2) in 2010. The proportion of subjects reporting 0 minutes per week of walking, moderate- and vigorous-intensity physical activity practice also did not vary between 2003 and 2010. However, the proportion of active adults decreased from 39.9% (95% CI 33.0; 42.7) in 2003 to 29.7% (95% CI 24.9; 34.5) in 2010 among high-income participants. Males were more active than females in both surveys.
Conclusions:
Leisure-time physical activity is stable among adults living in the South of Brazil, but high-income participants are becoming less active over time. Scaling up effective and promising physical activity interventions is urgently needed in Brazil.
Independent, Stratified, and Joint Associations of Sedentary Time and Physical Activity With Cardiovascular Disease: A Systematic Review
Charles Phillipe de Lucena Alves, Otávio Amaral de Andrade Leão, Felipe Mendes Delpino, Gregore Iven Mielke, Ulf Ekelund, Eduardo Caldas Costa, and Inácio Crochemore-Silva
Background: Recent statistics highlight cardiovascular diseases (CVD) as a major global cause of death. This review examines the methodological approaches and the main results of independent, stratified, and joint association of sedentary time (ST) and physical activity (PA) on CVD outcomes. Methods: We searched PubMed, Embase, Web of Science, and Scopus for prospective cohorts that examined the independent, stratified, or joint associations of ST and PA with CVD outcomes. Independent associations were defined as analyses mutually adjusted for PA and ST. Stratified associations were considered when there was a reference group in each stratum of PA or ST, and joint associations were defined by a single reference group for all other combined categories of ST and PA levels. Results: Of 45 articles, 69% explored independent association of ST or PA on CVD outcomes, while 31% using a stratified/joint approach. Most studies used self-reports for ST and PA and focused on CVD mortality. Mutually adjusted analyses identified ST positively and PA inversely associated to CVD outcomes. Stratified studies showed higher ST’s pronounced impact on CVD for lower PA levels. High PA mitigated but did not eliminate ST’s negative impact. Joint analyses revealed highest CVD risk in those with both high ST and low PA, and elevated risk in various intermediate combinations. Conclusions: Employing independent, stratified, and joint association approaches can yield distinct and complementary public health messages aimed at promoting cardiovascular health. Recommendations should aim to not only to encourage boosting PA levels, but also, concurrently decrease ST.
