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espanolAntecedentes: las evidencias sugieren que la exposicion a factores de riesgo relacionados con el exceso de peso se produce con mayor frecuencia en la segunda y tercera decadas de la vida. Por lo tanto, uno de los entornos mas propicios para la adquisicion de habitos que puedan inhibir el sobrepeso es la universidad. Objetivos: identificar la frecuencia de los ejercicios aerobicos y de fuerza y del consumo de frutas/verduras en estudiantes universitarios, y posteriormente establecer asociaciones entre los dos comportamientos de salud y el exceso de peso. Metodos: la muestra estaba compuesta de 5310 estudiantes universitarios. Las frecuencias de los ejercicios fisicos y del consumo de frutas/verduras se recopilaron mediante la aplicacion de un cuestionario online. El exceso de peso se establecio a partir del indice de masa corporal. Los datos se analizaron estadisticamente empleando analisis bivariados y de regresion logistica binaria. Resultados: la practica de ejercicios aerobicos y de fuerza fue relatada por el 80,4 % y el 51,6 % de la muestra, respectivamente. Solamente el 13 % de los estudiantes universitarios presentaron un consumo adecuado de frutas/verduras. La proporcion del exceso de peso fue equivalente al 39,1 %, siendo dicha proporcion significativamente mas elevada en los hombres. El riesgo de padecer exceso de peso identificado en los estudiantes universitarios que relataron no consumir frutas/verduras diariamente fue de dos a tres veces mayor que el de sus pares que refirieron un consumo adecuado (mujeres: OR = 2,92; IC 95 %, 2,07-4,12; hombres: OR = 1,98; IC 95 %, 1,41-3,02). La exposicion al riesgo del exceso de peso fue progresivamente menor conforme mayor era la frecuencia reportada de ejercicios aerobicos. Conclusion: los hallazgos sugieren la necesidad de promover iniciativas dirigidas al diseno e implementacion de programas de educacion y promocion de la salud en el contexto universitario a traves de acciones de orientacion sobre ejercicio fisico y consumo de alimentos que puedan ayudar a minimizar los riesgos de aparicion y desarrollo del exceso de peso. EnglishBackground: evidence suggests that exposure to risk factors related to excess body weight is more frequent in the second and third decades of life. Thus, one of the most propitious environments for the acquisition of habits that can inhibit overweight is the university. Objective: to identify the frequency of aerobic and strength exercises and of fruit/vegetable intake in university students, and subsequently establish associations between both health behaviors and excess body weight. Methods: the sample was comprised of 5,310 university students. An online questionnaire was used to collect the frequency of exercises and fruit/vegetable intake. The body mass index was used to define body weight status. The data were analyzed statistically by employing a bivariate analysis and binary logistic regression. Results: the practice of aerobic and strength exercises was reported by 80.4 % and 51.6 % of the sample, respectively. Only 13 % of the surveyed university students had an adequate fruit/vegetable intake. The proportion of excess body weight was 39.1 %, the condition being significantly higher in men. The risk for excess body weight identified in the university students who reported not consuming fruits/vegetables daily was two to three times higher than in their peers who reported an adequate intake (women: OR = 2.92 [95 % CI 2.07-4.12]; men: OR = 1.98 [95 % CI 1.41-3.02]). Exposure to the risk for excess body weight was progressively lower as the reported frequency of aerobic exercise became higher. Conclusion: these findings suggest the need to promote initiatives aimed at the preparation and implementation of health education and promotion programs in the university context, through actions of guidance about exercise and food intake that may help to minimize the risks of onset and development of excess body weight.

Background Findings available in literature indicate that metabolic syndrome (MetS) diagnosed in young ages tends to remain in adulthood. The aim of the study was to identify demographic, nutritional, anthropometric and behavioral correlates of MetS in a sample of adolescents from Dourados, Mato Grosso do Sul, Brazil. Methodology This is a cross-sectional school-based study involving 274 participants aged 12–18 years (186 girls and 88 boys). Anthropometric measurements were performed and a questionnaire with structured questions was applied for data collection. MetS was identified according to criteria proposed by the International Diabetes Federation. Data were statistically treated using bivariate analysis and hierarchical multiple regression. Results The proportion of adolescents identified with MetS was equivalent to 4.7% [95% CI (3.6–6.0)]. Multivariate analysis showed that older age (OR = 1.22 [1.04–1.73]) and higher economic class (OR = 1.25 [1.07–1.96]) were significantly associated with MetS. Among behavioral factors, longer recreational screen time (OR = 1.26 [1.05–1.94]) and low fruits/vegetables intake (OR = 1.49 [1.23–2.41]) were independently associated with MetS. Likewise, excess body weight (OR = 1.52 [1.24–2.41]) was significantly associated with the outcome. Conclusion The high proportion of adolescents with MetS and the identification of their correlates reinforce the need for early life style intervention and awareness programs in this population group.

This study aimed to compare the energy expenditure and intensity of active video games to that of treadmill walking in children and adolescents.Seventy-two boys and girls (aged 8-13 years) were recruited from local public schools. Energy expenditure and heart rate were measured during rest, during 3-km/hr, 4-km/hr, and 5-km/hr walks, and during active games (Adventure, Boxing I, Boxing II, and Dance). During walking and active games, we also assessed physical activity using an accelerometer.The energy expenditure of the active games Adventure, Boxing I, Boxing II, and Dance was similar to that of treadmill walking at 5 km/hr in boys and girls. Heart rate was significantly higher for the game Adventure compared with walking at 3 km/hr, 4 km/hr, and 5 km/hr and the game Dance in both genders. The heart rate of girls during the games Adventure and Dance was significantly higher compared with boys. There was a statistically significant difference (p .05, with an effect size ranging from 0.40 to 3.54) in the counts·minXBOX 360 Kinect games provide energy expenditure and physical activity of moderate intensity for both genders. The use of active video games can be an interesting alternative to increase physical activity levels.

Objective: To analyze the performance of three different diagnostic criteria of overweight and obesity (WHO, IOTF and Conde and Monteiro) using body mass index (BMI) as predictors of metabolic syndrome (MetS) in a representative sample of adolescents. Methods: A sample of 1035 adolescents aged 12–20 years (565 girls and 470 boys) was used in the study. BMI was calculated through the quotient of weight (kg)/height squared (m)2, and MetS was defined according to the criteria of the International Diabetes Federation. Sensitivity, specificity, and overall accuracy (area under the curve) were estimated using the receiver operating characteristic (ROC) curves method and used to describe the predictive performance. Results: The three diagnostic criteria showed higher absolute values of sensitivity and specificity for predicting MetS in boys and older adolescents. The highest sensitivity to identify MetS was found using the IOTF criterion (60–85%), while specificity values ≥ 90% were found for the three criteria. The Conde and Monteiro diagnostic criterion pointed to a significantly lower overall accuracy (0.52–0.64) than that of the WHO (0.70–0.84) and IOTF (0.75–0.89) diagnostic criterion. Conclusions: Overweight and obesity using BMI showed a moderate association with MetS, regardless of the diagnostic criteria used. However, the IOTF criterion showed better predictive capacity for the presence of MetS than the WHO and the Conde and Monteiro criteria. Resumo: Objetivo: Analisar o desempenho de três diferentes critérios diagnósticos de sobrepeso e obesidade (WHO, IOTF e Conde & Monteiro) a partir do índice de massa corporal (IMC) como preditores da síndrome metabólica (SMet) em amostra representativa de adolescentes. Métodos: A amostra foi constituída por 1035 adolescentes (565 moças e 470 rapazes) com idades entre 12 e 20 anos. O IMC foi calculado mediante quociente entre peso (kg)/altura (m)2 e SMet foi definida através dos critérios da International Diabetes Federation. Desempenho preditivo foi descrito a partir das estimativas de sensibilidade, especificidade e acurácia global (área sob a curva) utilizando-se do método de curvas Receiver Operating Characteristic. Resultados: Os três critérios diagnóstico apresentaram maiores valores absolutos de sensibilidade e especificidade para predição da SMet nos rapazes e nos adolescentes com mais idade. Maior sensibilidade para identificar SMet foi observada utilizando o critério IOTF (60% a 85%), enquanto especificidade ≥ 90% foi observada mediante o uso dos três critérios diagnósticos. O critério diagnóstico Conde & Monteiro apontou acurácia global (0,52 a 0,64) significativamente menor que os critérios diagnósticos WHO (0,70 a 0,84) e IOTF (0,75 a 0,89). Conclusões: Sobrepeso e obesidade a partir do IMC mostrou uma moderada associação com SMet, independentemente do critério diagnóstico empregado. Contudo, o critério IOTF demonstrou melhor capacidade preditiva para presença de SMet que os critérios WHO e Conde & Monteiro. Keywords: Body mass index, Diagnosis, Accuracy, Cardiovascular risk, Youth, Palavras-chave: Índice de massa corporal, Diagnóstico, Acurácia, Risco cardiovascular, Jovens

espanolIntroduccion: el sindrome metabolico (SMet) se ha diagnosticado en adolescentes, sin embargo, sigue siendo incierto que determinantes del estilo de vida se pueden asociar de forma independiente con su aparicion. Objetivo: verificar la asociacion entre determinantes del estilo de vida (actividad fisica, comportamiento sedentario y consumo de alimentos) y SMet mediante el control de indicadores demograficos y el estado nutricional antropometrico en una muestra de adolescentes de la region sur de Brasil. Sujetos y metodos: estudio transversal con 1.035 adolescentes (565 chicas y 470 chicos) de 12 a 20 anos. Se midieron valores antropometricos y se aplico un cuestionario con preguntas estructuradas. El SMet se identifico de acuerdo con los criterios propuestos por la International Diabetes Federation. Los datos fueron tratados mediante analisis bivariado y regresion multiple jerarquizada. Resultados: la prevalencia general de SMet fue del 4,5% [IC 95%: 3,8-5,4]. El analisis multivariado mostro una asociacion significativa entre SMet y edad (OR = 1,34 [IC 95%: 1,09-1,80]) y clase economica (OR = 1,35 [IC 95%: 1,08-1,86]). Entre los determinantes del estilo de vida, el alto tiempo de pantalla en actividad recreativa (OR = 1,32 [IC 95%: 1,07-1,94]) y la baja ingesta de frutas/vegetales (OR = 1,23 [IC 95%: 1,01-1,87]) se asociaron de forma independiente con el SMet. Del mismo modo, la obesidad (OR = 1,62 [IC 95%: 1,28-2,47]) se asocio significativamente con el SMet. Conclusion: en vista de la asociacion significativa con el SMet, las estrategias de intervencion deben disenarse para reducir el tiempo de pantalla recreativo y fomentar el consumo de frutas y verduras, especialmente entre los adolescentes mayores, de clase economica mas alta y obesos. EnglishBackground: metabolic syndrome (MetS) has been diagnosed in adolescents. However, it remains uncertain which determinants of lifestyle are independently associated with its occurrence. Objective: to verify the association between lifestyle determinants (physical activity, sedentary behavior and food consumption) and MetS, by controlling demographic indicators and anthropometric nutritional status in a sample of adolescents from the southern region of Brazil. Subjects and methods: a school-based cross-sectional study involving 1,035 adolescents (565 girls and 470 boys) aged 12 to 20 years. Anthropometric measurements were performed and a questionnaire was applied with structured questions. MetS was identified according to criteria proposed by the International Diabetes Federation. The data were treated using bivariate analysis and hierarchical multiple regression. Results: the overall prevalence of MetS was equivalent to 4.5% (95% CI: 3.8 to 5.4). Multivariate analysis showed a significant association between MetS and age (OR = 1.34 [95% CI, 1.09 to 1.80]) and economic class (OR = 1.35 [95% CI: 1.08 to 1.86]). Among the determinants of lifestyle, high recreational screen time (OR = 1.32 [95% CI: 1.07 to 1.94]) and low fruit/vegetable intake (OR = 1.23 [95% CI: 1.01 to 1.87]) were independently associated with MetS. Likewise, obesity (OR = 1.62 [95% CI: 1.28 to 2.47]) was significantly associated with the outcome. Conclusion: in view of the significant association with MetS, intervention strategies should be designed to reduce recreational screen time and encourage fruit/vegetable consumption, especially among older adolescents, with a high economic class and obesity status.

The aim of the study was to identify the existence of clusters in multiple lifestyle behaviors, including consumption of fruits/vegetables, sugary products/soft drinks, physical activity and sedentary behavior. The association between identified clusters and excess body weight in a sample of adolescents from Dourados, Brazil, was examined. This is a cross-sectional school-based study involving 578 participants aged 12&ndash, 18 of both sexes. Anthropometric measurements were performed and a questionnaire was applied with structured questions to collect data. Excess body weight was identified through body mass index. Cluster analysis was performed to identify sex-specific clusters of multiple lifestyle behaviors. Analysis of covariance and logistic regression were used to analyze associations between clusters and excess body weight. Six clusters were identified in both sexes. Girls and boys in the cluster characterized by greater time spent in sedentary behavior were 53% (OR = 1.53 [1.06&ndash, 2.26]) and 63% (OR = 1.63 [1.12&ndash, 2.35]) more likely to present excess body weight compared to their peers in the reference cluster. In the case of adolescents in the cluster characterized by high consumption of sugary products/soft drinks, girls were 47% more likely to be overweight (OR = 1.47 [1.05&ndash, 2.13]) and boys were 51% more likely (OR = 1.51 [1.05&ndash, 2.16]). High consumption of fruits/vegetables, low consumption of sugary products/soft drinks and less sedentary behavior was considered the most effective combination for the maintenance of a healthy weight.

We tested health criteria cutoff points from physical fitness variables proposed by the Fitnessgram program for detecting metabolic syndrome ( MetS) in a representative sample of 1,035 Brazilian adolescents (565 girls and 470 boys) aged 12-20 years. We studied five fitness tests: (a) back-saver sit and reach, (b) trunk lift, (c) curl-up, (d) push-up, and (e) progressive aerobic cardiovascular endurance run ( PACER), and we defined MetS through the criteria of the International Diabetes Federation. We described the predictive performance of each fitness test in terms of sensitivity, specificity, and area under the curve ( AUC) estimates of the receiver operating characteristic method. The AUCs for four tests ( back-saver sit and reach, trunk lift, curl-up, and push-up) revealed low accuracy for identifying MetS in both sexes (0.50 ≥ AUC ≤ 0.60), but AUCs for the PACER test demonstrated good accuracy values between 0.72 (0.68–0.76) and 0.83 (0.78–0.89). Thus, cutoff points proposed in the Fitnessgram program for the PACER test offer an effective means of screening adolescents at higher cardiometabolic risk, which, for the age-group used in this study, should be from 40.3-44.3 ml/kg/min for boys and 38.6-40.1 ml/kg/min for girls.

This study aimed to translate into Portuguese, perform the cross-cultural adaptation and verify the psychometric properties of the Adolescent Health Promotion Scale (AHPS) for use in Brazilian adolescents. The original version was translated following international recommendations. The final version of the translated scale was administered to a sample of 1,949 adolescents of both genders aged 12-18 years. An exploratory factor analysis and then a confirmatory factor analysis were completed to identify the baseline psychometric properties. After minor changes identified in the translation process, the committee of experts considered that the Portuguese version of the AHPS showed semantic, idiomatic, cultural and conceptual equivalence. The factor analysis confirmed the structure of six subscales originally proposed, by statistical indicators equivalent to χ2/df=1.83, CFI=0.948, GFI=0.969, AGFI=0.956 and RMSR=0.052. Factor validity and reliability were confirmed by suitable factor loadings and desirable realms of composite reliability (0.7) average variance extracted (0.5). In conclusion, translation, cross-cultural adaptation and psychometric properties of the AHPS were satisfactory, thus enabling its application in future Brazilian studies.Os objetivos do estudo foram traduzir para o idioma português, realizar adaptação transcultural e verificar propriedades psicométricas da Adolescent Health Promotion Scale (AHPS) para uso em adolescentes brasileiros. Versão original foi traduzida de acordo com recomendações internacionais. Versão final da escala traduzida foi administrada em uma amostra de 1.949 adolescentes de ambos os sexos com idade entre 12 e 18 anos. Para identificar as propriedades psicométricas iniciais foi realizada análise fatorial exploratória e, na sequência, análise fatorial confirmatória. Após discretas modificações apontadas no processo de tradução, comitê de juízes considerou que a versão para o idioma português da AHPS apresentou equivalências semântica, idiomática, cultural e conceitual. Análise fatorial confirmou estrutura de seis subescalas originalmente proposta, mediante indicadores estatísticos equivalentes a χ2 /gl=1,83, CFI=0,948, GFI=0,969, AGFI=0,956 e RMSR=0,052. Validade fatorial e confiabilidade foram confirmadas mediante adequadas cargas fatoriais e desejáveis dimensões de confiabilidade composta (0,7) e variância média extraída (0,5). Concluindo, tradução, adaptação transcultural e propriedades psicométricas da AHPS foram satisfatórias, o que viabiliza sua aplicação em futuros estudos no Brasil.

The objective of this study was to identify the motives for sport participation in a sample of young Brazilian athletes according to sex, age, and training history. A total of 1,517 participants (714 girls, 803 boys) ages 12 to 18 years were included in the study. The Portuguese version of the Participation Motivation Questionnaire was used to identify motives for sport participation. The most important motives were Skill Development and Fitness, whereas the least important were Fun and Achievement/Status. Sex, age, type of sport, onset of training, duration of training, training volume, and competitive experience significantly influenced the motives for sport participation reported by the athletes. These results will contribute to establish intervention programs designed to reduce sport dropout rates among young athletes.

Objective: To investigate the association between physical activity and quality of life in a sample of Brazilian older adults. Method: The Portuguese version of the World Health Organization Quality of Life Instrument-Older Adults Module and International Physical Activity Questionnaire was administered to 1,204 subjects (645 women and 559 men) aged ≥ 60 years. Results: Older adults of both genders who reported to be more physically active attributed higher scores to the sensory ability, autonomy, and intimacy domains, in addition to presenting significantly higher overall quality of life, irrespectively of age, marital status, educational level, and socioeconomic status. Specifically in women, the scores obtained for the social participation domain were significantly higher in the strata of active and very active subjects when compared to sedentary subjects. Discussion: The results indicate that increases in the levels of physical activity can contribute to improvements in quality of life of older adults.

Background Metabolic syndrome (MetS) has been diagnosed in adolescents and among the associated factors are low levels of physical activity, sedentary behavior over long periods and low cardiorespiratory fitness. However, specifically in adolescents, studies present conflicting results. The aim of the present study was to conduct a systematic review and meta-analysis of observational studies, in order to map the association between physical activity, sedentary behavior, cardiorespiratory fitness and MetS in adolescents. Methods A search was performed in the databases PubMed, SPORTDiscus, LILACS and the Cochrane Library. For the meta-analysis, the odds ratio (OR) was calculated together with the respective confidence intervals (95% CI), in which the measures of effect were analyzed by dichotomous data (exposure variables) with MetS used as events. Results Eighteen studies were included in the meta-analysis. Primary analysis demonstrated that low levels of physical activity (OR = 1.35 [1.03 to 1.79]; p = 0.03) and low cardiorespiratory fitness (OR = 4.05 [2.09 to 7.87]; p < 0.01) were significantly associated with the development of MetS, while for sedentary behavior, represented by screen time > 2 hours/day, a significant association was not identified (OR = 1.20 [0.91 to 1.59]; p = 0.20). Subgroup analyses demonstrated that the association between low physical activity and MetS was dependent on the use of the accelerometry technique (OR = 2.93 [1.56 to 5.47]; p < 0.01). Screen time > 2 hours/day was significantly associated with MetS only on weekends (OR = 2.05 [1.13 to 3.73]; p = 0.02). With respect to cardiorespiratory fitness, a significant association with MetS was found independent of the maximal oxygen uptake (VO2max) measurement method. Conclusions Low levels of physical activity, low indices of cardiorespiratory fitness and sedentary behavior, represented by screen time > 2 hours/day on weekends, were significantly associated with the development of MetS in adolescence.

The objective was to analyze indicators related to eating habits and their association with metabolic syndrome (MetS) in a representative sample of adults in a community from State of São Paulo, Brazil. The sample was comprised of 1,112 participants aged ≥ 20 years. Data from sociodemographic issues, indicators regarding eating habits, anthropometric measures, resting arterial pressure, blood glucose and plasma lipids were registered. MetS was assessed according to the NCEP-ATP III criteria. The results showed that adequate consumption of fruits and vegetables was reported by less than 10% of the individuals. Regular consumption of fatty foods (5 days/week) was reported by 54.2% and sugar-added products and soft drinks by 3 8.6% of the interviewees. Gender, age, schooling, socioeconomic level and nutritional status influenced significantly the eating habits. Prevalence of MetS was approximately 24%, significantly higher in men (27.8% vs 20.3%; p = 0.005). Risk to identify MetS in individuals who reported not consuming regularly fruits and vegetables was approximately two times higher than their peers who reported adequate intake (women: OR = 1.93; 95% CI 1.51 - 2.38; men: OR = 2.04; 95% CI 1.63 - 2.40). Exposure risk for MetS was progressively higher according to reported higher consumption of fatty foods, sugar-added products and soft drinks. The findings suggest interventions in order to emphasize healthy eating habits, which could help to minimize risk of MetS.

Objective - To analyze associations between levels of physical activity, cardiorespiratory fitness, dietary content, and risk factors that cause a predisposition towards cardiovascular disease. Methods - Sixty-two individuals aged between 20 and 45 years were evaluated. Levels of physical activity were established by estimates of energy demand corresponding to everyday activity; indices for cardiorespiratory fitness were obtained from estimates of maximal oxygen consumption; information about dietary content was obtained from dietary records kept on seven consecutive days. To indicate risk factors that cause a predisposition towards cardiovascular disease, use was made of body mass indexes, waist-hip circumference relationships, levels of arterial pressure and of plasma lipid-lipoprotein concentration. To establish associations between the variables studied, multiple regression analysis was used. Results - Physical activity levels and cardiorespiratory fitness levels were inversely correlated with the amount and distribution of body fat and arterial pressure. Taken together, the two variables were responsible for between 16% and 19% of the variation in arterial pressure. Total and saturated fat ingestion was associated with higher serum lipid levels. Both dietary components were responsible for between 49% and 61% of the variation in LDL-cholesterol. Conclusion – High ingestion of food rich in total and saturated fat and decreased levels of physical activity and of cardiorespiratory fitness are associated with an increased risk of cardiovascular disease, which supports previous data.

The purpose of this study was to analyze the single and independent associations of whole body composition and fat distribution with cardiovascular disease (CVD) risk factors and fitness in middle-aged men. Sixty-two healthy Caucasian men (37.6 +/- 2.9 yr, 81.8 +/- 11.3 kg, 171.5 +/- 4.9 cm) participated in the study. Dual-energy x-ray absorptiometry (DXA) was used to assess total and regional body composition. The triceps, biceps, midthigh, calf, subscapular, chest, abdominal and suprailiac skinfolds, and the waist, hip and midthigh circumferences, and sagittal diameter were estimated. Cardiovascular fitness was estimated with a submaximal test. Bivariate and partial correlation analysis were used to study the association of total body percent fat (%fat), DXA trunk fat and trunk skinfolds (sum of subscapular, chest, abdominal, and suprailiac) and fitness with insulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein AI (apo AI), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], and diastolic and systolic blood pressure. All anthropometric and DXA body composition variables were significantly correlated with TC/HDL-C (from .26 to .50, P < .05). Similar relationships were found for insulin, HDL-C, and systolic blood pressure (r from .26 to .47, P < .05). Cardiovascular fitness was significantly (P < .05) associated with insulin (r = -.36), HDL-C (r = .27), TC/HDL (r = -.27), and with systolic blood pressure (r = -.37). After controlling for trunk skinfolds, none of the anthropometric and DXA body composition variables were correlated with any of the CVD risk factors. Similarly, when controlling for trunk skinfolds, cardiovascular fitness was not related to any of the metabolic variables. After adjusting for %fat, DXA trunk fat, and cardiovascular fitness, trunk skinfolds remained significantly (P < .05) related to insulin (r = .35), HDL-C (r = -.40), TC/HDL-C (r = .43), and apo AI (r = -.39). In conclusion, this study suggests that subcutaneous truncal fat, as estimated by skinfolds, is an independent predictor of CVD risk factors, and that the association between cardiovascular fitness and these risk factors may be mediated by the levels of abdominal subcutaneous fat in Caucasian middle-aged men.

OBJECTIVE: To assess the prevalence of low body weight/thinness, overweight and obesity in a representative sample of children and adolescents from a Brazilian region with low economic development. METHODS: A total of 982 girls and 986 boys, aged seven to 17 years old and assisted by Segundo Tempo Program, from Montes Claros, Minas Gerais, Brazil, were included in the study. Low body weight/thinness, overweight and obesity were defined based on body mass cut-off indexes recommended by the International Obesity Task Force. The prevalence of the nutritional status according to sex and age was compared by chi-square test. RESULTS: In girls, the frequency of low body weight/thinness, overweight and obesity was 4.1, 18.4 and 3.8%, respectively; in boys, these percentages were 6.3, 13.2 and 2.9%, respectively. The low body weight/thinness for girls raised from 2.7% (7-10 years old) to 5.5% (15-17 years old); the body weight excess (overweight and obesity) decreased from 30.1 to 16.2% for the same age groups. In boys, the corresponding trends were from 3.2 to 9.4% for low body weight/thinness, and from 23.4 to 9.2%, for body weight excess. CONCLUSIONS: The data indicate that, even in a region with low economic status, the body weight excess was the main problem associated with nutritional health. The high overweight and obesity prevalence rates indicate the need of public policies for promoting healthy feeding behaviors and physical activity. OBJETIVO: Analizar la prevalencia de bajo peso corporal/delgadez, sobrepeso y obesidad en una muestra representativa de niños y adolescentes de una región brasileña de bajo desarrollo económico. MÉTODOS: Muestra constituida por 982 muchachas y 986 muchachos, de siete a 17 años, por el núcleo del Programa Segundo Tiempo de Montes Claros, Minas Gerais. Se definieron bajo peso corporal/delgadez, sobrepeso y obesidad por el índice de masa corporal, adoptándose los puntos de corte recomendados por la International Obesity Task Force. Se compararon las prevalencias de sexo y edad por la prueba de chi-cuadrado. RESULTADOS: En las muchachas, las prevalencias de bajo peso corporal/delgadez, sobrepeso y obesidad fueron de 4,1, 18,4 y 3,8%, respectivamente; en los muchachos, fueron de 6,3, 13,2 y 2,9%. En las muchachas, el índice de bajo peso corporal/delgadez aumentó de 2,7 para 5,5% para las franjas de edad de siete a 10 y de 15 a 17 años, respectivamente; el exceso de peso corporal (sobrepeso y obesidad), a su vez, redujeron de 30,1 para 16,2%, respectivamente, para esas franjas de edad. En los muchachos, las tendencias correspondientes fueron de 3,2 para 9,4% para bajo peso corporal/delgadez, y de 23,4 para 9,2% para el exceso de peso corporal. CONCLUSIONES: Los datos señalan que, aunque en una región de bajo desarrollo económico, el exceso de peso corporal fue el principal problema asociado al estado nutricional. Las elevadas prevalencias de sobrepeso y obesidad alertan para la necesidad de políticas públicas dirigidas a las prácticas de alimentación sana y de actividad física. OBJETIVO: Analisar a prevalência de baixo peso corporal/magreza, sobrepeso e obesidade em amostra representativa de crianças e adolescentes de uma região brasileira de baixo desenvolvimento econômico. MÉTODOS: Amostra constituída por 982 moças e 986 rapazes, de sete a 17 anos, assistidos pelo núcleo do Programa Segundo Tempo de Montes Claros, Minas Gerais. Definiram-se baixo peso corporal/magreza, sobrepeso e obesidade pelo índice de massa corpórea, adotando-se os pontos de corte recomendados pela International Obesity Task Force. Compararam-se as prevalências de sexo e idade pelo teste do qui-quadrado. RESULTADOS: Nas moças, as prevalências de baixo peso corporal/magreza, sobrepeso e obesidade foram de 4,1, 18,4 e 3,8%, respectivamente; nos rapazes, foram de 6,3, 13,2 e 2,9%. Nas moças, o índice de baixo peso corporal/magreza aumentou de 2,7 para 5,5% para as faixas etárias de 7-10 e de 15-17 anos, respectivamente; já o excesso de peso corporal (sobrepeso e obesidade) diminuiu de 30,1 para 16,2%, respectivamente para essas faixas etárias. Nos rapazes, as tendências correspondentes foram de 3,2 para 9,4% para o baixo peso corporal/magreza, e de 23,4 para 9,2% para o excesso de peso corporal. CONCLUSÕES: Os dados apontam que, mesmo em uma região de baixo desenvolvimento econômico, o excesso de peso corporal foi o principal problema associado ao estado nutricional. A elevada prevalência de sobrepeso e obesidade alerta para a necessidade de políticas públicas direcionadas às práticas de alimentação saudável e de atividade física.

The objective of the present study was to find out if there are differences in terms of sex, age, or country of origin for the components of health-related quality of life (HRQL) in samples of adolescents from three cities-in Argentina, Brazil, and Chile, respectively-using data collected through an internationally recognized and validated survey questionnaire, KIDSCREEN-52.The KIDSCREEN-52 questionnaire was administered to 1 357 adolescents between 12 and 17 years of age (48.6% of them male) in selected samples in the three countries. Univariate analysis of variation (ANCOVA) was used. Not only sex and age differences, but also differences for each component of HRQL, were found between the three country groups.The data showed significant differences between the three countries for each of the specific components of HRQL. Males scored significantly higher than females in the following components: Physical Well-being (P0.001), Psychological Well-being (P = 0.019), Moods and Emotions (P0.001), Self-perception (P = 0.001), Autonomy (P0.001), and Parent Relations and Home Life (P = 0.008). Furthermore, the average scores for Physical Well-being (P = 0.001), Psychological Well-being (P = 0.001), Self-Perception (P = 0.038), Autonomy (P = 0.001), Parent Relations and Home Life (P = 0.001), School Environment (P = 0.001), and Financial Resources (P = 0.022) showed a significantly declining trend with each advancing year, while average scores for the component Social Acceptance (Bullying) increased significantly with age (P0.001).The evidence suggests that interventions in disease prevention and health promotion should be developed for specific target groups, using appropriate actions depending on the sex and age of the adolescents.

The purpose of the study was to analyze the physical activity and the determinants of sedentary behavior in 1,268 Brazilian adolescents (638 girls, 630 boys) between the ages of 15 and 18 years, randomly selected from a relatively underdeveloped region. Data were collected from a community-based survey in the city of João Pessoa, Paraiba, Brazil. Information related to physical activity was derived on the short version of the International Physical Activity Questionnaire. The prevalence of sedentary behavior was 28.2% for girls and 19.1% for boys, whilst 28.9% of the girls and 36.7% of the boys showed high physical activity. The sedentary behavior varied by sociodemographic and environmental determinants studied. Parents' education, socioeconomic status, school's characteristics, transport to school, paid work, smoking, alcohol use, and BMI scores were significantly related to sedentary behavior for boys and girls.

Background:This study investigated the association between sociodemographic and behavioral factors and health standards based on physical fitness component scores in a sample of Brazilian schoolchildren.Methods:A sample of 1457 girls and 1392 boys aged 6 to 18 years performed a test battery of 5 items: 1) sit-and-reach, 2) curl-up, 3) trunk-lift, 4) push-up, and 5) progressive endurance run (PACER). The cut-off scores for gender and age suggested by the FitnessGram were adopted.Results:The findings showed that the sociodemographic and behavioral factors significantly associated with the ability of schoolchildren of meeting the health standards varied according to the fitness test. In the 5 tests used girls presented lower chance of meeting the health standards. Age and socioeconomic class were negatively associated with the performance in all physical tests. Schoolchildren aged ≤ 9 years or from families of lowest socioeconomic class presented approximately twice the chance of meeting the health standards than those aged ≥ 15 years and from more privileged families, specifically in the push-up (OR = 2.40; 95% CI 2.01–2.82) and PACER (OR = 2.18; 95% CI 1.84–2.54) tests.Conclusions:Interventions to promote health-related physical fitness should not only consider gender and age of schoolchildren, but also selected sociodemographic and behavioral factors, especially socioeconomic class and leisure activities.

The objective of this study was to describe the semantic and conceptual equivalences of the National College Health Assessment II (NCHA II). The original version of the NCHA II was translated into Portuguese and back-translated into English. A committee of experts analyzed the different versions of the questionnaire. The version of the translated NCHA II questionnaire was experimentally administered to a sample of 64 university students of both sexes. After minor changes identified in the translation process, the committee of experts concluded that the Portuguese version of the NCHA II showed semantic and conceptual equivalences. In conclusion, the initial stages of the process of cross-cultural adaptation of the NCHA II questionnaire were satisfactory. Future studies are necessary to identify psychometric properties and validation indicators prior to the effective recommendation of the instrument for safe use.

To identify the social and environmental determinants most strongly associated with overweight and obesity in Brazilian schoolchildren from a developing region.Data were collected from a community-based survey of schoolchildren from the Valley of Jequitinhonha, Minas Gerais, Brazil. The sample was composed of 5 100 school children aged 6-18 years. Overweight and obesity were defined by body mass index based on the current method recommended by the World Health Organization in 2007. Social and environmental determinants were collected by using a structured questionnaire.The prevalence of overweight and obesity was 11.1% and 2.7% in girls and 8.2% and 1.5% in boys, respectively. The chance of overweight was higher in schoolchildren who engaged in remunerated work (odds ratio [OR] = 2.19, 95% confidence interval [CI] 1.30- 3.26), whose parents had higher education levels (OR = 1.52, 95% CI 1.12-2.07), who had two or fewer siblings (OR = 1.74, 95% CI 1.21-2.49), and who were in a high economic class (OR = 1.93, 95% CI 1.32-2.85). Schoolchildren who traveled by car to school (OR = 1.50, 95% CI 1.14-1.91), lived5 km from school (OR = 1.64, 95% CI 1.06-2.39), and consumed foods sold in the school cafeteria (OR = 1.56, 95% CI 1.19-2.16) presented high odds of being overweight.The background from a particular region of a country should be considered when implementing preventive measures regarding overweight and obesity, especially for very poor, developing regions like the Valley of Jequitinhonha. Measures taken should consider a multilevel intervention that includes the family, school, and physical environment.

To validate the psychometric properties of the Brazilian version of the 2007 Youth Risk Behavior Survey (YRBS) questionnaire.The original version of the 2007 YRBS was translated into Portuguese and back-translated into English. The questionnaire versions were analyzed by a committee of experts. The committee used semantic, idiomatic, cultural and conceptual equivalences as criteria of analysis. The final version of the translated 2007 YRBS questionnaire was administered in two occasions, with an interval of two weeks, in a sample of 873 high school students of both sexes, in the city of Londrina, Southern Brazil, to identify the psychometric properties. Test-retest reliability was analyzed by calculating the Kappa index of agreement and prevalence rate of each type of risk behavior when application was repeated. Chi-square test was used to identify statistical differences between the first and second questionnaire applications.After minor changes identified in the translation process, the committee of experts concluded that the Portuguese version of the 2007 YRBS showed semantic, idiomatic, cultural and conceptual equivalences. Significant differences between the prevalence rates of both applications were found in 23.4% of items. The identification of 91% of items with moderate-to-substantial Kappa index of agreement and mean value of this index of 68.6% indicated the quality of psychometric properties of the Portuguese version of the 2007 YRBS.The translation, cross-cultural adaptation and psychometric qualities of the 2007 YRBS questionnaire were satisfactory, thus enabling its application in epidemiological studies in Brazil.

The present study was designed to analyze the impact of the habitual physical activity determined by International Physical Activity Questionnaire (IPAQ) on lipid profile in representative sample of adults. A sample of 361 subjects (196 women and 165 men) aged 20-60 years old was included in the study. Plasma lipid concentrations were measured by standard procedures. The results showed that HDL-cholesterol and VLDL-cholesterol levels were not significantly different across physical activity groups in both sexes. Total cholesterol, LDL-cholesterol and triglycerides were significantly different across physical activity groups in women and men, but the pattern of variation was different between genders. The results from logistic regression analysis indicated that the odds ratios for low plasma lipid levels was significant only in subjects classified as very active compared with sedentary. In conclusion, the results suggest that increased habitual physical activity determined by IPAQ present significant impact in the plasma lipid profile in adults of both sexes, independently of the age and of the variations of the body weight.

To analyze the impact of tobacco use on plasma lipid lipoprotein profile in representative sample of adolescents.A sample of 452 subjects (246 girls and 206 boys) 15 to 18 years old were included in the study. Each participant completed a structured and self-administered questionnaire concerning tobacco use. Plasma lipid-lipoprotein concentrations were measured by standard procedures. Differences between mean values were evaluated by analysis of covariance, controlling for saturated fat and cholesterol intake. Odds ratio was used to estimate the relative risk of the smokers being classified with an undesirable level of a plasma lipidlipoprotein parameter.The proportion of smokers was 20.9% for boys and 15.4% for girls. The average consumption of cigarettes per day was 9.2+/-4.7 for boys and 5.6+/-3.1 for girls. When compared with non-smokers, boy and girl smokers showed a significantly higher serum levels of total cholesterol, LDL-cholesterol, triglycerides and apolipoprotein B100, and significantly lower serum levels of HDL-cholesterol. Adolescent smokers tended to show a two-fold higher risk of altered lipid-lipoprotein levels than non-smokers.The present data could imply that intervention promoting a healthy lifestyle, including non smoking, should start at an early age to prevent or delay development of atherosclerotic lesions and ultimately to minimize the appearance of premature coronary heart disease in adults.

The purpose of this paper was to investigate associations between the centripetal distribution of the body fat and serum lipid-lipoproteins, blood pressure and the index Homa-IR of insulin resistance, adjusting for indicators of overweight and cardiorespiratory fitness. Eighty-nine voluntaries were analyzed (44 men and 45 women). The centripetal distribution of the body fat was analyzed through waist circumference (CC) and the overweight by the body mass index (BMI). The cardiorespiratory fitness was followed by the estimate VO(2)max by test of walking. After adjusted for BMI values were found significant coefficient of correlation between CC and levels of blood pressure and ApoB in men, and between CC and index Homa-IR and triglycerides in women. After adjusted for VO(2)max values were verified significant correlations between CC and ApoB and index Homa-IR in men, and between CC and index Homa-IR in women. In conclusion, depending on the sex, the quantity and distribution of the body fat can present different actions in the insulin resistance and associated dysfunctions. The cardiorespiratory fitness per se seems not to contribute on the minimization of the association between the centripetal distribution of the body fat and the index Homa-IR; but presents a considerable impact on the association between the centripetal distribution of the body fat and the lipid metabolism and the levels of blood pressure, mainly in men.

Cardiovascular autonomic responses to orthostatic challenges are affected by gender and cardiorespiratory fitness in adults. However, little is know about the effects of these factors in healthy adolescents. We studied 41 adolescents (20 boys and 21 girls) aged 12-17 years, divided into aerobic fitness tertiles based on the results of a maximal treadmill exercise test. Cardiac autonomic modulation was assessed by heart rate variability (HRV) analysis of 5-minute RR interval recordings before and after 70 degrees head-up tilt maneuver. HRV was analyzed by time (TD) and frequency domain (FD) methods. TD was analyzed by standard deviation of the RR intervals and the root mean square of successive differences of RR intervals. The power spectral components were studied at low (LF) and high (HF) frequencies and as the LF/HF ratio. We did not find any differences in TD and FD measures before and after tilt in either gender or fitness groups, except for a higher heart rate response for boys. These results suggests that cardiac autonomic responses to head-up tilt in healthy adolescents are not affected by gender or aerobic fitness.

Obesity is associated with alterations of the autonomic nervous system. Previous studies in adults have shown that obese individuals present a decreased cardiac autonomic response to postural challenges. However, little is known about the impact of overweight on autonomic responses to passive postural stress in adolescents.to compare cardiac autonomic responses to the head-up tilt maneuver between obese and non-obese adolescents by analyzing heart rate variability.Fourteen obese adolescents (15.5+/-1.6 years) were compared with twenty non-obese subjects (15.4+/-0.8 years). Cardiac autonomic modulation was studied by heart rate variability (HRV) analysis of 5 minute RR interval recordings before and after a 70 masculine head-up tilt maneuver. HRV was analyzed according to the time domain (TD) and frequency-domain (FD) methods. The power spectral components were studied at low (LF) and high (HF) frequencies and as the LF/HF ratio.Obese adolescents demonstrated significantly lower HF normalized units (38.2+/-11.1 vs 53.9+/-15.5, p0.05) and higher LF normalized units (60.7+/-11.3 vs 44.6+/-15.7, p0.05) in the supine position. No difference was found in any HRV parameters after head-up tilt. When comparing differences between the orthostatic and supine positions, obese adolescents showed lesser changes of LF normalized units (22.4+/-12.6 vs 38+/-16.4, p0.05) and HF normalized units (-21.9+/-12.4 vs -37.3+/-16.3, p0.05).Obese adolescents have an abnormal cardiac autonomic response to the head-up tilt maneuver, characterized principally by a decreased parasympathetic response.

This study was designed to compare air displacement plethysmography with dual-energy X-ray absorptiometry (DXA) and 3 other field methods for estimation of body composition. Subjects were 62 healthy, white men aged 37.6+/-2.9 y (weight: 81.8+/-11.3 kg; height: 171.5+/-4.9 cm). Body composition was also assessed by using body mass index, single-frequency bioelectrical impedance analysis, multi-frequency bioelectrical impedance spectroscopy, and the skinfold-thickness equations of Jackson and Pollock and Durnin and Womersley. Percentage body fat (%BF) with the plethysmograph was 23.4+/-7.0 and with DXA was 26.0+/-7.4. The 2.6% mean difference was significant (P< 0.05). Total error was 3.7%BF. As assessed by multiple regression analysis, %BF with the plethysmograph, age, weight, and height yielded a DXA-adjusted R2 value of 89.5% fat and an SEE of 2.4% fat. All other models had higher SEEs and lower adjusted R2 values: 4.3% and 66.5% for body mass index, 3.3% and 79.8% for bioelectrical impedance analysis, 3.6% and 76.2% for bioelectrical impedance spectroscopy, 3.7% and 74.55% for the equations of Jackson and Pollock, and 3.9% and 71.6% for the equations of Durnin and Womersley, respectively. The plethysmograph also predicted fat mass and fat-free mass more accurately than all other models, with a lower SEE and higher adjusted R2 value. In conclusion, although %BF was systematically underestimated, body composition was closely estimated with air displacement plethysmography in middle-aged men.