Search

Little has been published about the historical development of scientific evidence in the physical activity (PA) and public health research field. The study aimed to examine the evolution of knowledge in this field. A structured literature review using formal citation network analysis methods was conducted in June-2016. Using a list of influential PA publications identified by domain experts, a snowball sampling technique was used to build a compact citation network of 141 publications that represents the backbone of the field. Articles were coded by study type and research team characteristics, then analyzed by visualizing the citation network and identifying research clusters to trace the evolution of the field. The field started in the 1950s, with a health sciences focus and strong North American and European leadership. Health outcome studies appeared most frequently in the network and policy and interventions least. Critical articles on objective measurement and public policy have influenced the progress from an emphasis on health outcomes research at early stages in the field to the more recent emerging built environment and global monitoring foci. There is only modest cross-citation across types of study. To our knowledge, this paper is the first to systematically describe the development of research on PA and public health. The key publications include fundamental ideas that remain citable over time, but notable research and dissemination gaps exist and should be addressed. Increasing collaboration and communication between study areas, encouraging female researchers, and increasing studies on interventions, evaluation of interventions and policy are recommended., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: The Global Observatory for Physical Activity (GoPA!) was launched in response to the physical inactivity pandemic. The aim of this article is to present current information about surveillance, policy, and research on physical activity (PA) and health worldwide., Methods: Information was collected for 217 countries. For 139 of these nations we identified a contact who confirmed information's accuracy and completeness. Associations were calculated among surveillance, policy and research categories., Results: Of the 139 countries, 90.6% reported having completed 1 or more PA survey, but less than one-third had 3 or more. 106 included PA on a national plan, but only one-quarter of these were PA-specific. At least 1 peer reviewed publication was identified for 63.3% of the countries. Positive associations (P < .001) were found between research and policy (ρ = 0.35), research and surveillance (ρ = 0.41), and surveillance and policy (ρ = 0.31). Countries with a standalone plan were more likely to have surveillance. Countries with more research were more likely to have a standalone plan and surveillance., Conclusions: Surveillance, policy, and research indicators were positively correlated, suggesting that action at multiple levels tends to stimulate progress in other areas. Efforts to expand PA-related surveillance, policy, and research in lower income countries are needed.

On the eve of the 2012 summer Olympic Games, the first Lancet Series on physical activity established that physical inactivity was a global pandemic, and global public health action was urgently needed. The present paper summarises progress on the topics covered in the first Series. In the past 4 years, more countries have been monitoring the prevalence of physical inactivity, although evidence of any improvements in prevalence is still scarce. According to emerging evidence on brain health, physical inactivity accounts for about 3·8% of cases of dementia worldwide. An increase in research on the correlates of physical activity in low-income and middle-income countries (LMICs) is providing a better evidence base for development of context-relevant interventions. A finding specific to LMICs was that physical inactivity was higher in urban (vs rural) residents, which is a cause for concern because of the global trends toward urbanisation. A small but increasing number of intervention studies from LMICs provide initial evidence that community-based interventions can be effective. Although about 80% of countries reported having national physical activity policies or plans, such policies were operational in only about 56% of countries. There are important barriers to policy implementation that must be overcome before progress in increasing physical activity can be expected. Despite signs of progress, efforts to improve physical activity surveillance, research, capacity for intervention, and policy implementation are needed, especially among LMICs., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project., Methods: Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n=2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training., Results: The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers' strikes in both sites and lack of involvement of the canteen owners in schools., Conclusions: The Saude na Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil.

Background: This article evaluates the evolution of physical activity and health research in China through a bibliometric analysis focused on number of publications, study areas, and sex balance in authorship. Methods: A systematic review was conducted by the Global Observatory for Physical Activity for "physical activity and health" publications between 1950 and 2019. Here, we focus on the 610 Chinese publications identified, defined as those in which data collection took place in China. We assessed the number of publications, classified them into 5 areas (1) surveillance, (2) correlates and determinants, (3) health consequences, (4) interventions, and (5) policy, and analyzed female participation in authorship. Results: The first Chinese publication identified in the review was in 1990. Since, the average number of physical activity and health publications increased from one per year in the 1990s to 7.6 per year in the 2000s, and to 47 per year in the 2010s. Most publications focused on the correlates and determinants (38.7%) and the health consequences of physical activity (35.9%). Physical activity policy accounted for 2.3% of the publications. In the 1990s, 64% of the publications included at least one female author; this proportion increased to 90% in the 2010s. Conclusion: Despite a slow start, China's research on physical activity and health has grown rapidly since 2000. The distribution of publications by study areas and female participation in authorship is similar to that observed globally, with fewer publications focused on interventions and policy as compared with other topics. [ABSTRACT FROM AUTHOR]

Objective: To describe the evolution of physical activity (PA) research in Africa, examine income and gender inequalities, and discuss future possibilities. Methods: A secondary analyses of the Global Observatory for Physical Activity data on PA research in Africa (1950–2019). Results: We identified 514 PA articles from 47 African countries in the past 70 years. Majority (83.1%) of the articles were published between 2012 and 2019. Fifteen countries had no publications. Six countries (South Africa [n = 156], Nigeria [n = 85], Ethiopia [n = 44], Ghana [n = 41], Kenya [n = 39], and Cameroon [n = 20]) accounted for about 75% of the publications. Most articles were observational (92.4%), single-country studies (78.4%), with male first (58.4%) and last authors (68%), and were classified as surveillance studies (45.1%). Few studies addressed interventions (5.8%) and policy (3.5%) or used device-based PA measurement (14.0%). The number of articles per country was positively related to human population level (r =.552, P =.000) and gross domestic product % spent on research and development (r =.301, P =.040). The publication rate per 100,000 people was positively related with the human development index (r =.349, P =.016) and negatively with the gender inequality index (r = −.360, P =.019). Conclusions: Our results provide an overview and status of PA research in Africa, highlighting country differences and gender inequalities in authorship. The findings may be used to benchmark the evolution of research in the region and to inform areas for improvement. There is an urgent need for more PA interventions and policy studies in Africa. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate inequalities in leisure-time physical activity (PA) practice amid the COVID-19 pandemic in a southern Brazilian city. Methods: Four repeated population-based surveys were carried out. PA was collected using a questionnaire proposed by the authors and an adapted version of the leisure-time section of the International Physical Activity Questionnaire. The sociodemographic variables were sex, age, skin color, and education level. The participants also answered questions regarding social distancing measures compliance. Descriptive analyses based on proportions and their respective P values for categorical variables were presented. The chi-square test for heterogeneity and linear trend was used. Results: The sample is composed of 1556 individuals (66.1% female). Overall, between rounds 1 and 2, PA prevalence declined, followed by a gradual increase thereafter. PA practice during the pandemic was higher among men, individuals with higher education level, and individuals with white skin color in all rounds. In rounds 2, 3, and 4, PA was lower among individuals who were practicing more social distancing. Conclusion: To tackle the PA inequalities, policymakers and stakeholders need to confront disparities, defending greater availability of public policies that are attentive to inequalities, especially regarding gender, skin color, and educational level, to promote PA as a human right. [ABSTRACT FROM AUTHOR]

Background: Many of the known solutions to the physical inactivity pandemic operate across sectors relevant to the United Nations Sustainable Development Goals (SDGs). Methods: The authors examined the contribution of physical activity promotion strategies toward achieving the SDGs through a conceptual linkage exercise, a scoping review, and an agent-based model. Results: Possible benefits of physical activity promotion were identified for 15 of the 17 SDGs, with more robust evidence supporting benefits for SDGs 3 (good health and well-being), 9 (industry, innovation, and infrastructure), 11 (sustainable cities and communities), 13 (climate action), and 16 (peace, justice, and strong institutions). Current evidence supports prioritizing at-scale physical activity-promoting transport and urban design strategies and community-based programs. Expected physical activity gains are greater for low-and middle-income countries. In high-income countries with high car dependency, physical activity promotion strategies may help reduce air pollution and traffic-related deaths, but shifts toward more active forms of travel and recreation, and climate change mitigation, may require complementary policies that disincentivize driving. Conclusions: The authors call for a synergistic approach to physical activity promotion and SDG achievement, involving multiple sectors beyond health around their goals and values, using physical activity promotion as a lever for a healthier planet. [ABSTRACT FROM AUTHOR]

Background: To describe overall physical activity prevalence measured by the Global Physical Activity Questionnaire as well as inequalities in leisure-time physical activity among Brazilian adults (15 y and older). Methods: Data from the Brazilian Survey on Medicine Access, Utilization, and Rational Use of Medicines were analyzed. The study was carried out between September 2013 and February 2014. Physical activity was measured through Global Physical Activity Questionnaire and classified according to the recommendations of the World Health Organization. Additional analysis determined the contribution of each physical activity domain to the total amount of physical activity. Inequalities in terms of sex, age, and socioeconomic position were explored. Results: About one-third of the participants (37.1%; 95% confidence interval, 35.5-38.8) were physically inactive. Work-based activities were responsible for 75.7% of the overall physical activity. The prevalence of participants achieving physical activity guidelines considering only leisure-time activities was 17.8% (95% confidence interval, 16.7-19.2). Females and older participants were less active than their counterparts for both overall and leisure-time physical activity; socioeconomic status was positively associated to leisure-time physical activity. Conclusions: Major overall physical activity is attributed to work-related physical activity. Leisure-time physical activity, a key domain for public health, presents important gender and socioeconomic inequalities. [ABSTRACT FROM AUTHOR]

Objective: To investigate the influence of parental physical activity on offspring's nutritional status in the 1993 Pelotas (Brazil) birth cohort. Design: Birth cohort study. Setting: The main outcomes were overweight and obesity status of children. The main exposure was parental physical activity over time, measured during the 11, 15 and 18 years of age follow-ups. The exposure was operationalised as cumulative, and the most recent measure before the birth of child. We adjusted Poisson regression models with robust variance to evaluate crude and adjusted associations between parental physical activity and offspring's nutritional status. All analyses were stratified according to the sex of the parent. Participants: A total of 874 members from the 1993 Pelotas (Brazil) birth cohort followed-up at 22 years of age with their first-born child were analysed. Results: Children were, on average, 3·1 years old. Crude analyses showed that the mother's cumulative physical activity measure had an indirect association with the prevalence of children's obesity. The most recent maternal physical activity measure before the birth of the child was associated with 41 % lower prevalence of obesity in children, even after adjustment for confounders. Conclusions: The most recent maternal physical activity measure was indirectly associated with the prevalence of obesity in children. No associations were found for fathers, reinforcing the hypothesis of a biological effect of maternal physical activity on offspring's nutritional status. [ABSTRACT FROM AUTHOR]

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 ill 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. [ABSTRACT FROM AUTHOR]

Background: No data on leisure-time physical activity (LTPA) are available in Brazil for a representative sample of the whole country. The current study describes LTPA levels of the Brazilian adult and elderly populations and explores its association with sex, age, and schooling. Methods: A countrywide household-based cross- sectional study was carried out, including separate samples of adult and elderly individuals from 23 states in Brazil selected through a multistage approach. LTPA was assessed using the long version of the International Physical Activity Questionnaire. A cut-off point of 150 minutes per week was used. Results: 12,402 adult and 6617 elderly individuals were interviewed in 100 cities. The proportion of individuals below the 150 minutes per week threshold in terms of LTPA was 82.6% (95% CI 81.9; 83.2) among the adults and 86.5% (95% CI 85.7; 87.3) among elderly individuals. Among adults, prevalence estimates were very consistent across regions. Elderly subjects living in states in the Northeast and North regions of the country were less active than those from the other regions. A clear positive dose-response association was observed between LTPA and schooling. Conclusion: Alarming rates of low levels of LTPA are found in Brazil, thus suggesting the need of urgent actions. [ABSTRACT FROM AUTHOR]

Background: Evaluation studies of large scale physical activity promotion programs are rare in Latin America. The aim of the current study was to evaluate the association between various forms of exposure to Academia da Cidade (PAC), a professionally supervised intervention in Aracaju (Brazil), and leisure-time physical activity (LTPA). Methods: A population-based study including 2267 adults was carried out. LTPA was assessed using the long version of the International Physical Activity Questionnaire, and a cut-off of 150 minutes per week was used in the analyses. Results: In fully adjusted models, having ever heard about PAC was related to an odds of 1.8 (95% CI 1.4-2.2) for reaching the 150-minutes per week LTPA threshold. Equivalent odds ratios were 1.6 (95% CII .1-2.3) for having ever seen a PAC class, 14.3 (95% CI 12.3-16.4) for current and 4.0 (95% CI 1.4-11.3) for past PAC participation. Conclusion: Different sources of exposure to PAC were significantly associated with LTPA, which may suggest that professionally-supervised community classes offered for free may be a successful alternative for promoting physical activity in Brazil. If PAC happens to be expanded to other Brazilian areas, intervention studies may be carried out to evaluate its effectiveness. [ABSTRACT FROM AUTHOR]

Background: Based on the Brazilian National Health Promotion Policy (PNPS), the Ministry of Health (MoM) started stimulating and funding physical activity interventions in 2005, leading to the establishment of a countrywide network. The aim of the present article is to geographically describe this network (2005-2008) and to present structure and process evaluation indicators of interventions funded in 2006 and 2007. Methods: In 2005, the 27 state capitals received funding for carrying out physical activity-related interventions. From 2006 onwards, public calls for proposals were announced, and cities were selected through a competitive basis. Coordinators of interventions in cities who got funding in 2006 and 2007 answered to survey questions on structure and process aspects of the interventions. Results: The network currently comprises 469 projects, out of which over 60% are carried out in small cities (<30,000 inhabitants). The most frequently used public spaces for the interventions are squares and indoor sports courts. The main physical activity-related topic of the PNPS prioritized in the projects is healthy diet. The main partnerships developed are between City's Health and Education Secretariats. Conclusion: Expanding the network to 1000 cities by 2010 and continuing the evaluation efforts are the next goals of the Brazilian MoH. [ABSTRACT FROM AUTHOR]

Objectives: To explore whether participation in leisure-time physical activity (LTPA) is associated with participation in occupational, housework, and transport-related physical activity. Methods: Population-based crosssectional study covering a multistage sample of 972 subjects age 20 to 69 years. Physical activity was measured using the long version of the International Physical Activity Questionnaire. A LTPA score was calculated as follows: min/wk of walking + min/wk of moderate-intensity physical activity + (min/wk of vigorous-intensity physical activity × 2). Similar scores were generated for each domain. For categorical analyses, the scores were divided into 3 categories: 0 min/wk, 10-149 min/wk, and ≥150 min/wk. Results: The proportion of subjects practicing less than 150 min/wk of physical activity in each domain was: leisure-time (69.8%), occupational (58.3%), housework (35.0%), transportation (51.9%). Subjects with a transport-related physical activity score equal to or above 150 min/wk were 40% less likely to be sedentary in leisure-time in comparison with those who did not practice transport-related physical activity. Housework and occupational physical activity were not related to participation in LTPA. Conclusions: Future physical activity campaigns should focus on other domains instead of LTPA alone, particularly supporting transport-related physical activity as a strategy of health promotion. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the prevalence of physical activity advice, the source of the information, and the types of recommendation in a population-based sample of adults living in South Brazil. Methods: Population-based study including 972 adults living in Pelotas, Brazil. The outcome variable was based on the following question: "Has anyone ever recommended you to practice physical activity"? If the answer was positive, we asked who was responsible for the prescription (an open question, which was categorized later) and which recommendation was done. Results: The prevalence of physical activity advice was 56.2% (95% CI 52.3-60.1). Physical activity advice was mostly done by physicians (92.5%). Walking was, by far, the most frequent recommendation. Females were more likely to receive advice for physical activity practice than males (OR 1.74; 95% CI 1.30-2.31). Age, economic level, body mass index and leisure-time physical activity were positively associated with physical activity advice, while self-reported health presented an inverse association with the outcome. Conclusions: The prevalence of physical activity advice was high in this sample, suggesting that the Brazilian health system is incorporating physical activity in its routine. [ABSTRACT FROM AUTHOR]

Background: Youth violence is a major global public health problem. Three UK and Swedish studies suggest that low resting heart rate predicts male youth violence, but this has not been tested in other social settings nor for females.Methods: A prospective, population-based birth cohort study was conducted in Pelotas, Brazil. Heart rate was measured using a wrist monitor at ages 11, 15 and 18 years. Violent crime and non-violent crime were measured at age 18 in self-reports and official records (N = 3618). Confounding variables were assessed in the perinatal period and at age 11, in interviews with mothers and children. Logistic regression was used to estimate associations between quartiles of heart rate at each age, and violent and non-violent crime at age 18, separately for males and females.Results: Lower resting heart rate was a robust correlate of violent and non-violent crime for males. Comparing males in the lowest and top quartiles of heart rate at age 15 years, adjusted odds ratios were 1.9 for violent crime [95% confidence interval (CI) 1.4-2.7] and 1.7 for non-violent crime (95% CI 1.1-2.6). For females, crime outcomes were associated only with low resting heart rate at age 18. Associations were generally linear across the four heart rate quartiles. There was no evidence that associations differed according to socioeconomic status at age 15.Conclusions: Low resting heart rate predicted violent and non-violent crime for males, and was cross-sectionally associated with crime for females. Biological factors may contribute to individual propensity to commit crime, even in a middle-income setting with high rates of violence. [ABSTRACT FROM AUTHOR]

Objectives: Different accelerometer cutpoints used by different researchers often yields vastly different estimates of moderate-to-vigorous intensity physical activity (MVPA). This is recognized as cutpoint non-equivalence (CNE), which reduces the ability to accurately compare youth MVPA across studies. The objective of this research is to develop a cutpoint conversion system that standardizes minutes of MVPA for six different sets of published cutpoints.Design: Secondary data analysis.Methods: Data from the International Children's Accelerometer Database (ICAD; Spring 2014) consisting of 43,112 Actigraph accelerometer data files from 21 worldwide studies (children 3-18 years, 61.5% female) were used to develop prediction equations for six sets of published cutpoints. Linear and non-linear modeling, using a leave one out cross-validation technique, was employed to develop equations to convert MVPA from one set of cutpoints into another. Bland Altman plots illustrate the agreement between actual MVPA and predicted MVPA values.Results: Across the total sample, mean MVPA ranged from 29.7MVPAmind(-1) (Puyau) to 126.1MVPAmind(-1) (Freedson 3 METs). Across conversion equations, median absolute percent error was 12.6% (range: 1.3 to 30.1) and the proportion of variance explained ranged from 66.7% to 99.8%. Mean difference for the best performing prediction equation (VC from EV) was -0.110mind(-1) (limits of agreement (LOA), -2.623 to 2.402). The mean difference for the worst performing prediction equation (FR3 from PY) was 34.76mind(-1) (LOA, -60.392 to 129.910).Conclusions: For six different sets of published cutpoints, the use of this equating system can assist individuals attempting to synthesize the growing body of literature on Actigraph, accelerometry-derived MVPA. [ABSTRACT FROM AUTHOR]

Physical inactivity is one of the most important contributors to the global burden of disease and has become a global public health priority. We review the evidence on physical activity (PA) interventions, actions, and strategies that have the greatest potential to increase PA at the population level. Using the socio-ecological framework to conceptualize PA interventions, we show that PA can be targeted at multiple levels of influence and by multiple sectors outside the health system. Examples of promoting PA on a national scale are presented from Finland, Canada, Brazil, and Colombia. A strong policy framework, consistent investment in public health programs, multi-sectoral support and actions, and good surveillance characterize each of these success stories. Increasing PA globally will depend on successfully applying and adapting these lessons around the world taking into account country, culture, and context. [ABSTRACT FROM AUTHOR]

Background: There is rapidly-emerging evidence on the harmful health effects of sedentary behaviors. The aim of this paper was to quantify time in sedentary behaviors and document socio-demographic variations in different life domains among adults. Methods: A population-based survey was carried out in 2012 through face-to-face interviews with Brazilian adults aged 20+ years (N = 2,927). Information about time spent sedentary in a typical weekday was collected for five different domains (workplace, commuting, school/university, watching TV, and computer use at home). Descriptive and bivariate analyses examined variations in overall and domain-specific sedentary time by gender, age, educational attainment and socioeconomic position. Results: On average, participants reported spending 5.8 (SD 4.5) hours per day sitting. The median value was 4.5 (interquartile range: 2.5–8) hours. Men, younger adults, those with higher schooling and from the wealthiest socioeconomic groups had higher overall sedentary scores. TV time was higher in women, older adults and among those with low schooling and socioeconomic position. Sedentary time in transport was higher in men, younger adults, and participants with high schooling and high socioeconomic position. Computer use at home was more frequent among young adults and those from high socioeconomic groups. Sitting at work was higher in those with higher schooling and from the wealthiest socioeconomic groups. Sedentary behavior at school was related inversely to age and directly to schooling. Conclusion: Patterns of sedentary behavior are different by life domains. Initiatives to reduce prolonged sitting among Brazilian adults will be required on multiple levels for different life domains. [ABSTRACT FROM AUTHOR]

Background With an estimated 74% of all deaths attributable to non-communicable diseases (NCDs) in 2010, NCDs have become a major health priority in Brazil. The objective of the study was to conduct a comprehensive literature review on diabetes in Brazil; specifically: the epidemiology of type 2 diabetes, the availability of national and regional sources of data (particularly in terms of direct and indirect costs) and health policies for the management of diabetes and its complications. Methods A literature search was conducted using PubMed to identify articles containing information on diabetes in Brazil. Official documents from the Brazilian government and the World Health Organization, as well as other grey literature and official government websites were also reviewed. Results From 2006 to 2010, an approximate 20% increase in the prevalence of self-reported diabetes was observed. In 2010, it was estimated that 6.3% of Brazilians aged 18 years or over had diabetes. Diabetes was estimated to be responsible for 278,778 years of potential life lost for every 100,000 people. In 2013, it is estimated that about 7% of patients with diabetes has had one or more of the following complications: diabetic foot ulcers, amputation, kidney disease, and fundus changes. The estimated annual direct cost of diabetes was USD $3.952 billion in 2000; the estimated annual indirect cost was USD $18.6 billion. The two main sources of data on diabetes are the information systems of the Ministry of Health and surveys. In the last few years, the Brazilian Ministry of Health has invested considerably in improving surveillance systems for NCDs as well as implementing specific programmes to improve diagnosis and access to treatment. Conclusions Brazil has the capacity to address and respond to NCDs due to the leadership of the Ministry of Health in NCD prevention activities, including an integrated programme currently in place for diabetes. Strengthening the surveillance of NCDs is a national priority along with recognising the urgent need to invest in improving the coverage and quality of mortality data. It is also essential to conduct regular surveys of risk factors on a national scale in order to design effective preventive strategies. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease is an important public health threat. Such patients present high morbidity and mortality due to cardiovascular disease, with low quality of life and survival, and also high expenditure resulting from the treatment. Arterial hypertension is both a cause and a complication of kidney disease; also, arterial hypertension is a risk factor for cardiovascular disease among patients with kidney diseases. There is some evidence that exercise interventions may be beneficial to chronic kidney disease patients, but previous studies included only end-stage patients, i.e. those undergoing dialysis. This study aims to evaluate the effect of exercise on kidney function, quality of life and other risk factors for cardiovascular disease among non-diabetic chronic hypertensive kidney disease patients who are not undergoing dialysis.Methods: The participants will be located through screening hypertensive patients attended within the public healthcare network in Pelotas, a city in south of Brazil. Eligible individuals will be those with glomerular filtration rate between 15 and 59 ml/min x 1.73 m2. The randomization will be done in fixed-size blocks of six individuals such that 75 participants will be allocated to each group. At baseline, information on demographic, socioeconomic,behavioral, anthropometric, blood pressure and quality-of-life variables will be collected, and laboratory tests will be performed. The intervention will consist of three weekly physical exercise sessions lasting 60-75 minutes each, with a total duration of 16 weeks. The outcomes will be the kidney function progression rate, quality of life, blood pressure, lipid profile, hemoglobin level, ultrasensitive C-reactive protein level, and ankle-arm index. The patients in both groups (intervention and control) will be reassessed and compared partway through the study (8th week), at the end of the intervention (16th week) and in the 8th week after the end of the intervention.Discussion: There is still a scarcity of data relating to the effect of physical exercise among the most numerous group of individuals with kidney disease, i.e. patients undergoing conservative treatment. In particular, there is alack of randomized controlled studies. This study will help fill this gap. [ABSTRACT FROM AUTHOR]

Objectives. We sought to identify perceived personal barriers to physical activity and examine the potential association between these barriers and sociodemographic and behavioral variables, including participation in leisure-time physical activity. Methods. In 2003, we conducted a population-based study in Pelotas, Brazil. Participants aged 20 years and older were selected according to a multistage sampling strategy. Participants responded to both the International Physical Activity Questionnaire and a standardized questionnaire investigating 8 perceived personal barriers. Results. Only 26.8% of participants achieved 150 minutes per week of leisure-time physical activity. Lack of money (40.3%) and feeling too tired (38.1%) were the most frequently reported barriers to physical activity. A dose-response group association was observed between number of perceived barriers and level of physical activity. In the multivariable analysis, lack of time, dislike of exercising, feeling too tired, lack of company, and lack of money were associated with physical inactivity. Conclusion. Detection of the determinants of physical inactivity, a growing epidemic, should be a public health priority. Brazil is a middle-income (developing) country. The prevalence of most of the personal barriers studied was higher in this population than those levels observed in high-income (developed) countries. Perceiving 5 of the 8 barriers investigated was inversely associated with leisure-time physical activity level. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated the association between physical activity practice and medicine use; data from these studies are inconsistent. The aim of this study was to evaluate the association between level of physical activity and medicine use in adults aged 20 years or more. Methods: A population-based cross-sectional study was carried out in the first semester of 2002 in the urban area of Pelotas; a medium-sized Southern Brazilian city. Physical activity was assessed with the short version of the International Physical Activity Questionnaire. A physical activity score was created as the weekly time spent in moderate-intensity activities plus twice the weekly time spent in vigorous-intensity activities. Medicine use in the 15 days prior to the interview was also assessed. Adjusted analyses taking into account the sampling design was carried out using Poisson regression. Wald tests for heterogeneity and linear trend were used to calculate significance. Results: Out of the 3,182 individuals interviewed, 41% were not sufficiently active according to current physical activity guidelines. Only 34% of the subjects did not use medicines in the previous 15 days, and 18% used three or more drugs in the same period. Level of physical activity was inversely associated with the number of medicines used both in the crude and in the adjusted analyses. Conclusion: There are well-documented benefits of physical activity for several chronic diseases in the literature. Data from the present study suggest that medicine use is also positively affected by physical activity behavior. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Global physical activity levels: Surveillance progress, pitfalls, and prospects" byVincent van Hees in the July 21, 2012 issue and also includes response from authors regarding the same issue.

There is widespread concern that disruption to health services during the COVID-19 pandemic has led to declines in immunization coverage among young children, but there is limited information on the magnitude of such impact. High immunization coverage is essential for reducing the risk of vaccine preventable diseases. We used data from two nationwide sources covering the whole of Brazil. Data from the Information System of the National Immunization Program (SIPNI) on the monthly number of vaccine doses administered to young children were analyzed. The second source was a survey in 133 large cities in the 27 states in the country, carried out from August 24–27. Respondents answered a question on whether children under the age of three years had missed any scheduled vaccinations during the pandemic, and available vaccination cards were photographed for later examination. SIPNI data showed that, relative to January and February 2020, there was a decline of about 20% in vaccines administered to children aged two months or older during March and April, when social distancing was at the highest level in the country. After May, vaccination levels returned to pre-pandemic values. Survey data, based on the interviews and on examination of the vaccine cards, showed that 19.0% (95% CI 17.0;21.1%) and 20.6% (95% CI 19.0;23.1%) of children, respectively, had missed immunizations. Missed doses were most common in the North (Amazon) region and least common in the South and Southeast, and also more common among children from poor than from wealthy families. Our results show that the pandemic was associated with a reduction of about 20% in child vaccinations, but this was reverted in recent months. Children from poor families and from the least developed regions of the country were most affected. There is an urgent need to booster immunization activities in the country to compensate for missed doses, and to reduce geographic and socioeconomic inequalities. [ABSTRACT FROM AUTHOR]

The article presents the study of the physical activity (PA) trends in Sao Paulo, Brazil. It states that cross-sectional surveys were carried out using a corresponding sampling approaches and sample sizes while PA was measured using a shorter version of the International Physical Activity Questionnaire which generated weekly scores of moderate and vigorous-intense physical activities. It notes that the prevalence of the no PA has decreased in 2002 to 2008. It also mentions that the levels of PA are increasing in Sao Paolo, Brazil.

Background: Both the prevalence and mortality attributable to chronic obstructive pulmonary disease (COPD) seem to be increasing in low-income and middle-income countries, but few data are available. The aim of the PLATINO study, launched in 2002, was to describe the epidemiology of COLPD in five major Latin American cities: São Paulo (Brazil), Santiago (Chile), Mexico City (Mexico), Montevideo (Uruguay), and Caracas (Venezuela). Methods: A two-stage sampling strategy was used in the five areas to obtain probability samples of adults aged 40 years or older. These individuals were invited to answer a questionnaire and undergo anthropometry, followed by prebronchodilator and postbronchodilator spirometry. We defined COPD as a ratio less than 0·7 of postbronchodilator forced expiratory volume in the first second over forced vital capacity. Findings: Complete information, including spirometry, was obtained from 963 people in São Paulo, 1173 in Santiago, 1000 in Mexico City, 885 in Montevideo, and 1294 in Caracas. Crude rates of COPD ranged from 7·8% (78 of 1000; 95% CI 5·9-9·7) in Mexico City to 19·7% (174 of 885; 17·2-22·2) in Montevideo. After adjustment for key risk factors, the prevalence of COPD in Mexico City remained significantly lower than that in other cities. Interpretation: These results suggest that COPD is a greater health problem in Latin America than previously realised. Altitude may explain part of the difference in prevalence. Given the high rates of tobacco use in the region, increasing public awareness of the burden of COPD is important. [ABSTRACT FROM AUTHOR]

Context: Systematic reviews of public health interventions are useful for identifying effective strategies for informing policy and practice. The goals of this review were to (1) update a previous systematic review of physical activity interventions in Latin America which found that only school-based physical education had sufficient evidence to recommend widespread adoption; (2) assess the reporting of external validity elements; and (3) develop and apply an evidence typology for classifying interventions. Evidence acquisition: In 2010–2011, community-level, physical activity intervention studies from Latin America were identified, categorized, and screened based on the peer-reviewed literature or Brazilian theses published between 2006 and 2010. Articles meeting inclusion criteria were evaluated using U.S. Community Guide methods. External validity reporting was assessed among a subset of articles reviewed to date. An evidence rating typology was developed and applied to classify interventions along a continuum based on evidence about their effectiveness in the U.S. context, reach, adoption, implementation, institutionalization, and benefits and costs. Evidence synthesis: Thirteen articles published between 2006 and 2010 met inclusion criteria and were abstracted systematically, yet when combined with evidence from articles from the previous systematic review, no additional interventions could be recommended for practice. Moreover, the reporting of external validity elements was low among a subset of 19 studies published to date (median=21% of elements reported). By applying the expanded evidence rating typology, one intervention was classified as evidence-based, seven as promising, and one as emerging. Conclusions: Several physical activity interventions have been identified as promising for future research and implementation in Latin America. Enhanced reporting of external validity elements will inform the translation of research into practice. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity plays a role in the acquisition of heart disease, type 2 diabetes, and breast and colon cancer. The impact of such noncommunicable diseases on low- and middle-income countries is a major global health concern, but most studies in this area have focused on high-income countries. A better understanding of the factors that may influence physical activity in low- and middle-income countries is needed. Purpose: This study describes the prevalence of cycling and walking for transportation and their association with personal and environmental factors in adults from three state capitals in Brazil. Methods: In 2007–2009, a random-digit-dialing telephone survey was conducted with residents (aged ≥18 years) of Curitiba, Vitoria, and Recife, sampled through a clustered multistage sampling process. Walking and cycling for transportation, perception of the environment related to physical activity, and demographic and health characteristics were collected. Poisson regression was used to examine associations between cycling and walking for transportation with covariates stratified by cities. All analyses were conducted in 2011. Results: The prevalence of bicycling for transportation was 13.4%; higher in Recife (16.0%; 95% CI=13.7, 18.4) compared to Curitiba (9.6%; 95% CI=7.8, 11.4) and Vitoria (8.8%; 95% CI=7.34, 10.1); and 26.6% for walking regularly as a mode of transportation. The adjusted analysis showed that cycling is positively associated with being male (prevalence OR [pOR]=3.4; 95% CI=2.6, 18.4) and younger (pOR=2.9; 95% CI=1.8, 4.9) and inversely associated with having a college degree (pOR=0.3; 95% CI=0.2, 0.4). Walking for transportation is inversely associated with having a college degree (pOR=0.6; 95% CI=0.5, 0.8). No strong evidence of association was found of environmental indicators with walking or bicycling. Conclusions: The prevalence of active commuting was low and varied by city. Personal factors were more consistently associated with bicycling than with walking, whereas perceived environmental features were not related to active commuting. [Copyright &y& Elsevier]