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1. Effects of 12 weeks of functional training vs. Muay Thai on cardiac autonomic modulation and hemodynamic parameters in older adults: a randomized clinical trial

Author

Bruna T. C. Saraiva, Emerson Franchini, Alex S. Ribeiro, Luís A. Gobbo, Marília A. Correia, Luiz C. M. Vanderlei, Gerson Ferrari, William R. Tebar, and Diego G. D. Christofaro

Subjects
Combat sports, Aging, Blood Pressure, Exercise, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background The elevated blood pressure (BP) and lower cardiac autonomic modulation (CAM) are associated with higher morbidity mortality risk among older adults. Although exercise is an important intervention for cardiovascular promotion, it is unclear whether combat sports training could benefit cardiovascular outcomes as much as autonomic in this population. This study compared the effects of 12 weeks of Muay Thai (MT) training against functional training (FT) on CAM and hemodynamic parameters in older adults. Methods The sample consisted of 50 older adults (41 women; 66.0 ± 5.3 years old), who were equaly randomized into FT (n = 25) and MT (n = 25) intervention groups. CAM was measured by 30-min rest heart rate variability. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and resting heart rate (RHR) were measured using an automatic oscillometric device. Pulse pressure (PP) and the double product (DP) were also calculated. The interventions were carried out three times a week, with 60-min length per session, during 12 consecutive weeks. The intensity of the interventions was measured using the subjective perception of exertion scale and by accelerometer. Two-factor repeated measures analysis of covariance was used for groups comparison, considering intervention group and body mass as factors. The 95% confidence interval of the difference (95%CIdif) was also calculated and the effect size was measured using partial eta squared (η2 p). Results CAM indices did not show significant changes across moments and intervention groups. In hemodynamic parameters, only in DBP was there an effect of the moment (F1,39 = 8.206; P = 0.007; η2 p = 0.174, large) and interaction effect between group*moment (F1,39 = 7.950; P = 0.008; η2 p = 0.169, large). Specifically, the MT group at the post-training moment showed lower DBP (P = 0.010; 95%CIdif = -13.3; -1.89) in relation to the FT group. Furthermore, the MT group showed a decrease in DBP during training (P = 0.002; 95%CIdif = -10.3; -2.6). Also, an increase in training intensity was also found over the 12 weeks in FT, with no difference between the groups. Conclusion After 12 weeks of MT practice there was a reduction in DBP compared to FT in older adults. Trial registration NCT03919968 Registration date: 01/02/2019.

Published
2024
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2. Association of meeting the 24-h movement guidelines with high blood pressure in adolescents: a cross-sectional study

Author

Diego G. D. Christofaro, Gerson Ferrari, Gabriel G. Cucato, Jorge Mota, Danilo R. Silva, Luiz Carlos M. Vanderlei, William R. Tebar, and Javier Brazo-Sayavera

Subjects
Movement guidelines, Physical activity, Sedentary behaviour, Sleep, Cardiovascular parameters, Medicine, Science
Abstract

Abstract The 24-h movement guidelines for children and adolescents comprise recommendations for adequate sleep, moderate to vigorous physical activity (MVPA) and sedentary behaviour (SB). However, whether adolescents who meet these 24-h movement guidelines may be less likely to have high blood pressure (HBP) has not been established. The present study assessed the association between meeting 24-h movement guidelines and HBP in a school-based sample of 996 adolescents between 10–17 years (13.2 ± 2.4 years, 55.4% of girls). Blood pressure was measured using a digital oscillometric device, while sleep, MVPA and SB were measured using the Baecke questionnaire. The association between the 24-h movement guidelines and HBP was performed using binary logistic regression adjusted for sex, age, socioeconomic status, and body mass index. It was observed that less than 1% of the sample meet the three 24-h movement guidelines. The prevalence of HBP was lower in adolescents who meet all three movement 24-h guidelines (11.1%) compared to those who did not meet any guidelines (27.2%). Individual 24-h movement guidelines analysis showed that adolescents with adequate sleep were 35% less likely to have HBP (OR = 0.65; 95% CI 0.46–0.91). Meeting sleep guidelines combined with meeting MVPA (OR = 0.69; 95% CI 0.50–0.95) or SB (OR = 0.67; 95% CI 0.48–0.94) was inversely associated with HBP. Adolescents who meet two or three 24-h movement guidelines were respectively 47% (OR = 0.53; 95% CI 0.29–0.98) and 34% (OR = 0.66; 95% CI 0.48–0.91) less likely to have HBP. In adolescents, meeting sleep and 24-h movement guidelines were inversely associated with HBP.

Published
2024
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3. Association of Sports Practice in Childhood and Adolescence with Cardiac Autonomic Modulation in Adulthood: A Retrospective Epidemiological Study

Author

Diego Giulliano Destro Christofaro, William R. Tebar, Jorge Mota, Leandro D. Delfino, Amanda B. Santos, Raphael M. Ritti-Dias, Rômulo A. Fernandes, Gerson Ferrari, and Luiz Carlos M. Vanderlei

Subjects
Heart rate variability, Previous sports practice, Youth, Cardiovascular Health, Sports medicine, RC1200-1245
Abstract

Abstract Background Practicing sports during childhood and adolescence provides benefits to cardiac autonomic modulation (CAM) at these stages of life. However, it is not known whether these benefits to CAM persist into adulthood. Therefore, the objective of this study was to analyze the association of early sports practice (sports practice in childhood and/or adolescence) with CAM in adult life, regardless of habitual moderate-to-vigorous PA. Methods The sample of the present study consisted of 242 adults (141 women and 101 men; age: 41.99 ± 16.24). The assessment of CAM was performed using heart rate variability indices. Sports practice in childhood and adolescence was assessed using a questionnaire. The intensity of physical activity was assessed using accelerometry. To analyze the association between previous sports practice (childhood and/or adolescence) and CAM, the Generalized Linear Model was adopted, considering CAM indices as continuous variables and early sports practice as a 3-fold factor (no sports practice; sports practice in childhood or adolescence; and sports practice in both childhood and adolescence) adjusted by sex, age, socioeconomic condition, and moderate to vigorous PA. Results Sports practice in childhood was associated with the average standard deviation of all normal RR intervals expressed in milliseconds (SDNN): β = 5.89; 95%CI: 0.25;11.52, and the standard deviation of the long-term intervals between consecutive heartbeats (SD2): β = 7.63; 95%CI:1.04; 14.23 indices. Sports practice in adolescence was associated in adulthood with the SD2 index: β = 7.37; 95%CI: 0.71;14.04. Sports practice in at least one of the periods (childhood or adolescence) was significantly associated with the square root of the mean square of the differences between adjacent normal RR intervals for a period of time expressed in milliseconds (RMSSD) (β = 8.86; 95%CI = 0.71;17.01), and the standard deviation of the instantaneous beat to beat variability (SD1) (β = 6.21; 95%CI = 0.45;11.97). Sports practice at both stages of life was significantly associated with better SDNN (β = 7.70; 95%CI = 1.16;14.23) and SD2 (β = 10.18; 95%CI = 2.51;17.85). Conclusion Early sports practice was associated with better CAM in adulthood, independently of the current physical activity level. Based on these findings, sports practice is encouraged from childhood and adolescence, for benefits to CAM in adult life.

Published
2024
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4. Screen time is negatively associated with sleep quality and duration only in insufficiently active adolescents: A Brazilian cross-sectional school-based study

Author

Amanda B. dos Santos, Wagner L. Prado, William R. Tebar, Jared Ingles, Gerson Ferrari, Priscila K. Morelhão, Luan O. Borges, Raphael M. Ritti Dias, Victor S. Beretta, and Diego G.D. Christofaro

Subjects
Sedentary behavior, Sleep quality, Television, Exercise, Youth, Medicine
Abstract

Background: Time spent on screen devices affects sleep quality and duration leading to several health impairments in youth. Although physical activity (PA) benefits sleep patterns and decreases screen time in adolescents, it is unclear whether the relationship between sleep quality/duration and screen time could be influenced by PA levels. Objective: To analyze the association between sleep quality and duration with screen time in Brazilian adolescents according PA levels. Methods: The sample included 1010 adolescents aged 13.2 ± 2.4 years (n = 556 females − 55 % of the sample). Sleep quality and sleep duration, and PA were assessed by Mini Sleep and Baecke questionnaires, respectively. Participants in the highest quartile were classified as physically active. Screen time was analyzed by the self-reported number of hours spent on different screen devices (i.e., television, computer, videogame, and cellphone/tablet). Participants in the highest tertile were classified as having high screen time. Sex, age, and body mass index were considered covariates in binary logistic regression models. Results: Poor sleep quality was observed in 52.3 % of the sample, whereas 46.6 % reported sleeping less than eight hours/day. High screen time was associated with poor sleep quality (OR = 1.45; 95 %CI = 1.01–2.12) and insufficient sleep duration (OR = 1.52; 95 %CI = 1.01–2.03) in adolescents insufficiently active. There were no associations between screen time and sleep parameters in active adolescents. Conclusion: High screen time was associated with poor sleep quality and insufficient sleep duration only in insufficiently active adolescents. These results suggest that high PA levels may contribute to improving sleep patterns in pediatric population.

Published
2024
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5. Association of Early Sports Practice with Cardiovascular Risk Factors in Community-Dwelling Adults: A Retrospective Epidemiological Study

Author

Gabriela C. R. da Silva, William R. Tebar, Bruna T. C. Saraiva, Breno Q. Farah, Luiz Carlos M. Vanderlei, Gerson Ferrari, and Diego Giulliano Destro Christofaro

Subjects
Physical activity, Cardiometabolic, Youth, Motor behavior, Health, Sports medicine, RC1200-1245
Abstract

Key Points Sports practice has a protective effect against cardiovascular risk in children and adolescents. The prevalence of central obesity, diabetes, dyslipidemia and hypertension was lower in participants who reported early sports practice. Early sports practice was a protective factor against hypertension in adult life, independent of current physical activity level.

Published
2023
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6. Association between psoriasis and thyroid function: results from the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil)

Author

Vandrize Meneghini, William R. Tebar, Itamar Souza Santos, Carolina Castro Porto Silva Janovsky, Bianca de Almeida-Pititto, Paulo A. Lotufo, Alessandra C. Goulart, and Isabela M. Bensenor

Subjects
Psoriasis, triiodothyronine, thyroid-stimulating hormone, thyroxine, Medicine, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis.

Published
2023
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8. Patterns of sedentary behavior in adults: A cross-sectional study

Author

Gustavo O. Silva, Paolo M. Cunha, Max D. Oliveira, Diego G. D. Christofaro, William R. Tebar, Aline M. Gerage, Hélcio Kanegusuku, Marilia A. Correia, and Raphael M. Ritti-Dias

Subjects
physical activity, cardiometabolic health, exercise, accelerometer, sitting, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

IntroductionSedentary behavior (SB) has been associated with adverse health outcomes, however, it is not completely clear whether total time in SB during the day or prolonged uninterrupted SB are interrelated. The aim of the current study was to describe the different patterns of SB of adults, their relationships, and associated factors.MethodsThe sample included 184 adults aged ranging from 18 to 59 years old. SB was objectively measured by an accelerometer and the following SB pattern parameters were obtained: total time in sedentary bouts, mean time of sedentary bouts, and total time in sedentary breaks. Demographic data (age and sex), anthropometry [weight, height, body mass index (BMI)], blood pressure (BP), medical history (self-reported comorbid conditions), and cardiac autonomic modulation, were assessed to identify factors associated with SB. Multiple linear regressions were used to analyze the relationship between SB parameters and the associated factors.ResultsThe parameters of SB indicated 2.4 (0.9) h/day for total time in sedentary bouts, 36.4 (7.9) min for the mean time of sedentary bouts, and 9.1 (1.9) h/day for the total time in sedentary breaks. Multiple adjusted regression indicated that age was the only factor associated with SB patterns (p

Published
2023
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9. Relationship of Obesity with Lifestyle and Comorbidities in Public School Teachers—A Cross-Sectional Study

Author

William R. Tebar, Fernanda C. S. Gil, Leandro D. Delfino, Jefferson M. Souza, Jorge Mota, and Diego G. D. Christofaro

Subjects
body mass index, physical activity, screen time, active commuting, chronic diseases, Food processing and manufacture, TP368-456, Nutritional diseases. Deficiency diseases, RC620-627
Abstract

Obesity is one of the major public health burdens, and is a global pandemic that has been associated with lifestyle habits and comorbidities in the general population. Teachers comprise a wide category of workers with unestablished factors associated with obesity. This cross-sectional epidemiological study analyzed the association of obesity, defined by body mass index ≥ 30 kg/m², with work-related factors (years in the profession, hours worked weekly), lifestyle (sports practice, active commuting, TV viewing, smoking, alcohol consumption), and comorbidities (hypertension, diabetes, dyslipidemia) in a sample of 246 public school teachers. An elevated prevalence of obesity was observed in the sample (30.1%), which was associated with ≥2 h/day of TV viewing (OR: 2.10, p = 0.025) and hypertension (OR: 2.62, p = 0.010), whereas it was inversely associated with frequent active commuting by walking or cycling (OR: 0.22, p = 0.007), even after multiple adjustments. No association was observed between obesity and work-related factors. Actions focused on promoting active commuting while limiting TV time could be important strategies for facing the elevated prevalence of obesity in public school teachers. However, the analysis of longitudinal data and investigation of obesogenic determinants are still needed.

Published
2022
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10. Association of High Blood Pressure With Physical Activity, Screen-Based Sedentary Time, and Sedentary Breaks in a 2-Year Cohort of Community Dwelling Adults

Author

William R. Tebar, Gregore Iven Mielke, Raphael M. Ritti-Dias, Kelly Samara Silva, Daniel S. Canhin, Catarina C. Scarabottolo, Jorge Mota, and Diego G. D. Christofaro

Subjects
sedentary behavior, epidemiology, hypertension, lifestyle habits, cardiovascular risk factor, Public aspects of medicine, RA1-1270
Abstract

Objective: This study analyzed the association of high blood pressure (HBP) with physical activity, sedentary behavior, and sedentary breaks in 2-year follow-up.Methods: A sample of 331 middle-aged and older adults (mean age of 59.6 ± 17.3 years) was randomly selected and assessed at baseline and after 2 years of follow-up. HBP was considered as ≥140/90 mmHg values of systolic and diastolic blood pressure. Physical activity, sedentary behavior, and sedentary breaks were assessed by questionnaire. Age, sex, socioeconomic status, and body mass index were covariates.Results: Continuous HBP was observed in 26.3% of sample between baseline and follow-up. Adults who reported continuously high sedentary breaks at leisure activities were less likely to have HBP (OR = 0.34, p = 0.011), as well as those who remained high physically active (OR = 0.41, p = 0.016), even after mutual adjustment. No association was observed between high sedentary behavior and HBP at follow-up.Conclusion: Community dwelling adults who were high active and performed frequent sedentary breaks were less likely to have HBP in 2-year follow-up. Strategies for HBP control should considered both physical activities and leisure sedentary breaks in adult population.

Published
2022
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11. Does physical activity moderate the association between device-measured sedentary time patterns and depressive symptoms in adults?

Author

André O. Werneck, Aaron Kandola, William R. Tebar, Danilo R. Silva, Brendon Stubbs, and Diego G.D. Christofaro

Subjects
Exercise, sedentary behavior, sitting, depression, mood, Psychiatry, RC435-571
Abstract

Objectives: To investigate the association between sedentary time (ST) patterns and depressive symptoms, and whether moderate-to-vigorous physical activity (MVPA) can moderate this association. Methods: This cross-sectional study included a representative sample of 243 adults (mean age 41.8±16.7 years, 56.4% women) from a city in Southeast Brazil. Depressive symptoms were estimated through the Hospital Anxiety and Depression Scale (HADS). ST patterns (i.e., number of breaks, mean length of sedentary bouts, and number of long sedentary bouts), total ST, and MVPA were assessed using accelerometers. Results: Poisson regression models revealed associations of total ST (β = 0.063; 95%CI 0.011 to 0.116) and number of long bouts (0.108; 0.047 to 0.171) with depressive symptoms among men. MVPA moderated the associations of breaks and longer bouts of ST with depressive symptoms, with an increase of one break/hour, the increase of one long bout, and a decrease of 1 minute in mean bout length being associated with a reduction of 0.211 and increases of 0.081 and 0.166, respectively, in the number of depressive symptoms among men with physical inactivity (breaks = -0.211; -0.360 to -0.063; mean bout length = 0.081; 0.003 to 0.158; number of long bouts = 0.166; 0.090 to 0.242). Conclusions: Interventions that encourage breaking up ST should be helpful to reduce depressive symptoms among people with physical inactivity. Clinical trial registration: ClinicalTrials.gov (NCT03986879).

Published
2022
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12. Chronic inflammatory diseases, subclinical atherosclerosis, and cardiovascular diseases: Design, objectives, and baseline characteristics of a prospective case-cohort study ‒ ELSA-Brasil

Author

Isabela M. Bensenor, Alessandra C. Goulart, Alexandre C. Pereira, André R. Brunoni, Airlane Alencar, Raul D. Santos, Márcio S. Bittencourt, Rosa W. Telles, Luciana Andrade Carneiro Machado, Sandhi Maria Barreto, Bianca de Almeida-Pititto, Carolina Porto Silva Janovsky, José Augusto Sgarbi, William R. Tebar, Vandrize Meneghini, Fernando Barbosa Junior, Ana Cristina de Medeiros Ribeiro, Sandra Gofinet Pasoto, Rosa Maria R. Pereira, Eloísa Bonfá, Aytan M. Sipahi, Itamar de S. Santos, and Paulo A. Lotufo

Subjects
Chronic Inflammatory disease, Cardiovascular disease, Coronary artery calcium (CAC), Carotid intima-media thickness (CIMT), Fatal and non-fatal cardiovascular events, Medicine (General), R5-920
Abstract

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

Published
2022
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13. Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders

Author

Edner F. Zanuto, Raphael M. Ritti‐Dias, William R. Tebar, Catarina C. Scarabottolo, Leandro D. Delfino, Juliano Casonatto, Luiz Carlos M. Vanderlei, and Diego Giulliano Destro Christofaro

Subjects
Pediatrics, RJ1-570
Abstract

Objective: Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. Method: The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self‐reported and used to adjust the analysis, through hierarchical linear regression. Results: Total physical activity was associated with low RHR in boys (β = −0.52; 95% CI: −0.92, −0.12) and girls (β = −0.67; 95% CI: −1.07, −0.28). Although sporting physical activities were associated with low RHR in both boys (β = −0.58; 95% CI: −1.05, −0.11) and girls (β = −0.87; 95% CI: −1.34, −0.39), occupational physical activity was related to low RHR only in boys (β = −1.56; 95% CI: −2.99, −0.14). Conclusion: The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys. Resumo: Objetivo: Investigar a relação entre diferentes domínios de atividade física e frequência cardíaca de repouso (FCRep) em meninos e meninas. Método: A amostra incluiu 1.011 adolescentes, entre 10 e 17 anos. A FCRep foi medida por um monitor de frequência cardíaca e a atividade física foi avaliada no total e em três diferentes domínios (escolar, ocupacional e prática esportiva) através de um questionário. A antropometria foi obtida diretamente para o índice de massa corporal e gordura central. Etnia, comportamento sedentário e tabagismo foram autorrelatados e usados para ajustar a análise, através da regressão linear hierárquica. Resultados: A atividade física total foi associada à baixa FCRep nos meninos (β = −0,52; IC95% −0,92; −0,12) e meninas (β = −0,67; IC95% −1,07; −0,28). Embora as atividades físicas esportivas estivessem associadas à baixa FCRep em ambos, meninos (β = −0,58; IC95% −1,05, −0,11) e meninas (β = −0,87; IC95% −1,34, −0,39), a atividade física ocupacional estava relacionada à baixa FCRep apenas em meninos (β = −1,56; IC95% −2,99; −0,14). Conclusão: A prática de atividade física no domínio da prática esportiva e a atividade física total foram relacionadas à baixa FCRep em ambos os sexos, enquanto as atividades físicas ocupacionais foram associadas à FCRep apenas em meninos. Keywords: Physical activity, Resting heart rate, Sedentary behavior, School, Palavras‐chave: Atividade física, Frequência cardíaca de repouso, Comportamento sedentário, Escola

Published
2020
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14. Physical Activity Is Associated With Improved Eating Habits During the COVID-19 Pandemic

Author

Diego G. D. Christofaro, André O. Werneck, William R. Tebar, Mara C. Lofrano-Prado, Joao Paulo Botero, Gabriel G. Cucato, Neal Malik, Marilia A. Correia, Raphael M. Ritti-Dias, and Wagner L. Prado

Subjects
COVID-19, dietary pattern, exercise, food intake, lyfestyle, lockdown, Psychology, BF1-990
Abstract

The aim of this study was to analyze the association between physical activity and eating habits during the COVID-19 pandemic among Brazilian adults. A sample of 1,929 participants answered an online survey, however 1,874 were included in the analysis. The impact of the COVID-19 pandemic on eating habits was assessed inquiring about participants' intake of fruits, vegetables, fried foods, and sweets during the pandemic. Physical activity was assessed by asking participants about their weekly frequency, intensity and number of minutes/hours engaging in structured physical activities per week. Participants were then stratified into categories based on moderate-to-vigorous intensity (0–30; 31–90; 91–150; 151–300; and >300 min/week) and into active (≥150 min) or inactive (

Published
2021
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15. Increased Screen Time Is Associated With Alcohol Desire and Sweetened Foods Consumption During the COVID-19 Pandemic

Author

William R. Tebar, Diego G. D. Christofaro, Tiego A. Diniz, Mara Cristina Lofrano-Prado, Joao Paulo Botero, Marilia de Almeida Correia, Gabriel G. Cucato, Raphael Mendes Ritti-Dias, and Wagner Luiz do Prado

Subjects
sedentary behavior, dietary pattern, substance use, COVID-19, pandemic, Nutrition. Foods and food supply, TX341-641
Abstract

Background: Elevated screen time has been associated with addictive behaviors, such as alcohol and sugar intake and smoking. Considering the substantial increase in screen time caused by social isolation policies, this study aimed to analyze the association of increased screen time in different devices during the COVID-19 pandemic with consumption and increased desire of alcohol, smoking, and sweetened foods in adults.Methods: A sample of 1,897 adults with a mean age of 37.9 (13.3) years was assessed by an online survey, being composed by 58% of women. Participants were asked whether screen time in television, cell phone, and computer increased during the pandemic, as well as how much time is spent in each device. Closed questions assessed the frequency of alcohol and sweetened food consumption, smoking, and an increased desire to drink and smoke during the pandemic. Educational level, age, sex, feeling of stress, anxiety, depression, and use of a screen device for physical activity were covariates. Binary logistic regression models considered adjustment for covariates and for mutual habits.Results: Increased television time was associated with increased desire to drink (OR = 1.46, 95% CI: 1.12; 1.89) and increased sweetened food consumption (OR = 1.53, 95% CI: 1.18; 1.99), while an increase in computer use was negatively associated with consumption of alcohol (OR = 0.68, 95% CI: 0.53; 0.86) and sweetened foods (OR = 0.78, 95% CI: 0.62; 0.98). Increased cell phone time was associated with increased sweetened food consumption during the pandemic (OR = 1.78, 95% CI: 1.18; 2.67). Participants with increased time in the three devices were less likely to consume sweetened foods for ≥5 days per week (OR = 0.63, 95% CI: 0.39; 0.99) but were twice as likely to have sweetened food consumption increased during pandemic (OR = 2.04, 95% CI: 1.07; 3.88).Conclusion: Increased screen time was differently associated with consumption and desire for alcohol and sweets according to screen devices. Increased time in television and cell phones need to be considered for further investigations of behavioral impairments caused by the pandemic.

Published
2021
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16. Reduction of Physical Activity Levels During the COVID-19 Pandemic Might Negatively Disturb Sleep Pattern

Author

Tiego A. Diniz, Diego G. D. Christofaro, William R. Tebar, Gabriel G. Cucato, João Paulo Botero, Marilia Almeida Correia, Raphael M. Ritti-Dias, Mara C. Lofrano-Prado, and Wagner L. Prado

Subjects
sleep, COVID-19, physical activity, exercise, health, Psychology, BF1-990
Abstract

BackgroundThe outbreak of novel coronavirus disease 2019 (COVID-19) has caused a global panic and public concern due to its mortality ratio and lack of treatments/vaccines. Reduced levels of physical activity have been reported during the outbreak, affecting the normal daily pattern.ObjectiveTo investigate (i) the relationship of physical activity level with sleep quality and (ii) the effects of reduction physical activity levels on sleep quality.MethodsA Google form was used to address personal information, COVID-19 personal care, physical activity, and mental health of 1,907 adult volunteers. Binary logistic regression was used to verify the association of physical activity parameters and sleep quality.ResultsInsufficient physical activity levels were a risk factor to have disturbed sleep pattern [OR: 1.28, 95% CI (1.01–1.62)]; however, when the BMI was added to the analysis, there was no more statistical difference [OR: 1.23, 95% CI (0.96–1.57)]. On the other hand, we found that the reduction of physical activity levels was associated with negative changes in sleep quality [OR: 1.73, 95% CI (1.37–2.18)], regardless all the confounders [OR: 1.30, 95% CI (1.01–1.68)], unless when feeling of depression was added in Model 6 [OR: 1.28, 95% CI (0.99–1.66)].ConclusionDisruption in daily physical activity routine, rather than physical activity level, negatively influences sleep quality during the COVID-19 quarantine.

Published
2020
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17. Association of Early Sports Participation With Sedentary Behavior in Community-Dwelling Adults—The Role of Sociodemographic Factors in a Retrospective Epidemiological Study

Author

William R. Tebar, Luan O. Borges, Leandro D. Delfino, Jorge Mota, Raphael M. Ritti-Dias, and Diego G.D. Christofaro

Subjects
Orthopedics and Sports Medicine
Abstract

Background: The role of sociodemographic factors in the association between early sports participation (ESP) and sedentary behavior is unclear. We analyzed the association of ESP with sedentary behavior and identified the influence of sociodemographic factors in adulthood. Methods: A sample of 264 community-dwelling adults was randomly assessed (42.6 [17.0] y old, 57.6% women). Sociodemographic factors (age, gender, and socioeconomic status) and ESP (retrospectively) were assessed by questionnaire. Sedentary behavior was measured by accelerometer and self-reported for domains identification. The association between ESP and sedentary behavior domains and sociodemographic factors was analyzed by Poisson regression and presented in prevalence ratio (PR). Sociodemographic factors were separately included as covariates to identify their role in the main association analysis. Results: The ESP prevalence was 56.4% (n = 149). ESP participants included a higher proportion of men (59.7% vs 20.0%), had a lower age (36.8 [15.3] vs 50.8 [15.9]), and included a smaller proportion of individuals with low socioeconomic status (24.8% vs 43.5%) compared with those without ESP. The ESP was inversely associated with older age (PR = 0.58, P P P P = .036), and TV watching (PR = 0.67, P = .011). ESP was associated with driving (PR = 1.50, P = .028), office/paper work (PR = 1.63, P = .012), and using a cellphone (PR = 1.60, P = .009). The age was the main confounding factor of association between ESP and sedentary behavior, followed by socioeconomic status. No mediation role was identified. Conclusion: The ESP was associated with mentally active behavior domains and inversely associated with mentally passive sedentary behavior domains, but this association was majorly affected by sociodemographic factors, mainly by age.

Published
2023

18. Association of Musculoskeletal Pain With Sedentary Behavior in Public School Teachers: The Role of Habitual Physical Activity

Author

Jefferson M. de Souza, William R. Tebar, Leandro D. Delfino, Fernanda S.G. Tebar, Luis A. Gobbo, Marcia Franco, Claudiele C.M. da Silva, Crystian B.S. Oliveira, and Diego G.D. Christofaro

Subjects
Advanced and Specialized Nursing
Abstract

Sedentary behavior has been associated with musculoskeletal pain in school teachers. However, our hypothesis is that physical activity practice could mitigate this association.The aim of this study was to investigate the relationship of musculoskeletal pain with high screen-based sedentary behavior among public school teachers and whether physical activity could mitigate this relationship.A sample of 246 teachers from 13 public schools were assessed (45.0 ± 10.4 years, 76.0% of women). Musculoskeletal pain was assessed using the Nordic Musculoskeletal Questionnaire, screen-based sedentary behavior was measured considering the sum of screen time in television, computer, and smartphone/tablet, and physical activity using the Baecke habitual physical activity questionnaire. Binary logistic regression was used to verify the associations between high screen-based sedentary behavior and musculoskeletal pain in school teachers (Model 1-unadjusted; Model 2-adjusted by age, sex, and socioeconomic status; Model 3-variables of Model 2 + adjusted by physical activity).High screen-based sedentary behavior was associated with pain in neck (odds ratio = 2.09; 95%confidence interval = 1.08-4.04), upper back (odds ratio = 2.21; 95%confidence interval = 1.07-4.56), and low back (odds ratio = 1.91; 95%confidence interval = 1.00-3.65). However, after inserting the variables, including physical activity, these associations were mitigated.High screen-based sedentary behavior was associated with musculoskeletal pain in public school teachers. However, this relationship was mitigated after the inclusion of confounding variables, including physical activity.

Published
2023

19. Anxiety is more related to inadequate eating habits in inactive than in physically active adults during COVID-19 quarantine

Author

Diego G.D. Christofaro, William R. Tebar, Gabriela C.R. Silva, Mara C. Lofrano-Prado, Joao Paulo Botero, Gabriel G. Cucato, Neal Malik, Kristina Hollands, Marilia A. Correia, Raphael M. Ritti-Dias, and Wagner L. Prado

Subjects
Adult, Male, Nutrition and Dietetics, SARS-CoV-2, Endocrinology, Diabetes and Metabolism, B100, COVID-19, Feeding Behavior, Anxiety, C600, Quarantine, Humans, Female, Pandemics
Abstract

Background & aims: Anxiety can be related to reduced diet quality during pandemics such as COVID-19. However, it is not clear whether these relationships would be similar in inactive and physically active participants. The aim of this study was to analyze associations between anxiety and eating habits in physically active and inactive individuals during the COVID-19 pandemic. Methods: The sample consisted of 1826 adults (58.5% women) who were invited through social media to answer an online questionnaire. The instrument included questions related to physical activity, eating habits, health behavior, mental health (anxiety, depression, self-esteem, sadness and stress) and overall health. Anxiety, food habits (high food habits consumption ≥5 times per week) and physical activity (≥150 min per week) were assessed during the COVID-19 pandemic. The relationship between anxiety and eating habits according to levels of physical activity (inactive vs. active) was assessed using binary logistic regression adjusted for sex, age, education level, social isolation, and body mass index. Results: Among the inactive participants, anxiety was related with high consumption of sweets (OR = 1.43; 95% CI = 1.11–1.83) and fast foods (OR = 2.23; 95% CI = 1.05–4.74) while quarantining during the COVID-19 pandemic. No relationship was observed between anxiety and food consumption among physically active participants in the final model. Conclusion: Anxiety was associated with less desirable eating habits among physically inactive adults during the COVID-19 pandemic.

Published
2022

20. Does sedentary behaviour contribute to the development of a new episode of low back pain? A systematic review of prospective cohort studies

Author

Tatiana M. Damato, Diego G. D. Christofaro, Marina B. Pinheiro, Priscila K. Morelhao, Rafael Z. Pinto, Danilo De Oliveira Silva, William R. Tebar, Guilherme Henrique Dalaqua Grande, and Crystian B. Oliveira

Subjects
Adult, Young Adult, Anesthesiology and Pain Medicine, Humans, Prospective Studies, Middle Aged, Sedentary Behavior, Prognosis, Exercise, Low Back Pain
Abstract

To investigate whether the sedentary behaviour contributes to the development of new episodes of low back pain in adults.Searches were performed in five electronic databases from their inception to March 2022. Prospective cohort studies with people without low back pain at baseline investigating the effect of sedentary behaviour on the development of new episodes of low back pain at follow-up were considered eligible. Two independent authors screened, extracted the data and assessed the risk of bias of included studies. An adapted version of the Quality In Prognosis Studies (QUIPS) tool was used to assess the risk of bias. Meta-analyses were performed using random effect models to obtain a pooled risk ratio (RR) and 95% confidence intervals (CIs). Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the overall certainty of the evidence.Ten studies were included in this review, with a total sample ranging from 107 to 57,504 participants and mean age ranging from 21.7 to 53.6 years. Most studies (n = 9) assessed sedentary behaviour using self-reported methods, including validated questionnaires or single questions, except for one study that used video recording. The overall risk of bias of the included studies was low. Pooled analysis showed that people classified as sedentary or spending more time in sedentary activities were not likely to develop a new episode of low back pain (RR 1.01, 95% CI 0.98-1.04, ISedentary behaviour probably does not contribute to the development of new episodes of low back pain in an adult population.Sedentary behaviour does not appear to increase the chances of developing a new episode of low back pain. This might imply that health lifestyle contributors seem to be more related to the amount and type of physical activity, but not the amount of sedentary time. However, studies evaluating the relationship of the sedentary and physical activity with the development of a new episode of low back pain are still needed.

Published
2022

21. Abstract P676: Association of Lipoprotein Subfractions With Atherosclerosis in the Baseline Sample of ELSA-Brasil Cohort Study - A Cross-Sectional Analysis

Author

William R Tebar, Vandrize Meneghini, Alessandra C Goulart, Itamar S Santos, Raul D Santos, Marcio S Bittencourt, Giuliano Generoso, Alexandre Pereira, Michael J Blaha, Steven R Jones, Peter P Toth, James D Otvos, Paulo A Lotufo, and Isabela M Bensenor

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Introduction: The association between lipoprotein subparticles and atherosclerosis is not consistent in literature. For example, it is still unclear whether low-density lipoprotein particles (LDLP), high-density lipoprotein particles (HDLP), and triglyceride-rich lipoprotein particles (TRLP) were associated with carotid artery plaque (CAP) in adult population. Objective: We analyzed the cross-sectional association of LDLP, HDLP, and TRLP subparticles with CAP at ELSA-Brasil baseline. Methods: Data from 3801 participants (median age of 50.0[44.0-57.0] years, 54.3% of women) with no previous cardiovascular (CV) disease and without using lipid-lowering medications were analyzed. CAP presence was assessed by ultrasound images, while LDLP (total, large, medium and small), HDLP (total, large, medium and small) and TRLP (total, very large, large, medium, small and very small) were analyzed by nuclear magnetic resonance spectroscopy. Logistic regression models included all lipoprotein subparticles simultaneously and were adjusted by sociodemographic (age, sex, ethnicity, education, private health insurance) and CV risk factors (body mass index, smoking, alcohol consumption, family history of CV disease, diabetes, hypertension), with odds ratios (OR) and respective 95% confidence interval according to 1 standard deviation increase in the predictor. Results: The prevalence of CAP was 33.9% (n=1287). Participants with CAP had higher age (median 55.0 vs. 47.0, p Conclusion: The LDLP (large, medium and small) and TRLP (small and very small) were associated with CAP beyond sociodemographic and CV risk factors. This finding is in line with CV risk burden of large LDLP besides small LDLP and highlights a potential role of TRLP in atherosclerosis. However, further investigation between LDLP and TRLP with CAP progression is still needed.

Published
2023

22. Depressive Symptoms Associated With Musculoskeletal Pain in Inactive Adults During COVID-19 Quarantine

Author

Marilia de Almeida Correia, Diego Giulliano Destro Christofaro, Raphael Mendes Ritti-Dias, Mara Cristina Lofrano-Prado, João Paulo Botero, Gabriel Grizzo Cucato, Wagner Luiz do Prado, William R. Tebar, Gabriela C. R. Silva, Max Duarte de Oliveira, Universidade Estadual Paulista (UNESP), Northumbria University, Human Movement Science and Rehabilitation Graduation Program. Sao Paulo Federal University, Universidade Nove de Julho, California State University, and Independent researcher

Subjects
Adult, Male, Musculoskeletal pain, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Physical activity, Computer-assisted web interviewing, Musculoskeletal Pain, Humans, Medicine, Pandemics, Depression (differential diagnoses), Depressive symptoms, Advanced and Specialized Nursing, Depression, SARS-CoV-2, business.industry, COVID-19, Physical activity level, Cross-Sectional Studies, Quarantine, Physical therapy, Female, Original Article, Body region, business
Abstract

Made available in DSpace on 2022-04-28T19:44:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-02-01 Background: Depression has been associated with episodes of musculoskeletal pain. However, it is not clear whether such relationships could be mitigated according to the physical activity level. Aim: To describe, during the COVID-19 pandemic, the relationship between depression and musculoskeletal pain according to the physical activity levels. Design: Cross-sectional study. Methods: This research was conducted in Brazil between May 5 and March 17, 2020. Participants (N = 1872; 58% women) were invited through social media to answer a structured online questionnaire. Depressive symptoms were assessed through self-report of perception of depression during quarantine. Musculoskeletal pain was assessed based on the Nordic questionnaire identifying nine possible pain points in the body. Physical activity was assessed based on the weekly frequency, intensity, and duration of each session of physical activity the participants engaged in during COVID-19. The logistic binary regression analyzed the associations between depressive symptoms and musculoskeletal pain according to the participants’ level of physical activity. Results: Depressive symptoms were associated with pain in six different regions of the body in physically inactive participants. In physically inactive participants, those with depressive symptoms 1.51 (95% CI = 1.04-2.19) and 2.78 (95% CI = 1.81-4.26) times more likely to have pain in one or two and ≥three regions body regions, respectively. In active participants, depressive symptoms were not associated with pain. Conclusion: During the COVID-19 pandemic, depression was associated with musculoskeletal pain in physically inactive participants. São Paulo State University (Unesp) School of Technology and Sciences, SP Department of Sport Exercise and Rehabilitation Northumbria University, England Human Movement Science and Rehabilitation Graduation Program. Sao Paulo Federal University Universidade Nove de Julho California State University Independent researcher São Paulo State University (Unesp) School of Technology and Sciences, SP

Published
2022

23. Association between Leisure-Time and Commute Physical Activity and Pre-Diabetes and Diabetes in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Author

Yuri Sánchez-Martínez, Alessandra C. Goulart, Bianca de Almeida-Pititto, Bruce B. Duncan, Maria Inês Schmidt, Itamar de Souza Santos, Paulo A. Lotufo, William R. Tebar, and Isabela M. Benseñor

Subjects
Health, Toxicology and Mutagenesis, lifestyle, exercise, chronic diseases, insulin resistance, epidemiology, Public Health, Environmental and Occupational Health
Abstract

Background: Diabetes is an important public health problem due to its health impairments and high costs for health services. We analyzed the relationship between the domains of physical activity at leisure-time (LTPA) and at commuting (CPA) with diabetes and pre-diabetes in an ELSA-Brasil study. Methods: Data from 11,797 participants (52.5% women, 49.1 ± 7.2 years) were analyzed. LTPA and CPA were measured using the International Physical Activity Questionnaire. Diabetes and pre-diabetes were defined by medical history, medication use to treat diabetes or blood glucose. Logistic regression models were performed to estimate the association between LTPA and CPA with diabetes and pre-diabetes after adjustment for sociodemographic and cardiovascular risk factors. Results: The prevalence of LTPA and CPA was 24.4% and 34%, respectively. Physically active participants at LTPA were less likely to have pre-diabetes (OR = 0.86 [95% CI = 0.77–0.95]) and diabetes (OR = 0.80 [95% CI = 0.69–0.93]), compared with inactive participants. No association between CPA and diabetes/pre-diabetes was observed. LTPA was inversely associated with diabetes among men (OR = 0.73 [95% CI = 0.60–0.89]), but was not associated among women. Women who were active (OR = 0.78 [95% CI = 0.67–0.90]) (OR = 0.79 [95% CI = 0.65–0.95]) at LTPA were less likely to have pre-diabetes, than inactive women. Conclusion: LTPA was inversely associated with diabetes and pre-diabetes in the ELSA-Brasil participants. A different behavior was observed between genders.

Published
2023
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24. Association Between Physical Activity Levels in Different Domains and Cardiac Autonomic Modulation in Breast Cancer Survivors

Author

Mariana R. Palma, Luiz Carlos M. Vanderlei, Giuliano Tosello, Cristina Fregonesi, Fernanda E. Ribeiro, Gabriel G. Cucato, Raphael M. Ritti-Dias, William R. Tebar, and Diego Giulliano Destro Christofaro

Subjects
Oncology, Oncology (nursing)
Abstract

Breast cancer survivors frequently present cardiac autonomic dysfunction. Physical activity (PA) has been associated with better cardiac autonomic modulation (CAM) in breast cancer survivors.This study aimed to analyze the association between CAM and PA levels performed in different domains (work and occupation, sport and exercise, and leisure time and commuting) in breast cancer survivors.This is a cross-sectional study with 99 breast cancer survivors (age, 55.3 ± 10.4 years). Cardiac autonomic modulation was assessed by heart rate variability, and PA levels at work and occupation, sport and exercise, and leisure time and commuting were assessed using the Baecke PA questionnaire. The sum of these 3 domains provided the total PA. The Mann-Whitney test was used to compare CAM between active and inactive women in different domains of PA.Cardiac autonomic modulation was similar between active and inactive women in the different domains (P.05). However, when considering the total PA, active breast cancer survivors presented higher SDNN (average standard deviation of all normal RR intervals) (20.0 ± 13.4 vs 28.8 ± 14.0; P = .008) and SD2 (standard deviation of the long-term intervals between consecutive heartbeats) indices (29.2 ± 17.3 vs 38.7 ± 19.9; P = .005) compared with their inactive counterparts.Breast cancer survivors with higher total PA presented better CAM compared with their less active peers.The results of this study are promising and show the importance of increasing PA levels in different domains for the maintenance of cardiovascular health among breast cancer survivors.

Published
2022

25. Impact of COVID-19 pandemic on physical activity level and screen time is associated with decreased mental health in Brazillian adults: A cross-sectional epidemiological study

Author

Daniela T. Caldeira Silva, Wagner L. Prado, Gabriel G. Cucato, Marilia A. Correia, Raphael M. Ritti-Dias, Mara C. Lofrano-Prado, William R. Tebar, and Diego G.D. Christofaro

Subjects
Adult, Depression, COVID-19, B100, Anxiety, A300, Screen Time, Psychiatry and Mental health, Cross-Sectional Studies, Mental Health, Quality of Life, Humans, Exercise, Pandemics, Biological Psychiatry
Abstract

The objective was to verify whether the impact of COVID-19 on physical activity and screen time was associated with the impact on quality of life and symptoms of anxiety and depression in a sample of Brazilian adults. The invitation was made through social networks and the collection was carried out through electronic research. There was a decrease in quality of life and physical activity, and an increase in symptoms of anxiety and depression and screen time. These findings are important for new strategies that promote physically active habits during the pandemic .

Published
2022

26. Waist circumference was associated with 2-year blood pressure change in community dwelling adults independently of BMI

Author

Diego Giulliano Destro Christofaro, Gregore I. Mielke, Jorge Mota, Daniel S Canhin, Kelly Samara da Silva, Catarina Covolo Scarabottolo, Raphael Mendes Ritti-Dias, William R. Tebar, Universidade Estadual Paulista (UNESP), UNINOVE, Universidade Federal de Santa Catarina (UFSC), The University of Queensland, and Faculty of Sports - University of Porto (FADEUP)

Subjects
Adult, medicine.medical_specialty, Waist, Blood pressure change, Blood Pressure, Assessment and Diagnosis, Body Mass Index, Risk Factors, Internal medicine, Internal Medicine, medicine, Adults, Humans, Adiposity, Aged, Advanced and Specialized Nursing, business.industry, Abdominal obesity, General Medicine, Overweight, Middle Aged, Circumference, Cardiovascular health, Blood pressure, Hypertension, Cardiology, Independent Living, Waist Circumference, Cardiology and Cardiovascular Medicine, business
Abstract

Made available in DSpace on 2022-04-28T19:49:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-02-01 Objective The present study aimed to analyze the association of 2-year changes in BMI and waist circumference with changes in blood pressure (BP) in a randomized sample of community-dwelling adults. Methods A sample of 331 middle-aged and older adults (mean age of 59.6±17.3years) was randomly selected. Measurements of SBP and DBP, BMI, and waist circumference were collected at baseline and after 2-year follow-up. Chronological age, sex, socioeconomic status, ethnicity, and self-reported medical diagnosis and use of medication for hypertension, diabetes, and high low-density lipoprotein-cholesterol were covariates. Multiple linear regression models were adopted for statistical analysis. Results SBP was positively associated with BMI (β=0.48, P=0.013) and waist circumference (β=0.21, P=0.005) at baseline and only with waist circumference at follow-up (β=0.20, P=0.007). DBP was positively associated with BMI (β=0.31, P=0.009) and waist circumference (β=0.12, P=0.006) values at baseline and at follow-up (BMI β=0.42, P=0.001; waist circumference β=0.18, P=0.001). Only the 2-year changes in waist circumference were associated to changes in SBP (β=0.33, P=0.013), regardless of confounding factors and BMI. Conclusion It is suggested that waist circumference is the main factor for control over the time in strategies focused on BP management in adult population. Movement Science Post-graduation Program Physical Education Department Universidade Estadual Paulista - Unesp Post-graduation Program in Rehabilitation Science Universidade Nove de Julho UNINOVE Post-Graduation Program in Physical Education Physical Education Department Universidade Federal de Santa Catarina - UFSC Centre for Research on Exercise Physical Activity and Health School of Human Movement and Nutrition Sciences The University of Queensland Research Center in Physical Activity health and Leisure (CIAFEL) Laboratory for Integrative and Translational Research in Population Health (ITR) Faculty of Sports - University of Porto (FADEUP) Movement Science Post-graduation Program Physical Education Department Universidade Estadual Paulista - Unesp

Published
2021

27. Leisure-time exercise is associated with lower depressive symptoms in community dwelling adults

Author

Jorge Mota, Stefany C B Silva, Leonardo Gomes, Tatiana M. Damato, William R. Tebar, Diego Giulliano Destro Christofaro, André O. Werneck, Beatriz A S Aguilar, Universidade Estadual Paulista (Unesp), University of Porto, and Universidade de São Paulo (USP)

Subjects
Adult, Leisure time, Physical activity, 030209 endocrinology & metabolism, Physical Therapy, Sports Therapy and Rehabilitation, 03 medical and health sciences, Leisure Activities, 0302 clinical medicine, Humans, Medicine, Orthopedics and Sports Medicine, Exercise, domains, Depression (differential diagnoses), Depressive symptoms, Depression, business.industry, 030229 sport sciences, General Medicine, Mental health, accelerometer, Cross-Sectional Studies, depression, Independent Living, intensity, business, Clinical psychology
Abstract

Made available in DSpace on 2021-06-25T10:26:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Physical activity has been associated with enhanced mental health among adults. However, it is not clear in the literature which domains (occupational, transport and leisure-time exercise) and intensities (moderate, vigorous and moderate-to-vigorous) of activity provide the greatest benefits. The aim of the present study was to describe the association of different domains and intensities of physical activity with depressive symptoms in adults. This was a cross-sectional observational study conducted among 209 adults (≥18 years) in Brazil. Depressive symptoms were assessed using the HADS questionnaire (Hospital Anxiety and Depression Scale). Physical activity intensities (moderate, vigorous and moderate-to-vigorous) were device-measured by accelerometry. Physical activity in different domains (occupational, transport, and leisure-time exercise) was self-reported using a questionnaire. Chronological age, ethnicity, body mass index, highest academic achievement, employment status, alcohol consumption, tobacco smoking, chronic morbidity and soft-drink ingestion were adopted as adjustment confounding factors. Linear regression analysis revealed that total self-reported physical activity [β = –0.100 (95%CI: –0.180 to –0.019)] and leisure-time exercise [β = –0.311 (95%CI: –0.468 to –0.155)] were negatively associated with depressive symptoms, but only leisure-time exercise remained significant after adjustment for confounding factors [β = –0.243 (95%CI: –0.409 to –0.076)]. Thus, leisure-time exercise was cross-sectionally associated with lower depressive symptoms in community-dwelling adults. Highlights Leisure-time physical activity was the only physical activity domain associated with lower depressive symptoms. This association appears to be independent of potential confounders. Potential interventions should focus on leisure-time domain. São Paulo State University (Unesp) School of Technology and Sciences Research Center on Physical Activity Health and Leisure (CIAFEL) Faculty of Sport University of Porto Universidade de São Paulo (USP) Center for Epidemiological Research in Nutrition and Health Department of Nutrition School of Public Health Universidade de São Paulo (USP) São Paulo State University (Unesp) School of Technology and Sciences

Published
2021

28. Body dissatisfaction and its association with domains of physical activity and of sedentary behavior in a sample of 15,632 adolescents

Author

Daniela Tanajura Caldeira Silva, Ana Elisa von Ah Morano, William R. Tebar, Diego Giulliano Destro Christofaro, Lucas Antônio Colognesi, Daniel S Canhin, and Universidade Estadual Paulista (Unesp)

Subjects
lifestyle, 050103 clinical psychology, TV viewing, school, Ethnic group, Overweight, Sitting, Physical education, 03 medical and health sciences, 0302 clinical medicine, medicine, 0501 psychology and cognitive sciences, 030212 general & internal medicine, 05 social sciences, Public Health, Environmental and Occupational Health, Odds ratio, medicine.disease, Obesity, Mental health, nutritional status, self-perception, Pediatrics, Perinatology and Child Health, medicine.symptom, Psychology, Body mass index, Demography
Abstract

Made available in DSpace on 2020-12-12T01:28:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Body image is widely related to behavioral factors in adolescents and negative levels has been associated to poor physical and mental health. This study analyzed the association of physical activity and sedentary behavior with body dissatisfaction in adolescents. Data from 15,632 adolescents between 11 and 17 years from the Brazilian National Scholar Health Survey - PeNSE 2015 were analyzed. Body dissatisfaction was self-reported. Sedentary behavior was assessed by hours in television (TV) viewing and in overall sitting behaviors. Physical activity was assessed by amount of time in domains of active commuting, physical education classes at school, and physical activities outside the school. Analyses were adjusted by age, ethnicity, body mass index, and scholarity of mother. Body dissatisfaction prevalence was 18.5%, being higher in girls than boys (24.2 vs. 12.7%, p < 0.001). Female gender (OR = 2.35), higher age-group (OR = 1.64), high scholarity of mother (OR = 1.43), and had overweight/obesity (OR = 2.38/4.81) were positively related to body dissatisfaction. Higher sedentary time was associated with body dissatisfaction in adolescents when compared to less than 2 h/day of sedentary time (OR varying from 1.45 to 2.14). Physical activity was negatively associated with adolescent body dissatisfaction in all assessed domains, with odds ratio varying from 0.66 to 0.89. Body dissatisfaction showed an independent association of with total sedentary behavior (positively) and with different domains of physical activity (negatively) in a large scholar sample of Brazilian adolescents. Movement Sciences Post Graduation Program Sao Paulo State University - UNESP Post Graduation Program in Physiotherapy Sao Paulo State University - UNESP Department of Physical Education Faculty of Sciences and Technology Sao Paulo State University-UNESP, Roberto Simonsen Street, 305 Movement Sciences Post Graduation Program Sao Paulo State University - UNESP Post Graduation Program in Physiotherapy Sao Paulo State University - UNESP Department of Physical Education Faculty of Sciences and Technology Sao Paulo State University-UNESP, Roberto Simonsen Street, 305

Published
2020

29. Association of musculoskeletal pain with poor sleep quality in public school teachers

Author

Claudiele Carla Marques da Silva, Leandro D Delfino, Jefferson Marinho De Souza, William R. Tebar, Diego Giulliano Destro Christofaro, Rafael Z. Pinto, Crystian B. Oliveira, Fernanda C S Gil, Priscila K. Morelhão, Universidade Estadual Paulista (Unesp), and Universidade Federal de Minas Gerais (UFMG)

Subjects
Adult, Male, medicine.medical_specialty, Epidemiology, education, Population, Wrist pain, Logistic regression, Body Mass Index, Body pain, 03 medical and health sciences, 0302 clinical medicine, Musculoskeletal Pain, Sleep Initiation and Maintenance Disorders, Surveys and Questionnaires, Humans, Adults, Medicine, 030212 general & internal medicine, education.field_of_study, business.industry, Rehabilitation, Confounding, Public Health, Environmental and Occupational Health, Sleep disorders, Middle Aged, Low back pain, Occupational Diseases, Cross-Sectional Studies, Physical therapy, Female, Body region, School Teachers, medicine.symptom, business, Body mass index, Brazil, 030217 neurology & neurosurgery
Abstract

Made available in DSpace on 2020-12-12T02:00:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 BACKGROUND: Teachers perform repetitive movements all day, which can cause pain in body regions. This article analyzes the association of pain with sleep quality in this population. OBJECTIVE: The objective of the study was to analyze the relationship of musculoskeletal pain and sleep quality in teachers from public schools. METHODS: The sample consisted of 242 teachers, selected in a random process. Musculoskeletal pain and sleep quality were evaluated by using a questionnaire. The association between sleep quality and musculoskeletal pain was evaluated using the chi-square test. The magnitude of the associations was verified by Binary Logistic Regression, adjusted by sex, age, BMI, and socioeconomic status. RESULTS: Teachers with poor sleep quality presented higher body mass index (BMI) values when compared to teachers with good sleep quality (27.9 vs 26.0, p = 0.012). Teachers with poor sleep quality were approximately twice as likely to report thoracic pain (OR = 2.16[95% CI = 1.12-4.16]), wrist pain (OR = 3.28[95% CI = 1.18-9.07]), low back pain (OR = 3.09[95% CI = 1.29-7.41]), and ankle/foot pain (OR = 2.83[95% CI = 1.32-6.08]). CONCLUSIONS: Teachers with poor sleep quality were approximately twice as likely to present pain in several body parts. Our findings revealed that poor sleep quality was significantly associated with musculoskeletal pain in Brazilian teachers of public schools, regardless of confounding factors. São Paulo State University (Unesp) School of Technology and Sciences Presidente Prudente Department of Physical Therapy Universidade Federal de Minas Gerais (UFMG) São Paulo State University (Unesp) School of Technology and Sciences Presidente Prudente

Published
2020

30. Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders

Author

Catarina Covolo Scarabottolo, Leandro D Delfino, Edner Fernando Zanuto, Luiz Carlos Marques Vanderlei, Juliano Casonatto, Raphael Mendes Ritti-Dias, William R. Tebar, Diego Giulliano Destro Christofaro, Universidade Estadual Paulista (Unesp), Univ Nove Julho, and Univ Norte Parana

Subjects
Male, School, Total physical activity, Adolescent, Atividade física, Physical activity, RESTING HEART RATE, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Surveys and Questionnaires, 030225 pediatrics, Humans, Medicine, 030212 general & internal medicine, Child, Exercise, Escola, business.industry, Frequência cardíaca de repouso, Confounding, Heart rate monitor, lcsh:RJ1-570, lcsh:Pediatrics, Sedentary behavior, Anthropometry, Resting heart rate, Comportamento sedentário, Cross-Sectional Studies, Pediatrics, Perinatology and Child Health, Female, Sedentary Behavior, business, Body mass index, Demography
Abstract

Objective: Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. Method: The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression. Results: Total physical activity was associated with low RHR in boys (β = −0.52; 95% CI: −0.92, −0.12) and girls (β = −0.67; 95% CI: −1.07, −0.28). Although sporting physical activities were associated with low RHR in both boys (β = −0.58; 95% CI: −1.05, −0.11) and girls (β = −0.87; 95% CI: −1.34, −0.39), occupational physical activity was related to low RHR only in boys (β = −1.56; 95% CI: −2.99, −0.14). Conclusion: The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys. Resumo: Objetivo: Investigar a relação entre diferentes domínios de atividade física e frequência cardíaca de repouso (FCRep) em meninos e meninas. Método: A amostra incluiu 1.011 adolescentes, com idade entre 10 e 17 anos. A FCRep foi medida por um monitor de frequência cardíaca e a atividade física foi avaliada no total e em três diferentes domínios (escolar, ocupacional e prática esportiva) através de um questionário. A antropometria foi obtida diretamente para o índice de massa corporal e gordura central. Etnia, comportamento sedentário e tabagismo foram autorrelatados e usados para ajustar a análise, através da regressão linear hierárquica. Resultados: A atividade física total foi associada à baixa FCRep nos meninos (β = -0,52; IC95% -0,92; -0,12) e meninas (β = -0,67; IC95% -1,07; -0,28). Embora as atividades físicas esportivas estivessem associadas à baixa FCRep em ambos meninos (β = -0,58; IC95% -1,05, -0,11) e meninas (β = -0,87; IC95% -1,34, -0,39), a atividade física ocupacional estava relacionada à baixa FCRep apenas em meninos (β = -1,56; IC95% -2,99; - 0,14). Conclusão: A prática de atividade física no domínio da prática esportiva e a atividade física total foram relacionadas à baixa FCRep em ambos os sexos, enquanto as atividades físicas ocupacionais foram associadas à FCRep apenas em meninos. Keywords: Physical activity, Resting heart rate, Sedentary behavior, School, Palavras-chave: Atividade física, Frequência cardíaca de repouso, Comportamento sedentário, Escola

Published
2020

31. Sedentary behavior is associated with musculoskeletal pain in adolescents: A cross sectional study

Author

Lucas da Costa, Italo Ribeiro Lemes, William R. Tebar, Crystian B. Oliveira, Paulo H. Guerra, José Luiz G. Soidán, Jorge Mota, and Diego.G.D. Christofaro

Subjects
Male, Neck Pain, Adolescent, Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation, Cross-Sectional Studies, Musculoskeletal Pain, Back Pain, Humans, Orthopedics and Sports Medicine, Female, Sedentary Behavior, Child, Low Back Pain, Original Research
Abstract

BACKGROUND: High prevalence of back pain has been observed in adolescents. Sedentary behavior (SB) is considered a risk factor for musculoskeletal pain. The association between back pain and SB in the pediatric/adolescent population is not well established. OBJECTIVE: To investigate the association between SB and low back and neck pain in adolescents according to sex. METHODS: This is a cross-sectional study with children and adolescents aged 10-17 years, randomly recruited from public and private schools in Presidente Prudente, Brazil. All students enrolled in the selected schools were eligible to participate. SB was evaluated by adding the number of hours of use of screen devices, such as television, computer, video game, and smartphone/tablet. To assess neck and low back pain, the Nordic Musculoskeletal Questionnaire was used. Physical activity and socioeconomic status were assessed by the Baecke Questionnaire and the Brazilian Criteria for Economic Classification (ABEP), respectively. Odds ratio (OR) from Binary Logistic Regression in the unadjusted and adjusted model (physical activity, abdominal obesity, and socioeconomic status) showed the relationship between musculoskeletal pain and SB. RESULTS: A total of 1011 adolescents (557 girls) with a mean ± standard deviation age of 13.2±2.4 years were included. Moderate (OR = 1.80; 95%CI: 1.00, 3.23) and high (OR = 1.91; 95%CI: 1.02, 3.53) SB were associated with neck pain in girls. In boys, moderate SB [OR = 2.75; 95%CI: 1.31, 5.78) were associated with neck pain. Moderate (OR = 2.73; 95%CI: 1.45, 5.02) and high (OR = 2.49; 95%CI: 1.30, 4.76) SB were associated with low back pain only in girls. CONCLUSION: Moderate and high SB were associated with neck pain in girls and boys, while moderate and high SB were associated with low back pain only in girls.

Published
2022

32. Relationship of sleep quality with screen-based sedentary time and physical activity in adolescents — the moderating effect of body mass index

Author

Tatiana M. Damato, William R. Tebar, Crystian B. S. Oliveira, Bruna T. C. Saraiva, Priscila K. Morelhao, Raphael M. Ritti-Dias, Diego G. D. Christofaro, Universidade Estadual Paulista (UNESP), and Nove de Julho University (UNINOVE)

Subjects
Sedentary behavior, Otorhinolaryngology, Physical activity, Neurology (clinical), Sleep quality, Adolescents, Weight
Abstract

Made available in DSpace on 2022-04-28T19:49:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Objective: To analyze the association of sleep quality with reported screen-based sedentary time and reported physical activity, among overweight adolescents. Methods: Adolescents aged 10 to 17 years enrolled in public and private schools were included. Data collection was carried out during the school semesters of 2014–2015 and participants who did not participate in all evaluations were excluded. Sleep quality and physical activity were assessed by validated questionnaires. Screen-based sedentary time was assessed by self-reported mean daily hours spent on television, computer, smartphone/tablet, and videogames. Body mass index was objectively measured and adolescents were classified into normal weight and overweight according to cutoff points for age and sex. Multiple linear regression models adjusted by covariates (age, sex, ethnicity, and socioeconomic status) were used to analyze the relationship between variables. Results: A total of 1008 adolescents were assessed, with a mean age of 13.2 ± 2.4 years and a mean body mass index of 20.4 ± 4.3 kg/m2. Overweight was observed in 28.0% of sample, while 53.0% reported non-white ethnicity. Self-reported screen-based sedentary time was significantly related to poor sleep quality in adolescents (β = 0.116, p = 0.005), remaining significant only in those who were normal weight (β = 0.101, p = 0.007) in sensitivity analysis. Self-reported physical activity showed no relationship with sleep quality in both normal weight and overweight adolescents. Conclusion: Self-reported screen-based sedentary time was associated with poor sleep quality in adolescents, mainly among those with normal weight. The time spent on screen-based sedentary activities can impair sleep quality even in normal weight adolescents. Department of Physical Therapy Faculty of Science and Technology São Paulo State University (UNESP), Street Gustavo Costa da Silva, 204, Residencial Monte Azul, SP Department of Physical Education Nove de Julho University (UNINOVE) Department of Physical Education Faculty of Science and Technology São Paulo State University (UNESP) Department of Physical Therapy Faculty of Science and Technology São Paulo State University (UNESP), Street Gustavo Costa da Silva, 204, Residencial Monte Azul, SP Department of Physical Education Faculty of Science and Technology São Paulo State University (UNESP)

Published
2022

33. Association of sedentary behavior and early engagement in physical activity with low back pain in adolescents: a cross-sectional epidemiological stud y

Author

Crystian Bitencourt Oliveira, Rafael Z. Pinto, Gabriela C. R. Silva, William R. Tebar, Diego Giulliano Destro Christofaro, Ítalo Ribeiro Lemes, Universidade Federal de Minas Gerais (UFMG), Universidade do Oeste Paulista (UNOESTE), and Universidade Estadual Paulista (UNESP)

Subjects
medicine.medical_specialty, business.industry, Sitting, Logistic regression, Lifestyle, Low back pain, Confidence interval, Epidemiology, medicine, Orthopedics and Sports Medicine, Surgery, Musculoskeletal health, medicine.symptom, business, Sleep, Body mass index, Socioeconomic status, Exercise, Abdominal obesity, Demography
Abstract

Made available in DSpace on 2022-04-28T19:45:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Purpose: To investigate the association of sedentary behavior and physical activity from childhood to adolescence with prevalence of low back pain in adolescents. In addition, we also explored whether sleep quality influences this association. Methods: This is a cross-sectional epidemiological study. Participants (aged 10–17 years) were recruited from public and private schools in Brazil. Sedentary behavior and previous and current engagement in physical activity were assessed through questionnaires. Low back pain and sleep quality were assessed by the Nordic questionnaire and Mini-Sleep Questionnaire, respectively. Sex, age, body mass index, abdominal obesity, socioeconomic status and sleep quality were used as potential confounders. Binary logistic regression models were used to generate values of odds ratio (OR) and 95% confidence intervals (95%CI). Results: A total of 1,001 (44,5% boys; n = 446) were included. Overall prevalence of low back pain was 18%, with higher rates among inactive and sedentary participants. Physical inactivity from childhood to adolescence in combination with high sedentary behavior doubled the likelihood of having low back pain (OR = 2.40 [95%CI: 1.38–4.18]), independent of potential confounders. Sleep quality attenuates, but not eliminates, this association (OR = 2.19 [95%CI: 1.25–3.84]). Conclusion: Being inactive from childhood to adolescence in combination with high sedentary behavior is associated with low back pain in adolescents. Sleep quality seems to attenuate, but not eliminate, this association. Department of Physical Therapy Universidade Federal de Minas Gerais (UFMG), MG Faculdade de Medicina Universidade do Oeste Paulista (UNOESTE), SP Department of Physical Education Universidade Estadual Paulista (UNESP), SP Department of Physical Education Universidade Estadual Paulista (UNESP), SP

Published
2022

34. Effect of Different Sports Practice on Sleep Quality and Quality of Life in Children and Adolescents: Randomized Clinical Trial

Author

Camila Cassemiro Rosa, Crystian B. Oliveira, Juliano Casonatto, Bruna Thamyres Ciccotti Saraiva, William R. Tebar, Breno Quintella Farah, Diego Giulliano Destro Christofaro, Universidade Estadual Paulista (UNESP), Universidade do Oeste Paulista (UNOESTE), Universidade Federal Rural de Pernambuco, and Universidade do Norte do Paraná (UNOPAR)

Subjects
Quality of life, medicine.medical_specialty, Basketball, Children and adolescents, Sports medicine, Physical activity, Psychological intervention, Repeated measures design, Physical Therapy, Sports Therapy and Rehabilitation, Sleep quality, law.invention, Social support, Quality of life (healthcare), Health promotion, Randomized controlled trial, law, Motor behavior, Physical therapy, medicine, Orthopedics and Sports Medicine, Original Research Article, Psychology, human activities, Sport
Abstract

Made available in DSpace on 2022-04-28T19:47:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-12-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Background: Sports practice can promote several health benefits in pediatric populations; nonetheless, most of the studies that investigated these benefits are of cross-sectional design. Thus, our objective was to verify the effectiveness of two types of physical activities through sports, judo and ball games (soccer, volleyball, handball, and basketball) on the quality of sleep and life of Brazilian children and adolescents. Methods: The study is a randomized clinical trial, conducted with 65 participants of both sexes (6–15 years old) in a philanthropic institution in Brazil. The variables investigated were the quality of sleep and life, using the mini-sleep questionnaire and KidsCreen-52 questionnaires (this instrument has a scale ranging from 0 to 100, where 100 is the best value for each domain), respectively. The interventions carried out during 12 weeks (twice a week) were judo and ball games. In the statistical analysis, analysis of variance (ANOVA) for repeated measures was used and the level of statistical significance used was 5%. Results: Judo (P = 0.032) and ball games (P = 0.005) contributed to improving the quality of sleep in the participants. Considering the score of the domains of quality of life, judo and ball games significantly increased the perception of health and physical activity [mean = 6.9 (8.3%) and 8.91 (12.2%) points, respectively], autonomy [mean = 5.81 (7.3%) and 5.00 (6.9%) points], friends and social support (mean = 2.83 (3.8%) and 12.00 (15.9%) points), provocation and bullying [mean = 10.21 (18.1%) and 2.14 (4.1%) points]. Conclusion: It is concluded that both judo and ball games brought benefits to the quality of sleep and life of children and adolescents. Health promotion actions should encourage the increase in sports practice in children and adolescents to improve sleep and quality of life. Department of Physical Education School of Technology and Sciences São Paulo State University (UNESP), Roberto Simonsen Street, n° 305 Universidade do Oeste Paulista (UNOESTE) Universidade Federal Rural de Pernambuco Universidade do Norte do Paraná (UNOPAR) Department of Physical Education School of Technology and Sciences São Paulo State University (UNESP), Roberto Simonsen Street, n° 305 CAPES: 001 (scholarship)

Published
2021

35. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author

Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. Bojesen, Giuseppe Grosso, Seongjun Ha, Lauren Lissner, Mikhail Benet, Anastasia Markaki, Sanjay Rampal, Antônio Augusto Moura da Silva, Maria Lorenza Muiesan, Angelique Chan, Yvonne T. van der Schouw, Annamari Lundqvist, Philippe Amouyel, Kristyna Zejglicova, Charalambos Hadjigeorgiou, João Breda, Jørgen Meisfjord, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Vilma Irazola, Leng Huat Foo, Óscar Lopes, Dickman Gareta, Flavio Nervi, Imre Janszky, Ruzena Kubinova, Terho Lehtimäki, Mario V. Capanzana, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Shuohua Chen, Arvind Pandey, Luigi Palmieri, Roya Kelishadi, Srinivasan Kannan, Jie Mi, Robert Beaglehole, Liliana Dacica, Jyrki K. Virtanen, Mohan Deepa, Peter Ueda, Isti Ilmiati Fujiati, Hermann Pohlabeln, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, Mohsen Azimi-Nezhad, Henry Völzke, Karolina Milkowska, Zahra Mohammadi, Belgin Ünal, Magda Gasull, George S. Stergiou, Marshall K. Tulloch-Reid, Seppo Koskinen, James E. Bennett, Marcela González-Gross, Virginija Dulskiene, Idris Guessous, Assembekov Batyrbek, Kamarul Imran Musa, Jeannette Lee, Josep Redon, Bihungum Bista, Luisa M Macieira, Johan Sundström, Andres Metspalu, Lariane M Ono, Flora A. Ukoli, Salar Rahimikazerooni, Andrea Gualtieri, Trevor S. Ferguson, Félicité Tchibindat, Eliza Cinteza, Ha Tp Do, Tajana Zeljkovic Vrkic, Tuyen D Le, Alison J. Hayes, Abdul Basit, Chandini Nekkantti, Teresa Norat, Eunice Ugel, Gulmira Aitmurzaeva, Mariachiara Di Cesare, Abdul Hamid Zargar, Vincenzo Solfrizzi, Garry L. Jennings, Aline Meirhaeghe, Kaare Christensen, Päivi Mäki, Xu Lin, Ali Esmaeili, Joanna Baran, Aneta Grajda, Renata Cifkova, Alexandre C. Pereira, Martin Bobak, Iuliia A Rusakova, Keiu Nelis, Damian K Francis, Guansheng Ma, Axel C. Carlsson, Alejandro Diaz, Alireza Ansari-Moghaddam, N Capkova, Zumin Shi, Maria Turley, Imelda A. Agdeppa, Helena I. S. Nogueira, Marcia Scazufca, Katharina Maruszczak, Natascia Rinaldo, Paulo A. Lotufo, Nuno Lunet, Thor Aspelund, Caroline H.D. Fall, Antonio Cabrera de León, Ahmad Faudzi Yusoff, Holger Theobald, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Mihai Gafencu, Tandi E. Matsha, Ana B. Crujeiras, Ahmad Reza Dorosty, Alain Morejon, Weili Yan, Dominique Hange, Bekbolat Zholdin, Frédéric Gottrand, Jorge Mota, Jana Námešná, Stevo Popovic, Louise Eriksen, Line Lund Kårhus, Cihangir Erem, Juergen Breckenkamp, Mathilde Kersting, Yi Song, Martin McKee, Aleksandra Gomula, Rafaela Rosário, Enzo Manzato, S. Goya Wannamethee, Sounnia Mediene Benchekor, Azim Nejatizadeh, Krishna Kumar Aryal, Juan P. González-Rivas, Vedrana Sember, Stephen T. McGarvey, Jukka T. Salonen, Patrick Pasquet, Patricia Varona-Pérez, Amelia C. Crampin, Ramin Heshmat, Violeta Iotova, Juvenal Soares Dias-da-Costa, Oye Gureje, Aletta E. Schutte, João Luiz Bastos, Anelise Reis Gaya, Konrad Jamrozik, Dalia Luksiene, Amina Barkat, Maria Paula Santos, José Camolas, Azli Baharudin, Diego Vanuzzo, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, Albertino Damasceno, Davood Khalili, Simona Bo, Martina Müller-Nurasyid, Dominique Cottel, Markku Peltonen, Fikru Tullu, Ana Isabel Rito, Angélica Ochoa-Avilés, Annette J. Dobson, Christopher T. Cowell, Charumathi Sabanayagam, Rildo de Souza Wanderley Júnior, Oanh T. H. Trinh, Farahnaz Joukar, Mostafa K. Mohamed, Mostafa Qorbani, Jeongseon Kim, Helmut Schröder, Machi Suka, Natasja M. van Schoor, Jussi Kauhanen, Teresa Haugsgjerd, Goodarz Danaei, M. Fernanda Lima-Costa, Yong Tao, Elisabetta L. Romeo, Grazyna Jasienska, Victor Guillermo Sequera, Kazem Mohammad, Yanina Zócalo, Fernanda Cunha Soares, Jianfeng Wu, Mohammad Esmaeel Motlagh, María Elena Díaz-Sánchez, Monika Zuziak, Eldridge Ferrer, Anette Varbo, Leila Beltrami Moreira, Jeremy M. Jacobs, Kenneth James, Elena Sacchini, Pascal Bovet, Mahboubeh Parsaeian, Tania Lopez, Ya Xing Wang, Wojciech Drygas, Jody C Miller, Svetlana A. Shalnova, Maria Elisa Zapata, Chung T Nguyen, Nimmathota Arlappa, Edwige Landais, Thorkild I. A. Sørensen, Jeannette Klimont, Amirabbas Momenan, Erik J. Timmermans, Mari-Liis Tammesoo, Jost B. Jonas, Stefania Toselli, Maria Teresa Anselmo Olinto, Bahman Cheraghian, Kouamelan Doua, Esteban Carmuega, Marjeta Mišigoj-Duraković, Bo Werner, M. Arfan Ikram, Breige A. McNulty, Christa Meisinger, Clara Homs, Namuna Shrestha, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Alicia Matijasevich, Alison J Price, Ala'a Alkerwi, Kristine H. Allin, Lorenza Pilotto, Mohannad Al Nsour, Ingunn Holden Bergh, Marianna Noale, Heba Fouad, Vilnis Dzerve, Novie O. Younger-Coleman, Peter Willeit, Andrea R. V. R. Horimoto, Freda Pitakaka, Habiba Ben Romdhane, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Cristina Padez, Sarah P. Garnett, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tien Yin Wong, Rosa Haghshenas, Jonathan Giovannelli, Christina Howitt, Marleen E. Hendriks, Fadia AlBuhairan, Huashuai Chen, Gretchen A Stevens, Luís B. Sardinha, David Goltzman, Jenny M. Kindblom, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Rajendra Pradeepa, Yi-Ting Lin, Martin Neovius, Juan Francisco Miquel, Ellis Owusu-Dabo, Anil Poudyal, Marzieh Katibeh, Tanja Stocks, Veronica Mocanu, Ulla Roggenbuck, Robespierre Ribeiro, Gabriele Eiben, Mary Simon, Christine Cameron, Hamid Hakimi, Kamel Ajlouni, Jakub Stokwiszewski, Iulia Jurca Simina, Pietro Amedeo Modesti, Frederick C. W. Wu, Peter Kristensen, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Martijn Huisman, Betina H. Thuesen, Queenie Chan, Antonisamy Belavendra, Artur Mazur, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Marcos André Moura-dos-Santos, Jean Ferrières, Farhad Zamani, Shina Avi, Yves Kameli, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Thomas Meinertz Dantoft, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Azaliia M Tuliakova, Vera Lanska, Tint Swe Latt, Matthias Bopp, Abbas Rezaianzadeh, Rod Jackson, Johan Van der Heyden, Reecha Sofat, Koen Van Herck, Allan G. Hill, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Stela McLachlan, Ulrike Gehring, Ranko Stevanovic, Nagalla Balakrishna, Lekhraj Rampal, Marjolijn C. E. Bragt, Saeid Eslami, Napoleón Pérez-Farinós, G. K. Mini, Viktoria Anna Kovacs, Rosemarie Martin, Nahla Hwalla, Wei Zheng, Hoang Van Minh, Edward D Janus, Laetitia Huiart, Farhad Pourfarzi, Sudha Ramachandra Rao, Fred Paccaud, Marcia Makdisse, Aye Aye Sein, Enrique Gutiérrez-González, Yang Yang, Anneke Blokstra, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Wan Nazaimoon Wan Mohamud, Jesús Ibarluzea, Julio Zuñiga Cisneros, Laura Lauria, Argyro Karakosta, Dragana P Jovic, Jun Hata, Elio Riboli, Piotr Bandosz, Xun Tang, Parvina Mukhtorova, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Aleksandra Piwońska, Dusan Grafnetter, Mette Rasmussen, Daniel Weghuber, Sherali Rakhmatulloev, Martine Vrijheid, Johann Willeit, Motahareh Kheradmand, Małgorzata Mossakowska, Lechaba Tshepo, Dongfeng Gu, Hyeon Chang Kim, Vilmundur Gudnason, Maria Forsner, Peter Bjerregaard, Leon A. Simons, Rachael McLean, Japhet Killewo, Ramón Suárez-Medina, Y Nikitin, Eng Joo Tan, Jean Claude Mbanya, Aroor Bhagyalaxmi, Renata Kuciene, Kairat Davletov, Jose Eugenio Lozano, Afshin Ostovar, Niloofar Peykari, Guy De Backer, Soheir H Ahmed, Nicholas J. Wareham, Sai Yin Ho, Constanta Huidumac Petrescu, Maria Hassapidou, Iris Pigeot, Myriam Galfo, Susana Cararo Confortin, Blanca Sandra Ruiz-Betancourt, W. M. Monique Verschuren, Catterina Ferreccio, Fabio Galvano, Leila Houti, Daniel Bia, Annika Rosengren, Marcin Rutkowski, Biruta Velika, Joana Araújo, Fernando Rigo, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Marie Kunešová, Boban Mugoša, Sania Nishtar, Mangesh S. Pednekar, Shahla AlDhukair, Helle-Mai Loit, Antonis Zampelas, Altan Onat, Maciej Banach, Shohreh Naderimagham, Hajer Aounallah-Skhiri, Maja Bæksgaard Jørgensen, Yin Guo, Ewelina Czenczek-Lewandowska, Parasmani Dasgupta, Elvis Oa Wambiya, Inge Huybrechts, Raimund Erbel, Jari Jokelainen, Ana P. Ortiz, Stefan Kiechl, Emmanuel Cohen, Caleb Ochimana, Shynar Abdrakhmanova, Laura Censi, Iqbal Bata, Geetha R Menon, Snehalatha Chamukuttan, Pedro Plans-Rubio, Domenico Palli, Ana Azevedo, Slawomir Koziel, Benoît Salanave, Parinaz Mehdipour, Shu Ti Chiou, Lela Sturua, Lubica Ticha, Felipe Vogt Cureau, Jin Soo Moon, Ming-Hui Zhao, Urho M. Kujala, Nathalie Michels, Ertugrul Celikcan, Jaakko Tuomilehto, Judith Benedics, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, Andrea Rodriguez-Martinez, Tai Hing Lam, Yn-Tz Sung, Jürgen König, Kodavanti Mallikharjuna Rao, Hazzaa M. Al-Hazzaa, Karen Morgan, Bogdan Wojtyniak, Cynthia M. Pérez, Ilse Khouw, Manoli Garcia-de-la-Hera, Dong Wook Shin, Genc Burazeri, Ausra Petrauskiene, Charles Sossa Jérome, Kenisha Russell Jonsson, José Boggia, Daniela Galeone, Alice Bonilla-Vargas, Han Cg Kemper, Rahman Shiri, Stefaan Demarest, Else Karin Grøholt, San-Lin You, Adelheid Weber, Juha Auvinen, Aida Pilav, Sibel Gogen, Suzanne N Morin, Wan Mohamad Wan Bebakar, Viviane Cunha Cardoso, Kavumpurathu Raman Thankappan, Hana Zamrazilová, Frank Claessens, Karien Stronks, Helen Gonçalves, Tahir Aris, Luis Revilla, Sérgio Viana Peixoto, Zhamilya Battakova, Jing Liu, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Priscilla Duboz, Sandjaja, Tiina Laatikainen, Rafel Ramos, Sareh Eghtesad, Judith Simons, Orn Olafsson, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Aung Soe Htet, Bente Sparboe-Nilsen, Paul Elliott, Soon-Woo Park, Angel R. Gonzalez, Ying-Wei Wang, Rob M. van Dam, Ryutaro Ohtsuka, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Lynell V Maniego, Fariborz Mansour-Ghanaei, Maria Dorobantu, Giovanni Viegi, Xiaoguang Yang, Honor Bixby, Prakash C. Gupta, Ofra Kalter-Leibovici, Eugene Sobngwi, Ričardas Radišauskas, Jurate Medzioniene, Roy A Wong-McClure, Kim F. Michaelsen, Antonia Trichopoulou, Tania Tello, Francesco Branca, Johanna Gunnlaugsdottir, Els Clays, Wei-Yen Lim, Suzanne C. Ho, Toomas Veidebaum, Rebecca Goldsmith, Margot González-León, Matthias Nauck, Alibek Mereke, Marta Buoncristiano, Jakob Tarp, Rosalba Rojas-Martínez, Maya Tanrygulyyeva, Reza Malekzadeh, Abdonas Tamosiunas, Dimitrios Poulimeneas, Pedro Ordunez, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Anne Juolevi, Vassilis Zafiropulos, Emanuela Gualdi-Russo, Jordi Sunyer, Manu Raj, Chaoqiang Jiang, Sofia Malyutina, Efthymios Kapantais, Maria Lazo-Porras, Maung Maung Than Htike, Michael Hobbs, Ranjit Mohan Anjana, Merike Liivak, Johan G. Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. 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Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Wellcome TrustEuropean Commission, Clinical Developmental Psychology, APH - Mental Health, Sociology, The Social Context of Aging (SoCA), Nutrition and Health, Iurilli, Maria LC [0000-0003-0409-1635], Zhou, Bin [0000-0002-1741-8628], Ezzati, Majid [0000-0002-2109-8081], Apollo - University of Cambridge Repository, Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, Public and occupational health, APH - Health Behaviors & Chronic Diseases, VU University medical center, APH - Personalized Medicine, AGEM - Endocrinology, metabolism and nutrition, ACS - Diabetes & metabolism, APH - Global Health, ARD - Amsterdam Reproduction and Development, Adult Psychiatry, Global Health, APH - Quality of Care, APH - Methodology, ACS - Atherosclerosis & ischemic syndromes, Gómez Santos, Santiago Felipe, NCD Risk Factor Collaboration (NCD-RisC), Faculdade de Desporto, Faculdade de Ciências da Nutrição e Alimentação, Faculdade de Medicina, Tampere University, Clinical Medicine, Department of Clinical Chemistry, Eye Centre, Harvard TH Chan School of Public Health, Middlesex University, World Health Organization, Ministry of Health, University of Lausanne, Eduardo Mondlane University, Victor Babes University of Medicine and Pharmacy Timisoara, University of Sydney, Health and Nutrition, University of Auckland, Seoul National University, ICMR - National Institute of Nutrition, Capital Medical University Beijing An Zhen Hospital, Universidad Peruana Cayetano Heredia, University Tunis El Manar, University of Oulu, University of Zagreb, University of Ljubljana, Caja Costarricense de Seguro Social, Al-Quds University, National Center of Public Healthcare, Qatar University, Birzeit University, Usmanu Danfodiyo University Teaching Hospital, Instituto Mexicano del Seguro Social, Flinders University, Mahidol University, BRAC James P Grant School of Public Health, University of Copenhagen, Copenhagen University Hospital, Food and Nutrition Research Institute, Urmia University of Medical Sciences, Instituto Nacional de Ciencias Médicas y Nutrición, University of Amsterdam, Shahrekord University of Medical Sciences, Non-Communicable Diseases Research Center, University of Oslo, University of Bremen, Republican Center for Health Promotion, Endocrinology and Genetics, Princess Nourah bint Abdulrahman University, Kuwait Institute for Scientific Research, King Abdulaziz University, Dasman Diabetes Institute, Aldara Hospital and Medical Center, King Abdullah International Medical Research Center, Luxembourg Institute of Health, Bispebjerg and Frederiksberg Hospital, Barcelona Institute for Global Health CIBERESP, World Health Organization Regional Office for the Eastern Mediterranean, Bombay Hospital and Medical Research Centre, Research Center for Social Determinants of Health, UMR CNRS-MNHN 7206 Eco-anthropologie, University of Lille, Lille University Hospital, Western Norway University of Applied Sciences, Norwegian School of Sport Sciences, Madras Diabetes Research Foundation, Zahedan University of Medical Sciences, National Institute of Public Health, Institute of Public Health of the University of Porto, Norwegian Institute of Public Health, University of Massachusetts Amherst, Abt Associates, University of Iceland, University of Yaoundé1, Federal University of Pelotas, University of Medicine 1, Oulu University Hospital, Banska Bystrica Regional Authority of Public Health, Tel- Aviv University, Hebrew University of Jerusalem, University of Porto Medical School, Neyshabur University of Medical Sciences, Research Institute for Endocrine Sciences, Non- Communicable Diseases Research Center, Indian Council of Medical Research, University of Science and Technology, Medical University of Lodz, Medical University of Gdansk, Universidad Autónoma de Madrid CIBERESP, University of Rzeszów, University of Palermo, Pan American Health Organization, Mohammed V University de Rabat, University of Pernambuco, Baqai Institute of Diabetology and Endocrinology, Universidade Federal de Santa Catarina (UFSC), Dalhousie University, Jordan University of Science and Technology, Federal University of Maranhao, Al-Farabi Kazakh National University, University College Dublin, Christian Medical College, Care and Consumer Protection, Cafam University Foundation, Kazakh National Medical University, Lithuanian University of Health Sciences, University of Saõ Paulo, B J Medical College, Chirayu Medical College, Sunder Lal Jain Hospital, The Hospital for Sick Children, Aga Khan University, Shandong University of Traditional Chinese Medicine, Jiao-Tong University School of Medicine, Universidad de la República, Institute of Medical Research and Medicinal Plant Studies, Ufa Eye Research Institute, Nepal Health Research Council, University of Montenegro, University of Southern Denmark, University of Gothenburg, Universidade Federal do Rio de Janeiro (UFRJ), National Institute for Public Health and the Environment, University of Turin, University College London, Liverpool John Moores University, Nanyang Technological University Singapore, German Institute of Human Nutrition, Endocrinology Research Centre, Centro de Educación Médica e Investigaciones Clínicas, IRCCS Neuromed, Toulouse University School of Medicine, University of Zurich, University Hospital KU Leuven, Flemish Agency for Care and Health, Ghent University, FrieslandCampina, Universidad Central de Venezuela, Bielefeld University, World Health Organization Regional Office for Europe, 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, Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , 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Lind , Allan Linneberg , Lauren Lissner , Mieczyslaw Litwin , Lijuan Liu , Wei-Cheng Lo , Helle-Mai Loit , Khuong Quynh Long , Luis Lopes , Oscar Lopes , Esther Lopez-Garcia , Tania Lopez , Paulo A Lotufo , José Eugenio Lozano , Janice L Lukrafka , Dalia Luksiene , Annamari Lundqvist , Robert Lundqvist , Nuno Lunet , Charles Lunogelo , Michala Lustigová , Edyta Łuszczki , Guansheng Ma , Jun Ma , Xu Ma , George Ll Machado-Coelho , Aristides M Machado-Rodrigues , Luisa M Macieira , Ahmed A Madar , Stefania Maggi , Dianna J Magliano , Sara Magnacca , Emmanuella Magriplis , Gowri Mahasampath , Bernard Maire , Marjeta Majer , Marcia Makdisse , Päivi Mäki , Fatemeh Malekzadeh , Reza Malekzadeh , Rahul Malhotra , Kodavanti Mallikharjuna Rao , Sofia K Malyutina , Lynell V Maniego , Yannis Manios , Jim I Mann , Fariborz Mansour-Ghanaei , Enzo Manzato , Paula Margozzini , Anastasia Markaki , Oonagh Markey , Eliza Markidou Ioannidou , Pedro Marques-Vidal , Larissa Pruner Marques , Jaume Marrugat , Yves Martin-Prevel , Rosemarie Martin , Reynaldo Martorell , Eva Martos , Katharina Maruszczak , Stefano Marventano , Luis P Mascarenhas , Shariq R Masoodi , Ellisiv B Mathiesen , Prashant Mathur , Alicia Matijasevich , Tandi E Matsha , Christina Mavrogianni , Artur Mazur , Jean Claude N Mbanya , Shelly R McFarlane , Stephen T McGarvey , Martin McKee , Stela McLachlan , Rachael M McLean , Scott B McLean , Breige A McNulty , Sounnia Mediene Benchekor , Jurate Medzioniene , Parinaz Mehdipour , Kirsten Mehlig , Amir Houshang Mehrparvar , Aline Meirhaeghe , Jørgen Meisfjord , Christa Meisinger , Ana Maria B Menezes , Geetha R Menon , Gert Bm Mensink , Maria Teresa Menzano , Alibek Mereke , Indrapal I Meshram , Andres Metspalu , Haakon E Meyer , Jie Mi , Kim F Michaelsen , Nathalie Michels , Kairit Mikkel , Karolina Milkowska , Jody C Miller , Cláudia S Minderico , G K Mini , Juan Francisco Miquel , Mohammad Reza Mirjalili , Daphne Mirkopoulou , Erkin Mirrakhimov , Marjeta 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, Jaakko Mursu , Elaine M Murtagh , Kamarul Imran Musa , Sanja Music Milanovic , Vera Musil , Norlaila Mustafa , Iraj Nabipour , Shohreh Naderimagham , Gabriele Nagel , Balkish M Naidu , Farid Najafi , Harunobu Nakamura , Jana Námešná , Ei Ei K Nang , Vinay B Nangia , Martin Nankap , Sameer Narake , Paola Nardone , Matthias Nauck , William A Neal , Azim Nejatizadeh , Chandini Nekkantti , Keiu Nelis , Liis Nelis , Ilona Nenko , Martin Neovius , Flavio Nervi , Chung T Nguyen , Nguyen D Nguyen , Quang Ngoc Nguyen , Ramfis E Nieto-Martínez , Yury P Nikitin , Guang Ning , Toshiharu Ninomiya , Sania Nishtar , Marianna Noale , Oscar A Noboa , Helena Nogueira , Teresa Norat , Maria Nordendahl , Børge G Nordestgaard , Davide Noto , Natalia Nowak-Szczepanska , Mohannad Al Nsour , Irfan Nuhoglu , Eha Nurk , Terence W O'Neill , Dermot O'Reilly , Galina Obreja , Caleb Ochimana , Angélica M Ochoa-Avilés , Eiji Oda , Kyungwon Oh , Kumiko Ohara , Claes Ohlsson , Ryutaro Ohtsuka , Örn Olafsson , Maria 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Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)

Subjects
Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed

Published
2021

36. Association of Cardiovascular Risk Factors between Adolescents and Their Parents Is Mitigated by Parental Physical Activity—A Cross-Sectional Study

Author

William R. Tebar, Gerson Ferrari, Jorge Mota, Ewerton P. Antunes, Beatriz A. S. Aguilar, Javier Brazo-Sayavera, and Diego G. D. Christofaro

Subjects
Adolescent, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, Overweight, Cross-Sectional Studies, Cardiovascular Diseases, Risk Factors, Heart Disease Risk Factors, Surveys and Questionnaires, Hypertension, parent–child, hypertension, substance use, overweight, exercise, Humans, Female, Child, Exercise
Abstract

Introduction: It is hypothesized that children’s habits can be modulated by their parent’s lifestyle. However, it is still not established whether the relationship between cardiovascular risk factors (CVRF) in adolescents and their parents could be attenuated by parental physical activity levels. Objective: This study aimed to analyze the relationship of CVRF between adolescents and their parents according to parental physical activity level. Methods: A school-based sample of 1231 adolescents, 1202 mothers and 871 fathers were included (n = 3304). The CVRF assessed were overweight, hypertension, smoking and alcohol consumption. The parental physical activity level was assessed using a validated questionnaire, being classified into physically active and inactive parents. The statistical analysis considered all parents and stratification by physical activity level. Results: The prevalence of CVRF was higher in fathers than in mothers (70.6% vs. 54.9% for overweight, 23.3% vs. 19.7% for hypertension, 17.9% vs. 12.4% for smoking and 60.4% vs. 28.5% for alcohol consumption). Adolescents with active mothers showed lower prevalence of overweight (13.9% vs. 19.6%), while adolescents with active fathers showed higher prevalence of alcohol consumption (23.5% vs. 16.9%). The CVRF of both fathers and mothers were positively associated with CVRF of adolescents. However, the association of CVRF between adolescents and their parents was mitigated among active parents, while all the CVRF remained associated in physically inactive parents. Conclusion: The parental physical activity level seems to mitigate the association of CVRF between adolescents and their parents. The promotion of an active lifestyle at the family level can contribute to reduce CVRF among adolescents.

Published
2022

37. Physical activity domains are differently related with quality of life in breast cancer survivors: a cross-sectional study

Author

Diego Giulliano Destro Christofaro, William R. Tebar, Giuliano Tavares Tosello, Daniela T. Caldeira, Fernanda Elisa Ribeiro, Luiz Carlos Marques Vanderlei, Cristina Elena Prado Teles Fregonesi, Mariana Romanholi Palma, Universidade Estadual Paulista (UNESP), and Universidade do Oeste Paulista

Subjects
Gerontology, Cross-sectional study, General Mathematics, Population, Breast Neoplasms, Affect (psychology), Breast cancer, Cancer Survivors, Quality of life, Surveys and Questionnaires, Humans, Medicine, Survivors, education, Exercise, Socioeconomic status, Aged, education.field_of_study, business.industry, Applied Mathematics, Obstetrics and Gynecology, Middle Aged, medicine.disease, Mental health, humanities, Cross-Sectional Studies, Quality of Life, Marital status, Female, Neoplasm Recurrence, Local, business
Abstract

Made available in DSpace on 2022-04-28T19:45:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-26 OBJECTIVES: Treatments for breast cancer (BC) can lead to physical and mental impairments which may affect quality of life (QoL). Physical activity (PA) is highly recommended for this population due to its protective effect against BC relapse and its ability to reduce the health impact of treatment. However, it is not clear whether the different domains of PA are associated with better QoL of BC survivors. The current study aimed to verify the relationship between different PA domains with QoL of BC survivors. METHODS: The sample consisted of 128 women BC survivors, with a mean age of 58.2 ± 9.7 years. QoL was assessed using the Short-Form Health Survey questionnaire (SF-36) and PA was verified through the Baecke questionnaire, in domains of occupation, sports practice, and leisure time/commuting. The relationship between QoL and different PA domains was verified by linear regression, adjusted by age, marital status, and socioeconomic condition. RESULTS: Occupational PA was negatively related to physical limitations [β= -15.36 (-29.04 to -1.68] and body pain [β=-6.61 (-14.53 to 1.31) marginal association]. Sports practice was positively related to functional capacity [β= 4.24 (0.60 to 7.88)]. Leisure time/commuting PA was positively related to functional capacity [β = 7.17 (3.09 to 11.26)], vitality [β = 4.30 (0.39 to 8.22)], social aspects [β= 5.47 (0.80 to 10.15)], and mental health [β = 4.08 (0.40 to 7.75)]. CONCLUSIONS: Sports practice and leisure time/commuting PA were positively related to QoL in BC survivors, while occupational PA was negatively related to QoL, independently of age, marital status, and socioeconomic condition. Department of Physiotherapy School of Technology and Sciences São Paulo State University (Unesp) Department of Physical Education School of Technology and Sciences São Paulo State University (Unesp) Department of Medicine Universidade do Oeste Paulista Department of Physiotherapy School of Technology and Sciences São Paulo State University (Unesp) Department of Physical Education School of Technology and Sciences São Paulo State University (Unesp)

Published
2021

38. Validity and reliability of the Baecke questionnaire against accelerometer-measured physical activity in community dwelling adults according to educational level

Author

William R. Tebar, Raphael M. Ritti-Dias, Rômulo A. Fernandes, Tatiana M. M. Damato, Mauro V. G. de Barros, Jorge Mota, Lars Bo Andersen, and Diego G. D. Christofaro

Subjects
Adult, Multidisciplinary, Surveys and Questionnaires, Accelerometry, Humans, Reproducibility of Results, Female, Independent Living, Exercise
Abstract

Baecke questionnaire have been widely used to assess physical activity. However, the role of educational level on validity and reliability of Baecke questionnaire is still not stablished, being a factor that can potentially influence the accuracy of self-reported measures. The present study aimed to verify the validity and reliability of Baecke questionnaire for the measurement of physical activity in community dwelling adults according to education level. The sample included 251 adults (42.4±17.0 years, 55% of women). Physical activity was self-reported by Baecke questionnaire and objectively measured by accelerometer. The education level (EL) was classified by years of study into low (11 years). A 7-day test-retest reliability was analyzed by intraclass correlation coefficient. The relationship, agreement and validity of the Baecke questionnaire against accelerometry were analyzed by Spearman’s correlation, Kappa index, and ROC curve, respectively. The reliability of Baecke questionnaire were r = 0.97 (high EL), r = 0.78 (medium EL), and r = 0.68 (low EL). Sensitivity and specificity were 77% and 71% in high EL, 54% and 80% in medium EL and 33% and 89% in the low EL. Baecke questionnaire proved to be reliable and a valid measurement of habitual physical activity in adults with medium and high EL.

Published
2021

39. Physical activity across life stages and sleep quality in adulthood - an epidemiological study

Author

Catarina Covolo Scarabottolo, Luis Alberto Gobbo, Rafael Z. Pinto, Crystian B. Oliveira, Gabriela C. R. Silva, William R. Tebar, Diego Giulliano Destro Christofaro, Daniel S Canhin, Universidade Estadual Paulista (Unesp), and Universidade Federal de Minas Gerais (UFMG)

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Ethnic group, Overweight, Logistic regression, Odds, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Epidemiology, medicine, Humans, Exercise, Socioeconomic status, Aged, Retrospective Studies, Sleep quality, business.industry, Physical exercise, General Medicine, Middle Aged, Childhood, Adolescence, Cross-Sectional Studies, 030228 respiratory system, Health, Female, Observational study, medicine.symptom, business, Sleep, 030217 neurology & neurosurgery, Demography
Abstract

Made available in DSpace on 2021-06-25T10:30:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Objective: To analyze the association between the continuous physical activity (PA) at different life stages with sleep quality in adults. Methods: This is an observational study with a cross-sectional design. A sample of 843 adults (61.7% female) with a mean age of 56.6 (±18.3) years was randomly selected. The PA at different life stages was assessed retrospectively in childhood and adolescence, and the current PA was assessed by Baecke Physical Activity Questionnaire. Sleep quality was assessed using the Mini-Sleep Questionnaire. Variables of sex, age group, ethnicity, socioeconomic status, and current physical activity were covariates. The association between continuous PA at different life stages with sleep quality was analyzed by binary logistic regression models. Results: Overweight adults who practiced PA in adolescence were 46% less likely to have poor sleep quality when compared to those who did not practice physical activity in this life stage (Odds ratio = 0.54, p = 0.031). Adults who continued to practice PA at youth and adulthood were 49% less likely to have poor sleep quality when compared to those without continuous PA (Odds ratio = 0.51, p = 0.009). Conclusions: Poor sleep quality was negatively associated with continuous PA between youth and adulthood in overall sample and negatively associated with PA in adolescence among overweight adults. Department of Physical Education Post Graduation Program in Movement Sciences School of Technology and Sciences Sao Paulo State University (UNESP) Exercise Investigation Laboratory (LIVE) Department of Physical Education School of Technology and Sciences São Paulo State University (UNESP) Skeletal Muscle Assessment Laboratory (LABSIM) Department of Physical Education School of Technology and Sciences São Paulo State University (UNESP) Department of Physical Therapy. Universidade Federal de Minas Gerais (UFMG) Department of Physical Education Post Graduation Program in Movement Sciences School of Technology and Sciences Sao Paulo State University (UNESP) Exercise Investigation Laboratory (LIVE) Department of Physical Education School of Technology and Sciences São Paulo State University (UNESP) Skeletal Muscle Assessment Laboratory (LABSIM) Department of Physical Education School of Technology and Sciences São Paulo State University (UNESP) CAPES: 001

Published
2021

40. Relationship of sleep quality with screen-based sedentary time and physical activity in adolescents - the moderating effect of body mass index

Author

Tatiana M, Damato, William R, Tebar, Crystian B S, Oliveira, Bruna T C, Saraiva, Priscila K, Morelhao, Raphael M, Ritti-Dias, and Diego G D, Christofaro

Subjects
Sleep Quality, Adolescent, Humans, Sedentary Behavior, Overweight, Child, Sleep, Exercise, Body Mass Index
Abstract

To analyze the association of sleep quality with reported screen-based sedentary time and reported physical activity, among overweight adolescents.Adolescents aged 10 to 17 years enrolled in public and private schools were included. Data collection was carried out during the school semesters of 2014-2015 and participants who did not participate in all evaluations were excluded. Sleep quality and physical activity were assessed by validated questionnaires. Screen-based sedentary time was assessed by self-reported mean daily hours spent on television, computer, smartphone/tablet, and videogames. Body mass index was objectively measured and adolescents were classified into normal weight and overweight according to cutoff points for age and sex. Multiple linear regression models adjusted by covariates (age, sex, ethnicity, and socioeconomic status) were used to analyze the relationship between variables.A total of 1008 adolescents were assessed, with a mean age of 13.2 ± 2.4 years and a mean body mass index of 20.4 ± 4.3 kg/mSelf-reported screen-based sedentary time was associated with poor sleep quality in adolescents, mainly among those with normal weight. The time spent on screen-based sedentary activities can impair sleep quality even in normal weight adolescents.

Published
2021

41. Sports Participation from Childhood to Adolescence is Associated with Lower Body Dissatisfaction in Boys-A Sex-Specific Analysis

Author

William R, Tebar, Fernanda C S, Gil, André O, Werneck, Leandro D, Delfino, Diego Augusto, Santos Silva, and Diego G D, Christofaro

Subjects
Male, Cross-Sectional Studies, Adolescent, Body Dissatisfaction, Humans, Female, Child, Exercise, Body Mass Index, Retrospective Studies, Sports
Abstract

This study aimed to analyze the association between body dissatisfaction and sports participation from childhood to adolescence in a school-based sample of adolescents, according to sex.A total of 1011 adolescents of 13.1 ± 2.3 years of age were evaluated. Body dissatisfaction was assessed by the Silhouettes Scale and sports participation for at least one consecutive year was retrospectively assessed by closed specific questions related to childhood and adolescence periods. Body mass index (BMI) and abdominal obesity were objectively measured. Habitual practice of physical activity (PA), socioeconomic status (SES), and ethnicity were assessed through questionnaires.Sports participation from childhood to adolescence was observed in 55.1% of boys and in 41.2% of girls. Boys with body dissatisfaction showed lower habitual PA in leisure time (Baecke score = 4.38 ± 2.27 vs. 5.15 ± 2.25, p 0.05) and in total (Baecke score = 9.34 ± 2.64 vs. 9.96 ± 2.68, p 0.05) than those who were satisfied. No differences were observed among girls. Sports participation from childhood to adolescence was associated with 42% less chance of having body dissatisfaction in boys (OR = 0.58 [95%CI = 0.36-0.94]). No significant association was observed among girls.Sports participation from childhood to adolescence was negatively associated with body dissatisfaction in boys. The continuity of physical activity during youth may be an important modifiable factor to reduce body dissatisfaction.

Published
2021

42. Effects of active video games on children and adolescents: A systematic review with meta‐analysis

Author

Bruna Thamyres Ciccotti Saraiva, Claudiele Carla Marques da Silva, William R. Tebar, Crystian B. Oliveira, Leandro D Delfino, Diego Giulliano Destro Christofaro, Marcia R. Franco, and Rafael Z. Pinto

Subjects
Pediatric Obesity, medicine.medical_specialty, Waist, Adolescent, Physical Therapy, Sports Therapy and Rehabilitation, 030204 cardiovascular system & hematology, Body Mass Index, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Included study, medicine, Humans, Orthopedics and Sports Medicine, Child, Exercise, Randomized Controlled Trials as Topic, business.industry, Body Weight, 030229 sport sciences, Random effects model, Clinical trial, Quality of evidence, Video Games, Meta-analysis, Physical therapy, business, Body mass index
Abstract

OBJECTIVE To investigate the effectiveness of active video games (AVGs) on obesity-related outcomes and physical activity levels in children and adolescents. DESIGN Systematic review with meta-analysis. METHODS Literature search was performed in five electronic databases and the main clinical trials registries. Randomized controlled trials investigating the effect of AVGs compared with no/minimal intervention on obesity-related outcomes (body mass index [BMI], body weight, body fat, and waist circumference) and physical activity levels of children and adolescents were eligible. Two independent reviewers extracted the data of each included study. PEDro scale was used to assess risk of bias and GRADE approach to evaluate overall quality of evidence. Pooled estimates were obtained using random effect models. RESULTS Twelve studies were considered eligible for this review. Included studies mostly reported outcome data at short-term (less or equal than three months) and intermediate-term follow-up (more than 3 months, but

Published
2019

43. Physical activity levels are associated with regional bone mineral density in boys

Author

Diego Giulliano Destro Christofaro, Raphael Mendes Ritti-Dias, Vinicius Yukio Botelho Suetake, Bruna Thamyres Ciccotti Saraiva, William R. Tebar, Leandro D Delfino, Universidade Estadual Paulista (Unesp), and Universidade Nove de Julho–UNINOVE

Subjects
Male, musculoskeletal diseases, Adolescent, Physical activity, physical activity, Physical Therapy, Sports Therapy and Rehabilitation, Biology, 03 medical and health sciences, Absorptiometry, Photon, Sex Factors, 0302 clinical medicine, Animal science, children, Bone Density, Bone mineral density, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, Child, Exercise, Bone mineral, Maturity (geology), musculoskeletal, neural, and ocular physiology, Age Factors, 030229 sport sciences, musculoskeletal system, adolescent, Female, maturity
Abstract

Made available in DSpace on 2019-10-06T15:31:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 Background: Youth is a crucial period for bone gain, and physical activity (PA) has shown to increase bone mineral density (BMD) in this period. However, whether PA affects regional BMD is unclear. Thus, the aim of this study was to analyze the relationship between PA levels and regional BMD in youths. Methods: The sample included 110 children and adolescents aged 6–14 years. Body mass, height, sitting trunk length, and leg length were obtained for body mass index and maturity offset calculation. The arms, pelvis, spine, trunk, and legs BMD were measured by double energy X-ray absorptiometry. The PA was evaluated by questionnaire, and youths were classified as low, moderately, or highly physically active. Results: The sample included 63.7% boys and 36.3% girls with mean age of sample 9.5 (±1.6) yrs. Age, body mass index, and maturity offset were similar between sexes (p > 0.05). Boys with low PA levels had lower BMD Z-score for arms (−0.20 ± 0.71 vs. 0.30 ± 1.19, p = 0.006) and legs (−0.14 ± 1.00 vs. 0.35 ± 1.06, p = 0.026) compared to highly physically active youths. Multiple linear regression showed a positive linear relationship between legs BMD and PA in boys (β = 0.72 [95% CI = 0.09; 1.36]). Conclusion: In boys, low PA levels are associated with lower BMD in arms and legs. Post Graduation Program in Movement Sciences Sao Paulo State University–UNESP Departament of Physical Education Universidade Nove de Julho–UNINOVE GEAFS Research Group–Department of Physical Education Sao Paulo State University - UNESP Post Graduation Program in Physiotherapy Sao Paulo State University–UNESP Post Graduation Program in Movement Sciences Sao Paulo State University–UNESP GEAFS Research Group–Department of Physical Education Sao Paulo State University - UNESP Post Graduation Program in Physiotherapy Sao Paulo State University–UNESP

Published
2019

44. Association between handgrip strength and bone mineral density of Brazilian children and adolescents stratified by sex: a cross-sectional study

Author

Daniel Eduardo Rodrigues de Sousa, Bruna Thamyres Ciccotti Saraiva, Ricardo Ribeiro Agostinete, Diego Giulliano Destro Christofaro, Ismael Forte Freitas Júnior, William R. Tebar, Luis Alberto Gobbo, and Universidade Estadual Paulista (Unesp)

Subjects
Male, medicine.medical_specialty, Bone density, Adolescent, Cross-sectional study, 030209 endocrinology & metabolism, Pediatrics, RJ1-570, Fat mass, 03 medical and health sciences, 0302 clinical medicine, Absorptiometry, Photon, Internal medicine, medicine, Humans, 030212 general & internal medicine, Child, Bone mineral, Dual energy, Hand Strength, business.industry, Total body, Trunk, Cross-Sectional Studies, Health, Child, Preschool, Pediatrics, Perinatology and Child Health, Body Composition, Positive relationship, Female, Strength, business, Brazil, Research Article
Abstract

Background To examine the association of handgrip strength (HGS) and bone mineral density (BMD) of Brazilian children and adolescents. Methods The sample included 243 children and adolescents aged from 4 to 15 years (9.3 ± 2.2 years), 171 males and 72 females. The following measurements were performed: weight, height, trunk length, and years to the peak height velocity (PHV). The percentage lean soft tissue (PLST), percentage fat mass (PFM), and BMD were obtained using Dual Energy X-ray Absorptiometry (DXA) and HGS using a dynamometer. Results In girls, HGS was positively associated with higher BMD, even after the adjustments, by arms [β = 0.006; p p p = 0.008], and total body [β = 0.009; p Conclusion HGS was positively associated to BMD in boys and girls, regardless of age, PHV, PLST, and PFM.

Published
2021

45. Association of sedentary behavior and early engagement in physical activity with low back pain in adolescents: a cross-sectional epidemiological stud y

Author

Ítalo Ribeiro, Lemes, Crystian Bitencourt, Oliveira, Gabriela C R, Silva, Rafael Zambelli, Pinto, William R, Tebar, and Diego G, Christofaro

Subjects
Male, Cross-Sectional Studies, Adolescent, Humans, Female, Sedentary Behavior, Child, Exercise, Low Back Pain, Brazil
Abstract

To investigate the association of sedentary behavior and physical activity from childhood to adolescence with prevalence of low back pain in adolescents. In addition, we also explored whether sleep quality influences this association.This is a cross-sectional epidemiological study. Participants (aged 10-17 years) were recruited from public and private schools in Brazil. Sedentary behavior and previous and current engagement in physical activity were assessed through questionnaires. Low back pain and sleep quality were assessed by the Nordic questionnaire and Mini-Sleep Questionnaire, respectively. Sex, age, body mass index, abdominal obesity, socioeconomic status and sleep quality were used as potential confounders. Binary logistic regression models were used to generate values of odds ratio (OR) and 95% confidence intervals (95%CI).A total of 1,001 (44,5% boys; n = 446) were included. Overall prevalence of low back pain was 18%, with higher rates among inactive and sedentary participants. Physical inactivity from childhood to adolescence in combination with high sedentary behavior doubled the likelihood of having low back pain (OR = 2.40 [95%CI: 1.38-4.18]), independent of potential confounders. Sleep quality attenuates, but not eliminates, this association (OR = 2.19 [95%CI: 1.25-3.84]).Being inactive from childhood to adolescence in combination with high sedentary behavior is associated with low back pain in adolescents. Sleep quality seems to attenuate, but not eliminate, this association.

Published
2021

46. Increased Screen Time Is Associated With Alcohol Desire and Sweetened Foods Consumption During the COVID-19 Pandemic

Author

Diego Giulliano Destro Christofaro, João Paulo Botero, William R. Tebar, Raphael Mendes Ritti-Dias, Wagner Luiz do Prado, Marilia de Almeida Correia, Mara Cristina Lofrano-Prado, Tiego A. Diniz, Gabriel Grizzo Cucato, Universidade Estadual Paulista (Unesp), Universidade de São Paulo (USP), Independent Researcher, Universidade Nove de Julho—UNINOVE, Northumbria University, and California State University San Bernardino

Subjects
Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, substance use, lcsh:TX341-641, 030209 endocrinology & metabolism, B400, Logistic regression, 03 medical and health sciences, Screen time, 0302 clinical medicine, sedentary behavior, Environmental health, Pandemic, medicine, 030212 general & internal medicine, Social isolation, Depression (differential diagnoses), Nutrition, media_common, Consumption (economics), Nutrition and Dietetics, business.industry, pandemic, Addiction, digestive, oral, and skin physiology, COVID-19, Brief Research Report, B900, Anxiety, dietary pattern, medicine.symptom, business, lcsh:Nutrition. Foods and food supply, Food Science
Abstract

Made available in DSpace on 2021-06-25T10:27:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-03-24 Background: Elevated screen time has been associated with addictive behaviors, such as alcohol and sugar intake and smoking. Considering the substantial increase in screen time caused by social isolation policies, this study aimed to analyze the association of increased screen time in different devices during the COVID-19 pandemic with consumption and increased desire of alcohol, smoking, and sweetened foods in adults. Methods: A sample of 1,897 adults with a mean age of 37.9 (13.3) years was assessed by an online survey, being composed by 58% of women. Participants were asked whether screen time in television, cell phone, and computer increased during the pandemic, as well as how much time is spent in each device. Closed questions assessed the frequency of alcohol and sweetened food consumption, smoking, and an increased desire to drink and smoke during the pandemic. Educational level, age, sex, feeling of stress, anxiety, depression, and use of a screen device for physical activity were covariates. Binary logistic regression models considered adjustment for covariates and for mutual habits. Results: Increased television time was associated with increased desire to drink (OR = 1.46, 95% CI: 1.12; 1.89) and increased sweetened food consumption (OR = 1.53, 95% CI: 1.18; 1.99), while an increase in computer use was negatively associated with consumption of alcohol (OR = 0.68, 95% CI: 0.53; 0.86) and sweetened foods (OR = 0.78, 95% CI: 0.62; 0.98). Increased cell phone time was associated with increased sweetened food consumption during the pandemic (OR = 1.78, 95% CI: 1.18; 2.67). Participants with increased time in the three devices were less likely to consume sweetened foods for ≥5 days per week (OR = 0.63, 95% CI: 0.39; 0.99) but were twice as likely to have sweetened food consumption increased during pandemic (OR = 2.04, 95% CI: 1.07; 3.88). Conclusion: Increased screen time was differently associated with consumption and desire for alcohol and sweets according to screen devices. Increased time in television and cell phones need to be considered for further investigations of behavioral impairments caused by the pandemic. São Paulo State University (UNESP) Faculty of Science and Technology University of São Paulo—USP Post-graduation Program in Cell and Tissue Biology Independent Researcher Federal University of São Paulo—UNIFESP Universidade Nove de Julho—UNINOVE Department of Sport Exercise and Rehabilitation Northumbria University California State University San Bernardino São Paulo State University (UNESP) Faculty of Science and Technology

Published
2021

47. Association Between Different Domains of Physical Activity and Body Adiposity Indicators in Breast Cancer Survivors

Author

William R. Tebar, Giuliano Tavares Tosello, Diego Giulliano Destro Christofaro, Mariana Romanholi Palma, Luiz Carlos Marques Vanderlei, Daniela Tanajura Caldeira Silva, Fernanda Elisa Ribeiro, Universidade Estadual Paulista (UNESP), and University of Western Paulista (Unoeste) - Presidente Prudente

Subjects
Cancer Research, medicine.medical_specialty, Waist, Physical activity, Breast Neoplasms, Body fat percentage, Body composition, Motor activity, Body Mass Index, Breast cancer, Cancer Survivors, Internal medicine, medicine, Humans, Women, Obesity, Occupational activity, Survivors, Exercise, Adiposity, business.industry, Sedentary behavior, Circumference, medicine.disease, Cross-Sectional Studies, Oncology, Female, Breast neoplasms, business, Bioelectrical impedance analysis
Abstract

Made available in DSpace on 2022-05-01T11:07:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: To analyze the relationship between different physical activity (PA) domains and adiposity indicators in breast cancer survivors. Methods: This is a cross-sectional study, composed of 115 breast cancer (BC) survivors. Measurements of weight, height, waist circumference (WC), and hip circumference were objectively collected, as well as the analysis of body fat percentage through bioelectrical impedance analysis. The PA level was assessed by the Baecke questionnaire including domains related to occupational activity, leisure-time activity, and transportation, while the time spent in sedentary behavior was assessed through self-reported screen-time. Socioeconomic status was assessed through the Brazilian criteria for economic classification and considered as a covariate. Results: BC survivors with higher PA levels in leisure-time activity/sport presented reductions in body fat percentage (β = 1.13%; CI = -2.06; -0.21), BMI (β = 0.80 kg/m²; CI = -1.50; -0.11), WC (β = 1.89 cm; CI = -3.54; -0.23), and waist-to-height ratio (β = 0.13 cm; CI = -0.23; -0.02). Similar values were observed in PA during transportation and in total. There was no correlation between PA at work and adiposity indicators. Conclusion: Different PA domains were inversely related to body adiposity in BC survivors. São Paulo State University (Unesp) School of Technology and Sciences University of Western Paulista (Unoeste) - Presidente Prudente São Paulo State University (Unesp) School of Technology and Sciences

Published
2021

48. Sports Participation from Childhood to Adolescence is Associated with Lower Body Dissatisfaction in Boys—A Sex-Specific Analysis

Author

Diego Augusto Santos Silva, Diego Giulliano Destro Christofaro, William R. Tebar, Leandro D Delfino, André O. Werneck, Fernanda C S Gil, Universidade Estadual Paulista (Unesp), Universidade de São Paulo (USP), and Universidade Federal de Santa Catarina (UFSC)

Subjects
School, medicine.medical_specialty, Youth, Epidemiology, Physical activity, Ethnic group, 03 medical and health sciences, 0302 clinical medicine, Lower body, Medicine, 030212 general & internal medicine, Socioeconomic status, Abdominal obesity, 030219 obstetrics & reproductive medicine, business.industry, Public health, Public Health, Environmental and Occupational Health, Obstetrics and Gynecology, Sex specific, Body image, Pediatrics, Perinatology and Child Health, medicine.symptom, business, Body mass index, Demography
Abstract

Made available in DSpace on 2021-06-25T10:32:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objectives: This study aimed to analyze the association between body dissatisfaction and sports participation from childhood to adolescence in a school-based sample of adolescents, according to sex. Methods: A total of 1011 adolescents of 13.1 ± 2.3 years of age were evaluated. Body dissatisfaction was assessed by the Silhouettes Scale and sports participation for at least one consecutive year was retrospectively assessed by closed specific questions related to childhood and adolescence periods. Body mass index (BMI) and abdominal obesity were objectively measured. Habitual practice of physical activity (PA), socioeconomic status (SES), and ethnicity were assessed through questionnaires. Results: Sports participation from childhood to adolescence was observed in 55.1% of boys and in 41.2% of girls. Boys with body dissatisfaction showed lower habitual PA in leisure time (Baecke score = 4.38 ± 2.27 vs. 5.15 ± 2.25, p < 0.05) and in total (Baecke score = 9.34 ± 2.64 vs. 9.96 ± 2.68, p < 0.05) than those who were satisfied. No differences were observed among girls. Sports participation from childhood to adolescence was associated with 42% less chance of having body dissatisfaction in boys (OR = 0.58 [95%CI = 0.36–0.94]). No significant association was observed among girls. Conclusions for Practice: Sports participation from childhood to adolescence was negatively associated with body dissatisfaction in boys. The continuity of physical activity during youth may be an important modifiable factor to reduce body dissatisfaction. Post-Graduation Program in Movement Sciences Sao Paulo State University (UNESP), Roberto Simonsen street, 305 Post-Graduation Program in Physiotherapy Sao Paulo State University (UNESP) Department of Nutrition School of Public Health University of Sao Paulo (USP) Department of Physical Education Federal University of Santa Catarina (UFSC) Post-Graduation Program in Movement Sciences Sao Paulo State University (UNESP), Roberto Simonsen street, 305 Post-Graduation Program in Physiotherapy Sao Paulo State University (UNESP)

Published
2021

49. Strength training for arterial hypertension treatment: a systematic review protocol

Author

Allice Santos Cruz Veras, Jéssica Costa Rufino, William R. Tebar, Rafael Ribeiro Correia, Giovana Rampazzo Teixeira, and Universidade Estadual Paulista (Unesp)

Subjects
Drug, Protocol (science), medicine.medical_specialty, hypertension, Hypertension treatment, exercise, Strength training, business.industry, media_common.quotation_subject, Rehabilitation, education, Physical activity, food and beverages, physical activity, Physical Therapy, Sports Therapy and Rehabilitation, Blood pressure, Emergency medicine, medicine, strength training, Orthopedics and Sports Medicine, business, media_common
Abstract

Made available in DSpace on 2021-06-25T10:55:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Hypertension is one of the most prevalent chronic diseases and a leading cause of mortality worldwide. High blood pressure levels can be modified and controlled through both drug and non-drug treatments, such as physical exercise. However, the effects of strength training on hypertension is still not consensual in the literature. Objectives: The current review aimed to investigate, synthesize, and discuss the effects of strength training for treatment of hypertension in adults. Method: Six electronic databases; MEDLINE (through PubMed), Cochrane Library, EMBASE, Scopus, Lilacs, and the World Health Organization will be searched for randomized controlled trials which investigated a strength training intervention longer than 8 weeks to prevent or treat high blood pressure. The search will be performed in December 2020, by two independent reviewers. Studies published from database inception up to 2020, in English or Portuguese languages, will be included. The PICO question is defined as follows: Patients who have Hypertension; Intervention of strength training treatment; Comparison with patients without strength training or strength training pre- and post-treatment; and Outcome which reports clinical indices (crude number or proportion of variation). The risk of bias will be assessed using the Cochrane tool. The primary outcomes will be whether strength training interventions promote changes in blood pressure and its hypotensive effects. Secondary outcomes will analyze the intervention protocols of strength training on blood pressure, in order to synthesize, discuss, and determine the best type of protocol to be used in hypertension treatment in the adult population. PROSPERO registration number: CRD42020151269. Post-Graduation Program in Movement Sciences São Paulo State University - UNESP Presidente Prudente Department of Physical Education School of Technology and Sciences Sao Paulo State University - UNESP Presidente Prudente Post-Graduation Program in Movement Sciences São Paulo State University - UNESP Presidente Prudente Department of Physical Education School of Technology and Sciences Sao Paulo State University - UNESP Presidente Prudente

Published
2021

50. Relationship of Cardiac Autonomic Modulation with Cardiovascular Parameters in Adults, According to Body Mass Index and Physical Activity

Author

Breno Quintella Farah, Raphael Mendes Ritti-Dias, Tatiana M. Damato, Leandro D Delfino, Luiz Carlos Marques Vanderlei, William R. Tebar, Jorge Mota, Bruna Thamyres Ciccotti Saraiva, Diego Giulliano Destro Christofaro, Universidade Estadual Paulista (Unesp), Universidade Nove de Julho – Uninove, Faculdade de Desporto da Universidade do Porto, and Universidade Federal Rural de Pernambuco

Subjects
0301 basic medicine, medicine.medical_specialty, Heart rate, Physical activity, Pharmaceutical Science, Physical exercise, 030204 cardiovascular system & hematology, Overweight, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Genetics, Medicine, Trial registration, Genetics (clinical), business.industry, Cardiac modulation, 030104 developmental biology, Blood pressure, Cardiology, Molecular Medicine, Autonomic modulation, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Body mass index
Abstract

Made available in DSpace on 2021-06-25T10:21:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 This study aimed to analyze the relationship between cardiac autonomic modulation (CAM) and cardiovascular parameters (blood pressure and resting heart rate) in a sample of 256 adults, grouped by body mass index and sufficient moderate-to-vigorous physical activity (≥150 min/week). The sample showed different cardiovascular parameters and CAM according to body mass index, but not according to physical activity. Adults who are overweight and physically active presented higher relationship between CAM and blood pressure than those who are insufficiently active, similarly to normal weight groups. Recommended levels of physical activity may play an important role in the relationship of HRV with cardiovascular parameters in overweight adults, regardless of sex, age, socioeconomic level, and central fat. Trial registration: Registered at ClinicalTrials.gov (NCT03986879). [Figure not available: see fulltext.] Universidade Estadual Paulista – Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente Universidade Nove de Julho – Uninove Faculdade de Desporto da Universidade do Porto Universidade Federal Rural de Pernambuco Universidade Estadual Paulista – Unesp, Roberto Simonsen street, number 305, 19060-900, Campus de Presidente Prudente

Published
2021

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