The association between body mass index and health and economic outcomes in Brazil

Abstract Background Obesity is associated with significant physical, psychosocial and economic burden globally. In Brazil, almost 50% of the population is either overweight or obese. The prevalence of morbid obesity increased by 255% between 1975 and 2003. The current study sought to quantify the relationship between weight status and health outcomes. Methods Data from three waves (2011, 2012, and 2015) of the Brazil National Health and Wellness Survey, an Internet-based survey administered to a demographically diverse sample of Brazilian adults, were used. Body mass index category was calculated based on self-reported height and weight and respondents were categorized into five groups (normal, overweight, obese class I, obese class II, obese class III; n = 34,254). Multivariable analyses, controlling for sociodemographic variables and health history, tested the association with body mass index group and outcomes including health status (Medical Outcomes Study Short Form 12-Item Health Survey version 2/Medical Outcomes Study Short Form 36-Item Health Survey version 2), work productivity (Work Productivity and Activity Impairment-General Health Questionnaire), and costs associated with work impairment (indirect costs), self-reported healthcare resource use and associated direct costs. Results Overall, 53.6% of the surveyed Brazilian population reported being overweight or obese. In virtually all the analyses, increasing body mass index group was associated with significant and progressively worse outcomes. Most notable was the finding that hospitalization costs were over twice as high (R$3141.84 vs. R$1349.60) and indirect costs were nearly double (R$1656.80 vs. R$884.15) for obesity class III than for normal body mass index respondents. Conclusions Obesity rates in Brazil are considerable and, from a patient and societal perspective, increasingly burdensome, thereby highlighting the need for stakeholders to prioritize strategies for weight management interventions

Results from Estonia’s 2022 Report Card on Physical Activity for Children and Youth: Research Gaps and Five Key Messages and Actions to Follow

The aim of this article is to summarize the results of the 2022 Estonian Physical Activity Report Card across 10 indicators based on available scientific data and national databases, and, additionally, to compare the current results with previous Report Card results. A national expert panel, consisting of research and policy experts, identified the available sources and synthesized as well as graded relevant data related to the physical activity (PA) of Estonian children and youth. Grade B was assigned to Organized Sports and Physical Activity (B−), Community and Environment (B+), and Government (B). Grade C was assigned to Overall Physical Activity (C+), Physical Fitness (C+), Family and Peers (C−), and School (C+). The lowest grade, D, was assigned to Active Play (D), Active Transportation (D+), and Sedentary Behaviors (D−). In Estonia, the participation rate in organized sport is relatively high, and government in addition to community support seem to be at a relatively good level. However, a relatively high number of children and youth did not meet the current PA guidelines, and the levels of sedentary behavior and screen time were very high. The PA of children and youth should be a cross-disciplinary priority, and focus should be put on developing schoolyards and outdoor breaks, varied and easily accessible organized sport, the use of active transportation, and the implementation of physical education that supports leisure time activities

Linking atmospheric, terrestrial and aquatic environments: Regime shifts in the Estonian climate over the past 50 years.

Climate change in recent decades has been identified as a significant threat to natural environments and human wellbeing. This is because some of the contemporary changes to climate are abrupt and result in persistent changes in the state of natural systems; so called regime shifts (RS). This study aimed to detect and analyse the timing and strength of RS in Estonian climate at the half-century scale (1966-2013). We demonstrate that the extensive winter warming of the Northern Hemisphere in the late 1980s was represented in atmospheric, terrestrial, freshwater and marine systems to an extent not observed before or after the event within the studied time series. In 1989, abiotic variables displayed statistically significant regime shifts in atmospheric, river and marine systems, but not in lake and bog systems. This was followed by regime shifts in the biotic time series of bogs and marine ecosystems in 1990. However, many biotic time series lacked regime shifts, or the shifts were uncoupled from large-scale atmospheric circulation. We suggest that the latter is possibly due to complex and temporally variable interactions between abiotic and biotic elements with ecosystem properties buffering biotic responses to climate change signals, as well as being affected by concurrent anthropogenic impacts on natural environments