Trajectories of physical activity from mid to older age in women: 21 years of data from the Australian Longitudinal Study on Women’s Health

Background:Women’s physical activity varies across the adult lifespan. However, changes in physical activity among mid-aged women are not well understood. We analysed 21 years of data from women born in 1946–51 to identify: (1) trajectories of physical activity in the transition from mid- to old-age and (2) determinants of different physical activity trajectories. Methods: Data were from the 1946–51 cohort of the Australian Longitudinal Study on Women’s Health (N = 10,371). Surveys were mailed at three-year intervals from 1998 (age 47–52) to 2019 (age 68–73) to collect data on physical activity, sociodemographic factors (country of birth, area of residence, educational attainment, marital status, income management, paid work hours, living with children age &lt; 18, providing care), health indicators (menopause status, BMI, physical and mental health, chronic conditions), and health behaviours (smoking, alcohol status). Group-based trajectory modelling was used to identify trajectories of physical activity. Multinomial logistic regression models were used to examine the determinants of physical activity trajectories. Results:Five trajectories were identified: Low-stable (13.3% of participants), Moderate-stable (50.4%), Moderate-increasing (22.2%), High-declining (7.7%), and High-stable (6.6%). Sociodemographic characteristics (area of residence, education, income management, living with children, and providing care) were determinants of physical activity trajectories, but the strongest factors were BMI, physical and mental health. Women who were overweight/obese and had poor physical and mental health were less likely to be in the High-stable group than in any other group. Changes in these variables (increasing BMI, and declining physical and mental health) and in marital status (getting married) were positively associated with being in trajectories other than the High-stable group. Conclusions:Although most women maintained physical activity at or above current guidelines, very low physical activity levels in the Low-stable group, and declining levels in the High-declining group are concerning. The data suggest that physical activity promotion strategies could be targeted to these groups, which are characterised by socioeconomic disadvantage, high (and increasing) BMI, and poor (and worsening) physical and mental health. Removing barriers to physical activity in these women, and increasing opportunities for activity, may reduce chronic disease risk in older age.</p

Accelerometer-measured physical activity in mid-age Australian adults

BACKGROUND: Raw data from accelerometers can provide valuable insights into specific attributes of physical activity, such as time spent in intensity-specific activity. The aim of this study was to describe physical activity assessed with raw data from triaxial wrist-worn accelerometers in mid-age Australian adults. METHODS: Data were from 700 mid-age adults living in Brisbane, Australia (mean age: 60.4; SD:7.1 years). Data from a non-dominant wrist worn triaxial accelerometer (Actigraph wGT3X-BT), expressed as acceleration in gravitational equivalent units (1 mg = 0.001 g), were used to estimate time spent in moderate-vigorous intensity physical activity (MVPA; >100 mg) using different bout criteria (non-bouted, 1-, 5-, and 10-min bouts), and the proportion of participants who spent an average of at least one minute per day in vigorous physical activity. RESULTS: Mean acceleration was 23.2 mg (SD: 7.5) and did not vary by gender (men: 22.4; women: 23.7; p-value: 0.073) or education (p-value: 0.375). On average, mean acceleration was 10% (2.5 mg) lower per decade of age from age 55y. The median durations in non-bouted, 1-min, 5-min and 10-min MVPA bouts were, respectively, 68 (25th -75th : 45–99), 26 (25th -75th : 12–46), 10 (25th -75th : 3–24) and 8 (25th -75th : 0–19) min/day. Around one third of the sample did at least one minute per day in vigorous intensity activities. CONCLUSION: This population-based cohort provided a detailed description of physical activity based on raw data from accelerometers in mid-age adults in Australia. Such data can be used to investigate how different patterns and intensities of physical activity vary across the day/week and influence health outcomes

Influence of center-based child care on development of two-year-olds in a Brazilian cohort

OBJECTIVE To investigate the association between child care attendance since birth and development in two-years-old Brazilian children. METHODS The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression. RESULTS Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: β: 2.44, 95%CI: 0.83–4.05; some child care: β: 1.35, 95%CI: 0.17–2.53). CONCLUSIONS This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood

Prevalência de programas de promoção da saúde em unidades básicas de saúde no Brasil

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.OBJETIVO Estimar a prevalência de programas de promoção da saúde nas unidades básicas de saúde no Brasil. MÉTODOS Estudo transversal descritivo realizado por meio de entrevistas telefônicas com coordenadores de unidades básicas de saúde. Do total de 42.486 unidades básicas de saúde cadastradas pelo Ministério da Saúde, 1.600 foram aleatoriamente selecionadas. As unidades foram amostradas nas cinco regiões do País de acordo com a proporção de unidades em cada região. Foi analisada a presença ou não de cinco programas de promoção da saúde: promoção de atividade física, cessação de tabagismo, cessação de uso de álcool e drogas ilícitas, alimentação saudável e ambiente saudável. Foram coletados dados sobre o tipo de ações desenvolvidas nos programas e a presença ou não da Estratégia de Saúde da Família na unidade. RESULTADOS A maioria das unidades básicas de saúde (62,0%) referiu ter pelo menos três programas de promoção da saúde e apenas 3,0% não tinha nenhum. A promoção do ambiente saudável e da alimentação saudável foram os programas mais prevalentes (77,0% e 72,0%, respectivamente), enquanto o controle do tabaco e do álcool foram referidos em 54,0% e 42,0% das unidades de saúde, respectivamente. A promoção de atividade física foi referida em menos de 40,0% das unidades e teve grande variação regional, com prevalência de 51,0% nas unidades do Sudeste e apenas 21,0% nas do Norte. A maioria das unidades de saúde (61,0%) oferecia Estratégia de Saúde da Família, porém não foi verificada maior prevalência de programas de promoção da saúde nessas unidades em relação às outras. CONCLUSÕES Este estudo mostrou que programas de promoção da saúde estão presentes na maioria das unidades básicas de saúde. Políticas públicas devem fortalecer a infraestrutura das unidades básicas de saúde e melhorar a capacitação dos trabalhadores de saúde para executar adequadamente a agenda de promoção de saúde do governo brasileiro

Atividade física de lazer na população adulta brasileira: Pesquisa Nacional de Saúde 2013 e 2019

Objective: The aim of this study was to analyze the prevalence of leisure-time physical activity (PA) in 2013 and 2019 according to sociodemographic characteristics in Brazilian adults. Methods: We analyzed data from the National Health Surveys (PNS) conducted in 2013 and 2019. Prevalence of leisure-time PA (150+ minutes per week in physical activities) was calculated according to sex, age, education, race/skin color, Federative Units and regions of Brazil in 2013 and 2019. Poisson regression models and 95% confidence intervals (CI) were used to compare leisure-time PA across different groups in 2013 and 2019. Results: The proportion of Brazilian adults active in leisure-time increased from 22.7% (95%CI: 22.06-23.34 in 2013 to 30.1% (95%CI: 29.44-30.67) in 2019. The prevalence of leisure-time physical activity increased between 2013 and 2019 in 23 of the 27 Federative Units in Brazil. Both in 2013 and in 2019, the proportion of active people during leisure time was higher in men, young people, with a high level of education and individuals with white skin color. Overall, the magnitude of the observed differences in leisure-time PA between sociodemographic groups slightly decreased from 2013 to 2019. Conclusion: Despite the increase in the prevalence of leisure-time physical activity among Brazilian adults in the last six years, marked sociodemographic inequalities persist. The success of future public policies to promote physical activity in leisure must be evaluated from the perspective of social determinants of health and the reduction of inequalities in the practice of physical activity.Objetivo: Analisar a prática de atividade física (AF) no lazer de 2013 e 2019 na população adulta brasileira e segundo características sociodemográficas. Métodos: Análise da base de dados da Pesquisa Nacional de Saúde (PNS), comparando-se o indicador de AF no lazer na PNS 2013 e 2019. A prevalência de AF no lazer (150+ minutos por semana em atividades físicas) foi calculada de acordo com sexo, idade, escolaridade, raça/cor da pele, Unidades Federativas e regiões do Brasil em 2013 e 2019. Análises de regressão de Poisson e intervalos de confiança (IC) de 95% foram utilizados para a comparação da atividade física no lazer entre diferentes grupos populacionais em 2013 e 2019. Resultados: A proporção de adultos brasileiros ativos no lazer aumentou de 22,7% (IC95%: 22,06-23,34) em 2013 para 30,1% (IC95%: 29,44-30,67) em 2019. A prevalência de atividade física no lazer aumentou entre 2013 e 2019 em 23 das 27 Unidades Federativas do Brasil. Tanto em 2013 quanto em 2019, a proporção de ativos no lazer foi maior em homens, jovens, com alta escolaridade e indivíduos com cor da pele branca. De uma forma geral, a magnitude da diferença na prática de atividade física entre grupos sociodemográficos observada em 2013 diminuiu ligeiramente em 2019. Conclusão: Apesar do aumento na prevalência de atividade física no lazer em adultos brasileiros nos últimos seis anos, marcadas desigualdades sociodemográficas ainda persistem. O sucesso de futuras políticas públicas de promoção da atividade física no lazer deve ser avaliado sob a ótica dos determinantes socias de saúde e da redução de desigualdades na prática de atividade física

Worldwide surveillance of self-reported sitting time: a scoping review

Abstract: Background: Prolonged sitting time is a risk factor for chronic disease, yet recent global surveillance is not well described. The aims were to clarify: (i) the countries that have collected country-level data on self-reported sitting time; (ii) the single-item tools used to collect these data; and (iii) the duration of sitting time reported across low- to high-income countries. Methods: Country-level data collected within the last 10 years using single-item self-report were included. The six-stage methodology: (1) reviewing Global Observatory for Physical Activity! Country Cards; (2–4) country-specific searches of PubMed, the Demographic and Health Survey website and Google; (5) analysing the Eurobarometer 88.4; and (6) country-specific searches for World Health Organization STEPwise reports. Results: A total of 7641 records were identified and screened for eligibility. Sixty-two countries (29%) reported sitting time representing 47% of the global adult population. The majority of data were from high-income (61%) and middle income (29%) countries. The tools used were the International Physical Activity Questionnaire (IPAQ; n = 34), a modified IPAQ (n = 1) or the Global Physical Activity Questionnaire (GPAQ; n = 27). The median of mean daily sitting times was 4.7 (IQR: 3.5–5.1) hours across all countries. Higher-income countries recorded a longer duration of sitting time than lower-income countries (4.9 vs 2.7 h). Conclusions: This study provides an updated collation of countries collecting self-reported sitting time data. The daily sitting time findings should be interpreted cautiously. Current surveillance of sitting time is limited by a lack of coverage. Measures of population sitting time that are valid, feasible and sensitive to change should be embedded within global surveillance systems, to help guide future policy, research and practice. Trial registration: Not applicable

Tackling youth inactivity and sedentary behavior in an entire Latin America city

Real-world interventions are fundamental to bridge the research-practice gap in healthy lifestyle promotion. This study aimed to assess the impact of a 7-month, intensive, city-wide intervention ("Life of Health") on tackling youth inactivity and sedentary behavior in an entire Latin-American city (Jaguariuna, Brazil). For youth, a program focused on tackling inactivity/sedentary behavior was delivered at every school ( = 18). Plausibility assessments (pre-to-post design) were performed with 3,592 youth (out of 8,300 individuals at school age in the city) to test the effectiveness of the intervention. Primary outcomes were physical activity and sedentary behavior. Secondary outcome was BMI -score. Physical activity did not change (0; 95%CI:-2.7-2.8 min/day; = 0.976), although physically inactive sub-group increased physical activity levels (11.2; 95%CI:8.8-13.6 min/day; < 0.001). Weekday television and videogame time decreased, whereas computer time increased. Participants with overweight and obesity decreased BMI -score (-0.08; 95%CI:-0.11-0.05; < 0.001; -0.15; 95%CI:-0.19-0.11; < 0.001). This intervention was not able to change the proportion of physical inactivity and sedentary behavior in youth at a city level. Nonetheless, physically inactive individuals increased PA levels and participants with overweight and obesity experienced a reduction in BMI -score, evidencing the relevance of the intervention. Education-based lifestyle programs should be supplemented with environmental changes to better tackle inactivity/sedentary behavior in the real-world

Duas décadas de pesquisa em Epidemiologia da atividade física em Pelotas-RS

As evidências científicas acumuladas sobre a atividade física e seus benefícios à saúde consolidaram um robusto campo de conhecimento que cresceu ao longo dos anos no cenário científico nacional e internacional. A área que conhecemos hoje como atividade física e saúde inicia por volta de 1950 com os estudos de Jeremy Morris na Inglaterra. Nas décadas seguintes diversos estudos foram desenvolvidos, ainda que com um enfoque na aptidão física e, em seguida, as pesquisas científicas proporcionaram um melhor entendimento específico da atividade física. Estudos epidemiológicos clássicos do final da década de 1980 mostraram a importância da atividade física e materializaram-na como uma prioridade de pesquisa nos anos 90. A partir de então, ocorreu o fortalecimento das pesquisas populacionais e o surgimento de discussões sobre recomendações de prática de atividade física para a saúde. O campo de estudo originado em 1950, inicialmente sob liderança norte-americana e europeia, evoluiu gradualmente atingindo mais de mil publicações de artigos científicos anualmente e, após os anos 2000, veio firmar-se com pesquisas de todos os tipos, como os estudos de mensuração, correlatos, intervenções, consequências, recomendações, políticas e de perspectivas globais. No contexto brasileiro, as primeiras pesquisas epidemiológicas sobre atividade física começam a ser conduzidas principalmente na década de 1990. . Entretanto, apenas em 2000 foi publicado o primeiro estudo epidemiológico tendo a atividade física como a principal variável de interesse. É no início do novo milênio que ocorre o aumento expressivo de pesquisas e, a partir de então, inicia-se uma nova era das investigações em epidemiologia da atividade física no Brasil. No decorrer desses quase 70 anos, o Brasil contribuiu com a expressiva marca de 5% do total de publicações da área em todo o mundo. Foram cerca de 1200 artigos publicados nesse período, levando o país a ocupar a 4a posição no ranking mundial de produção científica nesse campo de conhecimento. O Brasil se caracterizou como o único país de renda média entre as 10 nações mais produtivas da área que contribuíram com quase 50% do conhecimento mundial sobre a temática, ficando atrás apenas dos Estados Unidos, Canadá e Austrália. A relevante participação do Brasil no cenário da pesquisa em atividade física e saúde se deu de forma similar ao ocorrido com a tendência mundial, embora um pouco mais tardia do que os países precursores. Contudo, o Brasil foi a primeira nação (se não a única) a ter um periódico científico, um congresso científico e uma sociedade científica específicas da área: Revista Brasileira de Atividade Física e Saúde, criada em 1995; Congresso Brasileiro de Atividade Física e Saúde, iniciado em 1997; e Sociedade Brasileira de Atividade Física e Saúde, fundada em 2008, que precederam suas respectivas versões internacionais. Além do destaque na pesquisa em seus diferentes eixos da área, o país também implementou inquéritos nacionais de vigilância e planos de políticas, em anos anteriores. O protagonismo brasileiro, em voga no novo milênio, teve seus passos marcados também ao ritmo do surgimento e desenvolvimento do grupo de Pelotas, com ênfase na epidemiologia da atividade física. Em 2003, uma pesquisa pelotense se torna a primeira a ser publicada em um periódico internacional e renomado da área. Em similitude, o pontapé inicial da área em Pelotas se dá com a publicação dos estudos em periódicos estrangeiros de relevante impacto, com pelos menos seis, dos 10 es- tudos pioneiros publicados até 2005

Promoção de atividade física e as políticas públicas no combate às desigualdades: reflexões a partir da Lei dos Cuidados Inversos e Hipótese da Equidade Inversa

This Essay reflects on some current approaches to the promotion of physical activity, proposing greater visibility for leisure-time physical activities and inequalities in access to them. The current scenario of increasing inequalities and the importance of confronting them, highlighting the pertinence of public policies, is presented and discussed in light of two theories, the Inverse Equity Hypothesis and the Inverse Care Law. The Inverse Equity Hypothesis seeks to understand how inequalities tend to be established in health indicators, based on an expected increase in inequalities when health innovations initially reach the more socially and economically privileged groups. Meanwhile, the Inverse Care Law emphasizes that the availability of adequate healthcare tends to vary inversely to the population's need. By relating the theories and the promotion of leisure-time physical activity, the essay defends the expansion of public policies aimed at not further increasing inequalities. Public policies and their association with Brazilian Unified National Health System (SUS) and its principles should be the priority. The essay thus defends approaches to promote socially contextualized leisure-time physical activities, capable of prioritizing the groups that need them the most