Associação entre fatores precoces e prática de atividade física referidas pelos pais em crianças de 5 a 7 anos / Association between early life factors and physical activity of practical reported by parents of children of 5 to 7 years old

Objetivo: Verificar se existe associação entre fatores precoces e indicadores de atividade física (AF) referida pelos pais em crianças de cinco a sete anos de idade. Métodos: Estudo transversal realizado com 784 crianças de escolas públicas e privadas do Recife-PE. Dados sobre fatores precoces e os indicadores de prática de AF foram coletados mediante questionário administrado na forma de entrevista com as mães/pais das crianças. Para análise dos dados foi empregado à regressão logística binária. Resultados: Verificou-se que as crianças que foram amamentadas exclusivamente ao seio por >6 meses tinham menos chance de apresentarem baixo nível de participação em jogos e brincadeiras ao ar livre, mas somente quando as mães relataram trabalhar durante a gestação (OR: 0,28; IC95%:0,11-0,68; p<0,02). Identificou-se que as crianças nascidas pré-termo e aquelas mais novas apresentavam menos chance de se deslocarem inativamente para a escola quando comparadas às a termo e a crianças mais velhas (primeiro filho) (OR: 0,51; IC95%: 0,29-0,89; p<0,02). As crianças nascidas pré-termo tinham duas vezes mais chances de não participarem de atividades físicas estruturadas em comparação às a termo (OR: 2,32; IC95%: 1,36-3,95; p<0,01). Conclusão: Os fatores precoces foram associados à prática de atividade física em crianças de cinco a sete anos de idade.

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

The influence of walkability on walking for transportation during the COVID-19 pandemic in the city of São Paulo, Brazil: a cohort study

Background: Less is known about the prospective pattern of walking for transportation and the influence of more walkable neighborhoods in middle-income countries, mainly after COVID-19. Objective: To analyze the influence of walkability on walking for transportation in São Paulo residents in the periods 2014-2015 (baseline) and 2020-2021(2nd wave). Methods: It was a cohort study conducted with a sample of 1,434 individuals (35.5% of baseline) in São Paulo city, Brazil. At baseline information was collected by face-to-face interview and at the 2nd wave by telephone interview. The outcomes analyzed were walking for transportation ≥ 10 minutes/week and ≥150 minutes/week, measured by the IPAQ long version . The exposure was more walkable neighborhoods grouped into quartiles considering the walkability in the 500m and 1,000m buffers. The covariates analyzed were sex, age group, and educational level. Multilevel mixed-effects logistic regressions were performed considering three models: 1) crude; 2) adjusted for time; and 3) adjusted for time, sex, age groups, and educational level. Results: There was a significant increase in adults who used walking for transportation during the follow-up period (≥ 10 minutes/week: 60.2% versus 71.0%; ≥ 150 minutes/week: 19.9% versus 23.3%) The multilevel models showed that subjects who were located in more walkable neighborhoods in the 1,000m buffer were more likely to walk for transportation ≥ 10 minutes/week (OR=1.46; CI95%:1.10-1.93) and ≥150 minutes/week (OR=1.38; CI95%:1.08-1.76), regardless of the covariates. Conclusions: Living in more walkable neighborhoods can influence walking for transportation, regardless of the individual characteristics of the subjects. It is important that future studies analyze the relationship between financial investments to improve urban mobility as a strategy to encourage active transportation

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

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

Relationship between physical activity and BMI with level of motor coordination performance in schoolchildren

International studies have shown that motor coordination was inversely associated with adiposity, and directly associated with other health outcomes. However, there are few national studies addressing this issue and the results are divergent. The aim of this study was to analyse the relationship between physical activity and body mass index (BMI) with the level of motor coordination performance in children. This cross-sectional study was performed with children aged 5-7 years old. The level of motor performance was evaluated by normative data of the motor quotients assessed by KTK test. BMI was calculated by body weight and height. The level of physical activity was assessed by a questionnaire applied by interviewers with parents. Statistical analysis was performed by Spearman and Pearson test, and multiple linear regression. The sample included 665 children with mean age of 6.29 (± 0.75) years old, and 52.6% were male. It was verified which total motor quotient (TMQ) was directly related to physical activity score (0.096; p = 0.013) and inversely related to BMI (-0.284; p<0.001). The relationship between BMI and TMQ was moderated by family income. BMI was inversely related to the level of motor performance, and the score of physical activity was directly related to the level of motor performance in children in a higher family income

Prevalência e fatores associados à inatividade física nos deslocamentos para escola em adolescentes Prevalence of physical inactivity and associated factors among adolescents commuting to school

O objetivo deste estudo foi verificar a prevalência e identificar fatores associados à inatividade física nos deslocamentos para escola em adolescentes. Trata-se de um estudo epidemiológico transversal baseado na análise secundária de dados de uma amostra de 4.207 adolescentes (14-19 anos). Os dados foram coletados por meio de um questionário previamente validado (GSHS-OMS). Foram classificados como "inativos nos deslocamentos" aqueles que relataram que não se deslocavam ativamente para ir à escola e/ou aqueles que o fazem, mas despendem menos de 20 minutos no trajeto de ida e volta. Observou-se que 43% (IC95%: 41,5-44,5) dos adolescentes são fisicamente inativos nos deslocamentos. Verificou-se que o local de residência e a escolaridade materna foram estatisticamente associados ao desfecho (inatividade física nos deslocamentos para escola) (p The aim of this study was to verify the prevalence of physical inactivity and associated factors among adolescents commuting to school. This was an epidemiological study based on secondary data from a sample of 4,207 adolescents (14-19 years). Data were collected through a previously validated questionnaire (GSHS-WHO). Adolescents were classified as "inactive in commuting" when they reported not commuting to school actively (e.g., walking or bicycling) and/or spent less than 20 minutes getting to and from school. 43% (95%CI: 41.5-44.5) of adolescents were physically inactive in commuting. Place of residence and maternal schooling were statistically associated with outcome (inactivity in commuting to school) (p < 0.01). Among male adolescents, physical inactivity in commuting was significantly associated with age (p = 0.02) and skin color (p = 0.04). Inactivity in commuting was relatively common when compared to other studies

How to improve active mobility in São Paulo, Brazil? Survey with leaders of nongovernmental organizations and public and private sector managers

This study aimed to describe a quantitative survey conducted with leaders to investigate effective and feasible actions that can be evaluated in computational models to inform policies to promote active mobility based in the city of São Paulo, Brazil. In 2022, an online survey was conducted during the Health Survey in São Paulo (Physical Activity and Environment study), which is monitored by representatives of nongovernmental organizations and public and private sector managers. A questionnaire was elaborated with three questions with 13 alternative answers about actions to promote walking and/or cycling. Leaders should select up to three alternatives based on their potential regarding: (1) effectiveness; (2) feasibility or ease of implementation; and (3) desire to verify tests in computational models to inform policies. The survey was answered by 18 leaders from 16 institutions, comprising 13 (72%) women and 12 (67%) representatives of the third sector, whose average age was 48 years and all had complete higher education. Reducing the speed of motor vehicles was the most cited option in all three questions. Other actions mentioned refer to controlling the traffic of vehicles in central areas, improving pedestrian safety, reducing the distances between homes and places of employment, conducting educational campaigns, and expanding and enhancing structures such as bicycle lanes and sidewalks. The results are relevant to support evidence-based decision-making in public management and to provide subsidies for the development of computational models with a view to promoting active mobility.<br/

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

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

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