Efeito de oito semanas de treinamento funcional sobre a composição corporal e aptidão física de idosos

Objetivo: avaliar o efeito de oito semanas de treinamento funcional sobre a composição corporal e aptidão física de idosos. Método: a amostra foi composta por 10 idosas (65,33 ± 4,08 anos), fisicamente ativas. O programa de exercícios funcionais foi realizado por um período de oito semanas consecutivas. A intensidade do exercício foi determinada por meio da percepção subjetiva de esforço (PSE) de Borg. Os testes utilizados para avaliar a capacidade funcional foram: teste de equilíbrio estático; teste de velocidade de levantar de uma posição sentada; teste de flexão do cotovelo; teste de levantar da cadeira em 30 segundos. A composição corporal foi avaliada através do aparelho de bioimpedância. Resultados: melhoras significativas foram observadas na mobilidade (p=0,018), força de membros superiores (p=0,000) e força de membros inferiores (p=0,000). Com relação a composição corporal, não foram identificadas nenhuma alteração significativa para nenhuma das variáveis analisadas. Conclusão: diante do exposto, conclui-se que oito semanas de treinamento funcional foram eficazes para a melhora da aptidão física de idosos

Prevalência de inatividade física e fatores associados em adolescentes

OBJETIVO: Estimar a prevalência de inatividade física em adolescentes (14 a 18 anos) da cidade de Maringá/PR e explorar sua associação com variáveis demográficas, socioeconômicas, comportamental e indicadores de estado nutricional. MÉTODOS: Estudo transversal com uma amostra representativa de escolares do ensino médio da cidade incluindo 991 (54,5% moças) de 12 colégios públicos e privados selecionados por meio de amostragem em múltiplos estágios. O nível de atividade física habitual foi verificado por meio do IPAQ modificado para adolescentes, usando como referência a última semana. A inatividade física foi definida 4 h/dia), estado nutricional e obesidade abdominal. RESULTADOS: A prevalência de inatividade física em adolescentes foi de 56,9% (moças= 57,9%, rapazes= 55,7%, p=0,46). Os fatores de risco associados à inatividade física foram pertencer ao nível socioeconômico mais baixo, estudar em escolas públicas e ser obeso. CONCLUSÃO: Encontramos uma alta prevalência de inatividade física no estudo. Faz-se urgentemente necessário o desenvolvimento de estratégias, que visem o aumento da atividade física, o que pode ser obtido por meio de desenvolvimento de conteúdos escolares que promovam estilos de vida saudável.OBJECTIVE: To estimate the prevalence of physical inactivity among adolescents (14-18 years) in the city of Maringá/PR and to explore its association with demographic, socioeconomic and behavioral, indicators of nutritional status variables. METHODS: Cross-sectional study with a representative sample of 991 adolescents (54.5% girls) from both public and private high schools selected through multi stage random sampling. The level of habitual physical activity was verified through the IPAQ modified for adolescents, using the last week as a reference period. Physical inactivity was defined as 4 h/d), nutritional status and abdominal obesity. RESULTS: Prevalence of physical inactivity among adolescents was 56.9% (girls = 57.9%, boys = 55.7%, p =. 046). The risk factors associated with physical inactivity were belonging to the lower socioeconomic level, studying at public schools and being obese. CONCLUSION: We found a high prevalence of physical inactivity in the study. It is urgently necessary to develop strategies aimed at increasing physical activity, which can be achieved by development of an educational content that promotes healthy life styles

Efeito de séries de alongamento sobre força e potência muscular avaliadas por dinamômetro isocinético em adolescentes

Ainda há controvérsias sobre a real influência do alongamento sobre a força e potência muscular, principalmente tratando-se de adolescentes. O objetivo do estudo foi verificar por meio do teste em dinamômetro isocinético, os efeitos de séries de alongamento sobre a força e potência muscular, dos extensores e flexores de joelho do membro inferior dominante. O estudo foi realizado com 11 adolescentes do sexo masculino (14,36±1,36 anos) sem experiência em treinamento com pesos. Foi realizado avaliações antropométricas de peso, estatura, IMC, dobras cutâneas e avaliação maturacional com utilização de placa de Tanner. Os participantes foram submetidos ao teste de força e potência muscular (60 e 300°/segundo, respectivamente), no dinamômetro isocinético. Na primeira visita, antes do teste os voluntários realizaram apenas um aquecimento em uma bicicleta ergométrica. Na segunda visita os participantes realizaram um protocolo de alongamento estático, composto por três séries de 40 segundos, com intervalo de 30 segundos entre as séries para cada grupo muscular envolvido. As variáveis analisadas foram pico de torque (Nm) e trabalho total (J). Foi verificada diferença significativa em apenas uma das variáveis analisadas, o pico de torque (Nm) na flexão de joelho a 60°/segundo (p=0,001), sendo maior, o valor encontrado para a condição com alongamento. Em relação ao trabalho total (J) na extensão e flexão do joelho, não foi verificada diferença significativa em nenhuma das variáveis analisadas quando comparadas as condições sem e com alongamento (p>0,05). Dessa forma conclui-se, que para adolescentes do sexo masculino a realização de alongamento possivelmente não influencia no desempenho da força e potência muscular.There are still controversies about the real influence of stretching on muscle strength and power, especially in the case of adolescents. The objective of the study was to verify, through the test in an isokinetic dynamometer, the effects of stretching series on muscle strength and power, of the knee extensors and flexors of the dominant lower limb. The study was carried out with 11 male adolescents (14.36±1.36 years) with no experience in weight training. Anthropometric assessments of weight, height, BMI, skinfolds and maturation assessment were performed using a Tanner plate. The participants were submitted to the muscular strength and power test (60 and 300°/second, respectively), in the isokinetic dynamometer. On the first visit, before the test, the volunteers performed only a warm-up on an exercise bike. On the second visit, participants performed a static stretching protocol, consisting of three sets of 40 seconds, with a 30-second interval between sets for each muscle group involved. The variables analyzed were peak torque (Nm) and total work (J). A significant difference was found in only one of the analyzed variables, the peak torque (Nm) in knee flexion at 60°/second (p=0.001), the value found for the condition with stretching being higher. Regarding the total work (J) in knee extension and flexion, no significant difference was observed in any of the analyzed variables when comparing the conditions without and with stretching (p>0.05). Thus, it is concluded that for male adolescents, stretching may not influence the performance of muscle strength and power

Effect of different intervals recuperative in responses on muscle, blood and hemodynamic

Weight training is a strategy of controlling the natural processes which occur with aging and the interval period between sets can determine the total workload of a training session. The objective of this study was to analyze the muscle performance, level of blood lactate and hemodynamic variables at different intervals of recovery after exercise on an isokinetic dynamometer. The study was conducted with eleven middle-aged individuals (57.00 ± 7.2 years) who practiced weight training for more than six months. The volunteers performed two visits to the Laboratory of Physical Evaluation of the University, where performed three sets of 10 repetitions with 60º/second (power) in the movement of knee extension and flexion on a Biodex isokinetic dynamometer brand 4.0. In the first visit, 60 seconds of rest between sets were made and, in the second visit, 90 seconds between sets. The variables analyzed were peak torque (Nm), total work (J), fatigue index (%), systolic and diastolic blood pressure (mmHg) and blood lactate concentration (mmol / L). To compare the data, we used analysis of variance (p <0.05). After the analysis, it was possible to verify that there were no significant differences between recovery interval of 60 and 90 seconds in relation to muscle strength, fatigue index and blood lactate concentration. Therefore, it is concluded that for individuals who are in the process of aging, apparently 60 or 90 seconds of rest between sets cause the same answers. This discovery may be important for physical education professional in exercise prescription.O treinamento com pesos é uma estratégia para controle de processos ocorridos com o envelhecimento e o período de intervalo entre as séries pode determinar a carga total de treinamento. O objetivo deste estudo foi analisar o desempenho muscular, lactato sanguíneo, índice de fadiga e variáveis hemodinâmicas em diferentes intervalos de recuperação após exercício isocinético. O estudo foi realizado com 11 indivíduos de meia idade (57.00 ± 7.2 anos) que praticavam treinamento com pesos a mais de seis meses. Os voluntários realizaram duas visitas ao Laboratório de Avaliação Física da Universidade, onde realizaram três séries de 10 repetições concêntricas com 60º/segundo na extensão e flexão de joelho em dinamômetro isocinético. Na primeira visita 60 segundos de descanso entre as séries foram realizados e na segunda visita 90 segundos. As variáveis analisadas foram pico de torque (Nm), Trabalho Total (J), Índice de Fadiga (%), Frequência Cardíaca (bpm), Pressão Arterial Sistólica e Diastólica (mmHg) e Concentração de Lactato Sanguíneo (mmol/L). Para comparação entre os dados foi utilizado a Análise de Variância (p<0.05). Após análise pode-se verificar que não houve diferenças significativas entre intervalo de recuperação de 60 e 90 segundos na força muscular, índice de fadiga, concentração de lactato sanguíneo e variáveis hemodinâmicas. Conclui-se que para indivíduos que estão em processo de envelhecimento, aparentemente 60 ou 90 segundos de intervalo entre as séries ocasionam as mesmas respostas. Esse achado pode ser importante para profissionais da educação física na prescrição de exercícios

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

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

RISCO CARDIOVASCULAR: PREVALÊNCIA E ASSOCIAÇÃO DE FATORES EM SERVIDORES PÚBLICOS

Introduo: O estilo de vida sedentrio, assim como o tabagismo, a hipertenso arterial, a dislipidemia e a obesidade so considerados os principais fatores de risco para a morte sbita. Objetivo: Estimar a prevalncia de risco cardiovascular e sua associao com outros fatores em servidores pblicos. Mtodos: Este foi um estudo de corte transversal em adultos, com idade superior a 29 anos e servidores da Universidade Estadual Norte do Paran (UENP). Amostra de 80 servidores pblicos (30 a 65 anos de idade) de ambos os sexos respondeu um questionrio em forma de entrevista sobre risco cardiovascular (Framinghan), atividade fsica (IPAQ-8) e caractersticas sociodemogrficas. Utilizou-se a estatstica descritiva e os testes de Qui-quadrado com correo de Mantel-Haenszel. Os valores de odds ratio no ajustados foram calculados com intervalo de confiana de 95% (IC95%), sendo adotado alfa (p) significativo de 5%. Resultados: A chance aumentada de desenvolver alguma doena cardaca nos prximos 10 anos se apresentou em 37,5% da amostra. O excesso de peso (OR=6,000: IC=1,825-9,721), circunferncia de cintura aumentada (OR=7,389: IC=2,677-20,396) e avano da idade associaram-se significativamente com o risco cardiovascular moderado. Concluso: A prevalncia de fatores de risco cardiovascular foi consideravelmente alta e a coexistncia de mltiplos fatores de risco nestes servidores demonstra tratar-se de uma populao no assistida. Sendo assim, torna-se importante a implantao de polticas para mudanas no estilo de vida deste segmento populacional. Palavraschave: Risco cardiovascular; trabalhadores; fatores associados