Changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease / Mudanças nos comportamentos de estilo de vida durante a pandemia COVID-19 em crianças e adolescentes com cardiopatia congênita

Abstract Objective: To describe the changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease and to investigate the association of congenital heart disease complexity with lifestyle behavior changes. Methods: Cross-sectional study with 127 children and adolescents with congenital heart disease, who underwent cardiac procedure (mean postoperative time: 10.11±3.13 years), conducted between December 2020 and January 2021. Lifestyle behaviors, such as dietary intake, physical activity, sedentary behavior, and sleep, were assessed through telephone interview based on validated questionnaires. Dietary patterns were identified using principal component analysis. Frequency of general and specific combinations of healthy and unhealthy lifestyle behavior changes was evaluated. Multinomial logistic regressions were used to test the association between congenital heart disease complexity and changes in lifestyle behavior. Results: The main lifestyle behaviors acquired during pandemic were: 83.5% decreased physical activity; 37.0% increased sedentary behavior; 26.0% slept more than usual; and 23.6% adopted a less-healthy dietary pattern. Almost half of the participants (41.8%) had at least one unhealthy change in lifestyle behavior. Complex congenital heart diseases were associated with increased sedentary behavior (OR 3.49, 95%CI 1.23-9.90). Conclusions: Children and adolescents with congenital heart disease had unhealthy lifestyle behavior during the pandemic, mainly in the form of reduced physical activity and increased sedentary behavior.

Resumo Objetivo: Descrever as mudanças nos estilos de vida durante a pandemia em crianças e adolescentes com cardiopatia congênita e investigar a associação da complexidade da cardiopatia congênita com as mudanças de estilo de vida. Métodos: Estudo transversal com 127 crianças e adolescentes com cardiopatia congênita, que realizaram procedimento cardíaco (tempo médio de pós-operatório: 10,11 (3,13) anos), realizado entre dezembro de 2020 e janeiro de 2021. O estilo de vida (alimentação, atividade física, comportamento sedentário e sono) foi avaliado por entrevista telefônica, com base em questionários validados. Padrões alimentares foram identificados por meio da análise de componentes principais. Frequência de combinações gerais e específicas de mudanças de estilo de vida saudável e não saudável foram avaliadas. Regressões logísticas multinominais foram utilizadas para testar associações. Resultados: Os principais comportamentos de estilo de vida adquiridos durante a pandemia foram: 83,5% reduziram a atividade física, 37,0% aumentaram o comportamento sedentário, 26,0% dormiram mais e 23,6% mudaram para um padrão alimentar menos saudável. Quase metade (41,8%) dos participantes teve pelo menos uma mudança não saudável no estilo de vida. Cardiopatias congênitas complexas foram associadas ao aumento do comportamento sedentário durante a pandemia (odds ratio 3,49, IC95% 1,23-9,90). Conclusões: Crianças e adolescentes com cardiopatia congênita apresentaram estilo de vida não saudável durante a pandemia, principalmente na forma de redução da atividade física e aumento do comportamento sedentário.

HDL-Cholesterol in Children and Adolescents with Congenital Heart Disease

Abstract Background Children and adolescents with congenital heart disease may be more likely to develop atherogenic cardiovascular diseases in adulthood. Therefore, the early identification of risk factors and intervention in childhood may be crucial for a good quality of life and longevity. Objectives To describe the distribution of high-density lipoprotein-cholesterol (HDL-c) levels and its association with socioeconomic, clinical and cardiovascular risk factors in children and adolescents with congenital heart disease. Methods Cross-sectional study with children and adolescents aged between 5 and 18 years, with congenital heart disease. Socioeconomic, clinical and cardiovascular risk factors were evaluated. HDL-c concentrations were evaluated by the direct method and categorized as desirable (>45 mg/dL), borderline (40-45 mg/dL) and low (<40 mg/dL). We also assessed the "undesirable" levels, consisting of the sum of "borderline" and "low" values for comparative purposes. The multivariate logistic regression analysis was used to evaluate the factor associated with undesirable HDL-c levels. A p<0.05 value was adopted as statistically significant. Results Mean HDL-c was 51.2 mg/dL (SD 12.6), with a prevalence of 33.2% of undesirable HDL-c. In the multivariate analysis, C-reactive protein levels ≥ 3mg/dL (OR 3.26; 95% CI 1.32-8.04), age ≥ 10 years old (OR: 2.11; 95% CI 1.12-3.99) and undesirable levels of triglycerides (OR 2.21; 95% CI 1.13-4.75) were associated with undesirable HDL-c. Conclusion In this sample of children and adolescents with congenital heart disease, almost one third presented low or borderline HDL-c levels. Age ≥10 years, C-reactive protein and triglycerides were associated with undesirable HDL-c levels. These factors should be considered in the prevention of cerebrovascular diseases in adulthood in this population.

Association between bone mineral density and content and physical growth parameters among children and adolescents diagnosed with HIV: a cross-sectional study

ABSTRACT BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

What anthropometric indicators are associated with insulin resistance? Cross-sectional study on children and adolescents with diagnosed human immunodeficiency virus

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

Muscle endurance of Brazilian children and adolescents: a systematic review of the literature / Resistência muscular de crianças e adolescentes brasileiros: uma revisão sistemática da literatura

ABSTRACT Muscle endurance (ME) is considered to be an important indicator of health-related fitness in childhood and adolescence. The present study aimed to identify and summarize the evidence on the prevalence of adequate ME in Brazilian children and adolescents (6 to 18 years old). A systematic search of studies published from 2009 to 2019 was performed in six databases (LILACS; SciELO; SportDiscus; Medline/PubMed; Web of Science; Scopus). We found 16,168 articles, 20 of which met the eligibility criteria and were included in this review for data extraction and assessment of their risk of bias. Among the 23,805 children and adolescents participating in the studies, 43.5% of the total (43.7% of boys and 41.0% of girls) had adequate abdominal ME. Different test batteries were reported, the main ones being PROESP/BR®, FITNESSGRAM®, and AAHPERD®. Most studies were carried out in the South (50.0%) and Southeast (20.0%) regions of Brazil. Regarding the distribution of studies by geographic region and human development index (HDI), there were no disparities in ME between studies conducted in regions with a lower HDI (43.1% for the Northeast and 32.2% for the North) and those with a higher HDI (46.8% for the South and 33.1% for the Southeast). We conclude that less than half of Brazilian children and adolescents of both genders have an abdominal ME adequate for health, with ​​slightly lower values among females.

RESUMO A resistência muscular (RM) tem sido considerada um importante indicador da aptidão relacionada a saúde na infância e adolescência. O estudo teve como objetivo identificar e sumarizar as evidências sobre a prevalência de RM adequada em crianças e adolescentes (6 a 18 anos) no Brasil. Foi realizada uma busca sistemática em seis bases de dados (LILACS; Scielo; SportDiscus; Medline/Pubmed; Web of Science; Scopus), de estudos publicados no período de 2009 a 2019. Foram encontrados 16.168 artigos, sendo que 20 estudos preencheram os critérios de elegibilidade e foram incluídos na presente revisão para extração dos dados e avaliação quanto o seu risco de viés. Entre as 23.805 crianças e adolescentes participantes nos estudos, 43,5% do total (43,7% dos meninos e 41,0% das meninas) apresentaram RM abdominal adequada. Diferentes baterias de testes foram identificadas, sendo as principais PROESP/BR®, FITNESSGRAM® e AAHPERD®. A maioria dos estudos foram realizados de na região Sul (50,0%) e Sudeste (20,0%) do Brasil. Em relação as distribuições dos estudos pelas regiões geográficas e índices de desenvolvimento humano (IDH), não houveram disparidades na RM entre os estudos nas regiões com menores IDH (Nordeste 43,1% e Norte 32,2%) e as de maiores IDH (Sul 46,8% e Sudeste 33,1%). Conclui-se que menos da metade das crianças e adolescentes brasileiras de ambos os sexos possuem uma RM abdominal adequada para a saúde, com valores ligeiramente inferiores no sexo feminino.

Flexibility of Brazilian children and adolescents: a systematic review of the literature / Flexibilidade de crianças e adolescentes brasileiros: uma revisão sistemática da literatura

abstract Flexibility is related to specific tissue properties of the body, which aim to determine the maximum range of motion of the joints without injury. This study aimed to identify and summarize the evidence on prevalence of adequate levels of flexibility in Brazilian children and adolescents (6 to 19 years old). We performed a systematic search of studies published from 2009 to 2019 in six databases (MEDLINE/PubMed; Scopus; SportDiscus; LILACS; Web of Science; SCIELO). Fourteen studies that compiled data from 11,666 participants in seven different Brazilian states were included. All studies conducted sit and reach tests to assess flexibility. Among all the children and adolescents in the analyzed studies, 58.9% of the total (62.0% of boys and 50.9% of girls) had adequate flexibility. We conclude that more than half of Brazilian children and adolescents have adequate flexibility for health.

resumo A flexibilidade está relacionada com propriedades específicas teciduais que permitem a amplitude máxima de movimento articular sem a presença de lesão. O presente estudo teve como objetivo identificar e sintetizar as evidências sobre a prevalência de níveis adequados de flexibilidade em crianças e adolescentes brasileiros (6 a 19 anos). Foi realizada uma busca sistematizada de estudos publicados de 2009 a 2019 em seis bases de dados (MEDLINE/PubMed; Scopus; SportDiscus; LILACS; Web of Science; SCIELO). Foram incluídos 14 estudos que compilaram dados de 11.666 participantes em sete estados brasileiros diferentes. Todos os estudos realizaram teste de sentar e alcançar para avaliar a flexibilidade. Dentre todas as crianças e adolescentes dos estudos analisados, 58,9% do total (62,0% dos meninos e 50,9% das meninas) apresentaram flexibilidade adequada. Concluímos que mais da metade das crianças e adolescentes brasileiros possuem flexibilidade adequada para a saúde.

Mudanças percebidas no estilo de vida no distanciamento social: validade preliminar do questionário / Change perceptions of lifestyle of social distance: preliminary validity of questionnaire

Este estudo teve como objetivos: 1) apresentar o questionário "Percepção das Mudanças no Estilo de Vida Durante o Período de Distanciamento Social" (PERMEV ), elaborado para a aplicação em adultos; 2) estimar a validade de face e conteúdo, e a reprodutibilidade. Foram elaboradas 40 questões agrupadas aos domínios: Alimentação, Atividade física, Comportamento sedentário, Sono, Controle do estresse, Relacionamentos, Comportamentos preventivos e Comportamentos durante o distan-ciamento social. Especialistas na área da saúde realizaram o julgamento da adequação e pertinência do conteúdo das questões. Posteriormente, o instrumento foi reestruturado e submetido à análise da validade de clareza por trabalhadores e estudantes de instituições de ensino superior. Em seguida, realizou-se a análise da reprodutibilidade com a aplicação do teste e reteste com intervalo de 15 a 30 dias e utilizou-se o coeficiente Kappa (K) para a concordância dos dados. O nível de significância es-tatística adotado foi de 5%. Participaram 75 especialistas para a etapa de validade de face e conteúdo, com valores médios de adequação de 89,3% e de pertinência de 89,7%. A validade de clareza foi de 90,2%. Participaram da reprodutibilidade 83 estudantes e servidores de instituições de ensino supe-rior brasileiras e o nível de concordância variou de K de 0,182 a 0,584. Conclui-se que o questionário PERMEV apresentou validade de face e conteúdo e de clareza excelente (≥ 90%), bem como a vali-dade de reprodutibilidade foi razoável para avaliar as mudanças no estilo de vida de adultos durante períodos de distanciamento social, a exemplo, a pandemia da COVID-19

The objectives were: 1) to present the questionnaire "Perception of Changes in Lifestyle During Social Dis-tance Period " (PERMEV ), designed for application in adults; 2) to estimate the face and content validity, and reproducibility. Forty questions were created, grouped into the following domains: Food, Physical Activ-ity, Sedentary Behavior, Sleep, Stress Control, Relationships, Preventive Behaviors and Behaviors during the pandemic. Specialists in the health area performed the judgment of the adequacy and relevance of the content of the questions. Subsequently, the instrument was restructured and submitted to clarity validity analysis by workers and students from higher education institutions. Then, the reproducibility analysis was performed with the application of the test and retest with an interval of 15 to 30 days and the Kappa coefficient (K) was used for data agreement. The level of statistical significance adopted was 5%. Total of 75 specialists participated in the face and content validation, and the mean values of adequacy was 89.3% and relevance was 89.7%. Clarity validity was 90.2%. Eighty-three students and workers from Brazilian higher education institutions participated in reproducibility, and the level of agreement ranged from K from 0.182 to 0.584. Concluded that the PERMEV questionnaire had excellent face and content validity and clarity (≥90%), as well as the reproducibility level was reasonable to assess changes in adult lifestyle during social distance period, for example, the COVID-19 pandemic

Association of physical activity and sedentary behavior at school with cardiovascular risk factors in adolescents / Associação da atividade física e comportamento sedentário realizados na escola com fatores de risco cardiovascular em adolescentes

Abstract The association of moderate to vigorous physical activity and sedentary behavior performed in the school context with cardiovascular risk factors is unclear. Thus, the purpose of this study was to evaluate whether MVPA and SB during school time are associated with single and clustered cardiovascular risk factors in 10- to 16-year-old school students. This study used the baseline data from a non-randomized controlled clinical trial ("MEXA-SE") conducted on 6th to 9th-grade students from schools in Florianopolis, Brazil. Skinfolds, resting blood pressure, 20-m shuttle-run test, fasting glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and white blood cell counts were obtained. MVPA and SB were objectively measured with accelerometers. A minimum of 180 minutes was considered valid school-time for analysis. Multiple linear regression adjusted for age, sex and habitual physical activity was used. School-time MVPA was positively associated with the peak VO2 (β = 0.17 ml.kg.min-1), and inversely associated with sum of four skinfolds (β = -0.96 mm), diastolic blood pressure (β = -0.36 mmHg), systolic blood pressure (β = -0.301 mmHg); triglycerides (β = -1.49 mg.dL-1), and clustered cardiovascular risk factors (β = -0.123). School-time SB was positively associated with clustered cardiovascular risk factors (β = 0.033). In conclusion, independently of habitual physical activity level, school-time MVPA and a lower time in SB were associated to single and clustered cardiovascular risk factors. Thus, the promotion of strategies aimed increase MVPA and reduce SB at school may prevent the onset and early accumulation of cardiovascular risk factors in adolescence.

Resumo A associação da atividade física moderada a vigorosa (AFMV) e do comportamento sedentário (CS) realizados no contexto escolar com fatores de risco cardiovascular é inconclusiva. Assim, o objetivo do presente estudo foi avaliar se a AFMV e o CS realizados durante o período escolar estão associados a fatores de risco cardiovasculares em escolares de 10 a 16 anos. Utilizou-se os dados da linha de base de um estudo clínico controlado não randomizado ("MEXA-SE") realizado com alunos do 6º ao 9º ano de escolas de Florianópolis, Brasil. Dobras cutâneas, pressão arterial, teste de vaivém de 20 metros, glicemia de jejum, triglicerídeos, colesterol total, lipoproteína de alta densidade e contagem de glóbulos brancos foram mensurados. A AFMV e CS foram medidos objetivamente com acelerômetros. Foi preconizado um período mínimo de 180 minutos de uso para considerar o tempo válido e realizou-se regressão linear múltipla ajustada para idade, sexo e atividade física habitual. A AFMV foi associada positivamente com VO2 pico (β=0,17 ml.kg.min-1) e inversamente associada à soma das quatro dobras cutâneas (β=-0,96 mm), pressão arterial diastólica (β=0,36 mmHg), pressão arterial sistólica (β=-0,301 mmHg); triglicerídeos (β=-1,49 mg.dL-1) e fatores de risco cardiovasculares agrupados (β=-0,123). Houve também associação positiva do CS com fatores de risco cardiovascular agrupados (β=0,033). Conclui-se que a AFMV e o CS foram associados a fatores de risco cardiovasculares. Assim, a promoção de estratégias que visem aumentar a AFMV e reduzir o SB no contexto escolar pode impedir o aparecimento e o acúmulo precoce de fatores de risco cardiovasculares na adolescência.

Suicidal behaviors and sedentary lifestyles among adolescents: A cross-sectional epidemiological study in Latin American and Caribbean countries

OBJECTIVES: To verify the association between suicidal behaviors (ideation, planning, and attempts) and sedentary behaviors among adolescents from four Latin American and Caribbean countries. METHODS: A cross-sectional epidemiological study was conducted in four countries in Latin America and the Caribbean (Bahamas, Curação, El Salvador, and Guatemala). The sample comprised 6,813 adolescents aged 11-18 years, of which, 3,559 were females. The three suicidal behaviors considered were ideation, planning, and attempts. Sedentary behavior was regarded as the time that adolescents spent sitting, excluding time at school. Crude and adjusted logistic regression were used to estimate the odds ratio (OR) and 95% confidence interval (CI). RESULTS: Suicidal ideation was present in 10.7% of males and 22.7% of females. Suicidal planning was present in 8.6% of males and 16.3% of females. Suicidal attempt was present in 9.3% of males and 16.3% of females. Sedentary behavior was present in 39.6% of males and 45.7% of females. It was identified that male adolescents who reported spending ≥3 hours/day in sedentary behavior were more likely to have suicidal ideation (OR: 1.42; 95% CI: 1.13-1.80), whereas female adolescents who reported spending ≥3 hours/day in sedentary behavior were more likely to have suicidal ideation (OR: 1.55; 95% CI: 1.30-1.83), planning (OR: 1.54; 95% CI: 1.28-1.86), and attempts (OR: 1.31; 95% CI: 1.09-1.57). CONCLUSION: Adolescents of both sexes who reported spending ≥3 hours/day in sedentary behaviors were more likely to have some suicidal behaviors than those who spent less time in sedentary behaviors.

Abdominal muscular endurance in Brazilian children and adolescents: systematic review of cross-sectional studies / Resistência muscular abdominal em crianças e adolescentes do Brasil: revisão sistemática dos estudos transversais

Abstract The literature has demonstrated the importance of musculoskeletal fitness in the prevention of chronic noncommunicable diseases. Although current recommendations of physical activities include strengthening and muscular endurance aspects, little is known about the muscular endurance levels of children and adolescents in a national scope. The aim of this study was to systematically review the literature to identify the prevalence of Brazilian children and adolescents who meet health criteria for muscular endurance. A hierarchical search was conducted in four databases (MEDLINE; Scopus; SciELO; LILACS) using the following terms: "muscular endurance", "muscle endurance", "physical fitness", "child", "adolescent", "adults" "school" and correspondents in the Portuguese language. Overall, 2,652 articles (2,269 had their title and abstract read) were found and 70 were eligible for reading in full. Seventeen studies were reviewed and evaluated for risk of bias. Among 32,661 children and adolescents, only 40.2% of boys and 31.9% of girls presented abdominal muscular endurance adequate for health, and most studies were conducted in the southern region of Brazil. The variability in procedures for evaluating abdominal muscular endurance and cut-points used for interpretation occurred due to the use of different standardizations (PROESP/BR®, FITNESSGRAM® and AAHPERD®). Less than half of Brazilian adolescents of both sexes have adequate abdominal muscular endurance for health. Studies investigating the causes and consequences of inadequate abdominal muscular endurance may contribute to strategies for disease prevention and health promotion of children and adolescents.

Resumo A literatura tem demonstrado a importância da aptidão musculoesquelética na prevenção de doenças crônicas não transmissíveis. Embora as recomendações atuais de atividades físicas incluam aspectos de fortalecimento e a resistência muscular, pouco se conhece sobre os níveis de resistência muscular de crianças e adolescentes numa abrangência nacional. O objetivo deste estudo foi revisar sistematicamente a literatura para identificar a prevalência de crianças e adolescentes brasileiros que atendem aos critérios de saúde para a resistência muscular. Foi conduzida uma busca sistemática em quatro bases de dados (MEDLINE; Scopus; SciELO; LILACS), utilizando os termos "muscular endurance", "muscle endurance", "physical fitness", "child", "adolescent", "adults", "school" e correspondentes no idioma português. Foram encontrados 2.652 artigos (2.269 tiveram seu título e resumo lidos) e 70 foram elegíveis para leitura na íntegra. Dezessete estudos foram revisados e avaliados quanto ao risco de viés. Entre 32.661 crianças e adolescentes, apenas 40,2% dos meninos e 31,9% das meninas apresentaram resistência muscular abdominal adequada para a saúde, sendo que a maior parte dos estudos foi conduzida na região Sul do Brasil. A variabilidade nos procedimentos para avaliação da resistência muscular abdominal e nos pontos de corte utilizados para interpretação ocorreu devido à utilização de diferentes padronizações (PROESP/BR®, FITNESSGRAM® e AAHPERD®). Menos da metade dos adolescentes brasileiros de ambos os sexos tem resistência muscular abdominal adequada para a saúde. Estudos que investiguem as causas e as consequências da resistência muscular abdominal inadequada podem contribuir para estratégias de prevenção de doenças e promoção da saúde de crianças e adolescentes.

Body image and anthropometric indicators in adolescents living with HIV / Imagem corporal e indicadores antropométricos emadolescentes vivendo com HIV

Abstract The aim of this study was to compare body image and anthropometric indicators among adolescents living with HIV and healthy adolescents (control group). In addition, we verified the associations of anthropometric indicators, infection/treatment, sexual maturity, and sociodemographic characteristics with body image in adolescents living with HIV. One hundred and eleven adolescents aged 10 to 15 years were divided into those living with HIV (n = 57) and a control group (n = 54). Body image was investigated using an eight-point body silhouette scale. Body weight, height, circumferences, and skinfolds were measured. Body image dissatisfaction was found in 54.4% of the adolescents living with HIV, with 38.6% of them wishing to increase their body size. Conversely, body image dissatisfaction was due to the desire to reduce body size in the control group (40.7%). No difference between the HIV and control groups was found for the anthropometric indicators analyzed. Gender (β = -0.52), age (β = 0.18), body weight (β = 0.07), body mass index (β = -0.19), and upper arm muscle area (β = -0.08) explained 42% of the variation in the body image score of adolescents living with HIV. Thinness is the main reason for body image dissatisfaction in adolescents living with HIV. Almost half the body dissatisfaction of adolescents living with HIV was explained by demographic and anthropometric variables.

Resumo Objetivou-se comparar a imagem corporal e os indicadores antropométricos entre adolescentes vivendo com HIV e sem o diagnóstico da infecção (grupo controle). Além disso, foram testadas associações entre variáveis antropométricas, infecção / tratamento, maturação sexual e sociodemográficas com a imagem corporal em adolescentes vivendo com HIV. Participaram 111 adolescentes com idade de 10 a 15 anos, divididos em adolescentes que vivem com HIV (n = 57) e controles (n = 54). A imagem corporal foi investigada a partir da escala de oito silhuetas corporais. As medidas antropométricas realizadas foram massa corporal, estatura, perímetros e dobras cutâneas. Foi encontrado que 54,4% dos adolescentes que vivem com o HIV estavam insatisfeitos com a imagem corporal, sendo que 38,6% indicaram insatisfação por magreza. Por outro lado, adolescentes do grupo controle demonstraram insatisfação com a imagem corporal por excesso de peso (40,74%). Não foi encontrada diferença entre o grupo HIV e controle para os indicadores antropométricos analisados. O sexo (β = -0,52), a idade (β = 0,18), a massa corporal (β = 0,07), o índice de massa corporal (β = -0,19) e a área muscular do braço (β = -0,08) explicaram 42% da variação do escore de imagem corporal em adolescentes que vivem com HIV. A insatisfação com a imagem corporal no grupo HIV é apontada pela magreza e no controle pelo excesso de peso. Quase metade da variação da imagem corporal dos adolescentes que vivem com HIV foram explicadas pelas variáveis demográficas e antropométricas.

Effectiveness of a multicomponent intervention on the screen time of Brazilian adolescents: non-randomized controlled study

The aim of this study was to verify the effectiveness of a multicomponent, school-based intervention in reducing screentime in adolescents according to sex. Methods: This is a non-randomized controlled intervention study focusing on cardiorespiratory fitness, body image, nutrition and physical activity. Screentime (television, computer/video game) was the secondary outcome of the intervention and was addressed using educational strategies (folders, posters, educational sessions and group discussions). Screen time was measured using a structured questionnaire validated in Brazilian adolescents and the excess time spent on-screen was defined as two hours or more daily. The effect of the intervention was analyzed by the McNemar test and logistic regression. Results: Intervention effectively reduced the proportion of adolescents exposed to more than two hours a day of computer/videogame in males from 71.7% to 57.5% (p= 0.002) and excessive time of television in females from 81.5% to 72.6% (p = 0.024), from the beginning to the end of the study in the group receiving intervention. However, no effect of intervention was found in the comparison between intervention and control groups for computer/video game time (OR = 0.822; p = 0.504) and television time (OR = 0.667; p = 0.252). Conclusion: The intervention was not effective in reducing screen time in the comparison between intervention and control groups, but it reduced the screen time of adolescents in the intervention group.(AU)

Are traditional body fat equations and anthropometry valid to estimate body fat in children and adolescents living with HIV?

Abstract The aim of this study was to assess the validity of traditional anthropometric equations and to develop predictive equations of total body and trunk fat for children and adolescents living with HIV based on anthropometric measurements. Forty-eight children and adolescents of both sexes (24 boys) aged 7-17 years, living in Santa Catarina, Brazil, participated in the study. Dual-energy X-ray absorptiometry was used as the reference method to evaluate total body and trunk fat. Height, body weight, circumferences and triceps, subscapular, abdominal and calf skinfolds were measured. The traditional equations of Lohman and Slaughter were used to estimate body fat. Multiple regression models were fitted to predict total body fat (Model 1) and trunk fat (Model 2) using a backward selection procedure. Model 1 had an R2 = 0.85 and a standard error of the estimate of 1.43. Model 2 had an R2 = 0.80 and standard error of the estimate = 0.49. The traditional equations of Lohman and Slaughter showed poor performance in estimating body fat in children and adolescents living with HIV. The prediction models using anthropometry provided reliable estimates and can be used by clinicians and healthcare professionals to monitor total body and trunk fat in children and adolescents living with HIV.

Exercício Melhora o Risco Cardiovascular, Aptidão Física e Qualidade de Vida em Crianças e Adolescentes Hiv+: Estudo Piloto / Exercise Improves Cardiovascular Risk Factors, Fitness, and Quality Of Life in Hiv+ Children and Adolescents: Pilot Study

Crianças e adolescentes infectados pelo HIV através da transmissão mãe-filho têm alto risco de desenvolver doenças cardiovasculares precoces devido à dislipidemia, resistência à insulina e inflamação crônica de baixo grau. O objetivo do estudo piloto foi analisar o efeito de um programa de exercícios físicos lúdicos sobre os desfechos cardiovasculares, morfológicos, metabólicos, de aptidão e qualidade de vida. Um ensaio clínico não-randomizado composto por 24 sessões de exercícios aeróbicos e resistidos foi aplicado a 10 crianças e adolescentes vivendo com o HIV, oriundos de Florianópolis, SC, Brasil. As seguintes variáveis foram obtidas antes e após o programa: colesterol total, HDL-c, LDL-c, triglicerídeos, glicose, proteína-C reativa em jejum, pressão arterial, espessura íntima-média da artéria carótida comum (EIM-ACC), resistência muscular, aptidão aeróbia, antropometria e qualidade de vida medida. Após a intervenção, observou-se diminuição da pressão arterial sistólica (-6,8mmHg, 6,6%, p = 0,019) e EIM-ACC (-60,0µm, 12,2%; p = 0,002) após 24 sessões. Observou-se aumento na resistência muscular dos membros superiores (+3,3 rep.min-1, 63,5%, p = 0,002), flexibilidade (+5,7 cm, 26,0%; p = 0,001) e qualidade de vida (+10,4 pontos, 27,5%, p = 0,003). Em nossa amostra de crianças e adolescentes vivendo com o HIV, um programa de exercícios de curta duração foi associado com melhora no risco cardiovascular, aptidão física e qualidade de vida

ATIVIDADE FÍSICA E GORDURA CORPORAL DE ADOLESCENTES VIVENDO COM HIV: UM ESTUDO COMPARATIVO / PHYSICAL ACTIVITY AND BODY FAT IN ADOLESCENTS LIVING WITH HIV: A COMPARATIVE STUDY

RESUMO Objetivo: Comparar a atividade física habitual entre adolescentes que vivem com o vírus da imunodeficiência humana (HIV) e seus pares saudáveis e testar a relação com indicadores antropométricos de gordura corporal. Método: Estudo transversal, com dois grupos de investigação, composto por 57 adolescentes (10-15 anos) com HIV e 54 adolescentes aparentemente saudáveis, pareados por sexo e idade. Medidas antropométricas foram realizadas e a atividade física habitual foi obtida por um questionário aplicado em entrevista. Os grupos foram comparados de acordo com os exercícios físicos e foi testada a correlação linear e correlação parcial (ajustada por sexo e idade) entre atividade física e os indicadores antropométricos. Resultados: Adolescentes que vivem com HIV apresentaram menor escore total de atividade física, comparados aos pares saudáveis (1,73 versus 2,14; p<0,001); porém tiveram maior participação nas práticas de educação física escolar. Ambos os grupos praticaram futebol e caminhadas mais frequentemente, entre as atividades físicas relatadas. Não houve correlação entre o escore total de atividade física e os indicadores antropométricos de gordura corporal, quando ajustado por sexo e idade. As variáveis sexo feminino (β=21,51), meses de exposição à terapia antirretroviral (β=1,26) e as classes econômicas “B” e “C” (β= 22,05 e β=28,15, respectivamente) explicaram 33% do somatório de dobras cutâneas de adolescentes que vivem com HIV (F=6,70; p<0,001). Conclusões: Adolescentes com o HIV têm menor escore de atividade física comparados aos pares saudáveis, porém a educação física escolar se mostrou um espaço favorável para o aumento dessa prática.

ABSTRACT Objective: To compare regular physical activity among adolescents living with human immunodeficiency virus (HIV) with their healthy peers, and to evaluate the relationship with anthropometric indicators of body fat. Methods: This was a cross-sectional study which investigated two groups: 57 adolescents (10-15 years of age) living with HIV, and 54 apparently healthy adolescents matched for sex and age. Physical activity was evaluated using a questionnaire and anthropometric measurements were performed. The groups were compared in terms of physical activity, and the linear and partial correlations (adjusted for age and sex) between physical activity and the anthropometric indicators were tested. Results: Adolescents living with HIV had a lower total activity score than their healthy peers (1.73 versus 2.14; p<0.001), but participated more frequently in physical education activities. Soccer and walking were the physical activities most frequently reported by adolescents of the two groups. No correlation was observed between total physical activity score and anthropometric indicators of body fat when adjusted for sex and age. Female gender (β=21.51), months of exposure to antiretroviral therapy (β=1.26), and socioeconomic classes B and C (β=22.05 and 28.15, respectively) explained 33% of the sum of skinfolds in adolescents living with HIV (F=6.70; p<0.001). Conclusions: Adolescents living with HIV have lower physical activity scores compared with their healthy peers, but physical education was found to be an opportunity to increase physical activity.

Contribution of Physical Education in the fields of sport, physical activity, health and education for children and young people living with HIV / Contributo da Educação Física na área do esporte, atividade física, saúde e educação para as crianças e jovens que vivem com o HIV

Abstract This narrative review examined documents that show the activity of Physical Education professionals for children and young people living with HIV. Forty documents were analyzed, highlighting the main contributions: 1) Sports / Physical Activity for social inclusion of youth in social vulnerability, reducing discrimination and stigma and development of motor skills; 2) Health, for treatment adherence, sexual and reproductive health, functional assessment, prescription, guidance and supervision of physical exercises; 3) Education, for prevention of infection / re-infection with HIV, education for sexual and reproductive health. These interventions include major initiatives to improve the quality of life and to coping the pandemic of HIV in children and young people.

Resumo Esta revisão narrativa examinou documentos sobre a atividade dos profissionais de Educação Física para as crianças e jovens que vivem com HIV. Foram analisados 40 documentos, destacando as principais contribuições: 1) Esporte / Atividade Física para a inclusão social de jovens em vulnerabilidade social, redução da discriminação e do estigma e desenvolvimento de habilidades motoras; 2) Saúde, para a adesão ao tratamento, saúde sexual e reprodutiva, avaliação funcional, prescrição, orientação e supervisão de exercícios físicos; 3) Educação, para a prevenção da infecção / re-infecção pelo HIV, para a saúde sexual e reprodutiva. Estas intervenções incluem as principais iniciativas para melhorar a qualidade de vida e enfrentamento da pandemia de HIV em crianças e jovens.

Pressão arterial elevada em adolescentes: prevalência e fatores associados / High blood pressure in adolescents: prevalence and associated factors

Objetivou-se verificar a prevalência e os fatores associados à pressão arterial (PA) elevada em adolescentes de um município Brasileiro. Estudo transversal, conduzido em 653 adolescentes (57,9% do sexo feminino) de 14 a 19 anos de idade, estudantes do ensino médio. A Pressão arterial sistólica (PAS) e a diastólica (PAD) foram mensuradas em todos os sujeitos. Variáveis sociodemográficas, do estilo de vida e índice de massa corporal foram obtidas. Regressão logística binária, bruta e ajustada, foi empregada com nível de significância de 5%. A média da PAS e PAD foi de 111,9 mmHg e 69,9 mmHg, respectivamente. A prevalência de PA elevada foi de 12,4%. Na análise multivariável foi identificado que jovens do sexo masculino (OR: 2,37; IC95%: 1,45-3,90), com escolaridade materna de até oito anos (OR: 1,84; IC95%: 1,03-3,30) e com excesso de peso (OR: 3,79; IC95%: 2,23-6,43), apresentaram maiores chances de PA elevada. O termo de interação entre sexo masculino e excesso de peso representou o subgrupo com maiores chances de PA elevada (OR: 6,41; IC95%: 3,00-13,16). Níveis pressóricos elevados acometem adolescentes da cidade de Ponta Grossa, Paraná, e os grupos com maiores chances de PA elevada foram os do sexo masculino, com escolaridade materna baixa e com excesso de peso.

The aim of this study was to assess the prevalence and associated factors of high Blood Pressure (BP) among adolescents in a Brazilian city. A cross-sectional study was conducted with 653 adolescents (57.9% female) of high school level between 14 and 19 years of age. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were measured. Social and demographic variables and lifestyle factors and body mass index were obtained. Binary logistic regression, crude and adjusted, was employed with a significance level of 5%. The mean SBP and DBP were 111.9 mmHg and 69.9 mmHg, respectively. The prevalence of high BP levels was 12.4%. The multivariable analysis revealed that males (OR: 2.37, 95% CI: 1.45, 3.90), adolescents with maternal education < 8 years (OR: 1.84, 95% CI: 1.03, 3.30) and overweight (OR: 3.79, 95% CI: 2.23, 6.43) had greater indices of high BP. The interaction term between males and overweight represented the subgroup with greater indices of high BP (OR: 6.41, 95% CI: 3.00, 13.16). High BP affects adolescents from Ponta Grossa, State of Paraná, and the groups with greater indices of high BP were males, with low maternal educational level and overweight.

Aptidão física relacionada à saúde de escolares de escola pública de tempo integral / Health-related physical fitness of integral time public school students

O objetivo do presente estudo é avaliar os níveis de aptidão física relacionada à saúde de crianças de escola pública de tempo integral do município de Ponta Grossa, Estado do Paraná. A amostra constituiu de 104 crianças de 8 a 10 anos de idade, com 47 do sexo masculino e 57 do sexo feminino. A avaliação constituiu da bateria de testes motores PROESP-BR, com ênfase em qualidades físicas relacionadas à saúde como: flexibilidade no teste de sentar e alcançar, aptidão cardiorrespiratória no teste de corrida ou caminhada de nove minutos e resistência muscular localizada através de teste de abdominais. A composição corporal foi mensurada utilizando-se o índice de massa corporal (IMC). A amostra apresentou diferenças entre os sexos nos seguintes testes: flexibilidade, na faixa etária de oito anos; abdominal, nos grupos de oito e nove anos; e no teste de 9 minutos, no grupo de 10 anos. O grupo feminino apresentou maiores características de sobrepeso, quando comparado ao masculino. Não foram verificadas diferenças estatisticamente significativas entre as idades. Os resultados observados não apresentaram níveis satisfatórios de aptidão física relacionada à saúde, revelando um risco aumentado a doenças crônicas não transmissíveis aos escolares.

The objective of the present study is to evaluate health-related physical fitness level in children of integral time public school of Ponta Grossa city, in the state of Paraná. The sample constituted of 104 children of 8 to 10 years old, 47 male and 57 female. The evaluation constituted of the PROESP-BR motor test battery, with emphasis in health-related physical qualities like: sit-and-reach flexibility test, 9 minutes run or walk cardio-respiratory test and muscular resistance identified through abdominal test. Body composition was assessed utilizing body mass index (BMI). Sample presented differences between sexes in the following tests: flexibility test, in eight age group; abdominal tests, in eight and nine groups; and 9 minutes test in ten group. Female group presented higher overweight characteristics comparing with male group. Statistically significant differences among ages have not been identified. Observed results did not present satisfactory health-related physical fitness levels, revealing an increased risk of chronic noncommunicable diseases in schoolchildren.

Estimativa da massa muscular esquelética em mulheres idosas: validade da impedância bioelétrica / Validity of bioelectrical impedance analysis for the estimation of skeletal muscle mass in elderly women

O presente estudo tem como objetivos: a) verificar a concordância entre os métodos da impedância bioelétrica (BIA) e da absortometria radiológica de dupla energia (DXA) para a estimativa da massa muscular esquelética (MME); e b) analisar o poder preditivo de variáveis antropométricas e da BIA para a predição da MME em idosas. Foram avaliadas 120 mulheres (60 a 81 anos), residentes na região Sul do Brasil. Mensuraram-se as variáveis antropométricas (massa corporal e estatura); a resistência e hidratação dos tecidos livres de gordura foram medidas pela técnica da BIA tetrapolar (Biodinamics - BF-310), e pela DXA de corpo inteiro (Lunar Prodigy DF + 14319 Radiation e software 7.52.002 DPX-L). A diferença entre os métodos foi verificada pelo teste t pareado, análise dos resíduos e o coeficiente de correlação. O valor preditivo das variáveis antropométricas e de BIA foi verificado pela regressão linear múltipla, adotando nível de significância de p < 0,05. Não houve diferença estatística entre os métodos para a estimativa da MME (p > 0,01). Observou-se que a BIA subestimou em média 0,8kg (IC95 por cento: -3,7; 2,0kg) a MME, quando comparada com a DXA. Foi observada alta correlação entre os métodos (r² = 0,75; p < 0,01). A análise de regressão demonstrou que a variável da razão entre a estatura ao quadrado e a resistência (EST²/R) explica 80 por cento da variação da MME, quando ajustada para massa corporal e idade, e essa relação é independente das variáveis de gordura corporal, hidratação dos tecidos magros e índice de massa corporal. Assim, nota-se que a equação da BIA, aqui testada, é válida para a estimativa da MME em mulheres idosas e seu valor pode ser mais bem predito pelo modelo de regressão proposto a partir da medida de EST²/R ajustada para a massa corporal e idade.

The objectives of the present study were: a) to determine the agreement between bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) for the estimation of skeletal muscle mass (SMM), and b) to analyze the predictive power of anthropometric variables and BIA for the prediction of SMM in elderly women. A total of 120 women (60 to 81 years), living in the southern region of Brazil, were studied. Anthropometric variables (body weight and height) were measured. Resistance and hydration of fat-free tissues were measured by tetrapolar BIA (Biodynamics, BF-310) and by whole-body DXA (Lunar Prodigy DF + 14319 Radiation and DPX-L software, version 7.52.002). Differences between methods were determined using the paired t-test, analysis of residuals and correlation coefficient. The predictive value of the anthropometric variables and BIA was evaluated by multiple linear regression, adopting a level of significance of p < 0.05. No significant difference in the estimation of SMM was observed between methods (p < 0.01). BIA underestimated SMM in mean of 0.8 kg (95 percentCI: -3.7; 2.0 kg) when compared to DXA. Correlation between methods was high (r² = 0.75; p < 0.01). Regression analysis demonstrated that the ratio between the square of height and resistance (HEIGHT²/R) explained 80 percent of the variation in SMM when adjusted to body weight and age, regardless of body fat, lean tissue hydration or body mass index. Thus, the BIA equation tested here is a valid tool for the estimation of SMM in elderly women and its value is best predicted by the regression model including HEIGHT²/R adjusted to body weight and age.

Utilização da impedância bioelétrica para estimativa da massa muscular esquelética em homens idosos: [revisão] / Use of bioelectrical impedance for the estimation of skeletal muscle mass in elderly men: [review]

O presente estudo tem como objetivos: a) verificar a concordância entre os métodos da impedância bioelétrica (BIA) e da absortometria radiológica de dupla energia (DEXA), para a estimativa da massa muscular esquelética (MME); b) analisar o poder preditivo das variáveis antropométricas e de BIA para predição da MME em idosos. Foram avaliados 60 homens idosos (61 a 80 anos), residentes na região Sul do Brasil. Mensuraram-se as variáveis antropométricas (massa corporal e estatura), as variáveis de resistência e hidratação dos tecidos livres de gordura foram medidas pela técnica da BIA tetrapolar (Biodinamics - BF-310), realizou-se também um scan de corpo inteiro através da DEXA (LUNAR PRODIGY DF + 14319 Radiation e software 7.52.002 DPX-L). A diferença entre os métodos foi verificada pelo teste “t”, análise dos resíduos e o coeficiente de correlação. O valor preditivo das variáveis antropométricas e de BIA foi verificado pela regressão Linear Múltipla. Observou-se que a BIA superestimou em média 0,6 kg (dp= 1,59) a MME, quando comparada com a DEXA, contudo não houve diferença estatística (p<0,05). Foi observada uma forte relação entre os métodos (r=0,90; p<0,01). A análise de regressão demonstrou que a variável EST²/R explica 86 por cento da variação da MME, quando ajustada para massa corporal e idade e esta relação é independente das variáveis de gordura corporal, hidratação dos tecidos livres de gordura e IMC. Assim, nota-se que o método da BIA, aqui testado, é válido para a estimativa da MME em homens idosos e seus valores podem ser melhor preditos pelo modelo de regressão proposto a partir da medida de EST²/R ajustada para a massa corporal e idade.

The aim of the present study was twofold: a) to determine the agreement between bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DEXA) for the estimation of skeletal muscle mass (SMM), and b) to analyze the predictive power of anthropometric variables and BIA for the prediction of SMM in the elderly. Sixty elderly men (61 to 80 years) from the southern region of Brazil were studied. Anthropometric variables (body weight and height) were measured, the resistance and hydration of fat-free tissues variables were determined by tetrapolar BIA (BF-310, Biodynamics). A whole body DEXA scan was also performed (Lunar Prodigy DF + 14319 Radiation and 7.52.002 DPX-L software). Differences between methods were analyzed using the t-test, analysis of residues and correlation coefficient. The predictive value of the anthropometric variables and BIA was evaluated by multiple linear regression. BIA overestimated SMM on average by 0.60 kg (sd=1.59) when compared to DEXA, however, no statistical difference was observed (p>0.05). There was a strong correlation between methods (r=0.90; p<0.01). Regression analysis demonstrated that the Ht²/R variable explained 86 percent of the variation in SMM when adjusted for body weight and age, and this relationship did not depend on body fat, hydration of fat-free tissues or BMI. Thus, BIA as tested here is a valid method for the estimation of SMM in elderly men and its values can be best predicted using the regression model proposed, which included Ht²/R adjusted for body weight and age.