Physical activity and the coronavirus pandemic: an urgent time to change the recommendation focus / Atividade física e a pandemia de coronavirus: um momento urgente para mudança no foco das recomendações

The COVID-19 pandemic is disrupting the routine daily life of millions of people. The pandemic associated restrictive measures impose unprecedented challenges, including the need to stay physically active in a social distancing scenario that drastically reduces access to physical activity (PA) spaces and opportunities. Therefore, we aimed to discuss the need for an urgent change in the main focus of PA recommendations. The total of PA needed for health promotion has been focused on the minimum of 150min/moderate-to-vigorous PA/week. It is time for a call for action toward shifting the focus of PA recommendations. Instead of the traditional "doing at least 150min/week of PA, and less than that if you can't reach that goal", recommendations should emphasize the idea of "move more, sit less and, if possible, accumulate 150min/PA/week. The coronavirus pandemic, its associated social distancing and impacts on PA opportunities impose an urgent change in PA recommendation main focus

A pandemia de COVID-19 alterou a rotina de milhões de pessoas. Medidas restritivas associadas à pandemia impõem desafios sem precedentes, incluindo a necessidade de nos mantermos fisicamente ativos em um cenário de distanciamento social que reduz drasticamente o acesso a espaços e oportunidades de atividade física (ATF). Discutimos a necessidade urgente de mudança no foco das recomendações de ATF. O total de ATF necessária para promoção da saúde tem sido centrado no mínimo de 150min de ATF moderada-vigorosa/sem. É momento para uma chamada de ação em direção à mudança no foco das recomendações. Ao invés do tradicional "acumule pelo menos 150min/ATF/sem, e menos que isso caso não consiga atingir esta meta", as recomendações deveriam enfatizar a ideia de "mexa-se mais ­ sente-se menos, podendo, acumule 150min/ATF/sem. A pandemia de coronavírus, o distanciamento social e os impactos nas oportunidades de ATF impõem uma mudança urgente no foco das recomendações de ATF

Agreement between BMI and body fat obesity definitions in a physically active population

ABSTRACT Objectives Body mass index (BMI) is a widely used proxy of body composition (BC). Concerns exist regarding possible BMI misclassification among active populations. We compared the prevalence of obesity as categorized by BMI or by skinfold estimates of body fat percentage (BF%) in a physically active population. Subjects and methods 3,822 military firefighters underwent a physical fitness evaluation including cardiorespiratory fitness (CRF) by the 12 min-Cooper test, abdominal strength by sit-up test (SUT) and body composition (BC) by BF% (as the reference), as well as BMI. Obesity was defined by BF% > 25% and BMI ≥ 30 kg/m2. Agreement was evaluated by sensitivity and specificity of BMI, positive and negative predictive values (PPV/NPV), positive and negative likelihood (LR+/LR-), receiver operating characteristic (ROC) curves and also across age, CRF and SUT subgroups. Results The prevalence of obesity estimated by BMI (13.3%) was similar to BF% (15.9%). Overall agreement was high (85.8%) and varied in different subgroups (75.3-94.5%). BMI underestimated the prevalence of obesity in all categories with high specificity (≥ 81.2%) and low sensitivity (≤ 67.0). All indices were affected by CRF, age and SUT, with better sensitivity, NPV and LR- in the less fit and older groups; and higher specificity, PPV and LR+ among the fittest and youngest groups. ROC curves showed high area under the curve (≥ 0.77) except for subjects with CRF ≥ 14 METs (= 0.46). Conclusion Both measures yielded similar obesity prevalences, with high agreement. BMI did not overestimate obesity prevalence. BMI ≥ 30 was highly specific to exclude obesity. Because of systematic under estimation, a lower BMI cut-off point might be considered in this population.