Association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil: a cross-sectional study

ABSTRACT BACKGROUND: Being active has been shown to have beneficial effects for the health of individuals with chronic diseases. However, data on the association between multimorbidity and physical activity are limited. OBJECTIVE: To investigate the association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil, according to sex. DESIGN AND SETTING: Cross-sectional population-based and household-based study derived from the second wave (2013-2014) of the EpiFloripa Aging Cohort Study. METHODS: Insufficiency of physical activity (outcome) was ascertained using the long version of the International Physical Activity Questionnaire (≤ 150 minutes/week). Eleven self-reported chronic diseases were identified. Multimorbidity was defined from the number of chronic diseases (none; 2 or 3; or 4 or more). The adjustment variables were age, schooling, marital status, income, smoking, alcohol consumption and cognition. Additionally, each chronic disease was adjusted for the others. Associations were tested using logistic regression (crude and adjusted). RESULTS: Among the 1197 participants (≥ 63 years), women (54.0%) were more likely than men (39.6%) to be insufficiently active. In the adjusted analysis, women and men with depressive symptoms, and men with diabetes, were more likely to be insufficiently active than those without symptoms. Multimorbid women were more likely to be insufficiently active, and the magnitude of the effect was strongest for 4 or more diseases. CONCLUSION: This study indicates that the associations were sex-specific. Depressive symptoms and multimorbidity were associated with insufficient physical activity among women, while diabetes was associated with insufficient physical activity among men.

Efeito do treinamento físico em diabéticos tipo I: revisão sistemática de ensaios clínicos randomizados / Effect of physical training on type I diabetics: systematic review of randomized controlled trials

O exercício físico (EF) tem sido recomendado no controle da diabetes tipo 1 (DM1), porém, seus efeitos na hemoglobina glicosilada (HbA1c), dose de insulina e perfil lipídico, ainda são controversos. O objetivo deste estudo foi analisar as evidências do EF em adolescentes com DM1, por meio de uma revisão sistemática. Realizou-se uma busca nas bases de periódicos PubMed, Biblioteca Virtual de Saúde e EBSCOHost. Foram incluídos estudos clínicos controlados e randomizados que testaram o efeito do EF na HbA1c, na dose de insulina e em marcadores do perfil lipídico em adolescentes com DM1, publicados em português ou inglês, entre 2000 e 2017. Foram incluídos cinco estudos em jovens de 10 a 16 anos. As intervenções foram com exercícios aeróbicos, exercícios combinados e pilates, em períodos de três a seis meses. A frequência foi uma a três vezes/semana, com sessões de 45 a 120 minutos e intensidades entre 40-85% da frequência cardíaca máxima (FCMáx), 80-90% da frequência cardíaca de reserva e 50-100% de 10 repetições máximas (RM). Apenas um estudo mostrou-se eficaz na melhora da HbA1c, dois na dose de insulina e quatro no perfil lipídico. Um estudo foi efetivo na HbA1c, na dose de insulina e no perfil lipídico simultaneamente, incluindo exercícios aeróbicos, de flexibilidade, neuromusculares e de equilíbrio, com intensidade de 65-85% FCMáx e 50-100% de 10 RM. Os resultados apontam que não existe consistência nos achados. Conclui-se que não há evidência científica suficiente e consistente do tipo, frequência, intensidade e duração dos programas de EF para adolescentes com DM1.

Exercise has been recommended for the control of type 1 diabetes mellitus (T1DM), but its effects on glycosylated hemoglobin (HbA1c), insulin dose and lipid profile are still controversial. This study aims to analyze evidence of exercise in adolescents with T1DM, through a systematic review. The search was carried out in the bases of periodicals PubMed, Biblioteca Virtual de Saúde and EBSCOHost. Controlled clinical trials and randomized studies were included that showed results on the effect of exercise on HbA1c, insulin dose and lipid profile in T1DM adolescents, published in Portuguese or English between the period 2000-2017. Were included five studies with adolescents in the age of 10 to 16. The interventions were with aerobic, combined exercises and pilates during the period of three to six months. The frequency was of one to three times/week with sessions of 45-120 min. Intensities ranged from 40-85% of the Maximum Heart Rate, 80-90% of the Heart Rate of Reservation and 50-100% of 10 Maximum Reps. One study was effective in HbA1c, two in the insulin dose and four in the lipid profile. Only one study was effective in improvement of theHbA1c, insulin dose and lipid profile simultaneously, including aerobic exercises, flexibility, neuromuscular and balance with intensity of 65-85% Maximum Heart Rate and 50-100% of 10 Maximum Reps. The results indicate that there is no consistency in the findings. We conclude that there is insufficient and consistent scientific evidence of the type, frequency, intensity, and duration of exercise programs for adolescents with T1DM.