Effects of a physical education intervention on children's physical activity and fitness: the PROFIT pilot study.

BACKGROUND: Physical education classes are widely accepted as one of the most effective settings for promoting physical activity and health and have often been used to implement physical activity interventions. The aim of this pilot study was to test a physical education intervention program on physical activity levels and physical fitness in a sample of school-age children. METHODS: Participants were a convenience sample of 50 children (34 experimental group and 16 in the comparative group) aged between 6 and 11 years old (Mean = 8.28 years). A 21-week intervention was implemented, consisting of high-intensity and physical fitness-focused exercises, in addition to a once-a-month extra class nutritional education. The following variables were evaluated before and post-intervention: physical fitness, sedentary behavior (SB), light physical activity (LPA), moderate physical activity (MVA), and vigorous physical activity (VPA). Propensity score analyses calculated the average treatment effect on the treated (ATET) within a quasi-experimental framework. RESULTS: Physical fitness variables showed improvements after the intervention, specifically for agility (ATET = -0.67 s; p < 0.001), cardiorespiratory fitness (ATET = 89.27 m; p = 0.045), lower limbs power (ATET = 4.47 centimeters; p = 0.025), and speed (ATET = -1.06 s; p < 0.001). For physical activity and SB levels, there were no improvements after intervention implementation. CONCLUSION: The intervention program showed preliminary effectiveness to improve physical fitness of children, but not SB nor physical activity.

A Novel Exploratory Graph-Based Analytical Tool for Functional Near-Infrared Spectroscopy in Naturalistic Experiments: An Illustrative Application in Typically Developing Children.

Naturalistic paradigms are being increasingly applied to investigate human brain function. Compared with resting-state and task-based paradigms in neuroimaging, naturalistic stimuli and situations can be potentially more readily translated to daily-life applications. Among neuroimaging modalities, functional near-infrared spectroscopy (fNIRS) is particularly suitable for naturalistic investigations and applications. However, specific and tailored statistical analysis to interrogate brain function using naturalistic fNIRS is warranted. Here, we describe an exploratory graph-centrality-based approach to investigating participants' spatiotemporal similarities from the fNIRS signal. We illustrate the usefulness of our approach in a sample of typically developing children (10 males and 9 females; mean age of 5.2 years old; sd = 0.78) while they watch the Inscapes movie designed for neuroimaging acquisition. A node in the left dorsal prefrontal cortex presented similar responses across children, and those fNIRS responses were in line with scene transitions in the movie stimulus. Our results suggest the feasibility of applying centrality graph-based measures to investigate brain function in naturalistic fNIRS during development.

Fatores associados aos comportamentos ativo e sedentário em adolescentes brasileiros: uma análise de redes / Factors associated with active and sedentary behaviors in Brazilian adolescents: a network analysis

O presente estudo verificou a associação entre variáveis sociodemográficas, características da esco-la, nível de atividade física (AF) e comportamento sedentário (CS) em adolescentes brasileiros. A amostra foi composta por 71.903 adolescentes entre 13 e 16 anos (52,8% meninas), matriculados no último ano do ensino fundamental, em escolas públicas e privadas do Brasil, participantes da terceira edição da Pesquisa Nacional da Saúde do Escolar (PeNSE). As informações foram recolhidas através de questionário. O tempo de AF na aula de Educação Física e extra aula de Educação Física, o tempo em deslocamento ativo e o tempo em CS foram associados às variáveis sociodemográficas (tipo de município, local da escola, escolaridade da mãe, percepção de insegurança, idade e sexo) e características da escola (tipo de escola e quadra disponível para uso). Utilizou-se a análise de rede. Quanto ao comportamento ativo, a topologia de rede mostrou que os meninos são mais ativos do que as meninas, principalmente na AF extra aula de Educação Física. Além disso, os resultados revelaram um maior tempo de AF na aula de Educação Física para os meninos, estudantes cujas mães apresentavam maior escolaridade, matriculados em escolas privadas e com quadra disponível para uso. Os estudantes matriculados em escolas públicas apresentaram maior tempo de AF em deslocamento ativo. Quanto ao CS, jovens do contexto urbano apresentaram maior exposição quando comparados aos pares do contexto rural. Conclui-se que as características sociodemográficas e da escola estão relacionadas com os comportamentos dos adolescentes brasileiros em todos os domínios da AF e no CS

The present study aimed to verify the association of sociodemographic correlates and school characteristics with levels of physical activity (PA) and sedentary behavior (SB) of Brazilian adolescents. The sample consisted of 71,903 adolescents between 13 and 16 years old (52.8% girls), enrolled in the last year in public and pri-vate elementary schools of Brazil, participants of the third edition of the National Survey of School Health (PeNSE). The time of PA in Physical Education class and extra Physical Education class, time in active commuting and time in SB were related to sociodemographic variables (type of municipality, place where the school is located, mother's schooling, perception of insecurity, age and gender) and school characteristics (type of school, block available for use). Data were analyzed using network analysis. The network topology showed that boys are more active than girls, especially in extra Physical Education`s PA. In addition, boys, students whose mothers have higher education, enrolled in private schools, which have a court available for use, have a positive association with longer time spent in PA in physical education classes. Students enrolled in public schools had a positive association with time spent in active commuting PA. As for SB, young people from the urban context are more exposed to SB than rural context. It was concluded that sociodemographic correlates and characteristics of the school were associated with all domains of the physical activity and sedentary behavior

Does parents' perception of the environment associates with outdoor physical activity duration in low-income preschoolers?

Parents' perception of the environment may influence the time spent in outdoor physical activities in pre-school children. This study aimed to analyze the association between parents' perception of the environment and outdoor physical activities outside the school in low-income preschoolers. In total, 129 preschoolers aged 3 to 5 years (4.4 years ± 0.7 years, 50% boys) and their parents participated in the study. An adapted version of the Neighborhood Environmental Walkability Scale was used to obtain parents' environmental perceptions. Outdoor physical activities was measured based on two questions considering the usual time spent in these activities during week and weekend days. Information on sociodemographic was collected by interview. Logistic regression was used to analyze the associations. Statistical analyses were conducted using SPSS, version 21.0. Most preschoolers (76.9%) had ≤ 2 hours/day in outdoor physical activities during the week while at the weekend, 65.9% reached > 2 hours. Parents' perception of unsafe traffic (OR = 0.39; p = 0.03) was associated with higher chances for a shorter time in outdoor physical activities both during the week and at the weekend (OR = 0.46; p = 0.04). Moreover, preschoolers' whose parents perceive a lack of places to walk (OR = 0.33; p = 0.02) and unsafe night time (OR = 0.36; p = 0.04) are more likely to spend less time in outdoor physical activities during the week. After adjustments for sociodemographic confounders, the perception of unsafe traffic (OR = 0.26; p = 0.01) and places to walk (OR = 0.15; p = 0.01) were predictors of preschooler's shorter time in outdoor physical activities during the week. Parents' perception of unsafe traffic and places to walk were associated with less time in outdoor physical activities in low-income preschoolers.

Effects of a multicomponent intervention on cardiovascular risk factors in overweight children: a randomized clinical trial in light of complex systems.

Analyzing the effects of interventions from a theoretical and statistical perspective that allows understanding these dynamic relationships of obesity etiology can be a more efficient and innovative way of understanding the phenomenon's complexity. Thus, we aimed to analyze the pattern of cardiovascular risk factors between-participants, and the effects within-participants of a multidisciplinary intervention on cardiovascular risk factors in overweight children. This is a randomized clinical trial, and 41 participated in this study. A multicomponent intervention (physical activities, nutritional and psychological counseling) was performed for 10 weeks. Anthropometric and hemodynamics measurements, lipid and glucose profile, cardiorespiratory fitness, and left ventricular mass were evaluated. A network analysis was done. Considering patterns in the network at baseline, WC, WHR, BMI, and Fat were the main variables for cardiovascular risks. Group was the most critical variable in the within-participant network. Participating in a multicomponent intervention and decreasing body fat promoted beneficial cardiovascular factors.

Association between Different Domains of Sedentary Behavior and Health-Related Quality of Life in Adults: A Longitudinal Study.

Extended periods of time on screen devices and sitting are the main activities that characterize sedentary behavior (SB), which negatively impacts the quality of life. This negative influence was demonstrated mainly by cross-sectional studies performed in high-income countries in which the effects of screen time on health-related quality of life (HRQoL) is not considered. Thus, we analyzed the association between the different domains of SB (i.e., subdomains of screen time-television, computer, cellphone) and the HRQoL in adults that live in Brazil during two years of follow-up. The sample included 331 adults. Subdomains of screen time (i.e., watching television, using computers, and cellphones) and of HRQoL (i.e., physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, and current health perception) were assessed by a structured questionnaire and SF-36, respectively. Our results indicate a significant increase in screen time during the two years of follow-up. Linear regression models indicated that although domains of SB were differently associated with HRQoL, in general, screen time was negatively associated with social functioning and positively associated with physical functioning during locomotion and activities of daily living (ADL), role-physical (i.e., physical issues during work and ADLs), and role-emotional (i.e., emotional issues during work and ADLs) after the two-year follow-up. In conclusion, screen time may positively or negatively influence some domains of HRQoL in adults.

Does parents' perception of the environment associates with outdoor physical activity duration in low-income preschoolers? / A percepção dos pais sobre o ambiente se associa à duração da atividade física ao ar livre em pré-escolares de baixa renda? / ¿La percepción de los padres sobre el entorno se asocia con la duración de la actividad física al aire libre en preescolares de bajos ingresos?

Parents' perception of the environment may influence the time spent in outdoor physical activities in pre-school children. This study aimed to analyze the association between parents' perception of the environment and outdoor physical activities outside the school in low-income preschoolers. In total, 129 preschoolers aged 3 to 5 years (4.4 years ± 0.7 years, 50% boys) and their parents participated in the study. An adapted version of the Neighborhood Environmental Walkability Scale was used to obtain parents' environmental perceptions. Outdoor physical activities was measured based on two questions considering the usual time spent in these activities during week and weekend days. Information on sociodemographic was collected by interview. Logistic regression was used to analyze the associations. Statistical analyses were conducted using SPSS, version 21.0. Most preschoolers (76.9%) had ≤ 2 hours/day in outdoor physical activities during the week while at the weekend, 65.9% reached > 2 hours. Parents' perception of unsafe traffic (OR = 0.39; p = 0.03) was associated with higher chances for a shorter time in outdoor physical activities both during the week and at the weekend (OR = 0.46; p = 0.04). Moreover, preschoolers' whose parents perceive a lack of places to walk (OR = 0.33; p = 0.02) and unsafe night time (OR = 0.36; p = 0.04) are more likely to spend less time in outdoor physical activities during the week. After adjustments for sociodemographic confounders, the perception of unsafe traffic (OR = 0.26; p = 0.01) and places to walk (OR = 0.15; p = 0.01) were predictors of preschooler's shorter time in outdoor physical activities during the week. Parents' perception of unsafe traffic and places to walk were associated with less time in outdoor physical activities in low-income preschoolers.

A percepção dos pais sobre o ambiente pode influenciar o tempo gasto em atividades físicas ao ar livre em crianças pré-escolares. Este estudo teve como objetivo analisar a associação entre a percepção dos pais sobre o ambiente e atividades físicas ao ar livre fora da escola em pré-escolares de baixa renda. No total, 129 pré-escolares de 3 a 5 anos (4,4 anos ± 0,7 anos, 50% meninos) e seus pais participaram do estudo. Uma versão adaptada da Escala de Caminhabilidade Ambiental do Bairro foi usada para obter as percepções ambientais dos pais. A atividade física ao ar livre foi mensurada com base em duas questões considerando o tempo habitual despendido nessas atividades durante a semana e os dias de fim de semana. As informações sociodemográficas foram coletadas por meio de entrevista. Foi utilizada regressão logística para analisar as associações. As análises estatísticas foram realizadas no SPSS, versão 21.0. A maioria dos pré-escolares (76,9%) teve ≤ 2 horas/dia em atividade física ao ar livre durante a semana enquanto no final de semana, 65,9% atingiu > 2 horas. A percepção dos pais sobre o trânsito inseguro (OR = 0,39; p = 0,03) foi associada a maiores chances de menor tempo de atividade física ao ar livre tanto durante a semana quanto no final de semana (OR = 0,46; p = 0,04). Além disso, pré-escolares cujos pais percebem falta de lugares para caminhar (OR = 0,33; p = 0,02) e período noturno inseguro (OR = 0,36; p = 0,04) são mais propensos a passar menos tempo em atividade física ao ar livre durante a semana. Após ajustes para fatores de confusão sociodemográficos, a percepção de trânsito inseguro (OR = 0,26; p = 0,01) e locais para caminhar (OR = 0,15; p = 0,01) foram preditores de menor tempo do pré-escolar em atividade física ao ar livre durante a semana. A percepção dos pais sobre o trânsito inseguro e os lugares para caminhar foram associados ao menor tempo de atividade física ao ar livre entre pré-escolares de baixa renda.

La percepción de los padres sobre el entorno puede influir en el tiempo dedicado a actividades físicas al aire libre en niños en edad preescolar. Este estudio tuvo como objetivo analizar la asociación entre la percepción de los padres sobre el ambiente y la actividade física al aire libre fuera de la escuela en preescolares de bajos recursos. En total, participaron en el estudio 129 preescolares de 3 a 5 años (4,4 años ± 0,7 años, 50% niños) y sus padres. Se utilizó una versión adaptada de la Escala de Caminabilidad Ambiental del Vecindario para obtener las percepciones ambientales de los padres. La actividade física al aire libre se midió a partir de dos preguntas considerando el tiempo habitual dedicado a estas actividades durante los días de semana y los fines de semana. La información sociodemográfica se recogió mediante entrevista. Se utilizó regresión logística para analizar las asociaciones. Los análisis estadísticos se realizaron con SPSS, versión 21.0. La mayoría de los preescolares (76,9%) tenían ≤ 2 horas/día en actividade física al aire libre durante la semana mientras que el fin de semana, el 65,9% alcanzaba > 2 horas. La percepción de los padres sobre el tráfico inseguro (OR = 0,39; p = 0,03) se asoció con mayores posibilidades de pasar menos tiempo en actividade física al aire libre tanto entre semana como en fin de semana (OR = 0,46; p = 0,04). Además, los preescolares cuyos padres perciben la falta de lugares para caminar (OR = 0,33; p = 0,02) e inseguridad en la noche (OR = 0,36; p = 0,04) tienen más probabilidades de pasar menos tiempo en actividade física al aire libre durante la semana. Después de los ajustes por factores de confusión sociodemográficos, la percepción de tráfico inseguro (OR = 0,26; p = 0,01) y lugares para caminar (OR = 0,15; p = 0,01) fueron predictores de menor tiempo en actividade física al aire libre de los preescolares durante la semana. La percepción de los padres sobre el tráfico inseguro y los lugares para caminar se asoció con menos tiempo en actividades físicas al aire libre en preescolares de bajos ingresos.

Physical Fitness Plays a Crucial Mediator Role in Relationships Among Personal, Social, and Lifestyle Factors With Adolescents' Cognitive Performance in a Structural Equation Model. The Cogni-Action Project.

Background: The beneficial relationship between physical fitness and cognitive performance is affected and modulated by a wide diversity of factors that seem to be more sensitive during the development stage, particularly during early adolescence. This study aimed to examine the role of physical fitness considering the multivariate association between age, health-related quality of life (HRQOL), school vulnerability index (SVI), body mass index z-score (BMIz), physical activity, and sleep problems with the cognitive performance in boys and girls. Method: Participants were 1,196 adolescents aged 10-14 years (50.7% of boys) from Chile. Three physical fitness components and eight cognitive tasks were measured. BMIz was determined using growth references by age and sex, whereas questionaries were used to assess sleep problems, physical activity, and HRQOL. SVI was established according to the score given by the Chilean Government to educational establishments. We performed a structural equation model (SEM) to test multivariate associations among study' variables by sex. Results: Fitness was positively associated with boys' and girls' cognitive performance (ß = 0.23 and ß = 0.17; p = 0.001, respectively). Moreover, fitness presented a significant mediator role in the relationships between BMIz, SVI, and physical activity with cognitive performance (indirect effect). Additionally, SVI showed a negative association both direct and indirect effect in all three fitness components and all cognitive tasks, being this relationship stronger in girls than in boys. Conclusion: Our findings suggest that physical fitness and all its components play a crucial mediator role in the associations between several factors associated with adolescents' cognitive performance. Thereby, educational and health strategies should prioritise improving physical fitness through physical activity. They also should address other factors such as school vulnerability, obesity, and the early gender gap in a comprehensive approach boosting cognitive performance among early adolescents. Trial registration: Research Registry (ID: researchregistry5791).

Are there differences between male and female badminton athletes in sleep, physical activity and sedentary time? / ¿existen diferencias entre atletas de basdminton masculinos y femeninos en el sueño, actividad física y tiempo de sedentarismo? / Existem diferenças entre atletas de badminton masculinos e femininos no sono, atividade física e tempo de sedentarismo?

ABSTRACT Introduction: High-performance athletes often undergo periods of exhaustive training and insufficient recovery, which can lead to decreased performance, but it is not clear whether there are any differences between the sexes in the level of habitual physical activity, sedentary time or sleep quantity and quality in young highly trained badminton athletes. Objectives: The aim of this study was to compare the habitual physical activity (PA), sedentary time and sleep quantity and quality of highly trained young male and female badminton athletes and non-athletes. Methods: Twenty-seven young badminton athletes and twenty-one non-athletes (control group) were recruited. Sleep duration and quality (total time in bed, total sleep time, wake after sleep onset, sleep efficiency and latency), total counts, vigorous activity time and sedentary time were measured using a tri-axial accelerometer. Results: Male athletes spent less sedentary time (p=0.028), more time in vigorous activity (p=0.016) and had higher total counts (p<0.001) than the male control group. There were no significant differences in sedentary time (p=0.702) or vigorous activity time (p=0.205) between the female athletes and non-athletes, but the female athletes accumulated higher total counts than the female control group (p=0.003). There were no significant differences between the sexes or groups for time in bed, total sleep time, sleep efficiency, wake after sleep onset and latency (p> 0.05). Conclusion: Among males but not females, young highly trained badminton athletes had less sedentary time and more time in vigorous activity than the non-athletes, however, there were no significant differences between the sexes or groups in sleep quantity and quality. Level of evidence III; Case-control study .

RESUMEN Introducción: Los atletas de alto rendimiento con frecuencia son sometidos a períodos de entrenamiento exhaustivo y recuperación insuficiente, lo que puede llevar a una disminución del desempeño, pero no está claro si hay diferencia entre los sexos en cuanto al nivel de actividad física habitual, tiempo sedentario, cantidad y calidad del sueño en jóvenes atletas de bádminton altamente entrenados. Objetivos: El objetivo de este estudio fue comparar la actividad física habitual (AF), el tiempo de sedentarismo y la duración y calidad del sueño en jóvenes atletas de bádminton altamente entrenados y de no atletas, del sexo femenino y masculino. Métodos: Fueron reclutados veintisiete jóvenes atletas de bádminton y veintiuno no atletas (grupo control). La duración y la calidad del sueño (tiempo total en la cama, tiempo total de sueño, vigilia después del inicio del sueño, eficiencia y latencia del sueño), counts totales, el tiempo en actividad vigorosa y el tiempo de sedentarismo fueron medidos con un acelerómetro triaxial. Resultados: Los atletas del sexo masculino tuvieron menos tiempo de sedentarismo (p = 0,028), más tiempo de actividad vigorosa (p = 0,016) y mayor cantidad de counts totales (p <0,001) que el grupo control masculino. No hubo diferencias significativas en el tiempo de sedentarismo (p = 0,702) o tiempo de actividad vigorosa (p = 0,205), entre las atletas y no atletas, pero las atletas del sexo femenino acumularon mayor cantidad de counts totales que el grupo control femenino (p = 0,003). No hubo diferencias significativas entre los sexos o grupos para tiempo en la cama, tiempo total de sueño, eficiencia del sueño, vigilia después del inicio del sueño y latencia (p> 0,05). Conclusiones: Entre hombres, pero no entre mujeres, los jóvenes atletas de bádminton altamente entrenados tuvieron menor tiempo de sedentarismo y mayor tiempo en actividades vigorosas que los no atletas; entretanto, no hubo diferencia significativa entre los sexos o grupos en la cantidad y calidad del sueño. Nivel de evidencia III; Estudio de caso control .

RESUMO Introdução: Atletas de alto rendimento com frequência são submetidos a períodos de treinamento exaustivo e recuperação insuficiente, o que pode levar à diminuição do desempenho, mas não está claro se há diferença entre os sexos quanto ao nível de atividade física habitual, tempo sedentário, quantidade e qualidade do sono em jovens atletas de badminton altamente treinados. Objetivos: O objetivo deste estudo foi comparar a atividade física habitual (AF), o tempo de sedentarismo e a duração e qualidade do sono em jovens atletas de badminton altamente treinados e de não atletas, do sexo masculino e feminino. Métodos: Vinte e sete jovens atletas de badminton e vinte e um não atletas (grupo controle) foram recrutados. A duração e a qualidade do sono (tempo total na cama, tempo total de sono, vigília após o início do sono, eficiência e latência do sono), counts totais, tempo em atividade vigorosa e tempo de sedentarismo foram medidos com um acelerômetro triaxial. Resultados: Atletas do sexo masculino tiveram menos tempo de sedentarismo (p = 0,028), mais tempo de atividade vigorosa(p = 0,016) e maior quantidade de counts totais (p < 0,001) do que o grupo controle masculino. Não houve diferença significante no tempo de sedentarismo (p = 0,702) ou tempo de atividade vigorosa (p = 0,205) entre as atletas e não atletas, mas as atletas do sexo feminino acumularam maior quantidade de counts totais que o grupo controle feminino (p = 0,003). Não houve diferença significante entre os sexos ou grupos para tempo na cama, tempo total de sono, eficiência do sono, vigília após o início do sono e latência (p> 0,05). Conclusões: Entre homens, mas não entre mulheres, os jovens atletas de badminton altamente treinados tiveram menor tempo de sedentarismo e maior tempo em atividades vigorosas do que os não atletas; entretanto, não houve diferença significante entre os sexos ou grupos na quantidade e qualidade do sono. Nível de evidência III; Estudo de caso controle .

School-Time Movement Behaviors and Fundamental Movement Skills in Preschoolers: An Isotemporal Reallocation Analysis.

Little is known of how reallocations of time spent in different movement behaviors during preschool might relate to preschoolers' fundamental movement skills (FMS), a key predictor of later physical activity (PA). Thus, the aim of this study was to examine (a) whether preschoolers' school-time movement was associated with their FMS and (b) the effects on FMS of reallocating time between PA and sedentary behavior (SB). This was a cross-sectional study, using intervention data with Brazilian low-income preschoolers. We observed Brazilian preschoolers of both sexes (Mage = 4.5, SD = 0.8 years-old; 101boys) over 10 hours of school-time and objectively assessed their PA and SB with Actigraph wGT3X and their FMS with the Test of Gross Motor Development - Second Edition. We explored the associations between school-time movement behaviors and FMS and between reallocated school-time movement behaviors and FES using compositional analysis in R (version 1.40-1), robCompositions (version 0.92-7), and lmtest (version 0.9-35) packages. This isotemporal reallocation showed that, for manipulative skills, reallocating time (5, 10, and 15 minutes, respectively) from light PA to SB was associated with increasing skill (0.14, 0.28, and 0.42 FMS units), raising questions as to whether fine motor activity occurred during SB. Thus, school-time movement significantly predicted FMS, with a modest increase in SB, at the expense of light PA eliciting improved manipulative skills.

Can physical education state policies impact on youth's health behaviors? A natural experiment study / Instrução normativa da educação física impacta nos comportamentos de saúde? Um experimento natural

Since 2011 an educational policy promulgated that public schools from Pernambuco have had to offer physical education (PE) class in the same shift where students are enrolled. This study examined the impact of the implementation of an educational policy on PE offering and students' participa-tion, and whether health related behaviors could be moderated by PE participation. It was a natural experiment study performed with data obtained from two cross-sectional studies (2007 and 2012) of a sample (n = 715) of high-school students from Caruaru. PE offering was assessed by asking students if they had PE class and adaptedquestionnairewas used to assess health-related informa-tion. It was observed that before policy implementation, most of the students (♂: 72.4%; ♀: 69.0%) was not engaged in any PE class during the week. After policy implementation the proportion of students who had at least one PE class/week increased (♂: 68.7%; ♀: 68.9%). Having ≥1 PE classes was not associated with the amount of physical activity either before (♂: OR = 1.47 (95%CI: 0.78 ­ 2.76)); ♀: OR = 1.02 (95%CI: 0.61­ 1.72) or after (♂: OR = 0.90 (95%CI: 0.51 ­ 1.58); ♀: OR = 1.06 (95%CI: 0.63 ­ 1.80)) policy implementation. Fruit consumption was the only health-related behavior associated to PE class (♂: OR = 1.55 (95%CI: 1.01 ­ 2.70); ♀: OR = 1.48 (95%CI: 1.02 ­ 2.10)). PE offering and participation of students improved and it seems that implementation of new policies for PE might impact on students' behaviors, although, regarding to some limitations, not sufficiently to impact on overall students' health behaviors

Desde 2011 uma instrução normativa estipulou que escolas públicas de Pernambuco ofertassem aulas de educação física (EF) no turno em que estudantes estão matriculados. Este estudo examinou o impacto dessa normativa na oferta de aulas de EF, na participação e sua associação com comportamentos de saúde dos estudantes. Tratou-se de um experimento natural realizado com dados de dois estudos transversais (2007 e 2012) de uma amostra (n = 715) de estudantes do ensino médio de Caruaru. A oferta de EF foi avaliada perguntando aos estudantes se eles tinham aula de EF, e um questionário adaptado foi utilizado para avaliar comportamentos de saúde. Verificou-se que antes da implementação da normativa a maioria dos estudantes não tinha aulas de EF (♂: 72,4%; ♀: 69,0%). Depois da implementação, a proporção de estudantes que tiveram uma aula de EF/semana aumentou (♂: 68,7%; ♀: 68,9%). Ter ≥1 aula de EF não foi associado o nível de atividade física em adolescentes antes (♂: RO= 1,47 (95%IC: 0,78­2,76); ♀: RO = 1,02 (95%IC: 0,61 ­ 1,72)) ou depois (♂: RO = 0,90 (95%IC: 0,51 ­ 1,58); ♀: RO = 1,06 (95%IC: 0,63 ­ 1,80)) da implementação. Consumo de frutas foi o único comportamento de saúde associado com as aulas de EF (♂: RO = 1,55 (95%IC: 1,01 ­ 2,70); ♀: RO = 1,48 (95%IC: 1,02 ­ 2,10). Após implementação da norma-tiva houve melhorias na oferta de aulas de EF e participação dos estudantes. Parece que isto pode impactar comportamentos de saúde em adolescentes, porém, devido limitações, é insuficiente para impactar os compor-tamentos de saúde no geral

Effects of a randomized controlled study on the behaviors of overweight schoolchildren / Efeitos de um estudo controlado randomizado sobre os comportamentos de escolares sobrepesados

This study aimed to determine the effects of a school-based multi-component intervention on accel-erometer-measured physical activity (PA) and sedentary behavior (SB) in schoolchildren overweight. This is a randomized controlled study with overweight schoolchildren, allocated to experimental group (EG; n = 13; 7.6 ± 0.8 years; 42.9% boys) and control group (CG; n = 17; 8.2 ± 0.9 years; 26.7% boys). The EG was submitted to a 10-week school-based intervention, comprised of PA and psychological sessions (behavioral therapy), and nutritional guidance. The CG followed the daily routine of life. The time of PA and SB were measured using accelerometers used for seven days. To compare mean SB, moderate to vigorous physical activity (MVPA) and total physical activity (TPA), generalized estimation equations (GEE) were used. It was observed thatthe average time in MVPA and TPA increased significantly in EG at the weekend (+ 40.9 min / day, p < 0.001; and + 51.6 min /day, p = 0.035, respectively) and at full week (+ 62.9 min/day, p < 0.001; and + 225.0 9 min/day, p = 0.038, respectively). There was no significant difference in time spent in SB after the intervention in both groups. Thus, it was concluded that the proposed school-based multicomponent intervention was effective in increasing levels of MVPA and TPA in overweight schoolchildren. This finding can optimize future interventions to promote a healthy lifestyle for schoolchildren in the school environment

Este estudo objetivou analisar o efeito de uma intervenção multicomponente de base-escolar sobre os níveis de atividade física (AF) e comportamento sedentário (CS) mensurados por acelerômetro, de escolares com sobrepeso. Trata-se de um estudo controlado randomizado com escolares sobrepesados alocadas em grupo ex-perimental (GE; n = 13; 7,6 ± 0,8 anos; 42,9% meninos) e grupo controle (GC; n = 17; 8,2 ± 0,9 anos; 26,7% meninos). O GE foi submetido a uma intervenção escolar de 10 semanas, composta por sessões de AF e psicológica (terapia comportamental) e orientação nutricional. O GC seguiu a rotina diária de vida. O tempo de AF e o CS foram medidos por meio de acelerômetros, utilizados durante sete dias. Para comparar o tempo médio de CS, atividade física moderada a vigorosa (AFMV ) e atividade física total (AFT), foram utilizadas equações de estimativa generalizadas (GEE). Observou-se queo tempo médio em AFMV e AFT aumentaram significativamente no GE no fim de semana (+ 40,9 min / dia, p < 0,001; e + 51,6 min / dia, p = 0,035, respectivamente) e na semana inteira (+ 62,9 min / dia, p < 0,001; e + 225,0 min/dia, p = 0,038, respectivamente). Não houve diferença significativa no tempo gasto em CS após a intervenção em ambos os grupos. Assim, conclui-se que uma intervenção multicomponente de base escolar proposta foi eficaz no aumento dos níveis de AFMV e AFT em escolares com sobrepeso. Esse achado pode otimizar futuras intervenções em promover um estilo de vida saudável de crianças no âmbito escolar

24-hour movement behaviour and executive function in preschoolers: A compositional and isotemporal reallocation analysis.

Adherence to healthy behaviours promotes several health benefits in preschool children, including executive function (EF). Recently, the predictive power of the 24-hour movement behaviour (24 h MB) composition on health outcomes has been evidenced; however, its relationship with EF in preschoolers is unknown. Thus, the present study had two objectives: (1) to analyse the associations between the 24 h MB composition and EF of preschoolers; and (2) to investigate the theoretical changes in EF when time in different movement behaviours is reallocated. This cross-sectional study was carried out with 123 preschoolers (3-5 years old) of low socioeconomic status. Physical activity (PA) and sedentary behaviour were assessed using an accelerometer for 7 days, sleep time was obtained through interviews with parents, and EF was measured using the Early Tool Box battery. To verify the association between 24 h MB and EF, compositional data analysis was used, and for time reallocation, compositional isotemporal substitution analysis was utilized. It was observed that the 24 h MB composition was positively associated with EF (p < .0001; R² = 0.34), and that reallocating 5, 10, 15 or 20 min of the time spent on sleep and light PA to moderate-to-vigorous PA, respectively, was associated with significant improvements in EF (p < .05). These findings provide hitherto unseen insight into the relationship between 24 h MB and EF in preschool children, and warrants consideration for researchers and practitioners seeking to improve EF and PA in preschool children.

A Network Perspective on the Relationship between Screen Time, Executive Function, and Fundamental Motor Skills among Preschoolers.

The present study aimed to analyze the dynamic and nonlinear association between screen time, executive function (EF), and fundamental motor skills (FMS) in preschoolers, considering sex and body mass index (BMI) from a network perspective. Forty-two preschoolers (24 boys, 3.91 ± 0.77 years old) provided screen time, EF, FMS, and BMI data. EF was measured using the Go/No Go task, and accuracy of Go (sustain attention), reaction time of Go, and accuracy of No Go (inhibitory control) were considered. Relationships between screen time, EF, FMS, sex, and BMI were explored using a network analysis. The emerged network highlights that screen time is intensely associated with the other variables in the network, while the accuracy of Go has the greater connectivity with other nodes in the network (2.27), being the most sensitive to potential intervention changes. Moreover, sex (1.74), screen time (0.93), and accuracy of Go (0.71) showed the greatest closeness. This study showed that in the emerged network, independent of sex, screen exposure affects the accuracy on Go task, and these components affect the variables in the network, as motor abilities and tasks involved in inhibitory control.

Sleep, sedentary behavior and physical activity: changes on children's routine during the COVID-19 / Sono, comportamento sedentário e atividade física: mudanças na rotina de crianças durante a COVID-19

Social isolation was adopted as a strategy to reduce the transmission speed of the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2) in several countries in the world, including Brazil. As a result, schools were closed and the routines of children altered, affecting sleep, sedentary behavior, and physical activity. The present study aims to compare the children's weekly routine and time spent on sleep, sedentary behavior and physical activity before and during the Coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study with a quantitative and qualitative approach was performed, with 120 parents, mothers or guardians of children from 5 to 10 years of age of both sexes enrolled in 5 full-time schools in Arapiraca, Alagoas, Brazil. To meet the research objective, two interviews were conducted between 27 May and 5 June, out addressing aspects of sleep, sedentary behavior, and physical activity before and during the COVID-19 pandemic. In the analysis of quantitative data, the paired sample t test was performed, while for qualitative data, discourse analysis was used. Significant differences (p < 0.05) were found in the routine and in sleep time (increase 10%) and screen time (increase 36%) before vs during the COVID-19 pandemic, on weekdays and weekends. There was also a reduction in the practice of physical activity (54%). Therefore, the findings indicate that behaviors during the COVID-19 pandemic could be harmful to children's health and that the school may be an important social environment to protect children from exposure to these behaviors

O isolamento social foi adotado como estratégia para reduzir a velocidade de transmissão da síndrome respiratória aguda grave de coronavírus 2 (SARS-CoV-2) em vários países do mundo, incluindo o Brasil. Como resultado, as escolas foram fechadas e as rotinas das crianças alteradas, afetando o sono, o comportamento sedentário e a atividade física. O presente estudo tem como objetivo comparar a rotina semanal das crianças e o tempo dispendido em sono, comportamento sedentário e atividade física antes e durante a pandemia da doença coronavírus 2019 (COVID-19). Estudo de caráter transversal e com abordagem quanti-qualitativa, com 120 pais, mães ou responsáveis de crianças de 5 a 10 anos de ambos os sexos, matriculadas em 5 escolas de tempo integral de Arapiraca, Alagoas, Brasil. Foram realizadas duas entrevistas, no período de 27 de Maio à 05 de Junho, abordando os aspectos do sono, comportamento sedentário e atividade física antes e durante a pandemia, a fim de atender o objetivo de pesquisa. Na análise dos dados quantitativos foi realizado o teste t de amostra emparelhada, já para os dados qualitativos foi utilizada a análise do discurso. Foram encontradas diferenças significativas (p < 0,05) na rotina e no tempo de sono (aumento de 10%), no tempo de tela (aumento de 36%) antes vs durante a pandemia de COVID-19, em dias de semana e finais de semana. Foi observada também uma redução na prática de atividade física (54%). Portanto, os achados indicam comportamentos durante a pandemia de COVID-19 que podem ser prejudiciais à saúde das crianças e a escola pode ser um ambiente social importante na proteção a exposição de tais condutas

Twenty-four-hour movement behaviours and fundamental movement skills in preschool children: A compositional and isotemporal substitution analysis.

Studies that have analysed the association between the different movement behaviours and fundamental movement skills (FMS) have considered it in an independent manner, disregarding the compositional nature of 24-h movement behaviours (24-h MB). The aim of this study was to investigate the relationship between the 24-h MB and FMS in preschoolers using a compositional data analysis . Two hundred and four preschoolers (4.5 ± 0.8 years old; 101 boys) provided objectively assessed physical activity (PA) and sedentary behaviour (SB) data (Actigraph wGT3X), and FMS (TGMD-2). Sleep duration (SD) was reported by parents. Association of daily composition of movement behaviours with FMS was explored using compositional analysis and isotemporal substitution (R Core Team, 3.6.1). When considered as a 24-h MB composition (PA, SB and SD), adjusted for age, BMI and sex, the composition predicted locomotor (r2 = 0.31), object control (r2 = 0.19), and total motor score (r2 = 0.35), respectively (all P < 0.001). Reallocation of time from light to moderate-to-vigorous PA was associated with greatest positive changes in total motor score. Achieving adequate balance between movement behaviours over the 24-h period, and its relationship with locomotor and object control skills should be considered and further investigated in early childhood.

Effects and prevalence of responders after a multicomponent intervention on cardiometabolic risk factors in children and adolescents with overweight/obesity: Action for health study.

This study aimed to verify the effect of a multicomponent intervention on cardiometabolic risk factors (CMRF), and to determine the prevalence of responders on CMRF among children and adolescents with overweight/obesity. This is a quasi-experimental study, developed with 35 children and adolescents with overweight/obesity (control group (CG) = 18; intervention group (IG) = 17), aged between 7 and 13 years. Participants in IG underwent a multicomponent intervention for 12 weeks. The following variables were evaluated: anthropometric measures, maturational stages and CMRF (body fatness, HOMA-IR, triglycerides, high-density and low-density lipoprotein) (HDL-C, LDL-C), total cholesterol (TC), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. There was a significant time x group interaction on body fatness (p < 0.001), HOMA-IR (p = 0.01), HDL-C (p < 0.001), LDL-C (p = 0.009) and TC (p < 0.001). The prevalence of responders for CMRF in IG and CG was respectively: body fatness (47%; 0%; p = 0.04), HOMA-IR (58.8%; 16.6%; p = 0.04); triglycerides (17.6%; 5.5%; p = 0.31); HDL-C (76.4%; 5.5%; p = 0.01), LDL-C (35.3%; 5%; p = 0.08), TC (64.7%; 5%; p = 0.01), AST (5.8%; 0%; p = 0.87), ALT (29.4%; 11.1%; p = 0.24) and AST/ALT ratio (24.4%; 22.2%; p = 0.67). Multicomponent intervention induced positive changes on CMRF along with a higher prevalence of positive adaptations in IG than the CG in some of the cardiometabolic outcomes assessed.

Sleep and childhood mental health: role of physical activity and cardiorespiratory fitness / Sono e saúde mental infantil: papel da atividade física e aptidão cardiorrespiratória / Sueño y salud mental infantil: papel de la actividad física y aptitud cardiorrespiratoria

ABSTRACT Introduction: Sleep is considered an important health indicator and plays a key role in brain development and plasticity. Objective: To ascertain whether there is a relationship between sleep quality and mental health indicators and whether organized physical activity (PA) or cardiorespiratory fitness (CRF) act as moderators of this association. Methods: This is a cross-sectional study with a quantitative approach. The sample consisted of 226 students between six and 11 years of age, male and female, in the early years of elementary education at a public school in Porto Alegre, Brazil, which was selected for convenience. CRF was measured by running test and six-minute walk. Sleep quality and organized physical activity outside of school were verified through an anamnesis, socioeconomic status through an adaptation of the ABEP (Brazilian Association of Research Companies) questionnaire, and mental health indicators with the assistance of the Strengths and Difficulties Questionnaire, all answered by parents. Frequencies, means, standard deviations and generalized linear models were used for the data analysis, while a 95% confidence interval was used for the analyses. Results: Sleep quality was associated with total difficulties (β=7.659, p<0.001), emotional symptoms (β= 1.754; p=0.001), hyperactivity/inattentiveness (β=3.054, p <0.001), conduct problems (β=1.619, p<0.001) and peer relationship problems (β=1.231; p=0.007) in boys. In girls it was related to total difficulties (β=3.421; p=0.006), and conduct problems (β=1.235; p=0.003). However, the interactions were not significant. Conclusion: Although they occur independently, stress is placed on the importance of sleeping well, engaging in organized PA and having good CRF levels for the improvement and maintenance of mental health. Level of evidence III; Case-control study.

RESUMO Introdução: O sono é considerado um importante indicador da saúde e tem papel fundamental no desenvolvimento e na plasticidade cerebral. Objetivo: Verificar se há relação entre a qualidade do sono e os indicadores de saúde mental e se a atividade física (AF) organizada ou aptidão cardiorrespiratória (APCR) atuam como moderadores dessa associação. Métodos: Trata-se de um estudo de corte transversal com abordagem quantitativa. A amostra foi composta por 226 alunos entre seis a 11 anos de idade do sexo feminino e masculino, estudantes dos anos iniciais do ensino fundamental de uma escola pública de Porto Alegre - Brasil, sendo a mesma selecionada por critério de conveniência. A APCR foi mensurada através do teste de corrida e da caminhada de seis minutos. A qualidade do sono e a AF organizada fora da escola foram verificadas através de uma anamnese, o nível socioeconômico através de uma adaptação do questionário da ABEP (Associação Brasileira de Empresas de Pesquisa) e os indicadores da saúde mental com o auxílio do Strengths and Difficulties Questionnaire, todos respondidos pelos pais. Para a análise de dados, utilizaram-se frequências, médias e desvios padrão e modelos lineares generalizados. Para as análises, utilizou-se um intervalo de confiança de 95%. Resultados: A qualidade do sono apresentou associação com o total de dificuldades (β=7,659; p<0,001), sintomas emocionais (β=1,754; p=0,001), hiperatividade/déficit de atenção (β=3,054; p<0,001), problemas de conduta (β=1,619; p<0,001) e problemas de relacionamento com colegas (β=1,231; p=0,007), nos meninos. Já nas meninas, apresentou relação com o total de dificuldades (β=3,421; p=0,006) e problemas de conduta (β=1,235; p=0,003). No entanto, as interações não foram significativas. Conclusão: Apesar de ocorrerem por vias independentes, destaca-se a importância de dormir bem, praticar AF organizada e ter bons níveis de APCR para a melhora e manutenção da saúde mental. Nível de evidência III; Estudo caso controle.

RESUMEN Introducción: El sueño es considerado un indicador importante de la salud y juega un papel fundamental en el desarrollo y la plasticidad cerebral. Objetivo: Verificar si hay relación entre la calidad del sueño y los indicadores de salud mental y si la actividad física (AF) organizada o aptitud cardiorrespiratoria (APCR) actúan como moderadores de esa asociación. Métodos: Se trata de un estudio de corte transversal, con abordaje cuantitativo. La muestra fue compuesta por 226 alumnos entre seis a 11 años de edad del sexo femenino y masculino, estudiantes de los años iniciales de la enseñanza fundamental de una escuela pública de Porto Alegre - Brasil, siendo la misma seleccionada por criterio de conveniencia. La APCR se midió a través del test de carrera y de caminata de seis minutos. La calidad del sueño y la AF organizada fuera de la escuela fueron verificadas a través de una anamnesis, el nivel socioeconómico a través de una adaptación del cuestionario de la ABEP (sigla para Asociación Brasileña de Empresas de Encuestas), y los indicadores de salud mental con la ayuda de Strengths and Difficulties Questionnaire, todos respondidos por los padres. Para el análisis de datos, se utilizaron frecuencias, promedios y desviaciones estándar y modelos lineales generalizados. Para los análisis, se utilizó un intervalo de confianza de 95%. Resultados: La calidad del sueño presentó asociación con el total de dificultades (β = 7,659, p <0,001), síntomas emocionales (β = 1,754; p = 0,001), hiperactividad/déficit de atención (β = 3,054; p<0,001) problemas de conducta (β=1,619, p<0,001), y problemas de relacionamiento con colegas (β = 1,231; p = 0,007) en los niños. En las niñas, presentó relación con el total de dificultades (β = 3,421; p = 0,006) y problemas de conducta (β = 1,235; p = 0,003). Sin embargo, las interacciones no fueron significativas. Conclusión: A pesar de ocurrir por vías independientes, se destaca la importancia de dormir bien, practicar AF organizada y tener buenos niveles de APCR para la mejora y mantenimiento de la salud mental. Nivel de evidencia III; Estudio caso control.

Evidences of construct validity, criteria and validation of the motor competence assessment batery of tests in preschoolers / Evidências de validade de construto, critério e fidedignidade da motor competence assessment em pré-escolares

ABSTRACT The literature has evidenced the need for validation studies of motor tests to assess motor competence (MC). Luz et al (2016) proposed a battery of tests, that is, the Motor Competence Assessment (MCA) to evaluate MC in Portuguese children and adolescents. The purpose of the present study was to investigate the evidences of this MCA validity in a sample of Brazilian preschoolers, in addition to assess the correlation between the MC results obtained through MCA and the Test of Gross Motor Development-2 (TGMD-2). 251 male and female preschool-age children from six reference Centers in Early Childhood Education in the city of João Pessoa-PB participated in study. Data were collected by using MCA and TGMD-2. The results of the Confirmatory Factor Analysis (CFA) showed two models, one of them with appropriate adjustment indexes. The interclass correlation coefficients ranged between 0.77 and 0.96, which indicates an excellent reliability; the correlation between MCA and TGMD-2 was significant with a moderate magnitude (r = 0.57, p <0.01). The structure of three latent variables of the MC construct in the MCA was confirmed by the CFA. However, a two-dimensional model is suggested. MCA and TGMD-2 seemed to measure similar aspects of MC. Reliability enabled us to conclude that the MCA protocol applied to preschoolers maintains temporal stability.

RESUMO A literatura tem evidenciado a necessidade de estudos de validação de testes motores para avaliação da competência motora (CM). Assim, Luz e colaboradores propuseram uma bateria de testes Motor Competence Assessment (MCA) para avaliação da CM em crianças e adolescentes portugueses. Objetivou-se investigar as evidências de validade da MCA em uma amostra de pré-escolares brasileiros e testar a correlação entre resultados da CM avaliados com a MCA e o Test of Gross Motor Development -2 (TGMD-2). Participaram 251 pré-escolares de ambos os sexos, de seis Centros de Referência em Educação Infantil de João Pessoa-PB. Os dados foram coletados por meio da MCA e do TGMD-2. Os resultados da análise fatorial confirmatória (AFC) mostraram dois modelos, um com índices de ajuste adequados; Os coeficientes de correlação interclasse variaram entre 0,77 e 0,96, indicando confiabilidade excelente; a correlação entre a MCA e o TGMD-2 foi significante com magnitude moderada (r = 0,57, p<0,01). A estrutura de três variáveis latentes do construto CM na MCA foi confirmada pela AFC. Entretanto, sugere-se um modelo bidimensional. A MCA e o TGMD-2 parecem medir aspectos semelhantes da CM. A confiabilidade permitiu concluir que o protocolo da MCA aplicado a pré-escolares mantém estabilidade temporal.

Physical activity, sedentary time and bone tissue: effects of an 8-months interdisciplinary program with overweight/obese children / Atividade física, tempo sedentário e tecido ósseo: efeitos de um programa interdisciplinar de oito meses com crianças com sobrepeso/obesidade

Moderate to vigorous physical activity plays a recognized osteogenic effect on bone. Moreover, sedentary time, and fat accumulation are unfavorable to bone health. Our study aimed (1) to examine changes in body composition, bone tissue, physical activity, and sedentary time; and (2) to explore whether changes in physical activity intensities and in sedentary time are associated with changes in bone outcomes after a school-based interdisciplinary intervention program. A total of 53 over-weight/obese students (10.6 ± 3.5 year-olds; 26 girls) participated in physical activity classes. Bone area, bone mass, and bone mineral density z-score, body composition (fat mass, fat lean mass), phys-ical activity, sedentary time and potential confounders (vitamin D and maturational status) were assessed at baseline, and 8 months later. General Linear Models were carried out and significance level was set at 5%. Changes in moderate to vigorous physical activity were positively correlated with changes in all bone mass indicators. We observed a significant overall effect of the intervention on bone mineral density z-score changes, however after adjustments for changes in sedentary time and moderate to vigorous physical activity, no effect was observed. Finally, variations in sedentary time and in moderate to vigorous physical activity play an important role in bone mass density in those participants of the interdisciplinary program

A atividade física moderada-vigorosa tem efeito osteogênico reconhecido no osso. Além disso, o tempo sedentário e o acúmulo de gordura são desfavoráveis à saúde óssea. Este estudo objetivou: (1) examinar mudanças na composição corporal, tecido ósseo, atividade física e tempo sedentário; e (2) explorar se as mudanças nas intensidades de atividade física e no tempo sedentário estão associadas a mudanças nos resultados ósseos após um programa de intervenção interdisciplinar de base escolar. 53 estudantes com sobrepeso/obesidade (10,6 ± 3,5 anos; 26 meninas) participaram de aulas com atividade física. Área óssea, massa óssea e escore z de densidade mineral óssea, composição corporal (massa gorda, massa magra de gordura), atividade física, tempo sedentário e potenciais confundidores (vitamina D e status maturacional) foram avaliados no início e após 8 meses. Modelos Lineares Generalizados foram realizados e o nível de significância foi estabelecido em 5%. Alterações na atividade física moderada-vigorosa foram positivamente correlacionadas com as mu-danças em todos os indicadores de massa óssea. Observou-se um efeito geral significativo da intervenção nas alterações do escore z de densidade mineral óssea, entretanto, após ajustes para mudanças no tempo sedentário e atividade física moderada-vigorosa, nenhum efeito foi observado. Por fim, variações no tempo sedentário e na atividade física moderada a vigorosa desempenham importante papel na densidade da massa óssea nos participantes do programa interdisciplinar