Intake of ultra-processed foods and sleep-related outcomes: A systematic review and meta-analysis.

The aim of this review article was to evaluate the association between the intake of ultra-processed foods and sleep-related outcomes through a systematic review and meta-analysis. Pubmed, LILACS, Scielo, Scopus, Embase, and Web of Science were searched on December 31, 2021, for studies that evaluated the association between ultra-processed foods and sleep-related outcomes (self-reported sleep duration and quality). Pooled odds ratios were assessed through a random-effects model; heterogeneity was evaluated using the I2 statistic. Fifteen cross-sectional studies were included; 14 showed that the high intake of ultra-processed foods was statistically significantly associated with sleep-related outcomes (sleep duration and quality). In the crude analysis, compared with low intake, high intake of ultra-processed foods increased the odds of sleep-related outcomes, with increased odds among children and/or adolescents, and null results among adults. When adjusted for cofounders, we found statistically significant results for all ages. The high intake of ultra-processed foods was associated with sleep-related outcomes, with moderate credibility of the evidence. Longitudinal studies and clinical trials confirming these findings are necessary.

Device-based physical activity and late-life depressive symptoms: An analysis of influential factors using share data.

BACKGROUND: Regular physical activity is effective for preventing and managing depression; however, only a few studies have assessed physical activity using device-based measures. We aimed to examine the association between device-based total physical activity and late-life depressive symptoms and explore which factors may explain this relationship. METHODS: Data from 10 European countries who participated in wave 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analyzed. Triaxial accelerometers (Axivity AX3; Axivity, Newcastle UK) were used to assess total physical activity. Depressive symptoms were assessed through the EURO-D scale. Possion regression models and mediation analysis were performed. RESULTS: The final sample included 785 older adults (70 participants had missing data in one or more variables and were excluded from the analysis) [mean (SD): age 68.6 (8.8) years; 59.2 % female]. After adjusting for several confounders, a 10 % increase in the mean acceleration was associated with lower depressive symptoms (B = -0.0228; 95%CI = -0.0395, -0.0061). This association was partly explained by limitations in activities of daily living and quality of life. LIMITATIONS: Cross-sectional design, convenience sample, bi-directionality, lack of cutoff points for classification of the Axivity AX3 placed in the thigh, into intensities. CONCLUSIONS: Higher device-based total physical activity was linked with lower depressive symptoms in older European adults. Future studies employing device-based measures that allow to better capture important physical activity dimensions (i.e., intensity) will better inform about dose-response relationships.

Association of parents' physical activity and weight status with obesity and metabolic risk of their offspring.

Our aim was to analyze the joint association of parental characteristics and offspring obesity indicators with metabolic risk in adolescents. A cross-sectional study was carried out with 972 adolescents and their parents. We observed that overweight adolescents who have a normal weight mother show lower metabolic risk in comparison with their counterparts with overweight mothers. In conclusion, mother's weight status moderates the relationship between offspring' obesity indicators and metabolic risk in adolescents.

Mental health of Brazilian adolescents during the COVID-19 pandemic.

We aimed to assess the factors associated with frequent sadness and nervousness in Brazilian adolescents, during the Covid-19 pandemic, in 9470 adolescents (aged 12-17 years), interviewed from June 27 to September 17, 2020. Prevalences and prevalence ratios were estimated according to socio-demographic variables and factors related to family, school, friends, and health. Brazilian adolescents often felt sad (32.4%) and nervous (48.7%). Higher prevalences of these feelings were related to: being female; aged 15-17 year; from families with financial difficulties; having learned little or nothing with remote education; missing friends; having few friends; family disagreements; having regular/bad health before the pandemic; and worsened health and sleep during the pandemic. Higher prevalence of nervousness was also found in adolescents who worked before the pandemic and those who reported lack of concentration and not knowing if they had COVID-19. Sadness and nervousness in Brazilian adolescents is high and the need for action by the government, schools, health services, and parents to mitigate the impact of the pandemic on the physical and mental health of adolescents. Special attention must be paid to adolescents with previous health problems and those belonging to the most socially vulnerable population.

The COVID-19 pandemic and changes in eating habits of Brazilian adolescents.

Introduction: The social distancing imposed by the COVID-19 pandemic influenced lifestyle and modified dietary patterns. Our objective was to evaluate the consumption of fruits and vegetables (FV), and ultra-processed foods (UPF), before and after the COVID-19 pandemic, as well as to identify the sociodemographic factors associated. Methods: This study used data from the "Convid Adolescents", a survey on health behaviors that were collected through an online questionnaire self-completed by 9.470 adolescents between 12 and 17 years of age during the pandemic in Brazil in 2020. Individuals were invited to participate through a chain-sampling procedure called "virtual snowballing". Information about FV, and UPF consumption before and during the pandemic period were reported. The independent variables used were sex, age group, race/color of skin, kind of school, education level of the mother, region of Brazil, financial difficulties during the pandemic, food insecurity, and social restrictions. Logistic regression models were used. Results: There was a reduction in the low consumption of FV (83.5% to 80.3%) and there was no significant difference in the high consumption of UPF (38.9% to 38.1%) before and during the pandemic. The incidence of low consumption of FV and high consumption of UPF during the pandemic was 20% and 13.8%, respectively. Girls, private school adolescents, who reported having food insecurity and financial difficulties during the pandemic were the most affected subgroups. Conclusions: Despite little change in the prevalence of FV and UPF consumption before and during the pandemic, the incidence of high consumption of UPF and low FV consumption was high, and it identified in specific population subgroups.

Comparison between ActiGraph GT3X and ActivPAL to assess sedentary behavior during the school period

Abstract Aims: This study aimed to compare the sedentary time measured using the ActiGraph GT3X accelerometer with the measurement of sitting and standing time obtained by ActivPAL inclinometers. Methods: This was a cross-sectional study conducted with a sample of 60 schoolchildren (34 males) of one elementary public school in Brazil. The students used both an ActiGraph GT3X accelerometer and an ActivPAL inclinometer, concurrently, positioned at the beginning and removed at the end of the school shift, for four days. For analysis, paired Student's t-tests, Pearson's correlation coefficients, intraclass correlation coefficients, and Bland-Altman plots were used. Results: When comparing sedentary time with sitting time, although correlated (r = 0.53; p < 0.001), the mean minutes were different (134.2 min/day in ActiGraph GT3X vs 120.3 min/day in ActivPAL; p < 0.001), with a bias of 13.9 min/day. When comparing the measurement of sedentary time with the sum of the sitting time plus standing time, different mean minutes were also observed (134.2 min/day in ActiGraph GT3X vs 177.0 min/day in ActivPAL; p < 0.001), and although the correlation was stronger (r = 0.75; p < 0.001), the bias was higher (−42.8 min/day). Conclusion: Sedentary time derived from the ActiGraph GT3X device should be used with caution to evaluate sedentary behavior in a school setting and may be interpreted only as non-moving activities (stationary behavior).

Association of parents' physical activity and weight status with obesity and metabolic risk of their offspring / Associação do status de atividade física e peso dos pais com os indicadores de obesidade e risco metabólico dos filhos

Abstract Our aim was to analyze the joint association of parental characteristics and offspring obesity indicators with metabolic risk in adolescents. A cross-sectional study was carried out with 972 adolescents and their parents. We observed that overweight adolescents who have a normal weight mother show lower metabolic risk in comparison with their counterparts with overweight mothers. In conclusion, mother's weight status moderates the relationship between offspring' obesity indicators and metabolic risk in adolescents.

Resumo Nosso objetivo foi analisar a associação combinada entre características dos pais e indicadores de adiposidade dos filhos com o risco metabólico em adolescentes. Foi realizado estudo transversal com 972 adolescentes e seus pais. Observamos que adolescentes com sobrepeso que possuem mãe com peso normal apresentaram menor risco metabólico em comparação com seus pares com mães que apresentam sobrepeso. Concluímos que o status de peso da mãe modera a relação entre indicadores de obesidade e risco metabólico dos adolescentes.

Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil.

This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12-17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. We used the "virtual snowball" sampling method, and students from private and public schools were included. A total of 9470 adolescents were analyzed. A hierarchical logistic regression model was used to find the factors associated with reporting at least two of three self-reported problems-sadness, irritability, and sleep problems. The main proximal factor was loneliness (AdjOR = 8.12 p < 0.001). Problems related to school closures also played an important role. Regular intake of fruits and vegetables, as well as physical activity, demonstrated a positive influence on emotional well-being, while excessive screen time (AdjOR = 2.05, p < 0.001) and alcohol consumption negatively affected outcomes (AdjOR = 1.73, p < 0.001). As for distal variables, less affluent adolescents were the most affected, and males reported fewer emotional problems than females. Uncertainty regarding the disease in a context of socioeconomic vulnerability, together with rises in unhealthy behaviors and isolation from their immediate social circles, have negatively affected adolescents' emotional status throughout the COVID-19 pandemic.

The COVID-19 pandemic and changes in the lifestyles of Brazilian adolescents.

OBJECTIVE: To analyze changes in the lifestyles of Brazilian adolescents during the COVID-19 pandemic. METHODS: Cross-sectional study carried out with adolescents who participated in the survey "ConVid Adolescentes - Pesquisa de Comportamentos". The indicators related to lifestyles before and during the COVID-19 pandemic were evaluated: consumption of healthy and unhealthy foods, physical activity and sedentary behavior, smoking and consumption of alcohol. Prevalence and 95% confidence intervals were calculated for the total population and according to sex and age group. RESULTS: A total of 9,470 adolescents participated in the study. During the period of social distancing, there was an increase in the prevalence of vegetables consumption (from 27.34 to 30.5%), frozen foods (from 13.26 to 17.3%), chocolates and sweets (from 48.58 to 52.51%), and time in front of screens (from 44.57 to 70.15%). On the other hand, there was a decrease in the practice of physical activity (from 28.70 to 15.74%) and in the consumption of alcohol (from 17.72 to 12.77%). Differences were observed according to sex and age group. CONCLUSION: The results show changes in the lifestyle of adolescents and an increase in health risk behaviors.

Factors affecting Brazilians' self-rated health during the COVID-19 pandemic.

This is a cross-sectional study investigating the factors affecting brazilians' self-rated health during the COVID-19 pandemic, based on data from the web-based behavior survey. Carried out from April 24 to May 24, 2020, the survey recruited participants by a chain sampling procedure. Its outcome was the worsening of self-rated health during the pandemic. Statistical analysis was based on a hierarchical model of determination. Logistic regression models were used to test the associations between sociodemographic characteristics, pre-existing health conditions, lifestyle indicators and intensity of social restraint measures, and biological and psychological issues during the pandemic. From the total sample of 45,161 participants, 29.4% reported worsening of health state during this period. After adjusting for hierarchical distal factors, the health problems mostly associated with worsening health state were: bad self-rated health (adjusted OR = 4.35, p < 0.001), health care seeking for mental health problem (adjusted OR = 3.95, p < 0.001), and for COVID-19 (adjusted OR = 3.60, p < 0.001). People who experienced sleep problems, worsening of back pain, depression and at least one flu symptom during the pandemic were twice as likely to report worsening of health status. Sedentary and eating behaviors and adherence to social distancing measures showed significant correlation with the outcome. There exists a relation between social, biological, and psychological factors, mediated by lifestyles and variables pertaining to confinement. Altogether, these factors have negatively affected self-rated health during the COVID-19 pandemic in Brazil.

Association of social and economic conditions with the incidence of sleep disorders during the COVID-19 pandemic. / Associação das condições sociais e econômicas com a incidência dos problemas com o sono durante a pandemia de COVID-19.

Sleep is a fundamental aspect for maintaining physical and emotional health, as well as one's well-being. Few studies have assessed the effect of socioeconomic conditions on sleep in the COVID-19 pandemic. Our objective was to analyze the increase or incidence of sleep disorders according to demographic and economic conditions, prior to the pandemic, and according to changes in financial, occupational, and household conditions during the pandemic. This study was conducted via web access, using data from April 24 to May 24, with 45,160 Brazilians (aged 18 or older), with a sample weighted by Brazilian National Household Sample Survey (PNAD) data. Change in sleep quality (outcome), monthly income, effect on family income, occupation/work, gender, age group, marital status, and change in domestic work (exposures) were reported. The percentages of onset or increase of sleep disorders and adjusted odds ratio were estimated. The chance of exacerbation of sleep disorders was 34%, 71%, and twice as high in people with income less than one minimum wage before the pandemic, in those who lost their job and in those who had a great decrease in their income/were without income, respectively. The chance of worsening sleep disorders was 82% higher in women; three times higher (OR = 3.14) in the population aged from 18 to 29, compared to the older adults; and higher with the increase in the amount of housework (OR = 2.21). Financial and occupational factors were determinants in the worsening of self-reported sleep quality, requiring rapid actions on these conditions in order to minimize this effect. Gender, age group, and household routines also deserve attention regarding sleep quality.

O sono é importante para a manutenção da saúde física, emocional e para o bem-estar. Poucos estudos avaliaram o efeito das condições socioeconômicas no sono no período da COVID-19. O objetivo foi analisar o aumento ou a incidência dos problemas do sono segundo condições demográficas e econômicas, prévias à pandemia, e segundo mudanças nas condições financeiras, ocupacionais e tarefas domésticas durante a pandemia. Estudo realizado via web, usando dados de 24 de abril a 24 de maio, com 45.160 brasileiros (18 ou mais), com amostra ponderada pelos dados da Pesquisa Nacional por Amostra de Domicílios (PNAD). Mudança na qualidade do sono (desfecho), renda mensal, efeito na renda familiar, na ocupação/trabalho, sexo, faixa etária, situação conjugal e alteração no trabalho doméstico (exposições) foram reportados. Estimamos os percentuais de início ou aumento dos problemas com o sono e os OR ajustados. A chance de exacerbação dos problemas com o sono foi de 34%, 71% e duas vezes maior nas pessoas com renda inferior a um salário mínimo antes da pandemia, nas que perderam o emprego e naquelas que tiveram a renda muito diminuída/ficaram sem renda, respectivamente. A chance de piorar os problemas do sono foi 82% maior nas mulheres; três vezes maior (OR = 3,14) na população com 18 a 29 anos, em relação aos idosos; e maior com o incremento da quantidade de tarefas domésticas (OR = 2,21). Fatores financeiros e ocupacionais foram determinantes na deterioração da qualidade do sono autorreferida, demandando ações rápidas sobre essas condições a fim de minimizar esse impacto. Gênero, faixa etária e rotinas domésticas também merecem atenção em relação à qualidade do sono.

El sueño es importante para mantener la salud física, emocional y bienestar. Pocos estudios evaluaron el efecto de las condiciones socioeconómicas en el sueño durante el período de la COVID-19. El objetivo fue analizar el aumento o incidencia de los problemas del sueño, según condiciones demográficas y económicas, previas a la pandemia, y según cambios en las condiciones financieras, ocupacionales y tareas domésticas durante la pandemia. Estudio realizado vía web, usando datos del 24 de abril al 24 de mayo, con 45 160 brasileños (18 o más), con una muestra ponderada por los datos de la Encuesta Nacional por Muestreo de Hogares (PNAD). Se informó de cambio en la calidad de sueño (desenlace), renta mensual, efecto en la renta familiar, en la ocupación/trabajo, sexo, franja etaria, situación conyugal y alteración en el trabajo doméstico (exposiciones). Estimamos los porcentajes de inicio o aumento de los problemas con el sueño y los OR ajustados. La oportunidad de exacerbación de los problemas con el sueño fue un 34%, 71% y 2 veces mayor en las personas con renta inferior a 1 salarios mínimos antes de la pandemia, en las que perdieron el empleo y en aquellas que tuvieron la renta muy disminuida/se quedaron sin renta, respectivamente. La oportunidad de empeorar los problemas de sueño fue un 82% mayor en las mujeres; tres veces mayor (OR = 3,14) en la población con 18 a 29 años, en relación con los ancianos; y mayor con el incremento de la cantidad de tareas domésticas (OR = 2,21). Los factores financieros y ocupacionales fueron determinantes en el deterioro de la calidad del sueño autoinformada, demandando acciones rápidas sobre estas condiciones, a fin de minimizar este impacto. Género, franja de edad y rutinas domésticas también merecen atención en relación con la calidad del sueño.

Changes in the prevalence of physical inactivity and sedentary behavior during COVID-19 pandemic: a survey with 39,693 Brazilian adults.

This study analyzed changes in the prevalence of physical inactivity and sedentary behaviors according to correlates during the COVID-19 pandemic among Brazilian adults. A national retrospective online survey was conducted with 39,693 Brazilian adults. Physical activity (weekly frequency and daily duration; cut-off point of 150 minutes/week), TV-viewing time and computer/tablet use (daily duration; cut-off point of 4 hours/day) before and during the pandemic period were reported. Sex, age group, schooling level, skin color, per capita income, country region, working status during the quarantine, and adherence to the quarantine were the correlates. Descriptive statistics were used. The prevalence of physical inactivity, high TV-viewing time and computer/tablet use increased, respectively, 26%, 266%, and 38% during the pandemic. While increases in physical inactivity and computer/tablet were more widespread, higher increases in the prevalence of high TV viewing tiem were observed among younger adults (660%), with higher schooling level (437%) and those who were at home office (331%). The prevalence of physical inactivity and sedentary behaviors increased in all population sub-groups during the COVID-19 pandemic in Brazil.

ConVid - Behavior Survey by the Internet during the COVID-19 pandemic in Brazil: conception and application methodology. / ConVid - Pesquisa de Comportamentos pela Internet durante a pandemia de COVID-19 no Brasil: concepção e metodologia de aplicação.

The ConVid - Behavior Survey was conducted in Brazil from April 24 to May 24, 2020, aiming to investigate changes in lifestyles and health conditions during the COVID-19 pandemic. In this article, we present the conception and methodology of the research. We used a cross-sectional study using an Internet questionnaire, with questions validated in previous health surveys. The sampling method "virtual snowball" was used, as well as post-stratification procedures. The results related to chronic non-communicable diseases and pre-pandemic lifestyles were compared with estimates from the 2013 Brazilian National Health Survey and 2019 Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey. The total sample was 45,161 people. After data weighing, the sample distributions of demographic variables were similar to population variables. Only people with a low schooling level were underrepresented. The comparison with the previous results showed similarity in most estimates: recommended consumption of fruits and vegetables (22.1%), recommended physical activity (35.2%), tobacco smoking habit (12.3%), frequent and abusive alcohol consumption (6.7%), obesity (21.2%), self-reported prevalence of hypertension (18.6%), diabetes (7.1%), and heart disease (4.4%). The online survey made it possible to know the population's health conditions during the pandemic. The similarity of the indicators with those obtained in traditional research allowed the validation of the mean estimates. Studies are needed to investigate how the endogenous effects of virtual social networks can be considered when estimating variance.

A ConVid - Pesquisa de Comportamentos foi realizada no Brasil de 24 de abril a 24 de maio de 2020, com o objetivo de investigar as mudanças nos estilos de vida e nas condições de saúde durante a pandemia de COVID-19. Neste artigo, apresentamos a concepção e metodologia da pesquisa. Estudo de corte transversal com a utilização de um questionário pela Internet, com questões validadas em inquéritos de saúde anteriores. O método de amostragem foi o "bola de neve virtual" e foram usados os procedimentos de pós-estratificação. Os resultados relativos às doenças crônicas não transmissíveis e estilos de vida pré-pandemia foram comparados às estimativas da Pesquisa Nacional de Saúde de 2013 e da Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico de 2019. A amostra total foi de 45.161 pessoas. Após a ponderação dos dados, as distribuições amostrais das variáveis demográficas foram semelhantes às populacionais. Apenas as pessoas de baixo nível de instrução foram sub-representadas. A comparação com os resultados anteriores mostrou similaridade na maioria das estimativas: consumo recomendado de frutas e legumes (22,1%), atividade física recomendada (35,2%), fumo de cigarros (12,3%), consumo frequente e abusivo de álcool (6,7%), obesidade (21,2%), prevalências autorreferidas de hipertensão (18,6%), diabetes (7,1%) e doença do coração (4,4%). O inquérito online possibilitou conhecer as condições de saúde da população durante a pandemia. A similaridade dos indicadores com os obtidos em pesquisas tradicionais permitiu validar as estimativas médias. Estudos são necessários para investigar como os efeitos endógenos das redes sociais virtuais podem ser levados em consideração na estimação da variância.

La ConVid - Encuesta de Comportamientos se realizó en Brasil del 24 de abril al 24 de mayo de 2020, con el objetivo de investigar los cambios en los estilos de vida y en las condiciones de salud durante la pandemia de COVID-19. En este artículo, se presenta la concepción y metodología de la encuesta. Estudio de corte transversal, utilizando un cuestionario por Internet, con cuestiones validadas en encuestas de salud anteriores. El método de muestra fue el de "bola de nieve virtual" y se usaron procedimientos de posestratificación. Los resultados relativos a las enfermedades crónicas no transmisibles y estilos de vida prepandemia se compararon con las estimaciones de la Encuesta Nacional de Salud de 2013 y de la Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas por Encuesta Telefónica de 2019. La muestra total fue de 45.161 personas. Tras la ponderación de los datos, las distribuciones de la muestra de las variables demográficas fueron semejantes a las poblacionales. Solamente las personas con un bajo nivel de formación estuvieron sub-representadas. La comparación con los resultados anteriores mostró similitud en la mayoría de las estimaciones: consumo recomendado de frutas y legumbres (22,1%), actividad física recomendada (35,2%), tabaco de liar para cigarrillos (12,3%), consumo frecuente y abusivo de alcohol (6,7%), obesidad (21,2%), prevalencias autoinformadas de hipertensión (18,6%), diabetes (7,1%) y enfermedad del corazón (4,4%). La encuesta online posibilitó conocer las condiciones de salud de la población durante la pandemia. La similitud de los indicadores con los obtenidos en investigaciones tradicionales permitió validar las estimaciones medias. Se necesitan estudios para investigar cómo los efectos endógenos de las redes sociales virtuales pueden ser tenidos en consideración en la estimación de la variancia.

Factors associated with increased cigarette consumption in the Brazilian population during the COVID-19 pandemic. / Fatores associados ao aumento do consumo de cigarros durante a pandemia da COVID-19 na população brasileira.

Social distancing measures adopted in various countries to mitigate the impact of the COVID-19 pandemic can lead to unwanted effects on their populations' health and behaviors. This study aimed to investigate smoking behavior in the Brazilian adult population during the COVID-19 pandemic and analyze factors associated with the increase in cigarette consumption. An online survey was performed, and the final sample included 45,160 individuals. The study used post-stratification weights and calculated crude prevalence ratios (PR) and adjusted by sex, age, and schooling, and respective 95% confidence intervals (95%CI). Poisson regression models with robust variance were applied to analyze associations between increased cigarette consumption and sociodemographic variables and adherence to social distancing, quality of sleep, state of mind, and changes in work and earnings. Prevalence of smokers was 12% (95%CI: 11.1-12.9), 34% of whom reported an increase in cigarette consumption. The increase was greater among women (PR = 1.27; 95%CI: 1.01-1.59) and individuals with incomplete secondary schooling (PR = 1.35; 95%CI: 1.02-1.79). The increase in cigarette consumption was associated with worse quality of sleep, feeling isolated from family members or sad, depressed, or anxious, loss of earnings, and worse self-rated health. Health promotion strategies, smoking prevention, and encouragement for smoking cessation, as well as mental health interventions, should be continued and reinforced in the context of social distancing during the COVID-19 pandemic.

Medidas de distanciamento social adotadas em diversos países para mitigar o impacto da pandemia de COVID-19 podem acarretar efeitos indesejáveis sobre a saúde e o comportamento das populações. Este estudo objetivou investigar o comportamento de fumar na população adulta brasileira durante a pandemia de COVID-19 e analisar os fatores associados ao aumento do consumo de cigarro. Foi realizado um inquérito virtual e a amostra final correspondeu a 45.160 indivíduos. Foram utilizados pesos de pós-estratificação e calculadas as razões de prevalência (RP) brutas e ajustadas por sexo, idade e escolaridade, e os respectivos intervalos de 95% de confiança (IC95%). Modelos de regressão de Poisson com variância robusta foram aplicados para a análise de associação entre o aumento do consumo de cigarros e as variáveis sociodemográficas e as relativas à adesão ao distanciamento social, qualidade do sono, estado de ânimo, alteração no trabalho e nos rendimentos. A prevalência de fumantes foi de 12% (IC95%: 11,1-12,9), dos quais 34% relataram aumento no consumo de cigarros. Esse aumento foi maior entre as mulheres (RP = 1,27; IC95%: 1,01-1,59) e entre indivíduos com o Ensino Médio incompleto (RP = 1,35; IC95%: 1,02-1,79). O aumento do consumo de cigarros esteve associado à piora da qualidade do sono, sentir-se isolado dos familiares, triste ou deprimido, ansioso, ficar sem rendimentos e pior avaliação do estado de saúde. Estratégias de promoção da saúde, de prevenção do uso e de incentivo à cessação do consumo de cigarros, bem como intervenções em saúde mental, devem ser continuadas e reforçadas no contexto de distanciamento social durante a pandemia de COVID-19.

Las medidas de distanciamiento social adoptadas en diversos países para mitigar el impacto de la pandemia de COVID-19 pueden acarrear efectos indeseables sobre la salud y el comportamiento de las poblaciones. Este estudio tuvo como objetivo investigar el comportamiento de fumar en la población adulta brasileña, durante la pandemia de COVID-19, y analizar los factores asociados al aumento del consumo de tabaco. Se realizó una encuesta virtual y la muestra final correspondió a 45.160 individuos. Se utilizaron pesos de pos-estratificación y se calcularon las razones de prevalencia (RP) brutas y ajustadas por sexo, edad y escolaridad, así como los respectivos intervalos de 95% de confianza (IC95%). Se aplicaron modelos de regresión de Poisson con variancia robusta para el análisis de asociación entre el aumento del consumo de tabaco y las variables sociodemográficas, así como las relativas a la adhesión al distanciamiento social, calidad del sueño, estado de ánimo, cambios en el trabajo e ingresos. La prevalencia de fumadores fue de un 12% (IC95%: 11,1-12,9), de los cuales un 34% relataron un aumento en el consumo de cigarrillos. Este aumento fue mayor entre las mujeres (RP = 1,27; IC95%: 1,01-1,59) y entre individuos con la enseñanza media incompleta (RP = 1,35; IC95%: 1,02-1,79). El aumento del consumo de tabaco estuvo asociado con un empeoramiento de la calidad del sueño, sentirse aislado de los familiares, triste o deprimido, ansioso, quedarse sin ingresos, al igual que con una peor evaluación del estado de salud. Las estrategias de promoción de salud, prevención del consumo y de alicientes para dejar el hábito de fumar, así como intervenciones en salud mental, deben ser continuas y estar reforzadas en el contexto de distanciamiento social durante la pandemia de COVID-19.

Older adults in the context of the COVID-19 pandemic in Brazil: effects on health, income and work. / Idosos no contexto da pandemia da COVID-19 no Brasil: efeitos nas condições de saúde, renda e trabalho.

The goal of this study is to characterize the population of older adults in Brazil during the COVID-19 pandemic with regard to health, socioeconomic conditions, gender inequality, adherence to social distancing and feelings of sadness or depression. It is a cross-sectional study carried out with Brazilian older adults who responded to an online health survey (N = 9,173), using a "virtual snowball" sampling method. Data were collected online via a self-administered questionnaire. Prevalence and confidence interval estimates were performed and verified for independence using Pearson's chi-square test. During the pandemic there was a fall in household income among almost half of older adults. Extreme social distancing was practiced by 30.9% (95%CI: 27.8; 34.1) and 12.2% (95%CI: 10.1; 14.7) did not adhere to it. Older adults who were not working before the pandemic adhered in greater numbers to extreme social distancing measures. Most of them presented comorbidities associated with a higher risk of developing the severe form of COVID-19. Feelings of loneliness, distress and sadness were frequent among older adults, especially women. The COVID-19 pandemic widened the inequality gap by affecting the most vulnerable older people. Strategies to mitigate loneliness and social distancing should consider social vulnerability and the marked difference between men and women in terms of household composition and socioeconomic and working conditions. The development of representative surveys of Brazilian older adults is recommended, investigating the impact of the pandemic on this population.

O presente estudo tem o objetivo de caracterizar a população idosa brasileira durante a pandemia de COVID-19, considerando suas condições de saúde, socioeconômicas, desigualdade de sexo, adesão ao distanciamento social e sentimento de tristeza ou depressão. Estudo transversal realizado com idosos brasileiros que participaram de um inquérito de saúde (N = 9.173), com método de amostragem "bola de neve virtual". Os dados foram coletados via web, por meio de questionário autopreenchido. Foram estimadas prevalências, intervalos de confiança e, para verificar a independência das estimativas, utilizou-se o teste qui-quadrado de Pearson. Durante a pandemia, houve diminuição da renda em quase metade dos domicílios dos idosos. O distanciamento social total foi adotado por 30,9% (IC95%: 27,8; 34,1) e 12,2% (IC95%: 10,1; 14,7) não aderiram. Idosos que não trabalhavam antes da pandemia aderiram em maior número às medidas de distanciamento social total. Grande parte apresentou comorbidades associadas ao maior risco de desenvolvimento da forma grave de COVID-19. Sentimentos de solidão, ansiedade e tristeza foram frequentes entre os idosos, especialmente entre as mulheres. A pandemia da COVID-19 aprofundou a desigualdade ao afetar os idosos mais vulneráveis. Estratégias para mitigar a solidão e o distanciamento social devem ser feitas levando-se em conta a vulnerabilidade social e a acentuada diferença entre homens e mulheres quanto à composição domiciliar e às condições socioeconômicas e de trabalho. Recomenda-se o desenvolvimento de pesquisas representativas da população idosa brasileira e que investiguem o impacto da pandemia neste grupo.

El objetivo de este estudio es caracterizar a la población anciana brasileña durante la pandemia de COVID-19, considerando sus condiciones de salud, socioeconómicas, desigualdad de sexo, adhesión al distanciamiento social y sentimiento de tristeza o depresión. Es un estudio transversal realizado con ancianos brasileños que participaron en una encuesta de salud virtual (N = 9.173), con un método de muestra "bola de nieve virtual". Los datos fueron recogidos vía web, mediante un cuestionario autocompletado. Se estimaron las prevalencias, intervalos de confianza y, para verificar la independencia de las estimaciones, se utilizó el test chi-cuadrado de Pearson. Durante la pandemia, hubo una disminución de la renta en casi la mitad de los domicilios de los ancianos. El distanciamiento social total fue adoptado por un 30,9% (IC95%: 27,8; 34,1) y 12,2% (IC95%: 10,1; 14,7) no se adhirieron. Los ancianos que no trabajaban antes de la pandemia se adhirieron en mayor número a las medidas de distanciamiento social total. Gran parte presentó comorbilidades asociadas a un mayor riesgo de desarrollo de la forma grave de COVID-19. Sentimientos de soledad, ansiedad y tristeza fueron frecuentes entre los ancianos, especialmente entre las mujeres. La pandemia de COVID-19 profundizó la desigualdad al afectar a los ancianos más vulnerables. Se deben elaborar estrategias para mitigar la soledad y el distanciamiento social, teniéndose en cuenta la vulnerabilidad social y la acentuada diferencia entre hombres y mujeres, respecto a la composición domiciliaria y las condiciones socioeconómicas y de trabajo. Se recomienda el desarrollo de investigaciones representativas de la población anciana brasileña, que investiguen el impacto de la pandemia en esta población.

The COVID-19 pandemic and changes in Brazilian adolescents' lifestyles Covid 19 e estilo de vida dos adolescentes / A pandemia de COVID-19 e mudanças nos estilos de vida dos adolescentes brasileiros

Objective: To analyze changes in the lifestyles of Brazilian adolescents during the COVID-19 pandemic. Methods: Cross-sectional study carried out with adolescents who participated in the "Covid Adolescentes - Behavior Survey". The indicators related to lifestyles before and during the pandemic were evaluated: consumption of healthy and unhealthy foods, physical activity and sedentary behavior, smoking and consumption of alcoholic beverages. Prevalence and 95% confidence intervals were calculated for the total population and according to sex and age group. Results: 9,470 adolescents participated in the study. During the period of social distance, there was an increase in the prevalence of consumption of vegetables (from 27.34% to 30.5%), frozen foods (from 13.26% to 17.3%), chocolates and sweets (from 48.58% to 52.51%) and time in front of screens (from 44.57% to 70.15%). On the other hand, there was a decrease in the practice of physical activity (from 28.7% to 15.74%) and in the consumption of alcoholic beverages (from 17.72% to 12.77%). Differences were observed according to sex and age group. Conclusion: The results show changes in the adolescents' lifestyles and an increase in health risk behaviors.

Objetivo: Analisar as mudanças nos estilos de vida dos adolescentes brasileiros durante pandemia de COVID-19. Métodos: Estudo transversal realizado com adolescentes que participaram do inquérito "Convid Adolescentes - Pesquisa de Comportamentos". Foram avaliados os indicadores relacionados aos estilos de vida antes e durante a pandemia: consumo de alimentos saudáveis e não saudáveis, prática de atividade física e comportamento sedentário, tabagismo e consumo de bebidas alcóolicas. Foram calculadas as prevalências e intervalos de confiança de 95% para população total e segundo sexo e faixa etária. Resultados: Participaram do estudo 9.470 adolescentes. Durante o período de distanciamento social, foi observado aumento nas prevalências de consumo de hortaliças (de 27,34% para 30,5%), de pratos congelados (de 13,26% para 17,3%), de chocolates e doces (de 48,58% para 52,51%) e do tempo em frente às telas (de 44,57% para 70,15%). Por outro lado, houve diminuição da prática de atividade física (de 28,7% para 15,74%) e do consumo de bebidas alcóolicas (de 17,72% para 12,77%). Foram observadas diferenças segundo sexo e faixa etária. Conclusão: Os resultados apontam mudanças nos estilos de vida dos adolescentes e aumento de comportamentos de risco à saúde. Objetivo: Analisar as mudanças nos estilos de vida dos adolescentes brasileiros durante pandemia de COVID-19. Métodos: Estudo transversal realizado com adolescentes que participaram do inquérito "Convid Adolescentes - Pesquisa de Comportamentos". Foram avaliados os indicadores relacionados aos estilos de vida antes e durante a pandemia: consumo de alimentos saudáveis e não saudáveis, prática de atividade física e comportamento sedentário, tabagismo e consumo de bebidas alcóolicas. Foram calculadas as prevalências e intervalos de confiança de 95% para população total e segundo sexo e faixa etária. Resultados: Participaram do estudo 9.470 adolescentes. Durante o período de distanciamento social, foi observado aumento nas prevalências de consumo de hortaliças (de 27,34% para 30,5%), de pratos congelados (de 13,26% para 17,3%), de chocolates e doces (de 48,58% para 52,51%) e do tempo em frente às telas (de 44,57% para 70,15%). Por outro lado, houve diminuição da prática de atividade física (de 28,7% para 15,74%) e do consumo de bebidas alcóolicas (de 17,72% para 12,77%). Foram observadas diferenças segundo sexo e faixa etária. Conclusão: Os resultados apontam mudanças nos estilos de vida dos adolescentes e aumento de comportamentos de risco à saúde.

Approaches and methods to assess sedentary behavior in Brazil: a systematic review / Abordagens e métodos para avaliar o comportamento sedentário no Brasil: uma revisão sistemática

Our aim was to characterize the Brazilian studies that evaluated sedentary behavior, describing the main characteristics of the studies and identifying the used instruments. Using the PRISMA meth-odology, the search occurred on 25 August 2019 and was updated on 17 October 2020 in the fol-lowing databases: PUBMED, LILACS, and SCIELO. Studies in English, Spanish, and Portuguese were included. The inclusion criteria were studies performed with a sample of Brazilians, and that used an instrument to evaluate sedentary behavior. In total, 229 articles were selected. The majority of the studies evaluated children and adolescents. Only 33 studies used device-derived measures and there was a great variability in the questionnaires used. Only 83/198 studies presented quality criteria for the instrument used. Most studies considered the screen time in a typical week plus weekend to characterize sedentary behavior. Therefore, sedentary behavior in Brazil has mostly been evaluated by different questionnaires, and few have been appropriately validated. These findings emphasize the importance of standardization and methodological rigor for assessing sedentary behavior in the Brazilian context

Nosso objetivo foi caracterizar os estudos brasileiros que avaliaram o comportamento sedentário, descrevendo as principais características dos estudos e identificando os instrumentos utilizados. Utilizando a metodologia PRISMA, a busca ocorreu em 25 de agosto de 2019 e foi atualizada em 17 de outubro de 2020 nas seguintes bases de dados: PUBMED, LILACS e SCIELO. Estudos em inglês, espanhol e português foram incluídos. Os critérios de inclusão foram estudos realizados com uma amostra de brasileiros e que utilizassem um ins-trumento para avaliar o comportamento sedentário. No total, foram selecionados 229 artigos. A maioria dos estudos avaliou crianças e adolescentes. Apenas 33 estudos usaram medidas derivadas de dispositivos e houve uma grande variabilidade nos questionários usados. Apenas 83/198 estudos apresentaram critérios de quali-dade para o instrumento utilizado. A maioria dos estudos considerou o tempo de tela em uma semana típica mais o fim de semana para caracterizar o comportamento sedentário. Portanto, o comportamento sedentário no Brasil tem sido avaliado em grande parte por diferentes questionários, e poucos foram devidamente va-lidados. Esses achados enfatizam a importância da padronização e do rigor metodológico para avaliação do comportamento sedentário no contexto brasileiro

Changes in Brazilians' socioeconomic and health conditions during the COVID-19 pandemic. / Mudanças nas condições socioeconômicas e de saúde dos brasileiros durante a pandemia de COVID-19.

OBJECTIVE: To describe changes in socioeconomic and health conditions of Brazilians during the COVID-19 pandemic. METHODOLOGY: Cross-sectional study with data from a web-based behavioral survey carried out from April 24 to May 24, 2020, with 45,161 participants recruited by the chain sampling method. A descriptive analysis of the survey topics was performed: adherence to social restriction measures, diagnosis of the new coronavirus, work situation and income, difficulties in routine activities, presence of comorbidities, psychological issues, and access to health services. Prevalence and respective 95% confidence intervals were estimated. RESULTS: Approximately 74% of Brazilians adhered to social restrictions. As for flu symptoms, 28.1% reported having at least one flu symptom, but only 5.9% underwent testing for COVID-19. Regarding the socioeconomic impact, 55.1% reported a decrease in family income, and 7.0% were left without any income; 25.8% of the people lost their jobs, with the group of informal workers being the most affected (50.6%). As for health conditions, 29.4% reported worsening of health status; 45%, having sleep problems; 40% frequently presented feelings of sadness, and 52.5%, of anxiety; 21.7% sought health care, and, among them, 13.9% did not get care. CONCLUSION: The findings show the importance of controlling the COVID-19 pandemic in Brazil, to mitigate the adverse effects on the socioeconomic and health conditions related to social restriction measures.

OBJETIVO: Descrever as mudanças nas condições socioeconômicas e de saúde dos brasileiros durante a pandemia de COVID-19. MÉTODOS: Estudo transversal com dados de pesquisa de comportamentos realizada pela internet de 24 de abril a 24 de maio de 2020 com 45.161 participantes recrutados por amostragem em cadeia. Foi feita uma análise descritiva de temas abordados na pesquisa: adesão às medidas de restrição social, diagnóstico do novo coronavírus, situação de trabalho e rendimentos, dificuldades nas atividades de rotina, presença de comorbidades, estado de ânimo e acesso aos serviços de saúde. Foram estimados as prevalências e os intervalos de 95% de confiança. RESULTADOS: Aproximadamente 75% dos brasileiros aderiram à restrição social. Quanto aos sintomas de gripe, 28,1% relatou ter apresentado algum sintoma, mas apenas 5,9% realizou teste para COVID-19. Em relação à situação socioeconômica, 55,1% relatou diminuição do rendimento familiar, e 7% ficou sem rendimento; 25,8% dos indivíduos ficaram sem trabalhar, sendo o grupo de trabalhadores informais o mais afetado (50,6%). Quanto às condições de saúde, 29,4% avaliou que a sua saúde piorou; 45% teve problemas no sono, 40% apresentou, frequentemente, sentimento de tristeza e 52,5% de ansiedade/nervosismo; 21,7% procurou serviço de saúde e, entre estes, 13,9% não conseguiu atendimento. CONCLUSÃO: Os achados mostram a importância do controle da pandemia de COVID-19 no Brasil, para mitigar os efeitos adversos na situação socioeconômica e nas condições de saúde relacionados às medidas de restrição social.

Association Between Device-Measured Moderate-to-Vigorous Physical Activity and Academic Performance in Adolescents.

BACKGROUND: Although many studies found a positive association between physical activity (PA) and academic performance (AP), most did not consider important variables of school setting and students' self-concept. AIMS: To analyze the association between moderate-to-vigorous PA (MVPA) and AP in adolescents, considering potential confounding variables of school setting and self-concept in adolescents. METHOD: The final sample was composed of 394 students (186 boys) with a mean age of 11.3 (SD = 0.8) years. The school grades were used as an indicator of AP. Measurements of body mass and stature were collected, and the body mass index was calculated and converted into z-score values. Maternal education, socioeconomic status, self-concept, and variables of the school setting were self-reported. MVPA and sedentary behavior (SB) were measured through accelerometry (GT3X and GT3X+; ActiGraph, Pensacola, Florida). Multiple linear regression was used for the association analyses, adopting p < .05. RESULTS: MVPA was inversely associated with global AP and mathematics only for girls: ß = -.105 (95% CI [-0.205, -0.006]; p = .038); ß = -.136 (95% CI [-0.261, -0.011]; p = .033). After adjusting for the school setting and self-concept, these significant associations disappear. DISCUSSION: MVPA was inversely associated with global AP and mathematics only for girls regardless of age, z-score body mass index, maternal education, socioeconomic status, and SB. However, after adjusting for school setting and self-concept, theses association disappear in mathematics and global AP, respectively. CONCLUSION: The device-measured MVPA was not associated with AP after controlling for important variables (school setting and self-concept).

The COVID-19 pandemic and changes in the lifestyles of Brazilian adolescents / A pandemia de COVID-19 e mudanças nos estilos de vida dos adolescentes brasileiros

ABSTRACT: Objective: To analyze changes in the lifestyles of Brazilian adolescents during the COVID-19 pandemic. Methods: Cross-sectional study carried out with adolescents who participated in the survey "ConVid Adolescentes - Pesquisa de Comportamentos". The indicators related to lifestyles before and during the COVID-19 pandemic were evaluated: consumption of healthy and unhealthy foods, physical activity and sedentary behavior, smoking and consumption of alcohol. Prevalence and 95% confidence intervals were calculated for the total population and according to sex and age group. Results: A total of 9,470 adolescents participated in the study. During the period of social distancing, there was an increase in the prevalence of vegetables consumption (from 27.34 to 30.5%), frozen foods (from 13.26 to 17.3%), chocolates and sweets (from 48.58 to 52.51%), and time in front of screens (from 44.57 to 70.15%). On the other hand, there was a decrease in the practice of physical activity (from 28.70 to 15.74%) and in the consumption of alcohol (from 17.72 to 12.77%). Differences were observed according to sex and age group. Conclusion: The results show changes in the lifestyle of adolescents and an increase in health risk behaviors.

RESUMO: Objetivo: Analisar as mudanças nos estilos de vida dos adolescentes brasileiros durante a pandemia de COVID-19. Métodos: Estudo transversal realizado com adolescentes que participaram do inquérito ConVid Adolescentes — Pesquisa de Comportamentos. Foram avaliados os indicadores relacionados aos estilos de vida antes e durante a pandemia: consumo de alimentos saudáveis e alimentos não saudáveis, prática de atividade física e comportamento sedentário, tabagismo e consumo de bebidas alcoólicas. As prevalências e os intervalos de confiança de 95% (IC95%) foram calculados para população total e segundo sexo e faixa etária. Resultados: Participaram do estudo 9.470 adolescentes. Durante o período de distanciamento social, foi observado aumento nas prevalências de consumo de hortaliças (de 27,34 para 30,5%), pratos congelados (de 13,26 para 17,3%), chocolates e doces (de 48,58 para 52,51%), e do tempo em frente às telas (de 44,57 para 70,15%). Por outro lado, houve diminuição da prática de atividade física (de 28,7 para 15,74%) e do consumo de bebidas alcoólicas (de 17,72 para 12,77%). Diferenças segundo sexo e faixa etária foram observadas. Conclusão: Os resultados apontam mudanças nos estilos de vida dos adolescentes e aumento de comportamentos de risco à saúde.