Association between the environment for physical activity in public schools and childhood obesity: a view in the light of complex systems.

This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

Association between the environment for physical activity in public schools and childhood obesity: a view in the light of complex systems / Associação entre ambiente para atividade física em escolas públicas e obesidade infantil: um olhar à luz de sistemas complexos

Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda.

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.

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

Association between unhealthy behavior and sleep quality and duration in adolescents / Associação entre comportamento não saudável e qualidade e duração do sono em adolescentes

Abstract Inadequate sleep has been associated with unhealthy behavior in adolescence. This study aimed to estimate the prevalence of negative sleep indicators (perceived poor-quality sleep and insufficient sleep duration) among students and to identify unhealthy behaviors associated with this outcome. This study is part of a school-based, cross-sectional survey conducted in 2011 in adolescents from Santa Catarina State, Brazil. High school students aged 15 to 19 years (n = 6,529) and enrolled in state public schools participated in the study. The students responded to a questionnaire on the number of hours slept (insufficient: < 8 h, sufficient: ≥ 8 h); perceived sleep quality (good or poor); and behavioral variables. Multinomial logistic regression was performed using reports of positive sleep indicators, and negative reports of one or two sleep indicators. Approximately 30% of adolescents reported a negative perception of sleep, indicating poor quality and insufficient duration. The use of computers/videogames (≥ 4 h/d) and excessive consumption of alcoholic beverages, salty snacks or sweets were associated with negative sleep indicators. A high number of young people displayed one or two negative sleep indicators, and it was found an association between these indicators and a number of unhealthy behaviors.

Resumo O sono inadequado tem sido associado com o comportamento não saudável na adolescência. Este estudo teve como objetivo estimar a prevalência de indicadores negativos do sono (percepção da má qualidade e duração insuficiente do sono) entre os alunos e identificar comportamentos não saudáveis associados a este resultado. Este estudo é parte de uma pesquisa de base escolar, transversal, realizada em 2011, em adolescentes do Estado de Santa Catarina, Brasil. Estudantes do ensino médio com idades entre 15 a 19 anos (n = 6.529) e matriculados em escolas públicas estaduais participaram do estudo. Os alunos responderam a um questionário sobre o número de horas dormidas (insuficiente: <8 h, suficiente: ≥ 8 h); qualidade do sono percebida (boa ou má); e variáveis comportamentais. Regressão logística multinomial foi realizada, utilizando os relatos de indicadores positivos do sono e relatos negativos de um ou dois indicadores do sono. Cerca de 30% dos adolescentes relataram uma percepção negativa do sono, indicando má qualidade e duração insuficiente. O uso de computadores / videogames (≥ 4 h/d) e consumo excessivo de bebidas alcoólicas, salgadinhos ou doces foram associados a indicadores negativos do sono. Um elevado número de jovens apresentou um ou dois indicadores negativos do sono, e verificou-se uma associação entre estes indicadores e uma série de comportamentos não saudáveis.

Commuting to school and to work among high school students in Santa Catarina state, Brazil: a comparative analysis between 2001 and 2011.

BACKGROUND: Commuting reflects an important opportunity for youth to engage in physical activity. This study aimed to compare modes of commuting to school and to work and to identify sociodemographic factors associated with various modes of transportation. METHODS: Epidemiologic study with a repeated cross-sectional design. Participants included high school students (15-19 years of age) from Santa Catarina state, Brazil, in 2001 (n = 5028) and 2011 (n = 6529). A questionnaire containing information on the type of transport used to commute to school and to work was administered. RESULTS: Walking/bicycling and the use of the bus to commute to school and to work remained stable after a decade; however, the use of car/motorcycle to school (6.4% versus 12.6%) and to work (10.2% versus 19.7%) increased significantly. In both cases, females more frequently used buses, whereas males commuted to work by car/bus. Students from rural areas more commonly commuted to school by car/motorcycle, whereas those from urban areas traveled to work more by bus. There was a greater use of cars/motorcycles by young people from higher-income families. CONCLUSIONS: The use of cars/motorcycles to commute to school/work has almost doubled in the last decade. Sex, residential area and income were associated with passive commuting.

Projeto COMPAC (comportamentos dos adolescentes catarinenses): aspectos metodológicos, operacionais e éticos / Health risk behaviors Project (COMPAC) in youth of the Santa Catarina State, Brazil: ethics and methodological aspects

Diversos levantamentos epidemiológicos de base escolar têm sido realizados por pesquisadores do mundo inteiro. O objetivo deste artigo é descrever os aspectos metodológicos utilizados no planejamento do projeto COMPAC (Comportamento do Adolescente Catarinense), realizado nos anos de 2001 e 2011. O projeto apresenta característica epidemiológica de base escolar, com abrangência estadual. A população incluiu estudantes de 15-19 anos, do Ensino Médio, das escolas da rede pública estadual de Santa Catarina. A amostra (n= 5.028 em 2001; n= 6.529 em 2011) foi representativa das seis regiões geográficas do estado e realizada em dois estágios, selecionando-se: (1) escolas estratificadas por porte (grande: 500 ou mais alunos; médio: 200-499 e pequeno: menor que 200); e (2) turmas selecionadas aleatoriamente, considerando a proporção de alunos por série e turno. Em 2001, participaram 5.463 estudantes, desses, excluíram-se 380 por estarem fora da faixa etária e as perdas foram de 55, por preenchimento incorreto do questionário. Em 2011, participaram 7.077 alunos, sendo excluídos 508 e perdidos 40 questionários, pelas mesmas razões citadas. Os estudantes responderam um questionário sobre estilo de vida e comportamentos de risco à saúde. Nos dois inquéritos, foi encontrada maior proporção de moças, de jovens solteiros, que moravam com a família e residiam em áreas urbanas. Em 2001, houve maior proporção de jovens de 17-19 anos, que trabalhavam; que estavam matriculados na 2ª série do Ensino Médio e estudavam à noite, em comparação ao inquérito de 2011. Os recursos metodológicos utilizados nesse estudo poderão subsidiar o desenvolvimento de pesquisas com jovens escolares.

Several school-based epidemiological surveys have been conducted by researchers worldwide. The aim of this article is to describe the methodological aspects used in planning the COMPAC Project (Behavior of Adolescents from Santa Catarina state) carried out in 2001 and 2011. The project presents state-wide school-based epidemiological characteristics (panel study). The population included public high school students between the ages of 15 to 19 years old from Santa Catarina. The sample (n = 5,028 in 2001; n = 6,529 in 2011) was representative of the six geographic regions of the state and was done in two stages, selecting the following items: (1) schools stratified by size (large: 500 or more students; medium: 200-499, and small: fewer than 200); and (2) shifts (day and evening), randomly chosen considering the proportion of students per grade and shift. In 2001, 5,463 students took part in the study, but 380 were excluded for being outside the age range and 55 were removed because they filled out the questionnaire incorrectly. In 2011, 7,077 students participated, but 508 were excluded and 40 removed for the same reasons mentioned above. The students responded a questionnaire on lifestyle and health risk behavior. Both surveys found a greater proportion of girls, single individuals, living with their family and residing in urban areas. The 2001 survey revealed a higher proportion of 17 to 19 year-olds who worked, who were enrolled in the second year of high school, and studied in the evening when compared to the 2011 survey. The methodological tools utilized in this study will can support the development of research with high school adolescents.

Lifestyle, self-reported morbidities, and poor sleep quality among Brazilian workers.

OBJECTIVE: To examine perceived poor sleep quality and its association with unhealthy lifestyle and self-reported morbidities among Brazilian workers. METHODS: This study was part of a national survey involving 47,477 workers who received a questionnaire about lifestyle. Chi-square tests and logistic regression (OR=Odds Ratio) were conducted. RESULTS: Poor sleep quality was reported by 21% of workers and was more prevalent among women (p<0.01). After being adjusted for socio-demographic indicators, negative perception of health, well-being, stress, self-reported morbidities, physical inactivity during leisure-time (OR: 1.18) in both genders, and inadequate fruit and vegetable intake (OR(men): 1.15; OR(women): 1.17), as well as excessive alcohol consumption (OR: 1.15) in men remained associated with poor sleep quality. With respect to morbidities, only diabetes in women (OR: 1.46) and hypertension in men (OR: 1.18) were associated with poor sleep quality. CONCLUSIONS: Our findings indicate that certain unhealthy behaviors and self-reported morbidities were associated with poor sleep quality. Efficient initiatives should be implemented to promote a healthier lifestyle among workers, which could reduce or control glucose levels and blood pressure in addition to improving perceived sleep quality.

Evidências preliminares de validade da seção de atividade física do Questionário de Atividade Física e Alimentação do Dia Anterior (QUAFDA) / Preliminary validation of the physical activity section of the Previous Day Physical Activity and Food Consumption Questionnaire

O objetivo principal do presente estudo foi determinar a validade da seção de atividade física do Questionário de Atividade Física e Alimentação do Dia Anterior (QUAFDA), instrumento proposto para estimar os níveis de atividade física e hábitos alimentares de escolares de sete a dez anos. Participaram do estudo 50 crianças matriculadas na rede de ensino de Parnamirim-RN (média de idade = 10,2 anos ± 1,49; 50% do sexo masculino). A validade foi analisada mediante comparações entre o escore gerado pelo QUAFDA e o número de passos obtidos com pedômetros. Para análise dos dados foram utilizados a correlação de Spearman (rs), a regressão linear, índice kappa (k) e os índices de sensibilidade e especificidade, para determinar a capacidade de pontos de corte do escore QUAFDA em identificar sujeitos que alcançaram as recomendações de número de passos. Uma correlação significativa (rs = 0,45; p < 0,001) foi encontrada entre o escore do questionário e o número de passos obtidos com o pedômetro. Uma sensibilidade e especificidade de 78% e 56%, respectivamente, foram encontradas. A concordância encontrada entre a classificação do número de passos e do escore QUAFDA (categorizado em maior ou menor que o 1º tercil) foi de k = 0,34. Estes resultados configuram-se como evidencias preliminares da validade do questionário QUAFDA, que pode ser utilizado para a estimativa da atividade física de escolares jovens em estudos epidemiológicos

This study evaluated the validity of the physical activity section from the Previous Day Physical Activity and Food Questionnaire (PDPAFQ), an instrument designed to estimate physical activity levels and food behavior of schoolchildren aged 7 to 10 year. Fifty schoolchildren (mean age, 10.22 ± 1.49; 50% male) from two public schools completed the PDPAFQ after wearing a pedometer for a day. Correlations between questionnaire cores and step counts were tested as numerical and categorical variables, using Spearman correlation, linear regression, kappa index and sensitivity and specificity analysis. A significant correlation (r = 0.45, p < 0.001) was found between step counts and PDPAFQ scores. The questionnaire (lower vs higher than first tertile) identified 78% (sensivity) of those who met the current age and gender-specific step count guidelines, whereas only 56% (specificity) of those not meeting the guidelines were classified as less active. The kappa index was 0.34. These results provide preliminary alidity evidences of the PDPAFQ, which can be used to stimate physical activity levels of schoolchildren in epidemiologic studies.