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Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:472-483. [PMID: 38158180 PMCID: PMC11184298 DOI: 10.1016/j.jshs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. METHODS To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. RESULTS We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. CONCLUSION Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
| | - Wendy J Brown
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison K Brinson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA
| | | | - Melanie Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
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Paudel S, Mishra GD, Veitch J, Mielke GI, Hesketh KD. Examination of Physical Activity, Organized Sport, and Sitting Time Among Women and Mothers From Culturally and Linguistically Diverse Backgrounds. J Phys Act Health 2024; 21:229-237. [PMID: 38086350 DOI: 10.1123/jpah.2023-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/29/2023] [Accepted: 11/14/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Little evidence is available from culturally and linguistically diverse (CALD) communities on the association between motherhood and physical activity (PA). This study aimed to examine independent and joint associations of cultural background and motherhood with meeting PA guidelines, participation in organized sports, and high sitting time (>8 h/d). METHODS We used self-reported cross-sectional data from survey 8 of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. PA was measured using the Active Australia Survey while organized sport and sitting time were measured using single items. CALD was defined as being born in a non-English speaking country or primarily speaking a non-English language at home. Multivariable-adjusted logistic regression analyses were used to examine independent and joint associations. RESULTS Data from 5967 women (mean age 42.4 [SD 1.5] y, 6.9% CALD, 81.2% mothers) were analyzed. Women of CALD background had lower odds of meeting PA guidelines (odds ratio; 95% confidence interval: 0.80; 0.64-0.98) and participation in organized sports (0.68; 0.54-0.86), but no statistically significant association with sitting time (0.90; 0.72-1.14). Mothers had lower odds of meeting PA guidelines (0.75; 0.64-0.87) and high sitting time (0.42; 0.36-0.49). Compared with non-CALD women without children, mothers (irrespective of cultural background) were less likely to meet PA guidelines and have high sitting time. The association of "cultural background and motherhood" with organized sports participation was only significant for CALD mothers. CONCLUSIONS Increased efforts and investments are needed to ensure that sports and other PA promotion interventions are culturally sensitive and engaging for CALD women and those with children.
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Affiliation(s)
- Susan Paudel
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Hesketh KR, Baird J, Crozier SR, Godfrey KM, Harvey NC, Cooper C, van Sluijs EM. Activity Behaviors Before and During Pregnancy Are Associated With Women's Device-Measured Physical Activity and Sedentary Time in Later Parenthood: A Longitudinal Cohort Analysis. J Phys Act Health 2023; 20:803-811. [PMID: 37573030 PMCID: PMC7615174 DOI: 10.1123/jpah.2022-0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE To explore how activity behaviors before/during pregnancy relate to those in later parenthood, we assessed associations between sitting and moderate-/strenuous exercise before/during pregnancy, and sedentary time (SED) and moderate to vigorous physical activity (MVPA) 4-7 years postpartum ("later parenthood"). METHODS Longitudinal data were from the Southampton Women's Survey, United Kingdom. Women reported time spent sitting (in hours per day), in moderate-strenuous exercise (hours per week), and in strenuous exercise (hours per week) at 3 time points before/during pregnancy (ie, preconception, at ∼12-wk and ∼34-wk gestation). From this, we derived 3 behavior trajectories for each woman. In later parenthood, women wore an accelerometer for ≤7 days (mean: 5.4 [SD: 1.8] d), which we used to derive 2 outcomes: minutes per day SED and in MVPA. Multilevel linear regression was used to explore associations between trajectories before/during pregnancy and device-measured SED/MVPA in later parenthood. RESULTS A total of 780 women provided valid data before/during pregnancy and in later parenthood. Consistent high sitters (vs low) were more sedentary 4-7 years postpartum (β = 39.5 min/d [95% confidence interval, 23.26 to 55.82]), as were women in groups who sat more in later pregnancy. Consistently high moderate/-strenuous exercisers (vs low) were 22% (95% confidence interval, 2%-47%) more active in later parenthood; those engaging in strenuous activity preconception tended to have higher MVPA as parents. CONCLUSIONS Trajectories of sitting and exercise before/during pregnancy are associated with SED and MVPA, respectively, in later parenthood. Interventions to reduce sitting in pregnancy and to encourage higher intensity activity preconception may benefit maternal and child health.
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Affiliation(s)
- Kathryn R. Hesketh
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, United Kingdom
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, United Kingdom
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Tornquist L, Tornquist D, Mielke GI, da Silveira MF, Hallal PC, Domingues MR. Maternal Physical Activity Patterns in the 2015 Pelotas Birth Cohort: From Preconception to Postpartum. J Phys Act Health 2023; 20:868-877. [PMID: 37558220 DOI: 10.1123/jpah.2022-0609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Motherhood has been associated with reduced leisure-time physical activity (LTPA) levels. We aim to assess maternal LTPA patterns from preconception to 4 years postpartum. METHODS The study was developed with mothers from the Pelotas 2015 Birth Cohort, Southern Brazil (n = 4273). LTPA data were self-reported for preconception, antenatal, and 3, 12, 24, and 48 months postpartum. Information on LTPA referring to preconception (3 mo before pregnancy) and each gestational trimester was retrospectively collected in perinatal. The prevalence of active mothers was calculated according to recommendations (≥150 min/wk). We described changes in LTPA between follow-ups and estimated the probability of mothers being active according to previous LTPA. We used group-based trajectory analysis to identify patterns of LTPA throughout the follow-ups. RESULTS The prevalence of active mothers during leisure time decreased in pregnancy and postpartum compared with preconception. At 12 months postpartum, LTPA levels rose again, but at 48 months, the rates of active mothers still had not returned to preconception levels. Prior LTPA engagement was an important determinant of the maintenance of LTPA. Trajectory analysis identified 4 patterns of maternal LTPA, and ∼80% of mothers were allocated to the "always inactive" group. Higher education and income, working outside the home, multiple births, and participating in the PAMELA study intervention were associated with a higher probability of mothers not being included in this predominantly inactive group. CONCLUSIONS Motherhood is associated with declining rates of women meeting physical activity recommendations during pregnancy and early postpartum.
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Affiliation(s)
- Luciana Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Debora Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD,Australia
| | | | - Pedro Curi Hallal
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL,USA
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Mielke GI, Doust J, Chan HW, Mishra GD. Physical Activity Accumulated Across Adulthood and Resting Heart Rate at Age 41-46 Years in Women: Findings From the Menarche to Premenopause Study. J Phys Act Health 2023; 20:823-831. [PMID: 37567574 DOI: 10.1123/jpah.2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/07/2023] [Accepted: 06/19/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE To investigate the association between physical activity accumulated from early (age 22-27 y) to mid (age 40-45 y) adulthood and resting heart rate at age 41-46 years in women. METHODS Data were from 479 participants in the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. Participants reported physical activity every 3 years from age 22-27 years to 40-45 years. Linear regression models were used to investigate the associations of a cumulative physical activity score (average physical activity across 18 y; up to 7 surveys) and changes in physical activity from age 22-33 years to 34-45 years with resting heart rate at age 41-46 years. RESULTS Average resting heart rate at age 41-46 years was 75 (SD: 11) beats per minute. An inverse nonlinear dose-response association between cumulative physical activity and resting heart rate was observed. Overall, accumulation of physical activity was associated with lower resting heart rate regardless of the age when physical activity was accumulated. Women in the highest tertile of physical activity at both age 22-33 years and 34-45 years had a resting heart rate, on average, 8 beats per minute lower (95% confidence interval, -11.42 to -4.69) than those consistently in the lowest tertile of physical activity. CONCLUSION Accumulating physical activity, irrespective of timing, appears to provide cardiovascular health benefits for women before the transition to menopause.
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Affiliation(s)
- Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD,Australia
| | - Jenny Doust
- School of Public Health, The University of Queensland, Brisbane, QLD,Australia
| | - Hsiu-Wen Chan
- School of Public Health, The University of Queensland, Brisbane, QLD,Australia
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, QLD,Australia
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Hayman M, Brown WJ, Brinson A, Budzynski-Seymour E, Bruce T, Evenson KR. Public health guidelines for physical activity during pregnancy from around the world: a scoping review. Br J Sports Med 2023; 57:940-947. [PMID: 36604155 DOI: 10.1136/bjsports-2022-105777] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Despite the known health benefits of physical activity (PA), pregnancy is a time of marked decline in PA levels. To provide women with reliable and trustworthy information, and to encourage greater participation in PA during pregnancy, many governments have developed guidelines for PA during pregnancy. Our aim was to synthesise the most recent public health guidelines on PA during pregnancy from different countries in order to understand the nature and extent of advice that is available. DESIGN Scoping review. DATA SOURCES Search of the grey literature, direct contact with international experts, screening of relevant academic literature and citation searching. ELIGIBILITY CRITERIA Public health guidelines developed or endorsed by government departments published since 2010. RESULTS Our search located 30 eligible guidelines, published in 11 different languages. There is remarkable concordance in the advice offered. For women with uncomplicated pregnancy, guidelines recommend: 150-300 min/week of moderate intensity aerobic activity; pelvic floor and muscle strengthening exercises; modification of some exercises (eg, supine position); and provide lists of warning signs to cease activity (eg, persistent dizziness, vaginal bleeding) and activities that should be avoided (eg, if high risk of falling/collision). Few guidelines offer specific advice for highly active women (eg, athletes), or trimester-specific or culturally specific considerations. CONCLUSIONS This review provides a summary of public health recommendations for PA during pregnancy around the world. The challenge is now to ensure that all who provide healthcare for women understand the guidelines and encourage safe participation in PA during pregnancy.
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Affiliation(s)
- Melanie Hayman
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Alison Brinson
- Anthropology, University of North Carolina College of Arts and Sciences, Chapel Hill, North Carolina, USA
| | | | - Tracy Bruce
- The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
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Hayman M, Keppel M, Stanton R, Thwaite TL, Alfrey KL, Alley S, Harrison C, Keating SE, Schoeppe S, Cannon SS, Haakstad LAH, Gjestvang C, Williams SL. A mixed-methods exploration of attitudes towards pregnant Facebook fitness influencers. BMC Public Health 2023; 23:569. [PMID: 36973705 PMCID: PMC10041693 DOI: 10.1186/s12889-023-15457-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Exercise during pregnancy is associated with various health benefits for both mother and child. Despite these benefits, most pregnant women do not meet physical activity recommendations. A known barrier to engaging in exercise during pregnancy is a lack of knowledge about appropriate and safe exercise. In our current era of social media, many pregnant women are turning to online information sources for guidance, including social media influencers. Little is known about attitudes towards pregnancy exercise information provided by influencers on social media platforms. This study aimed to explore attitudes towards exercise during pregnancy depicted by social media influencers on Facebook, and user engagement with posted content. METHODS A mixed-methods approach was used to analyse data from 10 Facebook video posts of social media influencers exercising during pregnancy. Quantitative descriptive analyses were used to report the number of views, shares, comments and emotive reactions. Qualitative analysis of user comments was achieved using an inductive thematic approach. RESULTS The 10 video posts analysed were viewed a total of 12,117,200 times, shared on 11,181 occasions, included 13,455 user comments and 128,804 emotive icon reactions, with the most frequently used icon being 'like' (81.48%). The thematic analysis identified three themes associated with attitudes including [1] exercise during pregnancy [2] influencers and [3] type of exercise. A fourth theme of community was also identified. Most user comments were associated with positive attitudes towards exercise during pregnancy and the influencer. However, attitudes towards the types of exercise the influencer performed were mixed (aerobic and body weight exercises were positive; resistance-based exercise with weights were negative). Finally, the online community perceived by users was mostly positive and recognised for offering social support and guidance. CONCLUSIONS User comments imply resistance-based exercise with weights as unsafe and unnecessary when pregnant, a perception that does not align with current best practice guidelines. Collectively, the findings from this study highlight the need for continued education regarding exercise during pregnancy and the potential for social media influencers to disseminate evidence-based material to pregnant women who are highly receptive to, and in need of reliable health information.
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Affiliation(s)
- Melanie Hayman
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia.
| | - Marian Keppel
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Robert Stanton
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
- Cluster for Resilience and Wellbeing, Appleton Institute, 44 Greenhill Road, Wayville, SA, 5034, Australia
| | - Tanya L Thwaite
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Kristie-Lee Alfrey
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Stephanie Alley
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Cheryce Harrison
- School of Public Health and Preventive Medicine, Monash University, Wellington Road, Melbourne, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Stephanie Schoeppe
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Summer S Cannon
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Lene A H Haakstad
- Department of Sports Medicine, Norwegian School of Sports Sciences, Ullevål Stadion Melbourne, P.O Box 4014, Oslo, VIC, 3800 0806, Norway
| | - Christina Gjestvang
- Department of Sports Medicine, Norwegian School of Sports Sciences, Ullevål Stadion Melbourne, P.O Box 4014, Oslo, VIC, 3800 0806, Norway
| | - Susan L Williams
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
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Beetham KS, Spathis JG, Hoffmann S, Brown WJ, Clifton V, Mielke GI. Longitudinal association of physical activity during pregnancy with maternal and infant outcomes: Findings from the Australian longitudinal study of women's health. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221142357. [PMID: 36560920 PMCID: PMC9793022 DOI: 10.1177/17455057221142357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Physical activity has known benefits during pregnancy; however, the optimum volume of physical activity through the different stages of pregnancy is not well known. OBJECTIVES The aims of this study were to investigate the associations of physical activity volume in pregnant women in each trimester of pregnancy with maternal and infant outcomes. DESIGN The study involved 1657 pregnant women from the Australian Longitudinal Study on Women's Health, who completed surveys from 2006 to 2012 (aged 28-39 years). METHODS Women reported being in either the first, second or third trimester of pregnancy. Women were grouped into four groups according to their self-reported physical activity during pregnancy: (1) Nil (0-<33.3 MET.min/week), (2) Low (33.3-<500 MET.min/week), (3) Moderate (500-<1000 MET.min/week) and (4) High (⩾1000 MET.min/week). Women who reported their physical activity during pregnancy completed a survey within three years after the birth, relating to outcomes associated with pregnancy and childbirth (gestational diabetes, hypertension, and antenatal depression and anxiety) and infant outcomes (birthweight and prematurity). RESULTS There was no association of physical activity in any trimester with infant birthweight, prematurity, gestational diabetes, hypertension or antenatal depression. Antenatal anxiety was less prevalent in women who reported low (1.7%) or moderate (1.1%) physical activity than in those who reported no activity (4.7%; p = 0.01). CONCLUSION Different amounts of physical activity during pregnancy were not associated with the measured adverse health outcomes. However, low and moderate amounts of physical activity were associated with reduced incidence of antenatal anxiety.
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Affiliation(s)
- Kassia S Beetham
- School of Behavioural and Health
Sciences, Australian Catholic University, Brisbane, QLD, Australia,School of Exercise and Nutrition
Sciences, Deakin University, Geelong, VIC, Australia,Kassia S Beetham, School of Behavioural and
Health Sciences, Australian Catholic University, 1100 Nudgee Road, Banyo,
Brisbane, QLD, 4014, Australia.
| | - Jemima G Spathis
- School of Behavioural and Health
Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Samantha Hoffmann
- School of Exercise and Nutrition
Sciences, Deakin University, Geelong, VIC, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition
Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Vicki Clifton
- Mater Research and Translational
Research Institute, Brisbane, QLD, Australia
| | - Gregore I Mielke
- School of Public Health, The University
of Queensland, Brisbane, QLD, Australia
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Câmara SMA, McGurk MD, Gigante D, Lima MDA, Shalaby AK, Sentell T, Pirkle CM, Domingues MR. Intersections between adolescent fertility and obesity-pathways and research gaps focusing on Latin American populations. Ann N Y Acad Sci 2022; 1516:18-27. [PMID: 35781886 PMCID: PMC9588536 DOI: 10.1111/nyas.14854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Latin America has notably elevated rates of adolescent fertility and obesity in women. Although numerous studies document associations between adolescent fertility and obesity across the life course, the pathways explaining their association are insufficiently theorized, especially regarding the factors in Latin America that may underpin both. Additionally, much of the existing research is from high-income countries, where fertility and obesity are trending down. In this paper, we review the various complex pathways linking adolescent fertility and obesity, highlighting research gaps and priorities, with a particular focus on Latin American populations. We carefully consider pregnancy's distinct impact on growth trajectories during the critical period of adolescence, as well as the cumulative effect that adolescent fertility may have over the life course. We also articulate a pathway through obesity as it may contribute to early puberty and thus, to adolescent fertility. If obesity is a cause of adolescent fertility, not a result of it, or if it is a mediator of early-life exposures to adulthood obesity, these are critical distinctions for policy aiming to prevent both obesity and early fertility. Research to better understand these pathways is essential for prevention efforts against obesity and undesired adolescent fertility in Latin America.
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Affiliation(s)
- Saionara M. A. Câmara
- Postgraduate program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Meghan D. McGurk
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Denise Gigante
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Mateus D. A. Lima
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Alena K. Shalaby
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Catherine M. Pirkle
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
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10
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Ricardo LIC, Hallal P, Domingues MR, Oliveira RS, Blumenberg C, Tornquist D, Tornquist L, Barros F, Crochemore-Silva I. Association between objectively measured physical activity of parents and children: The 2015 Pelotas birth cohort. Scand J Med Sci Sports 2022; 32:1287-1296. [PMID: 35488747 DOI: 10.1111/sms.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/18/2022] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The present study aims to verify the association between objectively measured physical activity (PA) of parents and child in the 2015 Pelotas Birth Cohort, a population-based Brazilian birth cohort. METHODS The main exposures were paternal moderate-to-vigorous PA (MVPA) collected when children were 1-year of age, and maternal MVPA when children were 2-years. The outcome was children's overall PA (ENMO in mg) at 4-years of age. PA was measured using wrist-worn ActiGraph accelerometers during seven complete days. Potential confounders were maternal age, maternal and paternal education, and household asset index. Crude and adjusted analyses were performed using linear regressions. RESULTS Our analytical sample comprised 1326 children with valid accelerometer data and with both parents. Mean child PA was 48.1 mg, being higher among boys compared with girls (Boys: 50 mg, 95% CI: 49.1; 50.9; Girls: 46 mg, 95% CI: 45.2; 46.8). Children's PA at 4 years was positively associated with maternal MVPA at age 2 years (p < 0.001) and paternal MVPA at age 1 year (p < 0.001). A child with both parents in the highest tertile of unbouted MVPA presented higher overall PA (p = 0.001). Similar results were found for boys; however, for girls, paternal unbouted MVPA was not associated with overall PA. CONCLUSION Overall, our results showed a positive impact of maternal and parental PA over 4-year-old children acceleration. These findings could be valuable when planning evidence-based interventions and policies to promote PA in young children, providing a broader perspective over the role of parents over children's behavior.
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Affiliation(s)
| | - Pedro Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | | | - Ricardo Santos Oliveira
- Department of Physical Education, Federal University of Rio Grande do Norte, Health Science Center, Natal, Brazil
| | - Cauane Blumenberg
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Debora Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Luciana Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Inácio Crochemore-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
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11
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Brown WJ, Hayman M, Haakstad LA, Lamerton T, Mena GP, Green A, Keating SE, Gomes GA, Coombes JS, Mielke GI. Australian Guidelines for Physical Activity in pregnancy and postpartum. J Sci Med Sport 2022; 25:511-519. [DOI: 10.1016/j.jsams.2022.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
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12
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Effects of Regular Exercise During Pregnancy on Early Childhood Neurodevelopment: The Physical Activity for Mothers Enrolled in Longitudinal Analysis Randomized Controlled Trial. J Phys Act Health 2022; 19:203-210. [PMID: 35168196 DOI: 10.1123/jpah.2021-0477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/10/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effect of exercise during pregnancy on early childhood neurodevelopment (cognitive, motor, and language domains). METHODS A randomized controlled trial nested into the 2015 Pelotas (Brazil) Birth Cohort was conducted. Healthy pregnant women were enrolled between 16 and 20 weeks of gestation; 424 women and their children (intervention [n = 141]; control [n = 283]) were analyzed. An exercise-based intervention 3 times per week was delivered over 16 weeks. Child neurodevelopment and its domains were assessed at 1, 2, and 4 years. Standardized mean differences and 95% confidence intervals are presented. RESULTS No effects of exercise during pregnancy on child neurodevelopment and its domains at age 1 year were observed. Compared with the control group, children from women in the exercise group had higher language score at age 2 years (standardized mean differences = 0.23; 95% confidence intervals, 0.02 to 0.44) and higher cognitive score (standardized mean differences = 0.22; 95% confidence intervals, 0.03 to 0.41) at age 4 years. No effects of exercise during pregnancy were observed in the motor domain at 1, 2, and 4 years. CONCLUSIONS No detrimental effects of exercise during pregnancy on child neurodevelopment were observed. In addition, these findings suggest that exercise during pregnancy can result in small benefits for language and cognitive development.
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13
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Hayman MJ, Alfrey KL, Waters K, Cannon S, Mielke GI, Keating SE, Mena GP, Mottola MF, Evenson KR, Davenport MH, Barlow SA, Budzynski-Seymour E, Comardelle N, Dickey M, Harrison CL, Kebbe M, Moholdt T, Moran LJ, Nagpal TS, Schoeppe S, Alley S, Brown WJ, Williams S, Vincze L. Evaluating Evidence-Based Content, Features of Exercise Instruction, and Expert Involvement in Physical Activity Apps for Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e31607. [PMID: 35044318 PMCID: PMC8811692 DOI: 10.2196/31607] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/01/2021] [Accepted: 11/17/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Guidelines for physical activity and exercise during pregnancy recommend that all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity and exercise during this life stage and are increasingly using mobile apps to access health-related information. However, the extent to which apps that provide physical activity and exercise advice align with current evidence-based pregnancy recommendations is unclear. OBJECTIVE This study aims to conduct a systematic search and content analysis of apps that promote physical activity and exercise in pregnancy to examine the alignment of the content with current evidence-based recommendations; delivery, format, and features of physical activity and exercise instruction; and credentials of the app developers. METHODS Systematic searches were conducted in the Australian App Store and Google Play Store in October 2020. Apps were identified using combinations of search terms relevant to pregnancy and exercise or physical activity and screened for inclusion (with a primary focus on physical activity and exercise during pregnancy, free to download or did not require immediate paid subscription, and an average user rating of ≥4 out of 5). Apps were then independently reviewed using an author-designed extraction tool. RESULTS Overall, 27 apps were included in this review (Google Play Store: 16/27, 59%, and App Store: 11/27, 41%). Two-thirds of the apps provided some information relating to the frequency, intensity, time, and type principles of exercise; only 11% (3/27) provided this information in line with current evidence-based guidelines. Approximately one-third of the apps provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. None of the apps actively engaged in screening for potential contraindications. Only 15% (4/27) of the apps collected information about the user's current exercise behaviors, 11% (3/27) allowed users to personalize features relating to their exercise preferences, and a little more than one-third provided information about developer credentials. CONCLUSIONS Few exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. None of the apps screened users for contraindications to physical activity and exercise during pregnancy, and most lacked appropriate personalization features to account for an individual's characteristics. Few involved qualified experts during the development of the app. There is a need to improve the quality of apps that promote exercise in pregnancy to ensure that women are appropriately supported to engage in exercise and the potential risk of injury, complications, and adverse pregnancy outcomes for both mother and child is minimized. This could be done by providing expert guidance that aligns with current recommendations, introducing screening measures and features that enable personalization and tailoring to individual users, or by developing a recognized system for regulating apps.
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Affiliation(s)
- Melanie J Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kristie-Lee Alfrey
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kim Waters
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Summer Cannon
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Gregore I Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Gabriela P Mena
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Michelle F Mottola
- R Samuel McLaughlin Foundation Exercise and Pregnancy Laboratory, School of Kinesiology, University of Western Ontario, London, ON, Canada
- Department of Anatomy & Cell Biology, University of Western Ontario, London, ON, Canada
- Children's Health Research Institute, University of Western Ontario, London, ON, Canada
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Margie H Davenport
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - S Ariel Barlow
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Emily Budzynski-Seymour
- Faculty of Sport, Health and Social Sciences, Solent University, Southampton, United Kingdom
| | - Natalie Comardelle
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Madison Dickey
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maryam Kebbe
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Taniya S Nagpal
- Faculty of Applied Health Sciences, School of Kinesiology, Brock University, Niagara Region, ON, Canada
| | - Stephanie Schoeppe
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Stephanie Alley
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Wendy J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Susan Williams
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Lisa Vincze
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
- Menzies Health Institute Queensland, Griffith Health Centre, Gold Coast, Australia
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All are equal, but some are more equal than others: social determinants of leisure time physical activity through the lens of intersectionality. BMC Public Health 2022; 22:36. [PMID: 34991542 PMCID: PMC8739989 DOI: 10.1186/s12889-021-12428-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background To date, no research has investigated social determinants of leisure time physical activity through the lens of intersectionality in a low- and middle-income country. Therefore, the aim of this study was to explore the intersectionality in leisure time physical activity in a nationwide sample of Brazilian adults. Methods Data from the Brazilian National Health Survey conducted in 2013 were analysed (N = 58,429). Prevalence of sufficient leisure time physical activity (150+ minutes per week in moderate-to-vigorous physical activity) was estimated according to gender, racial identity, education and income, and according to multiple combinations of these sociodemographic characteristics (i.e., multiple jeopardy index). Results The prevalence of sufficient leisure time physical activity was 22.9% (95%CI: 22.3 to 23.6). Overall, the prevalence of sufficient leisure time physical activity was highest among men, individuals with white skin colour, and among those in the highest group of education and income. Among men, white, with a university degree and in the highest quartile of income (3% of the population), the prevalence of sufficient leisure time physical activity was 48%. Among non-white women with low education and low income (8.1% of the population), the prevalence of sufficient leisure time physical activity was 9.8%. Conclusion Informed by the theory of intersectionality, findings of this study have shown that intersections of gender, racial identity and socioeconomic position of the Brazilian society strongly influence leisure time physical activity at the individual level. Targeted interventions to increase leisure time physical activity should address the complexities of social status intersections.
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Longitudinal Associations Between Device-Measured Physical Activity and Early Childhood Neurodevelopment. J Phys Act Health 2022; 19:80-88. [PMID: 34983024 DOI: 10.1123/jpah.2021-0587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to investigate longitudinal associations between physical activity and early childhood neurodevelopment. METHODS Data from 1673 children from the 2015 Pelotas (Brazil) birth cohort study were analyzed. Physical activity was measured using accelerometers on the wrist at ages 1, 2, and 4 years. Neurodevelopment was measured using the Battelle Development Inventory at age 4 years. Linear regression models were used to test trajectories and cumulative associations of physical activity with child neurodevelopment. RESULTS Of the 3 physical activity trajectories observed, children in the medium (β = 1.17; 95% confidence interval, 0.25 to 2.10) and high (β = 2.22; 95% confidence interval, 0.61 to 3.82) trajectories showed higher neurodevelopment scores than children in the lower activity trajectory. Cumulative analyses showed that children in the highest tertile of physical activity in all follow-ups presented a mean neurodevelopment score 4.57 (95% confidence interval, 2.63 to 6.51) higher than children in the lowest tertile in all follow-ups. All analyses showed a dose-response characteristic of association, with higher physical activity indicating higher neurodevelopment scores. CONCLUSIONS Physical activity may be an important predictor of neurodevelopment through early childhood.
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Mielke GI, Stopa SR, Gomes CS, Silva AGD, Alves FTA, Vieira MLFP, Malta DC. Leisure time physical activity among Brazilian adults: National Health Survey 2013 and 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210008. [PMID: 34910062 DOI: 10.1590/1980-549720210008.supl.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to analyze the prevalence of leisure-time physical activity in 2013 and 2019 according to sociodemographic characteristics in Brazilian adults. METHODS We analyzed data from the National Health Surveys conducted in 2013 and 2019. Prevalence of leisure-time physical activity (150+ minutes per week in physical activities) was calculated according to gender, age, education, race/skin color, Federative Units, and regions of Brazil in 2013 and 2019. Poisson regression models and 95% confidence intervals (95%CI) were used to compare leisure-time physical activity across different groups in 2013 and 2019. RESULTS The proportion of Brazilian adults active in leisure-time increased from 22.7% (95%CI 22.06-23.34) in 2013 to 30.1% (95%CI 29.44-30.67) in 2019. The prevalence of leisure-time physical activity increased between 2013 and 2019 in 23 of the 27 Federative Units in Brazil. Both in 2013 and in 2019, the proportion of active people during leisure time was higher in men, young people, with a high level of education and individuals with white skin color. Overall, the magnitude of the observed differences in leisure-time physical activity between sociodemographic groups slightly decreased from 2013 to 2019. CONCLUSIONS Despite the increase in the prevalence of leisure-time physical activity among Brazilian adults in the last six years, marked sociodemographic inequalities persist. The success of future public policies to promote physical activity in leisure must be evaluated from the perspective of social determinants of health and the reduction of inequalities in the practice of physical activity.
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Affiliation(s)
- Gregore Iven Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland - Brisbane, Australia
| | - Sheila Rizzato Stopa
- Department of Health Analysis and Surveillance of Non-Communicable Chronic Diseases, Ministério da Saúde - Brasília (DF), Brazil
| | - Crizian Saar Gomes
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Alanna Gomes da Silva
- School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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