Association between physical activity domains and depressive symptoms among Brazilian adults: does every move count?

This study aimed to investigate the practice of physical activities in the four domains (leisure time, transportation, household, and work) and the prevalence of depressive symptoms in Brazilian adults, in general and stratified by sex, schooling level, and having or not a self-reported diagnosis of depression. This is a cross-sectional study with data from 88,531 individuals aged 18 years or older, who responded to the Brazilian National Health Survey in 2019. The depressive symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9). Those who practice physical activities at least once a week in a given domain were considered physically active. Additionally, the calculation of physical activities duration was conducted and later divided into quartiles for each domain. For the association analyses, the crude odds ratio (crudeOR) and adjusted odds ratio (adjustedOR) were calculated for the total and stratified analyses. Individuals who are physically active during leisure time showed a lower chance of presenting depressive symptoms, in total (adjustedOR = 0.74; 95%CI: 0.64-0.86) and in all stratifications, except for individuals with self-reported depression. The associations of leisure-time physical activity were most frequent in those who practice from 121 to 360 minutes/week. The individuals who were active in the transportation, household, and work domains had a higher chance of presenting depressive symptoms in some groups, with more consistent results for household physical activities. The results showed that the relationship between physical activities and depression among Brazilians varies according to domain and duration, and that the concept that "every move counts" seemed to be correct only for the leisure-time domain.

[Body image perception, socioeconomic characteristics, and lifestyle in women participating in ELSA-Brasil in Bahia, Brazil]

Body image distortion is an alteration in the perception of the body that can have repercussions on health. This study aims to estimate the prevalence of body image accuracy and distortion among women participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) living in Bahia State, Brazil, and to investigate associations with socioeconomic characteristics, lifestyle, and gynecological care seeking. A total of 609 women aged 50 to 69 years participated in the study, who answered face-to-face questionnaires from 2012 to 2014. The Stunkard silhouette scale was used to investigate accurate or distorted perception for more or less weight. The relative risk ratio (RR) was calculated by multinomial logistic regression using Stata 13. Most participants have an accurate perception of their own bodies (53.7%). Among those with distorted perception, there is a tendency to distort towards less weight (38.1%). In the multinomial regression analysis, the variables race/skin color and education remained associated with the distortion towards underweight. The race/skin color variable was positively associated with the distortion towards underweight among Mixed-race women (RR = 1.89; 95%CI: 1.13-3.16) and black (RR = 2.10; 95%CI: 1.25-3.55), while the education variable among those with up to high school education (RR = 1.65; 95%CI: 1.18-2.33). There were no associations with the other variables or with distortion for more weight. The results contribute to explaining the relationships between body image perception and socioeconomic factors, revealing that women of different races/skin colors and varying educational levels are influenced in different ways by social discourses, impacting the perception of their body image.

The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases - The Gaps in Current Guidelines

BACKGROUND

Noncommunicable diseases (NCDs), also known as chronic diseases that are long-lasting, are considered the major cause of death and disability worldwide, and the six pillars of lifestyle medicine (nutrition, exercise, toxic control, stress management, restorative sleep, and social connection) play an important role in a holistic management of their prevention and treatment. In addition, medical guidelines are the most accepted documents with recommendations to manage NCDs.

OBJECTIVE

The present study aims to analyze the lack of lifestyle pillars concerning the major Brazilian medical guidelines for NCDs and identify evidence in the literature that could justify their inclusion in the documents.

METHOD

Brazilian guidelines were selected according to the most relevant causes of death in Brazil, given by the Mortality Information System, published by the Brazilian Ministry of Health in 2019. Journals were screened in the PUBMED library according to the disease and non-mentioned pillars of lifestyle.

RESULTS

Relevant causes of deaths in Brazil are acute myocardial infarction (AMI), diabetes mellitus (DM), and chronic obstructive pulmonary diseases (COPD). Six guidelines related to these NCDs were identified, and all address aspects of lifestyle, but only one, regarding cardiovascular prevention, highlights all six pillars. Despite this, a literature search involving over 50 articles showed that there is evidence that all the pillars can help control each of these NCDs.

CONCLUSION

Rarely are the six pillars of lifestyle contemplated in Brazilian guidelines for AMI, DM, and COPD. The literature review identified evidence of all lifestyle pillars to offer a holistic approach for the management and prevention of NCDs.

Impact of socioeconomic factors on lifestyle changes among employees of public higher education institutions in ELSA-Brasil during COVID-19 pandemic

This study aimed to identify lifestyle changes and associated sociodemographic factors in women and men participating in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) cohort during the COVID-19 pandemic. Longitudinal study with 3,776 (aged 58.8 years; SD ± 8.5) employees of public higher education institutions in the second follow-up and the wave-COVID of ELSA-Brasil. Data collected using structured questionnaires. An exploratory analysis was performed using binary and multinomial logistic regression on the dependent variables with two and three categories, respectively, by obtaining crude and adjusted odds ratio estimates in SPSS 20.0, considering a p-value < 0.05. There was a reduction in physical activity of 195.5 (SD ± 1,146.4) metabolic equivalents per week in women and 240.5 (SD ± 1,474.2) in men, and in smoking by 15.2%. There was an increase in alcohol consumption in men and women (434.2 ± 5,144.0; and 366.1 ± 4,879.0, respectively), in the food quality score (0.8 ± 3.7, women; 0.5 ± 3.7, men), sleeping time (0.4 ± 1.2, women; 0.5 ± 1.1, men), screen time (1.7 ± 2.4, women; 1.4 ± 2.3, men), and sitting time (1.7 ± 2.6, women; 1.5 ± 2.4, men) (hours/day). In total, 18.6% increased the purchase of ultra-processed foods and 36% increased the purchase of natural foods. Age and work activity contributed to increase the chance of purchasing ultra-processed foods, and age and adherence to social distancing influenced the shift to a more sedentary behavior, while income and active work favored the increase in alcoholic beverage consumption. These factors should be considered when developing public policies to avoid individual behaviors that are harmful to health during pandemics.

Openness and age influence cognitive progression: a longitudinal study

BACKGROUND

Some psychological and personality characteristics of individuals seem to determine behavioral patterns that are associated with better health throughout life and, consequently, prevent the progression of early cognitive changes to dementia.

OBJECTIVE

To identify which individuals have modified cognitive ratings after 24 months of follow-up and correlating with personality traits.

METHODS

One hundred and two volunteers were evaluated clinically and for personality characteristics and neuropsychological testing. Of these, 25 subjects were classified as cognitively normal (CN), 25 as subjective cognitive decline (SCD), 28 as nonamnestic mild cognitive impairment (naMCI), and 24 as amnestic mild cognitive impairment (amMCI) at baseline. Follow-up occurred over 2 years from the initial assessment, and the cognitive categories of the participants were re-analyzed every 6 months to observe differences in their classification.

RESULTS

Out of the 102 subjects, 65 remained at follow-up. The sample followed-up longitudinally was composed predominantly of women (65%), white (74%), with a mean age of 78 (±7.5) years old and 12 (±4.8) years of schooling. Throughout the process, 23% of CN, 15% of SDC, and 27% of naMCI individuals worsened cognitively. Amnestic with mild cognitive impairment volunteers remained stable or improved. Individuals with older age show more significant cognitive deterioration, and those with very low or high rates of the openness personality trait are associated with cognitive decline utilizing the Fisher exact test, probably because the open extremes influence choices, stress management, and behavioral maintenance.

CONCLUSION

The factors most associated with cognitive change in this group of older adults were age and the intensity of the openness aspects of personality.

Consumption of fruits and vegetables among older adults: findings from the ELSI-Brazil study

This study aimed to assess the prevalence of recommended consumption of fruits and vegetables and their associated factors in a national sample representative of the Brazilian population aged 60 or over. Baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted from 2015 to 2016, including 4,982 older individuals, were used. The recommended consumption of fruits and vegetables was assessed based on questions on the weekly and daily frequency of fruits, natural fruit juice, and vegetables. Intake of five or more servings of these foods on five or more days per week was considered as recommended consumption. Exploratory variables included socio-demographic characteristics, health behaviors, health conditions, and use of health services. Univariate and multiple logistic regression were used to examine the factors associated with the recommended consumption of fruits and vegetables. The prevalence of recommended consumption of fruits and vegetables was 12.9% (95%CI: 11.5-14.3). This consumption showed associations with gender (women - OR = 1.40; 95%CI: 1.08-1.82), age group (80 years or older - OR = 1.66; 95%CI: 1.16-2.37), education level (8 years or more - OR = 2.07; 95%CI: 1.51-2.86), smoking (former smokers - OR = 0.69; 95%CI: 0.55-0.85 and current smokers - OR = 0.50; 95%CI: 0.33-0.77) and medical appointments in the previous 12 months (OR = 1.88; 95%CI: 1.31-2.71). Our findings showed a low prevalence of the recommended consumption of fruits and vegetables among older Brazilian adults, drawing attention to the need for policies aimed at increasing this consumption in the studied population.

Exposure of patients with chronic kidney disease on dialysis to pesticides

INTRODUCTION

Pesticides can trigger kidney disease.

OBJECTIVE

To describe the exposure to pesticides of patients with chronic kidney disease on dialysis.

METHODS

Quantitative and descriptive field research, with 90 patients with chronic kidney disease on dialysis in two hemodialysis units in the state of Santa Catarina, through the application of a structured questionnaire. Participants were divided into two groups: with and without exposure to pesticides. The questionnaire was applied in hemodialysis clinics during treatment. Laboratory test values were collected from clinical records. Data were analyzed using descriptive statistics and association using the chi-square test. For laboratory test data, a comparison of means was performed using the unpaired Student's t-test between the groups.

RESULTS

The mean age of exposed participants was 58 years (±13.7; minimum = 23; maximum = 75) and that of non-exposed participants was 64 years old (±13.9; minimum = 35; maximum = 96). Of the 90 patients, 30% were exposed to pesticides. The mean exposure time was 6.7 ± 3.8 hours/day. There was a statistically significant association between the preparation of the mixture with pesticides and diabetes (p ≤ 0.048). There was no statistically significant difference between the results of laboratory tests in the exposed and non-exposed groups.

CONCLUSION

This study shows that pesticides can be triggering factors for chronic kidney disease (CKD); however, we must expand research in this field to prove the relationship between exposure to pesticides and CKD.

Hypertension in Workers: The Role of Physical Activity and its Different Dimensions

BACKGROUND

Physical activity, each type in its own manner, whether occupational, domestic or leisure, can play a significant role regarding high blood pressure (HBP). However, practicing physical activity only at leisure time, or in specific situations, can be insufficient to achieve the effective control of HBP.

OBJECTIVE

To analyze the isolated and cumulative effect of different types of physical activity and the prevalence of HBP among workers.

METHODS

A cross-sectional study with 1,070 Urban Cleaning and Footwear Industry workers in Bahia, who answered a survey, conducted by an interviewer on sociodemographic, occupational, lifestyle and hypertensive morbidity aspects. Weight, height, waist circumference and blood pressure were measured. Case of HBP: Systolic blood pressure ≥140 or diastolic blood pressure ≥90, or regular treatment for HBP. The occupational, domestic and leisure aspects of Physical Activity were studied. A multivariate analysis with Cox Regression was performed for cross-sectional studies.

RESULTS

The prevalence of HBP was 24%, being 37% among workers aged between 35-44 years, and 51% among workers aged between 45-54 years. The multivariate model showed that workers who were active in one form of physical activity only or no forms had 62% higher BP levels and that these levels were 25% higher among workers who were active in two out of three physical activity forms. Being a male, being older (> 31 years old) and being overweight were characteristics associated with HBP, with prevalence ratios of 1.62, 2.10 and 2.26, respectively.

CONCLUSIONS

There was a cumulative effect of the form of physical activity on the occurrence of HBP. Classifying active subjects at work or at home as inactive persons by relying only on the leisure form can lead to methodological errors. (Arq Bras Cardiol. 2020; 114(5):755-761).

Stress and overweight/obesity among nursing students

OBJECTIVE

analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students.

METHOD

this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed.

RESULTS

female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity.

CONCLUSION

overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.

Lifestyle, health characteristics and alcohol abuse in young adults who are non-daily smokers

CONTEXT AND OBJECTIVES

Despite the decline in the prevalence of tobacco use in many countries, including Brazil, there are growing numbers of smokers who continue to smoke at a low daily rate, or less frequently (non-daily smokers). This group needs to be better characterized in order to direct preventive actions and public health policies. The aim here was to compare lifestyle, health characteristics and alcoholism problems among young adult smokers, non-daily smokers and non-smokers.

DESIGN AND SETTING

This was a cross-sectional study in which volunteers from the university community and its surrounds in Santa Maria, State of Rio Grande do Sul, Brazil, were included between October 2007 and January 2008.

METHODS

Out of 1240 volunteers initially contacted in a university cafeteria, a total of 728 participants of mean age 22.45 ± 3.32 years were selected for final analysis. Data were collected using structured questionnaires.

RESULTS

In general, it was observed that the non-daily smokers showed intermediate characteristics in relation to the smokers and non-smokers. However, there was a significant association between non-daily smoking and alcohol abuse. The non-daily smokers presented an odds ratio of 2.4 (95% confidence interval: 1.10-5.48) in relation to the daily smokers and an odds ratio of 3.3 (confidence interval: 1.7-6.5) in relation to the non-smokers, with regard to presenting a positive CAGE test, thereby indicating alcohol abuse or dependence.

CONCLUSION

The study suggested that non-daily smoking and alcohol consumption were concomitant behaviors.

[Lifestyle and metabolic control in patients with type 2 diabetes mellitus. Construct validation of IMEVID questionnaire]

OBJECTIVE

To evaluate construct validity of an instrument to measure lifestyle in patients with type 2 diabetes mellitus (IMEVID questionnaire)

DESIGN

Comparative cross-sectional study.

SETTING

Six family medicine units (primary care).

PATIENTS

412 adults with type 2 diabetes.

MEASUREMENTS

The IMEVID was applied by self-administration and the following metabolic control parameters values were measured: body mass index (BMI), waist/hip index (WHI), hemoglobin A1C (HbA1C), total cholesterol (TC), triglycerides (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the average of fasting plasma glucose in the last three months (FG). The test hypothetic construct was that higher total scores in the IMEVID (better lifestyle) would be associated with lower values in the metabolic control parameters. Three groups of subjects were formed based on the total score: group one (quartile 75). Differences on these parameters between groups were researched.

RESULTS

389 subjects completed the study, 69,2% were women. Seven IMEVID domains had weak correlations at least with two of eight parameters (r between 0.22 and 0.16; P<.05). The total score had correlation with six of eight parameter (r between 0.18 and 0.10; P< or =.05). The group three subjects had lower levels of BMI, WHI, HbA1C, FG, TC and TGL than group one subjects (P<.05).

CONCLUSIONS

IMEVID has construct validity to measure the lifestyle in subjects with DM2. Its total score discriminates outstanding clinical characteristics in these patients.