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Background: To estimate the prevalence of different physical activity (PA) domains and sitting time (ST), and to analyze the association with sociodemographic indicators. Methods: Data from the most recent nationally representative survey from each of the South American countries, comprising 155,790 adults (18–64 y), were used. Data on leisure-time, transport, and occupational PA (all 3 domains as nonzero), total PA (≥150 min/wk), and ST (≥8 h/d) were assessed by specific questionnaires in each survey. Gender, age group (18–34, 35–49, and 50–64 y), and education (quintiles) were used as sociodemographic factors. Random effect meta-analysis of the association between sociodemographic factors and PA and ST were conducted. Results: The prevalence of PA guidelines compliance and elevated ST in South America was 70.3% and 14.1%, respectively. Women were less likely to achieve the recommended levels of total and domain-based PA. Participants in the highest quintile of education were more likely for elevated ST (2.80, 2.08–3.77), lower occupational PA (0.65, 0.44–0.95), but higher leisure-time PA (3.13, 2.31–4.27), in comparison with lowest quintile. Older adults were less likely to participate in total and leisure-time PA. Conclusion: Our findings highlight the urge to tackle the inequalities in PA practice in South America, especially gender and education inequalities, for leisure-time PA. [ABSTRACT FROM AUTHOR]

Background: The authors analyzed time trends and sociodemographic inequalities in different physical activity and sedentary behavior domains between 2003 and 2019. Methods: A secondary analysis of data from 5 cross-sectional Brazilian epidemiological surveys (World Health Survey—2003, National Household Sample Survey—2008/2015, and Brazilian Health Survey—2013/2019) conducted among a nationally representative sample of Brazilian adults. The authors used data on different domains of physical activity (leisure, commute, total transport, and total physical activity) and sedentary behavior (TV viewing and other types of screens) that were available in the different surveys. Gender, age group, country region, ethnicity, type of area and city, and quintiles of income and educational achievement were used as sociodemographic correlates. Results: The prevalence of leisure-time physical activity increased over time (2008: 7.0% vs 2019: 26.5%). There was also an increased trend of social inequality in leisure-time physical activity. A trend of reduction was observed for active commuting (2008: 35.0% vs 2019: 21.8%), while total transport physical activity was stable (2013: 49.5% vs 2019: 49.6%). Directions of findings were opposite for sedentary behavior, with reduced trend for >3 hours per day of TV viewing (2008: 34.8% vs 2019: 21.8%) and increased trend for >3 hours per day of other types of screen time (2008: 6.4% vs 2019: 22.2%). Conclusion: A positive trend exists in leisure-time physical activity, but there was also an increase in social inequalities for physical activity in Brazil. [ABSTRACT FROM AUTHOR]

To investigate the mediating role of social network size and perceived quality in the associations of physical activity with quality of life and depressive symptoms in middle-aged and older adults. We analyzed information of 10,569 middle-aged and older adults from waves 2 (2006–2007), 4 (2011–2012), and 6 (2015) of the Survey of Health, Ageing, and Retirement in Europe study (SHARE). Data on physical activity (moderate and vigorous intensities), social network (size and quality), depressive symptoms (EURO-D scale), and quality of life (CASP) were self-reported. Sex, age, country of residency, schooling, occupational status, mobility, and baseline values of the outcome were used as covariates. We created mediation models to test the mediating effect of social network size and quality in the association between physical activity and depressive symptoms. Social network size partly mediated the association between vigorous physical activity and depressive symptoms (7.1%; 95%CI: 1.7–12.6) as well as the association between moderate (9.9%; 1.6–19.7) and vigorous (8.1%; 0.7–15.4) physical activity and quality of life. Social network quality did not mediate any of the associations tested. We conclude that social network's size, but not satisfaction, mediates part of the association of physical activity with depressive symptoms and quality of life in middle-aged and older adults. Future physical activity interventions among middle-aged and older adults should consider increasing social interactions to facilitate benefits for mental health-related outcomes. [ABSTRACT FROM AUTHOR]

Exercise induces the release of small extracellular vesicles (sEVs) into circulation that are postulated to mediate tissue cross-talk during exercise. We previously reported that pregnant individuals released greater levels of sEVs into circulation after exercise compared to matched non-pregnant controls, but their biological functions remain unknown. In this study, sEVs isolated from the plasma of healthy pregnant and non-pregnant participants after a single bout of moderate-intensity exercise were evaluated for their impact on trophoblasts in vitro. Exercise-associated sEVs were found localized within the cytoplasm of BeWo choriocarcinoma cells, used to model trophoblasts in vitro. Exposure to exercise-associated sEVs did not significantly alter BeWo cell proliferation, gene expression of angiogenic growth factors VEGF and PLGF, or the release of the hormone human chorionic gonadotropin. The results from this pilot study support that exercise-associated sEVs could interact with trophoblasts in vitro, and warrant further investigation to reveal their potential role in communicating the effects of exercise to the maternal–fetal interface. [ABSTRACT FROM AUTHOR]

Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34–36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise. [ABSTRACT FROM AUTHOR]

To analyze the association between participation in physical education (PE) classes and social isolation among adolescents. We used data from the Global School-based Health Survey, comprising 266,156 adolescents from 69 countries/territories. Participation in PE classes (days/week) was reported by the students. Social isolation was assessed through questions regarding the number of friends and loneliness perception. Poisson regression models were used to identify the association of weekly participation in PE classes with social isolation, and harmonized meta-analyses were used to estimate a summary association. Results were expressed through prevalence ratios (PR) and their respective confidence intervals (95%CI). Adolescents who participated in PE classes on one [PR:0.87 (95%CI:0.83; 0.92)], two [0.84 (0.79; 0.89)], and three or more days per week [0.77 (0.73; 0.82)] had a lower prevalence of having a low number of friends than their peers with no PE classes. The loneliness perception was lower among those who participated in PE classes on one [0.86 (0.81; 0.90)], two [ 0.93 (0.87; 0.98)], and three or more days per week [0.94 (0.90; 0.98)] than among those who did not participate in PE classes. Participation in PE classes was also associated with lower social isolation (combined indicator: a low number of friends + loneliness perception) [1 PE day/wk: 0.88 (0.85; 0.92); 2PE days/wk: 0.88 (0.84; 0.92); ≥3 PE days/wk: 0.85 (0.82; 0.89)]. Participating in at least one PE class per week is associated with a lower perception of social isolation among adolescents. Countries should seek to promote student participation in PE classes as a way of reducing social isolation. • Participation in Physical Education classes is associated with a lower prevalence of social isolation. • Any participation in Physical Education classes is better than none. • Promoting participation in Physical Education classes could be a strategy of reducing social isolation among adolescents. [ABSTRACT FROM AUTHOR]

Quarantine periods change routines and behaviors with potential impact on different health outcomes. To determine the association between changes in physical activity and sedentary behaviors with changes in back pain during the COVID-19 pandemic quarantine among Brazilian adults. This was a nationwide survey through online questionnaires using data from 43,062 adults (≥ 18 years of age). Information on back pain was assessed using questions about episodes of back pain and worsening symptoms during the quarantine. The pattern of movement behaviors adopted before and during the pandemic were considered for physical inactivity (< 150 min/week of activity), high TV-viewing (≥ 4 h/d), and high computer/tablet use (≥ 4 h/d). Covariates included sex, age group, academic achievement, skin color, working status during the quarantine, and adherence to the quarantine. Logistic regression models were used for statistical analyses (weighted for national representativity). Becoming inactive (OR=1.76, 95% CI: 1.32, 2.37), with high TV-viewing (OR=1.35, 95% CI: 1.14, 1.61) and high computer/tablet use (OR=1.39, 95% CI: 1.11, 1.73) during the pandemic were associated with a higher incidence of back pain. The incidence of physical inactivity was also associated with increased back pain (OR=2.71, 95%CI: 1.64, 4.48). We conclude that increased physical inactivity and sedentary behaviors due to the COVID-19 pandemic quarantine are associated with the incidence and worsening symptoms of back pain among Brazilian adults. [ABSTRACT FROM AUTHOR]

To identify sources of weight stigma in physical activity (PA)-related milieus reported by pregnant women living with obesity. We also report person-informed strategies to improve the delivery of PA promotions and prescriptions to prevent weight stigma and improve maternal PA. This is a qualitative descriptive study and semi-structured interviews were conducted. Purposive sampling including pregnant women living with obesity, with a body mass index ≥35.0 kg/m2, ≥18 years of age, and receiving specialized prenatal care were recruited from an obstetrics clinic in Kingston, Canada. Data were assessed by a content analysis, whereby coded themes represented sources of weight stigma related to prenatal PA. Demographic characteristics (pre-pregnancy body mass index, age, gestational age) were summarized and presented as means and standard deviations. In-depth interview data were collected from eight women. Average pre-pregnancy BMI, age, and gestational age were 44.6±4.8 kg/m2, 32.0±4.1 years, 31.1±5.8 weeks, respectively. Two sources of weight stigma related to prenatal PA were identified: 1. Lack of visual representation – online images and images found in exercise promotional material do not include women who have obesity; 2. Lack of individualized recommendations – currently available prenatal PA guidelines and/or recommendations from healthcare providers do not always consider individual physical barriers or health goals women may have. By increasing body positive representation of pregnant women exercising and offering person-centered prenatal PA recommendations, maternal PA may improve including women living with obesity. Findings from this work can inform future PA interventions, health promotion programming, and prescriptions from prenatal care providers to implement person-oriented strategies to prevent weight stigma and improve the delivery of care for pregnant women living with obesity. [ABSTRACT FROM AUTHOR]

Introduction: Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries.Methods: Data from Estudio Latinoamericano de Nutrición y Salud adult study, an observational multicountry study (N=2,478), were analyzed in 2020. Data were collected between 2014 and 2015. Perceived neighborhood-built environment attributes were measured using the Neighbourhood Environment Walkability Survey. Sedentary time, light-intensity physical activity, and moderate-to-vigorous physical activity data were collected using accelerometers.Results: No associations between perceived neighborhood-built environment attributes and sedentary time were found. Positive perceptions of walking/cycling facilities (β=6.50, 95% CI=2.12, 10.39) were associated with more light-intensity physical activity. Perceptions of better aesthetics (Argentina) and better walking/cycling facilities (Brazil and Ecuador) were positively associated with light-intensity physical activity. Land use mix-diversity (β=0.14, 95% CI=0.03, 0.25), walking/cycling facilities (β=0.16, 95% CI=0.05, 0.27), aesthetics (β=0.16, 95% CI=0.02, 0.30), and safety from traffic (β=0.18, 95% CI=0.05, 0.24) were positively associated with moderate-to-vigorous physical activity. Land use mix-diversity, street connectivity, and safety from traffic were positively associated with moderate-to-vigorous physical activity in Venezuela.Conclusions: These findings have implications for policy recommendations, which can guide policies to promote physical activity in the region. Land use mix-diversity, walking/cycling facilities, aesthetics, and safety from traffic can maintain or increase the levels of light-intensity and moderate-to-vigorous physical activity among Latin American adults. [ABSTRACT FROM AUTHOR]

• Moderate to vigorous levels of physical activity were independently associated with a lower incidence of mild cognitive impairment. • Handgrip strength was associated a lower hazard for incident mild cognitive impairment and dementia. • Handgrip strength partly mediated the association between moderate to vigorous levels of physical activity and mild cognitive impairment. We analyzed the mediating role of handgrip strength in the association between moderate to vigorous physical activity and incident mild cognitive impairment and dementia. We used prospective data from 14 European countries participating in the Survey of Health, Ageing, and Retirement in Europe. 19,686 participants free of dementia and mild cognitive impairment (64.9 ± 8.7 years) were followed up for a mean of 10.2 years. Moderate to vigorous physical activity was self-reported, and handgrip strength was assessed with a dynamometer. Mild cognitive impairment was defined as 1.5 standard deviations below the mean of the standardized global cognition score, while dementia was determined by physician diagnosis. Gender, age, country, education, presence of chronic diseases, depressive symptoms, limitations in activities of daily living, body mass index, and baseline cognitive levels were used as covariates. Cox proportional hazards as well as mediation models were used. Moderate to vigorous physical activity for at least 1 day per week was independently associated with lower incident mild cognitive impairment (HR: 0.85; 95%CI: 0.74–0.98). A 10 % increase in handgrip strength was associated a 6 % lower hazard for incident mild cognitive impairment (0.94; 0.92–0.97) and 5 % lower hazard for incident dementia (0.95; 0.93–0.98). Handgrip strength partly mediated the association of moderate to vigorous physical activity with mild cognitive impairment (Coefficient: 0.03; 95%CI: 0.01–0.05; 17.9 %). Physical activity is independently associated with a lower incidence of mild cognitive impairment. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between sedentary time (ST) patterns and depressive symptoms, and whether moderate-to-vigorous physical activity (MVPA) can moderate this association. Methods: This cross-sectional study included a representative sample of 243 adults (mean age 41.8616.7 years, 56.4% women) from a city in Southeast Brazil. Depressive symptoms were estimated through the Hospital Anxiety and Depression Scale (HADS). ST patterns (i.e., number of breaks, mean length of sedentary bouts, and number of long sedentary bouts), total ST, and MVPA were assessed using accelerometers. Results: Poisson regression models revealed associations of total ST (b = 0.063; 95%CI 0.011 to 0.116) and number of long bouts (0.108; 0.047 to 0.171) with depressive symptoms among men. MVPA moderated the associations of breaks and longer bouts of ST with depressive symptoms, with an increase of one break/hour, the increase of one long bout, and a decrease of 1 minute in mean bout length being associated with a reduction of 0.211 and increases of 0.081 and 0.166, respectively, in the number of depressive symptoms among men with physical inactivity (breaks = -0.211; -0.360 to -0.063; mean bout length = 0.081; 0.003 to 0.158; number of long bouts = 0.166; 0.090 to 0.242). Conclusions: Interventions that encourage breaking up ST should be helpful to reduce depressive symptoms among people with physical inactivity. [ABSTRACT FROM AUTHOR]

Background: We tested whether stressful workplace characteristics confound or moderate the association between occupational physical activity and depressive symptoms.Method: We used data of 36,442 employed adults (16,992 women), with a mean age of 39.3 ± 12.6y, from the 2013 Brazilian National Health Survey. Depressive symptoms were assessed through the Patient Health Questionnaire-9 (cut-point: ≥10). Occupational physical activity was self-reported and classified using the cut-point of 150 min/week and the highest quintile. Ten stressful workplace characteristics (e.g. exposure to stress, noise, violence) were also self-reported dichotomously. Logistic regression models were used considering the adjustment for potential confounders.Results: Most of the stressful workplace characteristics were associated with elevated depressive symptoms (8/10 characteristics) and higher occupational physical activity (9/10 characteristics). Although there were no interactions in combined associations, we found that the association between occupational physical activity and depressive symptoms consistently reduced after adjusting for the cluster of positive screening for at least two stressful workplace characteristics in men [highest quintile: ORunadjusted: 1.63 (95%CI 1.22-2.17) vs ORadjusted: 1.36 (1.08-1.91); ≥150 min/week: ORunadjusted: 1.43 (1.09-1.88) vs ORadjusted: 1.25 (0.95-1.64)], and women [highest quintile: ORunadjusted: 2.15 1.73-2.66) vs ORadjusted: 1.83 (1.47-2.29); ≥150 min/week: ORunadjusted: 2.11 (1.68-2.65) vs ORadjusted: 1.80 (1.42-2.27)].Limitations: The cross-sectional design limits the causal inference.Conclusions: Stressful workplace characteristics did not moderate, but acted as confounders in the association between occupational physical activity and elevated depressive symptoms and should be considered in future studies. [ABSTRACT FROM AUTHOR]

Background: Our aim was to analyze the associations between multiple lifestyle behaviors and depressive symptoms.Methods: We included 4,725 adults (18-59y), that provided data in routine health evaluations of a hospital in Brazil, followed for a mean period of 3.1 ± 1.6 years. Physical activity, alcohol consumption (measured using Alcohol Use Disorders Identification Test) and tobacco smoking were categorized as: (1) absence of the behavior (inactivity i.e. not complying with 150 min of moderate-to-vigorous PA/week, not smoking, no risky drinking, i.e. AUDIT<5) during baseline and follow-up; (2) Absence during baseline and presence during follow-up; (3) Presence during baseline and absence during follow-up; (4) Presence during both time points. Depressive symptoms were measured with the Beck Inventory was adopted to analyze patterns of depressive symptoms over time (as exposure). C-reactive protein [HS-CRP]) was assessed and its role in the association was tested. Incidence indicators of behaviors and depressive symptoms were created and used as outcomes. We used crude and adjusted Poisson regression analysis.Results: Fully adjusted models revealed that persistently physical inactive participants (RR:1.71;95%CI:1.33-2.21), those who became physically inactive (1.68;1.19-2.26), with consistently risky drinking (1.62;1.15-2.30), and who became risky drinkers (1.62;1.15-2.30) had higher risk for incidence of elevated depressive symptoms. Vice versa participants with incidence of depressive symptoms over time presented higher risk for physical inactivity (1.44;1.11-1.87) and risky drinking (1.65;1.16-2.34) incidence. HS-CRP did not influence the associations.Limitations: Self-reported physical activity, binary tobacco smoking, and non-probabilistic sampling.Conclusions: There is a prospective relationship between elevated depressive symptoms and adverse lifestyle behaviors. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to analyze the association between sugar-sweetened beverage consumption and depressive symptoms, as well as the extent to which TV viewing and physical activity moderate this association. Methods: We used cross-sectional data from the 2013 Brazilian National Survey (Pesquisa Nacional de Sau'de) of 59,402 adults (33,482 women, mean age = 42.9 years, 95%CI 42.7-43.2 years). Depressive symptoms (Patient Health Questionnaire-9), physical activity, TV viewing, and sugarsweetened beverage consumption, as well as potential confounders (chronological age, ethnicity, consumption of candy/sweets and fruit, multimorbidity, education, and employment status) were selfreported. Poisson regression models were used for association analyses. Results: The consumption of 16 or more glasses/week of sugar-sweetened beverages was associated with higher levels of severe depressive symptoms among women compared to no consumption (prevalence ratio [PR] 1.71 [95%CI 1.38-2.11]). Consistent interactions were observed between 1-5 glasses and TV viewing (PR 2.09 [95%CI 1.06-4.12]) and between 11-15 glasses and TV viewing (PR 2.90 [95%CI 1.29-6.50]) among men compared to no consumption, given that the cooccurrence of sugar-sweetened beverage consumption and elevated TV viewing was associated with higher odds of severe depressive symptoms. Sugar-sweetened beverage consumption did not interact with physical activity, only presenting an independent association. Conclusion: Sugar-sweetened beverage consumption was independently associated with severe depressive symptoms among women and interacted with TV viewing, but not with physical activity among men. [ABSTRACT FROM AUTHOR]

Our aim was to investigate whether different types and social contexts of physical activity (PA) participation are prospectively associated with psychological distress and well-being among middle-aged adults. Data from the 1970 British Cohort Study was used (N = 5144–2733 women). At age 42y, participants reported their type of leisure-time PA, which was classified as individual PA or group PA (exposure). At age 46y, participants reported co-primary outcomes: psychological distress (Malaise Inventory) and well-being (Warwick-Edinburgh scale). Highest academic achievement, employment status, country of interview, baseline values of psychological distress and well-being, smoking, alcohol use, TV-viewing and total physical activity at 42y were used as covariates. Main analyses included linear regression stratifying by sex. Jogging, cross-country, road-running (both sexes) as well as team sports (men) were associated with higher well-being. Health, fitness, gym or conditioning activities and jogging, cross-country (women), road-running (women) and team sports (men) were associated with lower psychological distress. Participation in both individual and group PA were associated with lower psychological distress and higher well-being for both sexes in crude models. However, adjusted models revealed that only group PA was associated with lower psychological distress (B : −0.106; 95%CI: −0.188 to −0.025) and higher well-being (0.835; 0.050 to 1.619) among men but not women. In the sensitivity analysis, group PA was associated with higher well-being (0.855; 0.094 to 1.616) when compared with individual PA among men. Group PA was not associated with psychological distress among both sexes and well-being among women when compared with individual PA. Group PA was prospectively associated with lower psychological distress and higher well-being among men but not females. Future PA interventions could focus on group activities for males. Further research to understand the relationship between individual/group PA and mental health is required in females. • Both individual and group activities were associated with higher well-being and lower psychological distress in crude models. • Group PA was associated higher well-being when compared with individual PA practice, among men, in the adjusted models. • Future physical activity interventions for mental health could focus on group activities for males. [ABSTRACT FROM AUTHOR]

To investigate the association of social isolation with physical activity and leisure-time sedentary behavior among adolescents. We used data from the Global School-based Health Survey, including a representative sample of 296,861 adolescents (11-18y) from 79 countries (48.9% girls, 14.5 ± 1.6 years). Social isolation was estimated by combining the self-reported number of friends and loneliness perception. Physical activity and leisure-time sedentary behavior were assessed through questionnaires. Multinomial logistic regression models were created to analyze the associations of social isolation with physical activity and leisure-time sedentary behavior. Compared with those practicing ≥60 min of physical activity during 1‐4 days/week, social isolation was associated with a higher prevalence of not practicing physical activity (Prevalence ratio [PR]:1.24; 95%CI:1.19–1.29), and a lower prevalence of practicing during ≥5d/wk. (PR:0.91; 95%CI:0.88–0.94). Compared with <4 h/d of leisure-time sedentary behavior, being socially isolated was also associated with a higher prevalence of 4-7 h/d (PR: 1.08; 95%CI:1.03–1.14) and ≥ 8 h/d (PR: 1.24; 95%CI:1.16–1.33) of leisure-time sedentary behavior. Compared with those participants without elevated leisure-time sedentary behavior and with those practicing adequate physical activity, social isolation was independently associated with a higher prevalence of physical inactivity (PR: 1.20; 95%CI: 1.15–1.26) and elevated leisure-time sedentary behavior (PR: 1.21; 95%CI: 1.14–1.30), as well as with both risk factors simultaneously (PR: 1.36; 95%CI: 1.28–1.45). Reducing social isolation could be an important component of future interventions to reduce sedentary behavior and physical inactivity among adolescents. • Social isolation was associated with lower moderate-to-vigorous physical activity. • Social isolation was associated with a higher leisure-time sedentary behavior. • Social isolation was associated with the combination of lower PA and higher SB. [ABSTRACT FROM AUTHOR]