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Background: Our aim was to analyse the prospective association between psychological distress during early adulthood and physical activity trajectories between early and middle adulthood., Methods: We used data from the 1958 National Child Development Study (NCDS) (n=8994, 4388 women) and the 1970 British Cohort Study (BCS) (n=7014, 4388 women). Psychological distress was assessed using the Malaise inventory at 23 years in the 1958 NCDS and at 26 years at the 1970 BCS. Self-report leisure-time physical activity (LTPA) was assessed at 33 years, 42 years, 46 years, 50 years and 55 years in the 1958 NCDS as well as at 30 years, 34 years, 42 years and 46 years in the 1970 BCS. We created physical activity trajectories, using latent class growth analysis. Poisson regression analysis was used for association., Results: We identified three trajectories of physical activity during adulthood in both cohorts. Participants with psychological distress at 23 years were less likely to be in the persistently high trajectory (RR adjusted : 0.79; 95% CI 0.64 to 0.98) in the 1958 NCDS. In addition, participants with psychological distress at 26 years were less likely to be in the increased LTPA (0.73; 0.59 to 0.89) and persistently high (0.59; 0.50 to 0.69) trajectories, comparing with participants without psychological distress., Conclusion: Elevated psychological distress during early adulthood is associated with a lower probability of adopting positive trajectories of LTPA during adulthood., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity (MVPA). However, using only this cut-off could hide important information. For instance, from a population-level point of view, increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels. Also, including a more sensitive cut-point of ≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice. Thus, the current study aims to estimate the prevalence of ≥60 min of MVPA ≥1 days per week among adolescents globally, and to describe any relevant gender inequalities., Methods: We used representative datasets from 146 countries/territories collected between 2003 and 2019. MVPA was self-reported. Participants were grouped into younger (≤14 years old) and older (>14 years old) adolescents. Crude Poisson regression models were used to identify the relative differences in ≥60 min of MVPA ≥1 days per week between boys and girls, and random-effects meta-analysis models were used to identify the pooled estimates. Analyses were stratified by country and region., Results: Approximately 80% of both younger and older adolescents reported ≥60 min of MVPA ≥1 days per week. This prevalence was ≥94% in Europe and Central Asia and North America, while the estimates for the other regions were <77%. The prevalence of ≥60 min of MVPA ≥1 days per week was higher among boys than girls, with the largest differences occurring among the oldest adolescents (Prevalence ratio ≤14y = 1.04 (95% confidence interval (95%CI)): 1.03‒1.04) vs. Prevalence ratio >14y = 1.09 (95%CI: 1.08‒1.10))., Conclusion: Approximately 8 out of 10 adolescents reported accumulating ≥60 min of MVPA ≥1 days per week, with notable differences between regions. Gender differences were observed in several countries, especially among the oldest adolescents. Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve ≥60 min of MVPA ≥1 days per week and reducing gender inequalities., (Copyright © 2024. Production and hosting by Elsevier B.V.)

Objective: The current study aimed to explore the association of individual characteristics, social and environmental factors - school and region - in the intention to be physically active in Brazilian adolescents., Methods: This is a cross sectional study based on the third edition of the National School Health Survey. The study included a total of 53,937 adolescents. To assess the intention to be physically active, only who engaged in less than 300 min of physical activity per week were included. Participants were asked: "If you had the opportunity to practice physical activity most days of the week, what would your attitude be?" Individual characteristics, physical activity domains, social factors, school, and regional environments were used as exposures. Network analysis was utilized to evaluate the associations., Results: We observed that boys had higher intentions to be physically active compared to their peers, as did adolescents who perceived themselves as fat. In addition, students from private schools show a higher intention to regularly engage in physical activities, and in general, private schools offer more extracurricular physical activities., Conclusion: In conclusion, individual factors such as sex and body image perception, and environmental factors such as school administrative dependency and availability of extracurricular activities had a significant contribution to the intention to be physically active among Brazilian adolescents., (© 2023. The Author(s).)

Background: Sedentary behavior (SB; time spent sitting, as distinct from lack of exercise or physical activity) is associated with depression, yet little is known about the relationship between different types of SB (e.g., mentally-passive versus mentally-active) with depression and potential biological mediators of these associations., Methods: We used cohort data from the 1958 National Child Development Study (n = 4607; 50.4 % women), conducted in UK, employing the 44 y and 46 y waves as baseline, and the 50 y and 55 y waves as follow-up. Participants reported time spent in TV viewing and watching videos (mentally-passive SB); and, time sitting while doing light activities such as deskwork or driving a car during worktime (mentally-active SB). Depression diagnosis was self-reported during the initial and follow-up waves. Waist circumference, C-reactive protein, and glycated hemoglobin were examined as potential mediators., Results: Mentally-passive SB was associated with incident depression (HR: 1.43; 95%CI: 1.19; 1.71), while there was no association for mentally-active SB. Waist circumference (coefficient: -0.03; 95%CI: -0.05; -0.01; 9.2 %) and C-reactive protein (coefficient: -0.03; 95%CI: -0.04; -0.01; 8.3 %), but not glycated hemoglobin, partly mediated the association for mentally-passive SB., Conclusions: In the relationship of mentally-passive SB with incident depression, the mediating contributions of waist circumference and C-reactive protein point to possible inflammatory-related mechanisms., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

This study aimed to verify the association between the weekly frequency of physical education (PE) classes and leisure sitting time among adolescents. We analyzed data from 73 countries using the Global School-based Student Health Survey (283,233 adolescents between 11 and 18 years of age). Leisure sitting time and weekly frequency of PE classes were self-reported. Sex, age, and food insecurity were used as covariates and the analyses were stratified by world regions and country income level. Poisson regression models (random-effects meta-analysis) were used for the main analyses. In comparison with 1 PE class per week (reference group), those with no PE classes presented a lower prevalence of ≥ 3 h/d of leisure sitting time (PR [95%CI] = 0.94 [0.91; 0.98]). On the other hand, adolescents with 2 days (PR [95%CI] = 1.06 [1.02; 1.26]), 3-4 days (PR [95%CI] = 1.17 [1.12; 1.22]), and 5 days (PR [95%CI] = 1.08 [1.04; 1.11]) of PE classes presented a higher likelihood of ≥ 3 h/d of leisure sitting time. No clear differences were observed for the different world regions and country income levels. We conclude that a higher weekly frequency of PE classes is associated with increased leisure sitting time among adolescents worldwide., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Aim: To investigate the association of social isolation with physical activity and leisure-time sedentary behavior among adolescents., Methods: 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., Results: 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)., Conclusion: Reducing social isolation could be an important component of future interventions to reduce sedentary behavior and physical inactivity among adolescents., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: We analyzed the mediating role of handgrip strength in the association between moderate to vigorous physical activity and incident mild cognitive impairment and dementia., Methods: 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., Results: 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 %)., Conclusions: Physical activity is independently associated with a lower incidence of mild cognitive impairment., Competing Interests: Declaration of competing interest The authors declare that they have no competing interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

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.

Background: The presence of multimorbidity increases the risk of mortality, and identifying correlates of multimorbidity can direct interventions by targeting specific modifiable correlates. Here we aimed to investigate the association between two types of screen-based behaviors and multimorbidity., Methods: We used data from 87,678 Brazilian adults from the National Health Survey (2019). Multimorbidity (presence of two or more chronic conditions among 12 possibilities), TV-viewing, and time on other types of screens (computer, tablet, or cell phone), were self-reported. Crude and adjusted binary and multinominal logistic regression models were performed stratified by sex, age group, and the number of chronic conditions., Results: Considering adjusted values, 2 h/day as a reference, and reporting values in odds ratio (OR) and prevalence ratio (PR) with 95% confidence intervals (95%CI), multimorbidity presented associations with TV-viewing in general [from OR (95%CI) 1.10 (1.03-1.18) in 2 to < 3 h/d, to OR (95%CI) 1.57 (1.40-1.76) in ≥ 6 h/d], except in 2 to < 3 h/d time category for male and 35 to 49 years, and all time categories for 18 to 34 years. In addition, TV-viewing was associated with an increasing number of chronic conditions, all greater in ≥ 6 h/d [2 conditions - PR (95%CI) 1.24 (1.08-1.43); 3 conditions - PR (95%CI) 1.74 (1.45-2.08); 4 or more conditions - PR (95%CI) 2.29 (1.93-2.73)], except in 2 conditions on 2 to < 3 h/d. Other types of screen-based behaviors were only associated with multimorbidity among males [≥ 6 h/d: OR (95%CI) 1.22 (1.01-1.48)] and older individuals (65 years) in some time categories [3 to < 6 h/d: OR (95%CI) 1.98 (1.42-2.77) and ≥ 6 h/d: OR (95%CI) 1.73 (1.06-2.84)]., Conclusion: Intervention strategies for reducing screen time in Brazilian adults should focus mainly on TV-viewing, which seems to be associated with more harmful conditions than time on other types of screen-based behaviors., (© 2022. The Author(s).)

We analyzed the associations of screen-based behaviors with obesity, hypertension, and diabetes, and the moderation of different physical activity (PA) domains in these associations. We used data from the 2019 Brazilian National Health Survey, including data from 80,940 adults (mean age of 32.6 years). TV viewing, other screens (PC, tablet, and cell phone), PA domains (leisure-time, occupational, and transport) were collected via interview. Logistic regression models were used. There was a dose-response association of higher TV viewing with diabetes. Within the groups with medium and higher time spent on other screens, those with &lt; 150 min/week in leisure-time PA increased the odds for obesity [1-2.9 h/day: OR = 1.18 (1.01, 1.39)] and hypertension [1-2.9 h/day: OR = 1.29 (1.08, 1.53); ≥ 6 h/day: OR = 1.47 (1.03, 2.09)]. Likewise, among the participants who spent ≥ 6 h/day of TV viewing, those with &lt; 150 min/week of occupational PA presented higher odds for hypertension [OR = 1.61 (1.03, 2.53)]. In the group with higher use of other screens, &lt; 150 min per week of occupational PA was associated with lower odds for obesity [1-2.9 h/day: OR = 0.81 (0.68, 0.97)] and hypertension [≥ 6 h/day: OR = 0.65 (0.44, 0.98)]. In conclusion, the associations of other screens with obesity and hypertension were strongest among those without leisure-time PA, while the moderator role of occupational PA was not clear., (© 2022. The Author(s).)

Background: The current study aimed to describe the trends in gender, ethnicity, and education inequalities of types of leisure-time physical activity (LTPA) practiced by Brazilian adults from 2006 to 2019., Methods: We used data from 2006 to 2019 of the Brazilian Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey, which is an annual survey with a representative sample of adults (≥ 18y) living in state capital cities. The types of LTPA considered were walking, running, strength/gymnastics, sports, other LTPA, and no LTPA participation. Gender (women or men), ethnicity (white, black, brown, or yellow/indigenous), and years of formal education were also self-reported. We used relative frequencies and their respective 95% confidence intervals to analyze trends. The absolute and relative differences between the proportions were used to assess the inequalities., Results: We observed increases in inequalities related to gender and education (running and strength/gymnastics), while gender inequalities for sports, other types, and no LTPA participation decreased. There were persistent inequalities related to gender (walking) and education (sports, other types, and no LTPA participation). Considering ethnicity, we noted increases in inequality for strength/gymnastics, where white adults were more active than black and brown adults. In addition, white adults reported more access to LTPA than brown adults over the years analyzed., Conclusion: Women, black and brown people, and subjects with less schooling were the most unfavored groups. While some inequalities persisted over the years, others increased, such as ethnicity and education inequalities for strength/gymnastics., (© 2022. The Author(s).)

Background: To identify the prevalence and sociodemographic correlates of different domains of physical activity (PA) and higher sitting time among South American adolescents., Methods: Data from national surveys of 11 South American countries were analyzed, and comprised information on 166,901 adolescents. PA (≥ 60 min/day of moderate-vigorous PA), physical education classes (PEC) (≥ 3 classes/wk), active commuting to school (≥ 1 d/wk), and higher sitting time (≥ 3 h/d) were self-reported. Sociodemographic correlates, such as gender, age, and food security status were explored using a random effect meta-analysis for logistic parameters., Results: Recommended PA ranged between 7.5% (Brazil) and 19.0% (Suriname). Peru (2.2%) and Guyana (43.1%) presented the lowest prevalence of PEC and active commuting to school, respectively. Higher sitting time was less prevalent in Bolivia (24.6%) and more prevalent in Argentina (55.6%). Compared to girls, boys were more prone to reach recommendations for PA [OR = 1.94(1.65;2.28)]; to reach ≥ 3 PEC [OR = 1.17(1.04;1.33)] and to be active in commuting to school [(OR = 1.14(1.06;1.23)], but less prone to higher sitting time [OR = 0.89(0.82;0.96)]. Older adolescents had less odds of reach PA guidelines [OR = 0.86(0.77; 0.97)] and accumulated higher sitting time [OR = 1.27(1.14;1.41)]. Adolescents with food insecurity reported more PEC [OR = 1.12(1.04;1.21)] and active commuting to school [OR = 1.12(1.02;1.22)] but had less higher sitting time than their food security pairs [OR = 0.89(0.81;0.98)]., Conclusions: Few adolescents reach the PA recommendation. Actions aiming the promotion of PA and the reduction of sitting time must consider girls and older adolescents as target groups, as well as the specifics of each country., (© 2022. The Author(s).)

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: OR unadjusted: 1.63 (95%CI 1.22-2.17) vs OR adjusted : 1.36 (1.08-1.91); ≥150 min/week: OR unadjusted : 1.43 (1.09-1.88) vs OR adjusted : 1.25 (0.95-1.64)], and women [highest quintile: OR unadjusted : 2.15 1.73-2.66) vs OR adjusted : 1.83 (1.47-2.29); ≥150 min/week: OR unadjusted : 2.11 (1.68-2.65) vs OR adjusted : 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., (Copyright © 2022. Published by Elsevier B.V.)

We aimed to investigate correlates of TV viewing and other types of screen-based behaviors in a nationally representative sample of Brazilian adults. In the 2019 Brazilian National Health Survey (including 88,509 adults), TV viewing time and other types of screen behaviors (computer, tablet, and cellphone use) were self-reported and different geographical, sociodemographic, behavioral, and health status factors were investigated as potential correlates. Multinomial logistic regression models were used for the main analyses. Living in capital cities, urban areas, being unemployed, high consumption of soft drinks, obesity, and elevated depressive symptoms were each associated with more TV viewing and more time using other types of screens. There were differential associations between TV viewing and the use of other types of screen across age and socioeconomic variables. For instance, younger adults have a more diverse portfolio of screen time than older adults. To conclude, levels of screen-based behaviors vary by geographical, sociodemographic, behavioral, and health status characteristics. Interventions should focus on high-risk population groups and may benefit from targeting specific sedentary behaviors of interest., (© 2021. The Author(s).)

This study investigated the association among loneliness, number of friends, and participation in physical education classes, leisure-time physical activities, and active commuting. Data from 102,072 adolescents participating in the National School-based Health Survey aged 11-19 years were analyzed. Information about the study variables was self-reported through a questionnaire. Adolescents more active in physical education classes and leisure were less likely of having social isolation. Those more active in commuting were more likely of having social isolation. Interventions aimed at addressing social isolation in adolescence can prioritize school and leisure-time physical activities.

Background: Although there is a growing body of research pointing towards the need to investigate how different movement behaviors, such as physical activity and sleep, influence each other, the joint relationship between these factors and insomnia has been little explored among adolescents in developing countries., Objectives: To investigate the association between daily physical activity and insomnia in a national sample of Brazilian adolescents, according to the Human Development Index (HDI) of each Brazilian region., Design and Settings: Cross-sectional study on 102,072 Brazilian students aged 11 to 19 years, selected from all regions of the country., Methods: Information on insomnia and physical activity was self-reported by adolescents., Results: Our analyses revealed that girls who accumulated at least 60 minutes/day of physical activity on up to three days/week were less prone to present insomnia. This pattern of association was maintained only for those who lived in high HDI regions (odds ratio, 0.87; 95% confidence interval, 0.75-0.99). For boys, there was a positive association between the number of active days and protection against insomnia, especially for those who lived in high HDI regions., Conclusion: Even amounts of physical activity that were lower than the weekly guidelines, were associated with better sleep quality for Brazilian adolescents, especially girls, and even for those who lived in regions with greater social and economic vulnerability.