Objective To compare some anthropometric indexes of obesity and identify among them which one best discriminates the high coronary risk (HCR). Methods ResultsThe largest area under ROC curve was found between the C index and the HCR, in individuals of male sex, 0.80 (0.74-0.85 Conclusion Those results show that C and WHCR indexes are the best indexes of obesity to discriminate HCR. WC has intermediate discriminatory power and the BMI was the least suitable anthropometric index of obesity to discriminate HCR. Those data suggest that the indexes of abdominal obesity are better to discriminate HCR than the indexes of general obesity. Key words anthropometric indexes of obesity, coronary risk, abdominal obesityThe role of obesity was coronary risk factor is controversial. However, the best explanation for the association between obesity and ischemic heart disease is that it would occur in a subgroup of obese individuals, which means in people who showed adiposity located in the abdominal or central region, even in the absence of general obesity 1 . The accumulation of fat in the abdomen region has been described as the type of obesity that offers the greatest risk for the health of the individuals. The incidence of diabetes, atherosclerosis, gout, urinary calculus and sudden cardiac death is high in some obese individuals. However, an adiposity aspect that draws attention to is the regional distribution of fat in the body. Considering that perspective, the thickness of neck/sacral region skin folds and the fat-muscle proportion of brachio/femoral region were related, which created the masculine differentiation index. Through that index, fat was classified as (a) android; that located in the central region and more specific for men, and (b) gynoid; fat located more in the hips and thighs, and more specific for women 2 . Some years later 3 , abdominal obesity was related to the increase of risk of myocardial infarction, cerebrovascular accident and early death, with a strong association among those variables. Such findings were particularly important to the extent that, by then, there was an association only between general obesity levels and the mentioned diseases. In opposition to the concepts at that time, the highest risk of myocardial infarction or early death was found in men with high quantity of abdominal fat, which suggested that men, even lean, but with body fat concentrated in the abdomen are those with the highest risk to develop cardiovascular diseases.More recent researches still identify the abdominal fat as a powerful coronary risk factor, with the comparison among the many obesity indexes as cardiovascular risk factor, being the result of many studies 4,5,6 . In this study, the main objective was to analyze the anthropometric indexes of general and abdominal obesity as instruments of screening to discriminate high coronary risk (HCR). MethodsA cross-section study performed in Salvador, Bahia, Brazil, in 2000, in a subgroup of participants in "Monit" project, develop by the team of chronic non-transmi...
Objective. this study compares the performance of the waist-height ratio with other anthropometric indicators of obesity: waist circumference (WC), waist-to-hip ratio (WHR), conicity index (C Index), and body mass index (BMI) for discriminating the level of coronary risk (HCR). MethOds. a cross-sectional study of a subset of the participants enrolled on the "Monitoring Cardiovascular Diseases and Diabetes in Brazil" project (MONIT) was carried out in Salvador, Brazil (2000). The total sample comprised 968 people (391 men and 577 women) aged 30 to 74. First, the total area was calculated under the ROC curves between the C Index, WHR, waist/height ratio, WC, BMI and HCR at a 95% confidence interval. Sensitivity and specificity were then calculated. Analyses were carried out using STATA 7.0. Results. Areas under the ROC curves used as indicators of obesity were C Index 0.80, WHR 0.76, waist/height ratio 0.76, WC 0.73, and BMI 0.64 for men and Index C 0.75, WHR 0.75, waist/height ratio 0.69, WC 0.66 and BMI 0.59 for women. cOnclusiOn. Indicators of abdominal obesity are better at discriminating HCR than the usual obesity indicator (BMI). The waist/height ratios are closer to the results of other studies. Furthermore, the waist/height ratio whose statistical significance justifies its use.
IntroduçãoCom o processo da industrialização, existe um crescente número de pessoas que se tornam sedentárias com poucas oportunidades de praticar atividades físicas. Diversos autores têm demonstrado associação entre sedentarismo e agravos cardiovasculares 1 , câncer 2,3 , diabetes 4 e saúde mental 5 . Outros estudos demonstram que o sedentarismo no lazer está associado à hipertensão arterial e diabetes 6,7,8 , além de ser mais prevalente em mulheres, idosos e pessoas de baixa escolaridade 9,10 .Sedentarismo no lazer pode ser identificado como a não participação em atividades físi-cas nos momentos de lazer, considerando atividade física como qualquer movimento corporal produzido pela musculatura esquelética que resulte em gasto energético 11 , tendo componentes e determinantes de ordem bio-psicosocial, cultural e comportamental, podendo ser exemplificada por jogos, lutas, danças, esportes, exercícios físicos e deslocamentos.Para identificar o sedentarismo, o instrumento que vem sendo utilizado de forma mais freqüente é a versão curta do Questionário Internacional de Atividade Física (QIAF), que contempla as diversas facetas desse problema de saúde pú-blica: atividades domésticas, atividades no trabalho, atividades no lazer e deslocamentos 12 . Assim, o sedentarismo no lazer é um recorte do sedentarismo quando analisado globalmente.
Results suggest that the WHtR may be employed to identify CHR and must be compared to other anthropometric indicators of obesity.
OBJETIVO: No início da década de 90, foi proposto o índice de conicidade para avaliação da distribuição da gordura corporal, com base nas medidas de peso, estatura e circunferência da cintura. Este estudo teve como objetivo selecionar através da sensibilidade e especificidade os melhores pontos de corte para o índice de conicidade como discriminador de risco coronariano elevado. MÉTODOS: Estudo de corte transversal, com amostra composta por 968 adultos de 30-74 anos de idade, sendo 391 (40,4%) do sexo masculino. A análise foi feita por curva Receiver Operating Characteristic (ROC) para identificar a sensibilidade e especificidade do melhor ponto de corte do índice de conicidade como discriminador de risco coronariano elevado. Verificou-se também a significância estatística da área sob a curva ROC entre o índice de conicidade e risco coronariano elevado. Foi utilizado intervalo de confiança (IC) a 95%. RESULTADOS: A área total sob a curva ROC entre o índice de conicidade e risco coronariano foi de 0,80, IC 95% (0,74-0,85) para homens e 0,75, IC 95% (0,70-0,80) para mulheres. Os melhores pontos de corte para discriminar o risco coronariano elevado foram, para homens e mulheres, respectivamente, 1,25 (sensibilidade de 73,91% e especificidade de 74,92%) e 1,18 (sensibilidade de 73.39% e especificidade de 61,15%). CONCLUSÕES: Os resultados encontrados neste estudo sugerem que o índice de conicidade deve ser comparado aos demais indicadores antropométricos de obesidade e pode vir a ser utilizado para discriminar risco coronariano elevado.
OBJECTIVE The objective of this study is to investigate the adherence and the factors that influence adherence to physical activity in adults with dyslipidemia, hypertension, or diabetes.METHODS The analyses were based on data collected at the baseline of the 14,521 participants from the study ELSA-Brasil aged between 35 and 74 years. The level of leisure time physical activity was determined using the International Physical Activity Questionnaire. Logistic regression analyses were performed to examine the influence of the demographic data, socioeconomic conditions, perceived health status, and access to exercise facilities in the neighborhood on adherence to physical activity.RESULTS Men with hypertension and dyslipidemia were more active than women. The results show that 17.8%, 15.1%, and 13.9% of the subjects who reported dyslipidemia, hypertension, and diabetes, respectively, adhere to the physical activity recommendations. The factors positively associated with adherence were higher education and income. Older individuals who reported poor perceived health, were overweight and obese, regularly smoked, and had fewer opportunities to exercise in the neighborhood presented lower adherence.CONCLUSIONS The number of adults with dyslipidemia, hypertension, and diabetes who adhere to the physical activity recommendations is very low. Higher education and income are positively associated with adherence, while age, excess body weight, negative perceived health, regular smoking, and lack of opportunity to exercise in the neighborhood were considered barriers to physical activity.
SUMMARY INTRODUCTION The COVID-19 pandemic, caused by infections from a novel human coronavirus, has been reported since December 2019 in China but was only made official in March 2020. Since then, it has had an impact worldwide, both due to its aggressiveness and its fast propagation. Society has been facing this pandemic by following the recommendations and determinations of the WHO and the strategies deployed by governmental institutions. Among these, social isolation has been shown to be the most important, because when isolating, society tends to move less, with a consequent increase in physical inactivity and sedentary behavior, affecting its levels of physical fitness. The objectives of this review were: to review the most important effects of physical inactivity and sedentary behavior on the physical fitness levels of the population during the COVID-19 pandemic. CONCLUSION The role of a regular practice of activities on the levels of physical fitness is fundamental to define the balance of quality of life during a COVID-19.
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