Physical activity in adolescence may contribute to the development of healthy adult lifestyles, helping reduce chronic disease incidence. However, definition of the optimal amount of physical activity in adolescence requires addressing a number of scientific challenges. This article reviews the evidence on short- and long-term health effects of adolescent physical activity. Systematic reviews of the literature were undertaken using a reference period between 2000 and 2004, based primarily on the MEDLINE/PubMed database. Relevant studies were identified by examination of titles, abstracts and full papers, according to inclusion criteria defined a priori. A conceptual framework is proposed to outline how adolescent physical activity may contribute to adult health, including the following pathways: (i) pathway A--tracking of physical activity from adolescence to adulthood; (ii) pathway B--direct influence of adolescent physical activity on adult morbidity; (iii) pathway C--role of physical activity in treating adolescent morbidity; and (iv) pathway D - short-term benefits of physical activity in adolescence on health. The literature reviews showed consistent evidence supporting pathway 'A', although the magnitude of the association appears to be moderate. Thus, there is an indirect effect on all health benefits resulting from adult physical activity. Regarding pathway 'B', adolescent physical activity seems to provide long-term benefits on bone health, breast cancer and sedentary behaviours. In terms of pathway 'C', water physical activities in adolescence are effective in the treatment of asthma, and exercise is recommended in the treatment of cystic fibrosis. Self-esteem is also positively affected by adolescent physical activity. Regarding pathway 'D', adolescent physical activity provides short-term benefits; the strongest evidence refers to bone and mental health. Appreciation of different mechanisms through which adolescent physical activity may influence adult health is essential for drawing recommendations; however, the amount of exercise needed for achieving different benefits may vary. Physical activity promotion must start in early life; although the 'how much' remains unknown and needs further research, the lifelong benefits of adolescent physical activity on adult health are unequivocal.

SummaryObjectives: To explore the association between gender and leisure-time physical activity in a population-based sample of adults living in Brazil. To study a variety of variables possibly associated with physical activity levels. Methods:A multistage sampling of households was undertaken in Pelotas, a medium-sized Southern Brazilian city. Leisure-time physical activity was measured using the long version of the International Physical Activity Questionnaire. Data on potential predictors of leisure-time physical activity behavior were collected using a standardized questionnaire. 1 344 men and 1 756 women were interviewed. Several defi nitions of moderate and vigorous-intensity physical activity were used. Results:Regardless of the guideline used, males were more active than women. Socioeconomic level was positively associated with leisure-time physical activity in both genders. A positive dose-response between age and inactivity was found in men, but not among women.Conclusions: Because men and women have different levels of physical activity, and the variables associated with activity levels are not consistent across the genders, interventions promoting physical activity should take these differences into account.

OBJETIVO: Descrever a evolução da pesquisa epidemiológica em atividade física no Brasil. MÉTODOS: Revisão sistemática da literatura, realizada em bases de dados eletrônicas (Medline/PubMed, Lilacs, Ovid, Science Direct, BioMed Central e High Wire), em periódicos nacionais não indexados, por busca específica por autores e contato com pesquisadores. A seleção dos artigos teve como critérios de inclusão: amostra representativa de alguma população definida; tamanho da amostra de pelo menos 500 indivíduos; coleta de dados realizada no Brasil; mensuração de atividade física e relato dos resultados com base nessa variável. RESULTADOS: Foram incluídos 42 estudos. O primeiro artigo foi publicado em 1990, observando-se tendência de aumento de publicações a partir de 2000. Foi detectada disparidade regional nas publicações, com concentração de estudos nas regiões Sudeste e Sul. A maioria dos estudos (93%) utilizou questionários como instrumentos de pesquisa, cujos conteúdos variaram, assim como as definições operacionais de sedentarismo, dificultando a comparação dos resultados. CONCLUSÕES: Embora a literatura em epidemiologia da atividade física venha crescendo quantitativamente no Brasil, limitações metodológicas dificultam a comparação entre os estudos, tornando a padronização de instrumentos e definições essenciais para o avanço científico da área.

OBJECTIVE:To assess the association between regular physical activity in adolescence and leisure-time physical activity in adulthood, with emphasis on gender differences. METHODS:A population-based cross-sectional study was carried out in Pelotas, Southern Brazil, in 2003. A representative sample of households was selected in multiple stages and subjects aged 20-59 years were interviewed. Leisure-time physical activity was evaluated using the International Physical Activity Questionnaire. Data on adolescent physical activity were based on subjects' recall. RESULTS:Of 2,577 subjects interviewed, 27.5% were classified as adequately active, and 54.9% reported regular physical activity in adolescence. Subjects who engaged in regular physical activity during adolescence were more likely to be adequately active in adulthood (adjusted prevalence ratio 1.42; 95% CI: 1.23; 1.65). This effect was stronger in women (adjusted prevalence ratio: 1.51; 95% CI: 1.22; 1.86) than men (adjusted prevalence ratio: 1.35; 95% CI: 1.10; 1.67). CONCLUSIONS:Promoting physical activity in school age may be a successful intervention against the epidemic of adult inactivity. Although women were less likely to report regular physical activity in adolescence, the effect of this experience on adult behavior was stronger than in men.

Until a few years ago, a limited number of epidemiologists or public health experts mentioned the words “diabetes.” As new lifestyles, imported dietary practices, and globalization take roots in the developing world, as Africa is, today, diabetes and its complications are considered an epidemic in Africa, compelling African governments to start paying more attention to its impact as thousands of Africans run the risk of dying young. The potential severity of diabetes is such that some epidemiologists predict that its economic impact and death toll will surpass the ravages of HIV and AIDS in the near future. On the African sub-continent, present literature and the work of the World Diabetes Foundation have highlighted three countries, namely, Mali, Mozambique, and Zambia. However, the conditions in South Africa, Kenya, and Nigeria, some of the most developed areas of the continent, provide a clue to how people are coping and how governments are responding to diabetes and its full impact. This study is, therefore, a meta-summary of the incidence and prevalence of today's emerging silent killer or diabetes in Sub-Saharan Africa. The theme is that time is running out for Africa and that, as was for HIV/AIDS, by the time the governments wake up and stop denying the catastrophic potential of the epidemic, diabetes will simply overwhelm the continent's resources, and the world will witness the death of millions of Africans. The last section is a call for action against diabetes in terms of advocacy, promotion of awareness, and public health policies that empower people to diabetes self-management.

The study aimed to estimate the prevalence of smoking and alcohol intake among university students from the Federal University of Pelotas, Brazil (UFPel), as well as to investigate factors associated with both habits. The sample included 485 students who were admitted to the university in 2008. Students were sampled randomly across all schools of the UFPel campus, and answered a pre-tested questionnaire, which was administered in the classroom by a member of the research team. Of the individuals interviewed, 53.9% were females and 42.3% were under 20 years. Regarding alcohol intake, 75% used alcohol once a month or less frequently, and the prevalence of risk for abusive alcohol intake was 6.2%. Regarding smoking, 10.2% reported smoking regularly or on weekends. More than 90% of those who smoked or used alcohol started before entering the university. Smoking was directly related to age and inversely related to self-rated health. In terms of alcohol intake, those who lived with friends were more likely to use it. Our data suggest the need for implementing strategies to promote healthy lifestyles among university students. However, the fact that more than 90% of individuals started to smoke or drink before entering the university suggests that interventions should target adolescents as a whole, and not only those who are university students, because onset of smoking and alcohol intake seems to occur at earlier ages.

ContextSystematic reviews of public health interventions are useful for identifying effective strategies for informing policy and practice. The goals of this review were to (1) update a previous systematic review of physical activity interventions in Latin America which found that only school-based physical education had sufficient evidence to recommend widespread adoption; (2) assess the reporting of external validity elements; and (3) develop and apply an evidence typology for classifying interventions.Evidence acquisitionIn 2010–2011, community-level, physical activity intervention studies from Latin America were identified, categorized, and screened based on the peer-reviewed literature or Brazilian theses published between 2006 and 2010. Articles meeting inclusion criteria were evaluated using U.S. Community Guide methods. External validity reporting was assessed among a subset of articles reviewed to date. An evidence rating typology was developed and applied to classify interventions along a continuum based on evidence about their effectiveness in the U.S. context, reach, adoption, implementation, institutionalization, and benefits and costs.Evidence synthesisThirteen articles published between 2006 and 2010 met inclusion criteria and were abstracted systematically, yet when combined with evidence from articles from the previous systematic review, no additional interventions could be recommended for practice. Moreover, the reporting of external validity elements was low among a subset of 19 studies published to date (median=21% of elements reported). By applying the expanded evidence rating typology, one intervention was classified as evidence-based, seven as promising, and one as emerging.ConclusionsSeveral physical activity interventions have been identified as promising for future research and implementation in Latin America. Enhanced reporting of external validity elements will inform the translation of research into practice.

Purpose:To evaluate the validity and reliability of the telephone-administered long IPAQ version.Methods:The questionnaire was administered by telephone to adults on days 1 and 6. On day 1, the same questionnaire was administered by face-to-face interview, and accelerometers were delivered to subjects. Reliability was measured by comparing data collected using the telephone questionnaire on days 1 and 6. Validity was measured by comparing the telephone questionnaire data with (a) face-to-face questionnaire and (b) accelerometry.Results:Data from all instruments were available for 156 individuals. The Spearman correlation coefficient for telephone interview reliability was 0.92 for the leisure-time section of IPAQ, and 0.87 for the transport-related section of IPAQ. The telephone interview reliability kappa was 0.78. The Spearman correlation between the telephone-administered and the face-to-face questionnaire was 0.94 for the leisure-time and 0.82 for the transport-related section. The kappa was 0.69. There was a positive association between quartiles of accelerometer data and total telephone-administered IPAQ score (P < .001). The Spearman correlation was 0.22.Conclusions:The telephone-administered IPAQ presented almost perfect reliability and very high agreement with the face-to-face version. The agreement with accelerometer data were fair for the continuous score, but moderate for the categorical physical activity variables.