BackgroundThe primary aim of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was to determine the relationships between lifestyle behaviours and obesity in a multi-national study of children, and to investigate the influence of higher-order characteristics such as behavioural settings, and the physical, social and policy environments, on the observed relationships within and between countries.Methods/designThe targeted sample included 6000 10-year old children from 12 countries in five major geographic regions of the world (Europe, Africa, the Americas, South-East Asia, and the Western Pacific). The protocol included procedures to collect data at the individual level (lifestyle, diet and physical activity questionnaires, accelerometry), family and neighborhood level (parental questionnaires), and the school environment (school administrator questionnaire and school audit tool). A standard study protocol was developed for implementation in all regions of the world. A rigorous system of training and certification of study personnel was developed and implemented, including web-based training modules and regional in-person training meetings.DiscussionThe results of this study will provide a robust examination of the correlates of adiposity and obesity in children, focusing on both sides of the energy balance equation. The results will also provide important new information that will inform the development of lifestyle, environmental, and policy interventions to address and prevent childhood obesity that may be culturally adapted for implementation around the world. ISCOLE represents a multi-national collaboration among all world regions, and represents a global effort to increase research understanding, capacity and infrastructure in childhood obesity.

Objective1) To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2) To assess the methodological quality of the systematic reviews found.Methodology/Principal FindingsMedline; Excerpta Medica (Embase); PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers.ConclusionsThis overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted.

BackgroundIn the last decade, sedentary behavior has emerged as a new risk factor for health. The elderly spend most of their awake time in sedentary activities. Despite this high exposure, the impact of this sedentary behavior on the health of this population has not yet been reviewed. We systematically reviewed evidence for associations between sedentary behavior and multiple health outcomes in adults over 60 years of age.MethodsWe searched the Medline, Embase, Web of Science, SPORTDiscus, PsycINFO, CINAHL, LILLACS, and Sedentary Research Database for observational studies published up to May 2013. Additionally, we contacted members of the Sedentary Behaviour Research Network to identify articles that were potentially eligible. After inclusion, the methodological quality of the evidence was assessed in each study.ResultsWe included 24 eligible articles in our systematic review, of which only 2 (8%) provided high-quality evidence. Greater sedentary time was related to an increased risk of all-cause mortality in the older adults. Some studies with a moderate quality of evidence indicated a relationship between sedentary behavior and metabolic syndrome, waist circumference, and overweightness/obesity. The findings for other outcomes such as mental health, renal cancer cells, and falls remain insufficient to draw conclusions.ConclusionThis systematic review supports the relationship between sedentary behavior and mortality in older adults. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.

PurposePreviously, studies examining correlates of sedentary behavior have been limited by small sample size, restricted geographic area, and little socio-cultural variability. Further, few studies have examined correlates of total sedentary time (SED) and screen time (ST) in the same population. This study aimed to investigate correlates of SED and ST in children around the world.MethodsThe sample included 5,844 children (45.6% boys, mean age = 10.4 years) from study sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. Child- and parent-reported behavioral, household, and neighborhood characteristics and directly measured anthropometric and accelerometer data were obtained. Twenty-one potential correlates of SED and ST were examined using multilevel models, adjusting for sex, age, and highest parental education, with school and study site as random effects. Variables that were moderately associated with SED and/or ST in univariate analyses (p<0.10) were included in the final models. Variables that remained significant in the final models (p<0.05) were considered correlates of SED and/or ST.ResultsChildren averaged 8.6 hours of daily SED, and 54.2% of children failed to meet ST guidelines. In all study sites, boys reported higher ST, were less likely to meet ST guidelines, and had higher BMI z-scores than girls. In 9 of 12 sites, girls engaged in significantly more SED than boys. Common correlates of higher SED and ST included poor weight status, not meeting physical activity guidelines, and having a TV or a computer in the bedroom.ConclusionsIn this global sample many common correlates of SED and ST were identified, some of which are easily modifiable (e.g., removing TV from the bedroom), and others that may require more intense behavioral interventions (e.g., increasing physical activity). Future work should incorporate these findings into the development of culturally meaningful public health messages.

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INTRODUÇÃOA relação entre atividade física, saúde, qualidade de vida e envelhecimento vem sendo cada vez mais discutida e analisada cientificamente. Atualmente é praticamente um consenso entre os profissionais da área da saúde que a atividade física é um fator determinante no sucesso do processo do envelhecimento. É o objetivo desta revisão estabelecer os principais fatores determinantes do nível de atividade física durante o envelhecimento e os benefícios do estilo de vida ativo na prevalência de doenças crônicas não transmissíveis, na mortalidade e na manutenção da capacidade funcional durante esse processo.Alguns dos conceitos que serão utilizados ao longo da discussão dos assuntos aqui tratados têm sido adequadamente definidos e compilados pelos melhores especialistas da área, que em reunião especial chegaram a alguns consensos 1 . Dentre aqueles, os conceitos que merecem especial atenção são: a) Atividade física: definida como qualquer movimento corporal produzido em conseqüência da contração muscular que resulte em gasto calórico. b) Exercício: definido como uma subcategoria da atividade física que é planejada, estruturada e repetitiva; resultando na melhora ou manutenção de uma ou mais variá-veis da aptidão física. c) Aptidão física: é considerada não como um comportamento, mas uma característica que o indivíduo possui ou atinge, como a potência aeróbica, endurance muscular, força muscular, composição corporal e flexibilidade.Desta forma poderíamos também considerar a própria definição dos autores 1 , de epidemiologia da atividade físi-ca, como a parte da epidemiologia que se preocupa com: a) a associação entre os comportamentos da atividade físi-ca e a doença; b) a distribuição e determinantes dos comportamentos da atividade física em populações específi-cas; e c) a associação entre atividade física e outros comportamentos. Nível de atividade física, barreiras e motivação nos adultos de maior idadeDentre essas associações propostas pela epidemiologia da atividade física, têm surgido pesquisas tentando estabelecer o padrão do nível de atividade física em diferentes populações de indivíduos de maior idade. Em 1994, Caspersen et al. 1 compilaram informação de cinco grandes levantamentos realizados na população do sexo masculino maior de 65 anos da Inglaterra, Estados Unidos e Holanda. De acordo com aquelas pesquisas, a caminhada foi uma das atividades mais realizadas, variando de 38% a 72%, seguida pela jardinagem, que foi prevalente entre 37% e 67%. Já atividades como correr, trotar, jogar tênis e golfe foram realizadas por menos que um em cada dez indiví-duos.Dados provenientes de 2.783 homens e 5.018 mulheres maiores de 65 anos de idade da Pesquisa Nacional de Saú-de dos Estados Unidos de 1990 2 determinaram a prevalên-cia de atividade física regular, que naquele estudo foi definida como a participação em atividades físicas no tempo livre por três ou mais vezes por semana e por mais de 30 minutos nas últimas duas semanas. Com esses parâmetros os autores encontraram uma prevalência de atividade físi-ca re...

BackgroundWe compared 24-hour waist-worn accelerometer wear time characteristics of 9–11 year old children in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) to similarly aged U.S. children providing waking-hours waist-worn accelerometer data in the 2003–2006 National Health and Nutrition Examination Survey (NHANES).MethodsValid cases were defined as having ≥4 days with ≥10 hours of waking wear time in a 24-hour period, including one weekend day. Previously published algorithms for extracting total sleep episode time from 24-hour accelerometer data and for identifying wear time (in both the 24-hour and waking-hours protocols) were applied. The number of valid days obtained and a ratio (percent) of valid cases to the number of participants originally wearing an accelerometer were computed for both ISCOLE and NHANES. Given the two surveys’ discrepant sampling designs, wear time (minutes/day, hours/day) from U.S. ISCOLE was compared to NHANES using a meta-analytic approach. Wear time for the 11 additional countries participating in ISCOLE were graphically compared with NHANES.Results491 U.S. ISCOLE children (9.92±0.03 years of age [M±SE]) and 586 NHANES children (10.43 ± 0.04 years of age) were deemed valid cases. The ratio of valid cases to the number of participants originally wearing an accelerometer was 76.7% in U.S. ISCOLE and 62.6% in NHANES. Wear time averaged 1357.0 ± 4.2 minutes per 24-hour day in ISCOLE. Waking wear time was 884.4 ± 2.2 minutes/day for U.S. ISCOLE children and 822.6 ± 4.3 minutes/day in NHANES children (difference = 61.8 minutes/day, p < 0.001). Wear time characteristics were consistently higher in all ISCOLE study sites compared to the NHANES protocol.ConclusionsA 24-hour waist-worn accelerometry protocol implemented in U.S. children produced 22.6 out of 24 hours of possible wear time, and 61.8 more minutes/day of waking wear time than a similarly implemented and processed waking wear time waist-worn accelerometry protocol. Consistent results were obtained internationally. The 24-hour protocol may produce an important increase in wear time compliance that also provides an opportunity to study the total sleep episode time separate and distinct from physical activity and sedentary time detected during waking-hours.Trial registrationClinicalTrials.gov NCT01722500.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0172-x) contains supplementary material, which is available to authorized users.

This study considered the concordance of self-assessment and physician assessment of sexual maturity status; breasts, and pubic hair in girls, and genitals and pubic hair in boys. The subjects were Brazilian children, youth and young adults, 174 females and 178 males, 6-26 years of age. Each subject evaluated his/her level of sexual maturation and then was examined by a physician. The sexual maturity ratings of the subjects and physicians were compared. Overall, the results showed moderate to high concordance (60.9-71.3%) for both assessments of secondary sex characteristics; better concordance was found for pubic hair (69.7-71.3%) than for the breasts or genitals (60%). Age did not appear to influence the accuracy of self-evaluation; rather, accuracy was more dependent on stage of maturation of the subject. Correlations between self- and physician assessments, and replicate self- and physician assessments were relatively high. © 1994 Wiley-Liss, Inc.