Last data update: Jun 17, 2024. (Total: 47034 publications since 2009)
Records 1-24 (of 24 Records) |
Query Trace: Lobelo F [original query] |
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Public health and homelessness: A framework
Mosites E , Lobelo EE , Hughes L , Butler JC . J Infect Dis 2022 226 S372-s374 Over a half million Americans experience homelessness on any given night and more than 1.4 million experience it at some point over the course of a year [1, 2]. Between 2016 and 2020, the number of people experiencing homelessness increased. The homelessness epidemic is intertwined with other epidemics, both infectious and noninfectious. For example, among US veterans who were diagnosed with opioid use disorder in 2012, 35% were experiencing homelessness. Rates of cardiovascular disease in people experiencing homelessness exceed those of the general population [3], and prevalence of invasive cancers have been reported to be significantly higher, with poorer overall cancer survival [4]. Among people with human immunodeficiency virus (HIV), 8.5% experienced homelessness in the last year, and those who experienced homelessness were 48% less likely to sustain viral suppression [5]. Invasive group A Streptococcus, invasive meningococcal disease, and Bartonella quintana infection have all been identified with much higher frequency among people experiencing homelessness than the general population [6, 7]. |
Health Care Utilization and Clinical Characteristics of Nonhospitalized Adults in an Integrated Health Care System 28-180 Days After COVID-19 Diagnosis - Georgia, May 2020-March 2021.
Hernandez-Romieu AC , Leung S , Mbanya A , Jackson BR , Cope JR , Bushman D , Dixon M , Brown J , McLeod T , Saydah S , Datta D , Koplan K , Lobelo F . MMWR Morb Mortal Wkly Rep 2021 70 (17) 644-650 As of April 19, 2021, 21.6 million COVID-19 cases had been reported among U.S. adults, most of whom had mild or moderate disease that did not require hospitalization (1). Health care needs in the months after COVID-19 diagnosis among nonhospitalized adults have not been well studied. To better understand longer-term health care utilization and clinical characteristics of nonhospitalized adults after COVID-19 diagnosis, CDC and Kaiser Permanente Georgia (KPGA) analyzed electronic health record (EHR) data from health care visits in the 28-180 days after a diagnosis of COVID-19 at an integrated health care system. Among 3,171 nonhospitalized adults who had COVID-19, 69% had one or more outpatient visits during the follow-up period of 28-180-days. Compared with patients without an outpatient visit, a higher percentage of those who did have an outpatient visit were aged ≥50 years, were women, were non-Hispanic Black, and had underlying health conditions. Among adults with outpatient visits, 68% had a visit for a new primary diagnosis, and 38% had a new specialist visit. Active COVID-19 diagnoses* (10%) and symptoms potentially related to COVID-19 (3%-7%) were among the top 20 new visit diagnoses; rates of visits for these diagnoses declined from 2-24 visits per 10,000 person-days 28-59 days after COVID-19 diagnosis to 1-4 visits per 10,000 person-days 120-180 days after diagnosis. The presence of diagnoses of COVID-19 and related symptoms in the 28-180 days following acute illness suggests that some nonhospitalized adults, including those with asymptomatic or mild acute illness, likely have continued health care needs months after diagnosis. Clinicians and health systems should be aware of post-COVID conditions among patients who are not initially hospitalized for acute COVID-19 disease. |
Built Environment Approaches to Increase Physical Activity: A Science Advisory From the American Heart Association
Omura JD , Carlson SA , Brown DR , Hopkins DP , Kraus WE , Staffileno BA , Thomas RJ , Lobelo F , Fulton JE . Circulation 2020 142 (11) e160-e166 Engaging in regular physical activity is one of the most important things people can do to improve their cardiovascular health; however, population levels of physical activity remain low in the United States. Effective population-based approaches implemented in communities can help increase physical activity among all Americans. Evidence suggests that built environment interventions offer one such approach. These interventions aim to create or modify community environmental characteristics to make physical activity easier or more accessible for all people in the places where they live. In 2016, the Community Preventive Services Task Force released a recommendation for built environment approaches to increase physical activity. This recommendation is based on a systematic review of 90 studies (search period, 1980-June 2014) conducted using methods outlined by the Guide to Community Preventive Services. The Community Preventive Services Task Force found sufficient evidence of effectiveness to recommend combined built environment strategies. Specifically, these strategies combine interventions to improve pedestrian or bicycle transportation systems with interventions to improve land use and environmental design. Components of transportation systems can include street pattern design and connectivity, pedestrian infrastructure, bicycle infrastructure, and public transit infrastructure and access. Components of land use and environmental design can include mixed land use, increased residential density, proximity to community or neighborhood destinations, and parks and recreational facility access. Implementing this Community Preventive Services Task Force recommendation in communities across the United States can help promote healthy and active living, increase physical activity, and ultimately improve cardiovascular health. |
Do animal exhibitors support and follow recommendations to prevent transmission of variant influenza at agricultural fairs? A survey of animal exhibitor households after a variant influenza virus outbreak in Michigan
Stewart RJ , Rossow J , Conover JT , Lobelo EE , Eckel S , Signs K , Stobierski MG , Trock SC , Fry AM , Olsen SJ , Biggerstaff M . Zoonoses Public Health 2017 65 (1) 195-201 Influenza A viruses circulate in swine and can spread rapidly among swine when housed in close proximity, such as at agricultural fairs. Youth who have close and prolonged contact with influenza-infected swine at agricultural fairs may be at increased risk of acquiring influenza virus infection from swine. Animal and human health officials have issued written measures to minimize influenza transmission at agricultural exhibitions; however, there is little information on the knowledge, attitudes, and practice (KAP) of these measures among animal exhibitors. After an August 2016 outbreak of influenza A(H3N2) variant ("H3N2v") virus infections (i.e., humans infected with swine influenza viruses) in Michigan, we surveyed households of animal exhibitors at eight fairs (including one with known H3N2v infections) to assess their KAP related to variant virus infections and their support for prevention measures. Among 170 households interviewed, most (90%, 151/167) perceived their risk of acquiring influenza from swine to be low or very low. Animal exhibitor households reported high levels of behaviours that put them at increased risk of variant influenza virus infections, including eating or drinking in swine barns (43%, 66/154) and hugging, kissing or snuggling with swine at agricultural fairs (31%, 48/157). Among several recommendations, including limiting the duration of swine exhibits and restricting eating and drinking in the animal barns, the only recommendation supported by a majority of households was the presence of prominent hand-washing stations with a person to monitor hand-washing behaviour (76%, 129/170). This is a unique study of KAP among animal exhibitors and highlights that animal exhibitor households engage in behaviours that could increase their risk of variant virus infections and have low support for currently recommended measures to minimize infection transmission. Further efforts are needed to understand the lack of support for recommended measures and to encourage healthy behaviours at fairs. |
Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis
Zhang X , Devlin HM , Smith B , Imperatore G , Thomas W , Lobelo F , Ali MK , Norris K , Gruss S , Bardenheier B , Cho P , Garcia de Quevedo I , Mudaliar U , Jones CD , Durthaler JM , Saaddine J , Geiss LS , Gregg EW . PLoS One 2017 12 (5) e0176436 Structured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the effectiveness of lifestyle interventions on CVD risk among adults without IGT or diabetes. We systematically searched MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and PsychInfo databases, from inception to May 4, 2016. We selected randomized controlled trials of lifestyle interventions, involving physical activity (PA), dietary (D), or combined strategies (PA+D) with follow-up duration ≥12 months. We excluded all studies that included individuals with IGT, confirmed by 2-hours oral glucose tolerance test (75g), but included all other studies recruiting populations with different glycemic levels. We stratified studies by baseline glycemic levels: (1) low-range group with mean fasting plasma glucose (FPG) <5.5mmol/L or glycated hemoglobin (A1C) <5.5%, and (2) high-range group with FPG ≥5.5mmol/L or A1C ≥5.5%, and synthesized data using random-effects models. Primary outcomes in this review included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Totally 79 studies met inclusion criteria. Compared to usual care (UC), lifestyle interventions achieved significant improvements in SBP (-2.16mmHg[95%CI, -2.93, -1.39]), DBP (-1.83mmHg[-2.34, -1.31]), TC (-0.10mmol/L[-0.15, -0.05]), LDL-C (-0.09mmol/L[-0.13, -0.04]), HDL-C (0.03mmol/L[0.01, 0.04]), and TG (-0.08mmol/L[-0.14, -0.03]). Similar effects were observed among both low-and high-range study groups except for TC and TG. Similar effects also appeared in SBP and DBP categories regardless of follow-up duration. PA+D interventions had larger improvement effects on CVD risk factors than PA alone interventions. In adults without IGT or diabetes, lifestyle interventions resulted in significant improvements in SBP, DBP, TC, LDL-C, HDL-C, and TG, and might further reduce CVD risk. |
Effect of lifestyle interventions on glucose regulation among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis
Zhang X , Imperatore G , Thomas W , Cheng YJ , Lobelo F , Norris K , Devlin HM , Ali MK , Gruss S , Bardenheier B , Cho P , Garcia de Quevedo I , Mudaliar U , Saaddine J , Geiss LS , Gregg EW . Diabetes Res Clin Pract 2016 123 149-164 This study systematically assessed the effectiveness of lifestyle interventions on glycemic indicators among adults (18years) without IGT or diabetes. Randomized controlled trials using physical activity (PA), diet (D), or their combined strategies (PA+D) with follow-up 12months were systematically searched from multiple electronic-databases between inception and May 4, 2016. Outcome measures included fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), fasting insulin (FI), homeostasis model assessment-estimated insulin resistance (HOMA-IR), and bodyweight. Included studies were divided into low-range (FPG <5.5mmol/L or HbA1c <5.5%) and high-range (FPG 5.5mmol/L or HbA1c 5.5%) groups according to baseline glycemic levels. Seventy-nine studies met inclusion criteria. Random-effect models demonstrated that compared with usual care, lifestyle interventions achieved significant reductions in FPG (-0.14mmol/L [95%CI, -0.19, -0.10]), HbA1c (-0.06% [-0.09, -0.03]), FI (%change: -15.18% [-20.01, -10.35]), HOMA-IR (%change: -22.82% [-29.14, -16.51]), and bodyweight (%change: -3.99% [-4.69, -3.29]). The same effect sizes in FPG reduction (0.07) appeared among both low-range and high-range groups. Similar effects were observed among all groups regardless of lengths of follow-up. D and PA+D interventions had larger effects on glucose reduction than PA alone. Lifestyle interventions significantly improved FPG, HbA1c, FI, HOMA-IR, and bodyweight among adults without IGT or diabetes, and might reduce progression of hyperglycemia to type 2 diabetes mellitus. |
A comprehensive capacity assessment tool for non-communicable diseases in low- to middle-income countries: development and results of pilot testing
Garcia de Quevedo I , Lobelo F , Cadena L , Soares M , Pratt M . Glob Health Promot 2016 25 (1) 43-53 Non-communicable diseases (NCDs) are the leading causes of death worldwide, with higher rates of premature mortality in low- and middle-income countries (LMICs). This places a high economic burden on these countries, which usually have limited capacity to address this public health problem. We developed a guided self-assessment tool for describing national capacity for NCD prevention and control. The purpose of this tool was to assist countries in identifying key opportunities and gaps in NCD capacity. It was piloted in three countries between 2012 and 2013: Mozambique, Colombia, and the Dominican Republic. The tool includes details about NCD burden; health system infrastructure and primary care services; workforce capacity; surveillance; planning, policy, and program management; and partnerships. In the three pilot countries, the tool helped to identify differences in capacity needs pertaining to staff, training, and surveillance, but similarities were also found related to NCD challenges and opportunities. The NCD tool increased our understanding of needs and critical capacity elements for addressing NCDs in the three pilot countries. This tool can be used by other LMICs to map their efforts toward addressing NCD goals and defining priorities. |
Associations between noncommunicable disease risk factors, race, education, and health insurance status among women of reproductive age in Brazil - 2011
Mpofu JJ , de Moura L , Farr SL , Malta DC , Iser BM , Ivata Bernal RT , Robbins CL , Lobelo F . Prev Med Rep 2016 3 333-337 Background: Noncommunicable disease (NCD) risk factors increase the risk of adverse reproductive health outcomes and are becoming increasingly common in Brazil. Methods: We analyzed VIGITEL 2011 telephone survey data for 13,745 Brazilian women aged 18-44 years in a probabilistic sample from 26 Brazilian state capitals and the Federal District. We examined associations between NCD risk factors (fruit and vegetable intake, leisure time physical activity, alcohol consumption, smoking status, BMI and hypertension status) and race, education, and insurance using chi-square tests and multivariable logistic regression models, estimating the average marginal effects to produce adjusted relative risk ratios (aRRs). Analyses were conducted using SAS 9.3 survey procedures and weighted to reflect population estimates. Results: Women with less than a college education were more likely to report physical inactivity (adjusted relative risk (aRR) and 95% confidence interval = 1.1 (1.1-1.2)), smoking (aRR = 1.7 (1.3-2.2)), and self-reported diagnoses of hypertension (aRR = 2.0 (1.6-2.5)) compared to women with a college education or greater. Similarly, women without health insurance were more likely to report physical inactivity (aRR = 1.1 (1.1-1.2)), smoking (aRR = 1.4 (1.1-1.8)), and self-reported diagnoses of hypertension aRR = 1.4 (1.1-1.7)) compared to women with health insurance. Less variation was found by race and NCD risk factors. Conclusion: Targeted public health strategies and policies are needed to increase healthcare access and decrease educational and racial disparities in NCD risk factors among women of reproductive age in Brazil. © 2016.Published by Elsevier Inc. |
Iniciativas escolares y deportivas lideradas desde la Fédération Internationale de Football Association (FIFA): revisión sistemática
Correa JE , Meneses-Echavez JF , Barengo NC , Tovar G , Ruiz-Castellanos E , Lobelo F , Ramirez-Velez R . Glob Health Promot 2015 22 (3) 67-76 Introduccion: Los programas iniciados por la Federation Internationale de Football Association (FIFA) consisten en la difusion de mensajes relacionados con el cuidado de la salud y como estrategia de prevencion de lesiones deportivas entre los ninos y jovenes. El objetivo de esta revision sistematica fue resumir los resultados de la implementacion de los programas "FIFA 11 para la salud" y "FIFA 11+". Metodos: Se realizo una busqueda sistematica en las bases de datos electronicos de MEDLINE, EMBASE y Scopus, identificando los estudios que evaluaran la implementacion de los programas "FIFA 11 para la salud" y "FIFA 11+", durante los ultimos 10 anos (1 enero 2003 a 1 diciembre 2013). Resultados: Incluimos 17 estudios. Dos estudios evaluaron la implementacion del programa "FIFA 11 para la salud" y encontraron un aumento significativo en el conocimiento de los mensajes de promocion de la salud; 15 estudios evaluaron los efectos del programa "FIFA 11+", reportando una reduccion en el riesgo de lesiones deportivas y mejorias en el rendimiento deportivo. Discusion: Los programas "FIFA 11 para la salud" y "FIFA 11+" han demostrado resultados positivos para la salud, en el ambito escolar y deportivo. Conclusiones: Dichos programas del FIFA representan una oportunidad para crear habitos protectores y fomentar modos de vida saludables en ninos y jovenes. |
Physicians', nurses' and community health workers' knowledge about physical activity in Brazil: a cross-sectional study
Burdick L , Mielke GI , Parra DC , Gomes G , Florindo A , Bracco M , Lobelo F , Simoes EJ , Pratt M , Ramos LR , Moura L , Brownson RC , Hallal PC . Prev Med Rep 2015 2 467-472 OBJECTIVES: To measure knowledge of current recommendations of physical activity and consequences of physical inactivity among healthcare providers throughout Brazil. METHODS: A phone survey of 1600 randomly selected primary healthcare units in Brazil was conducted between January and July 2011. At each unit, a physician, nurse or community healthcare worker (n = 798) responded to a 40-minute survey, eliciting information about demographics, knowledge, and health behaviors pertaining to physical activity. RESULTS: Among nurses and community healthcare workers, > 95% reported needing more information on physical activity guidelines. Among physicians this proportion was 80%. Nearly 40% of the professionals incorrectly believed 90-min of moderate-intensity physical activity per week is the recommended amount for health benefits; nearly 30% believed that 90-min of vigorous-intensity activity per week is needed for the same purpose. More than 75% of all groups reported that type II diabetes, hypertension, depression, and coronary heart disease might result from physical inactivity, but on average only 60% from each group are aware of osteoporosis as a possible consequence of physical inactivity. CONCLUSIONS: Training health professionals in how to convey all relevant information about physical activity to their patients is critical for health promotion within the primary care system in Brazil. |
Prevalence of health promotion programs in primary health care units in Brazil
Ramos LR , Malta DC , Gomes GA , Bracco MM , Florindo AA , Mielke GI , Parra DC , Lobelo F , Simones EJ , Hallal PC . Rev Saude Publica 2014 48 (5) 837-44 OBJECTIVE: Assessment of prevalence of health promotion programs in primary health care units within Brazil's health system. METHODS: We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS: Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS: Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. |
Screen time, cardiorespiratory fitness and adiposity among school-age children from Monteria, Colombia
Arango CM , Parra DC , Gomez LF , Lema L , Lobelo F , Ekelund U . J Sci Med Sport 2014 17 (5) 491-5 OBJECTIVES: To explore the association between electronic media exposure (television viewing time, personal computer/video game use, total screen time), and waist circumference and body mass index, and study whether this association is independent of cardiorespiratory fitness, in a representative sample of adolescents from Monteria, Colombia. DESIGN: Cross-sectional study analyzing data from 546 students aged 11-18 years, from fourteen randomly selected schools. Z-scores for WC and BMI were calculated. METHODS: The physical activity module of the Global School Health Survey 2007 was used to determine EME, and the shuttle run test was used to assess CRF. Linear regression models adjusted by age, school location, physical activity level, type of institution (public or private), consumption of sweetened beverages, fast food, and fried food were used. RESULTS: Among boys, independently of cardiorespiratory fitness, high television viewing time (≥2h/day) (beta=+0.22; p<0.02), was positively associated with waist circumference. High total screen time (>3h/day) was positively associated with waist circumference (beta=+0.34; p<0.01), and body mass index (beta=+0.39; p<0.01). Among girls, sedentary behavior was not associated with adiposity, but cardiorespiratory fitness (beta=-0.04; p<0.02) was negatively associated with body mass index. CONCLUSIONS: These findings support the evidence on the negative impact of excessive electronic media exposure and low cardiorespiratory fitness, and highlight the need for interventions and prevention strategies. |
School-wide programs aimed at obesity among Latino youth in the United States: a review of the evidence
Holub CK , Lobelo F , Mehta SM , Sanchez Romero LM , Arredondo EM , Elder JP . J Sch Health 2014 84 (4) 239-46 BACKGROUND: In the past 30 years, childhood obesity rates have tripled, disproportionately affecting Latino children. From 2003 to 2006, 43.0% of Mexican-American children were classified as overweight compared with 36.9% of non-Hispanic Whites. Obesity interventions targeting children can have a significant impact in the school setting. METHODS: We conducted a systematic review of evidence-based, obesity-related interventions in the school setting. Inclusion criteria included: having 50% or more Latino children in the study, and usage of obesity-related outcomes (eg, body mass index [BMI] z-score, weight, and waist circumference, and body fat). RESULTS: The majority of identified studies included interventions that targeted both nutrition and physical activity. The most successful interventions were randomized, controlled trials or quasi-experimental controlled studies and had few limitations in execution in the study; however, overall results were mixed. There are promising results for interventions targeting Latino children who are already overweight or obese, but evidence of effectiveness is sparse. CONCLUSIONS: This review is the first to gather evidence-based research systematically aimed at obesity-related interventions in the school setting that are specifically focused on Latino children. Results of the review are promising and timely, given the exigency of the needed evidence, and the current state of childhood obesity in the United States. |
School-based programs aimed at the prevention and treatment of obesity: evidence-based interventions for youth in Latin America
Lobelo F , Garcia de Quevedo I , Holub CK , Nagle BJ , Arredondo EM , Barquera S , Elder JP . J Sch Health 2013 83 (9) 668-77 BACKGROUND: Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. METHODS: We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. RESULTS: Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. CONCLUSIONS: We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region. |
The cost of physical inactivity: moving into the 21st century
Pratt M , Norris J , Lobelo F , Roux L , Wang G . Br J Sports Med 2012 48 (3) 171-3 Physical inactivity is increasingly being recognised as a major problem in global health. The WHO estimates that 3.3 million people die around the world each year due to physical inactivity, making it the fourth leading underlying cause of mortality.1 Physical activity has beneficial effects on 23 diseases or health conditions.2 However, in most countries fewer than half of adults are active enough to reap most of these benefits.3 ,4 Given that inactivity increases the risk for many of the most costly medical conditions such as type 2 diabetes, stroke, ischaemic heart disease, falls and hip fractures, and depression, it is not surprising that physical inactivity has a substantial cost burden in addition to a large health burden. |
Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy
Lee IM , Shiroma EJ , Lobelo F , Puska P , Blair SN , Katzmarzyk PT . Lancet 2012 380 (9838) 219-29 BACKGROUND: Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population is inactive, this link presents a major public health issue. We aimed to quantify the effect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level. METHODS: For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population. FINDINGS: Worldwide, we estimate that physical inactivity causes 6% (ranging from 3.2% in southeast Asia to 7.8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3.9-9.6) of type 2 diabetes, 10% (5.6-14.1) of breast cancer, and 10% (5.7-13.8) of colon cancer. Inactivity causes 9% (range 5.1-12.5) of premature mortality, or more than 5.3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533,000 and more than 1.3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world's population by 0.68 (range 0.41-0.95) years. INTERPRETATION: Physical inactivity has a major health effect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially. FUNDING: None. |
Time spent traveling in motor vehicles and its association with overweight and abdominal obesity in Colombian adults who do not own a car
Florez Pregonero A , Gomez LF , Parra DC , Cohen DD , Arango Paternina CM , Lobelo F . Prev Med 2012 54 (6) 402-4 OBJECTIVE: This study examined associations between time spent traveling in motor vehicles per week (TSTMV) and BMI and abdominal obesity (AO) among Colombian adults residing in urban areas who do not own car. METHOD: Secondary data analysis of the 2005 National Nutrition Survey of Colombia was conducted. TSTMV was assessed using the long International Physical Activity Questionnaire. Body composition was measured in 7900 adults. Polytomous and binary logistic regressions were conducted, stratified by gender and adjusted for confounders, including physical activity (PA). RESULTS: Forty-two percent of participants were either overweight or obese according to their BMI, and 22.4% had AO. Males in the middle (10 to 149min) and highest (>150min) TSTMV tertiles were more likely to be overweight (POR=1.58, 95% CI=1.13-2.21 and POR=1.55, 95% CI=1.12-2.15 respectively, p-trend=0.012), obese (POR=2.39, 95% CI=1.43-3.99 and POR=1.93, 95% CI=1.22-3.08 respectively, p trend=0.019) and to have AO (POR=1.81, 95% CI=1.18-2.78 and POR=1.73, 95% CI=1.18-2.54 respectively, p-trend=0.009). Associations were not significant in females. CONCLUSIONS: TSTMV was positively associated with overweight and AO in adult Colombian males even after adjusting for PA. These findings highlight the potential deleterious health effects of sedentary behaviors such as prolonged traveling time, independently of having met PA recommendations. |
Cardiorespiratory fitness and proximity to commercial physical activity facilities among 12th grade girls
Dowda M , Pfeiffer KA , Lobelo F , Porter DE , Pate RR . J Adolesc Health 2012 50 (5) 497-502 PURPOSE: To investigate the relationship between proximity to commercial physical activity (PA) facilities and cardiorespiratory fitness of 12th grade girls. METHODS: Adolescent girls (n = 786, 60% African American, mean age = 17.6 +/- .6 years) performed a submaximal fitness test (Physical Work Capacity 170 test). Commercial PA facilities were mapped and counted within a .75-mile street-network buffer around girls' homes using Geographic Information Systems. Sedentary activities and vigorous physical activity (≥6 metabolic equivalents) were determined by the average number of 30-minute blocks reported per day on the 3-Day Physical Activity Recall. Mixed model regressions were calculated using school as a random variable. RESULTS: Girls had higher weight-relative Physical Work Capacity 170 test scores if there was a commercial PA facility (n = 186, 12.4 +/- 4.2 kg m/min/kg) within a .75-mile street-network buffer of home as compared with girls without a nearby facility (n = 600, 11.2 +/- 3.6 kg m/min/kg). After adjusting for demographic variables, sports participation, sedentary behaviors, and vigorous physical activity, having one or more commercial PA facilities within a .75-mile street-network buffer of homes was significantly related to cardiorespiratory fitness. CONCLUSIONS: Both with and without adjustment for covariates, the presence of a commercial PA facility within a .75-mile street-network buffer of a girl's home was associated with higher cardiorespiratory fitness. |
Associations of cardiorespiratory fitness in children and adolescents with physical activity, active commuting to school, and screen time
Aires L , Pratt M , Lobelo F , Santos RM , Santos MP , Mota J . J Phys Act Health 2011 8 S198-205 BACKGROUND: The objective of this study was to analyze associations of cardiorespiratory fitness (CRF) with physical activity, time spent watching television and using computer, mode of commuting to school (CS), and adiposity, by gender. METHODS: Participants were 1708 students (53.8% girls), aged 11 to 19 years. CRF was evaluated with a 20-meter shuttle-run test using VO2max by previously published equation. Maturation stages determined by Tanner's criteria, body mass index, and skinfolds were measured, and a questionnaire used to assess socioeconomic status, PA, television and computer time, and mode of CS. We conducted a regression analysis using CRF as the dependent variable. RESULTS: CRF was independent and positively associated with physical activity [beta = 0.338 (95% CI = 0.119; 0.188); P < .001] and with maturation [beta = -0.876 (95% CI = 0.666; 1.087); P < .001]; independent and negatively associated with television time [beta = -0.003 (95% CI = -0.005; -0.002); P < .001] and adiposity [beta = -0.068 (95% CI = -0.076; -0.060); P < .001]. CRF was positively associated with CS [beta = 0.337; (95% CI = 0.014; 0.741); P = .014]. No associations were found for computer time. CONCLUSIONS: These findings suggest that increasing overall physical activity levels through interventions in different domains such as active CS, reducing sedentary activities, such as television time, might be effective strategies for improving CRF in youth. |
Lessons learned after 10 years of IPAQ use in Brazil and Colombia
Hallal PC , Gomez LF , Parra DC , Lobelo F , Mosquera J , Florindo AA , Reis RS , Pratt M , Sarmiento OL . J Phys Act Health 2010 7 Suppl 2 S259-64 BACKGROUND: To describe the lessons learned after 10 years of use of the International Physical Activity Questionnaire (IPAQ) in Brazil and Colombia, with special emphasis on recommendations for future research in Latin America using this instrument. METHODS: We present an analytical commentary, based on data from a review of the Latin American literature, as well as expert consultation and the authors' experience in administering IPAQ to over 43,000 individuals in Brazil and Colombia between 1998 and 2008. RESULTS: Validation studies in Latin America suggest that the IPAQ has high reliability and moderate criteria validity in comparison with accelerometers. Cognitive interviews suggested that the occupational and housework sections of the long IPAQ lead to confusion among respondents, and there is evidence that these sections generate overestimated scores of physical activity. Because the short IPAQ considers the 4 physical activity domains altogether, people tend to provide inaccurate answers to it as well. CONCLUSIONS: Use of the leisure-time and transport sections of the long IPAQ is recommended for surveillance and studies aimed at documenting physical activity levels in Latin America. Use of the short IPAQ should be avoided, except for maintaining consistency in surveillance when it has already been used at baseline. |
Physical activity and electronic media use in the SEARCH for diabetes in youth case-control study
Lobelo F , Liese AD , Liu J , Mayer-Davis EJ , D'Agostino RBJr , Pate RR , Hamman RF , Dabelea D . Pediatrics 2010 125 (6) e1364-71 OBJECTIVE: The aim of this study was to characterize the physical activity (PA) and electronic media (EM) use habits of a population-based, ascertained sample of youths with diabetes mellitus (DM). METHODS: For this investigation, the Search for Diabetes in Youth Case-Control study (age: 10-20 y; 55% female) recruited 384 youths with provider-diagnosed type 1 DM, 90 youths with type 2 DM, and 173 healthy control subjects between 2003 and 2006, in 2 US centers. PA and EM use were assessed with a 3-day recall of activities, in 30-minute time blocks. Adherence to current recommendations was determined as a report of > or = 2 blocks of moderate/vigorous PA per day and <4 blocks of EM use per day. Differences in PA and EM use for DM/control groups were assessed with adjustment for age, study site, and race/ethnicity. RESULTS: Male subjects with type 2 DM reported lower levels of vigorous PA than did control subjects (1.1 vs 2.3 blocks; P < .05). Compliance with the moderate/vigorous PA recommendation among youths with type 2 DM was lower (68.3%), compared with youths with type 1 DM (81.7%; odds ratio: 0.51 [95% confidence interval: 0.26-1.00]; P = .047) and control subjects (80.4%; odds ratio: 0.48 [95% confidence interval: 0.23-1.02]; P = .05). Rates of compliance with EM use recommendations ranged from 29.5% to 49.1%. CONCLUSION: In this study, large proportions of youths with DM, especially type 2 DM, failed to meet PA and EM use recommendations. |
Built environment attributes and walking patterns among the elderly population in Bogota
Gomez LF , Parra DC , Buchner D , Brownson RC , Sarmiento OL , Pinzon JD , Ardila M , Moreno J , Serrato M , Lobelo F . Am J Prev Med 2010 38 (6) 592-9 BACKGROUND: There is increasing evidence that the built environment has an influence on physical activity; however, little is known about this relationship in developing countries. PURPOSE: This study examined the associations between attributes of the built environment and walking patterns among the elderly. METHODS: A multilevel cross-sectional study was conducted in 2007. Fifty neighborhoods were selected and 1966 participants aged > or =60 years were surveyed. Objective built environment measures were obtained in a buffer of 500 m using GIS. Environmental perceptions were assessed via questionnaire. RESULTS: People who lived in areas with middle park area (4.53%-7.98% of land) were more likely to walk for at least 60 minutes during a usual week (prevalence OR [POR]=1.42, 95% CI=1.02, 1.98). Those who lived in areas with the highest connectivity index (1.81-1.99) were less likely to report walking for at least 60 minutes (POR=0.64, 95% CI=0.44, 0.93). Participants who reported feeling safe or very safe from traffic were more likely to report walking for at least 60 minutes (POR=1.50, 95% CI=1.11, 2.03). The presence of Ciclovia (recreational program) was marginally associated with having walked at least 150 minutes in a usual week (POR=1.29, 95% CI=0.97, 1.73). CONCLUSIONS: This study showed that certain built and perceived environment characteristics were associated with walking among older adults living in Bogota. Further studies should be conducted to better understand the potential influence of the built environment on physical activity among the elderly population in the context of Latin American cities. |
Perceived and objective neighborhood environment attributes and health related quality of life among the elderly in Bogota, Colombia
Parra DC , Gomez LF , Sarmiento OL , Buchner D , Brownson R , Schimd T , Gomez V , Lobelo F . Soc Sci Med 2010 70 (7) 1070-6 This study examines associations between neighborhood environment attributes and health related quality of life (HRQOL) and self-rated health (SRH) among older adults (60 years and over) in Bogota, Colombia. Perceived and objective neighborhood environmental characteristics were assessed in a cross sectional multilevel design with 1966 older adults within 50 neighborhoods. Outcome variables included HRQOL (physical and mental dimensions) and SRH measured with the Spanish version of the Short Form 8 (SF-8). Independent variables included perceived and objective neighborhood characteristics as well as self-reported levels of walking. Hierarchical linear and logistic regression models were used for the analysis. Among perceived neighborhood characteristics, safety from traffic was positively associated with both HRQOL dimensions and SRH. Having safe parks was positively associated with the mental dimension of HRQOL and with SRH. Street noise was negatively associated with both HRQOL dimensions. Regarding objective neighborhood characteristics, residing in areas with more than eight percent of land covered by public parks was positively associated with SRH. Objective and perceived neighborhood characteristics could provide insight into potential interventions among older adults from rapidly urbanizing settings in Latin America. |
Prevalence of self-reported aerobic physical activity among U.S. States and territories--Behavioral Risk Factor Surveillance System, 2007
Loustalot F , Carlson SA , Fulton JE , Kruger J , Galuska DA , Lobelo F . J Phys Act Health 2009 6 S9-17 BACKGROUND: Accurate surveillance data on physical activity prevalence is important for U.S. states and territories as they develop programs and interventions to increase physical activity participation. METHODS: Using 2007 data from the Behavioral Risk Factor Surveillance System, we estimated the percentage of U.S. adults in each U.S. state and territory who met minimum aerobic activity criteria using the 2008 Physical Activity Guidelines for Americans (2008 Guidelines) and the Healthy People 2010 criteria for physical activity. SUDAAN was used to calculate prevalence estimates and 95% confidence intervals. RESULTS: The estimated prevalence of recommended aerobic activity in U.S. states and territories ranged from 44.5% to 73.3% according to 2008 Guidelines and from 30.8% to 60.0% according to Healthy People 2010 criteria. Absolute percent differences in prevalence among U.S. states and territories ranged from 11.7% to 19.1%, and relative percent differences ranged from 20.8% to 44.6%. CONCLUSIONS: In all U.S. states and territories, a larger proportion of U.S. adults met minimum aerobic activity criteria in the 2008 Guidelines than met corresponding criteria in Healthy People 2010. This difference, however, does not reflect an actual change in the amount of aerobic activity, but a change to the criteria for meeting 2008 Guidelines. |
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