O objetivo do estudo é descrever e verificar as possíveis associações entre os níveis de ApC com as características das aulas de educação física e as atividades de ocupação do tempo livre em escolares do ensino fundamental. Trata-se de um estudo de associação com abordagem quantitativa e corte transversal. A população são os escolares matriculados no ensino fundamental das escolas públicas municipais de Porto Alegre - RS. A amostra se caracteriza como voluntária, onde, foram avaliadas oito turmas, sendo dos anos iniciais e finais do ensino fundamental, totalizando 137 escolares. A ApC foi avaliada através do teste de corrida e caminhada de 6 minutos. A característica da aula de educação física (EFesc) foi avaliada através do instrumento SOFIT. As atividades físicas realizadas no tempo livre, foi avaliada através de uma questão do questionário IPQ-C, já as atividades sedentárias foram avaliadas através de uma questão específica, formulada pelos pesquisadores. Para o tratamento dos dados foram utilizadas análises descritivas, de variância e de associação, considerando um alfa de 0,05. Os resultados mostram que a maioria das crianças e adolescentes estão na zona de risco para saúde, tendo uma prevalência maior para as meninas, sendo 92,8%, e os meninos 79,5%. Já nas características das aulas, percebemos que os alunos permanecem a maior parte do tempo em intensidade baixa, seguida da intensidade leve e uma frequência muito pequena em intensidade alta. As atividades de ocupação do tempo livre apresentaram resultados, onde podemos observar que a maioria dos escolares realizam pelo menos uma vez na semana algum tipo de esporte, ou está engajada em alguma atividade de lazer ativo. O sexo apresentou uma relação significativa com a ApC (p<0,001), sendo que o modelo onde contém o sexo e a intensidade das aulas possui um (R²=0,257), explicando assim 25% do comportamento da ApC, já o β foi de (156,80) caracterizando então que o sexo masculino percorre 156,80 metros a mais no teste corrida e caminhada. Já intensidade da aula, quando olhada separadamente não apresenta associação com a ApC, porém possui um β relevante de (8,233), sendo que cada minuto a mais em que os alunos são submetidos a intensidade alta durante a aula, os mesmos percorrem 8,233 metros a mais no teste a cada de corrida e caminhada. Já a prática esportiva e o lazer ativo apresentaram associação com os níveis de ApC, sendo que quem não pratica esporte, percorre 187,838 metros a menos no teste de ApC. A partir dos resultados concluímos a maioria das crianças e adolescentes estão na zona de risco para saúde no que se refere a ApC. As intensidades das aulas, a prática esportiva, lazer ativo e o sexo apresentam influenciam positivamente nos níveis de ApC dos escolares. / The objective of the study is to describe and verify the possible associations between the levels of ApC with the characteristics of the physical education classes and the activities of occupation of free time in elementary school students. It is an association study with quantitative and cross-sectional approach. The population is the schoolchildren enrolled in elementary school in the municipal public schools of Porto Alegre - RS. The sample is characterized as voluntary, where eight classes were evaluated, being the initial and final years of elementary school, totaling 137 students. The ApC was evaluated through the 6-minute walk and run test. The characteristic of the physical education class (EFesc) was evaluated through the SOFIT instrument. The physical activities carried out in the free time were evaluated through an IPQ-C questionnaire, and the sedentary activities were evaluated through a specific question formulated by the researchers. For the data treatment, descriptive, variance and association analyzes were used, considering an alpha of 0.05. The results show that the majority of children and adolescents are in the health risk zone, with a higher prevalence for girls, being 92.8%, and boys 79.5%. In the characteristics of the classes, we noticed that the students remain most of the time in low intensity, followed by light intensity and a very low frequency in high intensity. The activities of occupation of the free time presented results, where we can observe that the majority of the students perform at least once a week some type of sport, or is engaged in some active leisure activity. Sex had a significant relationship with ApC (p <0.001), where the model containing sex and intensity of classes had a (R² = 0.257), explaining 25% of the behavior of ApC, whereas β was (156,80), characterizing that the male traverses 156.80 meters more in the running and walking test. The intensity of the class, when looked at separately, is not associated with ApC, but has a relevant β of (8,233), and every minute in which the students are submitted to high intensity during the class, they travel 8,233 meters a more on the test each of running and walking. On the other hand, sports practice and active leisure have been associated with ApC levels, and those who do not practice sports, travel 187,838 meters less in the ApC test. From the results we conclude that ApC is low among children and adolescents. The intensity of the classes, the sports practice and the active leisure have a positive influence on the ApC levels of the students. As a result, sex, sports and active leisure help increase ApC levels

O entendimento da aptidão cardiorrespiratória em crianças e jovens é hoje uma estratégia fundamental de controle da saúde em geral. No entanto, avaliar a aptidão cardiorrespiratória, de forma direta, demanda um custo financeiro alto, pessoal especializado e um tempo excessivo. Nesta perspectiva, inúmeros estudos vêm propondo testes que avaliem, de forma indireta, a aptidão cardiorrespiratória de crianças e jovens. Assim, o objetivo geral do estudo foi compreender os testes de corrida/caminhada de 6 e de 9 minutos e as relações que estes estabelecem com o VO2máx, economia de movimento (EM) e limiar anaeróbio (LA). O estudo propõe uma abordagem de validação de técnica de medida. A amostra foi do tipo não aleatória por conveniência, de corte transversal. Foram avaliados 96 sujeitos, sendo 46 do sexo masculino e 50 do sexo feminino, na faixa etária de 10 a 14 anos de idade. O estágio maturacional foi determinado de acordo com a pilosidade púbica através de Tanner (1962). Os testes de corrida/caminha de 6 e de 9 minutos foram avaliados pela maior distância alcançada no tempo determinado de cada teste. Os componentes da aptidão cardiorrespiratória foram obtidos através de um teste em esteira de carga progressiva até a exaustão, acompanhado pelo ergoespirômetro MedGraphics Cardiorespiratory Diagnostic Systems, modelo MGC/CPX-D. O valor médio de VO2 registrado durante o 4° minuto, a uma velocidade constante, foi considerado o valor de EM. VO2máx que foi obtido pelo maior valor alcançado durante o teste. O limiar ventilatório (LV) foi entendido como o VO2 expresso pelo segundo ponto de inflexão na curva de ventilação e do custo ventilatório de CO2 de cada indivíduo. Para todas as análises estatísticas foi utilizado o programa estatístico SPSS for Windows 10.0. O nível de significância adotado foi de 5%. Os principais resultados apontam que os índices alcançados no teste de 9 minutos (r= 0,632) apresentam melhor relação com o VO2máx de simples razão (ml.kg-1.min-1 ou kg-1) do que os mesmos no teste de 6 minutos (r=0,393). No entanto, o valor de r aumenta para 0,704 e 0,728 nos testes de 6 e de 9 minutos, respectivamente, quando os relacionamos com o VO2máx em expoentes alométricos (kg-0,67). Quanto ao comportamento dessas variáveis durante a puberdade, notamos incremento nos dois testes aeróbios e no VO2máx quando expresso em kg-0,67. No VO2máx (kg-1), os valores médios durante a puberdade se mantiveram estáveis. Quanto às diferenças entre os sexos, percebemos que os valores obtidos pelos meninos superam os das meninas em todas as variáveis. No entanto, percebemos que as diferenças são potencializadas quando expressamos o VO2máx em escalas alométricas (kg-0,67). No âmbito dos componentes da aptidão cardiorrespiratória constatamos que o VO2máx (kg-0,67), aliado a EM (%VO2máx) foram as variáveis que apresentaram maior poder preditivo sobre os testes aeróbios de campo analisados neste estudo, representando geralmente mais de 60% da explicação desses. Já o LV não estabeleceu relações suficientemente capazes de ser apontado como variável preponderante no desempenho dos testes de corrida/caminhada de 6 e de 9 minutos. Dessa forma, podemos concluir que os dois testes analisados são válidos para a avaliação da aptidão cardiorrespiratória se assumirmos que o VO2máx é mais bem representado pelo expoente de massa corporal kg-0,67. Além disso, constatamos que a EM, aliado à capacidade aeróbia máxima é fundamental no desempenho de testes de características aeróbias. Sendo assim, podemos sugerir a utilização do teste de corrida de 6 minutos à professores de educação física como parâmetro da aptidão cardiorrespiratória de seus alunos, pois além de ser um teste simples, de fácil compreensão e que permite sua aplicação em diferentes estruturas físicas, apresentou uma alta relação com o consumo máximo de oxigênio (kg-0,67). / The knowledge about the cardiorespiratory fitness in children and adolescents is a basic strategy of control of the health, considering that low indices of this capacity in this period of age can point important associations with hypokinetic disease in the adult age. However, to evaluate the cardiorespiratory fitness by direct methods demand a high financial cost, specialized people and excessively time. In this perspective, innumerable studies has been considering tests that measure by indirect methods the cardiorespiratory fitness of children and adolescents. Thus, the general objective of this study was to understand the of Run/walk in 6 minutes and Run/walk in 9 minutes tests and the relations that these establish with the VO2max. Moreover, we tried to identify the variables capable to determine the performance of both tests in individuals in the period of infancy and adolescence. The study considers an approach of validation of measuring technique. The sample was a not random type for convenience, with transversal cut analysis. 96 subjects had been evaluated, being 46 masculine and 50 feminine, with ages between 10 and 14 years old. The maturational status was determined by pubic hair according to Tanner (1962). The tests of Run/walk in 6 minutes and Run/walk in 9 minutes had been understood by the biggest distance reached in the definitive time of each test. The components of the cardiorespiratory fitness were gotten through a gradual load test in treadmill until the exhaustion, measured through a gas meter model (MedGraphics Cardiorespiratory Diagnostic Systems – MGC/CPX-D). The average value of VO2 registered during the 4th minute, in a constant speed, was considered the value of movement economy (ME). The VO2max was gotten by the highest value reached during the test. The ventilatory threshold was understood as the VO2 expressed for the second point of inflection in the curve of ventilation and CO2 ventilatory cost for each individual. For all the statistical analyses the statistical program SPSS for Windows 10.0 was used. The level of significance adopted for all the analyses was of 5%. The main results point that the indices reached in the test of 9 minutes (r = 0,632) present better relationship with the VO2max of simple reason (ml.kg-1.min-1 or kg-1) than the same ones in the test of 6 minutes (r=0,393). However, the value of r increases for 0,704 and 0,728 in the tests of 6 and 9 minutes, respectively, when we relate them with the VO2max in allometric exponents (kg-0,67). About the behavior of these variables during the puberty, we notice an increment in the two aerobic tests and in the VO2max expressed in kg-0,67. In the VO2max (kg-1), the average values during the puberty remained steady. About the differences between sexes, we perceive that the values gotten for the boys surpass of the girls in all variables. However, we perceive that the differences are powered when we express the VO2max in allometric scales (kg-0,67). About the components of the cardiorespiratory fitness, we evidence that the VO2max (kg-0,67), ally to the ME (%VO2max) had been the variables that had presented greater predictive power on the field aerobic tests analyzed in this study, representing generally more than 60% of the explanation of these. However, the ventilatory threshold did not establish relationships capable enough to be pointed as the preponderant variable in the performance of Run/walk in 6 minutes and Run/walk in 9 minutes tests. This way, we can conclude that the two analyzed tests are valid for the evaluation of the cardiorespiratory fitness if we assume that the VO2max is better represented by the allometric scales. Moreover, we evidence that the movement economy, ally to the maximum aerobic capacity is basic in the performance of aerobic characteristics tests. Thus, we can suggest the use of the Run/walk in 6 minutes test to any physical education teacher as a parameter of the cardiorespiratory fitness of his students, therefore it is a simple test, of easy understanding, that allows its application in different physical structures and it shows excellent relationship with the maximum oxygen consumption (kg-0,67).

O condicionamento cardiorrespiratório pode ser caracterizado como sendo um dos componentes da aptidão cardiorrespiratória, estando diretamente associado aos níveis de saúde e qualidade de vida. Existem formas diversas para se avaliar os níveis de condicionamento cardiorrespiratório durante a realização de exercícios, tanto de forma direta como indireta. Foi realizado um estudo do tipo transversal contando com idosos voluntários acima dos 60 anos, admitidos entre março de 2005 e abril de 2008, todos participantes do Projeto Idosos em Movimento Mantendo a Autonomia (IMMA), coordenado pelo Laboratório de Atividade Física e Promoção da Saúde (LABSAU) do Instituto de Educação Física e Desportos da Universidade do Estado do Rio de Janeiro (IEFD-UERJ) e implementado em parceria com a Universidade Aberta da Terceira Idade (UnATI-UERJ) com o objetivo de realizar a validação cruzada de equações para estimativa da ACR sem exercícios em amostra de idosos brasileiros. Portanto, esta pesquisa identificou evidências para se estimar a aptidão cardiorrespiratória através de um método sem exercícios apresentando baixo custo e risco a saúde dos idosos, desta forma, não necessitando a utilização de locais específicos e com equipamentos como bicicletas e esteiras ergométricas e também não havendo a necessidade de profissionais especializados na aplicação dos referidos testes / The cardiorespiratory fitness can be characterized as one of the components of cardiorespiratory fitness, being directly associated with levels of health and quality of life. There are several ways to assess cardiorespiratory fitness levels while performing exercises, ing directly and indirectly. A study of cross-sectional counting up elderly volunteers 60 years, admitted between March 2005 and April 2008, all participants of the project "Elderly in Movement Keeping Autonomy" (IMMA), coordinated by the "Physical Activity was conducted and Health Promotion "(LABSAU) of the Institute of Physical Education and Sports of Rio de Janeiro State University (EDFI-UERJ) and implemented in partnership with the Open University of the Third Age (UnATI-UERJ) in order to perform validation cross equations to estimate the ACR without exercise in Brazilian elderly sample. Therefore, this research identified evidence to estimate cardiorespiratory fitness through a workout without method presenting low cost and risk to the health of the elderly, thus not requiring the use of specific locations and equipment such as bikes and treadmills and also there is no the need for skilled professionals in the application of those tests

Cancer (CA) is the second leading cause of death in the United States preceded only by cardiovascular disease (CVD). Over the past 30 years, the 5-year survival rate for all cancers combined has increased by more than 20%. This improved survival rate is due to early diagnosis and advances in treatment involving a multimodality treatment approach that includes radiotherapy [RT] with about half of all CA patients receiving some type of RT sometime during the course of their treatment. Cardiotoxicity is one of the most important adverse reactions of RT and leads to a meaningful risk of CVD-related morbidity and mortality. Radiotherapy-related cardiotoxicity is a heterogeneous clinical syndrome characterized by symptoms related to impaired cardiac function due to radiation-injury to one or more cardiac structures. Furthermore, the relative risk of CVD increases with increasing incidental radiation dose to the heart. There is not a unified consensus on the definition of CA-related cardiotoxicity although most trials have focused on changes in resting systolic function, and/or development of cardiac symptoms.Commonly used tools to assess cardiac function are insensitive to minor injury hence subtle changes may go unnoticed for many years. Cardiotoxicity definitions should include a dynamic functional assessment of the CV system. This may allow detection of latent CV abnormalities before the precipitous decline of resting myocardial function or the development of CV symptomology that may impact quality of life. Cardiopulmonary exercise testing (CPET) including measurement of peak oxygen consumption (VO2) is the gold standard for the assessment of cardiorespiratory fitness (CRF). Cardiorespiratory fitness is a strong, independent predictor of mortality, CVD-related mortality, HF-related morbidity and mortality, CA-related mortality and may be involved in the pathophysiologic link between anti-CA related treatments and the increased risk of late CVD events. Emerging evidence indicates CRF may be reduced in CA survivors and have utility to detect subclinical cardiotoxicity, but this has not been evaluated in CA survivors treated with RT with significant heart involvement. This dissertation consists of one literature review and one comprehensive paper that will examine the ability of CPET to detect subclinical cardiotoxicity.

This meta-analysis investigated the association of gender and socioeconomic position with cardiorespiratory fitness in adolescents. Public health professionals know the importance of physical activity level as a modifiable behavior; however, the literature has revealed that more research is needed on the association of sociodemographic variables like gender and socioeconomic position with cardiorespiratory fitness in adolescents. Using the physical fitness and health outcomes conceptual model as a guide, the overall effect sizes across studies were assessed as well as the moderators of study design, sample size, age, and country. A systematic review of literature identified a total of 18 peer-reviewed studies meeting inclusion criteria, which yielded a total of 41 unique effect sizes. Meta-analysis utilizing a random effects model indicated that gender and socioeconomic position are associated with cardiorespiratory fitness and that age and country moderated these effects. The positive social change implication of this meta-analysis may provide evidence-based knowledge to public health officials, physical educators, and health educators who are considering changes in school health promotion policies and health promotion interventions geared toward different gender and socioeconomic groups. Long term results include increased physical activity, decreased clustered cardiovascular risk factors, and lowered all-cause and cardiovascular disease mortality as adolescents track into adulthood.

The goal of this dissertation research was to better understand relationships among physical activity (PA), cardiorespiratory fitness, adiposity, and cardiovascular (CV) health in children and adolescents. The aim of the first paper was to examine whether fitness and adiposity are independently associated with CV risk factors during puberty. Study participants were 126 prepubertal Caucasian children participating in a longitudinal four-year follow-up study. Fitness level was determined by VO2 max (L/min) obtained from maximal graded exercise testing and adiposity level was determined by the sum of skinfolds. Gender-specific individual growth curve models, including both VO2 max and the sum of skinfolds simultaneously, were fit to predict CV risk factor variables. Models also included covariates such as age, height, weight, and pubertal stage by the Tanner criteria. In both boys and girls, total cholesterol, triglyceride, LDL-C, and systolic blood pressure percentile were positively associated with the sum of skinfolds (P < 0.05), but not with VO2 max (P > 0.05). In conclusion, fitness was not associated with CV risk factors, after adjusting for adiposity, among healthy adolescents. This study suggests that adiposity may play a role in the mechanism underlying the effect of fitness on CV health during puberty. The aim of the second paper was to examine whether early adiposity level is inversely associated with subsequent PA behaviors in childhood. Study participants were 326 children participating in the Iowa Bone Development Study. PA and fat mass were measured using accelerometers and dual energy X-ray absorptiometry (DXA) at approximately 5, 8, and 11 years of age. Gender-specific generalized linear models were fit to examine the association between percent body fat (BF%) at age 8 and intensity-weighted moderate- to vigorous-intensity PA (IW-MVPA) at age 11. After adjusting for IW-MVPA at age 8, an interval between the age 5 and 8 examinations, residualized change scores of BF% and IW-MVPA from age 5 to 8 and mother's education level, BF% at age 8 was inversely associated with IW-MVPA at age 11 among boys (P < 0.05). After adjusting for IW-MVPA at age 8, physical maturity, and family income, BF% at age 8 was inversely associated with IW-MVPA at age 11 among girls (P < 0.05). Categorical analysis also showed that the odd of being in the lowest quartile relative to the highest quartile of IW-MVPA at three-year follow-up for boys and girls with high BF% was approximately four times higher than the odd for those with low BF% (P < 0.05). This study suggests that adiposity levels may be a determinant of PA behavior. Specific intervention strategies for overweight children may be needed to promote PA. The aim of the third paper was to examine whether accelerometer-measured daily light-intensity PA is inversely associated with DXA-derived body fat mass during childhood. The study sample was 577 children participating in the longitudinal Iowa Bone Development Study. Fat mass and PA were measured at about 5, 8, and 11 years of age. Two PA indicators were used, applying two accelerometer count cut-points: the daily sum of accelerometer counts during light-intensity PA (IW-LPA) and the daily sums of accelerometer counts during high-light-intensity PA (IW-HLPA). Measurement time point- and gender-specific multivariable linear regression models were fit to predict fat mass based on IW-LPA and IW-HLPA, including covariates, such as age, birth weight, fat-free mass, height, IW-MVPA and maturity (only for girls). Among boys, both IW-LPA and IW-HLPA were inversely associated with fat mass at age 11 (P < 0.05), but not at ages 5 and 8. Among girls, both LPA variables were inversely associated with fat mass at ages 8 and 11 (P < 0.10 for LPA at age 11, P < 0.05 for others), but not at age 5. In conclusion, this study suggests that light-intensity PA may have a preventive effect against adiposity among older children.

Highly-active antiretroviral therapy (HAART) has improved the prognosis of HIV-infected individuals. Unfortunately it has also been associated with impaired functional capacity and development of metabolic perturbations which increases health risk. This study tested the hypothesis that a combined cardiorespiratory and resistance exercise training (CARET) intervention may result in significant health benefits in HIV-infected individuals receiving HAART. Thirty-seven HIV-infected men and women, predominantly of lower socioeconomic status (SES), were recruited and randomly assigned to: 1) a group of moderate-intensity CARET for three months or 2) a control group receiving no exercise intervention for three months. At baseline and following the intervention, physical characteristics (body weight, body mass index, waist circumference, and blood pressure), physical fitness variables (estimated VO2max and one repetition maximum for upper and lower body), metabolic variables (fasting glucose and serum lipids), immune functioning (CD4+ T Cell count, CD4/CD8 ratio, and HIV RNA viral load), and quality of life (SF-36 Health Survey) were measured. Exercise participants evidenced increases in estimated VO2max (21%, p < 0.01), upper body strength (15%, p < 0.05), and lower body strength (22%, p < 0.05), while showing reductions in waist circumference (-2%, p < 0.05), and fasting glucose (-16%, p < 0.05). While the control group showed a significant decrease in CD4+ T cell count (-16%, p < 0.05) from baseline, the exercise group maintained a more stable count following training (-3%, p = 0.39). Finally, the exercise participants showed self-reported improvements in physical (11%, p < 0.03) and mental (10%, p < 0.02) quality of life. In conclusion, our study demonstrated that a three-month supervised and moderate intensity CARET program performed three times a week, can result in significant improvements in physical characteristics, physical fitness, metabolic variables, and physical and mental quality of life. Furthermore, the same intervention resulted in more favorable immunological responses following training in HIV-infected individuals of lower SES. Key words: Highly active antiretroviral therapy, HIV, combined aerobic and resistance exercise training, cardiorespiratory fitness, muscular strength, and immune functioning.

The increasing prevalence of abdominal obesity worldwide poses a serious public health problem and hence, presents a target for research designed to improve the assessment or treatment of abdominal obesity. Specifically, the first study in this thesis investigated the influence of age and gender on visceral (VAT) and abdominal subcutaneous adipose tissue (ASAT) for a given waist circumference (WC) in 481 men and women varying widely in age and BMI. Significant gender differences in VAT and ASAT for a given WC were observed, however, only the relationship between WC and VAT was substantially influenced by age. The second study examined whether the associations between VAT, ASAT and the metabolic syndrome (MetS) were altered depending on measurement methodology used to assess VAT and ASAT. The odds ratio (OR) for MetS was higher for total VAT volume (OR=7.26) and the partial volumes at T12-L1 (OR=7.46) and L1-L2 (OR=8.77) compared to the classic L4-L5 (OR=3.94) measurement. The OR for MetS was not substantially different among the ASAT measures (OR~2.6). Measurement site for VAT, but not ASAT, has a substantial influence on the magnitude of the association with MetS. The third study examined the independent associations between VAT, ASAT, liver fat and all-cause mortality in 291 men (97 decedents and 194 controls, mortality follow-up of 2.2±1.3 years). In a model including VAT, ASAT, liver fat, age, and length of follow-up, only VAT (1.93 [1.15-3.23]) remained a significant predictor of mortality. We concluded that VAT is a strong, independent predictor of all-cause mortality in men. The purpose of the final study was to determine the effect of aerobic exercise dose (energy expenditure) on WC in sedentary, overweight/obese postmenopausal women (n=424). The women were randomly assigned to a control group or one of three aerobic exercise groups that exercised at energy expenditures of 4-, 8-, or 12-kcal/kg body weight/week. By comparison to control, there were significant reductions in WC in the exercise groups (~3 cm, P <0.05), which were independent of weight loss. However, the amount of exercise performed was not associated with reductions in WC in a dose dependent manner. / Thesis (Ph.D, Kinesiology & Health Studies) -- Queen's University, 2007-05-17 19:24:06.777

The primary objective of this study was to assess the relationship between dietary patterns with diabetes and mortality risk from all-cause and cardiovascular disease while controlling for the confounding effects of fitness. The secondary objective was to examine the combined effects of dietary patterns and fitness on chronic disease and mortality risk. Participants consisted of 13,621 men and women from the Aerobics Center Longitudinal Study who completed a standardized medical examination and 3-day diet record between 1987 and 1999. Reduced rank regression was used to identify dietary patterns that were predictive of unfavorable profiles of cholesterol, white blood cell count, glucose, mean arterial pressure, HDL-cholesterol, uric acid, triglycerides, and body mass index. One primary dietary pattern emerged, which was labeled the “Unhealthy Eating Index”. This pattern was characterized by a large consumption of processed meat, red meat, white potato products, non-whole grains, added fat, and a small consumption of non-citrus fruits. After adjustment for covariates, the odds ratio for diabetes and the hazard ratio for all-cause mortality were 2.55 (95% confidence interval: 1.81-3.58) and 1.40 (1.02-1.91) in the highest quintile of the Unhealthy Eating Index when compared to the lowest quintile, respectively. After controlling for fitness, these risk estimates were reduced by 51.6% and 55.0%. The Unhealthy Eating Index was not a significant predictor of cardiovascular disease mortality before or after controlling for fitness. Examining the combined effects of dietary patterns and fitness revealed that both variables were independent predictors of diabetes (Ptrend <0.0001), while fitness (Ptrend <0.0001) but not unhealthy eating (Ptrend=0.071) significantly predicted all-cause mortality risk. These results suggest that both diet and fitness must be considered when studying disease. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2009-07-08 07:11:06.809

Os objetivos desse estudo foram verificar as associações entre atividade física (AF) organizada fora da escola, aptidão cardiorrespiratória (APCR) e qualidade do sono com os indicadores de saúde mental em crianças e verificar se a AF organizada fora da escola ou a APCR eram moderadores da relação entre a qualidade do sono com os indicadores de saúde mental. É um estudo de corte transversal, desenvolvido em 232 crianças (118 meninos e 114 meninas) de uma escola de ensino fundamental da rede estadual da cidade de Porto Alegre - RS, selecionada por conveniência. A saúde mental foi avaliada através do Strengths and Difficulties Questionnaire, respondido pelos pais. A AF organizada fora da escola e qualidade do sono também foram reportados pelos pais, através de perguntas de uma anamnese. A APCR foi avaliada através do teste de corrida e caminhada de 6 minutos. Como covariáveis, o nível socioeconômico (NSE) foi verificado através de uma adaptação do questionário da ABEP, além do sexo e idade (indicados pelos pais). Para análise de dados utilizou-se estatística descritiva, regressão linear generalizada, correlação e análises de moderação. Os resultados indicaram que, nos meninos, a AF organizada fora da escola apresentou associação com o total de dificuldades (β= 2,691; p= 0,03) e sintomas emocionais (β= 1,528; p< 0,001). A APCR relacionou-se com o total de dificuldades (β= -0,013; p< 0,001), hiperatividade/déficit de atenção (β= -0,006; p< 0,001) e problemas de relacionamento com colegas (β= -0,002; p< 0,001). Nas meninas, houveram associações entre o NSE com o total de dificuldades (β= 2,783; p= 0,03) e hiperatividade/déficit de atenção (β= 1,245; p= 0,01), além da idade com os problemas de conduta (β= -0,136; p< 0,001). A qualidade do sono apresentou associação com total de dificuldades (r= -0,45; p< 0,001), sintomas emocionais (r= - 0,31; p= 0,001), problemas de conduta (r= -0,29; p= 0,001), hiperatividade/déficit de atenção (r= -0,43; p< 0,001), e os problemas de relacionamento com colegas (r= - 0,25; p< 0,001), nos meninos. Já nas meninas a qualidade do sono associou-se com o total de dificuldades (r= -0,27; p< 0,001), sintomas emocionais (r= -0,18; p= 0,05), e problemas de conduta (r= -0,25; p= 0,01). A AF organizada fora da escola e APCR não foram moderadoras da relação entre a qualidade do sono e os indicadores de saúde mental. Diante das associações, conclui-se que crianças que mantém hábitos saudáveis como dormir bem, praticar AF organizada fora da escola e ter bons níveis de APCR, apresentam melhores níveis de saúde mental. / The aims of the present study were to verify the associations between organized physical activity (PA) outside school, cardiorespiratory fitness (CRF) and sleep quality as indicators of mental health in children, and to verify if organized PA outside school or CRF were moderators of the relationship between sleep quality with mental health indicators. It is a cross-sectional study, developed with 232 children (118 boys and 114 girls) of a public from Porto Alegre - RS, selected by convenience. Mental health was assessed through the Strengths and Difficulties questionnaire, answered by the parents. Also, the parents, through an anamnesis, reported organized PA and sleep quality. CRF was evaluated through the running and walking test of 6 minutes. As covariates, socioeconomic status was obtained by an adaptation of the ABEP questionnaire, in addition to gender and age. To data analysis were used descriptive statistics, generalized linear regression, correlation and moderation analyzes. The results indicated that, in boys, organized PA outside school showed association with total difficulties (β= 2.691; p= 0.03) and emotional symptoms (β= 1.528; p< 0.001). CRF was related with total difficulties (β= -0.013; p<0.001), hyperactivity/attention deficit (β= -0.006; p<0.001) and relationship problems with colleagues (β= -0.002; p< 0.001). In girls, there was an association between socioeconomic status with total difficulties ((β= 2.783; p= 0.03) and hyperactivity/attention deficit (β= 1.245; p= 0.01), besides age with conduct problems (β= -0.136; p<0.001). Sleep quality was associated with total difficulty (r= -0.45; p<0.001), emotional symptoms (r= -0.31; p=0.001), behavioral problems (r= -0.29; p=0.001), hyperactivity/attention deficit (r= - 0.43; p<0.001) and relationship problems with colleagues (r= -0.25; p<0.001), in boy. Already in girls, sleep quality was associated with total difficulties (r= -0.27; p<0.001), emotional symptoms (r= -0.18; p= 0.05) and behavioral problems (r= -0.25; p=0.01). Organized PA outside school and CRF were not moderators of the relationship between sleep quality and mental health indicators. Considering the associations, it is concluded that children who maintain healthy habits, such as sleeping well, practicing organized PA outside of school and having good levels of CRF, present better levels of mental health.