ABSTRACT CONTEXT: The relationship with body image, which is the way the body presents itself to each subject, can be aggravated in children and adolescents diagnosed with an human immunodeficiency virus (HIV) infection, since these patients use antiretroviral therapy and may suffer from the adverse effects of the treatment due to continuous use of medication. OBJECTIVE: To estimate the prevalence of body image dissatisfaction, to describe the assessment methods, and to identify associated factors in children and adolescents diagnosed with HIV. DESIGN AND SETTING: This is a systematic review. Department of Physical Education, Florianópolis - Brazil METHODS: We followed the procedures of the Preferred Reporting Items for Systematic Reviews (PRISMA) and the Cochrane recommendations in the selection of articles through a search performed in eight databases. RESULTS: Prevalence of body image dissatisfaction due to thinness was between 36.7–52.0% in males and 28.1–36.4% in females, and body image dissatisfaction due to overweight was between 8.0–31.2% in males and 21.9–50.0% in females. Factors associated with body image dissatisfaction were as follows: female sex, older age, low levels of physical activity, low self-esteem, higher body fat, higher body weight, greater arm muscle area, triceps skinfold thickness, and higher body mass index. CONCLUSION: Children and adolescents of both sexes diagnosed with HIV infection are dissatisfied by thinness and overweight of their body image. REGISTRATION: https://www.crd.york.ac.uk/prospero/ (CRD42021257676).

ABSTRACT BACKGROUND: Identifying the relationship between maximum consumption of oxygen and body fat percentage is important due to increased cardiovascular risk factors. OBJECTIVE: This study aimed to verify the association between body fat percentage determined by three predictive equations using anthropometric measures (Lohman, Boileau, and Slaughter) and maximum oxygen uptake (VO2max). We also aimed to estimate the capacity of these equations for explaining VO2max variations in adolescents according to sex. DESIGN AND SETTING: This was a cross-sectional study conducted in high schools in São José, Southern Brazil. METHODS: This study included 879 adolescents (14–19 years) from Southern Brazil. Aerobic fitness was assessed using the modified Canadian Aerobic Fitness Test. The independent variable was body fat percentage predicted by the Lohman, Boileau, and Slaughter equations. Analyses adjusted for sociodemographic variables, physical activity level, and sexual maturation were performed with P value < 0.05. RESULTS: All anthropometric prediction equations used to estimate body fat percentage explained VO2max variations in adolescents. In male adolescents, both regression models based on the Boileau et al.12 and Lohman10 equations revealed higher explanatory power for VO2max (20%) compared with that based on the Slaughter et al.13 equation (19%). In female adolescents, the model based on the anthropometric equation of Slaughter et al.13 showed the greatest explanatory power for VO2max (18%). CONCLUSION: The inverse relationship between VO2max and body fat intensifies the need for effective intervention programs that prioritize maintenance of appropriate body fat and aerobic fitness levels because inadequate levels of both factors result in negative health consequences.

Abstract The aim of this study was to investigate the agreement and reproducibility of a portable electrical impedance myography device (EIM - SKULPT®) for body fat percentage (BF%) estimation in young adults. Sixty young adults volunteered for the study (women, n=30, 25.0±7.7 years; 21.5±1.9 kg/m2; and men, n=30, 21.6±6.3 years; 22.5±1.8 kg/m2). Participants underwent air displacement plethysmography (ADP) and EIM measurements for agreement analysis. EIM was performed three times on the same day for the within-day reproducibility analysis. Seven days later, 37 participants repeated the EIM measurements for the between-days reproducibility analysis. Comparisons of EIM and ADP methods, and EIM repeated measurements were performed with the paired T-test or one-way ANOVA repeated measures, the Bland-Altman plot, and simple linear regressions. BF% was higher (p<0.05) when estimated by EIM (19.91 ± 5.70 for men, and 30.77 ± 5.89 for women) compared to ADP (15.28 ± 5.66 for men, and 27.31 ± 5.98 for women). The Bland-Altman analysis presented a bias of 4.4% (95%CI=-3.4–12.2) and linear regression presented an R2=0.78. For between-days reproducibility, EIM means did not differ (25.33±7.69 and 24.94±8.30, p=0.890). Thus, while the EIM device exhibited high reproducibility of BF% estimates, caution should be exercised when comparing the results with other techniques for measuring BF%. The EIM device overestimated BF% compared to ADP. However, the EIM measurements presented very good within-day and between-days reproducibility and, thus, the EIM device can be used for longitudinal monitoring of BF%.

Resumo O objetivo deste estudo foi investigar a concordância e a reprodutibilidade de um aparelho portátil de miografia por impedância elétrica (EIM - SKULPT®) para estimativa do percentual de gordura corporal (GC%) em adultos jovens. Sessenta adultos jovens foram voluntários para o estudo (mulheres, n=30, 25,0±7,7 anos; 21,5±1,9 kg/m2; e homens, n=30, 21,6±6,3 anos; 22,5±1,8 kg/m2). Os participantes fizeram medições de pletismografia de deslocamento de ar (ADP) e EIM para análise de concordância. A EIM foi realizada três vezes no mesmo dia para a análise de reprodutibilidade dentro do dia. Sete dias depois, 37 participantes repetiram as medições do EIM para a análise de reprodutibilidade entre dias. As comparações dos métodos EIM e ADP e medições repetidas do EIM foram realizadas com o teste T pareado ou medidas repetidas ANOVA de uma via, o gráfico de Bland-Altman e regressões lineares simples. O %GC foi maior (p<0,05) quando estimado pelo EIM (19,91 ± 5,70 para homens e 30,77 ± 5,89 para mulheres) em relação ao ADP (15,28 ± 5,66 para homens e 27,31 ± 5,98 para mulheres). A análise de Bland-Altman apresentou viés de 4,4% (IC95%=-3,4–12,2) e a regressão linear apresentou R2=0,78. Para a reprodutibilidade entre dias, as médias do EIM não diferiram (25,33±7,69 e 24,94±8,30, p=0,890). Assim, enquanto o dispositivo EIM exibiu alta reprodutibilidade das estimativas de %GC, deve-se ter cautela ao comparar os resultados com outras técnicas para medir %GC. O dispositivo EIM superestimou %GC em comparação com ADP. No entanto, as medidas de EIM apresentaram reprodutibilidade intradia e entre dias muito boa e, portanto, o dispositivo de EIM pode ser usado para monitoramento longitudinal de %GC.

ABSTRACT BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

Resumo O objetivo foi verificar a associação entre a prática de atividade física (AF) e a percepção do ambiente em adultos de uma cidade do Sul do Brasil. Estudo transversal de base populacional com 820 adultos, residentes na cidade de Criciúma-SC. A percepção do ambiente foi avaliada pela escala Neighborhood Environmental Walkability, e a AF no domínio do lazer e transporte ativo pela versão longa do Questionário Internacional de AF. Observou-se que o bairro com lugar público para a prática de exercícios físicos e o fato de passear com o cachorro estiveram associados a maiores prevalências de atendimento às recomendações de AF moderada à vigorosa (AFMV). O fato de ter convite de amigos e/ou parentes para AF, a realização de eventos esportivos e o hábito de passear com o cachorro estiveram associados à caminhada no lazer. O acesso a locais para aquisição de frutas/legumes frescos, alimentos light/diet, ter calçadas na maioria das ruas, ter faixas de segurança e ter eventos esportivos no bairro estiveram associados a maiores prevalências de deslocamento ativo. De forma contrária, lugares para lanches ou fast-food no bairro se associaram a menor prevalência de deslocamento ativo. A percepção de variáveis do ambiente esteve associada à AFMV, à prática de caminhada e ao transporte ativo.

Abstract The article aimed to verify the association between physical activity (PA) and perceived environment among adults from a city in southern Brazil. This is a population-based cross-sectional study with 820 adults living in the city of Criciúma-SC. Perceived environment was assessed using the Neighborhood Environmental Walkability scale and PA in the leisure and transportation domains using the long version of the International PA Questionnaire. It was observed that the neighborhood with public spaces for the practice of physical exercises and dog walking was associated with higher prevalence of compliance with moderate-to-vigorous physical activity (MVPA) guidelines. The fact of having an invitation from friends and/or relatives for PA, sporting events and the habit of dog walking were associated with leisure-time walking. Access to places for the purchase of fresh fruits/ vegetables, light/diet foods, to have sidewalks in most streets, to have pedestrian crossings and sporting events in the neighborhood were associated with higher prevalence of active transportation. Conversely, places for snacks or fast food in the neighborhood were associated with lower prevalence of active transportation. The perception of environmental variables was associated with MVPA, walking and active transportation.

Resumo O objetivo foi verificar a associação entre a prática de atividade física (AF) e a percepção do ambiente em adultos de uma cidade do Sul do Brasil. Estudo transversal de base populacional com 820 adultos, residentes na cidade de Criciúma-SC. A percepção do ambiente foi avaliada pela escala Neighborhood Environmental Walkability, e a AF no domínio do lazer e transporte ativo pela versão longa do Questionário Internacional de AF. Observou-se que o bairro com lugar público para a prática de exercícios físicos e o fato de passear com o cachorro estiveram associados a maiores prevalências de atendimento às recomendações de AF moderada à vigorosa (AFMV). O fato de ter convite de amigos e/ou parentes para AF, a realização de eventos esportivos e o hábito de passear com o cachorro estiveram associados à caminhada no lazer. O acesso a locais para aquisição de frutas/legumes frescos, alimentos light/diet, ter calçadas na maioria das ruas, ter faixas de segurança e ter eventos esportivos no bairro estiveram associados a maiores prevalências de deslocamento ativo. De forma contrária, lugares para lanches ou fast-food no bairro se associaram a menor prevalência de deslocamento ativo. A percepção de variáveis do ambiente esteve associada à AFMV, à prática de caminhada e ao transporte ativo.

Abstract The article aimed to verify the association between physical activity (PA) and perceived environment among adults from a city in southern Brazil. This is a population-based cross-sectional study with 820 adults living in the city of Criciúma-SC. Perceived environment was assessed using the Neighborhood Environmental Walkability scale and PA in the leisure and transportation domains using the long version of the International PA Questionnaire. It was observed that the neighborhood with public spaces for the practice of physical exercises and dog walking was associated with higher prevalence of compliance with moderate-to-vigorous physical activity (MVPA) guidelines. The fact of having an invitation from friends and/or relatives for PA, sporting events and the habit of dog walking were associated with leisure-time walking. Access to places for the purchase of fresh fruits/ vegetables, light/diet foods, to have sidewalks in most streets, to have pedestrian crossings and sporting events in the neighborhood were associated with higher prevalence of active transportation. Conversely, places for snacks or fast food in the neighborhood were associated with lower prevalence of active transportation. The perception of environmental variables was associated with MVPA, walking and active transportation.

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

Abstract INTRODUCTION: This study aimed to estimate the burden of stroke mortality due to low levels of physical activity (PA) in Brazil from 1990 to 2019. METHODS: Data from the 2019 Global Burden of Disease (GBD) study for Brazil and Brazilian states were used. We used the number of deaths, age-standardized mortality rates, summary exposure value, and fraction of population risk attributable to low levels of PA. To standardize all estimates, data from the population aged 25 years or older were considered. RESULTS: The risk of exposure to low PA, SEV values, for the Brazilian male population was 11.8% (95%UI: 6.7; 19.9) and for the Brazilian female population was 13.2% (95%UI: 8.6; 19.2) in 2019. For males, it was estimated that there were, respectively, 2,025 (95%UI: 271; 4,839) and 3,595 (95%UI: 658; 7,302) deaths in 1990 and 2019 due to stroke attributable to low PA. For females, there were 2,518 (95%UI: 498; 5,006) and 4,735 (95%UI: 1,286; 8,495) deaths in 1990 and 2019 due to stroke attributable to low PA, respectively. From 1990 to 2019, reductions of 44.0% for males (95%UI: −0.54; -0.05) and 52.0% for females (95%UI: −0.60; -0.30) in age-standardized mortality rates due to stroke attributed to low PA were observed. Approximately 6.1% (for males) and 7.3% (for females) of deaths in 2019 due to stroke could be avoided if the Brazilian population were physically active. CONCLUSIONS: These findings support the promotion of PA in all Brazilian states for preventing early mortality due to stroke.

ABSTRACT CONTEXT: The relationship with body image, which is the way the body presents itself to each subject, can be aggravated in children and adolescents diagnosed with an human immunodeficiency virus (HIV) infection, since these patients use antiretroviral therapy and may suffer from the adverse effects of the treatment due to continuous use of medication. OBJECTIVE: To estimate the prevalence of body image dissatisfaction, to describe the assessment methods, and to identify associated factors in children and adolescents diagnosed with HIV. DESIGN AND SETTING: This is a systematic review. Department of Physical Education, Florianópolis - Brazil METHODS: We followed the procedures of the Preferred Reporting Items for Systematic Reviews (PRISMA) and the Cochrane recommendations in the selection of articles through a search performed in eight databases. RESULTS: Prevalence of body image dissatisfaction due to thinness was between 36.7–52.0% in males and 28.1–36.4% in females, and body image dissatisfaction due to overweight was between 8.0–31.2% in males and 21.9–50.0% in females. Factors associated with body image dissatisfaction were as follows: female sex, older age, low levels of physical activity, low self-esteem, higher body fat, higher body weight, greater arm muscle area, triceps skinfold thickness, and higher body mass index. CONCLUSION: Children and adolescents of both sexes diagnosed with HIV infection are dissatisfied by thinness and overweight of their body image. REGISTRATION: https://www.crd.york.ac.uk/prospero/ (CRD42021257676).

RESUMO Introdução: A densidade mineral óssea (DMO) e o conteúdo mineral ósseo (CMO) variam dependendo do esporte praticado e região corporal, e sua medição pode ser uma forma eficaz de prever riscos para a saúde ao longo da vida de um atleta. Objetivo: Descrever os aspectos metodológicos (mensuração dos parâmetros ósseos, regiões corporais, erros de precisão e covariáveis) e comparar a DMO e o CMO por região corporal (corpo total, membros superiores, membros inferiores e tronco) em atletas universitários de diferentes modalidades esportivas. Métodos: A busca foi realizada nos bancos de dados PubMed, Web of Science, Scopus, ScienceDirect, EBSCOhost, SportDiscus, LILACS e SciELO. Foram selecionados estudos que: (1) compararam a DMO e o CMO de atletas que praticam pelo menos dois esportes; (2) usaram absorciometria de raios X de dupla energia (DXA) para avaliar os parâmetros ósseos e (3) com foco em atletas universitários. Os dados extraídos foram local do estudo, seleção dos participantes, sexo dos participantes, esporte praticado, tipo de estudo, parâmetros ósseos, modelo DXA, software utilizado, varredura e regiões corporais, erro de precisão, protocolo de precisão, covariáveis e comparação de parâmetros ósseos entre esportes por região do corpo. Resultados: Os principais resultados foram: 1) DMO como parâmetro ósseo mais investigado; 2) corpo total, coluna lombar e parte proximal do fêmur (principalmente colo do fêmur) como as regiões corporais mais estudadas; 3) embora não seja recomendado, o coeficiente de variação foi o principal indicador de erro de precisão; 4) massa corporal total e estatura como covariáveis mais usadas; 5) nadadores e corredores têm valores mais baixos de DMO e CMO e 6) especula-se que jogadores de basquete e ginastas têm maior potencial osteogênico. Conclusões: Nadadores e corredores devem incluir exercícios de sustentação de peso na rotina de treinamento. Além da massa corporal e da estatura, outras covariáveis são importantes. Os resultados desta revisão podem ajudar a orientar estratégias de intervenção focadas na prevenção de doenças e problemas de saúde durante e depois da carreira esportiva. Nível de evidência II, Revisão sistemática.

ABSTRACT Introduction: Bone mineral density (BMD) and bone mineral content (BMC) vary depending on the type of sport practiced and the body region, and their measurement can be an effective way to predict health risks throughout an athlete’s life. Objective: To describe the methodological aspects (measurement of bone parameters, body regions, precision errors and covariates) and to compare BMD and BMC by body region (total body, upper limbs, lower limbs and trunk) among university athletes practicing different sports. Methods: A search was performed on the databases PubMed, Web of Science, Scopus, ScienceDirect, EBSCOhost, SportDiscus, LILACS and SciELO. Studies were selected that: (1) compared BMD and BMC of athletes practicing at least two different sports (2) used dual-energy X-ray absorptiometry (DXA) to assess bone parameters (3) focused on university athletes. The extracted data were: place of study, participant selection, participants’ sex, sport practiced, type of study, bone parameters, DXA model, software used, scan and body regions, precision error, precision protocol, covariates and comparison of bone parameters between different sports by body region. Results: The main results were: 1) BMD is the most investigated bone parameter; 2) total body, lumbar spine and proximal femur (mainly femoral neck) are the most studied body regions; 3) although not recommended, the coefficient of variation is the main indicator of precision error; 4) total body mass and height are the most commonly used covariates; 5) swimmers and runners have lower BMD and BMC values; and 6) it is speculated that basketball players and gymnasts have greater osteogenic potential. Conclusions: Swimmers and runners should include weight-bearing exercises in their training routines. In addition to body mass and height, other covariates are important. The results of this review can help guide intervention strategies focused on preventing diseases and health problems during and after the athletic career. Level of evidence II; Systematic Review.

RESUMEN Introducción: La densidad mineral ósea (DMO) y el contenido mineral óseo (CMO) varían en función del deporte practicado y de la región corporal, y su medición puede ser una forma efectiva de predecir los riesgos para la salud a lo largo de la vida de un atleta. Objetivo: Describir los aspectos metodológicos (medición de parámetros óseos, regiones corporales, errores de precisión y covariables) y comparar la DMO y el CMO por región corporal (cuerpo total, miembros superiores, miembros inferiores y tronco) en atletas universitarios de diferentes deportes. Métodos: La búsqueda se realizó en las bases de datos PubMed, Web of Science, Scopus, ScienceDirect, EBSCOhost, SportDiscus, LILACS y SciELO. Se seleccionaron estudios que: (1) compararon la DMO y el CMO de atletas que practicaban al menos dos deportes; (2) utilizaron la absorciometría de rayos X de doble energía (DXA) para evaluar los parámetros óseos y (3) se centraron en atletas universitarios. Los datos extraídos fueron: ubicación del estudio, selección de los participantes, sexo de los participantes, deporte practicado, tipo de estudio, parámetros óseos, modelo de DXA, software utilizado, escaneo y regiones corporales, error de precisión, protocolo de precisión, covariables y comparación de parámetros óseos entre deportes por región corporal. Resultados: Los principales resultados fueron: 1) DMO como el parámetro óseo más investigado; 2) cuerpo total, columna lumbar y parte proximal del fémur (principalmente cuello femoral) como las regiones corporales más estudiadas; 3) aunque no se recomienda, el coeficiente de variación fue el principal indicador de error de precisión; 4) la masa corporal total y la altura fueron las covariables más utilizadas; 5) los nadadores y corredores presentan valores más bajos de DMO y CMO; 6) se especula un mayor potencial osteogénico en jugadores del baloncesto y gimnastas. Conclusiones: Los nadadores y corredores deben incluir ejercicios con pesas en su rutina de entrenamiento. Además de la masa corporal y la altura, otras covariables son importantes. Los resultados de esta revisión pueden guiar las estrategias de intervención centradas en la prevención de enfermedades y problemas de salud durante y después de la carrera deportiva. Nivel de evidencia II, Revisión Sistemática.

RESUMO Introdução: Os baixos níveis de aptidão aeróbica estão associados ao excesso de adiposidade corporal em adolescentes. Porém, os estudos que analisaram essa associação em adolescentes, utilizaram diferentes métodos e medidas para avaliar a aptidão aeróbica, o que dificulta a comparação dos resultados. Objetivos: Realizar uma revisão sistemática com metanálise de estudos que analisaram a associação entre aptidão aeróbica e indicadores antropométricos de adiposidade corporal em adolescentes de 10 a 19 anos. Métodos: Realizou-se busca sistemática em maio de 2016, atualizada em março de 2017, nas seguintes bases de dados eletrônicas: LILACS (BIREME), Embase, MEDLINE (PubMed), Web of Science (Web of Knowledge), Scopus e SPORTDiscus. Resultados: Foram selecionados 23 estudos. A metanálise indicou que à medida que aumentavam os níveis de aptidão aeróbica, diminuíam os valores de IMC, do perímetro da cintura e do percentual de gordura corporal dos adolescentes. Conclusões: Existe uma associação negativa entre aptidão aeróbica (avaliada pela medida da captação de oxigênio no teste de corrida de vaivém de 20 metros [20m Shuttle Run]) e percentual de gordura, IMC e perímetro da cintura dos adolescentes e associação negativa entre aptidão aeróbica (avaliada pela contagem de voltas no teste de vai e vem de 20 metros) e percentual de gordura corporal. Contudo, é necessária cautela na interpretação dos dados devido à heterogeneidade dos estudos analisados. Nível de evidência II; Revisão sistemática de Estudos de Nível II

ABSTRACT Introduction: Low aerobic fitness levels are associated with excess body adiposity in adolescents. However, studies that have analyzed this association in adolescents have used different methods and measures to evaluate aerobic fitness, making it difficult to compare the results. Objective: To conduct a systematic review with meta-analysis of studies that have analyzed the association between aerobic fitness and anthropometric body adiposity indicators in adolescents aged 10-19 years. Methods: A systematic search was performed in May 2016, updated in March 2017, in the following electronic databases: LILACS (BIREME), Embase, MEDLINE (PubMed), Web of Science (Web of Knowledge), Scopus, and SPORTDiscus. Results: Twenty-three studies were selected. The meta-analysis indicated that as the aerobic fitness levels increased, the BMI, waist circumference and body fat percentage values of the adolescents decreased. Conclusion: There is a negative association between aerobic fitness (evaluated by measuring maximum oxygen uptake in the 20-meter Shuttle Run test) and the body fat percentage, BMI and waist circumference of adolescents and a negative association between aerobic fitness (assessed by measuring the number of laps in the 20-meter Shuttle Run test) and body fat percentage. However, caution is required in the interpretation of data due to the heterogeneity of the studies analyzed. Level of Evidence II; Systematic review of studies with level II of evidence.

RESUMEN Introducción: La evidencia sugiere que los niveles bajos de aptitud aeróbica están asociados a un exceso de adiposidad corporal en los adolescentes. Sin embargo, los estudios que analizaron esta asociación en adolescentes utilizaron diferentes métodos y medidas para evaluar la aptitud aeróbica, lo que dificulta la comparación de los resultados encontrados. Objetivo: Realizar una revisión sistemática con metanálisis de estudios que evaluaron la asociación entre aptitud aeróbica e indicadores antropométricos de adiposidad corporal en adolescentes de 10 a 19 años. Método: Se realizó una búsqueda sistemática en mayo de 2016, actualizada em marzo de 2017, en las bases de datos electrónicas: LILACS (BIREME), Embase, MEDLINE (PubMed), Web of Science (Web of Knowledge), Scopus y SPORTDiscus. Esta revisión incluyó estudios transversales con adolescentes de 10 a 19 años que analizaron la asociación entre la aptitud aeróbica (con diferentes métodos de evaluación) y los indicadores antropométricos de la adiposidad corporal (utilizando la antropometría como método). Resultados: Se seleccionaron 23 estudios. El metanálisis indicó que a medida que aumentaban los niveles de aptitud aeróbica, el IMC, la circunferencia de la cintura y el porcentaje de grasa corporal de los adolescentes disminuían. Conclusión: Existe una asociación negativa entre la aptitud aeróbica (evaluada por el test Shuttle Run 20 metros mediante el consumo máximo de oxígeno) y el porcentaje de grasa, IMC y circunferencia de cintura de los adolescentes y una asociación negativa entre la aptitud aeróbica evaluada por el test Shuttle Run 20 metros según el número de vueltas y el porcentaje de grasa corporal. Sin embargo, se requiere precaución al interpretar los datos debido a la heterogeneidad de los estudios analizados. Nivel de evidencia II; Revisión sistemática de estudios de nivel II

ABSTRACT BACKGROUND: Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents. The direct adverse effects of HIV infection and combined antiretroviral therapy (ART) negatively contribute to bone metabolism. A direct relationship between muscle strength levels and BMD in HIV-infected adults and older adults has been described. However, it is unknown whether handgrip strength (HGS) is associated with bone mass in pediatric populations diagnosed with HIV. OBJECTIVE: To ascertain whether HGS levels are associated with BMC and BMD in HIV-infected children and adolescents. DESIGN AND SETTING: Cross-sectional study conducted in Florianãpolis, Brazil, in 2016. METHODS: The subjects were 65 children and adolescents (8-15 years) diagnosed with vertically-transmitted HIV. Subtotal and lumbar-spine BMC and BMD were obtained via dual-emission X-ray absorptiometry (DXA). HGS was measured using manual dynamometers. The covariates of sex, ART, CD4+ T lymphocytes and viral load were obtained through questionnaires and medical records. Sexual maturation was self-reported and physical activity was measured using accelerometers. Simple and multiple linear regression were used, with P < 0.05. RESULTS: HGS was directly associated with subtotal BMD (β = 0.002; R² = 0.670; P < 0.001), subtotal BMC (β = 0.090; R² = 0.734; P = 0.005) and lumbar-spine BMC (β = 1.004; R² = 0.656; P = 0.010) in the adjusted analyses. However, no significant association was found between HGS and lumbar-spine BMD (β = 0.001; R² = 0.464; P = 0.299). CONCLUSION: HGS was directly associated with BMD and BMC in HIV-infected children and adolescents.

Resumo Fundamento O aumento significativo de doenças cardiovasculares em países em desenvolvimento alerta sobre seu impacto em populações carentes. Objetivo Identificar a relação de agrupamentos de componentes da síndrome metabólica (SM) com aterosclerose e inflamação crônica em adultos e idosos. Métodos Análise transversal usando dados de dois estudos populacionais de tipo coorte realizados em Florianópolis, sul do Brasil (EpiFloripa Adult Cohort Study, n = 862, 39,9±11,5 anos; EpiFloripa Aging Cohort Study, n = 1197, 69,7±7,1 anos). Pressão arterial (PA), circunferência da cintura (CC), e níveis plasmáticos de lipídio e glicose foram analisados como fatores individuais ou como agrupamentos de componentes da SM (como número de componentes presentes em um indivíduo ou como combinações). Os desfechos incluíram espessura intima-media carotídea (EIMC), placas ateroscleróticas, e níveis de proteína C reativa (CRP). Regressão linear múltipla e regressão logística, ajustadas quanto aos fatores de confusão, foram usadas para análise. O nível de significância adotado foi de 5%. Resultados Indivíduos com PA e CC elevadas, dislipidemia e hiperglicemia (61,5%) apresentaram maiores valores de EIMC e PCR que aqueles que não apresentaram componentes de SM. CC elevada foi um determinante comum de inflamação sistêmica, ao passo que a coexistência de PA elevada e CC elevada (agrupamentos de dois ou três fatores) associou-se com maior EIMC (β entre +3,2 e +6,1 x 10-2 mm; p < 0,05) e PCR (EXPβ entre 2,18 e 2,77; p < 0,05). Conclusão A coexistência de PA e CC elevadas associou-se com maiores valores de EIMC e níveis de PCR. A obesidade central, isolada ou em combinação com outros fatores de risco, teve efeito sobre a inflamação sistêmica.

Abstract Background The significant increase in cardiovascular diseases in developing countries alerts about their impact on underprivileged populations. Objective To identify the relationship of clusters of metabolic syndrome (MS) components with atherosclerosis and chronic inflammation among adults and elderly. Methods Cross-sectional analysis using data from two population-based cohort studies in Florianópolis, Southern Brazil (EpiFloripa Adult Cohort Study, n = 862, 39.9±11.5 years; EpiFloripa Aging Cohort Study, n = 1197, 69.7±7.1 years). Blood pressure (BP), waist circumference (WC), and lipid and glucose levels were analyzed as individual factors or as clusters (either as the number of components present in an individual or as combinations of components). Outcomes included carotid intima-media thickness (IMT), atherosclerotic plaques, and C-reactive protein (CRP) levels. Multiple linear and logistic regression analyses adjusted for confounding factors were used. The statistical significance adopted was 5%. Results Individuals with high BP, elevated WC, dyslipidemia and hyperglycemia (6.1% of the sample) showed higher IMT and CRP than those negatives for all MetS components. Elevated WC was a common determinant of systemic inflammation, while the coexistence of high BP and elevated WC (clusters of two or three factors) was associated with higher IMT (β between +3.2 and +6.1 x 10-2 mm; p value < 0.05) and CRP (EXPβ between 2.18 and 2.77; p value < 0.05). Conclusion The coexistence of high BP and elevated WC was associated with increased IMT and CRP levels, but central obesity affected systemic inflammation either alone or in combination with other risk factors.

ABSTRACT It was our objective to estimate the prevalence and associated factors with low aerobic fitness among adolescents. A cross-sectional study was conducted with 575 subjects aged 11-17 years from Criciúma, SC, Brazil. The 9-minute walk/run test was used to assess aerobic fitness. Sociodemographic data and daily habits were collected using a self-administered questionnaire. Anthropometric evaluation was also performed to calculate anthropometric indicators of obesity. The Chi-square test and the binary logistic regression were used. The prevalence of low aerobic fitness in boys aged 11-13 years was 46.0% and in girls 40.5% (p< 0.05), while in boys aged 14-17 years, the prevalence was 59.6% and in girls 46.6 % (p<0.05). Boys aged 11-13 (OR: 5.04; 95%CI 1.93-13.17) and those aged 14-17 years (OR:3.78; 95%CI 1.90-7.52) and girls aged 11-13 years (OR: 3.62; 95%CI 1.24-10.52) from private schools were about four times more likely of having low aerobic fitness compared to those from public schools. Girls aged 11-13 years (OR: 2.40; 95%CI 1.04-5.54) with inadequate sleep were more likely to have low aerobic fitness than those with adequate sleep. High prevalence of low aerobic fitness was associated with private schools and inadequate sleep in both sexes.

RESUMO Introdução: A avaliação da composição corporal em atletas do sexo feminino de diferentes modalidades esportivas é importante para o monitoramento da saúde. Objetivos: Comparar a composição corporal de atletas universitárias, de diferentes modalidades coletivas (futebol de salão, flag football e voleibol). Métodos: Estudo transversal realizado com 45 atletas do sexo feminino, com idades entre 18 e 35 anos (22,8 ± 3,55). As variáveis dependentes foram a massa gorda corporal (MG) e a massa magra (MM) medida por pletismografia por deslocamento de ar. O conteúdo mineral ósseo ajustado para estatura (CMO/estatura) e densidade mineral óssea (DMO) foram medidos por absorciometria por dupla emissão de raios X. As variáveis independentes foram os esportes [flag football (n = 12); futebol de salão (n = 20); voleibol (n = 13)] e as covariáveis foram idade (anos completos), volume de treinamento (minutos por semana) e tempo de prática (anos completos). A análise de covariância foi utilizada. Resultados: Ao ajustar o modelo pelas covariáveis, as atletas de voleibol (19,27 kg ± 2,20) apresentaram valores maiores de MG com relação às de flag football (16,00 kg ± 1,70) e de futebol de salão (12,20 kg ± 1,30). Não houve diferença significativa na MM, CMO/estatura e DMO total entre os esportes, mesmo depois do ajuste para as covariáveis. Conclusões: As atletas de voleibol apresentaram maior MG em comparação com as atletas de flag football e futebol de salão. Não houve diferenças em MM, CMO/estatura e DMO entre os jogadoras de diferentes modalidades coletivas. Este estudo pode ajudar treinadores e outros profissionais do esporte a prevenir lesões em atletas com maior MG (voleibol) ou prevenir doenças como irregularidades menstruais, comuns em atletas com baixos níveis de gordura corporal (futebol de salão), que é um dos fatores de risco para a síndrome da tríade da atleta feminina (distúrbios alimentares, irregularidades menstruais e baixa DMO). Nível de evidência III; Estudo retrospectivo comparativo .

ABSTRACT Introduction: The assessment of body composition in female athletes of different sports is important for health monitoring. Objective: To compare body composition in university athletes of different team sports (indoor soccer, flag football and volleyball). Methods: A cross-sectional study carried out with 45 female athletes, aged 18 to 35 years (22.8 ± 3.55). The dependent variables were body fat mass (FM) and fat-free mass (FFM) measured by air displacement plethysmography. Bone mineral content, adjusted for height (BMC/height) and bone mineral density (BMD), were measured by dual energy X-ray absorptiometry. The independent variable was sport [flag football (n = 12); indoor soccer (n = 20); volleyball (n = 13)] and the covariates were age (complete years), training volume (minutes per week) and length of time playing the sport (complete years). Analysis of covariance was used. Results: Adjusting the model for covariates, volleyball athletes (19.27 kg ± 2.20) presented higher FM values compared to the flag football (16.00 kg ± 1.70) and indoor soccer players (12.20 kg ± 1.30). There was no significant difference in FFM, BMC/height and total BMD between sports, even after adjusting for covariates. Conclusion: Volleyball athletes presented higher FM compared to flag football and indoor soccer athletes. There were no differences in FFM, BMC/height and BMD among the players of the different team sports. This study can help coaches and other sports professionals to prevent injuries to athletes in sports such as higher FM (volleyball), or to prevent diseases such as menstrual irregularities, which are common in athletes who may have low levels of body fat (indoor soccer players), this being one of the risk factors for the female athlete triad (eating disorders, menstrual irregularities and low BMD). Level of evidence III; Retrospective comparative study .

RESUMEN Introducción: La evaluación de la composición corporal en atletas del sexo femenino de diferentes modalidades deportivas es importante para la monitorización de la salud. Objetivos: Comparar la composición corporal de atletas universitarias, de diferentes modalidades colectivas (fútbol de salón, flag football y vóleibol). Métodos: Estudio transversal realizado con 45 atletas del sexo femenino, con edades entre 18 y 35 años (22,8 ± 3,55). Las variables dependientes fueron la masa grasa (MG) y masa magra (MM) medida por pletismografía por desplazamiento de aire. El contenido mineral óseo ajustado para estatura (CMO/estatura) y densidad mineral ósea (DMO) fueron medidos por absorciometría por doble emisión de rayos X. Las variables independientes fueron los deportes [flag football (n = 12); fútbol de salón (n = 20); vóleibol (n = 13)] y las covariables fueron edad (años completos), volumen de entrenamiento (minutos por semana) y tiempo de práctica (años completos). Fue utilizado el análisis de covariancia. Resultados: Al ajustar el modelo por las covariables, las atletas de vóleibol (19,27 kg ± 2,20) presentaron valores mayores de MG con relación a las de flag football (16,00 kg ± 1,70) y de fútbol de salón (12,20 kg ± 1,30). No hubo diferencia significativa en la MM, CMO/estatura y DMO total entre los deportes, incluso después del ajuste para las covariables. Conclusiones: Las atletas de vóleibol presentaron mayor MG en comparación con los atletas de flag football y fútbol de salón. No hubo diferencias en MM, CMO/estatura y DMO entre las jugadoras de diferentes modalidades colectivas. Este estudio puede ayudar a entrenadores y otros profesionales del deporte a prevenir lesiones en atletas con mayor MG (vóleibol) o prevenir enfermedades como irregularidades menstruales, comunes en atletas con bajos niveles de grasa corporal (fútbol de salón), que es uno de los factores de riesgo para el síndrome de la tríada de la atleta femenina (disturbios alimentarios, irregularidades menstruales y baja DMO). Nivel de evidencia III; Estudio retrospectivo comparativo .