Comportamento sedentário em universitários: estimativas de acurácia, prevalências e fatores associados

Abstract

The high time spent in sedentary behavior (SB) can promote deleterious effects on the health of the population, since it is a risk factor for noncommunicable diseases and diseases and all-cause mortality. The objective of this study was to analyze SB in university students. This dissertation is composed by four articles, the first article being the systematic review study, which addressed the prevalence of SB and other methodological characteristics of the articles published on this topic in university students. The second article estimated the level of reproducibility and the concurrent validity of the sitting time, as measured by the International Physical Activity Questionnaire (IPAQ), in university students. The third, estimated the cutoff point of sitting time, which best discriminated the absence of risk factors for chronic noncommunicable diseases, identified through the Receiver Operating Characteristic (ROC) curves. The last one had the objective of estimating the prevalences and factors associated with CS, using the Prevalence Ratios (RP) as a measure of association, through the Poisson regression with 95% Confidence Interval. The level of significance was 5%. Regarding the first article, prevalences for sitting time were observed from 34.0% to 90.2%. The use of operational definitions and cutoff points were diversified, as well as the use of various instruments to estimate CS, some of which were not validated, as well as the lack of standardization between cut-off points for risk assessment due to high CS time. Among the factors associated with CS with higher prevalences, the most prominent were overweight and depressive symptoms. In the second article, in the comparison between the sitting time measured by the IPAQ and the accelerometer, there was low correlation for the time during the week and low to moderate for the time referring to the weekend, with values of agreement within the acceptable limits. In the third article, sitting time discriminated the absence of obesity in 20 year old male students who consumed vegetables up to 4 days a week. The best cutoff point (6 hours) was estimated for the absence of the referred high blood pressure. Finally, in the fourth article, there was a high prevalence of sitting time (75.9%) and women (PR = 1.09, 95% CI = 1.01-1.17), university students were insufficiently active (PR = 1 , 11, 95% CI = 1.03-1.19), and reported life stress self-assessment as negative negative (PR = 1.18, 95% CI = 1.05-1.32), presented higher prevalences of sitting time , while increasing age was associated with lower prevalences of high sitting time. It is concluded that among CS studies in university students, there is no standardization, using cut-off points and different definitions. IPAQ can be used to reliably measure CS in university students. The cutoff point that best discriminated the absence of high blood pressure was 6 hours, it was also found a high prevalence of CS among students and the most exposed groups were women, those with insufficient active and self-rated negative stress.

O objetivo deste estudo foi estimar o nível de reprodutibilidade e a validade concorrente do tempo sentado, mensurado pelo questionário International Physical Activity Questionnaire (IPAQ), em universitários de uma instituição do ensino superior de Minas Gerais, Brasil. Foi realizado um estudo correlacional com 61 universitários selecionados por conveniência em uma universidade pública do estado de Minas Gerais, Brasil. Os participantes deste estudo auto preencheram as medidas do tempo sentado do IPAQ, versão curta, intercalados por dois momentos diferentes para fins da análise de reprodutibilidade, e usaram o acelerômetro para estimativa do tempo sedentário global e emprego como padrão ouro na análise de validade concorrente. Foi empregado as análises de correlação, via coeficiente de correlação intraclasse e gráfico de dispersão de Bland-Altman, para analisar a associação e concordância, respectivamente, para as informações referente ao comportamento em um dia da semana e um dia do final de semana. O nível de significância adotado foi de 5%. Observou-se correlação baixa a moderada entre o tempo sentado durante um dia da semana e correlação baixa em um dia do final de semana e diferenças médias de concordância entre o teste e reteste do tempo sentado dentro dos limites de confiança. Na comparação entre o tempo sentado do IPAQ e acelerômetro, houve correlação em um dia da semana e baixa a moderada em um dia do final de semana, com valores de concordância dentro dos limites aceitáveis.

The objective of this study was to evaluate the level of reproducibility and the duration of a sitting period measured by the International Questionnaire on Physical Activity questionnaire (IPAQ) in university students of a higher education institution in Minas Gerais, Brazil. A correlational study was carried out with 61 university students selected for convenience at a public university in the state of Minas Gerais, Brazil. Participants in this self-study completed IPAQ sitting time measurements, short version, interspersed by two different moments for reproducibility analysis, used the accelerometer for time saving and employment as a global standard in concurrent validity analysis. This was the analysis of the bland-Altman, the coefficient of intraclass correlation and graphic of bland-Altman's dispersion, for the error or association and concordance. The level of significance was 5%. Observe the moderation between the whole days during the week and the interlocution on the first day of the week and the interpersonal means of an interview between the test and the duration of the session within the confidence limits. In the comparison between the sitting time of the IPAQ and accelerometer, there was correlation on a weekday and low to moderate on a weekend day, with concordance values within acceptable limits.

O objetivo deste estudo foi selecionar os melhores pontos de corte do tempo sentado como discriminador da ausência de morbidades referidas (obesidade, excesso de peso, pressão arterial elevada, colesterol elevado e glicemia elevada) em universitários de uma instituição pública do estado de Minas Gerais, Brasil. Este estudo de delineamento transversal foi realizado com amostra representativa de universitários dos cursos presenciais da Universidade Federal do Triângulo Mineiro, sede Uberaba, MG, Brasil. As informações foram obtidas via questionário, a variável testada foram as horas do tempo sentado (TS) por dia, durante a semana e as variáveis de classificação foram a ausência das morbidades, ou seja, não relatar pressão arterial elevada, colesterol elevado e glicemia elevada, e não ser classificado com excesso de peso e obesidade. As variáveis exploratórias incluíram aquelas relativas as características sociodemográficas, de vínculo com a universidade e comportamentos relacionados à saúde. Foram identificadas as áreas sob a curva ROC entre o TS e as variáveis de classificação, de modo geral e em relação as categorias das variáveis exploratórias. O nível de significância adotado foi de 5%. Participaram 1.110 universitários. O TS durante a semana discriminou a ausência da pressão arterial elevada para todos os universitários (ROC: 0,600; IC95%: 0,525 – 0,674), e para algumas variáveis exploratórias. O TS discriminou a ausência de obesidade em estudantes do sexo masculino, de 20 anos e que consumiam hortaliças até 4 dias por semana. Conclui-se que o melhor ponto de corte para a ausência de pressão arterial elevada foi de 6 horas.

The objective of this study was to select the best cutoff points of sitting time as discriminator of the absence of self-reported morbidities (obesity, excess weight, high blood pressure, high cholesterol and glycemic) in undergraduate of a public institution from Minas Gerais, Brazil. This cross-sectional study was carried out with a representative sample of undergraduate from the Federal University of Triângulo Mineiro, Uberaba, MG, Brazil. The information was obtained through a questionnaire, the variable tested was the sitting time (ST) per day during the week and the variables of classification were the absence, ie., not self-reported high blood pressure, cholesterol elevated and high blood glucose, and classified with overweight and obesity. Exploratory variables included sociodemographic, link with University and health-related behaviors. The areas under curve (AUC) between ST and classification variables were identified in general and categories of the exploratory variables. The level of significance was 5%. Participated 1,110 college. The ST during the week discriminated the absence of high blood pressure for all university students (AUC:0.600; CI95%: 0.525 – 0.674). The ST described the absence of obesity, in male, 20 years old students and that consumed vegetables for up to 4 days. Concluded that the best overall cutoff point for the absence of high blood pressure was 6 hours.

O objetivo do presente estudo foi estimar as prevalências e os fatores associados ao tempo sentado em universitários de Minas Gerais. Trata-se de estudo transversal realizado com universitários de uma instituição federal do estado de Minas Gerais. As informações foram obtidas por meio de questionário. O elevado tempo sentado foi o desfecho deste estudo e as variáveis independentes foram sexo, idade, situação conjugal, trabalho/estágio, tempo de universidade, período de estudo, consumo de frutas/sucos e verduras/saladas, prática de atividade física, índice de massa corporal e autoavaliação de estresse. A medida da associação foram as Razões de Prevalências (RP), estimadas pela regressão de Poisson, com ajuste para a variância robusta, nas análises brutas e ajustadas, para a análise ajustada foi utilizado o modelo hierárquico. O nível de significância adotado foi de 5%. Participaram deste estudo 1.156 universitários. A prevalência de elevado tempo sentado foi de 75,9%. Observou-se a associação com o elevado tempo sentado as mulheres (RP=1,09; IC95%=1,01-1,17), os universitários insuficientemente ativos (RP=1,11; IC95%=1,03-1,19) e que autoavaliaram o estresse na vida como negativo (RP=1,18; IC95%=1,05-1,32) e foi observado com o aumento da idade, a diminuição das prevalências de elevado tempo sentado. Conclui-se que as mulheres, universitários insuficientemente ativos e que relataram autoavaliação de estresse como negativa, apresentaram maiores prevalências de tempo sentado, enquanto os universitários mais velhos associaram-se com menores prevalências.

The objective of the present study was to estimate the prevalence and factors associated with the time spent in university students in Minas Gerais. This cross-sectional study was carried out with university students from a federal institution in the state of Minas Gerais. The information was obtained through a questionnaire. The high sitting time was the outcome of this study and the independent variables were sex, age, marital status, work / internship, university time, study period, consumption of fruits / juices and vegetables / salads, physical activity practice, body mass and self-assessment of stress. The measure of association was the Prevalence Ratios (PR), estimated by Poisson regression, with adjustment for the robust variance, in the crude and adjusted analyzes, for the adjusted analysis was used the hierarchical model. The level of significance was 5%. 1,56 university students participated in this study. The prevalence of high sitting time was 75.9%. It was observed the association with the high sitting time (PR = 1.09, 95% CI = 1.01-1.17), insufficiently active university students (RP = 1.11, 95% CI = 1.03-1 , 19) and self-rated life stress as negative (PR = 1.18, 95% CI = 1.05-1.32), and it was observed with increasing age, decreased prevalence of high sitting time. It was concluded that women, who were not active and who reported stress self-assessment as negative, had higher prevalences of sitting time, while older university students were associated with lower prevalence rates.

Estudos sobre o tema do comportamento sedentário (CS) em universitários têm sido publicados, diante disso o conhecimento sobre os métodos adotados torna-se importante para a ciência, e a caracterização das prevalências e fatores associados a esse atributo são essenciais no âmbito das políticas de saúde para esse grupo. Assim, o objetivo do presente estudo foi descrever as prevalências e os fatores associados, e as características metodológicas empregadas nas pesquisas sobre o CS em universitários. Uma busca nas bases de dados National Library of Medicine (PUBMED), Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS) e SCOPUS foi realizada. Este estudo adotou os itens e recomendações do Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), e os artigos selecionados foram analisados conforme as características metodológicas, além das prevalências e os fatores associados ao CS. Dos 1.740 artigos encontrados nas bases de dados, 23 fizeram parte dessa revisão. Foram observadas prevalências para o tempo sentado de 34,0% a 90,2%. O uso de definições operacionais e pontos de corte foram diversificados, além do uso de variados instrumentos para estimar o CS. Foi observada a falta de padronização entre os pontos de corte para determinação do CS e das definições operacionais, como uso de instrumentos não validados. Dentre os fatores associados com maiores prevalências, destacaram-se o excesso de peso e os sintomas depressivos. Conclui-se que que as prevalências de CS foram elevadas em domínios não relacionados ao tempo dedicado aos estudos e características biológicas e psicológicas representaram atributos mais associados ao CS.

The studies on the sedentary behavior (SB) in students from Universities have published. The knowledge about the methods adopted in surveys is important for science, and the characterization of the prevalence and associated factors this attribute are essential in the context of health policies for group. Thus, the objective of the present study was to describe the prevalence and associated factors, and the methodological characteristics used in SB research among university students. A search in the National Library of Medicine (PUBMED), Scientific Electronic Library Online (SciELO), Virtual Health Library (VHL) and SCOPUS databases was performed. This study adopted the items and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA), and the articles selected analyzed according to the methodological characteristics, as well as the prevalence and associated factors with SB. Of the 1,740 articles found in the databases, 23 were part of this review. The prevalence for sitting time observed from 34.0% to 90.2%. The use of operational definitions and cutoff points diversified, as well as the use of various instruments to estimate SB. The lack of standardization between cut-off points for SB determination and operational definitions observed, such as the use of non-validated instruments. Among the factors associated with higher prevalence, the most prominent were overweight and depressive symptoms. Concluded that the prevalence of SB was high in domains not related with the time devoted to studies and biological and psychological characteristics represented attributes more associated with SB.