LEANDRO FORNIAS MACHADO DE REZENDE
Projetos de Pesquisa
Unidades Organizacionais
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
45 resultados
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- Preventable fractions of colon and breast cancers by increasing physical activity in Brazil: perspectives from plausible counterfactual scenarios(2018) REZENDE, Leandro Fornias Machado de; GARCIA, Leandro Martin Totaro; MIELKE, Gregore Iven; LEE, Dong Hoon; WU, Kana; GIOVANNUCCI, Edward; ELUF-NETO, JoseBackground: Physical activity is associated with lower risk of colon and breast cancers. Herein we estimated preventable fractions of colon and breast cancers in Brazil by increasing population-wide physical activity to different counterfactual scenarios. Methods: We used data from a representative national survey in Brazil and corresponding relative risks of colon and postmenopausal breast cancers from a meta-analysis. Estimated cancer incidence was retrieved from GLOBOCAN and Brazilian National Cancer Institute. Five counterfactual scenarios for physical activity were considered: (i) theoretical minimum risk exposure level (>= 8,000 metabolic equivalent of tasks-minute/week-MET-min/week); (ii) physical activity recommendation (>= 600 MET-min/week); (iii) a 10% reduction in prevalence of insufficient physical inactivity (< 600 MET-min/week); (iv) physical activity level in each state equals the most active state in Brazil; (v) closing the gender differences in physical activity. Results: About 19% (3,630 cases) of colon cancers and 12% (6,712 cases) of postmenopausal breast cancers could be prevented by increasing physical activity to >= 8,000 MET-min/week. Plausible counterfactual scenarios suggested the following impact on cancer prevention: reaching physical activity recommendation: 1.7% (1,113 cases) of breast and 6% (1,137 cases) of colon; 10% reduction in physical inactivity prevalence: 0.2% (111 cases) of breast and 0.6% (114 cases) of colon; most active state scenario: 0.3% (168 cases) of breast and 1% (189 cases) of colon; reducing gender differences in physical activity: 1.1% (384 cases) of breast and 0.6% (122 cases) of colon. Conclusions: High levels of physical activity are required to achieve a sizable impact on breast and colon cancer prevention in Brazil.
- Sedentary behavior and health outcomes among older adults: a systematic review(2014) REZENDE, Leandro Fornias Machado de; REY-LOPEZ, Juan Pablo; MATSUDO, Victor Keihan Rodrigues; LUIZ, Olinda do CarmoBackground: In the last decade, sedentary behavior has emerged as a new risk factor for health. The elderly spend most of their awake time in sedentary activities. Despite this high exposure, the impact of this sedentary behavior on the health of this population has not yet been reviewed. We systematically reviewed evidence for associations between sedentary behavior and multiple health outcomes in adults over 60 years of age. Methods: We searched the Medline, Embase, Web of Science, SPORTDiscus, PsycINFO, CINAHL, LILLACS, and Sedentary Research Database for observational studies published up to May 2013. Additionally, we contacted members of the Sedentary Behaviour Research Network to identify articles that were potentially eligible. After inclusion, the methodological quality of the evidence was assessed in each study. Results: We included 24 eligible articles in our systematic review, of which only 2 (8%) provided high-quality evidence. Greater sedentary time was related to an increased risk of all-cause mortality in the older adults. Some studies with a moderate quality of evidence indicated a relationship between sedentary behavior and metabolic syndrome, waist circumference, and overweightness/obesity. The findings for other outcomes such as mental health, renal cancer cells, and falls remain insufficient to draw conclusions. Conclusion: This systematic review supports the relationship between sedentary behavior and mortality in older adults. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.
- The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used(2014) REY-LOPEZ, J. P.; REZENDE, L. F. de; PASTOR-VALERO, M.; TESS, B. H.We performed a systematic review of the prevalence of metabolically healthy obesity (MHO). Medline, Web of Science and EMBASE were searched for original articles from inception to November 2013. Only prospective and cross-sectional studies were included. After screening 478 titles, we selected 55 publications, of which 27 were population-based studies and were used in the narrative synthesis. From the 27 studies, we identified 30 definitions of metabolic health, mainly based on four criteria: blood pressure, high-density lipoprotein cholesterol, triglycerides and plasma glucose. Body mass index 30kgm(-2) was the main indicator used to define obesity (74% of the studies). Overall, MHO prevalence ranged between 6% and 75%. In the studies that stratified the analysis by sex, prevalence was higher in women (seven out of nine studies) and in younger ages (all four studies). One-third of the studies (n=9) reported the response rate. Of these, four reported a response rate of 70% and they showed MHO prevalence estimates between 10% and 51%. The heterogeneity of MHO prevalence estimates described in this paper strengthens calls for the urgent need for a commonly established metabolic health definition.
- Food environments in schools and in the immediate vicinity are associated with unhealthy food consumption among Brazilian adolescents(2016) AZEREDO, Catarina Machado; REZENDE, Leandro Fornias Machado de; CANELLA, Daniela Silva; CLARO, Rafael Moreira; PERES, Maria Fernanda Tourinho; LUIZ, Olinda do Carmo; FRANCA-JUNIOR, Ivan; KINRA, Sanjay; HAWKESWORTH, Sophie; LEVY, Renata BertazziBackground. Evidence of the influence of the school food environment on adolescent diet is still little explored in low-and middle-income countries. We aimed to evaluate the association between food environment in schools and the immediate vicinity and the regular consumption of unhealthy food among adolescents. Methods. We used cross-sectional data collected by the Brazilian National Survey of School Health (PeNSE) from a representative sample of adolescents attending 9th grade public and private schools in Brazil, in 2012. We estimated students' regular consumption (>5 days/week) of unhealthy food (soft drinks, bagged salty snacks, deep fried salty snacks and sweets) and school availability, in the cafeteria or an alternative outlet, of the same food plus some healthy options (fruit and natural fruit juice). We performed multilevel logistic regression models. Results. Having a cafeteria inside school selling soft drinks (private schools OR = 1.23; 95% CI = 1.14-1.33; public schools OR = 1.13; 95% CI = 1.06-1.20) and deep fried salty snacks (private schools OR = 1.41 95% CI = 1.26-1.57; public schools OR = 1.16 95% CI = 1.08-1.24) was associated with a higher consumption of these unhealthy foods of among students. In private schools, cafeteria selling fruit and natural fruit juice was associated with lower student consumption of bagged salty snacks (OR = 0.86; 95% CI 0.77-0.96) and soft drinks (OR = 0.85; 95% CI = 0.76-0.94). In addition, eating meals from the Brazilian School Food Program in public schools was associated with a lower consumption of unhealthy foods. Conclusions. Foods available in the school food environment are associated with the consumption of unhealthy food among adolescents in Brazil.
- Physical activity and cancer: an umbrella review of the literature including 22 major anatomical sites and 770 000 cancer cases(2018) REZENDE, Leandro Fornias Machado de; SA, Thiago Herick de; MARKOZANNES, Georgios; REY-LOPEZ, Juan Pablo; LEE, I-Min; TSILIDIS, Konstantinos K.; IOANNIDIS, John P. A.; ELUF-NETO, JoseObjective To provide an overview of the breadth and validity of claimed associations between physical activity and risk of developing or dying from cancer. Design Umbrella review. Data sources We searched Medline, Embase, Cochrane Database and Web of Science. Eligibility criteria for selecting studies Systematic reviews about physical activity and cancer incidence and cancer mortality in different body sites among general population. Results We included 19 reviews covering 22 cancer sites, 26 exposure-outcome pairs metaanalyses and 541 original studies. Physical activity was associated with lower risk of seven cancer sites (colon, breast, endometrial, lung, oesophageal, pancreas and meningioma). Only colon (a protective association with recreational physical activity) and breast cancer (a protective association with overall physical activity) were supported by strong evidence and highly suggestive evidence, respectively. Evidence from endometrial, lung, oesophageal, pancreas and meningioma presented hints of uncertainty and bias in the literature (eg, not reaching P values < 10(-6)) showing large between-study heterogeneity and/or not demonstrating a definite direction for the effect when 95% prediction intervals were considered. Four of the 26 meta-analyses showed small study effects and 4 showed excess significance. Conclusion Physical activity is associated with a lower risk of several cancers, but only colon and breast cancer associations were supported by strong or highly suggestive evidence, respectively. Evidence from other cancer sites was less consistent, presenting hints of uncertainty and/or bias.
- Sociodemographic and behavioral factors associated with physical activity in Brazilian adolescents(2014) REZENDE, Leandro Fornias Machado de; AZEREDO, Catarina Machado; CANELLA, Daniela Silva; CLARO, Rafael Moreira; CASTRO, Ines Rugani Ribeiro de; LEVY, Renata Bertazzi; LUIZ, Olinda do CarmoBackground: Physical activity in adolescents is associated with short-and long-term health benefits. Physical activity can occur in various domains and is influenced by a complex network of factors. The aims of this study are 1) to describe the physical activity of Brazilian adolescents in physical education classes, during leisure time, and during active commuting and 2) to investigate the socio-demographic and behavioral factors associated with physical activity. Methods: The representative sample included 109,104 Brazilian students in the final year of elementary school from 2,842 schools. The weekly frequency and duration of physical activity were assessed. A variety of socio-demographic and behavioral factors were studied. A multiple Poisson regression analysis was used to test for associations between physical activity and the socio-demographic and behavioral variables. Results: Most of the students (97.0%) engaged in physical activity in at least one of the domains studied, especially physical education at school (81.7%) and leisure time physical activity (67.5%). However, only 29% of the adolescents reached the recommended level of physical activity. Among the adolescents who reached the minimum recommended time for physical activity, the various domains contributed the following proportions to total physical activity: leisure time physical activity (PR 12.5; 95% CI 11.17-13.97), active commuting (PR 1.63; 95% CI 1.59-1.67), and physical education at school (PR 1.36; 95% CI 1.29-1.44). The weekly frequency of all activities was greater among boys than among girls. Moreover, nearly two-thirds (61.8%) of students spent more than two hours per day engaging in sedentary behaviors; the prevalence of sedentary behaviors was similar between boys and girls (59.0 and 64.5%, respectively). Total level of physical activity, leisure time physical activity, and active commuting were associated with higher nutritional scores. Conclusions: Physical activity is important in any health promotion program. Therefore, it is necessary to invest in policies and interagency initiatives that promote all domains and to ensure that the general population helps determine the scope and design of such policies.
- Environmental Interventions Are Needed to Provide Sustained Physical Activity Changes(2015) REZENDE, Leandro Fornias Machado de; REY-LOPEZ, Juan Pablo
- Lifestyle among former cancer patients in Brazil in 2013(2016) SILVA, Gulnar Azevedo e; REZENDE, Leandro Fornias Machado de; GOMES, Fabio da Silva; SOUZA JUNIOR, Paulo Roberto Borges de; SZWARCWALD, Celia Landman; ELUF-NETO, JosePeople who have been diagnosed with cancer tend to adopt healthier lifestyles. This study analyzes the prevalence of smoking, eating fruits and vegetables, exercise and the use of alcoholic beverages among individuals who reported to have been diagnosed with cancer in the PNS (Pesquisa Nacional de Saude or National Health Survey). The prevalence and corresponding 95% confidence intervals were calculated for consuming fruits and vegetables, sedentary lifestyle (no exercise), use of alcoholic beverages, being overweight and tobacco use. The associa-tion between having received a diagnosis of cancer and the risk and protection factors was analyzed using a Poisson regression, adjusted by sociodemographic variables and other chronic comorbidities. The analyses were stratified by time since the diagnosis and the type of cancer related to the factors analyzed. The types of cancer most often reported were breast and cervix in women, and prostate and stomach in men. Among those who had cancer diagnoses, there was a higher consumption of fruits and vegetables, higher proportion of ex-smokers, however, increased use of alcohol. There was no difference in the frequency of exercise or incidence of being overweight between the two groups. Measures to promote health and prevent chronic diseases should be implemented in the follow-up of people who have had cancer, in an effort to ensure integrated healthcare.
- Effect of Physical Inactivity on Major Noncommunicable Diseases and Life Expectancy in Brazil(2015) REZENDE, Leandro Fornias Machado de; RABACOW, Fabiana Maluf; VISCONDI, Juliana Yukari Kodaira; LUIZ, Olinda do Carmo; MATSUDO, Victor Keihan Rodrigues; LEE, I-MinBackground: In Brazil, one-fifth of the population reports not doing any physical activity. This study aimed to assess the impact of physical inactivity on major noncommunicable diseases (NCDs), all-cause mortality and life expectancy in Brazil, by region and sociodemographic profile. Methods: We estimated the population attributable fraction (PAF) for physical inactivity associated with coronary heart disease, type 2 diabetes, breast cancer, colon cancer, and all-cause mortality. To calculate the PAF, we used the physical inactivity prevalence from the 2008 Brazilian Household Survey and relative risk data in the literature. Results: In Brazil, physical inactivity is attributable to 3% to 5% of all major NCDs and 5.31% of all-cause mortality, ranging from 5.82% in the southeastern region to 2.83% in the southern region. Eliminating physical inactivity would increase the life expectancy by an average of 0.31 years. This reduction would affect mainly individuals with >= 15 years of schooling, male, Asian, elderly; residing in an urban area and earning >= 2 times the national minimum wage. Conclusions: In Brazil, physical inactivity has a major impact on NCDs and mortality, principally in the southeastern and central-west regions. Public policies and interventions promoting physical activity will significantly improve the health of the population.
- Bicycle-sharing system socio-spatial inequalities in Brazil(2018) DURAN, Ana Clara; ANAYA-BOIG, Esther; SHAKE, Joshua Daniel; GARCIA, Leandro Martin Totaro; REZENDE, Leandro Fornias Machado de; SA, Thiago Herick de