LEANDRO FORNIAS MACHADO DE REZENDE
Projetos de Pesquisa
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LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
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- 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.
- 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.
- 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.
- 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.
- Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews(2014) REZENDE, Leandro Fornias Machado de; LOPES, Mauricio Rodrigues; REY-LOPEZ, Juan Pablo; MATSUDO, Victor Keihan Rodrigues; LUIZ, Olinda do CarmoObjective: 1) To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2) To assess the methodological quality of the systematic reviews found. Methodology/Principal Findings: Medline; Excerpta Medica (Embase); PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers. Conclusions: This overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted.
- Coronary heart disease mortality, cardiovascular disease mortality and all-cause mortality attributable to dietary intake over 20 years in Brazil(2016) REZENDE, Leandro Fornias Machado de; AZEREDO, Catarina Machado; CANELLA, Daniela Silva; LUIZ, Olinda do Carmo; LEVY, Renata Bertazzi; ELUF-NETO, JoseBackground/objectives: In the last two decades, in Brazil, there has been a decreasing trend of consumption of in natura or minimally processed food, while intake of ultra-processed food has markedly increased. We estimated the contribution of dietary intake in trends from coronary heart disease mortality (CHDM), cardiovascular disease mortality (CVDM), and all-cause mortality (ACM) over 20 years in Brazil. Methods: We used a representative sample of Brazilian households located in metropolitan areas to estimate dietary intake in 1987/88 and 2008/09. For both periods, we estimated fractions of CHDM, CVDM, and ACM attributable to healthy (fruits and vegetables) and unhealthy food items (sugar-sweetened beverages, processed and red meat). We also estimated the number of prevented or postponed deaths attributable to these food items. Results: The fraction of CHDM attributable to all food items increased from 28.6% in 1987/88 to 38.7% in 2008/09. CVDM attributable to food items increased from 13.7% in 1974 to 19.3% in 2008/09. ACM attributable to all food items increased from 20.1% in 1987/88 to 27.3% in 2008/09. Without the decrease in healthy food item consumption, and the increase in unhealthy food items, 3195 deaths from coronary heart disease, 5340 from cardiovascular disease, and 16,970 from all causes could have been prevented or postponed. Conclusions: The burden of cardiovascular diseases and mortality attributable to dietary intake has increased over the last 20 years in Brazil. These findings suggest a need for a population prevention approach, focused on dietary intake to reduce the burden of disease.
- Personal, relational and school factors associated with involvement in fights with weapons among school-age youth in Brazil: a multilevel ecological approach (vol 63, pg 957, 2018)(2018) PERES, Maria Fernanda Tourinho; AZEREDO, Catarina Machado; REZENDE, Leandro Fornias Machado de; ZUCCHI, Eliana Miura; FRANCA-JUNIOR, Ivan; LUIZ, Olinda do Carmo; LEVY, Renata BertazziThe authors would like to include the funding note here which was found missing in the original publication.
- Case study in prevention(2016) REZENDE, L. F. M. de; REY-LóPEZ, J. P.; LUIZ, O. do Carmo; ELUF-NETO, J.In this chapter, we highlight our specifi c experience in conducting and reporting an overview of systematic reviews about sedentary behavior and health outcomes. In this overview, we aimed to cover all types of sedentary behavior, health outcomes, and age groups, taking into account the methodological quality of the systematic reviews. We hope to contribute to the discussion of methodological aspects of overviews of systematic reviews for prevention and health, especially on emerging determinants of health, where there is little conceptual or methodological uniformity between studies. © Springer International Publishing Switzerland 2016.
- Dietary intake of Brazilian adolescents(2015) AZEREDO, Catarina Machado; REZENDE, Leandro Fornias Machado de; CANELLA, Daniela Silva; CLARO, Rafael Moreira; CASTRO, Ines Rugani Ribeiro de; LUIZ, Olinda do Carmo; LEVY, Renata BertazziObjective: To analyse the dietary intake of Brazilian adolescents and investigate its association with sociodemographic factors as well as health-risk and health-protective behaviours. Design: Cross-sectional study. Setting: The study was based on data supplied by the National Survey of Schoolchildren's Health (2012) on sociodemographic factors, dietary intake and health-risk and health-protective behaviours of schoolchildren in Brazil. A nutritional scale was elaborated combining markers of healthy and unhealthy diets. Poisson regression analysis was applied to investigate the association between the sociodemographic factors and regular intake (>= 5 times/week) of selected foods; linear regression analysis was applied to investigate the association of sociodemographic and behavioural factors with nutritional scale score. Subjects: A total of 109 104 adolescents attending the ninth year of education at 2842 schools in Brazil. Results: Fewer than 30 % of the adolescents consumed raw or cooked vegetables on a regular basis, whereas more than one-third reported regular intake of sweets, soft drinks and sweet biscuits. Adolescents from the southern area and the oldest ones were those most exposed to inadequate dietary intake. The nutritional scale average score was higher in the students attending public school and exhibited a positive correlation with protective behaviours, such as being physically active, having meals with parents and eating breakfast, and a negative correlation with risk behaviours such as eating while studying or watching television and having smoked, drunk alcohol or used other drugs in the previous 30 d. Conclusions: The results indicate an association between undesirable nutritional habits and other risk behaviours among Brazilian adolescents.
- BEING YOUNG-BLACK-MALE INCREASES THE ODDS OF SUFFERING POLICE NON-LETHAL VIOLENCE IN BRAZIL, ACCORDING TO THE NATIONAL HEALTH SURVEY 2013(2018) PERES, Maria Fernanda; LEVY, Renata Bertazzi; REZENDE, Leandro Fornias Machado de; LUIZ, Olinda do Carmo; GRANGEIRO, Alexandre