Sedentary behavior, abdominal obesity and healthcare costs in Brazilian adults with cardiovascular diseases: a cross-sectional study

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ABSTRACT

BACKGROUND:

Research on the economic burden of sedentary behavior and abdominal obesity on health expenses associated with cardiovascular diseases is scarce.

OBJECTIVE:

The objective of this study was to verify whether sedentary behavior, isolated and combined with abdominal obesity, influences the medication expenditure among adults with cardiovascular diseases.

DESIGN AND SETTING:

This cross-sectional study was conducted in the city of President Prudente, State of São Paulo, Brazil in 2018.

METHODS:

The study included adults with cardiovascular diseases, aged 30-65 years, who were treated by the Brazilian National Health Services. Sedentary behavior was assessed using a questionnaire. Abdominal obesity was defined by waist circumference. Medication expenditures were verified using the medical records of each patient.

RESULTS:

The study included a total of 307 adults. Individuals classified in the group with risk factor obesity combined (median [IQ] USD$ 29.39 [45.77]) or isolated (median [IQ] USD$ 27.17 [59.76]) to sedentary behavior had higher medication expenditures than those belonging to the non-obese with low sedentary behavior group (median [IQ] USD$ 13.51 [31.42]) (P = 0.01). The group with combined obesity and sedentary behavior was 2.4 (95%CI = 1.00; 5.79) times more likely to be hypertensive.

CONCLUSION:

Abdominal obesity was a determining factor for medication expenses, regardless of sedentary behavior, among adults with cardiovascular diseases.

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Most cited references 49

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World Health Organization 2020 guidelines on physical activity and sedentary behaviour

Fiona Bull, Salih Al-Ansari, Stuart Biddle … (2020)

Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.

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Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.

I-Min Lee, Eric Shiroma, Felipe Lobelo … (2012)

Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population is inactive, this link presents a major public health issue. We aimed to quantify the eff ect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level. For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population. Worldwide, we estimate that physical inactivity causes 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3·9-9·6) of type 2 diabetes, 10% (5·6-14·1) of breast cancer, and 10% (5·7-13·8) of colon cancer. Inactivity causes 9% (range 5·1-12·5) of premature mortality, or more than 5·3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533 000 and more than 1·3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world's population by 0·68 (range 0·41-0·95) years. Physical inactivity has a major health eff ect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially. None.

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Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis

Richard M. Patterson, Eoin McNamara, Marko Tainio … (2018)

Purpose: To estimate the strength and shape of the dose–response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00–1.01) ≤ 8 h/day; 1.04 (1.03–1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99–1.02) ≤ 6 h/day; 1.04 (1.03–1.04) > 6 h/day). The association was linear (1.01 (1.00–1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01–1.04) ≤ 3.5 h/day; 1.06 (1.05–1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99–1.04) ≤ 4 h/day; 1.08 (1.05–1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02–1.04)) and T2D were linear (1.09 (1.07–1.12)). Conclusions: Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6–8 h/day of total sitting and 3–4 h/day of TV viewing was identified, above which the risk is increased. Electronic supplementary material The online version of this article (10.1007/s10654-018-0380-1) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Maria Carolina Castanho Saes Norberto:

ORCID: http://orcid.org/0000-0003-0326-3677

Role: conceptualization (equal)Role: writing – review and editing (equal)Role: investigation (equal)Role: methodology (equal)Role: data curation (equal)Role: validation (equal)Role: formal analysis (equal)Role: conceptualization (equal)Role: reviewed and approved the final version submitted for publication

Monique Yndawe Castanho Araujo:

ORCID: http://orcid.org/0000-0001-8131-8202

Role: project administration (equal)Role: resources (equal)Role: formal analysis (equal)Role: reviewed and approved the final version submitted for publication

Suelen Jane Ricardo:

ORCID: http://orcid.org/0000-0002-8933-6250

Role: investigation (equal)Role: reviewed and approved the final version submitted for publication

Charles Rodrigues Junior:

ORCID: http://orcid.org/0000-0001-8311-4617

Role: investigation (equal)Role: reviewed and approved the final version submitted for publication

Juziane Teixeira Guiça:

ORCID: http://orcid.org/0000-0002-7443-9919

Role: investigation (equal)Role: reviewed and approved the final version submitted for publication

Bruna Camilo Turi-Lynch:

ORCID: http://orcid.org/0000-0002-2803-1058

Role: review and editing (equal)Role: reviewed and approved the final version submitted for publication

Jamile Sanches Codogno:

ORCID: http://orcid.org/0000-0003-4273-9375

Role: supervision (equal)Role: reviewed and approved the final version submitted for publication

Journal

Journal ID (nlm-ta): Sao Paulo Med J

Journal ID (iso-abbrev): Sao Paulo Med J

Journal ID (publisher-id): spmj

Title: São Paulo Medical Journal

Publisher: Associação Paulista de Medicina - APM

ISSN (Print): 1516-3180

ISSN (Electronic): 1806-9460

Publication date (Electronic, pub): 11 December 2023

Publication date (Electronic, collection): 2024

Volume: 142

Issue: 3

Electronic Location Identifier: e2023029

Affiliations

[I ]MD. Master’s Student, Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.

[II ]PhD Professor, Post-graduate Program in Movement Sciences, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.

[III ]MSc, Physical Education, Post-Graduate Program in Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil.

[IV ]MD. Master’s Student, Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.

[V ]MD. Master’s Student, Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.

[VI ]PhD. Professor, Department of Physical Education and Exercise Science, Lander University, Greenwood, South Carolina, United States of America.

[VII ]PhD. Professor, Post-Graduation Program in Movement Sciences, Post-graduate program in Physiotherapy, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.

Author notes

Address for correspondence: Maria Carolina Castanho Saes Norberto, Universidade Estadual Paulista (UNESP), R. Roberto Simonsen, 305 — Presidente Prudente (SP), Brazil. CEP 19060-9000, Tel.: +55 (18) 32295734 / Fax: +55 (18) 32295730. E-mail: mariacarolinasaes12@ 123456hotmail.com

Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil

Conflicts of interest: None

Editor responsible for the evaluation process: Paulo Manuel Pêgo-Fernandes, MD, PhD

Author information

Maria Carolina Castanho Saes Norberto http://orcid.org/0000-0003-0326-3677

Monique Yndawe Castanho Araujo http://orcid.org/0000-0001-8131-8202

Suelen Jane Ricardo http://orcid.org/0000-0002-8933-6250

Charles Rodrigues Junior http://orcid.org/0000-0001-8311-4617

Juziane Teixeira Guiça http://orcid.org/0000-0002-7443-9919

Bruna Camilo Turi-Lynch http://orcid.org/0000-0002-2803-1058

Jamile Sanches Codogno http://orcid.org/0000-0003-4273-9375

Article

Other ID: 00206

DOI: 10.1590/1516-3180.2023.0029.140823

PMC ID: 10718638

PubMed ID: 38055423

SO-VID: 905de65f-c64c-4ab1-a265-fa2995445c3a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License

History

Date received : 27 March 2023

Date revision received : 06 June 2023

Date accepted : 14 August 2023

Page count

Figures: 2, Tables: 2, References: 44

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Sedentary behavior, abdominal obesity and healthcare costs in Brazilian adults with cardiovascular diseases: a cross-sectional study

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ABSTRACT

BACKGROUND:

OBJECTIVE:

DESIGN AND SETTING:

METHODS:

RESULTS:

CONCLUSION:

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Most cited references 49

World Health Organization 2020 guidelines on physical activity and sedentary behaviour

Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.

Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis

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