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      Caminhada e gastos com saúde em adultos usuários do sistema público de saúde brasileiro: estudo transversal retrospectivo Translated title: Walking and health care expenditures among adult users of the Brazilian public healthcare system: retrospective cross-sectional study

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          Abstract

          A inatividade física é um dos maiores desafios à saúde pública devido à sua associação com doenças crônicas e ao impacto econômico sobre o sistema público de saúde. Entretanto, a prática de caminhada pode auxiliar a amenizar esses problemas. Objetivo Verificar se existem associações entre prática de caminhada no lazer, presença de fatores de risco e gastos relacionados ao uso de serviços de saúde em usuários do sistema público de saúde brasileiro. Metodologia A amostra foi composta por 963 adultos. A prática de caminhada foi avaliada a partir de questionário de Baecke. Gasto com tratamento/ano foi avaliado pela demanda por serviços registrados nos prontuários clínicos. Resultados Prática de caminhada como atividade física de lazer foi referida por 64,4% dos participantes. Os grupos de maior prática de caminhada apresentaram menores valores para idade, IMC, CC e gastos com medicamentos. Indivíduos inseridos na categoria de maior envolvimento apresentaram 41% menos chances de estarem inserido no grupo de maior gasto total (OR=0.59; IC95% 0.39-0.89). Conclusão Verificou-se que a prática de caminhada como atividade física de lazer foi a mais frequente para a maioria dos usuários do SUS, a qual foi associada a menores gastos com medicamentos e no total.

          Translated abstract

          Physical inactivity is a major public health challenge due to its association with chronic diseases and the resulting economic impact on the public healthcare system. However, walking can help alleviate these problems. Aim To verify associations between walking during leisure-time, risk factors and health care expenditure among users of the Brazilian public health care system. Methods The sample consisted of 963 adults. Walking was evaluated using the Baecke questionnaire. The total expenditure per year was evaluated through the demand for health care services, verified in the medical records of each participant. Results Walking was reported as a physical activity during leisure-time by 64.4% of the participants. The group with the highest engagement in walking was younger and presented lower values for BMI, WC and expenditure on medication. Participants inserted in the category of higher involvement in walking were 41% less likely to be inserted into the group with higher total expenditure (OR = 0:59; 95% CI 0.39-0.89). Conclusion It was found that walking was the most frequent leisure-time physical activity reported by users of the Brazilian health care system and was associated with lower total and medication expenditure.

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          Most cited references38

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          Non-vigorous physical activity and all-cause mortality: systematic review and meta-analysis of cohort studies.

          Although previous studies have found physical activity to be associated with lower mortality, the dose-response relationship remains unclear. In this systematic review and meta-analysis we quantify the dose-response relationship of non-vigorous physical activity and all-cause mortality. We aimed to include all cohort studies in adult populations with a sample size of more than 10 000 participants that estimated the effect of different levels of light or moderate physical activity on all-cause mortality. We searched Medline, Embase, Cochrane (DARE), Web of Science and Global Health (June 2009). We used dose-response meta-regression models to estimate the relation between non-vigorous physical activity and mortality. We identified 22 studies that met our inclusion criteria, containing 977 925 (334 738 men and 643 187 women) people. There was considerable variation between the studies in their categorization of physical activity and adjustment for potential confounders. We found that 2.5 h/week (equivalent to 30 min daily of moderate intensity activity on 5 days a week) compared with no activity was associated with a reduction in mortality risk of 19% [95% confidence interval (CI) 15-24], while 7 h/week of moderate activity compared with no activity reduced the mortality risk by 24% (95% CI 19-29). We found a smaller effect in studies that looked at walking alone. Being physically active reduces the risk of all-cause mortality. The largest benefit was found from moving from no activity to low levels of activity, but even at high levels of activity benefits accrue from additional activity.
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            Censo Demográfico 2010

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              The effect of walking on fitness, fatness and resting blood pressure: a meta-analysis of randomised, controlled trials.

              The purpose of this review was to perform a meta-analysis on walking intervention studies in order to quantify the magnitude and direction of walking-induced changes that may alter selected cardiovascular risk factors. Twenty-four randomised controlled trials of walking were assessed for quality on a three-point scale. Data from these studies were pooled and treatment effects (TEs) were calculated for six traditional cardiovascular risk variables: body weight, body mass index (BMI), percentage body fat, aerobic fitness (V(O(2) )max in ml kg(-1) min(-1)) and resting systolic and diastolic blood pressure. Weighted TEs were analysed using a random effects model with weights obtained using the inverse of the individual TE variances. Random effects models were used to investigate the influence of both study quality and exercise volume ( or =150 min week(-1)). Random effects modelling showed that walking interventions increased V(O(2) )max and decreased body weight, BMI, percent body fat and resting diastolic blood pressure in previously sedentary adults (p<0.05 for all). The results of this study provide evidence that healthy but sedentary individuals who take up a programme of regular brisk walking improves several known risk factors for cardiovascular disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro )
                1413-8123
                November 2015
                : 20
                : 11
                : 3561-3568
                Affiliations
                [1 ] Universidade Estadual Paulista Júlio de Mesquita Filho Brasil
                Article
                S1413-81232015001103561
                10.1590/1413-812320152011.00092015
                bf5479c0-6b70-4ceb-b2b2-de0e6fb8af74

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Public Health

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=1413-8123&lng=en
                Categories
                Health Policy & Services

                Public health
                Walking,Health care expenditure,Primary health care,Caminhada,Gastos em saúde,Atenção primária à saúde

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