Associação entre volume e intensidade dos passos diários com indicadores de saúde cardiometabólica em pessoas idosas

Abstract

The aim of this thesis was to investigate the association between volume and intensity of daily steps with indicators of cardiometabolic health in community-dwelling older adults. Three cross-sectional studies were developed, including older adults aged between 60–80 years, without diagnosed cardiovascular disease and mobility limitation. In study 1 (n=222) the association with arterial stiffness was investigated, in study 2 (n=248) with a continuous cardiometabolic risk score (cMetS) and in study 3 (n=252) with body fat and abdominal fat. The number of steps per day (volume) and peak 30-min cadence (intensity) were measured by accelerometer for one week. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The cMetS was calculated considering blood pressure, waist circumference, HDL-cholesterol, triglycerides, and fasting glucose. Body fat and abdominal fat were measured by dual energy X-ray absorptiometry. The participants were categorized according to steps/day (inactive <5000; low active 5000–7499; active 7500–9999; highly active 10000+), and steps/min (lowest, < 40; low, 40–59; average, 60–79; high, 80–99; highest, 100+). Generalized linear models were used for data analyses with adjustments for confounders. The active and highly active groups had lower aPWV (β = −0.34 m/s; β = −0.51 m/s; p < 0.05, respectively), cMetS (β = –0.29; β = –0.40; p < 0.05, respectively), body fat (β= –2.2%; β= –4.3%; p<0.05; respectively) and abdominal fat (β= –3.6%; β= –5.4%; p<0.05; respectively) compared to the inactive group. Every increment of 1000 steps/day was associated with a decrease of 0.05 m/s in aPWV (p ˂ 0.001), of 0.06 in the cMetS (p <0.001), 0.5% of total body (p <0.001) and 0.7% abdominal fat (p = 0.001). The average, the high, and the highest groups had lower cMetS (β = –0.37; β = –0.42; β = – 0.81; p < 0.05, respectively), and lower body fat (β= –2.4%; β= –4.8%; β= –4.9%; p <0.05; respectively) compared to the lowest group. The high and highest groups of peak cadence had lower abdominal fat (β= –5.5%; β= –5.4%; p<0.05; respectively) compared to the lowest group. Every increment of 10 steps/min in peak 30-min cadence was associated with a decrease of 0.05 m/s in aPWV (p = 0.018), of 0.07 in cMetS (p = 0.003), 0.8% of body fat (p <0.001) and 1.0% abdominal fat (p < 0.001). In conclusion, older adults with greater volume and intensity of daily have better indicators of cardiometabolic health. A volume of more than 7,500 steps/day and a peak cadence of more than 80 steps/min were consistently associated with lower aPWV, cMetS, body fat and abdominal fat in this population. The results of this thesis may help guide recommendations on daily step volume and intensity to improve cardiometabolic health in older adults aged 60 to 80 years without mobility limitation.