Does context matter? : Domains of physical activity and sedentary behavior and their relations with well-being and health-related quality of life in adults
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2024
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As recomendações públicas para atividade física (AF) incidem no volume e na intensidade para benefícios na saúde física e mental, assim como na redução do comportamento sedentário (CS). No entanto, ambos os comportamentos podem ser acumulados em diversos contextos (domínios) da vida, como no trabalho, no lazer e nos transportes, e ainda não está claro na literatura, qual a relação entre a AF e o CS acumulados em diversos domínios com o bem-estar e a qualidade de vida. Esta tese procurou, através de uma revisão sistemática, três investigações observacionais e uma experimental, esclarecer estas lacunas, analisando ainda se estas relações poderiam ser distintas entre géneros e idades. A revisão sistemática indicou que quando se trata de bem-estar e qualidade de vida, a AF de lazer foi a que apresentou as associações positivas mais consistentes com diversos indicadores de bem-estar, assim como negativas com indicadores de doenças/transtornos mentais. Por outro lado, o CS no trabalho e no lazer foram os mais prejudiciais. Posteriormente, foram analisados dados de investigações observacionais, tendo sido encontrados como principais correlatos negativos para a satisfação com a vida (um dos principais indicadores de bem-estar subjetivo) o CS no trabalho, a perceção financeira baixa e a atividade física no transporte ou no trabalho (AF incidental), resultados em linha com as conclusões da revisão sistemática. Para tentar explorar se os domínios da AF estavam associados a outros indicadores de saúde, foi realizada uma segunda investigação observacional, tendo os seus resultados denotado que em adultos, ser fisicamente ativo através da AF de lazer confere benefícios adicionais à saúde, comparado a ser ativo durante a AF incidental. Estes resultados pareceram ser diferentes entre géneros, indicando que os papéis sociais podem assumir um efeito moderador em alguns benefícios. Uma vez que os domínios do CS têm sido menos explorados na literatura, foi também realizada uma investigação para identificar as relações deste tipo de comportamento nos diversos domínios com indicadores de bem-estar e qualidade de vida. Os resultados evidenciam que para adultos acima dos 25 anos, o CS no trabalho apresentou relações negativas, no entanto, para adultos mais jovens (18-24 anos), acumular tempo sentado durante o tempo de lazer pareceu ser mais prejudicial. Por fim, dados de uma investigação experimental indicaram que os adultos com trabalhos predominantemente sedentários, e que conseguiram reduzir o tempo sentado, foram também aqueles que alcançaram melhores resultados nas avaliações de bem-estar e qualidade de vida após 6 meses. No entanto, quando comparados com aqueles que não reduziram o tempo sentado, esta diferença não foi significativa. Tomados no seu conjunto os resultados desta tese indicam que para além do volume e intensidade, as recomendações de saúde sejam precisas em termos contextuais, indicando também o domínio como um facilitador de bem-estar e qualidade de vida. Além disso, com recomendações mais específicas será possível evitar a mensagem de que as pessoas que apenas conseguem cumprir o mínimo recomendado em domínios não relacionados ao lazer, obterão os mesmos benefícios que aqueles que realizam atividade física de lazer, reduzindo as desigualdades perpetuadas.
Public recommendations for physical activity (PA) focus on volume and intensity to benefit physical and mental health, as well as on the reduction of sedentary behavior (SB). However, both behaviors can be accumulated in different contexts (domains) of life, such as work, leisure, and transport, and it is still not clear in the literature what is the relationship for PA and SB accumulated in different domains with the well-being and quality of life. This thesis sought, through a systematic review, three observational and one experimental investigation, to clarify these gaps, while verifying whether these relationships could be distinct between sexes and age groups. The systematic review indicated that when it comes to well-being and quality of life, leisure-time PA presented the most consistent positive associations with various well-being indicators, as well as negative associations with indicators of mental illnesses/disorders. On the other hand, SB at work and leisure-time were the most harmful. Subsequently, we explored data from one of our observational investigations and found that SB at work, low financial perception, and PA for transport or at work (incidental PA) were the main negative correlates for life satisfaction (one of the main indicators of subjective well-being), which was in line with the findings from the systematic review. To discover whether the PA domains were associated with other health indicators, we also carried out a second observational investigation and found that in adults, being physically active during leisure-time confers additional health benefits compared to being active in incidental PA. These results appeared to differ between genders, indicating that social roles may have a moderating effect on some benefits. Since the domains of SB have been less explored in the literature, we carried out an investigation to identify the relationship of this type of behavior with indicators of well-being and quality of life. We found that for adults over 25 years old, SB at work showed negative relationships, however, for younger adults (18–24 years old), accumulating sitting time during leisure-time seemed to be more harmful. Finally, our experimental research indicated that adults with predominantly sedentary jobs, and who managed to reduce sitting time, were also those who achieved better results in well-being and quality of life assessments after six months. However, when compared to those who did not reduce sitting time, this difference was not significant. Therefore, we recommend that in addition to volume and intensity, health recommendations must be precise, while indicating the domain as a facilitator of well-being and quality of life. Furthermore, with more specific recommendations, it will be possible to avoid the message that people who can only meet the recommended minimum in non-leisure-related domains will obtain the same benefits as those who perform leisure-time physical activity, reducing perpetuated inequalities.
Public recommendations for physical activity (PA) focus on volume and intensity to benefit physical and mental health, as well as on the reduction of sedentary behavior (SB). However, both behaviors can be accumulated in different contexts (domains) of life, such as work, leisure, and transport, and it is still not clear in the literature what is the relationship for PA and SB accumulated in different domains with the well-being and quality of life. This thesis sought, through a systematic review, three observational and one experimental investigation, to clarify these gaps, while verifying whether these relationships could be distinct between sexes and age groups. The systematic review indicated that when it comes to well-being and quality of life, leisure-time PA presented the most consistent positive associations with various well-being indicators, as well as negative associations with indicators of mental illnesses/disorders. On the other hand, SB at work and leisure-time were the most harmful. Subsequently, we explored data from one of our observational investigations and found that SB at work, low financial perception, and PA for transport or at work (incidental PA) were the main negative correlates for life satisfaction (one of the main indicators of subjective well-being), which was in line with the findings from the systematic review. To discover whether the PA domains were associated with other health indicators, we also carried out a second observational investigation and found that in adults, being physically active during leisure-time confers additional health benefits compared to being active in incidental PA. These results appeared to differ between genders, indicating that social roles may have a moderating effect on some benefits. Since the domains of SB have been less explored in the literature, we carried out an investigation to identify the relationship of this type of behavior with indicators of well-being and quality of life. We found that for adults over 25 years old, SB at work showed negative relationships, however, for younger adults (18–24 years old), accumulating sitting time during leisure-time seemed to be more harmful. Finally, our experimental research indicated that adults with predominantly sedentary jobs, and who managed to reduce sitting time, were also those who achieved better results in well-being and quality of life assessments after six months. However, when compared to those who did not reduce sitting time, this difference was not significant. Therefore, we recommend that in addition to volume and intensity, health recommendations must be precise, while indicating the domain as a facilitator of well-being and quality of life. Furthermore, with more specific recommendations, it will be possible to avoid the message that people who can only meet the recommended minimum in non-leisure-related domains will obtain the same benefits as those who perform leisure-time physical activity, reducing perpetuated inequalities.
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SPORT, PHYSICAL EDUCATION, SEDENTARINESS, PHYSICAL ACTIVITY, DESPORTO, EDUCAÇÃO FÍSICA, SEDENTARISMO, ATIVIDADE FÍSICA