Contribuição da atividade física no perfil lipídico: estudo longitudinal de saúde do adulto (ELSA-Brasil)

Abstract

INTRODUCTION: The habitual physical activity (PA) induce desirable changes in plasma lipid levels, especially the increase of HDL-cholesterol (HDL) and reducing triglycerides (TG). There are similarities between the findings of studies on the advantage that causes PA in plasma lipid levels, however there is still a necessary to explain the role of the frequency and intensity of PA on this benefit. Such information is important for making more specific recommendations for PA to increase HDL and decrease LDL and TG. OBJETIVO: Estimate the contribution of PA to the distribution of HDL, LDL and TG among male and female participants of the baseline of the Longitudinal Study of Adult Health (ELSA Brasil) and to investigate if the association between PA and HDL; PA and TG; PA and LDL is modified according to the different assessment parameters of PA. METHODS: Cross-sectional study with participants aged between 35 and 69 years, both sexes. Data collection was conducted through interviews, anthropometric measurements, and laboratory tests. Participants who used drugs that influence the levels of HDL, LDL and TG were excluded. Physical activity was assessed by a modified International Physical Activity Questionnaire (IPAQ) modified. Three different parameters of PA were considered in the analysis: intensity (mild, moderate and strong); weekly time >150 minutes (WHO criteria) and total time PA in minutes. The analysis was performed by univariate and multivariate linear regression using the logarithmic transformation of TG. For inclusion in the multiple linear regression model the variables that were associated with p value <0,20 was chosen and remained in the final models variables that remained associated with the level of p<0,05, after all adjustments. Multiple linear regression was initially adjusted for sex and age, and then by possible confounding variables. RESULTS: Among the 15.105 participants in the Study ELSA-Brasil, 12,688 were included in this study, and 54.8% were female and the mean age was 50 years (± 8.12), 50% reported white skin, 52% had a higher education. The mean BMI was 26,8kg / m2 (± 4.76), 14% were smokers and 69%, users of alcoholic drink, being 8% excessive alcohol users. The mean values of HDL and LDL were, respectively, 49mg/dL and 134mg/dL for men and 60 mg/dL and 133mg/dL for women. Median values of TG were 131mg/dL for men and 100 mg/dL for women. Concerning weekly physical activity during leisure time, 78% of individuals engaged in light physical activity; 13%, and 9% in moderate, or intense PA, regardless of gender. The LDL proved ssociado the intensity of PA in univariate analysis, but lost significance after adjustment estatítica by sex and age. The final linear regression models showed that the levels of HDL increase with greater intensity of PA, which are higher in practice over 150min / week and grow by directly with the total time of PA. The intensity of PA explained 0.05% of the total distribution of HDL in the study population. The PA >150 min/week and total time explained respectively, 0.11% and 0.16% of the distribution of HDL. After adjustments, TG levels decreased significantly with increasing intensity of PA and with longer PA. The intensity of PA explained 0.19% of the distribution of TG in the population studied, since PA as recommended by WHO explains 0.03% of this distribution, and the total time PA explains 0.08%. Our results reinforce the importance of regular practice of physical activity for increasing HDL and reducing TG, but was not associated with levels of LDL. The best explanation for the intensity distribution of HDL and TG levels, but the relative contribution of PA to the general distribution of HDL and TG levels in the study population was small. Among the different parameters investigated the intensity of PA contributed more to explain the distribution of HDL and TG than the WHO recommendation of practice> 150 min/week. But it is noteworthy that our results reinforce the notion that PA practice as recommended by the WHO brings benefits on levels of these lipids.