Sedentary Behavior, Physical Inactivity, and the Prevalence of Hypertension, Diabetes, and Obesity During COVID-19 in Brazil.

Abstract

Objectives: To analyze, across the periods before, during, and after the implementation of Social Isolation and Distancing Measures (IMDIS): (a) changes in the prevalence of non-communicable chronic diseases (NCDs), stratified by age group in the Brazilian population; and (b) the association between physical inactivity (PI), insufficient moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) with the occurrence of these conditions. This cross-sectional study used data from VIGITEL (Brazil's Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey), an annual population-based telephone survey conducted across the country. Data were collected in 2019, 2021, and 2023, with a total sample size of 101,226 participants. Arterial hypertension (AH) and diabetes mellitus (DM) were self-reported, and obesity (OB) was diagnosed using body mass index. PI, insufficient MVPA, and SB were identified via VIGITEL indicators. Chi-square tests assessed differences in prevalence overall and by age group. Logistic regression models estimated odds ratios (ORs) for associations between demographic variables, behavioral factors, and the studied periods. The prevalence of AH and DM was highest among individuals over 60 years, reaching 61% after IMDIS, a period when OB also peaked across all age groups. Individuals aged 30-59 and those over 60 had higher odds of AH, DM, and OB across all periods. Female participants had higher ORs for AH and DM both before and after IMDIS. PI and insufficient MVPA were associated with increased odds of AH, DM, and OB in all periods, while SB significantly elevated the OR for OB at all time points. After IMDIS, there was an increase in the prevalence of AH, DM, and OB among older adults and younger individuals. PI, insufficient MVPA, SB, and advanced age were all associated with a greater likelihood of NCDs at every stage of the study. The high post-IMDIS rates of AH, DM, and OB highlight the need for urgent public health strategies. Low-cost programs, such as live videos and online group sessions, should be included in national physical activity guidelines. These initiatives are affordable, aligned with WHO goals, and reduce PI in IMDIS scenarios. Incorporating them into Academia da Saúde and Agita Brasil strengthens NCD prevention and increases the resilience of the health system for future health crises.