The impact of metabolic syndrome (MetS) on healthcare costs remains unclear in the literature. To determine the impact of MetS on primary healthcare costs of adults, as well as to identify the impact of physical activity and other covariates on this phenomenon. This cross-sectional study was conducted in the city of Presidente Prudente, State of São Paulo/Brazil, in 2016. The sample comprised 159 older adults (> 50 years) of both sexes (110 women) who were identified from their medical records in the Brazilian National Health Service. Healthcare costs (US$) were assessed through medical records and divided into medical consultations, medications, laboratory tests, and total costs. MetS was assessed using medical records. The Brazilian National Health Service spent more on consultations (US$ 22.75 versus US$ 19.39; + 17.3%) and medication (US$ 19.65 versus US$ 8.32; + 136.1%) among adults with MetS than among those without MetS, but the costs for laboratory tests were similar (P = 0.343). Total costs were 53.9% higher in adults with MetS than in those without the diagnosis of the disease (P = 0.001). Regarding total costs, there was an increase of US$ 38.97 when five components of MetS were present (P = 0.015), representing an increase of approximately 700%, even after adjusting for sex, age, and physical activity. In conclusion, the presence of the MetS is responsible for increasing primary care costs among older adults, especially in those related to medicines.

Physical activity (PA) practices seem to differ between weekdays and weekends and these pattern changes can affect body fat differently. However, previous studies did not assess the mediation effect of weekday and weekend PA on maintenance of body fat using sophisticated statistical models. To analyze the mediation effect of PA during weekdays and weekends on maintenance of fat mass over a 12-month follow-up. Longitudinal cohort study (12 months) conducted at a public university in Presidente Prudente, Brazil. A sample of 225 adults (117 females) was used. Body fatness and fat mass were assessed using dual-energy X-ray absorptiometry. PA levels were assessed using a pedometer. The statistical analysis consisted of paired-sample t tests, independent-sample t tests, Pearson correlations and mediation models. After 12 months, weekend PA had decreased while body composition indicators remained stable (without changes). The correlation between fat mass at baseline and follow-up was high for both sexes (men: 0.966; women: 0.941; P-value = 0.001 for both). Moreover, PA indices were inversely but moderately related to fat mass at baseline and follow-up. Lastly, weekend PA mediated the association between fat mass at baseline and follow-up (P-value < 0.05) by around 2% and 4%. Weekend PA mediated the association between fat mass at baseline and fat mass after one year of follow-up among these adults. Further studies are required to investigate the association between physical activity, body fat and other variables such as dietary patterns and sleep time.

Leisure-time physical activity seems relevant to prevent the development of chronic diseases and obesity. However, not much is known about the economic burden of these healthy behaviors, mainly in longitudinal designs. This study aimed to analyze the impact of walking and cycling on leisure-time on adiposity and healthcare costs among adults. This longitudinal study was conducted at a medium-size Brazilian city and included 198 participants with no missing data attended in the Brazilian Unified National Health System. Cycling and walking were assessed by a questionnaire with a face-to-face interview at four time-points (baseline, 6-month, 12-month, and 18-month). Healthcare costs were assessed using medical records. Adiposity markers included waist circumference and body fatness. Over the follow-up period, participants who were more engaged in cycling presented lower body fatness (p-value = 0.028) and healthcare costs (p-value = 0.038). However, in the multivariate model, the impact of cycling on costs was not significant (p-value = 0.507) due to the impact of number of chronic diseases (p-value = 0.001). Cycling on leisure-time is inversely related to adiposity in adults, whereas its role on preventing chronic diseases seems the main pathway linking it to cost mitigation.

Objectives: The aims of the study are to quantify the relationship between productivity loss and healthcare costs among adults with cardiovascular diseases and also to verify whether habitual physical activity (HPA) modulates this relationship. Methods: Information was obtained about healthcare costs, productivity loss, and HPA. Results: The sample consisted of 278 adults. Active workers who reported presenteeism and absenteeism due to cardiovascular diseases had higher direct costs (P < 0.05) than those who reported other reasons. Those who reported absenteeism spent US $187.33 more on healthcare services annually than those who did not miss work because of health reasons. However, an annual savings of US $53.00 was observed for each increase in the score of HPA. Conclusions: There was a positive correlation between absenteeism and direct healthcare costs among adults with cardiovascular diseases, and HPA positively affected this relationship.

Background: The aim of this study was to investigate whether health care costs were influenced by trajectories of physical activity (PA) over a 10-year period. Methods: Five hundred and forty-one users of primary health care services in Brazil were followed from 2010 to 2020. PA (questionnaire) was assessed every 2 years. The score of PA was used in latent class trajectory models, and 4 trajectories were chosen: (1) low (participants who started and finished the follow-up with the lowest PA values), (2) moderate (participants who started with moderate PA levels and had a slight decrease), (3) decreasing (participants who showed a marked decrease), and (4) high (participants who started and finished with the highest PA levels). Health care costs were retrieved from medical records. Quantile regression was performed to compare costs according to trajectories of PA. Results: Median values of PA scores decreased over time in all groups, but this was more evident in the Decreasing group (54% decline). Costs in each year became more highly skewed over time, with very high maximum costs (approximately US$ 200) noted in the Low and Decreasing groups. Moderate and High groups had lower costs than the Low group in both the median and 90th percentile analyses. Using the median data, compared with costs in the Low group, costs were reduced by 26% and 43% in the Moderate and High groups, respectively. In the 90th percentile, these reductions were 48% and 55%, respectively. Conclusion: The achieving and maintaining of moderate or high PA levels over 10 years was associated with significant cost savings.

- Objective The study aimed to perform a cost-effectiveness analysis comparing the treatment based on traditional drug therapy (TDT), in relation to alternative treatment based on combined TDT and exercise program (TDT +E) in real-life condition. Methods: The health outcomes monitored during the investigation were metabolic (glucose, cholesterol, and triglycerides) and body composition (weight, body mass index [BMI] and body fat percentage [%BF]) parameters of individuals within each group. Healthcare expenditures from each participant were estimated including information registered in medical records during 12 months of follow-up. Results: The intervention group showed economic advantages in comparison to control group for triglycerides, cholesterol, weight, BMI and body fat percentage and corresponding to savings of US$7.63/mg/dL, US$5.20/mg/dL, US$31.21/kg, US$69.38/kg/m2 and US$19.32/%BF. Results were maintained even after sensitivity analyzes. Conclusions: Exercise programs might be cost-effectiveness to public health interventions among hypertensive patients in primary health care facilities, due to reduced metabolic and body composition variables, which are risk factors for chronic diseases.