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v&#225;rias doen&#231;as cr&#244;nicas podem ter sua origem e progress&#227;o durante a adolesc&#234;ncia&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Para melhorar a sa&#250;de dos adolescentes&#44; &#233; importante promover comportamentos saud&#225;veis desde a inf&#226;ncia e&#44; principalmente&#44; durante a adolesc&#234;ncia&#46; Comportamentos saud&#225;veis s&#227;o um fator determinante para a sa&#250;de&#59; mudan&#231;as positivas podem ter impacto sobre os desfechos gerais da sa&#250;de&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> Os principais comportamentos associados &#224; sa&#250;de dos adolescentes s&#227;o&#58; atividade f&#237;sica&#44; menos tempo envolvido com multim&#237;dia&#44; alimenta&#231;&#227;o saud&#225;vel&#44; aus&#234;ncia de consumo de &#225;lcool e tabaco&#44;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">4&#8211;6</span></a> assim como uso de cafe&#237;na&#47; estimulantes&#44; priva&#231;&#227;o de sono&#44; uso de drogas&#44; sexo sem prote&#231;&#227;o e relacionamentos n&#227;o saud&#225;veis&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> Durante a transi&#231;&#227;o para a adolesc&#234;ncia e durante essa fase da vida&#44; h&#225; um aumento do desejo de experimentar coisas novas&#44; juntamente com a coragem e a curiosidade de testar comportamentos diferentes&#44; muitas vezes n&#227;o saud&#225;veis&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Como a adolesc&#234;ncia &#233; um momento cr&#237;tico para estabelecer uma base para a sa&#250;de de uma pessoa&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> &#233; importante compreender a pr&#225;tica comportamental durante a transi&#231;&#227;o do in&#237;cio da adolesc&#234;ncia at&#233; o seu fim&#46; Estudos sobre h&#225;bitos saud&#225;veis de adolescentes t&#234;m sido focados na rela&#231;&#227;o entre comportamentos individuais e seus desfechos sobre a sa&#250;de&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a> S&#227;o raras as tentativas de combinar v&#225;rios comportamentos relacionados &#224; sa&#250;de para criar uma solu&#231;&#227;o que expresse um estilo de vida saud&#225;vel&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Essa medida pode ser importante para as pol&#237;ticas p&#250;blicas de sa&#250;de&#44; influencia a maneira como os programas criados para promover estilos de vida saud&#225;veis s&#227;o desenvolvidos&#46; Assim&#44; h&#225; uma necessidade de entender como comportamentos saud&#225;veis e um estilo de vida saud&#225;vel variam durante essa fase da vida&#46; Dessa forma&#44; com uma amostra ampla e representativa de adolescentes de 37 pa&#237;ses e regi&#245;es&#44; este estudo teve como objetivo examinar a associa&#231;&#227;o entre a idade e as mudan&#231;as na preval&#234;ncia de comportamentos saud&#225;veis autorrelatados em adolescentes&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Procedimentos e participantes</span><p id="par0025" class="elsevierStylePara elsevierViewall">Os dados s&#227;o provenientes da base de dados da pesquisa internacional <span class="elsevierStyleItalic">Health Behavior in School&#8208;aged Children</span> &#40;HBSC&#41;&#44; de 2010&#44; dispon&#237;vel em <a href="http://www.uib.no/en/hbscdata">http&#58;&#47;&#47;www&#46;uib&#46;no&#47;en&#47;hbscdata</a>&#46; A pesquisa HBSC &#233; feita a cada quatro anos em diversos pa&#237;ses da Europa e da Am&#233;rica do Norte&#44; em amostras representativas de base escolar&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> A pesquisa analisa comportamentos e estilos de vida em adolescentes das 6&#170;&#44; 8&#170; e 10&#170; s&#233;ries&#44; com 11&#44; 13 e 15 anos&#46; Em cada pa&#237;s&#44; os adolescentes s&#227;o recrutados em escolas selecionadas aleatoriamente de uma lista estratificada por regi&#245;es&#46; Os procedimentos da pesquisa HBSC s&#227;o desenvolvidos atrav&#233;s de um protocolo de pesquisa padronizado internacionalmente&#44; a fim de permitir compara&#231;&#245;es transculturais&#46; Os m&#233;todos e a descri&#231;&#227;o do instrumento podem ser encontrados em outros estudos&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> A pesquisa foi conduzida e aprovada de acordo com as diretrizes &#233;ticas dos comit&#234;s de &#233;tica de cada pa&#237;s&#46; Por exemplo&#44; em Portugal&#44; a pesquisa foi conduzida de acordo com o Comit&#234; de &#201;tica da Faculdade de Medicina do Porto e o Sistema Nacional de Prote&#231;&#227;o de Dados&#46; O consentimento informado por escrito para participar do estudo foi exigido dos pais ou respons&#225;veis&#44; com a aprova&#231;&#227;o dos adolescentes&#46; A participa&#231;&#227;o foi an&#244;nima e n&#227;o houve incentivos para participa&#231;&#227;o&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">O n&#250;mero de adolescentes que participaram da pesquisa do HBSC 2010 foi de 213&#46;594 &#40;105&#46;099 meninos&#44; 108&#46;496 meninas&#41;&#46; Para o presente estudo&#44; os adolescentes selecionados foram aqueles que relataram n&#237;veis de atividade f&#237;sica&#44; comportamento sedent&#225;rio baseado em tempo de tela&#44; ingest&#227;o de frutas e vegetais&#44; consumo de &#225;lcool e tabagismo e com 11&#44; 13 e 15 anos &#40;ou seja&#44; as faixas et&#225;rias equivalentes &#224;s 6&#170;&#44; 8&#170; e 10&#170; s&#233;ries escolares&#41;&#46; A amostra final foi composta por 148&#46;839 adolescentes &#40;71&#46;415 meninos&#44; 77&#46;424 meninas&#41;&#46; A amostra final n&#227;o diferiu na distribui&#231;&#227;o por g&#234;nero&#44; idade e comportamentos relacionados &#224; sa&#250;de de todos os adolescentes participantes do HBSC 2010 e daqueles que n&#227;o foram inclu&#237;dos na an&#225;lise&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Medidas</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Caracter&#237;sticas sociodemogr&#225;ficas</span><p id="par0035" class="elsevierStylePara elsevierViewall">Os adolescentes relataram idade&#44; sexo&#44; pessoas com quem moravam e n&#250;mero de irm&#227;os&#46; Al&#233;m disso&#44; a escala de aflu&#234;ncia familiar foi usada para avaliar o n&#237;vel socioecon&#244;mico&#46; Foi perguntado aos adolescentes se a fam&#237;lia possu&#237;a carro&#44; se eles tinham um quarto individual&#44; se viajavam nas f&#233;rias e o n&#250;mero de computadores que havia na casa&#46; Posteriormente&#44; um escore composto foi calculado com base nas respostas a esses quatro itens e uma escala de tr&#234;s pontos foi obtida&#58; baixa &#40;0 a 2&#41;&#44; m&#233;dia &#40;3 a 5&#41; e alta &#40;6 a 9&#41;&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Comportamentos de estilo de vida saud&#225;vel e escore composto do estilo de vida saud&#225;vel</span><p id="par0040" class="elsevierStylePara elsevierViewall">Foi solicitado aos adolescentes que relatassem o n&#250;mero de dias em que tinham sido fisicamente ativos por pelo menos 60 minutos&#47;dia nos &#250;ltimos sete dias&#46; Antes de responder&#44; os adolescentes receberam uma defini&#231;&#227;o de atividade f&#237;sica&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> acompanhada de exemplos de algumas atividades relevantes para a idade&#46; As respostas foram dadas em uma escala de 8 pontos &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>nenhum a 7<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>diariamente&#41;&#46; As respostas foram dicotomizadas em &#8804; 6 vezes ou sete vezes por semana&#44; de acordo com as diretrizes de atividade f&#237;sica&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> Foi solicitado aos adolescentes que indicassem o tempo habitual &#40;horas por dia&#41; em que assistiam a televis&#227;o&#44; jogavam videogames e usavam o computador&#46; O comportamento baseado em tempo de tela foi calculado pela soma desses comportamentos&#46; O tempo de comportamento sedent&#225;rio baseado em tela foi dicotomizado em &#8805; 2 horas e &#60;<span class="elsevierStyleHsp" style=""></span>2 horas di&#225;rias&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> Foi solicitado aos adolescentes que relatassem a frequ&#234;ncia com que consumiam frutas e vegetais&#46; As op&#231;&#245;es foram &#8220;nunca&#8221;&#44; &#8220;menos de uma vez por semana&#8221;&#44; &#8220;uma vez por semana&#8221;&#44; &#8220;2&#8208;4 dias por semana&#8221;&#44; &#8220;5&#8208;6 dias por semana&#8221;&#44; &#8220;uma vez por dia&#8221; e &#8220;v&#225;rias vezes ao dia&#46; Os itens foram dicotomizados em &#8220;menos do que uma vez por dia&#8221; e &#8220;diariamente&#8221;&#44; pois o consumo di&#225;rio de frutas e vegetais &#233; um importante comportamento saud&#225;vel em escolares&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;16</span></a> Foi perguntado aos adolescentes com que frequ&#234;ncia consumiam &#225;lcool &#40;por exemplo&#44; cerveja&#44; vinho&#44; destilados&#41;&#46; Para cada op&#231;&#227;o&#44; as op&#231;&#245;es de resposta foram&#58; &#8220;nunca&#8221;&#44; &#8220;raramente&#8221;&#44; &#8220;todo m&#234;s&#8221;&#44; &#8220;toda semana&#8221; e &#8220;todos os dias&#8221;&#46; A ingest&#227;o de &#225;lcool &#233; prejudicial para a sa&#250;de dos adolescentes&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> As recomenda&#231;&#245;es s&#227;o de abstin&#234;ncia alco&#243;lica para essa faixa et&#225;ria&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> Assim&#44; as respostas foram dicotomizadas entre consumo de &#225;lcool &#40;independentemente da frequ&#234;ncia&#41; e aus&#234;ncia de consumo&#46; O uso de produtos de tabaco foi avaliado atrav&#233;s da quest&#227;o&#58; &#8220;Com que frequ&#234;ncia voc&#234; fuma atualmente&#63;&#8221; As op&#231;&#245;es de resposta eram &#8220;todos os dias&#8221;&#44; &#8220;pelo menos uma vez por semana&#44; mas n&#227;o todos os dias&#8221;&#44; &#8220;menos de uma vez por semana&#8221; ou &#8220;nunca&#8221;&#46; Como n&#227;o h&#225; limiar de seguran&#231;a para o tabagismo&#44; as respostas foram recodificadas como fumante atual &#40;regular ou eventual&#41; e n&#227;o fumante&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A maioria dos estudos sobre a sa&#250;de do adolescente tem se focado na rela&#231;&#227;o entre um desfecho espec&#237;fico de sa&#250;de e um dado comportamento<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a> Entretanto&#44; s&#227;o raros os estudos que tentaram combinar v&#225;rios comportamentos relacionados &#224; sa&#250;de para criar uma medida que expressasse um estilo de vida saud&#225;vel&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Tal medida poderia ser importante para as pol&#237;ticas p&#250;blicas de sa&#250;de&#44; influenciariamdo a maneira como os programas criados para promover estilos de vida saud&#225;veis s&#227;o desenvolvidos&#46; Dessa forma&#44; combinando todos esses comportamentos saud&#225;veis&#44; foi criado um escore composto para um estilo de vida saud&#225;vel&#46; Os adolescentes ganhavam um ponto ao marcar cada uma das seguintes categorias de estilo de vida saud&#225;vel&#58; a&#41; atividade f&#237;sica di&#225;ria&#44; b&#41; consumo di&#225;rio de frutas e vegetais&#44; c&#41; gasto menor do que duas horas di&#225;rias em comportamento sedent&#225;rio baseado em tela&#44; d&#41; aus&#234;ncia de consumo de &#225;lcool&#44; e&#41; n&#227;o fumar&#46; O escore de estilo de vida saud&#225;vel variou de 0 a 5&#44; com escore total de cinco comportamentos saud&#225;veis que representavam um estilo de vida saud&#225;vel&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">An&#225;lise de dados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Para toda a amostra&#44; foram calculadas estat&#237;sticas descritivas &#40;m&#233;dia&#44; desvio&#8208;padr&#227;o e porcentagens&#41;&#46; Estimativas e intervalos de confian&#231;a de 95&#37; foram relatados para a preval&#234;ncia de comportamentos de estilo de vida saud&#225;vel e para o n&#250;mero de crit&#233;rios de comportamento atendidos&#46; Al&#233;m disso&#44; o n&#250;mero m&#233;dio de comportamentos relatados tamb&#233;m foi calculado&#46; Essa informa&#231;&#227;o foi estratificada por idade &#40;11&#44; 13 e 15 anos&#41;&#46; Foram usados o teste qui&#8208;quadrado para tend&#234;ncias e Ancova para analisar a rela&#231;&#227;o entre a idade dos adolescentes&#44; os comportamentos de estilo de vida saud&#225;vel e o n&#250;mero de comportamentos relatados&#46; A an&#225;lise foi estratificada por g&#234;nero&#46; A an&#225;lise estat&#237;stica foi feita com o <span class="elsevierStyleItalic">software</span> SPSS &#40;IBM SPSS&#44; estat&#237;stica para Windows&#44; vers&#227;o 24&#44; NY&#44; EUA&#41;&#46; O n&#237;vel de signific&#226;ncia adotado foi de p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas dos dados da amostra s&#227;o apresentadas na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; A maioria dos adolescentes morava com a m&#227;e &#40;94&#44;1&#37;&#41;&#44; 77&#37; moravam com o pai em casa e mais de 80&#37; tinham irm&#227;os&#46; Apenas 5&#37; foram classificados como de n&#237;vel socioecon&#244;mico mais baixo&#46; Os demais eram de n&#237;vel socioecon&#244;mico m&#233;dio &#40;34&#44;7&#37;&#41; ou alto &#40;60&#44;3&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> apresenta a preval&#234;ncia de comportamentos de estilo de vida saud&#225;vel&#63;&#46; Entre os meninos de 15 anos&#44; os comportamentos saud&#225;veis menos prevalentes foram tempo de tela menor do que duas horas&#47;dia &#40;12&#44;8&#37;&#44; IC95&#37;&#58; 11&#44;7&#8208;14&#44;0&#41;&#44; consumo de frutas e vegetais todos os dias &#40;16&#44;2&#37;&#44; IC95&#37;&#58; 15&#44;1&#44; 17&#44;3&#41; e pr&#225;tica di&#225;ria de atividade f&#237;sica &#40;18&#44;9&#37;&#44; IC95&#37;&#58; 17&#44;8&#44; 20&#44;0&#41;&#46; Por outro lado&#44; a preval&#234;ncia de meninos que n&#227;o consumiam &#225;lcool &#40;89&#44;1&#44;5&#37;&#59; IC95&#37;&#58; 88&#44;6&#44; 89&#44;6&#41; e n&#227;o fumavam &#40;97&#44;3&#37;&#59; IC95&#37;&#58; 97&#44;1&#44; 97&#44;5&#41; foi maior aos 11 anos&#46; A preval&#234;ncia de todos os comportamentos saud&#225;veis diminuiu significativamente com a idade e a tend&#234;ncia decrescente foi mais pronunciada em rela&#231;&#227;o ao consumo de &#225;lcool &#40;&#8208;43&#44;5&#37;&#59; IC95&#37;&#58; &#8208;44&#44;1&#44; &#8208;42&#44;8&#41; e tabagismo &#40;&#8208;21&#44;6&#37;&#59; IC95&#37;&#58; &#8208;22&#44;1&#59; &#8208;21&#46;0&#41; do que em rela&#231;&#227;o &#224; atividade f&#237;sica&#44; tempo de tela inferior a duas horas&#47;dia e consumo di&#225;rio de frutas ou vegetais&#46; Apenas 4&#44;7&#37; &#40;IC 95&#37;&#58; 3&#44;4&#44; 6&#44;0&#41; dos meninos de 11 anos tinham um estilo de vida saud&#225;vel&#46; Os n&#250;meros s&#227;o ainda menores aos 13 anos &#40;3&#44;0&#37;&#59; IC95&#37;&#58; 1&#44;8&#44; 4&#44;2&#41; e 15 anos &#40;1&#44;5&#37;&#59; IC95&#37;&#58; 0&#44;3&#44; 2&#44;7&#41;&#46; A queda apresentou uma tend&#234;ncia significativa &#40;&#8208;3&#44;3&#37;&#59; IC95&#37;&#58; &#8208;3&#44;6&#59; &#8208;2&#44;9&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Entre as meninas de 15 anos&#44; a pr&#225;tica de atividade f&#237;sica di&#225;ria foi o menos prevalente dos comportamentos saud&#225;veis &#40;9&#44;4&#37;&#59; IC95&#37;&#58; 8&#44;3&#59; 10&#44;6&#41;&#44; seguido do tempo de tela menor do que duas horas&#47;dia &#40;18&#44;7&#37;&#59; IC95&#37;&#58; 17&#44;6&#59; 19&#44;8&#41; e consumo di&#225;rio de frutas e vegetais &#40;22&#44;6&#37;&#44; 95&#37; CI&#58; 21&#44;5&#44; 23&#44;6&#41;&#46; Mais de 90&#37; das meninas de 11 anos n&#227;o consumiam &#225;lcool &#40;93&#44;0&#37;&#59; 95&#37; CI&#58; 92&#44;6&#46; 93&#44;3&#41; e n&#227;o fumavam &#40;98&#44;8&#37;&#59; 95&#37; CI&#58; 98&#44;7&#44; 99&#44;0&#41;&#46; No entanto&#44; essa preval&#234;ncia diminui mais de 43&#37; para o n&#227;o consumo de &#225;lcool e mais de 20&#37; para o n&#227;o tabagismo&#46; Apenas 4&#44;4&#37; &#40;IC 95&#37;&#58; 3&#44;2&#44; 5&#44;7&#41; das meninas em 11 anos apresentavam um estilo de vida saud&#225;vel&#46; Os n&#250;meros diminuem para 2&#37; &#40;IC 95&#37;&#58; 0&#44;8&#44; 3&#44;2&#41; aos 13 anos e depois para menos de 1&#37; aos 15 anos&#46; A queda apresentou uma tend&#234;ncia significativa &#40;&#8208;1&#44;5&#37;&#59; IC95&#37;&#58; &#8208;1&#44;7&#44; &#8208;1&#44;3&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A m&#233;dia dos comportamentos saud&#225;veis por pa&#237;s&#44; estratificada por idade&#44; &#233; apresentada na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46; A m&#233;dia de comportamentos saud&#225;veis diminuiu significativamente em todos os pa&#237;ses&#44; dos 11 aos 15 anos&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discuss&#227;o</span><p id="par0075" class="elsevierStylePara elsevierViewall">Este estudo teve como objetivo examinar a associa&#231;&#227;o entre idade e mudan&#231;as na preval&#234;ncia autorrelatada de comportamentos saud&#225;veis em adolescentes&#46; Com o aumento da idade&#44; a preval&#234;ncia de adolescentes com estilo de vida saud&#225;vel diminuiu&#46; Apenas 4&#44;7&#37; dos meninos e 4&#44;4&#37; das meninas com 11 anos&#44; 3&#44;0&#37; dos meninos e 2&#44;0&#37; das meninas com 13 anos e 1&#44;5&#37; dos meninos e 0&#44;8&#37; das meninas com 15 anos de idade obtiveram um escore perfeito no estilo de vida saud&#225;vel&#46; Como um estilo de vida saud&#225;vel tem um impacto positivo na sa&#250;de e &#233; essencial para prevenir o in&#237;cio precoce de doen&#231;as cr&#244;nicas&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> esses resultados mostram que a maioria dos adolescentes est&#225; em risco&#46; As escolhas em rela&#231;&#227;o &#224; sa&#250;de durante a adolesc&#234;ncia podem comprometer sua sa&#250;de futura&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o &#224; atividade f&#237;sica&#44; h&#225; uma forte queda em sua pr&#225;tica dos 11 a 15 anos&#46; Todos os pa&#237;ses e regi&#245;es apresentaram resultados semelhantes que demonstraram uma diminui&#231;&#227;o da atividade f&#237;sica por idade&#46; A redu&#231;&#227;o de atividade f&#237;sica por idade tamb&#233;m foi documentada em estudos pr&#233;vios&#44; com medidas objetivas de atividade f&#237;sica&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">19&#44;20</span></a> &#192; medida que os adolescentes ficam mais velhos&#44; eles ganham maior independ&#234;ncia e s&#227;o expostos a outros ambientes e influ&#234;ncias &#40;por exemplo&#44; escola e pares&#41;&#46; Al&#233;m disso&#44; o custo das atividades tamb&#233;m influencia a diminui&#231;&#227;o da atividade f&#237;sica com a idade&#46; A atividade f&#237;sica durante a inf&#226;ncia &#233; principalmente informal&#46; No entanto&#44; os adolescentes tendem a praticar atividade f&#237;sica formal&#44; que tem custos econ&#244;micos associados &#40;por exemplo&#44; tornar&#8208;se membro de academias&#44; compra de equipamentos&#41;&#46; Dessa forma&#44; entre os adolescentes socioeconomicamente desfavorecidos&#44; h&#225; menos oportunidades e&#44; naturalmente&#44; o n&#250;mero de praticantes de atividade f&#237;sica diminui com a idade&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Em conson&#226;ncia com estudos anteriores&#44;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;22</span></a> o presente estudo indica que o comportamento sedent&#225;rio baseado em tempo de tela aumenta ao longo da adolesc&#234;ncia&#46; Essa tend&#234;ncia tende a aumentar&#44; uma vez que o tempo de tela com novas m&#237;dias aumentou significativamente nos &#250;ltimos anos&#44; especialmente depois que <span class="elsevierStyleItalic">smartphones</span> e dispositivos port&#225;teis&#44; como tablets&#44; alcan&#231;aram mais de 50&#37; do consumo entre adolescentes&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> Esse achado provavelmente reflete duas realidades para os adolescentes&#58; maior demanda acad&#234;mica e maior necessidade de intera&#231;&#227;o social&#46; Atualmente&#44; muitos aplicativos voltados para dispositivos com tela podem ser usados como ferramentas para ajudar os alunos nos deveres de casa e em diversos conte&#250;dos escolares&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Uma redu&#231;&#227;o no consumo de frutas e vegetais na adolesc&#234;ncia tem sido relatada<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> e a idade &#233; considerada um fator determinante desse consumo&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> A trajet&#243;ria decrescente do consumo de frutas e vegetais come&#231;a na inf&#226;ncia e continua at&#233; o in&#237;cio da idade adulta&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> Do in&#237;cio at&#233; a metade da adolesc&#234;ncia&#44; essa trajet&#243;ria decrescente destaca&#8208;se das m&#250;ltiplas mudan&#231;as no estilo de vida e nos aspectos f&#237;sicos e ambientais que ocorrem na adolesc&#234;ncia&#44; como a influ&#234;ncia dos pares ou sua disponibilidade nas escolas&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> A maior liberdade na escolha dos alimentos vivenciada pelos adolescentes e o n&#237;vel de apoio ao consumo de frutas e vegetais durante essa fase podem explicar a deteriora&#231;&#227;o no consumo desses itens durante a adolesc&#234;ncia com o aumento da idade&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Com rela&#231;&#227;o ao uso de &#225;lcool e tabaco&#44; esses comportamentos tendem a ser agrupados&#59; as trajet&#243;rias de consumo dessas subst&#226;ncias est&#227;o ligadas entre si&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> &#192; medida que a idade aumenta&#44; o consumo de &#225;lcool e o tabagismo tamb&#233;m aumentam&#46; Entre os comportamentos saud&#225;veis&#44; esses apresentaram uma maior redu&#231;&#227;o com a idade&#46; A mesma tend&#234;ncia foi observada anteriormente&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> o que significa que a transi&#231;&#227;o do in&#237;cio at&#233; a metade da adolesc&#234;ncia &#233; um per&#237;odo cr&#237;tico para o consumo alco&#243;lico e o tabagismo&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">A diminui&#231;&#227;o geral da preval&#234;ncia de comportamentos saud&#225;veis com a idade mostra que os adolescentes t&#234;m um estilo de vida prejudicial &#224; sua sa&#250;de&#44; colocam em risco sua sa&#250;de no futuro&#46; Isso fica claro neste estudo&#44; no qual menos de 2&#37; t&#234;m um estilo de vida saud&#225;vel aos 15 anos&#46; Como foi demonstrado&#44; os adolescentes se tornam mais independentes com a idade&#59; eles come&#231;am a ter interesses diferentes&#44; sofrem forte influ&#234;ncia dos colegas e passam mais tempo na escola sem a supervis&#227;o dos pais&#46; Portanto&#44; s&#227;o necess&#225;rias interven&#231;&#245;es para reverter o aumento da preval&#234;ncia de estilos de vida n&#227;o saud&#225;veis&#46; As escolas s&#227;o uma forma de proporcionar aos adolescentes habilidades para administrar e melhorar seu estilo de vida&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> As escolas s&#227;o importantes porque praticamente todos os adolescentes frequentam a escola&#44; onde passam muito tempo&#44; e nas escolas recebem os conhecimentos que podem ser usados para melhorar sua sa&#250;de&#46; H&#225; evid&#234;ncias de que a interven&#231;&#227;o de componente &#250;nico ou de multicomponentes nas escolas pode melhorar os comportamentos saud&#225;veis dos adolescentes em curto e longo prazo&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">24&#44;25&#44;28</span></a> Portanto&#44; um grande n&#250;mero de adolescentes poderia se beneficiar dessas interven&#231;&#245;es&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Este estudo tem pontos fortes e limita&#231;&#245;es que devem ser reconhecidos&#46; Um ponto forte &#233; que os achados s&#227;o provenientes de um estudo internacional composto por 42 pa&#237;ses com os mesmos instrumentos padronizados&#44; s&#227;o&#44; portanto&#44; pass&#237;veis de compara&#231;&#245;es&#46; Vale ressaltar a for&#231;a do fato de que apenas 5&#37; dos participantes t&#234;m baixo n&#237;vel na escala de abastan&#231;a familiar&#46; Espera&#8208;se&#44; portanto&#44; que seja poss&#237;vel generalizar os resultados&#44; porque n&#227;o h&#225; varia&#231;&#227;o significativa entre o n&#237;vel socioecon&#244;mico dos adolescentes&#46; O banco de dados do estudo HBSC cont&#233;m v&#225;rios valores ausentes&#46; Mais de 40&#46;000 adolescentes n&#227;o relataram os comportamentos saud&#225;veis e foram exclu&#237;dos da an&#225;lise de dados porque n&#227;o foi poss&#237;vel criar um escore combinado de estilo de vida saud&#225;vel baseado nos cinco comportamentos saud&#225;veis&#46; A coleta de dados baseou&#8208;se em informa&#231;&#245;es autorrelatadas&#44; sujeitas a vieses&#46; Al&#233;m disso&#44; consumir frutas ou vegetais diariamente n&#227;o significa que os adolescentes necessariamente consumiram as por&#231;&#245;es recomendadas para esses itens&#46; Seria importante medir com precis&#227;o o consumo de frutas e vegetais para determinar se o consumo est&#225; em acordo com as diretrizes&#47;recomenda&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> Por fim&#44; o desenho transversal impede uma infer&#234;ncia causal para a rela&#231;&#227;o entre um estilo de vida saud&#225;vel e a idade&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Os resultados deste estudo destacam que ainda h&#225; muito trabalho a ser feito para promover estilos de vida saud&#225;veis e conscientizar os adolescentes sobre os potenciais benef&#237;cios para a sua sa&#250;de&#46; Sabe&#8208;se que os comportamentos relacionados &#224; sa&#250;de s&#227;o estabelecidos durante esse per&#237;odo de desenvolvimento&#46; Por isso&#44; compreender a melhor forma de promover estilos de vida saud&#225;veis ainda &#233; de import&#226;ncia crucial nessa fase da vida&#46; Tamb&#233;m &#233; importante destacar que a menor preval&#234;ncia de adolescentes com estilo de vida saud&#225;vel parece corroborar que comportamentos n&#227;o saud&#225;veis tendem a se agrupar&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> As escolas tamb&#233;m podem melhorar o estilo de vida dos adolescentes atrav&#233;s do conhecimento&#46; Os seguintes pontos s&#227;o importantes para ensinar aos adolescentes&#58; as diretrizes f&#237;sicas&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> os problemas de sa&#250;de associados ao comportamento sedent&#225;rio com base no tempo de tela&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> a recomenda&#231;&#227;o sobre a quantidade de tempo adequada a ser gasto com esse comportamento&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> os h&#225;bitos de alimenta&#231;&#227;o saud&#225;vel&#44; a recomenda&#231;&#227;o sobre o consumo di&#225;rio de frutas e vegetais<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;16</span></a> e a abstin&#234;ncia de &#225;lcool<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> e tabagismo&#46; O conhecimento pode n&#227;o ser suficiente para melhorar o estilo de vida dos adolescentes&#44; mas ter o conhecimento posto em pr&#225;tica pode aumentar as chances de conscientizar os adolescentes sobre a import&#226;ncia de comportamentos saud&#225;veis&#44; com a inten&#231;&#227;o de que essa gera&#231;&#227;o possa tomar decis&#245;es fundamentadas no conhecimento sobre sua sa&#250;de&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflitos de interesse</span><p id="par0115" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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              "titulo" => "Comportamentos de estilo de vida saud&#225;vel e escore composto do estilo de vida saud&#225;vel"
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            1 => "Health behavior in school&#8208;aged children"
            2 => "Physical activity"
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            1 => "Comportamento relacionado &#224; sa&#250;de em escolares"
            2 => "Atividade f&#237;sica"
            3 => "Comportamento sedent&#225;rio"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Using a wide and representative sample of adolescents from 37 countries&#44; this study aimed to analyze how age changes adolescents&#8217; healthy lifestyle&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The study included 148&#44;839 adolescents who participated in the Health Behavior in School&#8208;aged Children 2010 survey&#46; A composite score of a healthy lifestyle was created using the combination of daily physical activity&#44; daily fruit and vegetable consumption&#44; &#60;2<span class="elsevierStyleHsp" style=""></span>h daily on screen&#8208;based behaviors&#44; abstinence from alcohol&#44; and abstinence from tobacco products&#46; Healthy lifestyle measures were based on self&#8208;report&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">4&#46;7&#37; of boys and 4&#46;4&#37; of girls aged 11 years&#44; 3&#37; of boys and 2&#37; of girls aged 13 years&#44; and 1&#46;5&#37; of boys and 0&#46;8&#37; of girls aged 15 scored perfectly on the healthy lifestyle score&#46; As age increased&#44; the prevalence of adolescents with a healthy lifestyle decreased&#46; In 37 countries and regions&#44; the prevalence of healthy behaviors decreased linearly between early adolescence and the age of 15 years&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In general&#44; adolescents do not have a healthy lifestyle&#46; Results from this study highlight that there is still much work to be done in promoting healthy lifestyles and to raise awareness among adolescents of the potential risk to their health status&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Com o uso de uma amostra ampla e representativa de adolescentes de 37 pa&#237;ses&#44; analisar como a idade muda o estilo de vida saud&#225;vel dos adolescentes&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Participaram 148&#46;839 adolescentes provenientes da pesquisa <span class="elsevierStyleItalic">Health Behavior in School&#8208;aged Children</span>&#44; de 2010&#46; Foi elaborado um escore composto de um estilo de vida saud&#225;vel&#44; com a combina&#231;&#227;o de atividade f&#237;sica di&#225;ria&#44; consumo di&#225;rio de frutas e vegetais&#44; menos de duas horas di&#225;rias de comportamento sedent&#225;rio baseado em tempo de tela&#44; abstin&#234;ncia de &#225;lcool e abstin&#234;ncia de produtos de tabaco&#46; As medidas do estilo de vida saud&#225;vel foram baseadas em autorrelato&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Obtiveram um escore perfeito no estilo de vida saud&#225;vel 4&#44;7&#37; dos meninos e 4&#44;4&#37; das meninas de 11 anos&#44; 3&#37; dos meninos e 2&#37; das meninas de 13 anos e 1&#44;5&#37; dos meninos e 0&#44;8&#37; das meninas de 15 anos&#46; Com o aumento da idade&#44; a preval&#234;ncia de adolescentes com estilo de vida saud&#225;vel diminuiu&#46; Em 37 pa&#237;ses e regi&#245;es&#44; a preval&#234;ncia de comportamentos saud&#225;veis diminuiu linearmente entre o in&#237;cio da adolesc&#234;ncia e os 15 anos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Em geral&#44; os adolescentes n&#227;o t&#234;m um estilo de vida saud&#225;vel&#46; Os resultados deste estudo destacam que ainda h&#225; muito trabalho a ser feito na promo&#231;&#227;o de estilos de vida saud&#225;veis e na conscientiza&#231;&#227;o dos adolescentes sobre os riscos potenciais para o seu estado de sa&#250;de&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Como citar este artigo&#58; Marques A&#44; Loureiro N&#44; Avelar&#8208;Rosa B&#44; Naia A&#44; Matos MG&#46; Adolescents&#8217; healthy lifestyle&#46; J Pediatr &#40;Rio J&#41;&#46; 2020&#59;96&#58;217&#8211;24&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Idade</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>11 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>13 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Vive com a m&#227;e</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Vive com o pai</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tem irm&#227;os ou irm&#227;</span>s</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#8208;2 irm&#227;os&#47;irm&#227;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;3 irm&#227;os&#47;irm&#227;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">EAF</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Baixa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas dos participantes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>148&#46;839&#41;</p>"
        ]
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      1 => array:8 [
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        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">IC&#44; intervalo de confian&#231;a&#46;</p>"
          "tablatextoimagen" => array:2 [
            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Meninos</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Comportamento de estilo de vida saud&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">11 anos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#46;138&#41; &#37; &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">13 anos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#46;816&#41; &#37; &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">15 anos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#46;461&#41; &#37; &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diferen&#231;a entre 15 e 11 anos &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atividade f&#237;sica di&#225;ria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;6 &#40;25&#44;4&#44; 27&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;9 &#40;22&#44;8&#44; 25&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;9 &#40;17&#44;8&#44; 20&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;7&#44;7 &#40;&#8208;8&#44;4&#44; &#8208;6&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tempo de tela &#60;<span class="elsevierStyleHsp" style=""></span>2 horas&#47;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;7 &#40;23&#44;5&#44; 25&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;1 &#40;15&#44;0&#44; 17&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;8 &#40;11&#44;7&#44; 14&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;11&#44;9 &#40;&#8208;12&#44;6&#44; &#8208;11&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Consumo di&#225;rio de frutas e vegetais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;5 &#40;21&#44;3&#44; 23&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;1 &#40;18&#44;0&#44; 20&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;2 &#40;15&#44;1&#44; 17&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;6&#44;3 &#40;&#8208;7&#44;0&#44; &#8208;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sem consumo de &#225;lcool&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#44;1 &#40;88&#44;6&#44; 89&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#44;9 &#40;76&#44;3&#44; 77&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#44;3 &#40;54&#44;4&#44; 56&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;33&#44;8 &#40;&#8208;34&#44;6&#44; &#8208;33&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sem tabagismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;3 &#40;97&#44;1&#44; 97&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#44;8 &#40;91&#44;4&#44; 92&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#44;7 &#40;76&#44;1&#44; 77&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;20&#44;6 &#40;&#8208;21&#44;2&#44; &#8208;20&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero de comportamentos relatados</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nenhum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4 &#40;&#8208;1&#44;0&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#40;0&#44;5&#44; 3&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;4 &#40;5&#44;2&#44; 7&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;0 &#40;5&#44;7&#44; 6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1 comportamento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;9 &#40;2&#44;6&#44; 5&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;9 &#40;7&#44;7&#44; 10&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;6 &#40;18&#44;5&#44; 20&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;7 &#40;15&#44;2&#44; 16&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2 comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;9 &#40;26&#44;7&#44; 29&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;9 &#40;29&#44;9&#44; 32&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;4 &#40;32&#44;4&#44; 34&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;6 &#40;4&#44;7&#44; 6&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3 comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;9 &#40;41&#44;9&#44; 43&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;9 &#40;38&#44;9&#44; 40&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;6 &#40;28&#44;5&#44; 30&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;13&#44;3 &#40;&#8208;14&#44;2&#44; &#8208;12&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>4 comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#44;2 &#40;19&#44;0&#44; 21&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;6 &#40;14&#44;4&#44; 16&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;5 &#40;8&#44;3&#44; 10&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;10&#44;7 &#40;&#8208;11&#44;3&#44; &#8208;10&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5 comportamentos <a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;7 &#40;3&#44;4&#44; 6&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;1&#44;8&#44; 4&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#40;0&#44;3&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;3&#44;3 &#40;&#8208;3&#44;6&#44; &#8208;2&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Todos os comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M&#233;dia do comportamento relatado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;6&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;3&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;8&#44; 1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;0&#44;8 &#40;&#8208;0&#44;8&#44; &#8208;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2284823.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Meninas</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Comportamento de estilo de vida saud&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">11 anos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22788&#41;&#37; &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">13 anos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27207&#41; &#37; &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">15 anos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27429&#41; &#37; &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diferen&#231;a entre 15 e 11 anos &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atividade f&#237;sica di&#225;ria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;2 &#40;17&#44;0&#44; 19&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;9 &#40;11&#44;8&#44; 14&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;4 &#40;8&#44;3&#44; 10&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;8&#44;8 &#40;&#8208;9&#44;4&#44; &#8208;8&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tempo de tela &#60;<span class="elsevierStyleHsp" style=""></span>2 horas&#47;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;3 &#40;32&#44;3&#44; 34&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#44;6 &#40;19&#44;5&#44; 21&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;7 &#40;17&#44;6&#44; 19&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;14&#44;6 &#40;&#8208;15&#44;4&#44; &#8208;13&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Consumo di&#225;rio de frutas e vegetais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;3 &#40;28&#44;2&#44; 30&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;8 &#40;22&#44;8&#44; 24&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;6 &#40;21&#44;5&#44; 23&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;6&#44;7 &#40;&#8208;7&#44;5&#44; &#8208;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sem consumo de &#225;lcool&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#44;0 &#40;92&#44;6&#44; 93&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#44;8 &#40;76&#44;2&#44; 77&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;5 &#40;48&#44;7&#44; 50&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;43&#44;5 &#40;&#8208;44&#44;1&#44; &#8208;42&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sem tabagismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#44;8 &#40;98&#44;7&#44; 99&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#44;1 &#40;91&#44;8&#44; 92&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#44;3 &#40;76&#44;7&#44; 77&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;21&#44;6 &#40;&#8208;22&#44;1&#44; &#8208;21&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#250;mero de comportamentos relatados</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nenhum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2 &#40;&#8208;1&#44;1&#44; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#40;1&#44;2&#44; 3&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;7 &#40;7&#44;6&#44; 9&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;6 &#40;8&#44;2&#44; 8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1 comportamento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;8 &#40;1&#44;5&#44; 4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;3 &#40;9&#44;2&#44; 11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;1 &#40;22&#44;1&#44; 24&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#44;4 &#40;19&#44;8&#44; 20&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2 comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;0 &#40;27&#44;9&#44; 30&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#44;6 &#40;33&#44;6&#44; 35&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#44;0 &#40;33&#44;0&#44; 35&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;0 &#40;4&#44;2&#44; 5&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3 comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;1 &#40;43&#44;1&#44; 45&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;5 &#40;36&#44;5&#44; 38&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;1 &#40;25&#44;0&#44; 27&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;18&#44;0 &#40;&#8208;18&#44;9&#44; &#8208;17&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>4 comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;6 &#40;18&#44;4&#44; 20&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;2 &#40;12&#44;1&#44; 14&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;2 &#40;6&#44;1&#44; 8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;12&#44;4 &#40;&#8208;13&#44;0&#44; &#8208;11&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5 comportamentos<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;4 &#40;3&#44;2&#44; 5&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;0&#44;8&#44; 3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8 &#40;&#8208;0&#44;3&#44; 2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;1&#44;5 &#40;&#8208;1&#44;7&#44; &#8208;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Todos os comportamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia do comportamento relatado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#40;2&#44;7&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;3&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;8&#44; 1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8208;0&#44;9 &#40;&#8208;0&#44;9&#44; &#8208;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Avaliado pelo teste do qui&#8208;quadrado para tend&#234;ncia&#46;</p>"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Avaliado por Ancova para an&#225;lise de contraste linear&#46; As an&#225;lises foram ajustadas para o fato de morar com a m&#227;e&#44; morar com o pai&#44; ter irm&#227;os ou irm&#227;s e escala de abastan&#231;a familiar&#46;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">EUA&#44; Estados Unidos da Am&#233;rica&#59; IC&#44; intervalo de confian&#231;a&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Pa&#237;ses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Meninos m&#233;dia &#40;IC 95&#37;&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Meninas m&#233;dia &#40;IC 95&#37;&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">11 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">13 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">11 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">13 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Irlanda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3222&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;2&#44;9&#44; 3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;6&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;2&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;2&#44;9&#44; 3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;1&#44;9&#44; 2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Maced&#244;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3073&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;9 &#40;2&#44;8&#44; 2&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;2&#44;9&#44; 3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;3&#44; 2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Su&#237;&#231;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5435&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;3&#44;0&#44; 3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;9 &#40;1&#44;8&#44; 2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;2 &#40;3&#44;1&#44; 3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#40;2&#44;3&#44; 2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Alemanha&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ucr&#226;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3858&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;7&#44; 1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#40;2&#44;6&#44; 2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#40;1&#44;7&#44; 1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eslov&#234;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4337&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;5&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#40;2&#44;6&#44; 2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;2&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;7&#44; 1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Su&#233;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5423&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;4&#44; 2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;7&#44; 1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#40;2&#44;6&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#40;1&#44;6&#44; 1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hungria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4151&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;0&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;6&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;8 &#40;2&#44;7&#44; 2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;5&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R&#250;ssia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4371&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;3&#44; 2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;9 &#40;1&#44;8&#44; 2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#40;2&#44;3&#44; 2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;9 &#40;1&#44;8&#44; 1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rep&#250;blica Tcheca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3815&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;4&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#40;1&#44;6&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;8 &#40;2&#44;7&#44; 2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;2&#44;0&#44; 2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;5&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pa&#237;ses Baixos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3675&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;4&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;5&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#40;2&#44;6&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#40;1&#44;4&#44; 1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dinamarca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2876&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;0&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#40;1&#44;4&#44; 1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#40;2&#44;7&#44; 2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2 &#40;2&#44;1&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#40;1&#44;4&#44; 1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gr&#233;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3610&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;4&#44; 2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;0&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;6&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;0&#44; 2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;5&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Esc&#243;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5480&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;2&#44;4&#44; 2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;0&#44; 2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#40;1&#44;7&#44; 1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;6&#44; 2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;1&#44;9&#44; 2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;5&#44; 1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Groenl&#226;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">575&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;4&#44; 2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;1&#44;9&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4 &#40;1&#44;2&#44; 1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;1&#44;8&#44; 2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3 &#40;1&#44;0&#44; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">It&#225;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4058&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;2&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;1&#44;9&#44; 2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#40;1&#44;5&#44; 1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;2&#44;0&#44; 2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;6 &#40;1&#44;5&#44; 1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cro&#225;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5510&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#40;2&#44;3&#44; 2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1 &#40;2&#44;0&#44; 2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;5 &#40;1&#44;4&#44; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;2&#44;5&#44; 2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;0 &#40;2&#44;0&#44; 2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4 &#40;1&#44;3&#44; 1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pa&#237;s de Gales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#40;2&#44;3&#44; 2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;7&#44; 1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5 &#40;1&#44;4&#44; 1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Est&#244;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2805&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;2&#44; 2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;9 &#40;1&#44;8&#44; 2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4 &#40;1&#44;3&#44; 1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4 &#40;2&#44;3&#44; 2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7 &#40;1&#44;6&#44; 1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3 &#40;1&#44;3&#44; 1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Let&#244;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3318&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;2&#44; 2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;7&#44; 1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3 &#40;1&#44;3&#44; 1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;3 &#40;2&#44;3&#44; 2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8 &#40;1&#44;7&#44; 1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2 &#40;1&#44;1&#44; 1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Finl&#226;ndia<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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Vol. 96. Núm. 2.
Páginas 217-224 (março - abril 2020)
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Vol. 96. Núm. 2.
Páginas 217-224 (março - abril 2020)
Artigo Original
Open Access
Adolescents’ healthy lifestyle
Estilo de vida saudável dos adolescentes
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3608
Adilson Marquesa,b,c,
Autor para correspondência
amarques@fmh.ulisboa.pt

Autor para correspondência.
, Nuno Loureiroc,d, Bruno Avelar‐Rosae,f, Ana Naiae,g, Margarida Gaspar de Matosc,e
a Universidade de Lisboa, Faculdade de Motricidade Humana, Centro Interdisciplinar do Estudo da Performance Humana, Lisboa, Portugal
b Universidade Nova de Lisboa, Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Lisboa, Portugal
c Universidade de Lisboa, Faculdade de Medicina, Instituto de Saúde Ambiental, Lisboa, Portugal
d Instituto Politécnico de Beja, Escola Superior de Educação, Beja, Portugal
e Universidade de Lisboa, Faculdade de Motricidade Humana, Lisboa, Portugal
f Universitat de Girona, Girona, Espanha
g Universidade de Lisboa, Faculdade de Arquitetura, Centro de Investigação em Arquitetura, Urbanismo e Design (CIAUD), Lisboa, Portugal
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Informação do artigo
Resume
Texto Completo
Bibliografia
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Estatísticas
Tabelas (3)
Tabela 1. Características dos participantes (n=148.839)
Tabela 2. Comportamento de uma medida composta de estilo de vida saudável
Tabela 3. Média de comportamentos saudáveis em cada país do estudo HBSC
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Abstract
Objective

Using a wide and representative sample of adolescents from 37 countries, this study aimed to analyze how age changes adolescents’ healthy lifestyle.

Methods

The study included 148,839 adolescents who participated in the Health Behavior in School‐aged Children 2010 survey. A composite score of a healthy lifestyle was created using the combination of daily physical activity, daily fruit and vegetable consumption, <2h daily on screen‐based behaviors, abstinence from alcohol, and abstinence from tobacco products. Healthy lifestyle measures were based on self‐report.

Results

4.7% of boys and 4.4% of girls aged 11 years, 3% of boys and 2% of girls aged 13 years, and 1.5% of boys and 0.8% of girls aged 15 scored perfectly on the healthy lifestyle score. As age increased, the prevalence of adolescents with a healthy lifestyle decreased. In 37 countries and regions, the prevalence of healthy behaviors decreased linearly between early adolescence and the age of 15 years.

Conclusions

In general, adolescents do not have a healthy lifestyle. Results from this study highlight that there is still much work to be done in promoting healthy lifestyles and to raise awareness among adolescents of the potential risk to their health status.

Keywords:
Health
Health behavior in school‐aged children
Physical activity
Sedentary behavior
Alcohol drink
Tobacco
Resumo
Objetivo

Com o uso de uma amostra ampla e representativa de adolescentes de 37 países, analisar como a idade muda o estilo de vida saudável dos adolescentes.

Métodos

Participaram 148.839 adolescentes provenientes da pesquisa Health Behavior in School‐aged Children, de 2010. Foi elaborado um escore composto de um estilo de vida saudável, com a combinação de atividade física diária, consumo diário de frutas e vegetais, menos de duas horas diárias de comportamento sedentário baseado em tempo de tela, abstinência de álcool e abstinência de produtos de tabaco. As medidas do estilo de vida saudável foram baseadas em autorrelato.

Resultados

Obtiveram um escore perfeito no estilo de vida saudável 4,7% dos meninos e 4,4% das meninas de 11 anos, 3% dos meninos e 2% das meninas de 13 anos e 1,5% dos meninos e 0,8% das meninas de 15 anos. Com o aumento da idade, a prevalência de adolescentes com estilo de vida saudável diminuiu. Em 37 países e regiões, a prevalência de comportamentos saudáveis diminuiu linearmente entre o início da adolescência e os 15 anos.

Conclusões

Em geral, os adolescentes não têm um estilo de vida saudável. Os resultados deste estudo destacam que ainda há muito trabalho a ser feito na promoção de estilos de vida saudáveis e na conscientização dos adolescentes sobre os riscos potenciais para o seu estado de saúde.

Palavras‐chave:
Saúde
Comportamento relacionado à saúde em escolares
Atividade física
Comportamento sedentário
Bebida alcoólica
Tabaco
Texto Completo
Introdução

O período de adolescência pode ser crítico para a saúde e a ocorrência de doenças durante a vida dos indivíduos,1 porque há algumas evidências de que hábitos adquiridos na adolescência podem permanecer até a idade adulta. Por exemplo, os hábitos de consumo alcoólico durante a adolescência aumentam a probabilidade de consumo pesado na vida adulta,2 assim como o consumo alimentar na adolescência é um preditor do consumo na idade adulta.3 Por esse motivo, várias doenças crônicas podem ter sua origem e progressão durante a adolescência.1

Para melhorar a saúde dos adolescentes, é importante promover comportamentos saudáveis desde a infância e, principalmente, durante a adolescência. Comportamentos saudáveis são um fator determinante para a saúde; mudanças positivas podem ter impacto sobre os desfechos gerais da saúde.4 Os principais comportamentos associados à saúde dos adolescentes são: atividade física, menos tempo envolvido com multimídia, alimentação saudável, ausência de consumo de álcool e tabaco,4–6 assim como uso de cafeína/ estimulantes, privação de sono, uso de drogas, sexo sem proteção e relacionamentos não saudáveis.7 Durante a transição para a adolescência e durante essa fase da vida, há um aumento do desejo de experimentar coisas novas, juntamente com a coragem e a curiosidade de testar comportamentos diferentes, muitas vezes não saudáveis.8

Como a adolescência é um momento crítico para estabelecer uma base para a saúde de uma pessoa,1,2 é importante compreender a prática comportamental durante a transição do início da adolescência até o seu fim. Estudos sobre hábitos saudáveis de adolescentes têm sido focados na relação entre comportamentos individuais e seus desfechos sobre a saúde.9,10 São raras as tentativas de combinar vários comportamentos relacionados à saúde para criar uma solução que expresse um estilo de vida saudável.11 Essa medida pode ser importante para as políticas públicas de saúde, influencia a maneira como os programas criados para promover estilos de vida saudáveis são desenvolvidos. Assim, há uma necessidade de entender como comportamentos saudáveis e um estilo de vida saudável variam durante essa fase da vida. Dessa forma, com uma amostra ampla e representativa de adolescentes de 37 países e regiões, este estudo teve como objetivo examinar a associação entre a idade e as mudanças na prevalência de comportamentos saudáveis autorrelatados em adolescentes.

MétodosProcedimentos e participantes

Os dados são provenientes da base de dados da pesquisa internacional Health Behavior in School‐aged Children (HBSC), de 2010, disponível em http://www.uib.no/en/hbscdata. A pesquisa HBSC é feita a cada quatro anos em diversos países da Europa e da América do Norte, em amostras representativas de base escolar.12 A pesquisa analisa comportamentos e estilos de vida em adolescentes das 6ª, 8ª e 10ª séries, com 11, 13 e 15 anos. Em cada país, os adolescentes são recrutados em escolas selecionadas aleatoriamente de uma lista estratificada por regiões. Os procedimentos da pesquisa HBSC são desenvolvidos através de um protocolo de pesquisa padronizado internacionalmente, a fim de permitir comparações transculturais. Os métodos e a descrição do instrumento podem ser encontrados em outros estudos.12 A pesquisa foi conduzida e aprovada de acordo com as diretrizes éticas dos comitês de ética de cada país. Por exemplo, em Portugal, a pesquisa foi conduzida de acordo com o Comitê de Ética da Faculdade de Medicina do Porto e o Sistema Nacional de Proteção de Dados. O consentimento informado por escrito para participar do estudo foi exigido dos pais ou responsáveis, com a aprovação dos adolescentes. A participação foi anônima e não houve incentivos para participação.

O número de adolescentes que participaram da pesquisa do HBSC 2010 foi de 213.594 (105.099 meninos, 108.496 meninas). Para o presente estudo, os adolescentes selecionados foram aqueles que relataram níveis de atividade física, comportamento sedentário baseado em tempo de tela, ingestão de frutas e vegetais, consumo de álcool e tabagismo e com 11, 13 e 15 anos (ou seja, as faixas etárias equivalentes às 6ª, 8ª e 10ª séries escolares). A amostra final foi composta por 148.839 adolescentes (71.415 meninos, 77.424 meninas). A amostra final não diferiu na distribuição por gênero, idade e comportamentos relacionados à saúde de todos os adolescentes participantes do HBSC 2010 e daqueles que não foram incluídos na análise.

MedidasCaracterísticas sociodemográficas

Os adolescentes relataram idade, sexo, pessoas com quem moravam e número de irmãos. Além disso, a escala de afluência familiar foi usada para avaliar o nível socioeconômico. Foi perguntado aos adolescentes se a família possuía carro, se eles tinham um quarto individual, se viajavam nas férias e o número de computadores que havia na casa. Posteriormente, um escore composto foi calculado com base nas respostas a esses quatro itens e uma escala de três pontos foi obtida: baixa (0 a 2), média (3 a 5) e alta (6 a 9).

Comportamentos de estilo de vida saudável e escore composto do estilo de vida saudável

Foi solicitado aos adolescentes que relatassem o número de dias em que tinham sido fisicamente ativos por pelo menos 60 minutos/dia nos últimos sete dias. Antes de responder, os adolescentes receberam uma definição de atividade física,13 acompanhada de exemplos de algumas atividades relevantes para a idade. As respostas foram dadas em uma escala de 8 pontos (0=nenhum a 7=diariamente). As respostas foram dicotomizadas em ≤ 6 vezes ou sete vezes por semana, de acordo com as diretrizes de atividade física.13 Foi solicitado aos adolescentes que indicassem o tempo habitual (horas por dia) em que assistiam a televisão, jogavam videogames e usavam o computador. O comportamento baseado em tempo de tela foi calculado pela soma desses comportamentos. O tempo de comportamento sedentário baseado em tela foi dicotomizado em ≥ 2 horas e <2 horas diárias.14 Foi solicitado aos adolescentes que relatassem a frequência com que consumiam frutas e vegetais. As opções foram “nunca”, “menos de uma vez por semana”, “uma vez por semana”, “2‐4 dias por semana”, “5‐6 dias por semana”, “uma vez por dia” e “várias vezes ao dia. Os itens foram dicotomizados em “menos do que uma vez por dia” e “diariamente”, pois o consumo diário de frutas e vegetais é um importante comportamento saudável em escolares.15,16 Foi perguntado aos adolescentes com que frequência consumiam álcool (por exemplo, cerveja, vinho, destilados). Para cada opção, as opções de resposta foram: “nunca”, “raramente”, “todo mês”, “toda semana” e “todos os dias”. A ingestão de álcool é prejudicial para a saúde dos adolescentes.17 As recomendações são de abstinência alcoólica para essa faixa etária.18 Assim, as respostas foram dicotomizadas entre consumo de álcool (independentemente da frequência) e ausência de consumo. O uso de produtos de tabaco foi avaliado através da questão: “Com que frequência você fuma atualmente?” As opções de resposta eram “todos os dias”, “pelo menos uma vez por semana, mas não todos os dias”, “menos de uma vez por semana” ou “nunca”. Como não há limiar de segurança para o tabagismo, as respostas foram recodificadas como fumante atual (regular ou eventual) e não fumante.

A maioria dos estudos sobre a saúde do adolescente tem se focado na relação entre um desfecho específico de saúde e um dado comportamento9,10 Entretanto, são raros os estudos que tentaram combinar vários comportamentos relacionados à saúde para criar uma medida que expressasse um estilo de vida saudável.11 Tal medida poderia ser importante para as políticas públicas de saúde, influenciariamdo a maneira como os programas criados para promover estilos de vida saudáveis são desenvolvidos. Dessa forma, combinando todos esses comportamentos saudáveis, foi criado um escore composto para um estilo de vida saudável. Os adolescentes ganhavam um ponto ao marcar cada uma das seguintes categorias de estilo de vida saudável: a) atividade física diária, b) consumo diário de frutas e vegetais, c) gasto menor do que duas horas diárias em comportamento sedentário baseado em tela, d) ausência de consumo de álcool, e) não fumar. O escore de estilo de vida saudável variou de 0 a 5, com escore total de cinco comportamentos saudáveis que representavam um estilo de vida saudável.

Análise de dados

Para toda a amostra, foram calculadas estatísticas descritivas (média, desvio‐padrão e porcentagens). Estimativas e intervalos de confiança de 95% foram relatados para a prevalência de comportamentos de estilo de vida saudável e para o número de critérios de comportamento atendidos. Além disso, o número médio de comportamentos relatados também foi calculado. Essa informação foi estratificada por idade (11, 13 e 15 anos). Foram usados o teste qui‐quadrado para tendências e Ancova para analisar a relação entre a idade dos adolescentes, os comportamentos de estilo de vida saudável e o número de comportamentos relatados. A análise foi estratificada por gênero. A análise estatística foi feita com o software SPSS (IBM SPSS, estatística para Windows, versão 24, NY, EUA). O nível de significância adotado foi de p <0,05.

Resultados

As características dos dados da amostra são apresentadas na tabela 1. A maioria dos adolescentes morava com a mãe (94,1%), 77% moravam com o pai em casa e mais de 80% tinham irmãos. Apenas 5% foram classificados como de nível socioeconômico mais baixo. Os demais eram de nível socioeconômico médio (34,7%) ou alto (60,3%).

Tabela 1.

Características dos participantes (n=148.839)

 
Sexo
Meninos  48,0 
Meninas  52,0 
Idade
11 anos  29,5 
13 anos  35,0 
15 anos  35,5 
Vive com a mãe
Não  5,9 
Sim  94,1 
Vive com o pai
Não  23,0 
Sim  77,0 
Tem irmãos ou irmãs
Não  16,8 
1‐2 irmãos/irmãs  66,8 
≥3 irmãos/irmãs  16,4 
EAF
Baixa  5,0 
Média  34,7 
Alta  60,3 

EAF, escala de abastança familiar.

A tabela 2 apresenta a prevalência de comportamentos de estilo de vida saudável?. Entre os meninos de 15 anos, os comportamentos saudáveis menos prevalentes foram tempo de tela menor do que duas horas/dia (12,8%, IC95%: 11,7‐14,0), consumo de frutas e vegetais todos os dias (16,2%, IC95%: 15,1, 17,3) e prática diária de atividade física (18,9%, IC95%: 17,8, 20,0). Por outro lado, a prevalência de meninos que não consumiam álcool (89,1,5%; IC95%: 88,6, 89,6) e não fumavam (97,3%; IC95%: 97,1, 97,5) foi maior aos 11 anos. A prevalência de todos os comportamentos saudáveis diminuiu significativamente com a idade e a tendência decrescente foi mais pronunciada em relação ao consumo de álcool (‐43,5%; IC95%: ‐44,1, ‐42,8) e tabagismo (‐21,6%; IC95%: ‐22,1; ‐21.0) do que em relação à atividade física, tempo de tela inferior a duas horas/dia e consumo diário de frutas ou vegetais. Apenas 4,7% (IC 95%: 3,4, 6,0) dos meninos de 11 anos tinham um estilo de vida saudável. Os números são ainda menores aos 13 anos (3,0%; IC95%: 1,8, 4,2) e 15 anos (1,5%; IC95%: 0,3, 2,7). A queda apresentou uma tendência significativa (‐3,3%; IC95%: ‐3,6; ‐2,9).

Tabela 2.

Comportamento de uma medida composta de estilo de vida saudável

Meninos
Comportamento de estilo de vida saudável  11 anos (n=21.138) % (IC 95%)  13 anos (n=24.816) % (IC 95%)  15 anos (n=25.461) % (IC 95%)  pb  Diferença entre 15 e 11 anos (IC 95%) 
Atividade física diária  26,6 (25,4, 27,7)  23,9 (22,8, 25,0)  18,9 (17,8, 20,0)  <0,001  ‐7,7 (‐8,4, ‐6,9) 
Tempo de tela <2 horas/dia  24,7 (23,5, 25,9)  16,1 (15,0, 17,2)  12,8 (11,7, 14,0)  <0,001  ‐11,9 (‐12,6, ‐11,2) 
Consumo diário de frutas e vegetais  22,5 (21,3, 23,7)  19,1 (18,0, 20,2)  16,2 (15,1, 17,3)  <0,001  ‐6,3 (‐7,0, ‐5,6) 
Sem consumo de álcool  89,1 (88,6, 89,5)  76,9 (76,3, 77,5)  55,3 (54,4, 56,1)  <0,001  ‐33,8 (‐34,6, ‐33,1) 
Sem tabagismo  97,3 (97,1, 97,5)  91,8 (91,4, 92,2)  76,7 (76,1, 77,3)  <0,001  ‐20,6 (‐21,2, ‐20,1) 
Número de comportamentos relatados
Nenhum  0,4 (‐1,0, 1,7)  1,7 (0,5, 3,0)  6,4 (5,2, 7,6)  <0,001  6,0 (5,7, 6,3) 
1 comportamento  3,9 (2,6, 5,2)  8,9 (7,7, 10,1)  19,6 (18,5, 20,7)  <0,001  15,7 (15,2, 16,3) 
2 comportamentos  27,9 (26,7, 29,0)  30,9 (29,9, 32,0)  33,4 (32,4, 34,4)  <0,001  5,6 (4,7, 6,4) 
3 comportamentos  42,9 (41,9, 43,9)  39,9 (38,9, 40,9)  29,6 (28,5, 30,6)  <0,001  ‐13,3 (‐14,2, ‐12,5) 
4 comportamentos  20,2 (19,0, 21,4)  15,6 (14,4, 16,7)  9,5 (8,3, 10,7)  <0,001  ‐10,7 (‐11,3, ‐10,0) 
5 comportamentos a  4,7 (3,4, 6,0)  3,0 (1,8, 4,2)  1,5 (0,3, 2,7)  <0,001  ‐3,3 (‐3,6, ‐2,9) 
Todos os comportamentos  Média (IC 95%)  Média (IC 95%)  Média (IC 95%)  pc  Média (IC 95%) 
Média do comportamento relatado  2,6 (2,6, 2,6)  2,3 (2,3, 2,3)  1,8 (1,8, 1,8)  <0,001  ‐0,8 (‐0,8, ‐0,8) 
Meninas
Comportamento de estilo de vida saudável  11 anos (n=22788)% (IC 95%)  13 anos (n=27207) % (IC 95%)  15 anos (n=27429) % (IC 95%)  pb  Diferença entre 15 e 11 anos (IC 95%) 
Atividade física diária  18,2 (17,0, 19,4)  12,9 (11,8, 14,0)  9,4 (8,3, 10,6)  <0,001  ‐8,8 (‐9,4, ‐8,2) 
Tempo de tela <2 horas/dia  33,3 (32,3, 34,4)  20,6 (19,5, 21,6)  18,7 (17,6, 19,8)  <0,001  ‐14,6 (‐15,4, ‐13,9) 
Consumo diário de frutas e vegetais  29,3 (28,2, 30,4)  23,8 (22,8, 24,9)  22,6 (21,5, 23,6)  <0,001  ‐6,7 (‐7,5, ‐5,9) 
Sem consumo de álcool  93,0 (92,6, 93,3)  76,8 (76,2, 77,4)  49,5 (48,7, 50,3)  <0,001  ‐43,5 (‐44,1, ‐42,8) 
Sem tabagismo  98,8 (98,7, 99,0)  92,1 (91,8, 92,4)  77,3 (76,7, 77,8)  <0,001  ‐21,6 (‐22,1, ‐21,0) 
Número de comportamentos relatados
Nenhum  0,2 (‐1,1, 1,5)  2,4 (1,2, 3,6)  8,7 (7,6, 9,9)  <0,001  8,6 (8,2, 8,9) 
1 comportamento  2,8 (1,5, 4,0)  10,3 (9,2, 11,5)  23,1 (22,1, 24,1)  <0,001  20,4 (19,8, 20,9) 
2 comportamentos  29,0 (27,9, 30,1)  34,6 (33,6, 35,5)  34,0 (33,0, 35,0)  <0,001  5,0 (4,2, 5,8) 
3 comportamentos  44,1 (43,1, 45,1)  37,5 (36,5, 38,4)  26,1 (25,0, 27,1)  <0,001  ‐18,0 (‐18,9, ‐17,2) 
4 comportamentos  19,6 (18,4, 20,8)  13,2 (12,1, 14,4)  7,2 (6,1, 8,4)  <0,001  ‐12,4 (‐13,0, ‐11,8) 
5 comportamentosa  4,4 (3,2, 5,7)  2,0 (0,8, 3,2)  0,8 (‐0,3, 2,0)  <0,001  ‐1,5 (‐1,7, ‐1,3) 
Todos os comportamentos  Média (IC 95%)  Média (IC 95%)  Média (IC 95%)  pc  Média (IC 95%) 
Média do comportamento relatado  2,7 (2,7, 2,7)  2,3 (2,3, 2,3)  1,8 (1,8, 1,8)  <0,001  ‐0,9 (‐0,9, ‐0,9) 

IC, intervalo de confiança.

a

Adolescentes com um estilo de vida saudável.

b

Avaliado pelo teste do qui‐quadrado para tendência.

c

Avaliado por Ancova para análise de contraste linear. As análises foram ajustadas para o fato de morar com a mãe, morar com o pai, ter irmãos ou irmãs e escala de abastança familiar.

Entre as meninas de 15 anos, a prática de atividade física diária foi o menos prevalente dos comportamentos saudáveis (9,4%; IC95%: 8,3; 10,6), seguido do tempo de tela menor do que duas horas/dia (18,7%; IC95%: 17,6; 19,8) e consumo diário de frutas e vegetais (22,6%, 95% CI: 21,5, 23,6). Mais de 90% das meninas de 11 anos não consumiam álcool (93,0%; 95% CI: 92,6. 93,3) e não fumavam (98,8%; 95% CI: 98,7, 99,0). No entanto, essa prevalência diminui mais de 43% para o não consumo de álcool e mais de 20% para o não tabagismo. Apenas 4,4% (IC 95%: 3,2, 5,7) das meninas em 11 anos apresentavam um estilo de vida saudável. Os números diminuem para 2% (IC 95%: 0,8, 3,2) aos 13 anos e depois para menos de 1% aos 15 anos. A queda apresentou uma tendência significativa (‐1,5%; IC95%: ‐1,7, ‐1,3).

A média dos comportamentos saudáveis por país, estratificada por idade, é apresentada na tabela 3. A média de comportamentos saudáveis diminuiu significativamente em todos os países, dos 11 aos 15 anos.

Tabela 3.

Média de comportamentos saudáveis em cada país do estudo HBSC

Países  Total  Meninos média (IC 95%)Meninas média (IC 95%)
    11 anos  13 anos  15 anos  11 anos  13 anos  15 anos 
Irlanda  3222  3,0 (2,9, 3,1)  2,6 (2,6, 2,7)  2,2 (2,2, 2,3)  3,0 (2,9, 3,1)  2,6 (2,5, 2,7)  2,0 (1,9, 2,1) 
Macedônia  3073  2,9 (2,8, 2,9)  2,5 (2,5, 2,6)  2,2 (2,1, 2,2)  3,0 (2,9, 3,1)  2,5 (2,5, 2,6)  2,3 (2,3, 2,4) 
Suíça  5435  3,0 (3,0, 3,1)  2,6 (2,5, 2,6)  1,9 (1,8, 2,0)  3,2 (3,1, 3,2)  2,7 (2,6, 2,7)  2,1 (2,0, 2,2) 
EUA  4951  2,8 (2,8, 2,9)  2,6 (2,6, 2,7)  2,3 (2,2, 2,4)  2,9 (2,9, 3,0)  2,5 (2,5, 2,6)  2,2 (2,1, 2,2) 
Luxemburgo  3029  3,0 (2,9, 3,1)  2,6 (2,5, 2,7)  2,0 (1,9, 2,1)  2,9 (2,8, 3,0)  2,6 (2,5, 2,6)  2,1 (2,0, 2,2) 
Bélgicaa  3266  2,9 (2,8, 3,0)  2,4 (2,3, 2,5)  2,0 (1,9, 2,1)  2,8 (2,8, 2,9)  2,4 (2,4, 2,5)  1,9 (1,8, 2,0) 
Israel  3026  2,7 (2,6, 2,7)  2,4 (2,3, 2,5)  2,0 (1,9, 2,1)  2,7 (2,6, 2,7)  2,5 (2,4, 2,5)  2,3 (2,2, 2,3) 
Islândia  9301  2,7 (2,6, 2,7)  2,3 (2,3, 2,4)  2,0 (1,9, 2,0)  2,9 (2,8, 2,9)  2,5 (2,5, 2,5)  2,0 (2,0, 2,1) 
Canadá  11672  2,6 (2,6, 2,7)  2,4 (2,4, 2,4)  2,0 (2,0, 2,1)  2,8 (2,8, 2,9)  2,3 (2,2, 2,3)  1,9 (1,9, 1,9) 
França  4771  2,7 (2,6, 2,8)  2,3 (2,3, 2,4)  1,9 (1,8, 1,9)  2,8 (2,7, 2,8)  2,4 (2,3, 2,4)  2,0 (1,9, 2,0) 
Áustria  3778  2,9 (2,8, 3,0)  2,5 (2,4, 2,5)  1,6 (1,5, 1,6)  3,1 (3,0, 3,1)  2,4 (2,3, 2,5)  1,5 (1,4, 1,6) 
Espanha  3919  2,8 (2,7, 2,9)  2,3 (2,2, 2,3)  1,9 (1,8, 1,9)  2,8 (2,7, 2,9)  2,3 (2,2, 2,3)  1,7 (1,6, 1,8) 
Alemanha  3871  2,8 (2,7, 2,8)  2,3 (2,2, 2,3)  1,6 (1,5, 1,7)  2,9 (2,8, 3,0)  2,4 (2,3, 2,5)  1,7 (1,6, 1,8) 
Romênia  3678  2,6 (2,5, 2,7)  2,2 (2,1, 2,3)  1,7 (1,7, 1,8)  2,7 (2,6, 2,8)  2,3 (2,3, 2,4)  2,0 (1,9, 2,0) 
Eslováquia  3813  2,5 (2,5, 2,6)  2,3 (2,2, 2,3)  1,9 (1,8, 1,9)  2,6 (2,6, 2,7)  2,2 (2,1, 2,3)  1,9 (1,8, 1,9) 
Bélgicab  3257  2,6 (2,6, 2,7)  2,3 (2,2, 2,4)  1,6 (1,6, 1,7)  2,7 (2,6, 2,8)  2,4 (2,3, 2,5)  1,7 (1,6, 1,8) 
Portugal  3349  2,6 (2,5, 2,6)  2,3 (2,2, 2,3)  1,7 (1,7, 1,8)  2,6 (2,6, 2,7)  2,2 (2,1, 2,2)  1,9 (1,8, 2,0) 
Inglaterra  2243  2,6 (2,5, 2,7)  2,3 (2,2, 2,4)  1,9 (1,8, 2,0)  2,7 (2,6, 2,8)  2,2 (2,1, 2,2)  1,7 (1,6, 1,8) 
Polônia  3229  2,5 (2,4, 2,6)  2,1 (2,1, 2,2)  1,9 (1,8, 2,0)  2,6 (2,6, 2,7)  2,2 (2,2, 2,3)  1,8 (1,8, 1,9) 
Ucrânia  3858  2,5 (2,5, 2,6)  2,2 (2,1, 2,3)  1,8 (1,7, 1,9)  2,7 (2,6, 2,8)  2,2 (2,1, 2,3)  1,7 (1,7, 1,8) 
Eslovênia  4337  2,6 (2,5, 2,6)  2,1 (2,1, 2,2)  1,6 (1,5, 1,7)  2,7 (2,6, 2,8)  2,3 (2,2, 2,3)  1,8 (1,7, 1,9) 
Suécia  5423  2,5 (2,4, 2,5)  2,2 (2,1, 2,2)  1,8 (1,7, 1,8)  2,7 (2,6, 2,7)  2,1 (2,1, 2,2)  1,7 (1,6, 1,8) 
Hungria  4151  2,6 (2,5, 2,7)  2,1 (2,0, 2,2)  1,6 (1,6, 1,7)  2,8 (2,7, 2,8)  2,2 (2,1, 2,3)  1,6 (1,5, 1,7) 
Rússia  4371  2,3 (2,3, 2,4)  2,2 (2,1, 2,3)  1,9 (1,8, 2,0)  2,4 (2,3, 2,4)  2,1 (2,1, 2,2)  1,9 (1,8, 1,9) 
República Tcheca  3815  2,5 (2,4, 2,6)  2,2 (2,1, 2,2)  1,7 (1,6, 1,7)  2,8 (2,7, 2,8)  2,0 (2,0, 2,1)  1,6 (1,5, 1,7) 
Países Baixos  3675  2,5 (2,4, 2,6)  2,2 (2,1, 2,3)  1,6 (1,5, 1,7)  2,7 (2,6, 2,7)  2,2 (2,1, 2,2)  1,5 (1,4, 1,6) 
Dinamarca  2876  2,5 (2,5, 2,6)  2,1 (2,0, 2,2)  1,5 (1,4, 1,6)  2,7 (2,7, 2,8)  2,2 (2,1, 2,2)  1,5 (1,4, 1,6) 
Grécia  3610  2,5 (2,4, 2,5)  2,1 (2,0, 2,2)  1,6 (1,6, 1,7)  2,6 (2,5, 2,6)  2,1 (2,0, 2,1)  1,6 (1,5, 1,7) 
Escócia  5480  2,5 (2,4, 2,5)  2,1 (2,0, 2,1)  1,7 (1,7, 1,8)  2,6 (2,6, 2,7)  2,0 (1,9, 2,0)  1,6 (1,5, 1,6) 
Groenlândia  575  2,6 (2,4, 2,8)  2,1 (1,9, 2,3)  1,4 (1,2, 1,7)  2,6 (2,5, 2,8)  2,0 (1,8, 2,2)  1,3 (1,0, 1,5) 
Itália  4058  2,3 (2,2, 2,3)  2,0 (1,9, 2,0)  1,5 (1,5, 1,6)  2,6 (2,5, 2,6)  2,0 (2,0, 2,1)  1,6 (1,5, 1,6) 
Croácia  5510  2,4 (2,3, 2,4)  2,1 (2,0, 2,1)  1,5 (1,4, 1,5)  2,6 (2,5, 2,6)  2,0 (2,0, 2,1)  1,4 (1,3, 1,4) 
País de Gales  3208  2,4 (2,3, 2,5)  2,0 (2,0, 2,1)  1,7 (1,6, 1,8)  2,5 (2,4, 2,5)  1,8 (1,7, 1,9)  1,5 (1,4, 1,6) 
Estônia  2805  2,3 (2,2, 2,4)  1,9 (1,8, 2,0)  1,4 (1,3, 1,5)  2,4 (2,3, 2,5)  1,7 (1,6, 1,8)  1,3 (1,3, 1,4) 
Letônia  3318  2,3 (2,2, 2,3)  1,8 (1,7, 1,9)  1,3 (1,3, 1,4)  2,3 (2,3, 2,4)  1,8 (1,7, 1,9)  1,2 (1,1, 1,3) 
Finlândiac  3103    2,4 (2,3, 2,5)  1,8 (1,7, 1,8)    2,3 (2,2, 2,3)  1,8 (1,7, 1,9) 
Noruegac  1783    2,3 (2,2, 2,4)  1,7 (1,6, 1,8)    2,3 (2,2, 2,4)  1,7 (1,6, 1,8) 

EUA, Estados Unidos da América; IC, intervalo de confiança.

a

Francês.

b

Flamengo.

c

Sem dados de adolescentes com 11 anos. A comparação foi feita entre 15 e 13 anos.

Diferenças entre as idades foram testadas por Ancova. As análises foram ajustadas para o fato de viver com a mãe, viver com o pai, ter irmãos ou irmãs e escala de abastança familiar.

Em todos os países foi observada diferença significativa na média de comportamento relatada entre as idades (p <0,001).

Os países foram organizados pela média geral de comportamentos saudáveis relatados.

Discussão

Este estudo teve como objetivo examinar a associação entre idade e mudanças na prevalência autorrelatada de comportamentos saudáveis em adolescentes. Com o aumento da idade, a prevalência de adolescentes com estilo de vida saudável diminuiu. Apenas 4,7% dos meninos e 4,4% das meninas com 11 anos, 3,0% dos meninos e 2,0% das meninas com 13 anos e 1,5% dos meninos e 0,8% das meninas com 15 anos de idade obtiveram um escore perfeito no estilo de vida saudável. Como um estilo de vida saudável tem um impacto positivo na saúde e é essencial para prevenir o início precoce de doenças crônicas,4 esses resultados mostram que a maioria dos adolescentes está em risco. As escolhas em relação à saúde durante a adolescência podem comprometer sua saúde futura.

Em relação à atividade física, há uma forte queda em sua prática dos 11 a 15 anos. Todos os países e regiões apresentaram resultados semelhantes que demonstraram uma diminuição da atividade física por idade. A redução de atividade física por idade também foi documentada em estudos prévios, com medidas objetivas de atividade física.19,20 À medida que os adolescentes ficam mais velhos, eles ganham maior independência e são expostos a outros ambientes e influências (por exemplo, escola e pares). Além disso, o custo das atividades também influencia a diminuição da atividade física com a idade. A atividade física durante a infância é principalmente informal. No entanto, os adolescentes tendem a praticar atividade física formal, que tem custos econômicos associados (por exemplo, tornar‐se membro de academias, compra de equipamentos). Dessa forma, entre os adolescentes socioeconomicamente desfavorecidos, há menos oportunidades e, naturalmente, o número de praticantes de atividade física diminui com a idade.

Em consonância com estudos anteriores,21,22 o presente estudo indica que o comportamento sedentário baseado em tempo de tela aumenta ao longo da adolescência. Essa tendência tende a aumentar, uma vez que o tempo de tela com novas mídias aumentou significativamente nos últimos anos, especialmente depois que smartphones e dispositivos portáteis, como tablets, alcançaram mais de 50% do consumo entre adolescentes.23 Esse achado provavelmente reflete duas realidades para os adolescentes: maior demanda acadêmica e maior necessidade de interação social. Atualmente, muitos aplicativos voltados para dispositivos com tela podem ser usados como ferramentas para ajudar os alunos nos deveres de casa e em diversos conteúdos escolares.22

Uma redução no consumo de frutas e vegetais na adolescência tem sido relatada24 e a idade é considerada um fator determinante desse consumo.25 A trajetória decrescente do consumo de frutas e vegetais começa na infância e continua até o início da idade adulta.26 Do início até a metade da adolescência, essa trajetória decrescente destaca‐se das múltiplas mudanças no estilo de vida e nos aspectos físicos e ambientais que ocorrem na adolescência, como a influência dos pares ou sua disponibilidade nas escolas.25 A maior liberdade na escolha dos alimentos vivenciada pelos adolescentes e o nível de apoio ao consumo de frutas e vegetais durante essa fase podem explicar a deterioração no consumo desses itens durante a adolescência com o aumento da idade.24

Com relação ao uso de álcool e tabaco, esses comportamentos tendem a ser agrupados; as trajetórias de consumo dessas substâncias estão ligadas entre si.27 À medida que a idade aumenta, o consumo de álcool e o tabagismo também aumentam. Entre os comportamentos saudáveis, esses apresentaram uma maior redução com a idade. A mesma tendência foi observada anteriormente,27 o que significa que a transição do início até a metade da adolescência é um período crítico para o consumo alcoólico e o tabagismo.

A diminuição geral da prevalência de comportamentos saudáveis com a idade mostra que os adolescentes têm um estilo de vida prejudicial à sua saúde, colocam em risco sua saúde no futuro. Isso fica claro neste estudo, no qual menos de 2% têm um estilo de vida saudável aos 15 anos. Como foi demonstrado, os adolescentes se tornam mais independentes com a idade; eles começam a ter interesses diferentes, sofrem forte influência dos colegas e passam mais tempo na escola sem a supervisão dos pais. Portanto, são necessárias intervenções para reverter o aumento da prevalência de estilos de vida não saudáveis. As escolas são uma forma de proporcionar aos adolescentes habilidades para administrar e melhorar seu estilo de vida.28 As escolas são importantes porque praticamente todos os adolescentes frequentam a escola, onde passam muito tempo, e nas escolas recebem os conhecimentos que podem ser usados para melhorar sua saúde. Há evidências de que a intervenção de componente único ou de multicomponentes nas escolas pode melhorar os comportamentos saudáveis dos adolescentes em curto e longo prazo.24,25,28 Portanto, um grande número de adolescentes poderia se beneficiar dessas intervenções.

Este estudo tem pontos fortes e limitações que devem ser reconhecidos. Um ponto forte é que os achados são provenientes de um estudo internacional composto por 42 países com os mesmos instrumentos padronizados, são, portanto, passíveis de comparações. Vale ressaltar a força do fato de que apenas 5% dos participantes têm baixo nível na escala de abastança familiar. Espera‐se, portanto, que seja possível generalizar os resultados, porque não há variação significativa entre o nível socioeconômico dos adolescentes. O banco de dados do estudo HBSC contém vários valores ausentes. Mais de 40.000 adolescentes não relataram os comportamentos saudáveis e foram excluídos da análise de dados porque não foi possível criar um escore combinado de estilo de vida saudável baseado nos cinco comportamentos saudáveis. A coleta de dados baseou‐se em informações autorrelatadas, sujeitas a vieses. Além disso, consumir frutas ou vegetais diariamente não significa que os adolescentes necessariamente consumiram as porções recomendadas para esses itens. Seria importante medir com precisão o consumo de frutas e vegetais para determinar se o consumo está em acordo com as diretrizes/recomendações.15 Por fim, o desenho transversal impede uma inferência causal para a relação entre um estilo de vida saudável e a idade.

Os resultados deste estudo destacam que ainda há muito trabalho a ser feito para promover estilos de vida saudáveis e conscientizar os adolescentes sobre os potenciais benefícios para a sua saúde. Sabe‐se que os comportamentos relacionados à saúde são estabelecidos durante esse período de desenvolvimento. Por isso, compreender a melhor forma de promover estilos de vida saudáveis ainda é de importância crucial nessa fase da vida. Também é importante destacar que a menor prevalência de adolescentes com estilo de vida saudável parece corroborar que comportamentos não saudáveis tendem a se agrupar.29 As escolas também podem melhorar o estilo de vida dos adolescentes através do conhecimento. Os seguintes pontos são importantes para ensinar aos adolescentes: as diretrizes físicas,13 os problemas de saúde associados ao comportamento sedentário com base no tempo de tela,30 a recomendação sobre a quantidade de tempo adequada a ser gasto com esse comportamento,14 os hábitos de alimentação saudável, a recomendação sobre o consumo diário de frutas e vegetais15,16 e a abstinência de álcool18 e tabagismo. O conhecimento pode não ser suficiente para melhorar o estilo de vida dos adolescentes, mas ter o conhecimento posto em prática pode aumentar as chances de conscientizar os adolescentes sobre a importância de comportamentos saudáveis, com a intenção de que essa geração possa tomar decisões fundamentadas no conhecimento sobre sua saúde.

Conflitos de interesse

Os autores declaram não haver conflitos de interesse.

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Como citar este artigo: Marques A, Loureiro N, Avelar‐Rosa B, Naia A, Matos MG. Adolescents’ healthy lifestyle. J Pediatr (Rio J). 2020;96:217–24.

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