Ana Jessica Pinto

• Doctor of Philosophy
• Post-doctoral Fellow at University of Colorado

Rheumatoid arthritis (RA) is characterized by deteriorated vascular health and increased cardiovascular risk. Physical activity (PA) is recommended for cardiovascular management in RA, but evidence on the associations between objectively-measured PA and vascular health markers in RA is limited. In this cross-sectional study, eighty-two post-menopau...

Purpose We investigated the effects of a 4-month intervention targeting sedentary behavior on sedentary time and physical activity level, clinical parameters, cardiometabolic risk factors, inflammatory markers, and health-related quality of life in post-menopausal women with rheumatoid arthritis. Methods This was a 4-month, parallel-group, randomi...

Sedentary behaviours—i.e. ‘too much sitting as distinct from too little exercise’—are ubiquitous in modern societies. Accumulating epidemiological evidence indicates that higher volumes of sedentary behaviour are associated with elevated risks for all-cause mortality, cardiovascular disease incidence and mortality, type 2 diabetes incidence and som...

Background: Sedentary behavior (SB) has negative effects on health, even in the context of achieving physical activity (PA) guidelines. It is unclear how total volume and patterns of accumulation of SB may vary among overweight/obese adults with and without uncomplicated type 2 diabetes (T2D) and whether SB is related to aerobic capacity. Purpose:...

Sedentary behaviors (SB) are characterized by a low energy expenditure while in a sitting or reclining posture. Evidence relevant to understanding the physiology of SB can be derived from studies employing several experimental models: bed rest, immobilization, reduced step count, and reducing/interrupting prolonged SB. We examine the relevant physi...

Aim: To investigate the association between physical activity and immunogenicity among SARS-CoV-2 seropositive patients with autoimmune rheumatic diseases prior to and following a 2-dose schedule of CoronaVac (Sinovac inactivated vaccine). Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial co...

Introduction Cardiopulmonary exercise testing (CPET) may capture potential impacts of COVID-19 during exercise. We described CPET data on athletes and physically active individuals with or without cardiorespiratory persistent symptoms. Methods Participants’ assessment included medical history and physical examination, cardiac troponin T, resting e...

Background: Physical activity associates with improved immunogenicity following a 2-dose schedule of CoronaVac (Sinovac's inactivated SARS-CoV-2 vaccine) in patients with autoimmune rheumatic diseases (ARD). This study evaluates whether physical activity impacts vaccine-induced antibody responses to a booster dose in this population. Methods: Th...

Background: Social distancing measures designed to contain the COVID-19 pandemic can restrict physical activity, a particular concern for high-risk patient groups. We assessed rheumatoid arthritis patients' physical activity and sedentary behavior level, pain, fatigue, and health-related quality of life prior to and during the social distancing me...

Background: To compare the acute and chronic effects of frequent, short physical activity (PA) bouts spread throughout the day to a time-matched intervention consisting in a single continuous daily bout of PA on glucose control and potential underlying mechanisms in adults at risk of developing type 2 diabetes (T2D). Methods: BURST2D is a single-ce...

BACKGROUND Physical activity (PA) is a cornerstone of type 2 diabetes mellitus (T2DM) treatment. Sex differences in PA behavior or barriers/facilitators to PA among individuals with T2DM are unclear. PURPOSE To summarize the evidence related to sex differences in participation in PA and barriers/facilitators to PA among individuals with T2DM acros...

Background: To investigate the effect of 200,000IU of vitamin D3 on hospital length of stay in patients with coronavirus disease 2019 (COVID-19). Methods: This RCT was conducted in two centers in Sao Paulo, Brazil. The primary outcome was hospital length of stay (HLOS). Results: Of 240 randomized patients, 237 were assessed in the primary outcome....

This prospective cohort study within an open‐label, single‐arm, phase 4 vaccination trial (clinicaltrials.gov #NCT04754698) aimed to investigate the association between physical activity and persistent anti‐SARS‐CoV‐2 antibodies 6 months after two‐dose schedule of CoronaVac in autoimmune rheumatic diseases (ARD) patients (n=748). Persistent immunog...

We examined whether weight loss following HAES®-based interventions associates with changes in cardiometabolic risk factors and quality of life of women with obesity. This was an exploratory, ancillary analysis of a 7-month, mixed-method, randomized controlled trial. Fifty-five women (age: 33.0 ± 7.2; BMI: 30–39.9 kg/m²) were included in this study...

This randomized controlled study aimed to investigate whether a single bout of exercise prior to the homologous booster dose of a SARS-CoV-2 inactivated vaccine could enhance immunogenicity in patients with spondyloarthritis. We selected 60 consecutive patients with spondyloarthritis (SpA). Patients assigned to the intervention group performed an e...

Background: The modulating effect of vitamin D on cytokine levels in severe coronavirus disease 2019 (COVID-19) remains unknown. Objectives: To investigate the effect of a single high-dose of vitamin D3 on cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. Methods: This is a post-hoc, ancillary and...

Aim: We aimed to explore how a group of classical ballet dancers perceived their eating attitudes and their bodies, with special attention to the potential presence of eating disorders (EDs) symptoms and body image (dis)satisfaction. Methods: A cross-sectional, mixed-method study was conducted on fourteen trained classical ballet dancers (18–30 yea...

This study aimed to investigate the association between physical activity and persistent anti-SARS-CoV-2 antibodies 6 months after two-dose schedule of CoronaVac in autoimmune rheumatic diseases (ARD) patients. This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial (clinicaltrials.gov #NCT04754698), conducte...

This study aimed to investigate whether a single bout of exercise prior to the homologous booster dose of a SARS-CoV-2 inactivated vaccine (Sinovac-CoronaVac) could enhance immunogenicity in patients with dysfunctional immune system. This was a randomized controlled trial (1:1) within a single-arm, phase 4 vaccination trial, conducted in São Paulo,...

Introduction: Among healthy adolescents, school closures and home confinement were shown to increase unhealthier eating habits and sedentary behavior. It remains unknown to which extent the pandemic has impacted the lifestyle of adolescents with chronic conditions. Thus, the aim of this study is to report on the impact of the COVID-19 outbreak on e...

Objectives To investigate whether physical activity is associated with enhanced immunogenicity of a SARS-CoV-2 inactivated vaccine (Coronavac) in patients with autoimmune rheumatic diseases (ARD) (n=898) and in non-ARD (n=197) individuals without pre-existing immunogenicity to SARS-CoV-2. Methods This was a prospective cohort study within an open-...

Exercise is a treatment in rheumatoid arthritis but participation in moderate-to-vigorous exercise is challenging for some patients. Light-intensity breaks in sitting could be a promising alternative. We compared the acute effects of active breaks in sitting with those of moderate-to-vigorous exercise on cardiometabolic risk markers in patients wit...

Background: Regular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease-2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investig...

Immunocompromised individuals show lower vaccine immunogenicity, which may be modulated by physical activity. This prospective cohort study within a phase-4 vaccination trial investigated whether physical activity is associated with enhanced immunogenicity of Coronavac (SARS-CoV-2 inactivated vaccine) in patients with autoimmune rheumatic diseases...

Objective: To determine the dose-response relationship between prolonged sitting and vascular function in healthy individuals and those with metabolic disturbances. To investigate the acute effects, on vascular function, of interventions that target interrupting prolonged sitting. Design: Systematic review with meta-analysis. Data sources: Ovi...

Changes in emotional state due to the COVID-19 pandemic may potentially modify eating habits, which may differ as a function of body mass index (BMI). Using a self-reported, questionnaire-based survey we evaluated Brazilian women during the pandemic for: (i) the influence of BMI on changes in eating habits, food choice determinants, and psychologic...

Objective To examine the SARS-CoV-2 infection rate in a cohort of 6500 professional athletes and staff during the 2020 football (soccer) season in São Paulo, Brazil. Methods This retrospective cohort study included 4269 players (87% male, age: 21.7±4.2 years) and 2231 staff (87% male, age: 42.6±11.9 years) from 122 teams (women: n=16) involved in...

Background: Vitamin D acts as a mediator in the immune system regulating antiviral mechanisms and inflammatory processes. Vitamin D insufficiency has been suggested as a potential risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, although its impact on the prognosis of hospitalized patients with coronavirus di...

Background: The aim of this study was to investigate possible associations between food consumption and eating habits and food choice determinants in women during COVID-19 pandemic. Methods: This is a cross-sectional survey conducted in Brazil between June and September, 2020, during which time social distancing measures were in place. Results: Par...

Purpose To report on the impact of the COVID-19 outbreak on eating habits and sedentary behavior among adolescents with multiple chronic conditions (n=347) from a tertiary, referral hospital vs . healthy peers. Methods This observational study was conducted in Sao Paulo (Brazil) between July and October 2020, period in which a set of social distan...

Importance: The efficacy of vitamin D3 supplementation in coronavirus disease 2019 (COVID-19) remains unclear. Objective: To investigate the effect of a single high dose of vitamin D3 on hospital length of stay in patients with COVID-19. Design, setting, and participants: This was a multicenter, double-blind, randomized, placebo-controlled tri...

To assess the rheumatologists’ knowledge and willingness to prescribe physical activity, we conducted a nationwide survey. All adult and paediatric rheumatologist members of the Brazilian Rheumatology Society were invited to fulfil a questionnaire on their knowledge and willingness to promote physical activity. Four hundred twenty-eight rheumatolog...

Key points Rheumatoid arthritis (RA) patients present exacerbated blood pressure responses to exercise, but little is known regarding the underlying mechanisms involved. This study assessed autonomic and haemodynamic responses to exercise and to the isolated activation of muscle metaboreflex in post‐menopausal women with RA. Participants with RA sh...

Purpose This small-scale, prospective cohort study nested within a randomized controlled trial aimed to investigate the possible associations between physical activity levels and clinical outcomes among hospitalized patients with severe COVID-19. Methods Hospitalized patients with severe COVID-19 were recruited from Clinical Hospital of the School...

Importance Patients with COVID-19 may exhibit 25-hydroxyvitamin D deficiency, but the beneficial effects of vitamin D 3 supplementation in this disease remain to be proven by randomized controlled trials. Objective To investigate the efficacy and safety of vitamin D 3 supplementation in patients with severe COVID-19. Design, Setting, and Particip...

We aimed to evaluate the influence of nutritional status on eating habits and food choice determinants among Brazilian women during the COVID-19 outbreak. This cross-sectional survey was conducted between June and September, 2020, period in which social distancing measures were in place. Participants (n=1,183) were classified as normal weight (60.4...

We investigated fat women’s perceptions of their own bodies and their experiences with weight-related discriminations, and how these situations affected their well-being. Thirty-nine obese women were interviewed, and three axes of analysis were identified: (1) repercussions of being fat, (2) living with a fat body, and (3) am I a person or just a f...

We assessed physical activity using accelerometers and a questionnaire in 33 post-bariatric patients who reported to be adherent (n = 15) or not (n = 18) to social distancing due to the COVID-19 pandemic. Patients adherent to social distancing spent more time in sedentary behavior (1.1 h/day, 0.1, 2.2; p = 0.045) and less time in moderate-to-vigoro...

Background: Social distancing measures designed to contain the COVID-19 pandemic can explicitly and implicitly restrict physical activity, a particular concern for high-risk patient groups. Using a within-subjects design with objective measurement (via validated accelerometers), we assessed rheumatoid arthritis patients' physical activity and seden...

The shortage of essential medical care has become a major health concern as the Covid‐19 pandemic continues to unfold. The population of Sao Paulo, Brazil, has been severely impacted due to the very‐high prevalence of Covid‐19 cases, and as the health system promptly adjusted to accommodate infected patients, the problem of access to essential care...

Objectives: To assess physical activity levels in post-bariatric patients who adhered or not to social distancing measures due to the Covid-19 pandemic. Our secondary aim was to compare physical activity estimates between objectively measured and self-reported physical activity level. Methods: In this descriptive, cross-sectional study, we assessed...

Background/Objectives This was an out-of-hospital screening of health status and lifestyle during the Covid-19 pandemic in post-operative bariatric patients from Sao Paulo, Brazil, prevented from face-to-face health care. Subjects/Methods In this cross-sectional study, 66 patients were remotely (via phone call) and in-person (by home visit) assess...

Social distancing has been adopted worldwide to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Social isolation is likely to lead to a decline in physical activity, which could result in immune system dysfunction, thereby increasing infection susceptibility and exacerbating the pathophysiology of conditions that...

Physical inactivity is common during periods of self-isolation, but for patients with rheumatic diseases, there are crucial benefits to be gained from maintaining an active lifestyle throughout the COVID-19 pandemic. Patients should be provided with support to maintain physical activity and avoid prolonged periods of time spent sitting.

Background: Patients with rheumatoid arthritis spend most of their daily hours in sedentary behavior (sitting), a predisposing factor to poor health-related outcomes and all-cause mortality. Interventions focused on reducing sedentary time could be of novel therapeutic relevance. However, studies addressing this topic remain scarce. We aim to inve...

To investigate the association between food consumption stratified by processing level and cardiovascular risk factors in rheumatoid arthritis. In this cross-sectional study, 56 patients (age: 62.5 ± 7.9 years, BMI: 28.4 ± 5.1 kg/m2) had food consumption evaluated according to the processing level (e.g., unprocessed or minimally processed foods, pr...

Our aim was to investigate the prevalence of symptoms related to eating disorders, disordered eating and body image perception, and attitudes toward eating in a group of elite male artistic gymnastics. Seventeen athletes took part in this quali-quantitative, cross-sectional study. Presence of eating disorders symptoms, and body image perception and...

Objective: The aim of this study was to assess the impact of a real-world, citywide intervention on physical activity and eating habits in a Latin American city with more than 50,000 inhabitants. Methods: This was a plausibility assessment of a real-life intervention. A probabilistic sample (n = 1,424) from Jaguariuna (Sao Paulo, Brazil) was ass...

This study investigated the effect of open-placebo on cycling time-trial (TT) performance. Twenty-eight trained female cyclists completed a 1-km cycling TT following a control session or an open-placebo intervention. The intervention consisted of an individual presentation, provided by a medic, in which the concept of open-placebo was explained to...

Background: Administration of open-placebo has shown benefits in several clinical conditions although no study has investigated its effect on exercise performance. Aim: To investigate the effect of open-placebo on exercise performance. Methods: Twenty-eight trained female cyclists completed a 1-km cycling TT following a control session or an open-p...

Background Creatine supplementation could be a non-expensive, safe and effective dietary intervention to counteract bone loss. The aim of this study was to investigate whether long-term creatine supplementation can improve bone health in older, postmenopausal women. Methods A double-blind, placebo-controlled, parallel-group, randomized trial was c...

AIM To investigate the effects of rheumatoid arthritis (RA) on resting cardiovascular autonomic function and on pressor and sympathetic responses to muscle mechanoreflex and metaboreflex activation. METHODS Thirty‐seven post‐menoupausal women with RA (60±7 yrs, 27.1±4.9 kg/m ² , 19.2±4.7 ml.kg ⁻¹ .min ⁻¹ ) and 9 matched controls (CON) (59±7 yrs, 2...

INTRODUCTION: Health at Every Size (HAES) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes and on enhancing pleasure derived from consuming food to achieve sustainable healthy eating outcomes. However, to the best of our knowledge, there are no studies in the literature assessing the effects of...

Real-world interventions are fundamental to bridge the research-practice gap in healthy lifestyle promotion. This study aimed to assess the impact of a 7-month, intensive, city-wide intervention (“Life of Health”) on tackling youth inactivity and sedentary behavior in an entire Latin-American city (Jaguariuna, Brazil). For youth, a program focused...

Context The growing use of interventions based on the Health at Every Size® (HAES®) in obesity management. Objective This study aimed to summarize the health‐related effects of HAES®‐based interventions on people with overweight and obesity. Data sources MEDLINE (via PubMed), EMBASE, Cochrane Library, LILACS, Google Scholar, OpenGrey and Grey Lit...

Exercise is the treatment of choice for fibromyalgia (FM), but little is known about resistance exercise prescription to modulate pain in this condition. This study aimed to compare the effects of different resistance exercise models, comprising self-selected or prescribed intensity, on pain in FM patients. In a cross-over fashion, 32 patients unde...

Health at Every Size® (HAES®) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes. This study examined multiple physiological, attitudinal, nutritional, and behavioral effects of a newly developed, intensive, interdisciplinary HAES®-based intervention in obese women. This was a prospective, seven-...

Baseline characteristics between participants who retained and those who dropped out, stratified by groups. Data are expressed as mean ± SD or n (%) of total sample per group. Significance level defined as p ≤ 0.05 (nonpaired t-test or chi-square test). (DOCX)

A physical activity program based on the Health at Every Size® approach–an innovative proposal. (DOCX)

Purpose: Cross-sectional studies suggest that training can increase muscle carnosine (MCarn), although longitudinal studies have failed to confirm this. A lack of control for dietary β-alanine intake or muscle fibre type shifting may have hampered their conclusions. The purpose of the present study was to investigate the effects of high-intensity...

Background/objective: Recent studies have indicated that cardiac autonomic dysfunction is an early sign of cardiovascular impairment in rheumatoid arthritis (RA). Previous studies have mainly focused on resting assessments; however, analysis of heart rate (HR) responses to exercise might provide additional information on cardiac autonomic dysfunct...

Background: This manuscript describes the design and rationale of a clinical trial that aims to investigate the multiple physiological, attitudinal, nutritional, and behavioral effects of a new interdisciplinary intervention based on the Health at Every Size® (HAES®) approach in obese women. Methods: This will be a prospective, 7-month, randomiz...

This review aims to (1) summarize the estimates of physical inactivity and sedentary behavior in autoimmune rheumatic diseases; (2) describe the relationship between physical (in)activity levels and disease-related outcomes; (3) contextualize the estimates and impact of physical inactivity and sedentary behavior in autoimmune diseases compared to o...

Objective The objectives of this paper are to objectively measure habitual physical activity levels in patients with primary Sjögren’s syndrome (pSS) with mild disease activity and to determine to which extent it may be associated with physical capacity and function and clinical features. Methods In this cross-sectional study, 29 women with pSS we...

Objective: To compare muscle strength (i.e. lower- and upper-body strength) and function between physically inactive childhood-onset systemic lupus erythematosus patients (C-SLE) and healthy controls (CTRL). Methods: This was a cross-sectional study and the sample consisted of 19 C-SLE (age between 9 and 18 years) and 15 CTRL matched by age, sex,...

Objective: To compare muscle strength (i.e. lower- and upper-body strength) and function between physically inactive childhood-onset systemic lupus erythematosus patients (C-SLE) and healthy controls (CTRL). Methods: This was a cross-sectional study and the sample consisted of 19 C-SLE (age between 9 to 18 years) and 15 CTRL matched by age, sex,...

Objective: To examine the temporal pattern of PTH, PO4, ACa and Ca(2+) during and after exercise. Design and setting: A laboratory-based study with a cross-over design, comparing 30 min of running at 55%, 65% and 75%VO2max, followed by 2.5-h of recovery. Blood was obtained at baseline, after 2.5, 5, 7.5, 10, 15, 20, 25 and 30 min of exercise and...

Objective: To compare aerobic capacity and health-related quality of life (HRQL) in physically inactive adult (A-SLE) and childhood-onset SLE (C-SLE) patients with mild/inactive disease versus healthy controls. Methods: In a cross-sectional study, 39 patients (C-SLE: n = 18; 9-18 years; and A-SLE: n = 21; 23-45 years) with inactive disease activ...

To examine the agreement and association between objectively measured and indirectly assessed physical activity levels in patients with juvenile dermatomyositis (JDM) and juvenile systemic lupus erythematosus (JSLE) patients. The sample consisted of 19 JDM patients (age 8 to 22 years) and 20 JSLE patients (age 9 to 18 years). Physical activity leve...