Main results
We observe an inverse relationship between physical inactivity and HDL-C—that is, those who were sedentary or below the WHO Recommendations for physical activity were at 2.6 greater odds of having a lower HDL compared with those meeting or exceeding WHO physical activity recommendations.
In previous studies, Quaresma et al. [
14] and Silva et al. [
29] pointed out the impossibility of describing the epidemiological profile of communities in the Legal Amazon and highlighted the importance of studies in this context. This reforms the political, clinical, and scientific relevance of the present study, as it is the first research on the level of physical activity and lipid profile in this population (promoting, also, social representation of these communities).
This type of study with vulnerable populations is difficult due to cultural barriers that make access to research difficult. Problems related to feedback on participants’ health situations after the survey limited the number of surveys and the number of participants studied (also making it difficult to build a discussion in the present study).
Interpretation
Although the benefits of regular practice of physical activity are globally recognized and capable of promoting immensurable effects on health economics to the population, their practice is not yet part of the largest share of people around the world [
30]. Level of physical activity is internationally used in epidemiological studies that assess associations of physical activity with different health outcomes (risk of all-cause and cardiovascular mortality, breast and prostate cancer, fractures, recurrent falls, disability, cognitive decline, dementia, Alzheimer’s disease). disease, and depression), however, physical activity is different from exercise, and this has been a confounding discussion in studies [
27,
28].
Among the benefits include the rise of HDL cholesterol; reduction of LDL cholesterol, triglycerides, and arterial pressure; improves glucose-insulin homeostasis in fasting and postprandial; induces and maintains weight loss; improves psychological well-being. It is also likely to reduce inflammation; increase endothelial function, and help to stop smoking [
9]. The results of this study that physical inactivity was associated with alteration on HDL-C were previously verified in different populations. In this way seems to have a consensus about the health protector effect of practicing physical activity and the inverse relation is also true [
2,
3,
5,
6].
A great amount of physical activity (duration and intensity) is associated more significantly with cardiovascular risks factors, including dyslipidemia [
6,
7]. Individuals with more than one cardiovascular risk factor such as hypertension, high cholesterol, or smoking, have a better chance to have cardiovascular diseases. Although exercise had been proved to control individuals’ risk factors, the evidence of its effects on multiple risks remains uncertain, it is necessary to realize high-quality clinical trials that evaluate the effect of exercise in people with high cardiovascular risk [
9].
Recently some studies have advocated the non-HDL cholesterol to guide lipid control, however, this should be recommended for those who have hypertriglyceridemia or any cardiometabolic abnormality [
3,
8]. The HDL has been studied for exerting antiatherogenic effects through biological mechanisms and has anti-inflammatory, anti-apoptotic, and anti-thrombotic effects in endothelial cells of healthy people, in this way, analyse structure and components of HDL rather than the fraction of HDL cholesterol after application of physical training program can be useful to learn about its effects [
31].
However, it should be noted the ethical differences in lipidic profiles and in cardiovascular disease risk documented are attributed, in part, to genetic, socioeconomic, and lifestyle differences [
1]. In this way, the lifestyle characteristics of the traditional communities studied lead to believe that, although the basic health problems still have no resolution, the prevalence of chronic conditions has gained high proportions in the traditional rural communities, as well as in urbanized ones.
Thus, it contributes to increasing the central problem of health attention systems, with complete epidemiologic transition in developed countries, a social response of fragmented health, with more attention in acute conditions and to acute events of chronic conditions. This situation is not exclusive to Brazil, rural communities in China were found low HDL associated with high levels of central obesity and corporal composition index [
32].
A progressive change in the socio-economic situation and a greater influence of western elevated the problems of evitable cardiovascular diseases, it is estimated that the prevalence of ischemic cardiac disease is the principal cause of death also in countries with low income until 2030 [
1]. In the case of artisanal fishermen, despite good economic indicators of the production sector and commercialization, the traditional fishermen have big difficulties to get in other activities and the profit from fishing is not sufficient to have a life with better quality [
17].
The quilombolas is yet found in the communities high poverty rates, as well as higher rates of malnutrition, lower rates of sanitation and education of the country; about 74.73% of families, are found in an extreme poverty situation, having as main source income benefits from the government, they are a group with special risk to cardiovascular morbimortality, justified the priority in the implementation of attention measures [
33]. The characteristics of both groups there studied to show the necessity to protect, prevent and improve health and education measures, minimal conditions, free and quality to improve their life quality.
The present study has limitations that must be addressed. The first one refers to the design of this research (cross-sectional), which has no explanatory power on cause and effect (thus, we suggest conducting a longitudinal study to provide additional information related to the variables investigated in this study); the second refers to the sampling method (for convenience), because, although the sample size was adequate for the outcome investigated in this study, little is known (in the scientific contingent) about the characteristics studied in vulnerable populations; and the third refers to the lack of nutritional monitoring of the participants—we emphasize that research in these communities is of great complexity, whether due to cultural barriers, logistical barriers to accessing communities, or due to the low investment in research in this context.