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Physical activity and mortality: what is the dose response and how big is the effect?
British Journal of Sports Medicine ( IF 18.4 ) Pub Date : 2020-01-21 , DOI: 10.1136/bjsports-2019-101765
Ulf Ekelund 1, 2 , Knut Eirik Dalene 3 , Jakob Tarp 3 , I-Min Lee 4, 5
Affiliation  

More than 60 years of research have consistently shown that physical activity beneficially affects several health outcomes and reduces the risk of premature mortality. The Harvard Alumni Study, one of the first studies to suggest a dose–response association between physical activity and health, examined the association between ‘total’ physical activity (defined as strenuous sports, walking and stair climbing) and participation in strenuous sports and the risk of heart attack in about 17 000 men.1 ‘Total’ physical activity was categorised into groups based on energy expenditure in physical activity per week. The following were the important observations: (1) there was a substantial risk reduction when comparing the ‘inactive’ reference group expending <500 kcal per week in ‘total’ physical activity with the second group expending 500–999 kcal per week; (2) there was graded dose–response association, with declining risk up to about 3000 kcal per week of ‘total’ physical activity, beyond which the benefits plateaued; and (3) energy expenditure from strenuous sports appeared to have greater protective effect than ‘total’ volume of activity. However, the latter observation may partly be explained by more accurate reporting of sporting activities compared with physical activities of daily living of lower intensity (eg, stair climbing and walking). The dose–response curve from the landmark paper by Paffenbarger et al 1 was subsequently confirmed after accounting for confounding,2 and it has been replicated in women and ethnically diverse populations from low-income and middle-income countries.3–5 These previous studies assessed physical activity using different self-report instruments, which may be prone to cognitive biases (eg, recall bias) and which may result in overestimation of physical activity and underestimation of sedentary time. Due to …

中文翻译:

体力活动和死亡率:什么是剂量反应,影响有多大?

60 多年的研究一致表明,身体活动有益于多种健康结果,并降低过早死亡的风险。哈佛校友研究是最早提出身体活动与健康之间存在剂量反应关系的研究之一,它检查了“总”身体活动(定义为剧烈运动、步行和爬楼梯)与参加剧烈运动和大约 17 000 名男性心脏病发作的风险。1 “总”体力活动根据每周体力活动的能量消耗分为几组。以下是重要的观察结果:(1) 比较“不活动”参考组花费 < 每周“总”体力活动消耗 500 大卡,第二组每周消耗 500-999 大卡;(2) 存在分级的剂量反应关联,每周“总”体力活动达到约 3000 kcal 的风险下降,超过该值后收益趋于稳定;(3) 剧烈运动的能量消耗似乎比“总”活动量具有更大的保护作用。然而,与较低强度的日常生活的身体活动(例如,爬楼梯和步行)相比,体育活动的报告更准确,可以部分解释后一种观察结果。Paffenbarger 等人 1 具有里程碑意义的论文中的剂量-反应曲线随后在考虑混杂因素后得到证实,2 并且它已在来自低收入和中等收入国家的女性和不同种族的人群中得到复制。3-5 这些先前的研究使用不同的自我报告工具评估身体活动,这些工具可能容易出现认知偏差(例如,回忆偏差),并可能导致高估身体活动和低估久坐时间。由于 …
更新日期:2020-01-21
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