BMJ:高水平运动,能降低这5类疾病的风险
2016/08/12
这项分析是由美国华盛顿大学研究者根据174项研究,涵盖了近1.5亿人次的跟踪记录完成。分析发现:高水平的体能活动可以降低5类疾病的风险,包括乳腺癌、大肠癌、糖尿病、贫血性心脏病和中风。

8月9日,来自美国华盛顿大学的博士后Hmwe H Kyu在BMJ上发文证实:高水平的体能活动可以降低5类疾病的风险,其中包括2型糖尿病。该数据来自174项研究,涵盖了149,184,285人次的后续跟踪工作,分析发现:每天越是有规律的体能活动(包括娱乐、通勤、职业活动以及家庭杂务),罹患乳腺癌、大肠癌、糖尿病、贫血性心脏病和中风的风险越低。

众所周知,世界卫生组织(World Health Organization)推荐的每日总活动水平为600MET(代谢当量),这相当于每周快走150min或者跑步75min的量。

但该研究中的高水平的运动量远远超出了这个推荐标准。当每日运动水平从600MET上升到3000~4000MET时,罹患5类疾病的风险是显著降低的。

作者解释道,每周能达到3000MET的人群,一般包含了多种不同类型的体能活动,譬如爬楼梯10min,打扫卫生15min,园艺20min,跑步20min,走路或骑自行车25min等。

该文章的另一作者Mohammad H Forouzanfar补充道:任何水平的体能活动总归比不运动要好。虽然3000MET听起来可能有点大,但它关乎了生活中所有领域的总活动。对那些不想锻炼的人,医生可以鼓励他们把体育活动纳入日常生活中,例如把家务活变成锻炼。值得一提的是,这项研究没有检测到最佳好处的阈值,但建议个人根据自身情况,在推荐水平内进行更多的活动。

另一项荟萃分析包括了100多万个样本,分析发现:每天1小时的中等强度的运动,如快走或骑自行车,可以抵消你每天久坐8小时带来的副作用。这项研究称:“久坐不动”是一个致命杀手,每年在全球导致了530万人过早死亡,与吸烟造成的危害等同,是肥胖的两倍。因此有专家警告:静坐是一种新式吸烟。

剂量——反应关系

该研究是首个量化“剂量-反应关系”的荟萃分析,研究了所有体能运动和五种慢性疾病的风险关联。174项前瞻性队列研究包括35例乳腺癌,26例结肠癌,43例糖尿病,55例缺血性心脏病,19例缺血性卒中(有些包括一个以上的终点。)

以糖尿病为例,与没有体力活动相比,每周运动600MET的人(最低推荐活动水平)的风险降低了2%,当每周运动量从600MET增加到3600 MET,风险降低了19%,但当每周运动量达到9000至12000MET时,风险降低量仅比原来3600 MET时多下降0.6%。

总而言之,与不常活动的人(每周运动量<600MET)相比,对于那些在高水平活动的人(每周运动量≥见过8000MET),它们的乳腺癌风险降低了14%;结肠癌降低了21%;2型糖尿病降低了28%;缺血性心脏病和缺血性卒中依次降低了25%、26%。

体育活动应该如何量化?

在随后的社论中,来自苏格兰思克莱德大学Strathclyde学院全球公共卫生部的Philippe Autier教授点评道:该研究在处理生活方式因素上的不同数据方面具有前瞻性,对预防慢性疾病具有相当重要的意义。不足的是,当前的分类系统将每日运动量与体能活动结合起来,不能解决试验中异质性问题。由于该研究是以测量活动强度、频率和持续度的MET为基准,并不能告知我们在较短时间内的强烈体能活动与较长时间内轻松体能活动间的关系。

但毋庸置疑,这项研究证实了增加体能活动的水平,对于个体而言是有利消息,再说每周达到3000MET 的活动量对于大多数人而言还是很可行的。

推荐阅读:

Get Moving: High Physical-Activity Level Reduces Risk of 5 Diseases

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  • Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013

    Objective To quantify the dose-response associations between total physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events. Design Systematic review and Bayesian dose-response meta-analysis. Data sources PubMed and Embase from 1980 to 27 February 2016, and references from relevant systematic reviews. Data from the Study on Global AGEing and Adult Health conducted in China, Ghana, India, Mexico, Russia, and South Africa from 2007 to 2010 and the US National Health and Nutrition Examination Surveys from 1999 to 2011 were used to map domain specific physical activity (reported in included studies) to total activity. Eligibility criteria for selecting studies Prospective cohort studies examining the associations between physical activity (any domain) and at least one of the five diseases studied. Results 174 articles were identified: 35 for breast cancer, 19 for colon cancer, 55 for diabetes, 43 for ischemic heart disease, and 26 for ischemic stroke (some articles included multiple outcomes). Although higher levels of total physical activity were significantly associated with lower risk for all outcomes, major gains occurred at lower levels of activity (up to 3000-4000 metabolic equivalent (MET) minutes/week). For example, individuals with a total activity level of 600 MET minutes/week (the minimum recommended level) had a 2% lower risk of diabetes compared with those reporting no physical activity. An increase from 600 to 3600 MET minutes/week reduced the risk by an additional 19%. The same amount of increase yielded much smaller returns at higher levels of activity: an increase of total activity from 9000 to 12 000 MET minutes/week reduced the risk of diabetes by only 0.6%. Compared with insufficiently active individuals (total activity <600 MET minutes/week), the risk reduction for those in the highly active category (≥8000 MET minutes/week) was 14% (relative risk 0.863, 95% uncertainty interval 0.829 to 0.900) for breast cancer; 21% (0.789, 0.735 to 0.850) for colon cancer; 28% (0.722, 0.678 to 0.768) for diabetes; 25% (0.754, 0.704 to 0.809) for ischemic heart disease; and 26% (0.736, 0.659 to 0.811) for ischemic stroke. Conclusions People who achieve total physical activity levels several times higher than the current recommended minimum level have a significant reduction in the risk of the five diseases studied. More studies with detailed quantification of total physical activity will help to find more precise relative risk estimates for different levels of activity.

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