Erlichman J, Kerbey A L, James W P T
International Obesity Task Force, North Gower Street, London, UK.
Obes Rev. 2002 Nov;3(4):257-71. doi: 10.1046/j.1467-789x.2002.00077.x.
The modern scientific study of physical activity began soon after World War II and focused on the epidemic of cardiovascular disease that was beginning to engulf the Western world. Early 'exercise prescriptions' then specified intense bouts of vigorous activity as the most effective way to maintain cardiovascular fitness and 'heart health'. Doctors and other health professionals then grew concerned that progressively fewer individuals were heeding this advice at a time when physical activity from manual work was becoming less common. Evidence was also emerging in the late 1980s that the value of accumulated, moderately intense activities, now of increasing importance during leisure time, may have been overlooked, or at least underplayed, in the prevention of heart disease, diabetes and some cancers. Perhaps in population terms adherence to moderate 'lifestyle' activities would be better than to the earlier vigorous recommendations. Social policy therefore shifted in the United States in 1996; the US Surgeon General's report set out the basic public health message of '30 min of moderate activity five, and preferably all, days of the week'. This recommendation was broadly adopted throughout much of the Western world. How this change in health strategy might impact on unhealthy weight gain and the growing obesity epidemic was given little attention. Here we examine how post-war public health policy in physical activity developed in an attempt primarily to prevent cardiovascular disease. In the following article we examine why too little attention may have been given to unhealthy weight gain and investigate how this may have happened. Then we consider how much physical activity--and of what kind--is needed to prevent unhealthy weight gain.
对身体活动的现代科学研究始于第二次世界大战后不久，重点关注当时开始席卷西方世界的心血管疾病流行情况。早期的“运动处方”将高强度的剧烈活动指定为维持心血管健康和“心脏健康”的最有效方式。当时，医生和其他健康专业人员开始担心，在体力劳动带来的身体活动变得越来越不常见的时代，听从这一建议的人越来越少。20世纪80年代末也有证据表明，在预防心脏病、糖尿病和某些癌症方面，累积的中等强度活动的价值可能被忽视了，或者至少没有得到充分重视，而现在这种活动在休闲时间变得越来越重要。也许从人群角度来看，坚持适度的“生活方式”活动比早期的剧烈活动建议更好。因此，1996年美国的社会政策发生了转变；美国卫生局局长的报告提出了“每周五天，最好是每天进行30分钟中等强度活动”的基本公共卫生信息。这一建议在西方世界的大部分地区得到了广泛采纳。人们很少关注这种健康策略的变化可能如何影响不健康的体重增加和日益严重的肥胖流行。在这里，我们研究战后身体活动方面的公共卫生政策是如何发展的，主要目的是预防心血管疾病。在接下来的文章中，我们将探讨为什么对不健康的体重增加关注过少，并调查这种情况是如何发生的。然后，我们将考虑需要多少身体活动以及何种类型的活动来预防不健康的体重增加。
