Fang Jing, Wylie-Rosett Judith, Cohen Hillel W, Kaplan Robert C, Alderman Michael H
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
Am J Prev Med. 2003 Nov;25(4):283-9. doi: 10.1016/s0749-3797(03)00207-1.
The association of physical inactivity and elevated body mass index (BMI) with cardiovascular disease (CVD) risk is well established. The relationship of dietary caloric intake and CVD risk is less certain.
The epidemiologic follow-up of the First National Health and Nutrition Examination Survey (1971-1992) was examined to determine the relationship of caloric intake, BMI, and physical activity to CVD mortality. Of 14,407 participants, 9790 subjects aged 25 to 74 years met inclusion criteria. The CVD mortality rate was the outcome.
During the 17 years of follow-up, there were 3183 deaths, 1531 of which were due to CVD (9.11/1000 person-years). People with relatively less physical activity, lower caloric intake, and who were overweight (BMI 25 to 29.9 kg/m(2)) and obese (BMI > or =30 kg/m(2)) had a less favorable baseline CVD risk profile than did those who were more active and of normal weight and had greater caloric intake. Age- and race/ethnicity-adjusted CVD mortality rates were highest among those with the least physical activity and lowest caloric intake, and who were overweight or obese. Moreover, subjects of normal weight who exercised most were more likely to have high caloric intake and lower CVD mortality (5.9 vs 14.7 per 1000 person-years, p =0.01) than subjects who were obese and exercised least. In Cox regression analysis, controlling for relevant CVD risk factors, least physical activity was independently associated with increased CVD mortality (hazard ratio=1.32, 95% confidence interval [CI]=1.13-1.53); and obesity was associated with increased CVD mortality (hazard ratio=1.24, 95% CI=1.06-1.44). Although highest dietary caloric intake was associated with reduced CVD mortality (hazard ratio=0.83, 95% CI=0.74-0.93), after adjusting for physical activity and BMI, there was no significant association of highest caloric intake with CVD mortality (hazard ratio=0.91, 95% CI=0.81-1.01).
In this large general population sample, lower levels of physical activity and obesity were independently associated with decreased CVD survival. Moreover, when BMI, physical activity, and other relevant characteristics were taken into account, caloric intake was not related to CVD mortality.
缺乏身体活动和体重指数（BMI）升高与心血管疾病（CVD）风险之间的关联已得到充分证实。饮食热量摄入与CVD风险之间的关系尚不确定。
对第一次全国健康和营养检查调查（1971 - 1992年）进行流行病学随访，以确定热量摄入、BMI和身体活动与CVD死亡率之间的关系。在14407名参与者中，9790名年龄在25至74岁的受试者符合纳入标准。CVD死亡率作为研究结果。
在17年的随访期间，共有3183人死亡，其中1531人死于CVD（9.11/1000人年）。身体活动相对较少、热量摄入较低、超重（BMI为25至29.9 kg/m²）和肥胖（BMI≥30 kg/m²）的人群，其基线CVD风险状况比那些身体活动较多、体重正常且热量摄入较高的人群更差。在年龄和种族/族裔调整后，身体活动最少、热量摄入最低且超重或肥胖的人群CVD死亡率最高。此外，与最少运动的肥胖受试者相比，运动最多的正常体重受试者更有可能热量摄入高且CVD死亡率较低（每1000人年分别为5.9和14.7，p = 0.01）。在Cox回归分析中，控制相关CVD风险因素后，最少的身体活动独立与CVD死亡率增加相关（风险比 = 1.32，95%置信区间[CI] = 1.13 - 1.53）；肥胖与CVD死亡率增加相关（风险比 = 1.24，95% CI = 1.06 - 1.44）。尽管最高的饮食热量摄入与降低的CVD死亡率相关（风险比 = 0.83，95% CI = 0.74 - 0.93），但在调整身体活动和BMI后，最高热量摄入与CVD死亡率无显著关联（风险比 = 0.91，95% CI = 0.81 - 1.01）。
在这个大型普通人群样本中，较低水平的身体活动和肥胖独立与CVD生存率降低相关。此外，当考虑BMI、身体活动和其他相关特征时，热量摄入与CVD死亡率无关。
