Miller Y D, Dunstan D W
School of Human Movement Studies, The University of Queensland, Australia.
J Sci Med Sport. 2004 Apr;7(1 Suppl):52-9. doi: 10.1016/s1440-2440(04)80278-0.
This review summarises current evidence relating to the effectiveness of physical activity (PA) interventions for treating overweight and obesity and type 2 diabetes. Interventions to increase PA for the treatment of overweight and obesity in both children and adults have primarily consisted of health education and behaviour modification strategies in clinical settings or with selected families or individuals. Although evidence is limited, strategies to reduce sedentary behaviours appear to have potential for reducing obesity among children and adolescents. Among adults, strategies that combine diet and PA are more effective than PA strategies alone. Combined lifestyle strategies are most successful for maintained weight loss, although most programs are unsuccessful in producing long-term changes. There is little evidence about compliance to prescribed behaviour changes or the factors that promote or hinder compliance to lifestyle changes. Limited evidence suggests that continued professional contact and self-help groups can help sustain weight loss. Most of the interventions for the treatment of type 2 diabetes have been conducted in clinical settings and have typically required the use of extensive resources. Evidence suggests that interventions can lead to small but clinically meaningful improvements in glycaemic control, even in the absence of weight loss. A recent study demonstrated that a multifactorial intervention (diet, PA and pharmaceutical) can reduce the risk of diabetes complications in individuals with type 2 diabetes. Nevertheless, there is little evidence about the effectiveness of community-based interventions in producing long-term changes in glycaemic control and reduced mortality in people with type 2 diabetes.
本综述总结了当前有关体育活动(PA)干预对超重、肥胖及2型糖尿病治疗效果的证据。增加PA以治疗儿童和成人超重及肥胖的干预措施主要包括临床环境中或针对特定家庭或个人的健康教育及行为改变策略。尽管证据有限,但减少久坐行为的策略似乎有降低儿童和青少年肥胖的潜力。在成年人中,饮食与PA相结合的策略比单纯的PA策略更有效。综合生活方式策略在维持体重减轻方面最为成功,不过大多数项目在实现长期改变方面并不成功。关于遵守规定行为改变的情况或促进或阻碍生活方式改变依从性的因素,几乎没有证据。有限的证据表明持续的专业联系和自助小组有助于维持体重减轻。大多数2型糖尿病治疗干预措施是在临床环境中进行的,通常需要大量资源。有证据表明,即使在没有体重减轻的情况下,干预措施也能在血糖控制方面带来虽小但具有临床意义的改善。最近一项研究表明,多因素干预(饮食、PA和药物治疗)可降低2型糖尿病患者发生糖尿病并发症的风险。然而,关于基于社区的干预措施在实现2型糖尿病患者血糖控制长期改变及降低死亡率方面的有效性,几乎没有证据。