Medical Research Council, Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.
Int J Obes (Lond). 2009 Apr;33(4):497-506. doi: 10.1038/ijo.2009.25. Epub 2009 Feb 17.
Cross-sectional data suggest a strong association between low levels of physical activity and obesity. The EPIC-PANACEA (European Prospective Investigation into Cancer-Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of home And obesity) project was designed to investigate the associations between physical activity and body mass index (BMI) and waist circumference based on individual data collected across nine European countries.
In the European Prospective Investigation into Cancer and Nutrition (EPIC), 519 931 volunteers were recruited between 1992 and 2000, of whom 405 819 had data on main variables of interest. Height, body weight and waist circumference were measured using standardized procedures. Physical activity was assessed using a validated four-category index reflecting a self-reported usual activity during work and leisure time. The associations between physical activity and BMI and waist circumference were estimated using multilevel mixed effects linear regression models, adjusted for age, total energy intake, smoking status, alcohol consumption and educational level.
A total of 125 629 men and 280 190 women with a mean age of 52.9 (s.d. 9.7) and 51.5 (s.d. 10.0) years, respectively were included. The mean BMI was 26.6 kg/m(2) (s.d. 3.6) in men and 25.0 kg/m(2) (s.d. 4.5) in women. Fifty percent of men and 30% of women were categorized as being active or moderately active. A one-category difference in the physical activity index was inversely associated with a difference of 0.18 kg/m(2) in the mean BMI (95% confidence interval, CI, 0.11, 0.24) and 1.04-cm (95% CI 0.82, 1.26) difference in waist circumference in men. The equivalent figures for women were 0.31 kg/m(2) (95% CI 0.23, 0.38) and 0.90 cm (95% CI 0.71, 1.08), respectively.
Physical activity is inversely associated with both BMI and waist circumference across nine European countries. Although we cannot interpret the association causally, our results were observed in a large and diverse cohort independently from many potential confounders.
横断面数据表明，体力活动水平低与肥胖之间存在很强的关联。EPIC-PANACEA（欧洲癌症前瞻性调查-体力活动、营养、酒精、戒烟、外出就餐和肥胖）项目旨在根据横跨 9 个欧洲国家收集的个人数据，研究体力活动与体重指数（BMI）和腰围之间的关联。
在欧洲癌症与营养前瞻性调查（EPIC）中，1992 年至 2000 年间招募了 519931 名志愿者，其中 405819 名志愿者有主要变量的数据。身高、体重和腰围采用标准化程序测量。体力活动使用反映工作和休闲时间习惯性活动的经过验证的四分类指数进行评估。使用多水平混合效应线性回归模型，调整年龄、总能量摄入、吸烟状况、饮酒和教育水平，估计体力活动与 BMI 和腰围之间的关联。
共纳入 125629 名男性和 280190 名女性，平均年龄分别为 52.9（标准差 9.7）和 51.5（标准差 10.0）岁。男性的平均 BMI 为 26.6kg/m2（标准差 3.6），女性为 25.0kg/m2（标准差 4.5）。50%的男性和 30%的女性被归类为活跃或适度活跃。体力活动指数每增加一个等级，男性的平均 BMI 差异为-0.18kg/m2（95%置信区间，CI，0.11，0.24），腰围差异为 1.04cm（95% CI 0.82，1.26）。女性的相应数值分别为 0.31kg/m2（95% CI 0.23，0.38）和 0.90cm（95% CI 0.71，1.08）。
在 9 个欧洲国家，体力活动与 BMI 和腰围均呈负相关。虽然我们不能从因果关系上解释这种关联，但我们的结果是在一个大型且多样化的队列中观察到的，独立于许多潜在的混杂因素。
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