The Academy of Finland, Health Research Unit, 00501 Helsinki, Finland.
Obes Rev. 2010 Mar;11(3):202-21. doi: 10.1111/j.1467-789X.2009.00653.x. Epub 2009 Sep 9.
The purpose of this systematic review was to study the relative health risks of poor cardio-respiratory fitness (or physical inactivity) in normal-weight people vs. obesity in individuals with good cardio-respiratory fitness (or high physical activity). The core inclusion criteria were: publication year 1990 or later; adult participants; design prospective follow-up, case-control or cross-sectional; data on cardio-respiratory fitness and/or physical activity; data on BMI (body mass index), waist circumference or body composition; outcome data on all-cause mortality, cardiovascular disease mortality, cardiovascular disease incidence, type 2 diabetes or cardiovascular and type 2 diabetes risk factors. Thirty-six publications filled the criteria for inclusion. The data indicate that the risk for all-cause and cardiovascular mortality was lower in individuals with high BMI and good aerobic fitness, compared with individuals with normal BMI and poor fitness. In contrast, having high BMI even with high physical activity was a greater risk for the incidence of type 2 diabetes and the prevalence of cardiovascular and diabetes risk factors, compared with normal BMI with low physical activity. The conclusions of the present review may not be applicable to individuals with BMI > 35.
本系统评价的目的是研究心肺功能良好（或体力活动水平高）的正常体重人群与心肺功能差（或体力活动水平低）的肥胖人群相比，相对健康风险的差异。核心纳入标准为：发表年份为 1990 年或之后；成年参与者；前瞻性随访、病例对照或横断面设计；有关于心肺功能和/或体力活动的数据；有关于 BMI（体重指数）、腰围或身体成分的数据；有全因死亡率、心血管疾病死亡率、心血管疾病发病率、2 型糖尿病或心血管和 2 型糖尿病危险因素的数据。有 36 篇文献符合纳入标准。数据表明，与 BMI 正常但心肺功能差的个体相比，BMI 较高但有氧能力较好的个体全因死亡率和心血管疾病死亡率的风险较低。相比之下，与低体力活动的正常 BMI 相比，即使有较高的体力活动，高 BMI 也是 2 型糖尿病发病率和心血管及糖尿病危险因素患病率的更高风险因素。本综述的结论可能不适用于 BMI>35 的个体。
