Sport and Exercise Sciences Research Institute, University of Ulster, Jordanstown, UK.
Proc Nutr Soc. 2010 Feb;69(1):178-84. doi: 10.1017/S0029665109991741. Epub 2009 Dec 3.
The increased prevalence of CVD deaths in the past 60 years is a result in considerable part of the influence of environmental and lifestyle changes, including decreased daily energy expenditure through physical exertion. Physical activity prescription has therefore become an important public health issue. Exercise guidelines have evolved considerably since their first publication by the American College of Sports Medicine (ACSM) in 1978. Guidelines initially focused on moderate- to vigorous-intensity exercise to develop and maintain cardiorespiratory fitness. However, in the face of escalating physical inactivity, public health agencies sought to develop an exercise prescription more palatable to the sedentary majority and in 1995 recommended the accumulation of 30 min moderate-intensity exercise on most days of the week. The unexpected result of this message was that some individuals believed that vigorous exercise was not necessary, whilst others believed that low levels of physical activity were sufficient. In 2008 the ACSM and the American Heart Association sought to clarify this position and published an updated recommendation in which: the beneficial role of vigorous-intensity exercise is explicitly stated; adults are encouraged to combine moderate- and vigorous-intensity exercise to meet the minimum recommendation of moderate-intensity physical activity for a 30 min on 5 d/week or vigorous-intensity aerobic activity for 20 min on 3 d/week; the dose-response relationship between physical activity and health is reinforced. The immense challenge for public health professionals now lies in encouraging the sedentary population to adopt a more active lifestyle.
在过去的 60 年中，CVD 死亡率的上升在相当程度上是环境和生活方式变化影响的结果，包括通过体力活动减少日常能量消耗。因此，运动处方已成为一个重要的公共卫生问题。自 1978 年美国运动医学学院 (ACSM) 首次发布运动指南以来，运动指南发生了很大的变化。指南最初侧重于中等至高强度运动，以发展和保持心肺健康。然而，面对不断增加的身体活动不足，公共卫生机构试图制定一个更受久坐不动的大多数人欢迎的运动处方，并于 1995 年建议每周大多数日子积累 30 分钟中等强度的运动。这条信息的意外结果是，一些人认为剧烈运动是不必要的，而另一些人则认为低水平的身体活动就足够了。2008 年，ACSM 和美国心脏协会试图澄清这一立场，并发布了一份更新的建议，其中明确指出了高强度运动的有益作用；鼓励成年人将中等强度和高强度运动相结合，以满足每周 5 天中等强度身体活动 30 分钟或每周 3 天剧烈有氧运动 20 分钟的最低推荐量；强化了身体活动与健康之间的剂量反应关系。现在，公共卫生专业人员面临的巨大挑战是鼓励久坐不动的人群采取更积极的生活方式。
