School of Kinesiology & Health Studies, Queen's University, Kingston, Ontario, Canada.
Med Sci Sports Exerc. 2012 Apr;44(4):625-36. doi: 10.1249/MSS.0b013e31823a90ae.
Physical activity (PA) positively influences health-related quality of life (HRQL), whereas obesity is associated with significant HRQL impairments. Active-obese persons often have similar or lower risk of cardiovascular outcomes and mortality than inactive-healthy weight persons; however, the combined PA-weight status effects on HRQL are unclear. The aim was to investigate the combined association of PA and body mass index (BMI) with HRQL in Canadian adults and older adults.
Cross-sectional data included 110,986 participants ≥ 18 yr from the 2005 Canadian Community Health Survey, representing an estimated 22,563,527 Canadians. HRQL indicators included: Self-Rated Health (SRH), Participation and Activity Limitation due to illness/injury (PAL), and Total Disability Days (physical + mental) during the past 14 d (TDD). Prevalence of adverse HRQL was estimated by BMI, PA, and combined BMI-PA categories. Adjusted logistic regression was used to assess the odds of adverse HRQL by BMI, PA, and BMI-PA. Analyses were stratified by sex and age (18-44, 45-64, ≥65 yr).
In both men and women of all ages, inactive individuals had greater likelihood of fair/poor SRH, and sometimes/often PAL, at all BMI levels; conversely, in active individuals, being underweight, overweight, or obese had little effect on SRH and PAL. Associations were weaker for TDD, where the greatest influence was in older adults from inactivity combined with underweight. Overweight showed less association to HRQL in males and older adults, whereas underweight showed stronger association in males and older adults.
When examining BMI-PA in combination, PA emerges as the more important correlate of HRQL, regardless of weight status. This reinforces the importance of PA to health outcomes over and above the benefits related to weight loss or maintenance.
身体活动（PA）对健康相关生活质量（HRQL）有积极影响，而肥胖与 HRQL 显著受损有关。与不活动的健康体重人群相比，活跃肥胖人群的心血管结局和死亡率风险通常相似或更低；然而，PA 和体重状况对 HRQL 的综合影响尚不清楚。本研究旨在调查加拿大成年人和老年人中 PA 和体重指数（BMI）与 HRQL 的综合关联。
横断面数据包括来自 2005 年加拿大社区健康调查的 110986 名≥18 岁的参与者，代表了约 22563527 名加拿大人。HRQL 指标包括：自我报告的健康状况（SRH）、因疾病/伤害导致的参与和活动受限（PAL），以及过去 14 天内的总残疾天数（身体+精神）（TDD）。通过 BMI、PA 和 BMI-PA 类别来估计不良 HRQL 的患病率。使用调整后的逻辑回归来评估 BMI、PA 和 BMI-PA 对不良 HRQL 的可能性。分析按性别和年龄（18-44、45-64、≥65 岁）分层。
在所有年龄段的男性和女性中，不活跃的个体在所有 BMI 水平上都更有可能出现健康状况一般/较差的 SRH，有时/经常出现 PAL；相反，在活跃的个体中，体重过轻、超重或肥胖对 SRH 和 PAL 几乎没有影响。TDD 的相关性较弱，在不活动和体重过轻的老年人中影响最大。超重对男性和老年人的 HRQL 相关性较小，而体重过轻对男性和老年人的相关性较大。
在综合考虑 BMI-PA 时，PA 是 HRQL 的更重要相关因素，而与体重状况无关。这强调了 PA 对健康结果的重要性，超过了与减肥或维持体重相关的益处。
