Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
Am J Cardiol. 2013 Aug 1;112(3):380-6. doi: 10.1016/j.amjcard.2013.03.040. Epub 2013 May 3.
Individual associations of alcohol consumption and physical activity with cardiovascular disease are relatively established, but the joint associations are not clear. Therefore, the aim of this study was to examine prospectively the joint associations between alcohol consumption and physical activity with cardiovascular mortality (CVM) and all-cause mortality. Four population-based studies in the United Kingdom were included, the 1997 and 1998 Health Surveys for England and the 1998 and 2003 Scottish Health Surveys. In men and women, respectively, low physical activity was defined as 0.1 to 5 and 0.1 to 4 MET-hours/week and high physical activity as ≥5 and ≥4 MET-hours/week. Moderate or moderately high alcohol intake was defined as >0 to 35 and >0 to 21 units/week and high levels of alcohol intake as >35 and >21 units/week. In total, there were 17,410 adults without prevalent cardiovascular diseases and complete data on alcohol and physical activity (43% men, median age 55 years). During a median follow-up period of 9.7 years, 2,204 adults (12.7%) died, 638 (3.7%) with CVM. Cox proportional-hazards models were adjusted for potential confounders such as marital status, social class, education, ethnicity, and longstanding illness. In the joint associations analysis, low activity combined with high levels of alcohol (CVM: hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.28 to 2.96, p = 0.002; all-cause mortality: HR 1.64, 95% CI 1.32 to 2.03, p <0.001) and low activity combined with no alcohol (CVM: HR 1.93, 95% CI 1.35 to 2.76, p <0.001; all-cause mortality: HR 1.50, 95% CI 1.24 to 1.81, p <0.001) were linked to the highest risk, compared with moderate drinking and higher levels of physical activity. Within each given alcohol group, low activity was linked to increased CVM risk (e.g., HR 1.48, 95% CI 1.08 to 2.03, p = 0.014, for the moderate drinking group), but in the presence of high physical activity, high alcohol intake was not linked to increased CVM risk (HR 1.32, 95% CI 0.52 to 3.34, p = 0.555). In conclusion, high levels of drinking and low physical activity appear to increase the risk for cardiovascular and all-cause mortality, although these data suggest that physical activity levels are more important.
饮酒和体力活动与心血管疾病的个体关联相对明确，但联合关联尚不清楚。因此，本研究旨在前瞻性地研究饮酒和体力活动与心血管疾病死亡率（CVM）和全因死亡率的联合关联。纳入了英国的四项基于人群的研究，分别是 1997 年和 1998 年英格兰健康调查和 1998 年和 2003 年苏格兰健康调查。在男性和女性中，低体力活动分别定义为每周 0.1 至 5 和 0.1 至 4 MET 小时，高体力活动定义为每周≥5 和≥4 MET 小时。适度或高度饮酒定义为每周>0 至 35 和>0 至 21 单位，高度饮酒定义为每周>35 和>21 单位。共有 17410 名无心血管疾病且完整记录饮酒和体力活动数据的成年人（43%为男性，中位年龄为 55 岁）。在中位随访 9.7 年期间，有 2204 名成年人（12.7%）死亡，其中 638 人（3.7%）死于 CVM。Cox 比例风险模型调整了潜在混杂因素，如婚姻状况、社会阶层、教育、种族和长期疾病。在联合关联分析中，低活动水平与高水平饮酒（CVM：风险比[HR] 1.95，95%置信区间[CI] 1.28 至 2.96，p=0.002；全因死亡率：HR 1.64，95%CI 1.32 至 2.03，p<0.001）和低活动水平与无饮酒（CVM：HR 1.93，95%CI 1.35 至 2.76，p<0.001；全因死亡率：HR 1.50，95%CI 1.24 至 1.81，p<0.001）相关联，与适度饮酒和高水平体力活动相比，风险最高。在每个给定的酒精组内，低活动水平与 CVM 风险增加相关（例如，适度饮酒组 HR 1.48，95%CI 1.08 至 2.03，p=0.014），但在高体力活动水平下，高饮酒量与 CVM 风险增加无关（HR 1.32，95%CI 0.52 至 3.34，p=0.555）。总之，高水平饮酒和低体力活动似乎会增加心血管疾病和全因死亡率的风险，但这些数据表明，体力活动水平更为重要。
