Herman K M, Carver T E, Christou N V, Andersen R E
Department of Kinesiology & Physical Education, McGill University, Montreal, QC, Canada.
Clin Obes. 2014 Oct;4(5):267-76. doi: 10.1111/cob.12069. Epub 2014 Aug 7.
Physical activity (PA) is an important adjunct to bariatric surgery in the treatment of severe obesity; however, patient PA levels prior to and in the short-term following surgery are usually low. Scarce data exist describing PA and sedentary behaviours in the long term following surgery. The objectives were to describe PA and sitting time in bariatric patients 1-16 years post-surgery and assess their associations with patient, surgery and weight-loss characteristics. A total of 398 bariatric patients (73% female; mean age 47 ± 11 years, mean 6 ± 4 years since surgery) completed a telephone questionnaire. Patients reported moderate-to-vigorous PA (MVPA: # sessions week(-1) ≥30 min), sitting time (h d(-1)) and change in PA and sitting time vs. pre-surgery (more/same/less). Associations with patient, surgery and weight-loss characteristics were assessed. Only 53% of patients reported ≥1 session week(-1) MVPA, mean sitting time was 7 ± 4 h d(-1), 74% of patients reported more PA and 53% reported less sitting, now vs. pre-surgery. Age, sex, smoking status, pre-surgery body mass index, time-since-surgery and percent excess weight lost were significantly associated with PA and/or sitting outcomes. Patients currently experiencing ≥50% excess weight loss had over three times the odds of reporting ≥1 session week(-1) MVPA (odds ratio [95% confidence interval] 3.28 [1.57, 6.89]) and almost four times greater odds of reporting 'more' PA vs. pre-surgery (3.78 [2.15, 6.62]) compared with their less successful counterparts. Results point to low PA and high sedentariness among bariatric patients in the long-term following surgery, associated with several characteristics. Associations with long-term weight management highlight the need for tailored interventions to promote active living in this patient population.
体育活动(PA)是治疗重度肥胖症的减肥手术的重要辅助手段;然而,患者在手术前及术后短期内的PA水平通常较低。关于术后长期PA和久坐行为的描述性数据稀缺。本研究的目的是描述减肥手术患者术后1至16年的PA和久坐时间,并评估它们与患者、手术及体重减轻特征之间的关联。共有398名减肥手术患者(73%为女性;平均年龄47±11岁,平均术后6±4年)完成了一份电话调查问卷。患者报告了中度至剧烈PA(MVPA:每周≥30分钟的次数)、久坐时间(每天小时数)以及与术前相比PA和久坐时间的变化(更多/相同/更少)。评估了这些因素与患者、手术及体重减轻特征之间的关联。只有53%的患者报告每周≥1次MVPA,平均久坐时间为每天7±4小时,74%的患者报告与术前相比PA增多,53%的患者报告久坐时间减少。年龄、性别、吸烟状况、术前体重指数、术后时间以及超重减轻百分比与PA和/或久坐结果显著相关。目前超重减轻≥50%的患者报告每周≥1次MVPA的几率是体重减轻效果较差的患者的三倍多(优势比[95%置信区间]3.28[1.57,6.89]),报告PA“增多”的几率几乎是术前的四倍(3.78[2.15,6.62])。结果表明,减肥手术患者术后长期PA水平较低且久坐时间较长,这与多个特征相关。与长期体重管理的关联凸显了针对该患者群体制定个性化干预措施以促进积极生活方式的必要性。