Collings P J, Wijndaele K, Corder K, Westgate K, Ridgway C L, Sharp S J, Atkin A J, Stephen A M, Bamber D, Goodyer I, Brage S, Ekelund U
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Pediatr Obes. 2016 Apr;11(2):107-14. doi: 10.1111/ijpo.12031. Epub 2015 Apr 27.
The data regarding prospective associations between physical activity (PA) and adiposity in youth are inconsistent.
The objective of this study was to investigate associations between baseline levels of objectively measured PA and changes in adiposity over 2.5 years from mid-to-late adolescence.
This was an observational cohort study in 728 school students (43% boys) from Cambridgeshire, United Kingdom. Fat mass index (FMI, kg m(-2) ) was estimated at baseline (mean ± standard deviation age: 15 ± 0.3 years) and follow-up (17.5 ± 0.3 years) by anthropometry and bioelectrical impedance. Habitual PA was assessed at baseline by ≥3 d combined heart rate and movement sensing. Average daily PA energy expenditure (PAEE) and the time (min d(-1) ) spent in light, moderate and vigorous intensity PA (LPA, MPA and VPA, respectively) was estimated. Multilevel models were used to investigate associations between baseline PA and change in FMI (ΔFMI). Adjustment for baseline age, sex, follow-up duration, area-level socioeconomic status, season of PA assessment, sedentary time, energy intake and sleep duration was made; baseline FMI was also added in a second model.
FMI increased significantly over follow-up (0.6 ± 1.2 kg m(-2) , P < 0.001). Baseline PAEE and LPA positively predicted ΔFMI in overfat participants (P ≤ 0.030), as did VPA in initially normal fat participants (P ≤ 0.044). There were further positive associations between PAEE and ΔFMI in normal fat participants, and between MPA and ΔFMI in both fat groups, when adjusted for baseline FMI (P ≤ 0.024).
Baseline PAEE and its subcomponents were positively associated with small and unlikely clinically relevant increases in ΔFMI. These counter-intuitive findings may be explained by behavioural changes during the course of study follow-up.
关于青少年身体活动(PA)与肥胖之间前瞻性关联的数据并不一致。
本研究的目的是调查客观测量的PA基线水平与从青春期中期到后期2.5年内肥胖变化之间的关联。
这是一项对来自英国剑桥郡的728名在校学生(43%为男孩)进行的观察性队列研究。通过人体测量和生物电阻抗在基线(平均±标准差年龄:15±0.3岁)和随访(17.5±0.3岁)时估计脂肪质量指数(FMI,kg m⁻²)。通过连续≥3天的心率和运动传感在基线时评估习惯性PA。估计平均每日PA能量消耗(PAEE)以及在轻度、中度和剧烈强度PA(分别为LPA、MPA和VPA)中花费的时间(min d⁻¹)。使用多水平模型研究基线PA与FMI变化(ΔFMI)之间的关联。对基线年龄、性别、随访持续时间、地区层面的社会经济地位、PA评估季节、久坐时间、能量摄入和睡眠时间进行了调整;在第二个模型中还加入了基线FMI。
随访期间FMI显著增加(0.6±1.2 kg m⁻²,P<0.001)。基线PAEE和LPA正向预测超重参与者的ΔFMI(P≤0.030),初始体重正常参与者中的VPA也是如此(P≤0.044)。在调整基线FMI后,正常体重参与者中PAEE与ΔFMI之间以及两个体重组中MPA与ΔFMI之间存在进一步的正相关(P≤0.024)。
基线PAEE及其子成分与ΔFMI的小幅且不太可能具有临床相关性的增加呈正相关。这些与直觉相反的发现可能可以通过研究随访过程中的行为变化来解释。