Bouchard Claude, Blair Steven N, Katzmarzyk Peter T
Pennington Biomedical Research Center, Baton Rouge, LA.
Arnold School of Public Health, University of South Carolina, Columbia.
Mayo Clin Proc. 2015 Nov;90(11):1533-40. doi: 10.1016/j.mayocp.2015.08.005. Epub 2015 Oct 5.
Epidemiological studies have found that time spent in sedentary behaviors, levels of physical activity, and cardiorespiratory fitness are all associated with mortality rates. They are also related to the risks of obesity, type 2 diabetes mellitus, hypertension, cardiovascular disease, aging-associated frailty, and cancer. The evidence is such that the National Institutes of Health recently launched a new Common Fund initiative aimed at identifying the molecular transducers of adaptation to physical activity in various tissues and organs. It has been estimated that 9.4% of all 57 million deaths in the world in 2008 could be attributed to physical inactivity, which translates into more than 5 million deaths worldwide. Physical inactivity has a deleterious effect that is comparable to smoking and obesity. Importantly, this global estimate relates to levels of physical activity and does not take into account sedentary behavior and cardiorespiratory fitness. Currently, there are national and international guidelines for physical activity level that are highly concordant. The weekly recommendations include 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or some combination of moderate and vigorous activity with 2 days of resistance exercise. However, these guidelines offer no recommendations regarding sedentary time or goals for cardiorespiratory fitness levels. It will be increasingly important for disease prevention, successful aging, and reduction of premature mortality to broaden the focus of the public health message to include not only more physical activity but also less sitting and higher cardiorespiratory fitness. We briefly review the evidence and discuss key issues to be addressed to make this approach a reality.
流行病学研究发现，久坐行为的时长、身体活动水平和心肺适能均与死亡率相关。它们还与肥胖、2型糖尿病、高血压、心血管疾病、与衰老相关的身体虚弱以及癌症的风险有关。有证据表明，美国国立卫生研究院最近发起了一项新的共同基金计划，旨在确定各种组织和器官中适应身体活动的分子传感器。据估计，2008年全球5700万死亡病例中有9.4%可归因于缺乏身体活动，这意味着全球有超过500万人死亡。缺乏身体活动的有害影响与吸烟和肥胖相当。重要的是，这一全球估计涉及身体活动水平，并未考虑久坐行为和心肺适能。目前，国家和国际层面关于身体活动水平的指南高度一致。每周的建议包括150分钟的中等强度活动、75分钟的高强度活动，或中等强度和高强度活动的某种组合以及2天的抗阻运动。然而，这些指南并未就久坐时间或心肺适能水平的目标提出建议。对于疾病预防、成功老龄化和降低过早死亡率而言，扩大公共卫生信息的重点，不仅包括增加身体活动，还包括减少久坐和提高心肺适能，将变得越来越重要。我们简要回顾相关证据，并讨论为实现这一方法需要解决的关键问题。
