Lo Feng En, Lu Po Jung, Tsai Min Kuang, Lee June Han, Wen Christopher, Wen Chi Pang, Wai Jackson Pui Man, Tsao Chwen Keng, Chiang Po Huang, Lyu Shu Yu, Ma Ko Lu, Chi Ying-Chen, Li Chu-Shiu, Liu Chwen-Chi, Wu Xifeng
Department of Leisure and Recreation Management, Asia University, Taichung, Taiwan.
Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
PLoS One. 2016 Apr 4;11(4):e0152246. doi: 10.1371/journal.pone.0152246. eCollection 2016.
To assess the benefits of regular exercise in reducing harms associated with betel quid (BQ) chewing.
The study cohort, 419,378 individuals, participated in a medical screening program between 1994 and 2008, with 38,324 male and 1,495 female chewers, who consumed 5-15 quids of BQ a day. Physical activity of each individual, based on "MET-hour/week", was classified as "inactive" or "active", where activity started from a daily 15 minutes/day or more of brisk walking (≥3.75 MET-hour/week). Hazard ratios for mortality and remaining years in life expectancy were calculated.
Nearly one fifth (18.7%) of men, but only 0.7% of women were chewers. Chewers had a 10-fold increase in oral cancer risk; and a 2-3-fold increase in mortality from lung, esophagus and liver cancer, cardiovascular disease, and diabetes, with doubling of all-cause mortality. More than half of chewers were physically inactive (59%). Physical activity was beneficial for chewers, with a reduction of all-cause mortality by 19%. Inactive chewers had their lifespan shortened by 6.3 years, compared to non-chewers, but being active, chewers improved their health by gaining 2.5 years. The improvement, however, fell short of offsetting the harms from chewing.
Chewers had serious health consequences, but being physically active, chewers could mitigate some of these adverse effects, and extend life expectancy by 2.5 years and reduce mortality by one fifth. Encouraging exercise, in addition to quitting chewing, remains the best advice for 1.5 million chewers in Taiwan.
评估定期锻炼在降低与嚼槟榔相关危害方面的益处。
该研究队列由419378人组成，他们在1994年至2008年间参加了一项医学筛查项目，其中有38324名男性和1495名女性嚼槟榔者，他们每天食用5至15颗槟榔。根据“代谢当量小时/周”对每个人的身体活动进行分类，分为“不活跃”或“活跃”，其中活动起始于每天至少15分钟的快走（≥3.75代谢当量小时/周）。计算死亡率和预期寿命剩余年数的风险比。
近五分之一（18.7%）的男性是嚼槟榔者，但女性中只有0.7%是嚼槟榔者。嚼槟榔者患口腔癌的风险增加了10倍；患肺癌、食管癌、肝癌、心血管疾病和糖尿病的死亡率增加了2至3倍，全因死亡率翻倍。超过一半的嚼槟榔者身体不活跃（59%）。身体活动对嚼槟榔者有益，全因死亡率降低了19%。与不嚼槟榔者相比，不活跃的嚼槟榔者寿命缩短了6.3年，但活跃的嚼槟榔者通过增加2.5年的寿命改善了健康状况。然而，这种改善不足以抵消嚼槟榔带来的危害。
嚼槟榔者有严重的健康后果，但身体活跃的嚼槟榔者可以减轻其中一些不良影响，并将预期寿命延长2.5年，将死亡率降低五分之一。除了戒除嚼槟榔外，鼓励锻炼仍然是对台湾150万嚼槟榔者的最佳建议。
