Bauman Adrian E, Grunseit Anne C, Rangul Vegar, Heitmann Berit L
Prevention Research Collaboration, School of Public Health, University of Sydney, Level 6, Charles Perkins Centre, Johns Hopkins Drive, Sydney, NSW, 2006, Australia.
HUNT Research Centre, Faculty of Medicine, Department of Public health and General practice, NTNU - Norwegian University of Science and Technology, Levanger, Norway.
BMC Public Health. 2017 Oct 5;17(1):788. doi: 10.1186/s12889-017-4806-6.
Most studies of physical activity (PA) epidemiology use behaviour measured at a single time-point. We examined whether 'PA patterns' (consistently low, consistently high or inconsistent PA levels over time) showed different epidemiological relationships for anthropometric and mortality outcomes, compared to single time-point measure of PA.
Data were the Danish MONICA (MONItoring Trends and Determinants in CArdiovascular Disease) study over three waves 1982-3 (time 1), 1987-8 (time 2) and 1993-4 (time 3). Associations between leisure time single time-point PA levels at time 1 and time 3, and sport and active travel at times 1 and 2 with BMI, waist, hip circumference and mortality (death from coronary heart disease (CHD) and cardiovascular disease (CVD)) were compared to 'PA patterns' spanning multiple time points. PA pattern classified participants' PA as either 1) inactive or low PA at both time points; 2) moderate level PA at time 1 and high activity at time 3; or 3) a 'mixed PA pattern' indicating a varying levels of activity over time. Similarly, sport and active travel were also classified as indicating stable low, stable high and mixed patterns.
The moderately and highly active groups for PA at times 1 and 3 had up to 1.7 cm lower increase in waist circumference compared with the inactive/low active group. Across 'PA patterns', 'active maintainers' had a 2.0 cm lower waist circumference than 'inactive/low maintainers'. Waist circumference was inversely related to sport but not active travel. CHD risk did not vary by activity levels at time 1, but was reduced significantly by 43% for high PA at time 3 (vs 'inactive' group) and among 'active maintainers' (vs 'inactive/low maintainers') by 62%. 'Sport pattern' showed stronger reductions in mortality for cardiovascular disease and CHD deaths among sport maintainers, than the single time point measures.
PA patterns demonstrated a stronger association with a number of anthropometric and mortality outcomes than the single time-point measures. Operationalising PA as a sustained behavioural pattern may address some of the known under-estimation of risk for poor health in PA self-report measurements and better reflect exposure for epidemiological analysis of risk of health outcomes.
大多数体力活动（PA）流行病学研究使用的是在单一时间点测量的行为。我们研究了与PA的单时间点测量相比，“PA模式”（随时间始终保持低、高或不一致的PA水平）对于人体测量和死亡率结果是否显示出不同的流行病学关系。
数据来自丹麦心血管疾病趋势和决定因素监测（MONICA）研究的三个阶段，即1982 - 1983年（时间1）、1987 - 1988年（时间2）和1993 - 1994年（时间3）。比较了时间1和时间3的休闲时间单时间点PA水平，以及时间1和时间2的运动与主动出行与体重指数（BMI）、腰围、臀围和死亡率（冠心病（CHD）和心血管疾病（CVD）死亡）之间的关联，与跨越多个时间点的“PA模式”进行对比。PA模式将参与者的PA分为以下几类：1）在两个时间点均为不活动或低PA；2）时间1为中等水平PA，时间3为高活动量；或3）“混合PA模式”，表明随时间活动水平有所变化。同样，运动和主动出行也被分类为稳定低、稳定高和混合模式。
与不活动/低活动组相比，时间1和时间3的PA中、高活动组腰围增加量最多低1.7厘米。在“PA模式”中，“活跃维持者”的腰围比“不活动/低维持者”低2.0厘米。腰围与运动呈负相关，但与主动出行无关。CHD风险在时间1时不因活动水平而异，但在时间3时，高PA组（与“不活动”组相比）和“活跃维持者”（与“不活动/低维持者”相比）的CHD风险显著降低43%和62%。“运动模式”显示，与单时间点测量相比，运动维持者中心血管疾病和CHD死亡的死亡率降低更为显著。
与单时间点测量相比，PA模式与一些人体测量和死亡率结果显示出更强的关联。将PA作为一种持续的行为模式来实施，可能解决PA自我报告测量中已知的对健康不良风险估计不足的问题，并更好地反映健康结果风险的流行病学分析中的暴露情况。
