Health Council of the Netherlands, P.O. Box 16052, 2500, BB, The Hague, The Netherlands.
University Medical Center, Utrecht, the Netherlands.
Int J Behav Nutr Phys Act. 2018 Jun 25;15(1):58. doi: 10.1186/s12966-018-0661-9.
The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population.
Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence.
The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and muscle-strengthening activities, and (3) sedentary behaviour were formulated separately for adults and children.
There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health.
本研究旨在为荷兰普通人群制定基于循证的体力活动指南。
对 PubMed 中分别总结体力活动和久坐行为与全因死亡率和 15 种主要慢性疾病和状况发病风险之间关系的随机对照试验和前瞻性队列研究的英文荟萃分析进行了两项系统评价。其他结局指标包括心血管疾病和 2 型糖尿病的危险因素、身体机能和体能。基于这些综述，专家委员会制定了体力活动指南。在制定指南时，委员会首先仅选择具有较强证据水平的实验和观察性前瞻性发现，然后整合两种证据。
在大量结局指标上发现的有益效果证据足够强，可以制定增加体力活动和减少久坐行为的指南。同时，目前的证据不足以量化需要多少体力活动才能产生有益的健康效果，或者久坐行为达到什么程度会产生有害影响。一个普遍原则是，在当前活动水平的每一级上，进一步增加体力活动会带来额外的健康益处，而对于目前不活跃或仅处于低强度活动的人，效果相对更大。针对成年人和儿童，分别制定了三条关于（1）中等和剧烈强度体力活动、（2）骨骼和肌肉强化活动和（3）久坐行为的具体指南。
仍然需要基于证据的体力活动指南来指导公共卫生政策。需要进行研究，既要客观（数量）测量体力活动，又要主观（类型和质量）测量体力活动，以更好地估计健康所需的体力活动类型和实际量。
