Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN.
Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Menopause. 2019 Jan;26(1):16-23. doi: 10.1097/GME.0000000000001168.
Weight gain frequently occurs after smoking cessation. The objective of this study was to examine whether weight gain after smoking cessation was attenuated by physical activity (PA) in postmenopausal women.
A total of 4,717 baseline smokers from the Women's Health Initiative were followed for 3 years. One thousand two hundred eighty-two women quit smoking, and 3,435 continued smoking. Weight was measured at baseline and at the year 3 visit. PA was assessed at both times by self-report, summarized as metabolic equivalent task-hours per week. Multiple linear regression models were used to assess the association between PA and postcessation weight gain, adjusting for potential confounding factors.
Compared with continuing smokers, quitters gained an average of 3.5 kg (SD = 5.6) between the baseline and year 3 visit. Quitters with decreased PA had the highest amount of weight gain (3.88 kg, 95% CI: 3.22-4.54); quitters with increased PA (≥15 metabolic equivalent task-hours /week) had the lowest weight gain (2.55 kg, 95% CI: 1.59-3.52). Increased PA had a stronger beneficial association for postcessation weight gain for women with obesity compared to normal weight women. Quitters who had low PA at baseline and high PA at year 3 and were also enrolled in a dietary modification intervention had nonsignificant weight gain (1.88 kg, 95% CI: -0.21-3.96) compared with continuing smokers.
Our data demonstrate that even a modest increase in PA (equivalent to current recommendations) can attenuate weight gain after quitting smoking among postmenopausal women, especially in combination with improved diet.
戒烟后常出现体重增加。本研究旨在探讨绝经后女性中,戒烟后的体重增加是否因体力活动(PA)而减轻。
共纳入 4717 名来自妇女健康倡议的基线吸烟者,随访 3 年。1282 名女性戒烟,3435 名继续吸烟。体重在基线和第 3 年就诊时测量。PA 在两次就诊时均通过自我报告评估,总结为每周代谢当量任务小时数。多线性回归模型用于评估 PA 与戒烟后体重增加之间的关联,同时调整潜在的混杂因素。
与继续吸烟者相比,戒烟者在基线和第 3 年就诊期间平均体重增加 3.5kg(SD=5.6)。PA 减少的戒烟者体重增加最多(3.88kg,95%CI:3.22-4.54);PA 增加(≥15 代谢当量任务小时/周)的戒烟者体重增加最少(2.55kg,95%CI:1.59-3.52)。与正常体重女性相比,肥胖女性戒烟后体重增加,PA 增加与获益的关联更强。基线时 PA 低、第 3 年 PA 高且参加饮食干预的戒烟者,与继续吸烟者相比,体重增加无显著差异(1.88kg,95%CI:-0.21-3.96)。
我们的数据表明,即使是适度增加 PA(相当于目前的推荐量)也可以减轻绝经后女性戒烟后的体重增加,尤其是与改善饮食相结合时。