五年运动训练对老年人全因死亡率的影响——Generation 100 研究：随机对照试验。
Effect of exercise training for five years on all cause mortality in older adults-the Generation 100 study: randomised controlled trial.
机构信息
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Post Box 8905, 7491 Trondheim, Norway.
Department of Thoracic Medicine, Clinic of Thoracic and Occupational Medicine, St Olavs University Hospital, Trondheim, Norway.
出版信息
BMJ. 2020 Oct 7;371:m3485. doi: 10.1136/bmj.m3485.
OBJECTIVE
To evaluate the effect of five years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (70-77 years).
DESIGN
Randomised controlled trial.
SETTING
General population of older adults in Trondheim, Norway.
PARTICIPANTS
1567 of 6966 individuals born between 1936 and 1942.
INTERVENTION
Participants were randomised to two sessions weekly of high intensity interval training at about 90% of peak heart rate (HIIT, n=400), moderate intensity continuous training at about 70% of peak heart rate (MICT, n=387), or to follow the national guidelines for physical activity (n=780; control group); all for five years.
MAIN OUTCOME MEASURE
All cause mortality. An exploratory hypothesis was that HIIT lowers mortality more than MICT.
RESULTS
Mean age of the 1567 participants (790 women) was 72.8 (SD 2.1) years. Overall, 87.5% of participants reported to have overall good health, with 80% reporting medium or high physical activity levels at baseline. All cause mortality did not differ between the control group and combined MICT and HIIT group. When MICT and HIIT were analysed separately, with the control group as reference (observed mortality of 4.7%), an absolute risk reduction of 1.7 percentage points was observed after HIIT (hazard ratio 0.63, 95% confidence interval 0.33 to 1.20) and an absolute increased risk of 1.2 percentage points after MICT (1.24, 0.73 to 2.10). When HIIT was compared with MICT as reference group an absolute risk reduction of 2.9 percentage points was observed (0.51, 0.25 to 1.02) for all cause mortality. Control participants chose to perform more of their physical activity as HIIT than the physical activity undertaken by participants in the MICT group. This meant that the controls achieved an exercise dose at an intensity between the MICT and HIIT groups.
CONCLUSION
This study suggests that combined MICT and HIIT has no effect on all cause mortality compared with recommended physical activity levels. However, we observed a lower all cause mortality trend after HIIT compared with controls and MICT.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01666340.
目的
评估与体力活动建议相比，五年监督运动训练对老年人（70-77 岁）死亡率的影响。
设计
随机对照试验。
地点
挪威特隆赫姆的老年人群体。
参与者
1936 年至 1942 年间出生的 6966 名个体中的 1567 名。
干预措施
参与者被随机分配到每周两次的高强度间歇训练（HIIT，约 90%的峰值心率，n=400）、中等强度连续训练（MICT，约 70%的峰值心率，n=387）或遵循国家体力活动指南（n=780；对照组）；所有这些都持续五年。
主要观察指标
全因死亡率。一个探索性假设是 HIIT 比 MICT 降低死亡率的效果更好。
结果
1567 名参与者（790 名女性）的平均年龄为 72.8（2.1）岁。总体而言，87.5%的参与者报告整体健康状况良好，80%的参与者在基线时报告中等或高体力活动水平。对照组和 MICT 和 HIIT 联合组之间的全因死亡率没有差异。当分别分析 MICT 和 HIIT 时，以对照组为参考（观察到的死亡率为 4.7%），HIIT 后绝对风险降低 1.7 个百分点（危险比 0.63，95%置信区间 0.33 至 1.20），MICT 后绝对风险增加 1.2 个百分点（1.24，0.73 至 2.10）。当 HIIT 与 MICT 作为参考组进行比较时，全因死亡率的绝对风险降低了 2.9 个百分点（0.51，0.25 至 1.02）。对照组选择进行更多的 HIIT 运动，而不是 MICT 组参与者进行的运动。这意味着对照组达到了介于 MICT 和 HIIT 组之间的运动强度。
结论
这项研究表明，与推荐的体力活动水平相比，MICT 和 HIIT 的联合应用对全因死亡率没有影响。然而，与对照组和 MICT 相比，我们观察到 HIIT 后全因死亡率呈下降趋势。
试验注册
ClinicalTrials.gov NCT01666340。
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