Sriram Karishma, Mulder Hillary S, Frank Heather R, Santanam Taruni S, Skinner Asheley C, Perrin Eliana M, Armstrong Sarah C, Peterson Eric D, Pencina Michael J, Wong Charlene A
Duke University School of Medicine, Durham, North Carolina.
Duke Clinical Research Institute, Durham, North Carolina.
Am J Prev Med. 2021 Jan;60(1):95-103. doi: 10.1016/j.amepre.2020.06.027.
This study examines the dose-response relationship between moderate-to-vigorous physical activity and cardiometabolic measures in adolescents.
Cross-sectional spline analyses were performed using 2003-2016 National Health and Nutrition Examination Survey data among adolescents (aged 12-19 years, N=9,195) on objectively measured (2003-2006) and self-reported (2007-2016) weekly mean minutes of moderate-to-vigorous physical activity and cardiometabolic measures (systolic and diastolic blood pressure, total cholesterol, high-density lipoprotein, BMI, and cardiorespiratory fitness). Inflection points were determined for nonlinear relationships.
For objective moderate-to-vigorous physical activity, female adolescents had significant nonlinear associations with inflection points at 90 minutes/week for BMI percentile and systolic blood pressure. Male adolescents had inflection points at 150 weekly minutes of objective activity for BMI percentile and cardiorespiratory fitness. BMI percentile was about 7% lower for female and male adolescents at 150 weekly minutes of objectively measured moderate-to-vigorous physical activity than at 0 minutes. For self-reported moderate-to-vigorous physical activity, inflection points were at 375 minutes/week (diastolic blood pressure for female adolescents) and 500 minutes/week (systolic blood pressure for male adolescents).
Among several significant dose-response relationships between physical activity and cardiometabolic health in adolescents, consistent and often nonlinear relationships were identified for BMI, with inflection points at 90-150 minutes of objective moderate-to-vigorous physical activity. Notable differences in associations and linearity were identified by sex and physical activity measure (objective or self-reported). These results support calls for any increase in physical activity among adolescents and suggest that recommendations closer to the adult guidelines of 150 weekly minutes of physical activity may be health promoting and more attainable for youth than the current recommendation of 420 weekly minutes.
本研究探讨青少年中等到剧烈身体活动与心血管代谢指标之间的剂量反应关系。
利用2003 - 2016年国家健康与营养检查调查数据，对青少年（12 - 19岁，N = 9195）进行横断面样条分析，数据包括客观测量的（2003 - 2006年）和自我报告的（2007 - 2016年）每周中等到剧烈身体活动的平均分钟数以及心血管代谢指标（收缩压和舒张压、总胆固醇、高密度脂蛋白、体重指数和心肺适能）。确定非线性关系的拐点。
对于客观测量的中等到剧烈身体活动，女性青少年在每周90分钟时，体重指数百分位数和收缩压存在显著非线性关联且有拐点。男性青少年在每周150分钟的客观活动量时，体重指数百分位数和心肺适能有拐点。在每周客观测量的中等到剧烈身体活动量达到150分钟时，女性和男性青少年的体重指数百分位数比0分钟时约低7%。对于自我报告的中等到剧烈身体活动，拐点分别在每周375分钟（女性青少年舒张压）和每周500分钟（男性青少年收缩压）。
在青少年身体活动与心血管代谢健康之间的几种显著剂量反应关系中，发现体重指数存在一致且常为非线性的关系，客观中等到剧烈身体活动90 - 150分钟时有拐点。按性别和身体活动测量方式（客观或自我报告）确定了关联和线性方面的显著差异。这些结果支持呼吁青少年增加身体活动，并表明接近成人指南中每周150分钟身体活动的建议可能比目前每周420分钟的建议更有利于健康促进且更适合青少年。
