针对老年人群的身体成分：运动行为的改变重要吗？PREDIMED-Plus试验的纵向分析。
Targeting body composition in an older population: do changes in movement behaviours matter? Longitudinal analyses in the PREDIMED-Plus trial.
作者信息
Galmes-Panades Aina M, Konieczna Jadwiga, Varela-Mato Veronica, Abete Itziar, Babio Nancy, Fiol Miquel, Antonio de Paz José, Casas Rosa, Olbeyra Romina, Ruiz-Canela Miguel, Palau-Galindo Antoni, Castañer Olga, Martín-García Arturo, Estruch Ramón, Vidal Josep, Buil-Cosiales Pilar, Wärnberg Julia, Salas-Salvadó Jordi, Martínez J Alfredo, Romaguera Dora
机构信息
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain.
出版信息
BMC Med. 2021 Jan 6;19(1):3. doi: 10.1186/s12916-020-01847-9.
BACKGROUND
The optimal distribution between physical activity (PA) levels and sedentary behaviour (SB) for the greatest benefits for body composition among older adults with overweight/obesity and chronic health conditions remains unclear. We aimed to determine the prospective association between changes in PA and in SB with concurrent changes in body composition and to examine whether reallocating inactive time into different physical activity levels was associated with 12-month change to body composition in older adults.
METHODS
Longitudinal assessment nested in the PREDIMED-Plus trial. A subsample (n = 1564) of men and women (age 55-75 years) with overweight/obesity and metabolic syndrome from both arms of the PREDIMED-Plus trial was included in the present analysis. Participants were followed up at 6 and 12 months. Physical activity and SB were assessed using validated questionnaires. Out of 1564 participants, 388 wore an accelerometer to objectively measure inactive time and PA over a 7-day period. At each time point, participants' body composition was measured using dual-energy X-ray absorptiometry (DXA). Standard covariate-adjusted and isotemporal substitution modelling were applied to linear mixed-effects models.
RESULTS
Increasing 30 min of total PA and moderate-to-vigorous physical activity (MVPA) was associated with significant reductions in body fat (β - 0.07% and - 0.08%) and visceral adipose tissue (VAT) (- 13.9 g, and - 15.6 g) at 12 months (all p values < 0.001). Reallocating 30 min of inactive time to MVPA was associated with reductions in body fat and VAT and with an increase in muscle mass and muscle-to-fat mass ratio (all p values < 0.001).
CONCLUSIONS
At 12 months, increasing total PA and MVPA and reducing total SB and TV-viewing SB were associated with improved body composition in participants with overweight or obesity, and metabolic syndrome. This was also observed when substituting 30 min of inactive time with total PA, LPA and MVPA, with the greatest benefits observed with MVPA.
TRIAL REGISTRATION
International Standard Randomized Controlled Trial (ISRCTN), 89898870 . Retrospectively registered on 24 July 2014.
背景
对于超重/肥胖且患有慢性健康问题的老年人，身体活动（PA）水平和久坐行为（SB）之间的最佳分布以实现对身体成分的最大益处仍不明确。我们旨在确定PA和SB的变化与身体成分的同时变化之间的前瞻性关联，并研究将不活动时间重新分配到不同的身体活动水平是否与老年人身体成分的12个月变化相关。
方法
嵌套于PREDIMED-Plus试验中的纵向评估。本分析纳入了PREDIMED-Plus试验双臂中年龄在55 - 75岁、患有超重/肥胖和代谢综合征的男性和女性子样本（n = 1564）。在6个月和12个月时对参与者进行随访。使用经过验证的问卷评估身体活动和SB。在1564名参与者中，388人佩戴了加速度计，以客观测量7天内的不活动时间和PA。在每个时间点，使用双能X线吸收法（DXA）测量参与者的身体成分。将标准协变量调整和等时替代模型应用于线性混合效应模型。
结果
在12个月时，总PA增加30分钟和中等至剧烈身体活动（MVPA）增加与身体脂肪（β - 0.07%和 - 0.08%）和内脏脂肪组织（VAT）（ - 13.9克和 - 15.6克）显著减少相关（所有p值 < 0.001）。将30分钟的不活动时间重新分配为MVPA与身体脂肪和VAT减少以及肌肉量和肌肉与脂肪量之比增加相关（所有p值 < 0.001）。
结论
在12个月时，增加总PA和MVPA以及减少总SB和看电视的SB与超重或肥胖及代谢综合征参与者的身体成分改善相关。当用总PA、低强度身体活动（LPA）和MVPA替代30分钟的不活动时间时也观察到了这一点，其中MVPA带来的益处最大。
试验注册
国际标准随机对照试验（ISRCTN），89898870。于2014年7月24日进行回顾性注册。
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