Yerramalla Manasa S, McGregor Duncan E, van Hees Vincent T, Fayosse Aurore, Dugravot Aline, Tabak Adam G, Chen Mathilde, Chastin Sebastien F M, Sabia Séverine
Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, 10 Avenue de Verdun, 75010, Paris, France.
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.
Int J Behav Nutr Phys Act. 2021 Jul 12;18(1):83. doi: 10.1186/s12966-021-01157-0.
Moderate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention. At older ages, the role of sedentary behaviour (SB) and light intensity physical activity (LIPA) remains unclear. Evidence so far is based on studies examining movement behaviours as independent entities ignoring their co-dependency. This study examines the association between daily composition of objectively-assessed movement behaviours (MVPA, LIPA, SB) and incident CVD in older adults.
Whitehall II accelerometer sub-study participants free of CVD at baseline (N = 3319, 26.7% women, mean age = 68.9 years in 2012-2013) wore a wrist-accelerometer from which times in SB, LIPA, and MVPA during waking period were extracted over 7 days. Compositional Cox regression was used to estimate the hazard ratio (HR) for incident CVD for daily compositions of movement behaviours characterized by 10 (20 or 30) minutes greater duration in one movement behaviour accompanied by decrease in another behaviour, while keeping the third behaviour constant, compared to reference composition. Analyses were adjusted for sociodemographic, lifestyle, cardiometabolic risk factors and multimorbidity index.
Of the 3319 participants, 299 had an incident CVD over a mean (SD) follow-up of 6.2 (1.3) years. Compared to daily movement behaviour composition with MVPA at recommended 21 min per day (150 min/week), composition with additional 10 min of MVPA and 10 min less SB was associated with smaller risk reduction - 8% (HR, 0.92; 95% CI, 0.87-0.99) - than the 14% increase in risk associated with a composition of similarly reduced time in MVPA and more time in SB (HR, 1.14; 95% CI, 1.02-1.27). For a given MVPA duration, the CVD risk did not differ as a function of LIPA and SB durations.
Among older adults, an increase in MVPA duration at the expense of time in either SB or LIPA was found associated with lower incidence of CVD. This study lends support to public health guidelines encouraging increase in MVPA or at least maintain MVPA at current duration.
中等到剧烈身体活动(MVPA)被认为是预防心血管疾病(CVD)的关键。在老年人群中,久坐行为(SB)和轻度身体活动(LIPA)的作用仍不明确。目前的证据基于将运动行为作为独立个体进行研究,而忽略了它们之间的相互依存关系。本研究探讨了客观评估的运动行为(MVPA、LIPA、SB)的日常构成与老年人新发CVD之间的关联。
白厅II加速度计子研究的参与者在基线时无CVD(2012 - 2013年,N = 3319,女性占26.7%,平均年龄 = 68.9岁),佩戴腕部加速度计7天,从中提取清醒期间SB、LIPA和MVPA的时间。使用成分Cox回归估计运动行为日常构成导致新发CVD的风险比(HR),该日常构成的特点是一种运动行为持续时间增加10(20或30)分钟,同时另一种行为持续时间减少,而第三种行为保持不变,与参考构成相比。分析对社会人口学、生活方式、心血管代谢危险因素和多重疾病指数进行了调整。
在3319名参与者中,299人在平均(标准差)6.2(1.3)年的随访期间发生了新发CVD。与每天MVPA为推荐的21分钟(每周150分钟)的日常运动行为构成相比,MVPA增加10分钟且SB减少10分钟的构成与风险降低幅度较小相关——降低8%(HR,0.92;95%CI,0.87 - 0.99)——而与MVPA时间同样减少且SB时间增加的构成相关的风险增加14%(HR,1.14;95%CI,1.02 - 1.27)。对于给定的MVPA持续时间,CVD风险不因LIPA和SB持续时间的变化而不同。
在老年人中,发现以牺牲SB或LIPA时间为代价增加MVPA持续时间与较低的CVD发病率相关。本研究支持鼓励增加MVPA或至少维持当前MVPA持续时间的公共卫生指南。