Ahmadi Matthew N, Inan-Eroglu Elif, Mishra Gita D, Salis Amanda, Stamatakis Emmanuel
Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Prev Med. 2023 Mar;168:107435. doi: 10.1016/j.ypmed.2023.107435. Epub 2023 Feb 4.
We examined the association of changes in physical activity and diet with obesity development and changes in body fat percentage, body mass index, and waist circumference. 31,344 adults without obesity at baseline (age = 56.0 ± 7.5 years; female = 49.1%) from the UK Biobank were included. Physical activity was categorised based on public health guidelines as: inactive; insufficient; and sufficient. Diet category was assigned based on an established composited score that included consumption of fruits, vegetables, fish, red meat (unprocessed), and processed meat. Diet was categorised as: poor; reasonable; and good. Physical activity and diet changes were categorised based on changes in category: worsened; stable; increased (physical activity)/improved (diet). During a mean follow up of 6.8 (SD = ±2.3) years, 1354 (4.3%) participants developed obesity. Compared to stable physical activity-diet, increasing physical activity was associated with the lowest obesity odds, across diet changes (e.g., OR [95%CI]: diet worsened (0.89 [0.69, 1.15]); diet improved (0.65 [0.48, 0.89])). Increasing physical activity with improved diet was associated with the largest difference in body fat percentage (β:-0.62 [-0.82, -0.41]), body mass index (-0.37 [-0.47, -0.28]), and waist circumference (-1.21 [-1.63, -0.79]). Excluding adults with a history of smoking, or major illness, lowered obesity odds among participants with increased physical activity by an additional 11%-21%. In those who decreased physical activity obesity was attenuated when combined with diet improvement. Improvements in physical activity or diet mutually attenuated the deleterious associations of the other behaviour's deterioration. In most analyses, increases in physical activity conferred consistent positive associations against the development of obesity, across dietary change groups.
我们研究了身体活动和饮食变化与肥胖发展以及体脂百分比、体重指数和腰围变化之间的关联。纳入了英国生物银行中31344名基线时无肥胖的成年人（年龄 = 56.0 ± 7.5岁；女性 = 49.1%）。身体活动根据公共卫生指南分为：不活跃；不足；充足。饮食类别根据既定的综合评分来划分，该评分包括水果、蔬菜、鱼类、红肉（未加工）和加工肉类的摄入量。饮食分为：差；合理；良好。身体活动和饮食变化根据类别变化分为：恶化；稳定；增加（身体活动）/改善（饮食）。在平均6.8（标准差 = ±2.3）年的随访期间，1354名（4.3%）参与者患上了肥胖症。与稳定的身体活动 - 饮食相比，在不同饮食变化中，增加身体活动与最低的肥胖几率相关（例如，比值比[95%置信区间]：饮食恶化（0.89[0.69, 1.15]）；饮食改善（0.65[0.48, 0.89]））。身体活动增加且饮食改善与体脂百分比（β：-0.62[-0.82, -0.41]）、体重指数（-0.37[-0.47, -0.28]）和腰围（-1.21[-1.63, -0.79]）的最大差异相关。排除有吸烟史或重大疾病的成年人后，身体活动增加的参与者中肥胖几率又降低了11% - 21%。在身体活动减少的人群中，与饮食改善相结合时肥胖风险会降低。身体活动或饮食的改善相互减弱了另一种行为恶化的有害关联。在大多数分析中，在不同饮食变化组中，身体活动的增加对肥胖的发展都呈现出一致的正向关联。
