Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
Ann Med. 2023;55(2):2245429. doi: 10.1080/07853890.2023.2245429.
In earlier studies, the health benefits of physical activity have only been related to leisure time physical activity (LTPA). High occupational physical activity (OPA) might even be harmful. The current physical activity recommendations do not separate the OPA and LTPA. We investigated the effect of LTPA and OPA on cardiovascular morbidity and mortality during long-term follow-up. We also examined how heavy work affects the benefits of leisure time exercise.
The study was part of the OPERA study and the baseline examinations were conducted between the years 1991 and 1993. The Follow-up of events continued until the end of the year 2020. Study subjects ( = 1044) were divided into four groups according to their LTPA ("no exercise", "irregular", "regular" and "heavy regular") and into three groups according to their OPA ("no activity", "mild" and "heavy"). The amount of exercise was self-reported and the exercise status was defined at the beginning of the study. Study subjects were followed up for their overall mortality (26 years), fatal and non-fatal CVD events (24 and 20 years) and heart failure (20 years). The survival analysis was performed using Kaplan-Meier curves and Cox-proportional hazard models.
"Heavy" OPA group subjects belonging to the "irregular" (less than 1-2 times 30 min exercise per week) LTPA group experienced the lowest overall mortality compared to other LTPA groups. Also, overall mortality was increased in the "mild" ( = 0.002) and CVD mortality in the" heavy" ( = 0.005) OPA group compared to "no activity". The incidence of heart failure was increased in the "no exercise" LTPA compared to the "heavy regular" ( = 0.015) group.
Study subjects who were in physically demanding occupations (heavy OPA) seemed to benefit from less LTPA than WHO currently recommends. Thus we suggest targeting different LTPA recommendations to different OPA groups.
在早期的研究中，身体活动的健康益处仅与闲暇时间身体活动（LTPA）有关。高职业体力活动（OPA）甚至可能有害。目前的身体活动建议并未将 OPA 和 LTPA 分开。我们研究了长期随访中 LTPA 和 OPA 对心血管发病率和死亡率的影响。我们还研究了重体力工作如何影响闲暇时间运动的益处。
该研究是 OPERA 研究的一部分，基线检查于 1991 年至 1993 年进行。事件随访持续到 2020 年底。研究对象（ = 1044）根据 LTPA（“无运动”、“不规律”、“规律”和“重规律”）分为四组，并根据 OPA（“无活动”、“轻度”和“重度”）分为三组。运动量是自我报告的，运动状态是在研究开始时确定的。研究对象随访时间为总体死亡率（26 年）、致命和非致命 CVD 事件（24 年和 20 年）和心力衰竭（20 年）。生存分析采用 Kaplan-Meier 曲线和 Cox 比例风险模型进行。
属于“不规律”（每周少于 1-2 次 30 分钟运动）LTPA 组的“重度”OPA 组受试者的总体死亡率最低，与其他 LTPA 组相比。此外，与“无活动”相比，“轻度”（ = 0.002）和 CVD 死亡率（ = 0.005）的 OPA 组的总体死亡率增加。与“重度规律”（ = 0.015）相比，LTPA 为“无运动”的心力衰竭发生率增加。
从事体力要求高的职业（重度 OPA）的研究对象似乎从比世界卫生组织目前建议的更少的 LTPA 中获益。因此，我们建议针对不同的 OPA 组制定不同的 LTPA 建议。
