Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China.
Nanjing Normal University, Nanjing, China.
JMIR Public Health Surveill. 2024 Mar 27;10:e47517. doi: 10.2196/47517.
The increasing annual global deaths are attributable to noncommunicable chronic diseases (NCDs). Adhering to healthy lifestyle behaviors is associated with lower NCD risk, particularly among individuals with ample movement, enough sleep, and reduced sedentariness. Nevertheless, there are only few prospective assessments on the association of interactions between daily activities with NCD prevention, while the associations between adhering to Canadian 24-Hour Movement Guidelines (24HGs) for adults and NCD risks are still unknown. Compared to the general population, obese and overweight populations are at a higher risk of developing NCDs. Currently, it is unclear whether the health benefits of adhering to 24HGs differ between the general population and the obese population.
This study explores prospective associations between adherence to 24HGs and NCD risks by weight status among overweight and obese adults in China.
This decadal study consists of 9227 adults aged 35 years and older without any major NCDs at enrolment in the China Health and Nutrition Survey (2004-2011) and followed up until 2015. The exposure of interest was the overall score of compliance with 24HGs measured by participants' self-report, wherein 1 point was assigned for compliance to each component, resulting in an aggregated score ranging from 0 to 3. The primary outcome was the first occurrence of major NCDs (high blood pressure, stroke, diabetes, cancer, and acute myocardial infarction). Log-binomial regression models were used to evaluate the associations.
: Overall, 4315 males and 4912 females, with 25,175 person-years of follow-up, were included in our analyses. The average baseline age was 50.21 (SD 11.04) years. Among the overweight and obese groups, those adhering to 1 (risk ratio [RR] 0.37, 95% CI 0.19-0.74; P=.004), 2 (RR 0.37, 95% CI 0.19-0.72; P=.003), and 3 (RR 0.32, 95% CI 0.14-0.73; P=.006) recommendations of 24HGs had a significantly lower NCD risk than those not adhering to any of the activity guidelines. Among the normal or underweight groups, those adhering to 1 (RR 0.49, 95% CI 0.27-0.96; P=.03) and 3 (RR 0.40, 95% CI 0.17-0.94; P=.03) components had a significantly lower NCD risk than those not adhering to any of the activity guidelines.
In this prospective study, we found that active adherence to recommendations of 24HGs was associated with lower risks of NCDs, especially among overweight and obese participants. Additionally, overweight and obese individuals who met at least 1 component of 24HGs were at a significantly lower risk for NCDs, but this protective effect was not found among individuals in the normal and underweight groups. Individuals with excess body weight who tend to be more susceptible to health risks may gain greater health benefits than the general population by adhering to the recommendations of 24HGs.
全球每年的死亡人数不断增加，这主要归因于非传染性慢性疾病（NCDs）。坚持健康的生活方式行为与降低 NCD 风险有关，尤其是在有充足运动、足够睡眠和减少久坐行为的人群中。然而，目前仅有少数前瞻性研究评估了日常活动与 NCD 预防之间的相互作用关系，而坚持加拿大 24 小时运动指南（24HGs）与 NCD 风险之间的关系仍不清楚。与一般人群相比，肥胖和超重人群患 NCD 的风险更高。目前，尚不清楚坚持 24HGs 对一般人群和肥胖人群的健康益处是否存在差异。
本研究旨在探讨超重和肥胖成年人中，坚持 24HGs 与 NCD 风险之间的前瞻性关联，并按体重状况进行分层分析。
本研究是一项长达十年的队列研究，纳入了中国健康与营养调查（2004-2011 年）中年龄在 35 岁及以上、无重大 NCD 且基线时未患有任何重大 NCD 的 9227 名成年人，并随访至 2015 年。暴露因素为参与者自我报告的遵守 24HGs 的综合得分，其中每个组成部分得 1 分，总分范围为 0 至 3 分。主要结局为首次发生重大 NCD（高血压、中风、糖尿病、癌症和急性心肌梗死）。使用对数二项式回归模型评估关联。
： 共有 4315 名男性和 4912 名女性，随访时间为 25175 人年，纳入了我们的分析。平均基线年龄为 50.21（SD 11.04）岁。在超重和肥胖组中，与不遵守任何活动指南的参与者相比，遵守 1 项（RR 0.37，95%CI 0.19-0.74；P=.004）、2 项（RR 0.37，95%CI 0.19-0.72；P=.003）和 3 项（RR 0.32，95%CI 0.14-0.73；P=.006）建议的参与者的 NCD 风险显著降低。在正常或体重不足组中，与不遵守任何活动指南的参与者相比，遵守 1 项（RR 0.49，95%CI 0.27-0.96；P=.03）和 3 项（RR 0.40，95%CI 0.17-0.94；P=.03）组成部分的参与者的 NCD 风险显著降低。
在这项前瞻性研究中，我们发现积极遵守 24HGs 的建议与较低的 NCD 风险相关，尤其是在超重和肥胖参与者中。此外，至少遵守 24HGs 一项组成部分的超重和肥胖个体患 NCD 的风险显著降低，但在正常和体重不足组的个体中未发现这种保护作用。体重超标的个体更容易受到健康风险的影响，他们通过遵守 24HGs 的建议可能比一般人群获得更大的健康益处。
