Morris J N
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, University of London, England.
Med Sci Sports Exerc. 1994 Jul;26(7):807-14.
Forty years of population studies have shown that physical activity can protect against coronary heart disease (CHD) in men of middle and early old age. Vigorous aerobic effort was required for protection of British civil servants; high levels of other activity usually accompanied this. Serious methodologic problems are illustrated from studies of these British office workers, elite Harvard alumni, and U.S. men at high risk. Because of uncertainties in defining optimal exercise, the strength of protection may be underestimated. Some possible lines of advance are suggested: collaboration between physiologists and epidemiologists to expand the content of activity information beyond caloric costs; study of sweating and hard breathing as indicators of activity that is "vigorous" for the individual; focusing on coronary thrombosis, hypothetically the principal locus of protection; a shift to measurement of cardiorespiratory, endurance fitness; and randomized trial, e.g., of high risk men with low HDL-C and high fibrinogen levels. Responding to public need and the opportunities, physical activity could be today's "best buy" in public health for the West.
四十年的人口研究表明，体育活动能够预防中老年男性患冠心病（CHD）。英国公务员需要进行剧烈的有氧运动来预防疾病，通常还伴随着高水平的其他活动。对这些英国办公室职员、哈佛精英校友以及美国高危男性的研究揭示了严重的方法学问题。由于在定义最佳运动方面存在不确定性，保护作用的强度可能被低估。文中提出了一些可能的改进方向：生理学家和流行病学家合作，将活动信息的内容扩展到热量消耗之外；研究出汗和剧烈呼吸，以此作为对个体而言“剧烈”活动的指标；关注冠状动脉血栓形成，假定这是主要的保护位点；转向测量心肺耐力健康状况；以及进行随机试验，例如针对高密度脂蛋白胆固醇（HDL-C）水平低且纤维蛋白原水平高的高危男性。顺应公众需求和机遇，体育活动如今可能成为西方公共卫生领域“最划算的选择”。
