Craig S B, Bandini L G, Lichtenstein A H, Schaefer E J, Dietz W H
Department of Pediatrics, New England Medical Center, Boston, MA 02111, USA.
Pediatrics. 1996 Sep;98(3 Pt 1):389-95.
Inconsistent findings reported for the effect of physical activity on lipids, lipoproteins, and blood pressure in children may be due to errors inherent in the methods used to measure physical activity, lack of control for other cardiovascular risk factors, or both. The purpose of this study was to evaluate the association between physical activity assessed using direct measures of energy expenditure and cardiovascular risk factors, controlling for dietary intake and percent body fat.
Nonresting energy expenditure was determined in 49 8- to 11-year-old girls from measurements of daily energy expenditure (using doubly-labeled water, 2H2(18)O) and resting metabolic rate (using indirect calorimetry). Self-reported recall of the hours of participation in physical activities of at least moderate intensity (energy expenditure at least four times the resting metabolic rate, METS > or = 4) during the previous year was also obtained. Percent body fat was estimated from the measurement of total body water with H2(18)O. Concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apo B), apo A-I, lipoprotein (a), insulin, and estradiol, as well as the waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, and dietary intake from 7-day food records were measured. Data were analyzed using Pearson product-moment correlation and stepwise multiple regression.
Self-reported hours of participation in activities with METS (metabolic equivalents) of 4 or greater significantly predicted LDL-C and apo B concentrations, even after adjustment for percent body fat and percentage of dietary energy from saturated fat. Nonresting energy expenditure adjusted for weight, a measure of the energy spent on physical activity, did not predict LDL-C or high-density lipoprotein cholesterol concentrations. Body mass index and insulin concentration predicted systolic and diastolic blood pressure, respectively.
These findings suggest that the intensity of physical activity may be a more important determinant of LDL-C in children than the energy spent on physical activity.
关于体育活动对儿童血脂、脂蛋白和血压影响的研究结果不一致,这可能是由于用于测量体育活动的方法存在固有误差、缺乏对其他心血管危险因素的控制,或两者兼而有之。本研究的目的是评估使用能量消耗直接测量法评估的体育活动与心血管危险因素之间的关联,并控制饮食摄入和体脂百分比。
通过测量每日能量消耗(使用双标水,2H2(18)O)和静息代谢率(使用间接量热法),确定了49名8至11岁女孩的非静息能量消耗。还获得了她们对上一年参与至少中等强度体育活动(能量消耗至少为静息代谢率的四倍,代谢当量>METS≥4)小时数的自我报告回忆。通过用H2(18)O测量全身水分来估算体脂百分比。测量了总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apo B)、apo A-I、脂蛋白(a)、胰岛素和雌二醇的浓度,以及腰臀比、收缩压、舒张压和7天食物记录中的饮食摄入量。使用Pearson积矩相关和逐步多元回归分析数据。
即使在调整了体脂百分比和饱和脂肪占饮食能量的百分比之后,自我报告的参与METS(代谢当量)为4或更高活动的小时数仍能显著预测LDL-C和apo B浓度。调整体重后的非静息能量消耗,即体育活动所消耗能量的一种度量,不能预测LDL-C或高密度脂蛋白胆固醇浓度。体重指数和胰岛素浓度分别预测收缩压和舒张压。
这些发现表明,体育活动的强度可能比体育活动所消耗的能量更能决定儿童的LDL-C水平。