背景:非传染性慢性疾病(NCDs)导致全球每年死亡人数增加。坚持健康的生活方式行为与降低NCD风险相关,特别是在有充足运动的个人中,充足的睡眠减少了镇静。然而,关于日常活动与非传染性疾病预防之间相互作用的关系的前瞻性评估很少,虽然遵守加拿大成人24小时运动指南(24HG)与NCD风险之间的关联仍然未知。与普通人群相比,肥胖和超重人群发生非传染性疾病的风险较高.目前,目前尚不清楚坚持24HGs对健康的益处在普通人群和肥胖人群之间是否存在差异.
目的:本研究探讨了在中国超重和肥胖成年人中,24HGs依从性与NCD风险(体重状况)之间的前瞻性关联。
方法:这项年代际研究包括9227名35岁及以上的成年人,他们在中国健康与营养调查(2004-2011)中没有任何主要的非传染性疾病,并随访至2015年。感兴趣的暴露是参与者自我报告测量的24HG依从性的总体得分,其中每个组件的合规性分配1分,导致汇总得分范围从0到3。主要结果是首次出现主要非传染性疾病(高血压,中风,糖尿病,癌症,和急性心肌梗塞)。使用对数二项回归模型来评估关联。
结果::总体,4315名男性和4912名女性,经过25,175人年的随访,包括在我们的分析中。平均基线年龄为50.21(SD11.04)岁。在超重和肥胖人群中,那些坚持1(风险比[RR]0.37,95%CI0.19-0.74;P=.004),2(RR0.37,95%CI0.19-0.72;P=0.003),和3(RR0.32,95%CI0.14-0.73;P=.006)建议24HGs的NCD风险显著低于不遵守任何活动指南的建议.在正常或体重不足的人群中,坚持1个(RR0.49,95%CI0.27~0.96;P=.03)和3个(RR0.40,95%CI0.17~0.94;P=.03)成分的NCD风险显著低于不坚持任何活动指南的人群.
结论:在这项前瞻性研究中,我们发现,积极遵守24HGs的建议与非传染性疾病的风险较低有关,尤其是超重和肥胖的参与者。此外,至少满足24HGs的1个组分的超重和肥胖个体的非传染性疾病风险显著降低,但在正常组和体重不足组的个体中没有发现这种保护作用。通过遵守24HGs的建议,体重过重的人往往更容易受到健康风险的影响,可能比普通人群获得更大的健康益处。
BACKGROUND: 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.
OBJECTIVE: This study explores prospective associations between adherence to 24HGs and NCD risks by weight status among overweight and obese adults in China.
METHODS: 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.
RESULTS: : 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.
CONCLUSIONS: 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.