肥胖比體適能不佳更致命


  【24drs.com】根據線上發表於12月20日國際流行病學期刊的一篇研究,青春期後期的有氧體適能程度低會增加早逝風險。
  
  這些研究結果發現,體適能好之肥胖男性的死亡風險,大於體適能不好但體重正常的男性,因而破除了肥胖但體適能好的概念。
  
  瑞典Umea大學社會醫學與復健系研究生Gabriel Hogstrom等人寫道,在這篇研究中,我們發現,18歲時的有氧體適能與早逝風險之間,呈現梯度性關聯。
  
  另一個有趣的研究結果是,在追蹤期間,體適能不佳之男性的任何原因死亡風險,比肥胖但體適能佳者低30%;這些結果不同於「肥胖但體適能好、不會增加死亡風險」的概念。
  
  許多研究支持「經常運動可降低死亡風險」的觀念,不過,關於低體適能程度有害健康的研究,主要聚焦在年長者,少有研究探討年輕族群有氧體適能與健康的直接關聯。
  
  這篇研究的資料來自「Swedish Military Conscription Registry」,包括了在1969-1996年間徵召入伍的1,317,713名瑞典男性(平均年齡18歲)。在入伍時,這些男性進行了基本評估,包括有氧體適能測試,測試到因為疲勞而停止為止,研究者採用全國登記資料探討了所有原因以及特定原因的死亡;死亡率資訊來自全國死因登記資料庫。
  
  在平均28.8年追蹤期間內,有44,301名男性死亡。
  
  校正年齡與入伍年之後,有氧體適能程度最高的男性,各種原因死亡風險比體適能程度最低者少51%(風險比[HR]為0.49;95%信賴區間[CI]為0.47 - 0.51),校正體重後的體適能分析也獲得類似的結果(HR, 0.52;95% CI, 0.50 - 0.54)。
  
  酒精及麻醉劑濫用與死亡的關聯最強(HR, 0.20;95% CI, 0.15 - 0.26)。
  
  肥胖男性受惠於體適能良好的程度低於正常體重男性(互動P值< .001),相較於肥胖且有氧體適能程度最高的男性,任何體適能程度、體重正常男性的所有原因死亡率風險都比較低(30% - 48%;所有的P值都 < .05)。
  
  當體重增加時,有氧體適能的效益降低,校正年齡與入伍年之後,體適能程度前半段的正常體重男性,死亡率風險比後半段者低34% (HR, 0.66;95% CI, 0.64 - 0.68),過重男性的這個效益降到28%,最肥胖者的效益則是消失殆盡。
  
  作者們寫道,這個結果挑戰了目前「肥胖者可以藉由體適能完全抵銷死亡率風險」的觀念。
  
  他們結論指出,儘管這篇研究因為觀察型性質而有限制,這些研究結果認為,對於降低早逝風險,年輕時[身體質量指數]低比體適能程度更重要。
  
  最後,研究觀察到較低的[身體質量指數]類別與體適能之間的關聯,但是在肥胖者沒有,增加了反駁「健康肥胖」的證據。
  
  資料來源:http://www.24drs.com/
  
  Native link:Obesity More Deadly Than Lack of Fitness

Obesity More Deadly Than Lack of Fitness

By Veronica Hackethal, MD
Medscape Medical News

Low aerobic fitness during late adolescence increases the risk for early death, according to a study published online December 20 in the International Journal of Epidemiology.

The results also undermine the "fat but fit" concept by showing that physically fit obese men are at higher risk for death than unfit normal-weight men.

"In the present study, we found a graded association between aerobic fitness at the age of 18 years and the risk of early death," write Gabriel Hogstrom, PhD, a postgraduate student in the Department of Community Medicine and Rehabilitation at Umea University, Sweden, and colleagues.

"Also of interest was the finding that the risk of death from any cause during follow-up was 30% lower in unfit normal-weight men than in obese fit men," they continued. "These results counter the notion that the 'fat but fit' condition does not increase mortality risk."

Much research supports the idea that frequent physical activity decreases the risk for death. Research on the detrimental health effects of low fitness levels, however, has focused mainly on older populations. Few studies have looked at the direct link between aerobic fitness and health in younger individuals.

The study drew data from the Swedish Military Conscription Registry and included 1,317,713 Swedish men (mean age, 18 years) conscripted into the Swedish military between 1969 and 1996. At the time of conscription, the men underwent baseline assessments that included aerobic fitness testing, in which they cycled until fatigue caused them to stop. The researchers looked at all-cause and cause-specific death, using national registers. Mortality information came from the National Cause of Death Registry.

During a mean follow-up of 28.8 years, 44,301 of the men died.

After adjusting for age and conscription year, men with the highest aerobic fitness levels had 51% lower risk for all-cause death (hazard ratio [HR], 0.49; 95% con?dence interval [CI], 0.47 - 0.51) compared with those with the lowest fitness levels. Similar findings resulted from analyses of weight-adjusted fitness (HR, 0.52; 95% CI, 0.50 - 0.54).

Alcohol and narcotic abuse had the strongest associations with death (HR, 0.20; 95% CI, 0.15 - 0.26).

Obese men benefited less than normal-weight men from being physically fit (P interaction < .001). Normal-weight men in all levels of aerobic fitness had lower risk for all-cause mortality (30% - 48%; P < .05 for all) compared with obese men with the highest levels of aerobic fitness.

The benefits of aerobic fitness decreased as weight increased. After adjusting for age and year, normal-weight men in the upper half of aerobic fitness had 34% lower risk for death than those in the lower half (HR, 0.66; 95% CI, 0.64 - 0.68). This benefit decreased to 28% in overweight men, and disappeared entirely in men with the highest levels of obesity.

This finding "challenges the currently held idea that obese individuals can fully compensate mortality risk by being physically fit," the authors write.

"Despite the limitation posed by the observational nature of this study, these results suggest that low [body mass index] early in life is more important than high physical fitness, with regard to reducing the risk [for] early death," they conclude.

"Finally, associations were observed between fitness and the risk of early death in lower [body mass index] categories, but not in the obese category, adding to the evidence against the existence of healthy obesity."

The authors have disclosed no relevant financial relationships.

Int J Epidemiol. Published online December 20, 2015.

    
相關報導
回顧發現:肥胖基因對減重無影響
2016/9/30 下午 04:58:33
兒科醫師提供的肥胖介入方法難以減少BMI
2016/9/26 下午 03:57:35
大麻衍生製劑可能有助於第二型糖尿病
2016/9/21 下午 03:39:06

上一頁
   1   2   3   4   5   6   7   8   9   10  




回上一頁