Adiposity as compared with physical activity in predicting mortality among women
Adiposity as compared with physical activity in predicting mortality among women
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DOI：
10.1056/nejmoa042135
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发表时间：
2004-12-23
影响因子：
158.5
通讯作者：
Manson, JE
中科院分区：
文献类型：
--
作者：
Hu, FB;Willett, WC;Manson, JE
高水平的体力活动是否能抵消肥胖引起的死亡风险的增加是有争议的。方法我们在1976年对116，564名年龄在30到55岁之间、没有已知的心血管疾病和癌症的妇女进行了体重指数和体力活动与死亡的关系的研究。282人死亡，2370人死于心血管疾病，5223人死于癌症，2689人死于其他原因。在从不吸烟的妇女中，死亡率随着体重指数值的增加而单调增加（趋势P < 0.001）。在对所有参与者的综合分析中，肥胖预示着更高的死亡风险，无论体力活动水平如何。高水平的体力活动似乎对所有肥胖水平都有益，但并不能消除与肥胖相关的较高死亡风险。与苗条的女性相比（即，他们的身体质量指数低于25），（他们每周锻炼3.5小时或以上），死亡的多变量相对危险度为1.55（95%置信区间，1.42至1.70）对于瘦和不活动的女性，1.91（95%置信区间，1.60至2.30）（定义为体重指数为30或更高），但活跃，和2.42（95%置信区间，2.14至2.73）不活跃，肥胖妇女。即使是成年期适度的体重增加，与身体活动无关，也与更高的死亡风险有关。我们估计多余的重量（定义为体重指数25或更高）和缺乏身体活动（每周运动少于3.5小时）加起来可能占所有过早死亡的31%，心血管疾病死亡的59%，在不吸烟的女性中，21%的人死于癌症。死亡的预言者
BACKGROUNDWhether higher levels of physical activity can counteract the elevated risk of death associated with adiposity is controversial.METHODSWe examined the associations of the body-mass index and physical activity with death among 116,564 women who, in 1976, were 30 to 55 years of age and free of known cardiovascular disease and cancer.RESULTSDuring 24 years of follow-up, 10,282 deaths occurred - 2370 from cardiovascular disease, 5223 from cancer, and 2689 from other causes. Mortality rates increased monotonically with higher body-mass-index values among women who had never smoked ( P for trend < 0.001). In combined analyses of all participants, adiposity predicted a higher risk of death regardless of the level of physical activity. Higher levels of physical activity appeared to be beneficial at all levels of adiposity but did not eliminate the higher risk of death associated with obesity. As compared with women who were lean (i.e., they had a body-mass index lower than 25) and active ( they spent 3.5 or more hours exercising per week), the multivariate relative risks of death were 1.55 ( 95 percent confidence interval, 1.42 to 1.70) for lean and inactive women, 1.91 ( 95 percent confidence interval, 1.60 to 2.30) for women who were obese ( defined as a body-mass index of 30 or higher) but active, and 2.42 ( 95 percent confidence interval, 2.14 to 2.73) for inactive, obese women. Even modest weight gain during adulthood, independent of physical activity, was associated with a higher risk of death. We estimate that excess weight ( defined as a body-mass index of 25 or higher) and physical inactivity ( less than 3.5 hours of exercise per week) together could account for 31 percent of all premature deaths, 59 percent of deaths from cardiovascular disease, and 21 percent of deaths from cancer among nonsmoking women.CONCLUSIONSBoth increased adiposity and reduced physical activity are strong and independent predictors of death.