Informing national guidelines on adolescent and young adult physical activity and sedentary behavior to prevent cardiovascular disease

项目摘要/摘要 心血管疾病(CVD)是美国人的主要死亡原因，体力活动是一种强有力的 降低这种风险的方法。在我们对最佳体力活动持续时间的理解上仍然存在严重的差距 以及青春期和青春期的久坐行为，如果并发和未来的心血管疾病的风险 避免，并被明确确定为2018年卫生和人类事务部的优先研究领域 美国卫生与公众服务部(HHS)的体力活动指南。青春期和青春期是至关重要的 为成年后的身体活动设定模式的过渡期，可能代表着一个关键的窗口 进行早期干预。这个K08的总体目标是发展证据来弥合HHS-铰接的差距 通过描述青春期久坐行为的独立影响和身体活动的阈值 关于预防晚年心血管疾病的青壮年指南，以告知未来HHS指南。中心假设是 久坐不动的青少年和年轻人将需要更高的体力活动水平来降低心血管疾病的风险 在成年以后。这个项目将分析来自青少年大脑认知的纵向队列数据 发展研究(ABCD)，全国青少年至成人健康纵向研究(ADD Health)，以及 青年冠状动脉风险发展(CARDIA)研究。具体目标将：(1)确定 当代形式的久坐行为(屏幕时间)与青少年心血管疾病的独立相关性 风险因素发生率；(2)评估获得HHS推荐的青少年的关联(60分钟/天，7 青少年在特定年龄范围内的体力活动水平(每天30分钟，每周5天)与成年人(每天30分钟，每周5天)相比 成年期与心血管疾病危险因素的发病率；以及(3)估计青少年和 年轻人久坐行为、体力活动剂量及其交互作用对晚年心血管疾病死亡率的影响。这个 候选人的长期职业目标是成为一名独立的医生-流行病学家 优化青春期和青壮年行为以预防晚年心血管疾病的可行证据。建议数 职业发展计划将提供以下方面的培训和指导：(1)体力活动、久坐行为和 心血管疾病流行病学和测量；(2)纵向分析和建模方法；(3)指南 发展和实施；(4)职业发展和独立规划。培训将是 通过课程、研讨会、教程、会议、实践经验和积极的指导来实现。这个 指导团队包括全国公认的心血管流行病学专家，包括青少年和年轻人 成人医学、身体活动/久坐行为、生物统计学、指南的制定和实施 科学。这本K08的完成将在下一版中为青少年和年轻人提供具体的指导 美国人的体力活动指南。K08将使用实施支持未来的R01授权 促进实现预防心血管疾病的国家体力活动指南的科学和建模方法， 与NHLBI通过数据和实施科学减少心脏病的战略愿景保持一致。

PROJECT SUMMARY / ABSTRACT Cardiovascular disease (CVD) is the leading cause of death in the United States and physical activity is a potent way to decrease this risk. Serious gaps remain in our understanding of the optimal duration of physical activity and sedentary behavior during adolescence and young adulthood if risk for concurrent and future CVD is to be averted, and were specifically identified as priority research areas in the 2018 Department of Health and Human Services (HHS) Physical Activity Guidelines for Americans. Adolescence and young adulthood are critical transition periods that set physical activity patterns for the rest of adulthood and may represent a critical window for early intervention. The overall objective of this K08 is to develop evidence to bridge the HHS-articulated gaps by describing independent effects of sedentary behavior in adolescence and thresholds of physical activity in young adulthood on the prevention of later-life CVD to inform future HHS guidelines. The central hypothesis is that highly sedentary adolescents and young adults will require higher physical activity levels to reduce CVD risk in later adulthood. This project will analyze longitudinal cohort data from the Adolescent Brain Cognitive Development (ABCD) Study, the National Longitudinal Study of Adolescent to Adult Health (Add Health), and the Coronary Artery Risk Development in Young Adults (CARDIA) Study. The Specific Aims will: (1) determine independent associations of contemporary forms of sedentary behavior (screen time) in adolescents with CVD risk factor incidence; (2) evaluate associations of attaining HHS-recommended adolescent (60 mins/day, 7 days/week) versus adult (30 mins/day, 5 days/week) physical activity levels during specific age ranges in young adulthood with incidence of CVD risk factors; and (3) estimate population-level lifetime effects of adolescent and young adult sedentary behaviors, physical activity dose, and their interactions on later-life CVD mortality. The candidate’s long-term career objective is to become an independent physician-epidemiologist generating actionable evidence to optimize adolescent and young adult behaviors to prevent CVD later in life. The proposed career development plan will provide training and mentorship in: (1) physical activity, sedentary behavior, and CVD epidemiology and measurement; (2) longitudinal analyses and modeling methods; (3) guideline development and implementation; and (4) career development and plan for independence. Training will be achieved through coursework, seminars, tutorials, conferences, hands-on experience, and active mentoring. The mentoring team includes nationally recognized experts in cardiovascular epidemiology, adolescent and young adult medicine, physical activity/sedentary behavior, biostatistics, guideline development, and implementation science. Completion of this K08 will inform specific guidance for adolescents and young adults in the next edition of the Physical Activity Guidelines for Americans. The K08 will support a future R01 grant using implementation science and modeling approaches to promote attainment of national physical activity guidelines to prevent CVD, aligned with NHLBI’s strategic vision of reducing heart disease through data and implementation science.