National Associations of Objectively Measured Physical Activity and Mortality

描述(由申请者提供)：2008年，美国政府发布了第一份体育锻炼建议，介绍了为所有美国人提供实质性健康益处的体育锻炼的类型和数量。这些指南部分是基于对健康结果的流行病学研究，包括全原因和心血管(CVD)死亡率。然而，这些研究主要依赖于自我报告的体力活动。自我报告的措施，如问卷，在检测常见的和散布在一天中的活动方面是有限的，例如无组织的或计划外的活动，以及轻微或久坐的活动。相比之下，加速计提供了一种对身体活动和久坐行为的客观测量。据我们所知，目前还没有发表过关于客观测量的体力活动或久坐行为与心血管疾病之间关系的流行病学研究。这项建议是对计划公告(PA-09-244)“促进心血管和肺健康的营养和体力活动研究(R21)”的响应。利用以人群为基础的多样化成人样本，我们通过(1)利用加速法对体力活动的客观测量，以及(2)包括未被研究的和有代表性的人群，来解决该计划宣布的高优先领域。使用2003-2006年国家健康和营养检查调查(NHANES)中登记的成人样本(n=9142)，我们将确定客观评估的体力活动和久坐行为与全因和心血管疾病死亡风险的相关性。我们的次要目标包括(1)使用潜在类别分析来确定客观评估的体力活动模式，并确定这些模式与全因和心血管疾病死亡风险的关联，以及(2)确定自我报告的体力活动与全因和心血管疾病死亡风险的关联，并将结果与使用客观测量的体力活动发现的关联进行比较。对于NHANES队列，体力活动既使用自我报告的评估，也使用客观的测量方法，即Actigraph加速计。加速度计可以准确地检测到运动，这些运动可以转化为久坐、轻微、适度和剧烈的体力活动。参与者档案将使用国家死亡指数(NDI)与2009年前的死亡率联系起来。我们有足够的能力来检测体力活动与各种原因和心血管疾病死亡率之间的联系。拟议的成本效益研究的结果可以为国家体力活动指南提供证据，与体力活动和久坐行为相关的更具体，更具普遍性，因为NHANES包括具有代表性的美国成年人样本。

DESCRIPTION (provided by applicant): In 2008, the US government released its first physical activity recommendations about the types and amounts of physical activity that offered substantial health benefits to all Americans. The guidelines were based, in part, on epidemiologic studies of health outcomes, including all-cause and cardiovascular (CVD) mortality. However, those studies relied mainly on self-reported physical activity. Self-reported measures, such as questionnaires, are limited in detecting activity that is common and interspersed throughout the day, such as unstructured or unplanned activities, as well as activity that is light or sedentary. By contrast, accelerometers provide an objective measure of physical activity and sedentary behavior. To our knowledge, there are no published epidemiologic studies of the association between objectively measured physical activity or sedentary behavior with CVD. This proposal is in response to the Program Announcement (PA-09-244) "Nutrition and Physical Activity Research to Promote Cardiovascular and Pulmonary Health (R21)". Using a population- based diverse sample of adults, we address the program announcement high priority areas by (1) utilizing objective measures of physical activity with accelerometry and (2) including understudied and representative populations. Using the adult sample of participants enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2003-06 (n=9142), we will determine the associations of objectively-assessed physical activity and sedentary behavior with the risk of all-cause and CVD mortality. Our secondary aims include (1) using latent class analysis to determine patterns of objectively-assessed physical activity and determine the association of these patterns with the risk of all-cause and CVD mortality and (2) determining the association of self-reported physical activity with the risk of all-cause and CVD mortality, and contrast the resulting associations with those found using objectively-measured physical activity. For the NHANES cohort, physical activity was determined using both a self-reported assessment and an objective measure, the ActiGraph accelerometer. The accelerometer accurately detects movement that can be translated into sedentary, light, moderate, and vigorous physical activity. Participant files will be linked with mortality through 2009 using the National Death Index (NDI). We have sufficient power to detect associations between physical activity and all- cause and CVD mortality. Results from the proposed cost-effective study can provide evidence towards the national physical activity guidelines with more specificity related to physical activity and sedentary behavior and greater generalizability, because NHANES includes a representative sample of US adults.