National Associations of Objectively Measured Physical Activity and Mortality

描述（由申请人提供）：2008年，美国政府发布了第一份关于体育活动类型和数量的建议，这些建议对所有美国人的健康都有实质性的好处。该指南部分基于健康结果的流行病学研究，包括全因和心血管（CVD）死亡率。然而，这些研究主要依赖于自我报告的身体活动。自我报告的措施，如问卷调查，在检测日常活动和穿插活动方面是有限的，如无组织或计划外的活动，以及轻度或久坐的活动。相比之下，加速度计提供了身体活动和久坐行为的客观测量。据我们所知，目前还没有关于客观测量的身体活动或久坐行为与心血管疾病之间关系的流行病学研究发表。本提案是为了响应项目公告（PA-09-244）“营养和体育活动研究促进心血管和肺部健康（R21）”。使用基于人群的不同成人样本，我们通过(1)利用加速度计的客观体育活动测量和(2)包括未充分研究和代表性人群来解决计划宣布的高优先领域。使用2003- 2006年参加国家健康与营养调查（NHANES）的成人样本（n=9142），我们将确定客观评估的身体活动和久坐行为与全因和心血管疾病死亡风险的关系。我们的次要目的包括：(1)使用潜在分类分析来确定客观评估的身体活动模式，并确定这些模式与全因和心血管疾病死亡率风险的关联；(2)确定自我报告的身体活动与全因和心血管疾病死亡率风险的关联，并将结果与客观测量的身体活动发现的关联进行对比。对于NHANES队列，身体活动是通过自我报告评估和客观测量（ActiGraph加速度计）来确定的。加速度计可以准确地检测运动，这些运动可以转化为久坐、轻度、中度和剧烈的身体活动。参与者的档案将通过国家死亡指数（NDI）与2009年之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全因死亡率和心血管疾病死亡率之间的关系。由于NHANES包含了美国成年人的代表性样本，因此这项具有成本效益的研究结果可以为国家体育活动指南提供证据，该指南与体育活动和久坐行为有关，具有更大的普遍性。

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. PUBLIC HEALTH RELEVANCE: Findings from this study can provide new evidence on the contribution of physical activity and sedentary behaviors to all-cause and cardiovascular disease mortality among a representative sample of US adults. The inclusion of an objective measure of physical activity allows these associations to be explored with greater accuracy than was done in prior cohort studies. The results will be generalizable to the US adult population due to the study cohort sampling. Findings will help address critical gaps in understanding these associations, inform public health guidelines for physical activity, and assist prevention strategies of this amenable behavior.