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目的了解南京、上海部分城区居民的超重/肥胖现状,并分析体力活动与超重/肥胖的关系。方法采用多阶段分层随机抽样方法,于2013年3—10月对上海、南京4个主城区8个社区里756名常住居民进行调查。采用专门设计的身体活动日志,应用因子分析法确定体力活动模式,进而分析不同体力活动模式对超重/肥胖的潜在影响。结果上海、南京成年人超重/肥胖总发生率为39.6%,其中女性为29.4%,男性为51.4%。采用因子分析确定的4种体力活动模式,其中久坐模式(χ~2=15.302,P=0.007)和居家模式(χ~2=17.676,P=0.004)与超重/肥胖发生率显著相关。多因素logistic回归分析显示,久坐模式因子得分与超重/肥胖呈正相关(OR=1.251,95%CI 1.031~1.457),居家模式因子得分与超重/肥胖呈负相关(OR=0.716,95%CI 0.486~0.908)。在调整性别、年龄、文化程度等混杂变量后,久坐模式和居家模式与超重/肥胖间仍存在相关。久坐模式Q1组静坐活动时间百分比远低于Q4组(52%和67%,P<0.01),居家模式Q4组低强度活动时间百分比高于Q1组(59%和51%,P<0.01);久坐模式和居家模式Q4组平均能量消耗水平是Q1组的0.94倍和1.13倍。结论以静态活动为主要特征的久坐模式和以家务性劳动为主要特征的居家模式与超重/肥胖密切相关,日常生活中除了满足每天30分钟中高强度体育锻炼外,通过低强度活动中断或替代静坐行为会对超重/肥胖个体产生额外的显著健康效应。
Objective To understand the prevalence of overweight / obesity among urban residents in Nanjing and Shanghai and to analyze the relationship between physical activity and overweight / obesity. Methods A multistage stratified random sampling method was used to survey 756 permanent residents from 8 communities in four main districts of Shanghai and Nanjing from March to October in 2013. A specially designed physical activity log was used to determine physical activity patterns using factor analysis to analyze the potential impact of different patterns of physical activity on overweight / obesity. Results The overall incidence of overweight / obesity among adults in Shanghai and Nanjing was 39.6%, of whom 29.4% were women and 51.4% were males. Four physical activity patterns determined by factor analysis were significantly associated with incidence of overweight / obesity with sedentary pattern (χ ~ 2 = 15.302, P = 0.007) and pattern of home (χ ~ 2 = 17.676, P = 0.004). Multivariate logistic regression analysis showed that the sedentary mode factor score was positively correlated with overweight / obesity (OR = 1.251, 95% CI 1.031-1.457), and negatively correlated with overweight / obesity (OR = 0.716, 95% CI 0.486 ~ 0.908). After adjusting for gender, age, educational level and other miscellaneous variables, sedentary patterns and patterns of home and overweight / obesity are still related. In sedentary mode, percentage of sit-in activity in Q1 group was significantly lower than that in Q4 group (52% vs 67%, P <0.01), and percentage of low-intensity activity in Q4 group was significantly higher than that in Q1 group (59% vs 51%, P <0.01) ; Sedentary mode and home mode Q4 average energy consumption level is Q1 group 0.94 times and 1.13 times. Conclusions The sedentary pattern with static activity as the main feature and the home pattern with chore effect as the main feature are closely related to overweight / obesity. In addition to satisfying 30 minutes of daily high-intensity physical exercise, daily activity is interrupted or replaced by low-intensity activity Sit-ups result in extra significant health effects on overweight / obese individuals.