老年女性体质健康促进：基于模式与组合的身体活动建议

张宪亮; 杜黎涛; 陈斯; 贺强; 潘洋

doi:10.16469/j.css.202301004

老年女性体质健康促进：基于模式与组合的身体活动建议

Physical Health Promotion in Older Women: Physical Activity Recommendations Based on Patterns and Combinations

摘要

摘要: 目的:探讨老年女性不同模式、组合的身体活动(PA)和久坐行为(SB)与体质健康之间的关系,为老年女性的体质健康促进提出建议。方法:受试者连续7 d佩戴三轴加速度计,测量中高强度PA(MVPA)、低强度PA(LPA)、持续性PA(单次≥10 min)、分散性PA(单次<10 min)、30 min持续性SB(单次≥30 min)和60 min持续性SB(单次≥60 min)。同时,根据每日参与MVPA和SB的不同时间,定义低MVPA高SB、低MVPA低SB、高MVPA高SB和高MVPA低SB四种组合类型。根据《国民体质测定标准手册(老年人部分)》的要求进行老年女性体质健康测试,分别定义总分<15分和≥15分为体质健康不合格组和合格组。使用二分类Logistic回归探讨不同模式、组合的PA和SB与体质健康水平的关系,使用限制性立方样条探讨MVPA与体质健康水平的非线性关系。结果:共1 124人纳入到数据分析中。控制多个混杂因素后,1)总MVPA、分散性MVPA、总LPA、分散性LPA及持续性LPA均与老年女性更高的体质健康水平显著相关(P<0.05),总SB和30 min持续性SB与更低的体质健康水平显著相关(P<0.05);2)高MVPA高SB组合和高MVPA低SB组合均与更高的体质健康水平显著相关(P<0.05);3)每日参与MVPA总时间与体质健康不合格OR值呈近似“L”形的非线性关系曲线,随着参与MVPA时间的增加,老年女性体质健康不合格率逐渐下降,达到约30 min后下降幅度趋于平缓。结论:老年女性的PA和SB与体质健康水平呈现显著的剂量效应关系。无论强度大小,参与一定量的身体活动就能获得体质健康收益。MVPA对老年女性的体质健康促进最为高效,每日30 min MVPA能获得最高效的体质健康收益。老年女性应尽量避免长时间久坐,另外,无论久坐时间长短,达到一定量的MVPA就能获得体质健康收益。

Abstract: Objective: To explore the associations between different patterns and combinations of physical activity(PA), sedentary behavior(SB) and physical health in older women, so as to provide physical health promotion suggestions for them. Methods: PA and SB were assessed by triaxial accelerometer and were classified as moderate-intensity PA(MVPA), light-intensity PA(LPA),sporadic PA(PA bout lasts<10 minutes), bouted PA(PA bout lasts≥10 minutes), 30 min-bouted SB(SB bout lasts≥30 minutes)and 60 min-bouted SB(SB bout lasts≥60 minutes). In addition, different combinations of PA and SB were classified as low MVPA with high SB, low MVPA with low SB, high MVPA with high SB and high MVPA with low SB according to MVPA and SB volume per day. The assessment of physical health was based on Standards Handbook of National Measurement of Physical Health for Older Adult. All participants were classified as qualified group or not qualified group(total physical health points≥15 or<15).Multivariate-adjusted binary logistic regression was used to examine the associations of different patterns and combinations of PA and SB with physical health. Restricted cubic spline was conducted to investigate the non-linear relationships between MVPA and physical health. Results: A total of 1124 older women were enrolled in the final data analysis. After the adjustment of several confounders, it was shown that 1) total MVPA, sporadic MVPA, total LPA, sporadic LPA and bouted LPA were significantly associated with higher physical health level(P<0.05), total SB and 30 min-bouted SB were significantly associated with lower physical health level(P<0.05); 2) the combinations of high MVPA with high SB, high MVPA with low SB were both significantly related to higher physical health level; 3) daily total MVPA time and low physical health level of older women showed a non-linear relationship with an approximate L-shaped curve. Conclusions: There was a significant “dose-response” associations of PA, SB with physical health in older women. Regardless of intensity, physical health benefits can be gained by engaging in a certain amount of PA. MVPA is high-efficiency in promoting physical health in older women, and engaging in 30 minutes of MVPA per day is most effective to achieve physical health benefits. Older women are suggested to avoid prolonged SB, health benefits can be gained by engaging in a certain amount of MVPA regardless of the duration of SB.

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