《柳叶刀全球健康》:体育锻炼可避免早逝?

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我们一直都知道体育锻炼对身体好,却少有人能给出确切的数据说明。几天前,《柳叶刀全球健康》已在线发布了一项描述性研究的结果:全球平均因体育锻炼避免的过早死亡人口的预防比例为15.0%,保守估计等于每年避免的过早死亡人数为390万(95%CI  2.5-5.6)。


研究团队获取了168个国家先前发表的有关体育活动普及率(2001-2016)和全因死亡率的相对风险数据,结合了蒙特卡罗模拟的数据来估计特定国家/地区中平均因体育锻炼避免的过早死亡人口的预防比例(PFP)(对应于避免的死亡率百分比)及其95%的置信区间。PFP分数增加表示由于体育锻炼避免的死亡比例增加。世界卫生组织对运动量的建议是一周内至少进行150分钟的中等强度有氧运动,或进行75分钟的剧烈强度活动,或同等水平组合运动,而各国之间达到建议体育锻炼量的人口比例差异很大。通过将这些数据与对运动活跃人群与非活跃人群相比早亡相对风险的估计值结合起来,研究者对由于人们活跃于运动而避免的过早死亡的比例进行估计。他们发现,在全球范围内,由于体育锻炼,过早死亡的平均数(中位数)比原先降低了15%(女性为14%,男性为16%),相当于每年挽救了大约390万条生命。


非洲地区的PFP分数中位数最高(16.6% [范围12.1-20.5]),而美洲最低(13.1% [10.8-16.6])。低收入国家(17.9% [12.3-20.5])的PFP分数往往高于高收入国家(14.1% [6.6-17.8])。在全球范围内,男性(16.0% [7.8-20.7])的中位PFP分数高于女性(14.1% [5.0-20.4])。而现有的体育活动普及率有助于在所有国家避免过早死亡。


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原文阅读

Background

Disease and mortality burdens of unhealthy lifestyle behaviours are often reported. In contrast, the positive narrative around the burdens that an existing behaviour have averted is rarely acknowledged. We aimed to estimate the prevented fraction for the population (PFP) for premature mortality averted by physical activity on a global scale.

Methods

In this descriptive study, we obtained previously published data on physical activity prevalence (2001–16) and relative risks of all-cause mortality for 168 countries. We combined the data in Monte-Carlo simulations to estimate country-specific, mean PFP values, corresponding to percentage of mortality averted, and their 95% CIs. High prevented fractions indicated an increased proportion of deaths averted due to physical activity. Using mortality data for all people in a country aged 40–74 years, we estimated the number of premature deaths averted for all adults and by gender. We present the median and range of the prevented fractions globally, by WHO region, and by World Bank income classification.

Findings

The global median PFP was 15·0% (range 6·6–20·5), conservatively equating to 3·9 million (95% CI 2·5–5·6) premature deaths averted annually. The African region had the highest median prevented fraction (16·6% [range 12·1–20·5]) and the Americas had the lowest (13·1% [10·8–16·6]). Low-income countries tended to have higher prevented fractions (group median 17·9% [12·3–20·5]) than high-income countries (14·1% [6·6–17·8]). Globally, the median prevented fraction was higher for men (16·0% [7·8–20·7] than women (14·1% [5·0–20·4]).

Interpretation

Existing physical activity prevalence has contributed to averting premature mortality across all countries. PFP has utility as an advocacy tool to promote healthy lifestyle behaviours. By making the case of what has been achieved, the prevented fraction can show the value of current investment and services, which might be conducive to political support.


参考文献


Strain T, Brage S, Sharp SJ, et al. Use of the prevented fraction for the population to determine deaths averted by existing prevalence of physical activity: a descriptive study. Lancet Glob Health. 2020;8(7):e920-e930. doi:10.1016/S2214-109X(20)30211-4



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