山东大学席波团队分析了美国体育锻炼指南与全因或特定原因死亡的相关性。2020年7月1日，该研究发表在《英国医学杂志》上。

为了使用全国代表性的美国成年人样本，来确定根据2018年美国体育锻炼指南推荐的体育运动与全因和特定原因死亡率之间的关联，研究组进行了一项基于人群的队列研究。 

研究组将1997-2014年的国民健康访问调查与截至2015年12月31日的国家死亡指数记录关联起来，共招募了479856名18岁以上的参与者。根据参与者自述的每周在有氧体育锻炼和肌肉增强运动上所花费的闲暇时间，根据体育锻炼指南将其分为四组：运动不足、仅有氧运动、仅肌肉增强运动、以及有氧联合肌肉增强运动。主要结局指标是全因死亡和特定原因的死亡，包括心血管疾病、癌症、慢性下呼吸道疾病、事故和伤害、阿尔茨海默氏病、糖尿病、流感和肺炎、以及肾炎肾病综合症或肾病。

平均随访8.75年后，共有59819名成年人全因死亡，其中13509名因心血管疾病死亡，14375名因癌症死亡，3188名因慢性下呼吸道疾病死亡，2477名因意外和伤害死亡，1470名因阿尔茨海默氏病死亡，1803名因糖尿病死亡，1135名因流感和肺炎死亡，1129名因肾炎、肾病综合征或肾病死亡。

与那些不符合体育锻炼指南的人（268193例）相比，参加推荐的肌肉增强运动（21428，风险比为0.89）或有氧运动（113851例，风险比为0.71）降低了全因死亡的风险；同时参加这两种运动的人生存获益更大（76384，风险比为0.60）。此外，因心血管疾病、癌症和慢性下呼吸道疾病引起的特定死亡率的模式很相似。

研究表明，成年人在休闲时间参加有氧运动和肌肉增强运动的程度达到2018年美国人体育锻炼指南的建议水平，可显著降低全因和特定原因死亡率的风险。

附：英文原文

Title: Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study

Author: Min Zhao, Sreenivas P Veeranki, Costan G Magnussen, Bo Xi

Issue&Volume: 2020/07/01

Abstract: Objective To determine the association between recommended physical activity according to the 2018 physical activity guidelines for Americans and all cause and cause specific mortality using a nationally representative sample of US adults.

Design Population based cohort study.

Setting National Health Interview Survey (1997-2014) with linkage to the National Death Index records to 31 December 2015.

Participants 479856 adults aged 18 years or older.

Exposures Participant self-reports of the amount of leisure time spent in aerobic physical activity and muscle strengthening activity each week were combined and categorised into four groups: insufficient activity, aerobic activity only, muscle strengthening only, and both aerobic and muscle strengthening activities according to the physical activity guidelines.

Main outcome measures All cause mortality and cause specific mortality (cardiovascular disease, cancer, chronic lower respiratory tract diseases, accidents and injuries, Alzheimer’s disease, diabetes mellitus, influenza and pneumonia, and nephritis, nephrotic syndrome, or nephrosis) obtained from the National Death Index records.

Results During a median follow-up of 8.75 years, 59819 adults died from all causes, 13509 from cardiovascular disease, 14375 from cancer, 3188 from chronic lower respiratory tract diseases, 2477 from accidents and injuries, 1470 from Alzheimer’s disease, 1803 from diabetes mellitus, 1135 from influenza and pneumonia, and 1129 from nephritis, nephrotic syndrome, or nephrosis. Compared with those who did not meet the physical activity guidelines (n=268193), those who engaged in recommended muscle strengthening activity (n=21428; hazard ratio 0.89, 95% confidence interval 0.85 to 0.94) or aerobic activity (n=113851; 0.71, 0.69 to 0.72) were found to be at reduced risk of all cause mortality; and even larger survival benefits were found in those engaged in both activities (n=76384; 0.60, 0.57 to 0.62). In addition, similar patterns were reported for cause specific mortality from cardiovascular disease, cancer, and chronic lower respiratory tract diseases.

Conclusions Adults who engage in leisure time aerobic and muscle strengthening activities at levels recommended by the 2018 physical activity guidelines for Americans show greatly reduced risk of all cause and cause specific mortality. These data suggest that the physical activity levels recommended in the guidelines are associated with important survival benefits.

DOI: 10.1136/bmj.m2031

Source: https://www.bmj.com/content/370/bmj.m2031