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节食的肥胖老年人应该进行有氧运动、抗阻运动还是缺一不可
Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults


Dennis T. Villareal ... 其他 • 2017.05.18
相关阅读
• 有氧运动联合抗阻运动对节食的肥胖老年人效果最好 • 减重、运动或两者联合与肥胖老年人身体功能的关系

对于老年肥胖者,有氧运动和抗阻运动应受到重视

 

林旭†*,孙亮†,刘鑫‡

†中国科学院上海生命科学研究院营养科学研究所;‡ 西安交通大学医学部公共卫生学院

* 通讯作者

 

世界卫生组织(WHO)对肥胖的定义是:体内脂肪积累过多或异常而影响健康的一种状态,并在1997年将肥胖定义为一种疾病。而美国医学会在2013年将肥胖作为疾病,一些医疗保险公司随后将治疗肥胖纳入医疗保险。我国目前有近1亿肥胖人口,居全球首位。根据2012年的数据,我国成人超重率和肥胖率分别是30.1%和11.9%。作为“沉默的杀手”,肥胖能2~3倍地增加2型糖尿病、心血管疾病、痛风和脂肪肝等代谢性疾病的风险。与此同时,我国人口老龄化趋势正在加剧。根据国家统计局数据,在2005~2015年的10年中,我国65岁以上人口的比例增加了约40%,已达到了全部人口的10.5%1。而根据“2010年中国慢病监测”,2010年我国60岁以上老年人的超重者(25 kg/m2≤BMI<30 kg/m2)比例为29.3%,肥胖者(BMI≥30 kg/m2)比例为5.3%2。因此,寻找切实有效的适合老年人群的体重管理方案和措施对预防和控制代谢性疾病的发生发展极为关键。

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摘要


背景

肥胖会导致老年人虚弱;然而,减重可能加速与衰老相关的肌肉和骨量丢失,以及由此产生的肌肉减少和骨量减少。

 

方法

在纳入160名肥胖老年人的临床试验中,我们评价了几项运动方式对逆转虚弱、预防减重导致的肌肉和骨量丢失的有效性。参与者被随机分配接受体重管理项目加上三种运动项目之一——有氧训练、抗阻训练或有氧联合抗阻训练,或分配至对照组(无体重管理和运动项目)。主要结局是从基线至6个月时,体能表现测试(Physical Performance Test)评分的变化(评分范围是0~36分;较高的评分表示较好的体能表现)。次要结局包括其他虚弱指标、身体成分、骨矿物质密度和身体功能的变化。

 

结果

共有141名参与者完成了研究。联合组的体能表现测试评分比有氧组和抗阻组有更大幅上升(分别为27.9~33.4分[上升21%]对29.3~33.2分[上升14%]和28.8~32.7分[上升14%];Bonferroni校正后的P=0.01和P=0.02);所有运动组的评分都比对照组有更大幅上升(组间比较P<0.001)。联合组和有氧组的峰值耗氧量(mL/[kg·min])(分别为17.2~20.3 [上升17%]和17.6~20.9 [上升18%])比抗阻组(17.0~18.3 [上升8%])有更大幅上升(两项比较P均<0.001)。联合组和抗阻组的力量(分别为272~320 kg [上升18%]和288~337 kg [上升19%])比有氧组有更大幅上升(265~270 kg [上升4%])(两项比较P均<0.001)。所有运动组的体重均降低9%,但对照组没有显著变化。联合组和抗阻组的瘦体重比有氧组下降幅度更小(分别为56.5~54.8 kg [下降3%]和58.1~57.1 kg [下降2%]对55.0~52.3 kg [下降5%]),全髋骨矿物质密度的情况相同(g/cm2;分别为1.010~0.996 [下降1%]和1.047~1.041 [下降0.5%]对1.018~0.991 [下降3%])(所有比较P均<0.05)。运动相关的不良事件包括肌肉骨骼损伤。

 

结论

在测试的所有方法中,减重加上有氧联合抗阻运动对改善肥胖老年人的功能状态最为有效(由美国国立卫生研究院资助;LITOE试验在ClinicalTrials.gov注册号为NCT01065636)。





作者信息

Dennis T. Villareal, M.D., Lina Aguirre, M.D., A. Burke Gurney, Ph.D., P.T., Debra L. Waters, Ph.D., David R. Sinacore, Ph.D., P.T., Elizabeth Colombo, M.D., Ph.D., Reina Armamento-Villareal, M.D., and Clifford Qualls, Ph.D.
From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center — both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine — both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.).Address reprint requests to Dr. Villareal at Baylor College of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Ave., Houston, TX 77030, or at dennis.villareal@bcm.edu.

 

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