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郭凯明, 赵一凡, 赵平平, 刘芳, 徐溪, 张朝, 周脉耕, 蒋炜. 正常高值血压职业人群健走干预效果等时替代模型分析[J]. 中国公共卫生, 2023, 39(7): 863-869. DOI: 10.11847/zgggws1140132
引用本文: 郭凯明, 赵一凡, 赵平平, 刘芳, 徐溪, 张朝, 周脉耕, 蒋炜. 正常高值血压职业人群健走干预效果等时替代模型分析[J]. 中国公共卫生, 2023, 39(7): 863-869. DOI: 10.11847/zgggws1140132
GUO Kaiming, ZHAO Yifan, ZHAO Pingping, LIU Fang, XU Xi, ZHANG Chao, ZHOU Maigeng, JIANG Wei. Effect of brisk walking intervention in occupational populations with normal high blood pressure: an isotemporal substitution model-based analysis[J]. Chinese Journal of Public Health, 2023, 39(7): 863-869. DOI: 10.11847/zgggws1140132
Citation: GUO Kaiming, ZHAO Yifan, ZHAO Pingping, LIU Fang, XU Xi, ZHANG Chao, ZHOU Maigeng, JIANG Wei. Effect of brisk walking intervention in occupational populations with normal high blood pressure: an isotemporal substitution model-based analysis[J]. Chinese Journal of Public Health, 2023, 39(7): 863-869. DOI: 10.11847/zgggws1140132

正常高值血压职业人群健走干预效果等时替代模型分析

Effect of brisk walking intervention in occupational populations with normal high blood pressure: an isotemporal substitution model-based analysis

  • 摘要:
      目的  了解正常高值血压职业人群健走干预效果,为正常高值血压职业人群健康改善提供量化建议。
      方法  收集参与2016年“万步有约”中国职业人群健走激励干预项目中有完整人口学信息、健康体测和步行数据的4855名正常高值血压职业人群相关资料,采用等时替代模型分析低强度体力活动(LPA)、中等强度体力活动(MPA)、高强度体力活动(HPA)替代久坐行为(SB)对健康结果指标的替代效应。
      结果  等时替代模型分析结果显示,在保持总行为活动时间不变的情况下,30 min/d的MPA时间代替相同时间的SB会使正常高值血压职业人群的体质指数(BMI)、体脂率(BFP)、内脏脂肪指数(VAI)分别额外下降0.102(β = – 0.102)、0.150%(β = – 0.150)和0.071(β = – 0.071)。亚组分析结果显示,30 min/d的MPA时间代替相同时间的SB会使男性正常高值血压职业人群BMI额外下降0.120(β = – 0.120),女性正常高值血压职业人群BFP和VAI分别额外下降0.287%(β = – 0.287)和0.119(β = – 0.119),40~49岁正常高值血压职业人群BMI、BFP和VAI分别额外下降0.127(β = – 0.127)、0.192%(β = – 0.192)和0.098(β = – 0.098),BMI超重肥胖正常高值血压职业人群BMI和VAI分别额外下降0.160(β = – 0.160)和0.080(β = – 0.080),中心性肥胖正常高值血压职业人群BMI、BFP和VAI分别额外下降0.206(β = – 0.206)、0.216%(β = – 0.216)和0.127(β = – 0.127),BFP正常的正常高值血压职业人群BMI和BFP分别额外下降0.063(β = – 0.063)和0.143%(β = – 0.143),BFP肥胖正常高值血压职业人群BMI额外下降0.189(β = – 0.189),VAI肥胖正常高值血压职业人群BMI、BFP和VAI分别额外下降0.144(β = – 0.144)、0.200%(β = – 0.200)和0.104(β = – 0.104);30 min/d的HPA时间代替相同时间的SB会使男性正常高值血压职业人群BFP和VAI分别额外下降0.641%(β = – 0.641)和0.295(β = – 0.295), ≥ 50岁正常高值血压职业人群BFP和VAI分别额外下降1.020%(β = – 1.020)和0.520(β = – 0.520),BFP肥胖正常高值血压职业人群BFP额外下降0.748%(β = – 0.748)。
      结论  30 min/d的MPA时间替代相同时间的SB可不同程度改善正常高值血压职业人群的BMI、BFP和VAI,且在全人群中LPA、HPA与SB之间对于健康改善可能不具有等时替代作用,在该人群中可推广100~130步/分的中等强度健走运动。

     

    Abstract:
      Objective  To examine the effect of brisk walking intervention in occupational populations with normal high blood pressure, and to provide quantified evidence for health improvement of occupational population with normal high blood pressure.
      Methods  The information on demographics, physical examination and walking of 4 855 workers with normal high blood pressure were extracted from a brisk walking incentive intervention program for occupation populations conducted during 2016 in China. The substitution effects of low intensity physical activity (LPA), moderate intensity physical activity (MPA) and high intensity physical activity (HPA) instead of sedentary behavior (SB) on health outcomes were analyzed with isochronal substitution model.
      Results   The results of isochronous substitution model analysis showed that the body mass index (BMI), body fat rate (BFP) and visceral fat index (VAI) of occupational people with normal high blood pressure decreased by 0.102 (β = – 0.102), 0.150% (β = – 0.150) and 0.071 (β = – 0.071), respectively when the SB was replaced by MPA time of 30 min/d during the same period. The results of subgroup analysis showed that MPA time of 30 min/d instead of SB during the same period could decrease BMI by an additional 0.120 (β = – 0.120) in male occupational population with normal high blood pressure, and an additional 0.287% (β = – 0.287) and 0.119 (β = – 0.119) in BFP and VAI in female occupational group with normal high blood pressure, respectively. BMI, BFP and VAI decreased by 0.127 (β = – 0.127), 0.192% (β = – 0.192), and 0.098 (β = – 0.098) in normal high blood pressure occupational group aged 49 years old; while BMI and VAI decreased by 0.160 (β = 0.160) and 0.080 (β = – 0.080) in overweight and obese occupational group. BMI, BFP and VAI decreased by an additional 0.206 (β = – 0.206), 0.216% (β = – 0.216) and 0.127 (β = – 0.127), respectively, and BMI and BFP decreased by an additional 0.063 (β = – 0.063) and 0.143% (β = – 0.143) in normal high blood pressure occupation group with normal BFP. The BMI could be decreased by 0.189 (β = – 0.189) in the normal high blood pressure occupational group with BFP-indicated obesity, while the BMI, BFP and VAI could be decreased by 0.144 (β = 0.144), 0.200% (β = – 0.200) and 0.104 (β = – 0.104) in the normal high blood pressure occupational group with VAI-indicated obesity. A 30 min/d HPA time instead of SB during the same period resulted in an additional decrease of 0.641% (β = – 0.641) and 0.295 (β = – 0.295) in BFP and VAI in men with normal high blood pressure, and an additional 1.020% (β = – 1.020) and 0.520 (β = – 0.520) in BFP and VAI in those ≥ 50 years old; BFP could be decreased by an additional 0.748% (β = – 0.748) in normal high blood pressure occupational population with BFP-indicated obesity.
      Conclusion   A 30 min/d MPA time instead of SB during the same period can improve the BMI, BFP and VAI at different degrees in the occupational populations with normal high blood pressure; however there may be no isochronous substitution for health improvement effect of LPA and HPA instead of SB in the whole population; the moderate intensity walking exercise of 100 – 130 steps/min can be promoted in this population.

     

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