能量平衡研究的10大问题

肥胖是较长时间段内热量摄入和消耗失衡导致的结果。两者之间的关系可以用能量平衡方程描述,能量储存的速率等于能量摄入减去消耗的速率。尽管这种基于简单数学运算的关系可能容易理解,但在现实中,各种已知和未知的系统影响能量平衡的各个组成部分(能量储存,能量摄入,能量消耗)。显然,如果对于能量平衡有完整的理解,有效的预防和治疗策略就不会让肥胖在世界范围内大规模流行。本文的目的是针对能量平衡的组成部分进行简要的概述,确定10个关键主题以及悬而未决的问题,如果这些问题得以解决,可以推动整个研究领域。这些主题涉及多个方面,从一般(方法学问题)到特定领域。这个列表并不是详尽无遗,但却为能量平衡领域的科学家制定了研究议程,为公共卫生专家制定肥胖干预的措施提供了建议。

Commentary on Wang Y et al.“An Overview of Non-exercise Estimated Cardiorespiratory Fitness:Estimation Equations,Cross-Validation and Application”

Commentary for Wang et al.As documented well by Wang and co-authors[8],cardiores-piratory fitness(CRF)is a very strong determinant of many health outcomes,such as cardiovascular disease(CVD),type 2 diabetes,several forms of cancer,functional disabili-ties,and other issues.This point has been well established over the past several decades in many populations in many countries[1,3-5,7].Despite the importance of CRF,it is not often measured in clinical medicine and health research,because of time constraints and economic factors[6].The gold standard for measuring CRF is by a maximal exercise test in a laboratory,in which respiratory gas analyses are used to calculate maximal oxygen consumption during the test.This requires expensive equipment and considerable staff time and effort.Another approach is to not measure respiratory gases,but to determine the maximal work load from a treadmill or cycle ergometer exercise test.However,this approach also requires laboratory equipment and staff.It is also possible to estimate CRF from submaximal walk-ing or step tests,but these also require well trained staff and time.Another possible approach would be to obtain CRF data without doing an exercise test.This may seem unreal-istic,but non-exercise test models to predict CRF have been available for over 30 years[2].Wang and colleagues present references for these early tests[8].

Are flexibility and muscle-strengthening activities associated with functional limitation?

This retrospective cohort study examined the relationship between self-reported participation in flexibility and muscular strengthening activities and the development of functional limitation(i.e.,once an individual has difficulty with or becomes unable to perform activities of daily living).Data were obtained from 1318 adults(mean age 49.59.7 years;98.7%Caucasian;14.9%female)enrolled in the Aerobics Center Longitudinal Study from 1979 to 2004 and free of functional limitation at baseline.Mail-back health surveys were used to prospectively determine incident functional limitation.Participation in muscle-strengthening and flexibility activities was assessed via self-report.Adjusted logistic regression analyses were used to determine the odds ratios(OR)and corresponding 95%confidence intervals for developing functional limitation during follow-up based on participation in general and specific categories of flexibility(‘Stretching’,‘Calisthenics’,or‘Exercise Class’)and musclestrengthening activities(‘Calisthenics’,‘Free Weights’,‘Weight Training Machines’,or‘Other’).Overall,42.6%of the sample reported incident functional limitation.After adjusting for potential confounders(e.g.,age,sex,cardiometabolic risk factors),those who reported performing muscle-strengthening activities in general(n=685)were at lower risk of developing functional limitation[OR=0.79(0.63–1.00)].In addition,the specific flexibility activities of stretching(n=491)and calisthenics(n=122)were associated with 24%and 38%decreased odds of incident functional limitation,respectively.General muscle-strengthening,stretching,and calisthenics activities are prospectively associated with decreased risk of incident functional limitation in generally healthy,middleaged and older adults.Thus,both public health and rehabilitation programs should highlight the importance of flexibility and muscle-strengthening activities during adulthood to help preserve functional capacity.