体力活动在肥胖治疗与心脏代谢健康中的作用:美国心脏协会科学声明
该科学声明总结体力活动在促进减重、维持减重及心脏代谢健康中的作用,作为综合肥胖治疗的补充。单独体力活动除非有氧活动水平极高,否则难以实现临床意义的减重(至少5%初始体重);但与饮食、药物或手术联合可增强减重和心脏代谢结局。声明还概述了针对性减重咨询和利用数字技术的循证策略。
要点
- 体力活动独立于减重改善高血压、胰岛素抵抗和血脂异常等心脏代谢危险因素。
- 单独体力活动难以实现至少5%初始体重的临床意义减重,除非有氧活动水平极高。
- 体力活动与饮食负能量平衡、肥胖药物或手术联合可增强总减重和心脏代谢结局。
核心结论
- 体力活动是综合肥胖治疗的关键组成部分,独立于减重改善心脏代谢危险因素,并与其它干预联合增强减重效果。
研究设计与样本
- 美国心脏协会科学声明,总结体力活动在减重、维持减重和心脏代谢健康中的作用,并概述循证咨询策略和数字技术应用。
主要发现
- 单独体力活动除非有氧活动水平极高,否则不太可能产生至少5%初始体重的临床意义减重。
- 体力活动与饮食诱导的负能量平衡、肥胖药物或手术治疗联合可增加总减重并改善心脏代谢结局。
- 体力活动和运动方案独立于减重改善高血压、胰岛素抵抗和血脂异常。
临床怎么用
- 临床医生应将体力活动纳入综合肥胖治疗,并与饮食、药物或手术联合以增强减重和心脏代谢获益。
- 利用数字技术等循证策略进行针对性减重咨询,帮助患者设定现实体力活动目标。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
原文
Weight loss and weight loss maintenance are prominent topics of discussion for clinicians and health professionals involved in treatment to reduce obesity and the risk of cardiovascular disease. Because physical activity is a key component of comprehensive obesity treatment, this scientific statement summarizes the role of physical activity in promoting weight loss, weight loss maintenance, and cardiometabolic health, complementing lifestyle, pharmacological, and surgical-based weight loss intervention strategies. Independently of weight loss, physical activity and exercise programs improve major cardiometabolic risk factors, including hypertension, insulin resistance, and dyslipidemia, which are highly prevalent in patients with overweight or obesity. As a single treatment modality, physical activity and exercise programs are unlikely to result in clinically meaningful weight loss (ie, at least 5% loss of initial body weight) unless aerobic physical activity levels are exceptionally high. When combined with diet-induced negative energy balance, obesity medication, or surgical treatment, increased physical activity can augment total weight loss and improve cardiometabolic outcomes. Because clinicians and health professionals play a pivotal role in fostering and sustaining patients' health goals, this scientific statement also provides an overview of evidence-based strategies for targeted weight loss counseling and for leveraging digital technology, particularly to engage patients and achieve realistic physical activity goals.
引用
- Swift DL, Ross LM, Laddu DR, et al. Role of Physical Activity in Obesity Treatment and Cardiometabolic Health: A Scientific Statement From the American Heart Association. Circulation. 2026. PMID: 42220241. doi:10.1161/CIR.0000000000001441
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。