北京市体重正常和肥胖人群体力活动状况的研究
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摘要
肥胖发病率在世界范围内呈逐年上升趋势，肥胖与多种疾病包括心脑血管疾病、Ⅱ型糖尿病、某些肿瘤发生以及相关死亡关系密切。体力活动对肥胖有一定的影响，但是，目前对体力活动模式研究的较少。
目的：描述比较体重正常和肥胖人群的体力活动状况，为肥胖的预防和治疗提供依据。
研究对象和方法：1998年-2000年参加“膳食和体力活动对体成分(％BF)的相对影响”课题的130人，其中，体重正常组(体脂百分比)男性18人、女性25人；肥胖组男性45人、女性42人。体力活动调查采用加速度计(Computer Science and Applications，CSA)和MONICA一周体力活动问卷法。能量消耗用双标水(Doubly Labeled Water,DLW)法和根据各种体力活动计算能量消耗。％BF用单标水(Deuterium Oxide Dilution，D_2O)方法测量。
结果：(1)体重正常组男性和女性进行体育锻炼的比例、时间、方式和频率均高于肥胖组男性和女性；体重正常组男性和女性进行业余散步的比例和时间均有高于肥胖组男性和女性业余散步的趋势，但差异没有显著性。当平均每天业余散步的时间大于等于60分钟时，体重正常组男性和女性业余散步的比例均显著高于肥胖组男性和女性；体重正常组男性做家务的比例和时间均高于肥胖组男性，体重正常组女性做家务的比例和时间均低于肥胖组女性。当平均每天做家务时间大于等于60分钟时，体重正常组男性和女性做家务的比例均高于肥胖组，差异具有显著性(P＜0.05)；体重正常组男性的交通比例和时间均低于肥胖组男性，体重正常组女性的交通时间高于肥胖组女性；体重正常组男性的工作比例和时间均低于肥胖组男性，体重正常组女性的工作时间高于肥胖组女性；体重正常组男性和女性的睡眠时间均高于肥胖组男性和女性。(2)体重正常组男性和女性的轻
北京市体重正常和肥胖人群体力活动状况的研究
钟师赵斌教授马冠生研究员
度体力活动时间均低于肥胖组男性和女性的轻度体力活动时间;体重正常
组男性和女性的中度体力活动时间均高于肥胖组男性和女性的中度体力活
动时间;体重正常组男性参加重度体力活动的比例和时间均低于肥胖组男
性，体重正常组女性参加重度体力活动的比例低于肥胖组女性，重度体力
活动时间高于肥胖组女性。(3)分别用DLW方法测量的总能量消耗(Total
Ene尽Expenditure，TEE)和CsA调整后的总能量消耗(predietion Total Ene汀
Expenditure，尸TEE)表示:肥胖组男性和女性的TEE均高于体重正常组男性
和女性的TEE，差异具有显著性(尸<0 .01)。体重正常组男性和女性每公斤
体重的能量消耗高于肥胖组男性和女性每公斤体重的能量消耗，差异具有
显著性(尸<0.01)。体重正常组男性和女性的活动记数(加速度的总和)
均高于肥胖组男性和女性。肥胖组男性和女性的体力活动能量消耗(ActMty
Enery ExPenditure，AEE)和基础代谢能量消耗有高于体重正常组男性和女
性的AEE和基础代谢能量消耗的趋势，但差异没有显著性。肥胖组男性和
女性的体力活动水平(Physicial activity Level，PAL)均低于体重正常组男性
和女性的体力活动水平，差异具有显著性(尸<0.05)。
多元逐步回归分析结果发现，与男性%BF关系最大的是工作日体育锻
炼(p二一679)，然后依次为工作日步行购物(p二一0.619)、睡眠时间(p
二一0.468)，周末步行购物(p二一0.343);与女性%BF的关系最大的是工作
日步行购物(p=一0.716)，然后依次为工作日体育锻炼(p=一0.618)、周
末体育锻炼(p=一0.458)、睡眠时间(p=一0.343)、骑自行车上下班(p
二一0.269)、周末散步(p=一0.269)。
结论:本研究发现，在男性中，工作日体育锻炼、工作日步行购物、
睡眠时间、周末步行购物的时间越高，肥胖发生的危险性越低;在女性中，
工作日步行购物、工作日体育锻炼、周末体育锻炼、骑自行车上下班、睡
眠时间、周末散步、周末骑自行车的时间越高，肥胖发生的危险性越低。
北京市体重正常和肥胖人群体力活动状况的研究导师赵斌教授马冠生研究员
另外，还发现:虽然肥胖组的TEE和AEE高于体重正常组的丁EE和AEE，但
是肥胖组男性和女性的每公斤体重的能量消耗、活动记数和PAL明显低于体
重正常组男性和女性的每公斤体重的能量消耗、活动记数和PAL。说明PAL
越高，肥胖发生的危险性越低。
The prevalence of obesity has been rising up all over the world. Obesity is a well-established risk factor for cardiovascular disease, diabetes, hyperlipidemia, hypertension, osteoathritis, stroke and some categories of cancers. It is also linked to increased risk for morbidity and mortality. Physical activity is a stronger influence factor on obesity than other environments. However, currently, few studies for physical activity patterns .
Objective: Describe and Compare of physical activity patterns of multitude with different body composition, Provide basis for fat prevention and treatmeat.
Objects and Methods: 130 people who take part in "the relative effects of dietary fat and physical activity on body composition" study in 1998-2000. 18 Males with normal weight (body fat percentage), 25 females with normal weight, 45 males with obesity, 42 female with obesity, physical activity (by Computer Science and Applications and WHO MONICA questionnaire),total energy expenditure (by DLW and calculated energy expenditure for all physical activity ), percentage body fat (by D2O).
Results: (1) Kinds, frequency and proportion of physical exercise in normal weight males and females are higher than in those obesity. The time when take part in physical exercise of normal weight is longer than those of obesity. The difference is obvious (jP<0.05). In workdays, The normal weight males spend more time in shopping, doing housework and leisure time talking than obesity males. The normal weight females spend more time in riding bikes for work than obesity females (P<0.05). The normal weight males spend more time in doing housework than those obesity when the time is longer than or equal to 30 minutes, The difference is obvious (P<0.05). The normal weight males and females spend more time in shopping than those obesity when the
time is longer than or equal to 60 minutes. The difference is obvious (P<0.05). In weekends, normal weight males spend more time in leisure time walking than those obesity when the time is longer than or equal to 60 minutes. The difference is obvious (P<0.05). Normal weight females spend more tine in doing housework, shopping, leisure time talking than those obesity. The normal weight females spend more time in leisure time walking than those obesity when the time is longer than or equal to 60 minutes. The difference is obvious (P<0.05). (2) light-intensity physical activity of normal weight males and females are low than those of obesity, they spend more time in moderate- intensity physical activity than obesity. (3) The total energy expenditure by using Doubly Labeled Water and adjuisted energy expenditure for CSA show that: The obesity males and females' total energy expenditure is higher than those of normal weight. The difference is obvious (P<0.0\). The obesity males and females' physical activity ener
gy expenditure (AEE) and basal metabolism, energy expenditure are both higher than those of normal weight. The difference is not obvious. (4) The obesity males and females' energy expenditure of per kilgram body weight and physical activity level (PAL) is lower than those of normal weight. The difference is obvious (P<0.05).
Stepwise multiple regression analysis showed that the dorminant factor of %BF in boys is exercise on the weekdays( P = -0.679), and in turn going shopping by feet on the weekdays( β = -0.619), sleeping time( β = -0.468), going shopping by feet on the weekend( β = -0.343),; that the dorminant factor of %BF in girl is going shopping by feet on the weekdays( β = -0.716), and in turn exercise on the weekdays( β = -0.618), and weekend( β = -0.458), sleeping time( β = -0.343), go and from work by bicycle( β = -0.269), walking on the weekend( β = -0.269).
Conclusion: The result indicated that:the more time it spend on exercise going shopping by feet on the weekdays sleeping etc. in man , the lower of the
risk, it develop obesity, and in woman the more time it spend on going shopping on the weekdays exercise all the week, go and from work by bicycle, sleeping ,walking on
目的：描述比较体重正常和肥胖人群的体力活动状况，为肥胖的预防和治疗提供依据。
研究对象和方法：1998年-2000年参加“膳食和体力活动对体成分(％BF)的相对影响”课题的130人，其中，体重正常组(体脂百分比)男性18人、女性25人；肥胖组男性45人、女性42人。体力活动调查采用加速度计(Computer Science and Applications，CSA)和MONICA一周体力活动问卷法。能量消耗用双标水(Doubly Labeled Water,DLW)法和根据各种体力活动计算能量消耗。％BF用单标水(Deuterium Oxide Dilution，D_2O)方法测量。
结果：(1)体重正常组男性和女性进行体育锻炼的比例、时间、方式和频率均高于肥胖组男性和女性；体重正常组男性和女性进行业余散步的比例和时间均有高于肥胖组男性和女性业余散步的趋势，但差异没有显著性。当平均每天业余散步的时间大于等于60分钟时，体重正常组男性和女性业余散步的比例均显著高于肥胖组男性和女性；体重正常组男性做家务的比例和时间均高于肥胖组男性，体重正常组女性做家务的比例和时间均低于肥胖组女性。当平均每天做家务时间大于等于60分钟时，体重正常组男性和女性做家务的比例均高于肥胖组，差异具有显著性(P＜0.05)；体重正常组男性的交通比例和时间均低于肥胖组男性，体重正常组女性的交通时间高于肥胖组女性；体重正常组男性的工作比例和时间均低于肥胖组男性，体重正常组女性的工作时间高于肥胖组女性；体重正常组男性和女性的睡眠时间均高于肥胖组男性和女性。(2)体重正常组男性和女性的轻
北京市体重正常和肥胖人群体力活动状况的研究
钟师赵斌教授马冠生研究员
度体力活动时间均低于肥胖组男性和女性的轻度体力活动时间;体重正常
组男性和女性的中度体力活动时间均高于肥胖组男性和女性的中度体力活
动时间;体重正常组男性参加重度体力活动的比例和时间均低于肥胖组男
性，体重正常组女性参加重度体力活动的比例低于肥胖组女性，重度体力
活动时间高于肥胖组女性。(3)分别用DLW方法测量的总能量消耗(Total
Ene尽Expenditure，TEE)和CsA调整后的总能量消耗(predietion Total Ene汀
Expenditure，尸TEE)表示:肥胖组男性和女性的TEE均高于体重正常组男性
和女性的TEE，差异具有显著性(尸<0 .01)。体重正常组男性和女性每公斤
体重的能量消耗高于肥胖组男性和女性每公斤体重的能量消耗，差异具有
显著性(尸<0.01)。体重正常组男性和女性的活动记数(加速度的总和)
均高于肥胖组男性和女性。肥胖组男性和女性的体力活动能量消耗(ActMty
Enery ExPenditure，AEE)和基础代谢能量消耗有高于体重正常组男性和女
性的AEE和基础代谢能量消耗的趋势，但差异没有显著性。肥胖组男性和
女性的体力活动水平(Physicial activity Level，PAL)均低于体重正常组男性
和女性的体力活动水平，差异具有显著性(尸<0.05)。
多元逐步回归分析结果发现，与男性%BF关系最大的是工作日体育锻
炼(p二一679)，然后依次为工作日步行购物(p二一0.619)、睡眠时间(p
二一0.468)，周末步行购物(p二一0.343);与女性%BF的关系最大的是工作
日步行购物(p=一0.716)，然后依次为工作日体育锻炼(p=一0.618)、周
末体育锻炼(p=一0.458)、睡眠时间(p=一0.343)、骑自行车上下班(p
二一0.269)、周末散步(p=一0.269)。
结论:本研究发现，在男性中，工作日体育锻炼、工作日步行购物、
睡眠时间、周末步行购物的时间越高，肥胖发生的危险性越低;在女性中，
工作日步行购物、工作日体育锻炼、周末体育锻炼、骑自行车上下班、睡
眠时间、周末散步、周末骑自行车的时间越高，肥胖发生的危险性越低。
北京市体重正常和肥胖人群体力活动状况的研究导师赵斌教授马冠生研究员
另外，还发现:虽然肥胖组的TEE和AEE高于体重正常组的丁EE和AEE，但
是肥胖组男性和女性的每公斤体重的能量消耗、活动记数和PAL明显低于体
重正常组男性和女性的每公斤体重的能量消耗、活动记数和PAL。说明PAL
越高，肥胖发生的危险性越低。
The prevalence of obesity has been rising up all over the world. Obesity is a well-established risk factor for cardiovascular disease, diabetes, hyperlipidemia, hypertension, osteoathritis, stroke and some categories of cancers. It is also linked to increased risk for morbidity and mortality. Physical activity is a stronger influence factor on obesity than other environments. However, currently, few studies for physical activity patterns .
Objective: Describe and Compare of physical activity patterns of multitude with different body composition, Provide basis for fat prevention and treatmeat.
Objects and Methods: 130 people who take part in "the relative effects of dietary fat and physical activity on body composition" study in 1998-2000. 18 Males with normal weight (body fat percentage), 25 females with normal weight, 45 males with obesity, 42 female with obesity, physical activity (by Computer Science and Applications and WHO MONICA questionnaire),total energy expenditure (by DLW and calculated energy expenditure for all physical activity ), percentage body fat (by D2O).
Results: (1) Kinds, frequency and proportion of physical exercise in normal weight males and females are higher than in those obesity. The time when take part in physical exercise of normal weight is longer than those of obesity. The difference is obvious (jP<0.05). In workdays, The normal weight males spend more time in shopping, doing housework and leisure time talking than obesity males. The normal weight females spend more time in riding bikes for work than obesity females (P<0.05). The normal weight males spend more time in doing housework than those obesity when the time is longer than or equal to 30 minutes, The difference is obvious (P<0.05). The normal weight males and females spend more time in shopping than those obesity when the
time is longer than or equal to 60 minutes. The difference is obvious (P<0.05). In weekends, normal weight males spend more time in leisure time walking than those obesity when the time is longer than or equal to 60 minutes. The difference is obvious (P<0.05). Normal weight females spend more tine in doing housework, shopping, leisure time talking than those obesity. The normal weight females spend more time in leisure time walking than those obesity when the time is longer than or equal to 60 minutes. The difference is obvious (P<0.05). (2) light-intensity physical activity of normal weight males and females are low than those of obesity, they spend more time in moderate- intensity physical activity than obesity. (3) The total energy expenditure by using Doubly Labeled Water and adjuisted energy expenditure for CSA show that: The obesity males and females' total energy expenditure is higher than those of normal weight. The difference is obvious (P<0.0\). The obesity males and females' physical activity ener
gy expenditure (AEE) and basal metabolism, energy expenditure are both higher than those of normal weight. The difference is not obvious. (4) The obesity males and females' energy expenditure of per kilgram body weight and physical activity level (PAL) is lower than those of normal weight. The difference is obvious (P<0.05).
Stepwise multiple regression analysis showed that the dorminant factor of %BF in boys is exercise on the weekdays( P = -0.679), and in turn going shopping by feet on the weekdays( β = -0.619), sleeping time( β = -0.468), going shopping by feet on the weekend( β = -0.343),; that the dorminant factor of %BF in girl is going shopping by feet on the weekdays( β = -0.716), and in turn exercise on the weekdays( β = -0.618), and weekend( β = -0.458), sleeping time( β = -0.343), go and from work by bicycle( β = -0.269), walking on the weekend( β = -0.269).
Conclusion: The result indicated that:the more time it spend on exercise going shopping by feet on the weekdays sleeping etc. in man , the lower of the
risk, it develop obesity, and in woman the more time it spend on going shopping on the weekdays exercise all the week, go and from work by bicycle, sleeping ,walking on
引文
1. World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: WHO, 1998.
2. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000; 160:898-904.
3. Must A, Spadano J, Coakley E, et al. The disease burden associated with overweight and obesity. JAMA 1999; 282:1523-1529.
4. Thomas P, et al. weighing the options. Criteria for evaluating Weight-Management Programs. National Academy Press, Washington D.C. USA. I995.
5. Colditz GA. Economic cost of obesity and inactivity. Medicine and Science in Sport and Exercise 1999:31:S663-S667.
6．陈吉棣，体力活动、膳食营养与慢性病．中国运动医学杂志．1999：18(1)：46-50．
7. National Research Council. Committee on Diet and Health. Implications for reducing chronic disease risk. Washington DC. National Academy Press 1998.
8. Maia J.A.R, Thomas M, Beunen G; et al. Genetic fatctors in physical activity levels. Am J Prey Med 2002; 23(2s): 87-91.
9. Popkin BM, Doak CM. The obesity epidemic is a worldwide phenomenon. Nutr Rev 1998; 56:106-14.
10. Flegal KM, The obesity epidemic in children and adults: current evidence and research issues. Med Sci Sports Exert 1999; 31(suppl): S509-14.
11. Cumings S, Parham ES, Strain GW. Position of the American Dietetic Association: Weight management. J Am Diet Assoc 2002; 102:1145-1155.
12. Flegal KM, Carroll MD, kuczmarski RJ, Johnson. Overweight and obesity in the United States: Prevalence and trends, 1960-1994.Int J Obes Relat Metab Discord 1998; 22:39-47.
13. Schaefer DC, Cheskin LJ. Uodate on obesity treatment. Gastroenterologist 1998; 6:136-145.
14. National Center for Health Statistics. Prevalence of overweight and obesity among adults. Atlanta, GA: National Center for Disease Control and Prevention. Available at: www.cde.gov/nchs/product/pubs/pubd/hestats/obese.htm. Accessed August 4,2002.
15．武阳丰，周北凡，陶寿淇等．我国中年人群超重率和肥胖率的现状和发展趋势．中华流行病学杂志．2002；23：11-15．
16．秦百里．现代文明病和国民体育锻炼．南京体育学院报．2002；12；1(4)：78-79．
17. U.S. Department of health and human services centers for disease control and prevention. National Center for Chronic disease Prevention and Health Promotion The President's Council on Physical Fitness and Sports. Physical activity and Health. A Report of the Surgeon General. Internation Medical Publishing. 1996; 12-21.
18. U.S. Department of health and human services centers for disease control and prevention. National Center for Chronic disease Prevention and Health Promotion The President's Council on Physical Fitness and Sports. Physical activity and Health. Patterns and Trends in Physical Activity. A Report of the Surgeon General. Internation Medical Publishing. 1996; 176-207.
19. Russell R. pate, Michael Pratt, MD, MPH; Steven N Blair, PED; et-al.. Physical Activity and Public Health. JAMA 1995; Vol 273, No.5.
20．陈君石，闻之梅等译，现代营养学．人民卫生出版社．1995；384．
21. Dipietro L, Kohl HW 3_(rd),Barlow CE, et al. Improvement in cardiorespiratory fitness attenuate age-related weight gain in healthy men and women: The Aerobics Center Longitudinal Study.Int J Obes Relat Metab Disord 1998; 22:55-62.
22. Ross R, Freeman JA, Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exerc Sport Sci Rev 2000; 28:165-170.
23. Ross R, Dagnone D, Jones P J, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men: A randomized, controlled trial. Ann Intern Med 2000; 133: 92-103.
24. Ross R, Jassen I. Is abdominal fat preferentially reduced in response to exercise-induced weight loss? Med Sci Sports Exerc 1999; 31:S568-S572.
25．董忠，高京晓．中老年妇女体育活动与心血管疾病的危险．国外医学社会医学分册．2001；18(3)：122-125．
26．邢连波，张青萍．中等强度活动与成年人健康．山西师大体育学院学报．2000；15(2)：76-76．
27．李恩中．体力活动、膳食营养和血脂．周口师范高等专科学院学报．1999；16(5)：89-91．
28. Willett WC, Lenart E. Reproducibility and Validity of food-frequency questionnaires. In: Willett W. Nutritional Epidemioligy 2nd ed. New York: Oxgord Univerdity Press.1998; 13.
29. Yao et al. Field methods for body composition assessment are valid in healthy Chinese adults. J Nutr 2002; 132: 310-317.
30. Krummel DA, Gordon P, Newcomer RR, et al. Dietary intakes and leisure-time physical activity in West Virginians. W V Med J 2001; 97(6): 295-301.
31. Westerterp KR, Goran M. Relationship between physical activity related energy expenditure and body composition: a gender difference. Int J Obes Relat Metab Disord 1997;21:184-8.
32. Ulf Ekelund, Michael S. Physical activity assessed by activity monitor and doubly labeled water in children. Med Sci.Sports Exerc 2004: 33(2): PP.275-281.
33. Bnrbnmb A, William L, Haskell M, et al. Compendium of Physical Activities: an update of activity codes and MET intensities. Med Sci.Sports Exerc 2000;32(9): s498-s516.
34. Ekelund UL, Aman J, Yngve A, et al. physicial activity but not energy expenditure is reduced in obese adolescents: a case-control study. Am J Clin Nutr 2002; 76:935-41.
35. John R. Sirard, EL. Melanson L, et al. Field evaluation of the Computer Science and Applications, Inc. Physical activity monitor. Med Sci.Sports Exerc 2000; 32(3): 695-700.
36. WHO(1997).The MONICA Optional Study of Physical Activity (MOSPA). Med Sci.Sports Exert 25:S162-169.
37．陈炳卿主编．营养与食品卫生学．1994；276-282．
38．W.P.T.James编著．人体热能需要量．联合国粮农组织．1998；8．
39. Van Loan. Multicompartment model of body composition assessment on Chinese American adults. AM J Hum Biol 1997;9:21-7.
40. World Health Organization. Obesity: Preventing and Managing the Global Epidemic.Report of a WHO consultation. Technical Report Series 894. Geneva: 2000.
41. Lohman TG, Houtkooper L, Going SB. Body fat measurements goes high tech. Not all are created equal. ACSM Health Fitness J. 1997; 1: 30.
42. Hill JO. Commerford R. Physical activity fat balance and energy balance. Int J Sport Nutr 1996; 6:80-92.
43. Kleges RC. Kleges LM. Haddock Ck, et al.A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults. Am J Clin Nutr 1992; 55: 818-826.
44. Simsolo RB, et al. the regulation of adipose tissue and muscle lipoprotein lipase in runners by detraining. J Clin Invest 1993; 92:2124-2132.
45. Saltzman E, et al. the role of energy expenditure in energy regulation: Findings from a decade of research. Nutrition Review 1995; 53(8): 209-215.
46. Owens JF, Metthew KA, Wing RR, et al. Can physical activity mitigate the effects of
aging in middle-aged women? Circulation 1992; 85; 1265—1270.
47. Williamson DF, Madans J. Recreational physical activity and ten-year weight change in US national cohort. Int J Obes 1993; 17: 279-286.
48. Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med 1993; 119:646-649.
49. Tammelin T, Laitinen J, Nayha S. Change in the level of physical activity form adolescence into adulthood and obesity at the age of 31 years. Int J Obes 2004: 23, 198-206.
50. Nobuyuki M, Hidetake N, Akie M. Daily walking reduces visceral adipose tissue areas and improves insulin resistance in Japanese obese subjects. Diabetes Research and Clinical Practice 2002; 58: 101-107.
51. Katherine S, Paul J, Mathias N, et al. Genetic and Environmental influences on Total-body and Central Abdominal Fat: The Effect of Physical Activity in Female Twins. Ann Intern Med 1999; 130: 873-882.
52. Giugliano R, Carneiro EC. Factors associated with obesity in school children. J Pediatr 2004; 80(1):17-22.
53. Miyatake N, et al. Daily walking reduces visceral adipose tissue areas and improves insulin resistance in Japanese obese subjects. Diabetes Research and Clinical Practice 2002;58:101-107.
54. Van Baak MA, Van Mil E, Astrup AV, et al. Leisure-time activity is an important determinant of long-term weight maintenance after weight loss in the Sibutramine Trial on Obesity Reduction and Maintenance. Am J Clin Nutr 2003; 78(2):209-14.
55．崔凤华，李桂芝．休闲体育运动对人体健康的积极作用．石油教育．2000：5：108-109．
56. Andersen PS, Schnohr P, Scroll M, et al. Mortality associated with Physical activity in leisure time, at work, in sports and cycling ti work. Ugeskr Laeger. 2002; 164(11): 1501-6.
57．潘信伟，洪玉玲，汪慧珍等．体力活动与心血管病危险因素．中国慢性病预防与控制杂志．1994；2(4)：157-159．
58. Droyvold WB, Hlomen J, Midthjell K, et al. BMI change and leisure time physical activity: an 11-y follow-up study in apparently healthy men aged 20-69y with normal weight at baseline. Int J Obes Relat Metab Disord 2004; 28(3): 410-7.
59. Wenche DB, Hlomen J, Kruger O, et al. Leisure-time physical activity and change in body mass index: an 11-y follow-up study of 9357 normal weight health women 20-49 years old. J Women Health. 2004; (13): 55-62.
60. Jeffery RW, Wing RR, Sherwood NE, et al. Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr 2003 78(4): 684-9.
61. pratt M, Maeera CA, Blanton C. Levels of physical activity and inactivity in children and adults in the United State: current evidence and research issues. Med Sci Sports Exerc. 1999;31(11): s526-33.
62. Westerterp KR. Pattern and intensity of physical activity. Nature 2001; 410:539-548.
63. Penny GL, Linda SA, Barry MP. Ethnic differences in physical activity and inactivity patterns and overweight status. Obes Res 2002; 10:141-149.
64. PA Abbott, PS Davies Habitual physical activity and physical activity intensity :their relation to body composition in 5.0-10.5-y-old children. Eur J Clin Nutr 2004; 58(2): 285-91.
65. McMurray RG, Harrekk JS, Deng S, et al. The influence of physical activity, socioeconomic status and ethnicity on the weight status of adolescents. Obes Res 2000; 8:130-9.
66．白玉龙，陈世益，杨晓冰等．运动对老年人身体构成的影响．现代康复杂志．1997；1(2)： 126-127．
67. Jerome L, Abramson, Vaccarino, et-al. Relationship between physical activity and inflammation among apparently healthy middle-aged and older us adults. Arch Intern Med 2002;162:1286-1292.
68. Hapanen N, Miilunpalo S, Vuori I, et-al. Characteristics of leisure time physical activity associated with decreased risk of premature all-cause and cardiovascular disease mortality in middle -aged men. Am J Epidemiol 1996; 143(9): 870-880,
69. Cris AS, Brian D Duscha, Johanna L. Johnson, et-al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity. Arch Intern Med 2004; 164:1-39.
70. Kyle UG, Morabia A, Schutz Y, et al. Sedentarism affects body fat mass index and fat-free mass index in adults aged 18-98 years. Nutrition 2004; 20(3):255-60.
71. Wilmore JH. Body composition in sports and exercise: Direction for future research. Med Sci Sports Exerc 1983; 15:21-31.
72. Deborah A J, Barbara E, Janet B, et al. Moderate Leisure-Time Physical Activity. Arch Fam Med 1998;7:285-289.
73. Jeffery RW, Wing RR, Sherwood NE, et al. Physical activity and weight loss: does
prescribing higher physical activity goals improve outcome? Am J Clin Nutr 2003 78(4): 684-9.
74. Westerterp KR.Obesity and physical activity. Int J Obes 1999; 23(sl): 59-64
75. Goran MI, Hunter G, Nagy TR, et al. Physical activity related energy expenditure and fat mass in young children. Int J Pbes Relat Metab Disord 1997;21:171-8.
76. Lazzer S, Boirie Y, Bitar A, et al. Assessment of enery expenditure associated with physical activities in free-living obese and nonobese adolescents. Am J Clin Nutr 2003; 78(3):471-9.
77．邵淑丽，李波，徐兴军等．肥胖机体的能量代谢与脂代谢．齐齐哈尔师范学院学报，1996；16(3)：58-68．
78. Ekelund U, Aman J, Yngve A, et al. Physical activity but not enery expenditure is reduced in obese adolescents: a case-control study. Am J Clin Nutr 2003; 78(1): 193-4.
79. Rippe JM, Hess S. The role of physicial activity in the prevention and management of obesity. J am Diet Assoc 1998; 98(S2): s31-8.
80. Westerterp KR, Meijer GA, Janssen EM, et al. Long-term effect of physical activity on energy balance and body composition. BR J Nutr 1992; 68:21-30.
81. Salome HK, Christina S, Hester H, et al. Physical inactivity is the major determinant of obesity in black women in the North West province, South Africa: the Thusa study. Nutrition 2002; 18:422-427.
82. Janet E. Fulton, Louise CM, Kathleen L. Watson, et-al. Influence If body composition on physical activity validation studies using doubly labeled water. J Appl Physiol 2004; 96:1357-1364.
83. Elizabeth JB, Janice OC, Rebecca A, et al. Total energy expenditure, body fatness, and physical activity in childen aged 6-9y. AM J clin Nutr 2001; 74: 524-8.
84. Fogelholm M, Kujala U, Kaprio J. Predictors of weight change in middle-aged and old men. Obes Res 2000; 8: 367-373.
85. Blair SN, Pietro L, Davis D, Phydical activity patterns associated with cardiorespiratory fitness and reduced mortality: The Aerobics Longitudinal Study. Am J Public Heslth 1998; 88:1807-1813.
2. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000; 160:898-904.
3. Must A, Spadano J, Coakley E, et al. The disease burden associated with overweight and obesity. JAMA 1999; 282:1523-1529.
4. Thomas P, et al. weighing the options. Criteria for evaluating Weight-Management Programs. National Academy Press, Washington D.C. USA. I995.
5. Colditz GA. Economic cost of obesity and inactivity. Medicine and Science in Sport and Exercise 1999:31:S663-S667.
6．陈吉棣，体力活动、膳食营养与慢性病．中国运动医学杂志．1999：18(1)：46-50．
7. National Research Council. Committee on Diet and Health. Implications for reducing chronic disease risk. Washington DC. National Academy Press 1998.
8. Maia J.A.R, Thomas M, Beunen G; et al. Genetic fatctors in physical activity levels. Am J Prey Med 2002; 23(2s): 87-91.
9. Popkin BM, Doak CM. The obesity epidemic is a worldwide phenomenon. Nutr Rev 1998; 56:106-14.
10. Flegal KM, The obesity epidemic in children and adults: current evidence and research issues. Med Sci Sports Exert 1999; 31(suppl): S509-14.
11. Cumings S, Parham ES, Strain GW. Position of the American Dietetic Association: Weight management. J Am Diet Assoc 2002; 102:1145-1155.
12. Flegal KM, Carroll MD, kuczmarski RJ, Johnson. Overweight and obesity in the United States: Prevalence and trends, 1960-1994.Int J Obes Relat Metab Discord 1998; 22:39-47.
13. Schaefer DC, Cheskin LJ. Uodate on obesity treatment. Gastroenterologist 1998; 6:136-145.
14. National Center for Health Statistics. Prevalence of overweight and obesity among adults. Atlanta, GA: National Center for Disease Control and Prevention. Available at: www.cde.gov/nchs/product/pubs/pubd/hestats/obese.htm. Accessed August 4,2002.
15．武阳丰，周北凡，陶寿淇等．我国中年人群超重率和肥胖率的现状和发展趋势．中华流行病学杂志．2002；23：11-15．
16．秦百里．现代文明病和国民体育锻炼．南京体育学院报．2002；12；1(4)：78-79．
17. U.S. Department of health and human services centers for disease control and prevention. National Center for Chronic disease Prevention and Health Promotion The President's Council on Physical Fitness and Sports. Physical activity and Health. A Report of the Surgeon General. Internation Medical Publishing. 1996; 12-21.
18. U.S. Department of health and human services centers for disease control and prevention. National Center for Chronic disease Prevention and Health Promotion The President's Council on Physical Fitness and Sports. Physical activity and Health. Patterns and Trends in Physical Activity. A Report of the Surgeon General. Internation Medical Publishing. 1996; 176-207.
19. Russell R. pate, Michael Pratt, MD, MPH; Steven N Blair, PED; et-al.. Physical Activity and Public Health. JAMA 1995; Vol 273, No.5.
20．陈君石，闻之梅等译，现代营养学．人民卫生出版社．1995；384．
21. Dipietro L, Kohl HW 3_(rd),Barlow CE, et al. Improvement in cardiorespiratory fitness attenuate age-related weight gain in healthy men and women: The Aerobics Center Longitudinal Study.Int J Obes Relat Metab Disord 1998; 22:55-62.
22. Ross R, Freeman JA, Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exerc Sport Sci Rev 2000; 28:165-170.
23. Ross R, Dagnone D, Jones P J, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men: A randomized, controlled trial. Ann Intern Med 2000; 133: 92-103.
24. Ross R, Jassen I. Is abdominal fat preferentially reduced in response to exercise-induced weight loss? Med Sci Sports Exerc 1999; 31:S568-S572.
25．董忠，高京晓．中老年妇女体育活动与心血管疾病的危险．国外医学社会医学分册．2001；18(3)：122-125．
26．邢连波，张青萍．中等强度活动与成年人健康．山西师大体育学院学报．2000；15(2)：76-76．
27．李恩中．体力活动、膳食营养和血脂．周口师范高等专科学院学报．1999；16(5)：89-91．
28. Willett WC, Lenart E. Reproducibility and Validity of food-frequency questionnaires. In: Willett W. Nutritional Epidemioligy 2nd ed. New York: Oxgord Univerdity Press.1998; 13.
29. Yao et al. Field methods for body composition assessment are valid in healthy Chinese adults. J Nutr 2002; 132: 310-317.
30. Krummel DA, Gordon P, Newcomer RR, et al. Dietary intakes and leisure-time physical activity in West Virginians. W V Med J 2001; 97(6): 295-301.
31. Westerterp KR, Goran M. Relationship between physical activity related energy expenditure and body composition: a gender difference. Int J Obes Relat Metab Disord 1997;21:184-8.
32. Ulf Ekelund, Michael S. Physical activity assessed by activity monitor and doubly labeled water in children. Med Sci.Sports Exerc 2004: 33(2): PP.275-281.
33. Bnrbnmb A, William L, Haskell M, et al. Compendium of Physical Activities: an update of activity codes and MET intensities. Med Sci.Sports Exerc 2000;32(9): s498-s516.
34. Ekelund UL, Aman J, Yngve A, et al. physicial activity but not energy expenditure is reduced in obese adolescents: a case-control study. Am J Clin Nutr 2002; 76:935-41.
35. John R. Sirard, EL. Melanson L, et al. Field evaluation of the Computer Science and Applications, Inc. Physical activity monitor. Med Sci.Sports Exerc 2000; 32(3): 695-700.
36. WHO(1997).The MONICA Optional Study of Physical Activity (MOSPA). Med Sci.Sports Exert 25:S162-169.
37．陈炳卿主编．营养与食品卫生学．1994；276-282．
38．W.P.T.James编著．人体热能需要量．联合国粮农组织．1998；8．
39. Van Loan. Multicompartment model of body composition assessment on Chinese American adults. AM J Hum Biol 1997;9:21-7.
40. World Health Organization. Obesity: Preventing and Managing the Global Epidemic.Report of a WHO consultation. Technical Report Series 894. Geneva: 2000.
41. Lohman TG, Houtkooper L, Going SB. Body fat measurements goes high tech. Not all are created equal. ACSM Health Fitness J. 1997; 1: 30.
42. Hill JO. Commerford R. Physical activity fat balance and energy balance. Int J Sport Nutr 1996; 6:80-92.
43. Kleges RC. Kleges LM. Haddock Ck, et al.A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults. Am J Clin Nutr 1992; 55: 818-826.
44. Simsolo RB, et al. the regulation of adipose tissue and muscle lipoprotein lipase in runners by detraining. J Clin Invest 1993; 92:2124-2132.
45. Saltzman E, et al. the role of energy expenditure in energy regulation: Findings from a decade of research. Nutrition Review 1995; 53(8): 209-215.
46. Owens JF, Metthew KA, Wing RR, et al. Can physical activity mitigate the effects of
aging in middle-aged women? Circulation 1992; 85; 1265—1270.
47. Williamson DF, Madans J. Recreational physical activity and ten-year weight change in US national cohort. Int J Obes 1993; 17: 279-286.
48. Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med 1993; 119:646-649.
49. Tammelin T, Laitinen J, Nayha S. Change in the level of physical activity form adolescence into adulthood and obesity at the age of 31 years. Int J Obes 2004: 23, 198-206.
50. Nobuyuki M, Hidetake N, Akie M. Daily walking reduces visceral adipose tissue areas and improves insulin resistance in Japanese obese subjects. Diabetes Research and Clinical Practice 2002; 58: 101-107.
51. Katherine S, Paul J, Mathias N, et al. Genetic and Environmental influences on Total-body and Central Abdominal Fat: The Effect of Physical Activity in Female Twins. Ann Intern Med 1999; 130: 873-882.
52. Giugliano R, Carneiro EC. Factors associated with obesity in school children. J Pediatr 2004; 80(1):17-22.
53. Miyatake N, et al. Daily walking reduces visceral adipose tissue areas and improves insulin resistance in Japanese obese subjects. Diabetes Research and Clinical Practice 2002;58:101-107.
54. Van Baak MA, Van Mil E, Astrup AV, et al. Leisure-time activity is an important determinant of long-term weight maintenance after weight loss in the Sibutramine Trial on Obesity Reduction and Maintenance. Am J Clin Nutr 2003; 78(2):209-14.
55．崔凤华，李桂芝．休闲体育运动对人体健康的积极作用．石油教育．2000：5：108-109．
56. Andersen PS, Schnohr P, Scroll M, et al. Mortality associated with Physical activity in leisure time, at work, in sports and cycling ti work. Ugeskr Laeger. 2002; 164(11): 1501-6.
57．潘信伟，洪玉玲，汪慧珍等．体力活动与心血管病危险因素．中国慢性病预防与控制杂志．1994；2(4)：157-159．
58. Droyvold WB, Hlomen J, Midthjell K, et al. BMI change and leisure time physical activity: an 11-y follow-up study in apparently healthy men aged 20-69y with normal weight at baseline. Int J Obes Relat Metab Disord 2004; 28(3): 410-7.
59. Wenche DB, Hlomen J, Kruger O, et al. Leisure-time physical activity and change in body mass index: an 11-y follow-up study of 9357 normal weight health women 20-49 years old. J Women Health. 2004; (13): 55-62.
60. Jeffery RW, Wing RR, Sherwood NE, et al. Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr 2003 78(4): 684-9.
61. pratt M, Maeera CA, Blanton C. Levels of physical activity and inactivity in children and adults in the United State: current evidence and research issues. Med Sci Sports Exerc. 1999;31(11): s526-33.
62. Westerterp KR. Pattern and intensity of physical activity. Nature 2001; 410:539-548.
63. Penny GL, Linda SA, Barry MP. Ethnic differences in physical activity and inactivity patterns and overweight status. Obes Res 2002; 10:141-149.
64. PA Abbott, PS Davies Habitual physical activity and physical activity intensity :their relation to body composition in 5.0-10.5-y-old children. Eur J Clin Nutr 2004; 58(2): 285-91.
65. McMurray RG, Harrekk JS, Deng S, et al. The influence of physical activity, socioeconomic status and ethnicity on the weight status of adolescents. Obes Res 2000; 8:130-9.
66．白玉龙，陈世益，杨晓冰等．运动对老年人身体构成的影响．现代康复杂志．1997；1(2)： 126-127．
67. Jerome L, Abramson, Vaccarino, et-al. Relationship between physical activity and inflammation among apparently healthy middle-aged and older us adults. Arch Intern Med 2002;162:1286-1292.
68. Hapanen N, Miilunpalo S, Vuori I, et-al. Characteristics of leisure time physical activity associated with decreased risk of premature all-cause and cardiovascular disease mortality in middle -aged men. Am J Epidemiol 1996; 143(9): 870-880,
69. Cris AS, Brian D Duscha, Johanna L. Johnson, et-al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity. Arch Intern Med 2004; 164:1-39.
70. Kyle UG, Morabia A, Schutz Y, et al. Sedentarism affects body fat mass index and fat-free mass index in adults aged 18-98 years. Nutrition 2004; 20(3):255-60.
71. Wilmore JH. Body composition in sports and exercise: Direction for future research. Med Sci Sports Exerc 1983; 15:21-31.
72. Deborah A J, Barbara E, Janet B, et al. Moderate Leisure-Time Physical Activity. Arch Fam Med 1998;7:285-289.
73. Jeffery RW, Wing RR, Sherwood NE, et al. Physical activity and weight loss: does
prescribing higher physical activity goals improve outcome? Am J Clin Nutr 2003 78(4): 684-9.
74. Westerterp KR.Obesity and physical activity. Int J Obes 1999; 23(sl): 59-64
75. Goran MI, Hunter G, Nagy TR, et al. Physical activity related energy expenditure and fat mass in young children. Int J Pbes Relat Metab Disord 1997;21:171-8.
76. Lazzer S, Boirie Y, Bitar A, et al. Assessment of enery expenditure associated with physical activities in free-living obese and nonobese adolescents. Am J Clin Nutr 2003; 78(3):471-9.
77．邵淑丽，李波，徐兴军等．肥胖机体的能量代谢与脂代谢．齐齐哈尔师范学院学报，1996；16(3)：58-68．
78. Ekelund U, Aman J, Yngve A, et al. Physical activity but not enery expenditure is reduced in obese adolescents: a case-control study. Am J Clin Nutr 2003; 78(1): 193-4.
79. Rippe JM, Hess S. The role of physicial activity in the prevention and management of obesity. J am Diet Assoc 1998; 98(S2): s31-8.
80. Westerterp KR, Meijer GA, Janssen EM, et al. Long-term effect of physical activity on energy balance and body composition. BR J Nutr 1992; 68:21-30.
81. Salome HK, Christina S, Hester H, et al. Physical inactivity is the major determinant of obesity in black women in the North West province, South Africa: the Thusa study. Nutrition 2002; 18:422-427.
82. Janet E. Fulton, Louise CM, Kathleen L. Watson, et-al. Influence If body composition on physical activity validation studies using doubly labeled water. J Appl Physiol 2004; 96:1357-1364.
83. Elizabeth JB, Janice OC, Rebecca A, et al. Total energy expenditure, body fatness, and physical activity in childen aged 6-9y. AM J clin Nutr 2001; 74: 524-8.
84. Fogelholm M, Kujala U, Kaprio J. Predictors of weight change in middle-aged and old men. Obes Res 2000; 8: 367-373.
85. Blair SN, Pietro L, Davis D, Phydical activity patterns associated with cardiorespiratory fitness and reduced mortality: The Aerobics Longitudinal Study. Am J Public Heslth 1998; 88:1807-1813.