通勤方式与体重指数的变化：来自英国生物银行的前瞻性纵向证据。
Change in commute mode and body-mass index: prospective, longitudinal evidence from UK Biobank.
作者信息
Flint Ellen, Webb Elizabeth, Cummins Steven
机构信息
Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
International Centre for Lifecourse Studies, Department of Epidemiology and Public Health, University College London, London, UK.
出版信息
Lancet Public Health. 2016 Dec;1(2):e46-e55. doi: 10.1016/S2468-2667(16)30006-8.
BACKGROUND
Insufficient physical activity is a determinant of obesity and cardiovascular disease. Active travel to work has declined in high-income countries in recent decades. We aimed to determine which socioeconomic and demographic characteristics predicted switching to or from active commuting, whether switching from passive to active commuting (or the reverse) independently predicts change in objectively measured body-mass index (BMI), and to ascertain whether any association is attenuated by socioeconomic, demographic, or behavioural factors.
METHODS
This study used longitudinal data from UK Biobank. Baseline data collection occurred at 22 centres between March, 2006, and July, 2010, with a repeat assessment at one centre (Stockport) between August, 2012, and June, 2013, for a subset of these participants. Height and weight were objectively measured at both timepoints. We included individuals present at both timepoints with complete data in the analytic sample. Participants were aged 40-69 years and commuted from home to a workplace on a regular basis at both baseline and follow-up. Two exposures were investigated: transition from car commuting to active or public transport commuting and transition from active or public transport to car commuting. Change in BMI between baseline and repeat assessment was the outcome of interest, assessed with bivariate and multivariate logistic regression models.
FINDINGS
502 656 individuals provided baseline data, with 20 346 participating in the repeat assessment after a median of 4·4 years (IQR 3·7-4·9). 5861 individuals were present at both timepoints and had complete data for all analytic variables. Individuals who transitioned from car commuting at baseline to active or public transportation modes at follow-up had a decrease in BMI of -0·30 kg/m (95% CI -0·47 to -0·13; p=0·0005). Conversely, individuals who transitioned from active commuting at baseline to car commuting at follow-up had a BMI increase of 0·32 kg/m (0·13 to 0·50; p=0·008). These effects were not attenuated by adjustment for hypothesised confounders. Change in household income emerged as a determinant of commute mode transitions.
INTERPRETATION
Incorporation of increased levels of physical activity as part of the commute to work could reduce obesity among middle-aged adults in the UK.
FUNDING
UK Medical Research Council.
背景
身体活动不足是肥胖和心血管疾病的一个决定因素。近几十年来，高收入国家中主动通勤上班的情况有所减少。我们旨在确定哪些社会经济和人口特征能够预测主动通勤方式的转变，从被动通勤转变为主动通勤（或反之）是否能独立预测客观测量的体重指数（BMI）的变化，并确定社会经济、人口或行为因素是否会削弱这种关联。
方法
本研究使用了英国生物银行的纵向数据。2006年3月至2010年7月期间，在22个中心进行了基线数据收集，2012年8月至2013年6月期间，对其中一部分参与者在一个中心（斯托克波特）进行了重复评估。在两个时间点均对身高和体重进行了客观测量。我们将在两个时间点均有完整数据的个体纳入分析样本。参与者年龄在40 - 69岁之间，在基线和随访时均定期从家通勤至工作场所。研究了两种暴露情况：从开车通勤转变为主动或公共交通通勤，以及从主动或公共交通通勤转变为开车通勤。基线和重复评估之间BMI的变化是感兴趣的结果，通过双变量和多变量逻辑回归模型进行评估。
结果
502656名个体提供了基线数据，其中20346名在中位时间4.4年（四分位间距3.7 - 4.9年）后参与了重复评估。5861名个体在两个时间点均有数据且所有分析变量数据完整。在基线时开车通勤而在随访时转变为主动或公共交通方式的个体，BMI下降了 - 0.30 kg/m²（95%置信区间 - 0.47至 - 0.13；p = 0.0005）。相反，在基线时主动通勤而在随访时转变为开车通勤的个体，BMI增加了0.32 kg/m²（0.13至0.50；p = 0.008）。对假设的混杂因素进行调整后，这些效应并未减弱。家庭收入的变化成为通勤方式转变的一个决定因素。
解读
将增加身体活动纳入通勤方式中，可能会降低英国中年成年人的肥胖率。
资金来源
英国医学研究理事会。
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