成人每日靜態行為時間上限之建議

Recommended limit for time spent in daily sedentary behaviors among adults

古博文(Po-Wen Ku) ； 陳上迪(Shang-Ti Chen) ； 鄭聖儒(Rutherford Ru) ； 陳俐蓉(Li-Jung Chen)

《台灣公共衛生雜誌》 38卷3期 (2019/06) Pp. 228-235

https://doi.org/10.6288/TJPH.201906_38(3).108009

摘要

久坐已逐漸被視為公共衛生的重要課題，並建議所有成人均應設法減少每日靜態行為。本篇綜論在於檢視靜態行為與健康之相關議題，並討論發展每日靜態行為時間上限的可能性。透過回顧每日靜態時間的相關研究證實，本文針對以下與靜態時間及健康有關之議題進行評析與討論：（1）探討各國成年人每日從事靜態行為的現況；（2）彙整與分析世界衛生組織以及各國針對靜態時間所發布的指導原則；（3）透過系統性文獻探討與統合分析的研究證據，探究每日靜態行為時間上限的建議；（4）靜態行為的測量方法可能會調節靜態時間與死亡率間的關係。最後歸結本文的結論與提出未來建議。整體而論，花費過多時間在靜態行為會提高成年人的罹病率及死亡風險。自陳式問卷相較於儀器測量，較容易低估每日靜態時間。儘管近來已有統合分析建議成年人每日超過9小時靜態時間會增加死亡風險。但基於使用客觀測量靜態時間的研究有限，目前仍未足以訂立有關每日靜態時間的建議上限。未來仍需持續累積採用大型樣本且使用客觀儀器測量靜態時間的前瞻性世代以檢驗這些發現。

關鍵字

久坐 ； 加速規 ； 客觀測量 ； 切分點

並列摘要

Prolonged sitting is increasingly being considered a severe concern in public health recommendations, which suggests that all adults should reduce the amount of daily sedentary time. This review examines several crucial aspects of sedentary behaviors and health and discusses the possibilities of developing public health guidelines on daily sedentary time. The following issues were observed and analyzed to review the evidence regarding sedentary time and health: First, the profile of the daily sedentary time of adults across different countries was described. Second, the physical activity guidelines provided by the World Health Organization or government authorities of various countries were reviewed. Third, evidence was obtained on systematic reviews and meta-analyses to explore the recommended limit of daily sedentary time; spending a higher amount of time on sedentary activities than the recommended threshold may damage adult health. Fourth, measurement methods of sedentary behaviors may moderate the associations between sedentary time and mortality across studies. Finally, conclusions and suggestions for future research were proposed. In summary, an increased sedentary time is associated with high morbidity and mortality risks in adults. Self-reported questionnaires typically underestimate the total sedentary time compared with that obtained using device-based measures. Recent meta-analyses revealed that sedentary time of ＞9 h/day may increase the all-cause mortality risk. However, based on few studies conducted with objectively-assessed sedentary time, the current evidence is insufficient to form guidelines. More large-scale and long-term prospective studies with objective measures of sedentary time are required to validate these findings.

並列關鍵字

prolonged sitting ； accelerometer ； objective measure ； cut-off point

參考文獻

古博文、孫文榮、陳俐蓉：老年人靜態行為問卷之發展。大專體育學刊 2016；1 8：41-55。doi:10.5297/ser.1801.004。 Ku PW, Sun WJ, Chen LJ. Development of the sedentary behavior questionnaire for the elderly. Sports Exerc Res 2016;18:41-55. doi:10.5297/ser.1801.004. [In Chinese: English abstract]

Tremblay MS, Aubert S, Barnes JD, et al. Sedentary Behavior Research Network (SBRN) – Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act 2017;14:75. doi:10.1186/s12966-017-0525-8.

Patterson R, McNamara E, Tainio M, et al. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol 2018;33:811-29. doi:10.1007/s10654-018-0380-1.

Stamatakis E, Ekelund U, Ding D, Hamer M, Bauman AE, Lee IM. Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings. Br J Sports Med 2019;53:377-82. doi:10.1136/bjsports-2018-099131.

Ekelund U, Steene-Johannessen J, Brown WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet 2016;388:1302-10. doi:10.1016/S0140-6736(16)30370-1.