最新觀點：運動強度與延長壽命效果的科學證據

Chia-Hua Kuo

doi:10.5297/ser.1801.editorial

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社会科学 > 体育学

DOI： 10.5297/ser

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最新观点：运动强度与延长寿命效果的科学证据

Viewpoint: Scientific Evidence Regarding Life-Prolonging Effect of Exercise Training

郭家骅(Chia-Hua Kuo)

大专体育学刊； 18 卷 1 期 (2016 / 03 / 31) ， Pi - iv

繁体中文;英文 DOI： 10.5297/ser.1801.editorial

2 个人觉得这篇文章赞

摘要 │ 参考文献 (6) │ 被引用文献 (5) │ 国际计量

摘要〈TOP〉

目前已累积非常多的研究证据证实运动有利於改善代谢疾病，由於证据结果的一致性很高，目前已没有什麽争论，代谢疾病通常是人类与动物死亡的重要前兆，运动可延长寿命，为下一个重要研究假设。有关寿命的研究，在二十年前规律运动是否可延长寿命的证据仍然相当缺乏，无法作出结论。当时动物研究均以较短命的啮齿类动物为主，采用自主运动 (voluntary exercise) 的方式，发现在动物开始老化到大量死亡的初始期，确实自发性运动量高的动物平均寿命较长。平均寿命指接受该实验组的动物群存活剩下 50% 的对应时间长度（介入日开始计算）。然而，自主运动有先天的研究限制，即在生命後期由於好动的动物与少动的动物活动量趋於一致，无法判别最高寿命是否可被运动延长，最高寿命系指该介入组最後 10% 存活者寿命的平均。动物研究的限制，使得我们一直无法很有把握的回答运动是否可延长寿命这个问题。直到最近有几个大样本人体研究与统合分析(meta-analysis) 显示：一、增加身体活动量确实与未来死亡率的降低有关 (Samitz, Egger, &Zwahlen, 2011)；二、运动强度愈高者，未来死亡率愈低，即使 50 到 60 岁间改变习惯将中低强度改为高强度，也能在未来十年後显现减少死亡率的效果 (Byberg et al., 2009)；三、对超过 50 岁以上的高血糖者，较易造成肌肉损伤的肌力训练对改善老人代谢指标的效果，远比造成肌肉损伤少的有氧训练好 (Cauza et al., 2005)；四、年龄超过 50 岁以上者，有氧训练的代谢改善效果逐渐消失 (Short et al., 2003)。这些重要研究结果除了证明运动可抗老化，也打破大部分人认为中低强度运动（走路或慢跑）可能较适当的猜测。因此，基於这些较新的证据，对於中高龄人口应建议的运动处方，不再适用学生的 333 原则。目前大部分专家的猜想是运动强度应订在中低强度即可，尽量避免剧烈运动，但根据研究证据显示中低大专体育学刊第18卷 第1期，i-iv页（2016年3月）DOI:10.5297/ser.1801.editoriali大专体育学刊18(1)-00 1 前页.indd 1 2016/4/12 上午 09:50:47ii 郭家骅强度运动虽然有些许效果，但效果不强。因此专家给予正确建议时必须回归科学证据来给予个人能承受的高强度的运动，未必要长时间耐力运动。至於为什麽愈易造成肌肉损伤的高强度运动，反而愈能改善代谢功能延长寿命。最可能的原因在於人类是多细胞生物，而多细胞生物应被视为「由众多具有合作能力的单细胞构成的社会」。在一个社会中，运动挑战造成自然筛选 (natural selection) 的结果，适者生存不适者淘汰，存活下来的细胞与新生细胞重新建构新的社会合作体，除能适应新环境，也使得全身细胞平均年龄下降。下次承受相同挑战，一样能安然存活度过。运动强度愈高，淘汰筛选门槛愈高，虽恢复时间增长，更能作大幅度的汰旧换新。目前已有完整的研究发现可杀死动物身上的老细胞即可明显增加寿命 (Baker et al., 2016; Tsygankov, Liu, Sanoff,Sharpless, & Elston, 2009)。最近的这些新的证据也给我们带来新的研究主题，例如：人体如何辨认运动後不健康的细胞给予破坏？破坏後的讯息如何启动细胞再生机制？恢复时间应该多长？我们希望透过这些新发现，提供给《大专体育学刊》的读者最新的研究方向，期望产生出对於社会大众有益的新知识。

并列摘要〈TOP〉

A large body of evidence from well-designed studies has repeatedly validated the beneficial effect of exercise training on metabolic health in animals and humans. Metabolic disorders are generally known as early signs of death during aging. However, insufficient research effort in the past 20 years limited us to conclude the life-prolonging effect of exercise training. One of the reasons accounted for this uncertainty comes from the difficulty to conduct human trial for entire life. Furthermore, most of animal studies use voluntary exercise as an experimental model. During early life, physically active animals tend to have longer average lifespan compared to less active counterparts. Average lifespan defined by the time length when 50% of the cohort can no longer survived. But during the time period when animals are rapidly dying, voluntary physical activity drops as well. It is thus hard to distinguish the causal relationship between physical activity level and maximum lifespan on such kind of studies. Maximum lifespan is often defined as the mean lifespan of the most long-lived 10% of a given group (i.e., exercise training or sedentary cohort). Such limitation of animal studies prevents us from making clear-cut conclusion on the question whether exercise training can prolong lifespan. Until recently, data from several longitudinal studies and meta-analysis provide answer for the question. First, life expectancy is relatively higher among those people who participated in high intensity than low intensity of exercise (Samitz, Egger, & Zwahlen, 2011). The surviving chance during aging appears to be positively correlated with exercise intensity in humans. Second, for those individuals aged around 50 ~ 60 years, increasing exercise intensity from moderate to high levels significantly increases survival rate 10 years later to a level similar to the high intensity cohort (Byberg et al., 2009). Third, muscle-damaging exercise like strength training, has much better improving effect on metabolic measures compared to aerobic training with much less muscle damage in hyperglycemic participants aged around 57 years (Cauza et al., 2005). Aforementioned evidence denies speculation and current belief of most experts who consider moderate aerobic exercise is the best for improving human survival (Short et al., 2003). Based on these data, “333” exercise guideline suggested by Taiwan government may need to be modified for adults. “333” represents exercise duration of 30 min, intensity of 130 beat per min, and frequency of 3 times per week. This guideline may be slightly helpful in health among sedentary people, but we do not expect an impressive health outcome according to aforementioned empirical data. Here we recommend an individual to push their exercise intensity to the highest tolerable level for improving survival. A major question remains that is why the exercise producing greater damage offers better benefit for survival compared to those moderate intensity exercise? The most likely answer accounts for the dose-dependent lifeprolonging effect is that human should be regarded as a "society" instead of "an individual." To be more specific, human body is a society of cells where natural selection is taking place among cells in a society at different agelevel. Exercise provides acute challenge to select the cells that has the best capability to cooperate with other partner cells for survival. Advantage of multicellular organism to be existed is achieved by natural selection on cooperativity among specialized cells. Thus, increasing exercise intensity will kill greater number of impotent (less cooperative) cells in human body, which in turn results in reduced average age of cell population in human body, and strengthen our capability against the life-threatening challenge. In consistent with this thought, recent new evidence has found that increasing killing mechanism to eliminate unhealthy population of cells can increase lifespan in animals (Baker et al., 2016; Tsygankov, Liu, Sanoff, Sharpless, & Elston, 2009). Aforementioned evidence collectively gives us a new area of future study, such as how those unhealthy cells are recognized, and how many destructive signals are involved to trigger cell renewal. The message of the paper is hereby to offer readers of the Journal for further investigation to benefit our own survival, as the primary goal of human life.

参考文献 ( 6 ) 〈TOP〉

Baker, D. J.,Childs, B. G.,Durik, M.,Wijers, M. E.,Sieben, C. J.,Zhong, J.,van Deursen, J. M(2016).Naturally occurring p16Ink4a-positive cells shorten healthy lifespan.Nature,530,184-189.
Byberg, L.,Melhus, H.,Gedeborg, R.,Sundström, J.,Ahlbom, A.,Zethelius, B.,Michaëlsson, K.(2009).Total mortality after changes in leisure time physical activity in 50 year old men: 35 year follow-up of population based cohort.British Journal of Sports Medicine,43(7),482.
Cauza, E.,Hanusch-Enserer, U.,Strasser, B.,Ludvik, B.,Metz-Schimmerl, S.,Pacini, G.,Haber, P.(2005).The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus.Archives of Physical Medicine and Rehabilitation,86(8),1527-1533.
Samitz, G.,Egger, M.,Zwahlen, M.(2011).Domains of physical activity and all-cause mortality: Systematic review and dose-response meta-analysis of cohort studies.International Journal of Epidemiology,40(5),1382-1400.
Short, K. R.,Vittone, J. L.,Bigelow, M. L.,Proctor, D. N.,Rizza, R. A.,Coenen-Schimke, J. M.,Nair, K. S.(2003).Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity.Diabetes,52(8),1888-1896.

被引用文献 ( 5 ) 〈TOP〉

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