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运动对上海市成年超重/肥胖者身体形态和心血管机能的影响

The Study on Influence of Sport Towards the Body Shape and Cardiovascular Function of the Overweight and Obesity Adults of Shanghai

作者: 专业:体育教育训练学 导师:马海峰 年度:2010 学位:硕士  院校: 上海体育学院

Keywords

Adults of Shanghai, Overweight and obesity, Lose weight by exercise, Body shape, Cardiovascular functions

        研究目的:随着人们生活水平的迅速提高,膳食结构和行为方式的不合理趋势,科学知识普及程度欠缺,导致成人肥胖发生率迅速上升。肥胖给人们生活带来不便,甚至还影响其身心健康。肥胖使人们失去优美的曲线,而且危害健康,引起更种疾病;有研究表明,成人期发生的糖尿病、高血压、心脏病等疾病与肥胖密切相关,过重的体重和过量的脂肪堆积可导致心血管功能的损害,引起很多心血管疾病。心血管机能的好坏,将会直接影响人体的健康水平和寿命的期限,因此对超重/肥胖患者的身体形态和心血管机能评定有着极其重要的意义。本文从运动减肥的角度,连续八个月的跟踪调查,对上海社区成人超重/肥胖者进行科学运动指导,然后根据实验测试指标的变化,研究运动对成人超重/肥胖者身体形态和心血管机能的影响,提高人们对健康的认识,增强体质健康水平,为超重/肥胖者进行科学减肥寻求更好的运动方式。研究方法:研究对象为参与2008-2009年上海市民体质干预活动的上海市332位社区超重或肥胖居民。肥胖诊断标准为中国肥胖问题工作组关于中国肥胖汇总工作报告中的成人超重/肥胖筛查BMI值分类标准,其中BMI≥24为超重,BMI≥28为肥胖,并参照相应的体脂率(男>20%,女>25%为肥胖)。以各区各街道社区指导员带领根据所选运动项目分队进行运动。运动干预前,对受试者运动习惯与以往病史调查并进行台阶运动负荷试验,并根据测试结果制定个性化的运动处方:采用长时间中小强度的有氧运动的方法,督促受试者进行运动锻炼,运动时间必须长于30min,一般为持续45min以上,每周至少运动4-5次,建议受试者坚持每天运动,总时间持续8个月。研究结果:形态指标的变化:就总体变化程度而言,除身高和腰臀比没有显著差异外,BMI有显著性变化(P<0.05),体重、瘦体重、体脂率、腰围、臀围均有非常显著性变化(P<0.01),其中,瘦体重增加,BMI、腰围、臀围和体脂率均下降,且趋近于正常值。机能指标的变化:减肥前后的安静心率、收缩压均有非常显著性变化(P<0.01),脉压差和舒张压有显著性变化(P<0.05),其中脉压差减小,安静心率、收缩压、舒张压均有所下降。相同运动负荷后心率的变化:相同负荷下,减肥后心率的变化幅度明显小于减肥前的负荷心率变化。结论:1.上海市超重/肥胖患者的健身减肥意识不强,肥胖科学和减肥知识缺乏,且社区没有从事对此类人群咨询和指导的专业机构和人员。2.适宜的运动干预对普通市民超重/肥胖成年人身体形态有良好的作用,可明显降低受试者的体重和体脂率,增加其瘦体重;而体重的下降和瘦体重的增加,则进一步表明适宜的运动可有效减肥、改善受试者的身体形态。3.适宜的运动干预对超重/肥胖成年人的心血管机能有明显的改善作用,可明显降低受试者的安静心率和血压,使受试者在相同运动负荷下,减肥后的心率变化幅度明显变小。建议:1.肥胖知识水平的高低关系着肥胖的预防和控制效果,因此,建议在社区开展形式各样的肥胖知识教育活动,增强超重或肥胖人群的肥胖知识水平,提高他们参加运动的积极性。加大对超重/肥胖人群的健康知识教育和肥胖知识的宣传力度,组织并开展关于肥胖科学的专业讲座,由相关部门委派专业人员根据患者的个体差异性制定个性的科学合理的运动减肥处方,以增加这部分人群的减肥健身意识,使更多的超重/肥胖人群加入到科学减肥的队伍中。2.为防止超重/肥胖人群减肥后出现体重反弹,建议受试者在参加实验后,继续坚持本实验采取的有氧运动处方进行锻炼,使自己真正成为体育锻炼的从事者和受益者,并为终身体育奠定基础。
    Purpose:Along with rapid advance of people’s life, fallacious trend of diet structure and manner, low prevalence rate of science knowledge, obesity incidence rises rapidly into maturity. Obesity brings inconvenience to people’s life, even effects physical and mental health. It deprives of people’s graceful shape and causes various diseases; according to a study, diabetes、hypertension heart disease etc., which occurred in adulthood are all closely related to obesity, over weight and superfluous adipose tissue may cause various cardiovascular diseases. Cardiovascular function effects people’s body heath and life-span, thereby, it makes very important sense that overweight and fat people make assessment of body shape and cardiovascular function. In terms of losing weight through exercise, with 8-months’tracking survey and guidance to the adult obesity in Shanghai community, we aim to research exercise effect on body shape and cardiovascular function, to enhance people’s heath knowledge and fitness sense, to look after better exercise for fat people.Methods:Study objects are 332 Shanghai community residents who are overweight and obesity participated in the 2008~2009 Constitution and Health Intervention of Shanghai Citizen. Conform to the summing-up report on the work of China Obesity Working Group, diagnostic criteria of obesity is BMI (body mass index) norm for screening overweight and obesity in adults. BMI≥24 overweight, BMI≥28 obesity, and refer to relevant fat rate (namely male>20%, female>25% is obesity). According to choices, take exercise respectively at the guidance of each community coach. Before intervention, research volunteers’exercise habit and medical record and take step test, according to test result, set down personal exercise method:take long time aerobics at low and moderate intensity, supervise and urge volunteers to take more than 30min exercise, commonly over 45min and every week at least 4-5 times, volunteers are suggested to exercise everyday and last 8 months.Results:Shape Norm variety:As far as overall change is concerned, except for stature and waist-to-hip ratio (WHR), BMI has distinct variety (P< 0.05), also body mass、lean body mass (LBM)、fat rate、waistline and hipline (P< 0.01), meanwhile, LBM increases, BMI、waistline、hipline and fat rate fall and all approach normal index.Function Index variety:Forward and backward weight lose, both resting heart rate and systolic pressure have very distinct variety (P< 0.01), pulse pressure difference and diastolic blood pressure have distinct variety (P< 0.05), meanwhile, pulse pressure difference diminish, the resting heart rate、systolic pressure and diastolic blood pressure all fall.Heart rate variety with same exercise:With some intensity exercise, variety scope of heart rate after losing weight is distinctly less than before.Conclusions:1. Overweight/fat people in Shanghai is lack sense of fitness, about obesity and weight lose, lack of scientific knowledge, and in community no professional institution or personnel engaged in relevant consultation and guidance.2. Proper exercise intervention take good effect on overweight and obesity and body shape to normal people and adults, it clearly reduces volunteer’s bodyweight and fat rate, increases lean body mass; however, the decline of body mass and the increase of lean body mass make it clearer that proper exercise is good for weight lose and body shape.3. Proper exercise intervention is also good for cardiovascular function; it clearly reduces resting heart rate and blood pressure, after losing weight, variety scope of heart rate clearly diminished.Suggestions:1. The levels of obesity knowledge affect the prevention and control for obesity. Therefore, we suggest that community should carry out kinds of obesity education activities to improve the obesity knowledge of overweight and fat persons and arouse their enthusiasm and the activity of taking in sport. And enhance health education and obesity knowledge propaganda, organize and carry out specialized lectures about obesity, and relevant department should appoint professionals to set down personal proper exercise method according to patients’individual diversity, to enhance this groups’fitness sense and attract more overweight/fat people to join us to lose weight through scientific and proper methods.2. To avoid weight rebound, we suggest volunteers to keep this aerobics exercise and be a real participant and beneficiary of athletic exercise and establish foundation for one’s lifelong exercise.
        

运动对上海市成年超重/肥胖者身体形态和心血管机能的影响

摘要4-6
Abstract6-7
缩语表(Abbreviations and Acronyms)8-11
1 前言11
2 文献综述11-19
    2.1 超重/肥胖定义及其标准的界定11-12
    2.2 肥胖的分类12
    2.3 超重/肥胖产生的原因12-13
        2.3.1 遗传因素12
        2.3.2 与摄食中枢相关的因素12-13
        2.3.3 热量摄取因素:摄入过多,消耗少13
        2.3.4 与运动有关的因素13
        2.3.5 其他因素13
    2.4 肥胖对人体的危害13-14
        2.4.1 肥胖对身体形态的影响13-14
        2.4.2 肥胖对心血管系统的影响14
        2.4.3 肥胖的其他危害14
    2.5 运动的减肥机制14-17
        2.5.1 运动调节能量代谢平衡14-15
        2.5.2 运动调节体脂,改善身体成分15
        2.5.3 运动调节胰岛素代谢15
        2.5.4 运动调节酶活性,改善脂代谢15-16
        2.5.5 运动调节肥胖基因的表达,在一定程度上抗衡基因的缺陷16
        2.5.6 运动改善心血管机能16
        2.5.7 运动的其他健康功能16-17
    2.6 国内外研究现状17-19
        2.6.1 国外肥胖病研究现状17
        2.6.2 国内肥胖病研究现状17-19
    2.7 以往研究的不足19
3 研究方法与内容19-23
    3.1 文献资料法19
    3.2 访谈法19
    3.3 实验法19-22
        3.3.1 实验对象身体基本情况19-20
        3.3.2 测试指标与方法20-21
        3.3.3 运动干预方法21-22
    3.4 数理统计法22
    3.5 技术路线22-23
4. 实验结果23-26
    4.1 受试者肥胖状况的调查结果23-24
    4.2 运动对身体形态各指标的影响24-25
        4.2.1 运动对身高、体重及其派生指标、体脂率和瘦体重的影响24-25
        4.2.2 运动对身体围度各指标的影响25
    4.3 运动对心血管机能各指标的影响25-26
        4.3.1 运动对安静心率和血压的影响25-26
        4.3.2 运动对运动中各负荷即时心率的影响26
5. 分析与讨论26-32
    5.1 受试者肥胖状况的结果分析26-27
    5.2 运动对受试者身体形态的影响27-29
        5.2.1 运动对受试者身高、体重的影响27-28
        5.2.2 运动对受试者身体围度的影响28
        5.2.3 运动对受试者体脂率的影响28-29
        5.2.4 运动对受试者瘦体重的影响29
    5.3 运动对受试者心血管机能的影响29-31
        5.3.1 运动对受试者安静心率的影响29-30
        5.3.2 运动对受试者安静血压以及脉压差的影响30
        5.3.3 运动对受试者台阶试验运动中各级负荷结束即时心率的影响30-31
    5.4 科学有效减肥运动干预方法制定依据31-32
        5.4.1 明确的运动目的31
        5.4.2 特色种类繁多的运动项目31
        5.4.3 适宜的运动强度31
        5.4.4 合理的运动持续时间和频率31-32
        5.4.5 运动中需要注意的事项32
6. 结论与建议32-33
7. 致谢33
8. 参考文献33-41
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