關於 aerobic activity ，我們在網路上蒐集到這些相關的討論、資訊與評價

#更多精美圖片請點留言處文章連結

全世界兒童與青少年，普遍面臨肥胖的威脅 ; 要處理肥胖問題，除了注重飲食，還需要運動介入。該如何替兒童及青少年規劃運動呢？我們可以參考運動員長期發展模型 (Long Term Athlete Development Model, LTAD)。

肥胖流行病學

根據世界衛生組織 (WHO) 和倫敦帝國學院 (Imperial College London) 的研究，過去 40 年來，肥胖兒童與青少年 (5~19 歲) 的人口數，成長了至少 10 倍以上 ; 根據這項統計，未來將會有更多兒童與青少年，迫切需要專業團隊介入，來減緩肥胖人口增長趨勢。

在台灣，根據國民健康署統計，台灣成年人過重及肥胖盛行率 43% (男性 48.9%、女性38.3%) ; 國中生過重及肥胖比率為 29.8% (男生 34.3%、女生 25.0%) ; 國小學童過重及肥胖比率為 30.4% (男童為 34.2%、女童為26.2%)。

『肥胖』，又是第 2 型糖尿病的危險因子。根據統計，台灣學童新診斷糖尿病，54% 是第 2 型糖尿病 (發生率約為10萬分之6.5, 1992-1999)，高峰期落在青春期 13-15 歲，肥胖是主要危險因素。

指引建議

美國疾病管制與預防中心 (Centers for Disease Control and Prevention, CDC) 針對兒童與青少年肥胖問題，提出以下建議：

1⃣️健康的飲食習慣 (Develop healthy eating habits)
2⃣️限制高卡路里食物 (Limit calorie-rich temptations)
3⃣️保持活動 (Help children stay active)
4⃣️減少久坐 (Reduce sedentary time)
5⃣️充足睡眠 (Ensure adequate sleep)

其中，保持活動 (Help children stay active)，除了可以培養孩子對於運動的興趣，還能帶來以下好處：

1⃣️體重管理 (Helping with weight management)
2⃣️強化骨骼 (Strengthening bones)
3⃣️降低血壓 (Decreasing blood pressure)
4⃣️減輕壓力和焦慮 (Reducing stress and anxiety)
5⃣️增加自信 (Increasing self-esteem)

世界衛生組織 (WHO) 與美國疾病管制與預防中心 (CDC) 皆建議：3 至 5 歲兒童，一整天都要保持活躍。 6 至 17 歲的兒童和青少年，每天至少 60 分鐘身體活動。

兒童與青少年正處於發育階段，運動訓練主要著重在三個面向：有氧運動 (Aerobic Activity)、肌力訓練 (Muscle-Strengthening)、骨骼強化訓練 (Bone-Strengthening)，以有氧運動為最大占比。

運動員長期發展模型 (Long Term Athlete Development Model, LTAD)

理想的運動養成應該像正金字塔，先培養紮實的基礎運動
 (有趣, FUNdamentals)，接著往上訓練爆發力、速度
、敏捷，最後專注專項運動技能。

在運動領域，台灣的家庭、學校、社會觀念與歐美迥異，台灣小孩的運動養成，似乎是顛倒狀態... 台灣小孩普遍沒有紮實的基礎運動
訓練，長大後對運動沒興趣者，比比皆是。

該如何栽培出熱愛運動的小孩，讓他(她)變成大谷翔平呢？我們可以參考『運動員長期發展模型 (Long Term Athlete Development Model, LTAD)』。

在青春期以前，我們要先培養運動素養 (Physical Literacy
)，青春期後則以終身運動 (Active
For Life) 為目標。根據年齡，分成六個階段：

1⃣️Active Start：開始運動 (No specific ratios)
2⃣️FUNdamentals：快樂運動 (All activities FUN)
3⃣️Learning to Train：70% 訓練 <-> 30% 競賽
4⃣️Train to Train：60% 訓練 <-> 40% 競賽
5⃣️Train to Compete：40% 訓練 <-> 60% 競賽
6⃣️Train to Win：25% 訓練 <-> 75% 競賽

成長每個階段，運動的『訓練/競賽比例』都不一樣，隨著成長發育，應循序漸進地拉高競賽佔比。

各種訓練最佳時間點

進入青春期的時間點，男、女生不同，生長速度也不一樣，青春期是身高成長最大速度 (peak height velocity, PHV) 的重要階段，此階段是安排『Train to Train』的最佳時刻。

根據男、女生的發育速度，我們可以在正確的時間點，安排適當的菜單。譬如說，在進入青春期之前，我們先安排『柔軟度』、『速度』、『技能』等項目 ; 青春期，則以『耐力』、『速度』為主 ; 青春期後，則安排『力量』相關肌力訓練。

總結

只要有心，人人都可以變成大谷翔平！

在台灣，『萬般皆下品，唯有讀書高』，在歐美，運動卻是不可或缺的生活元素 ; 台灣小孩長大後，為什麼會對運動沒有興趣，其中一個可能原因，就是從小沒有培養對運動的興趣。

參考運動員長期發展模型 (Long Term Athlete Development Model, LTAD)，培養終身運動的習慣，只要有心，人人都可以成就投打二刀流🏆

【家庭醫學】~ 兒童的身體活動/體適能 和 腦部發育

上週一個神經內科的朋友問我，為什麼幫小朋友排那麼多體能活動？是不是為了幫助他們腦部發育？

在她問我之前，根本沒想過這個問題耶！所以趁週末的空檔，念了一些文獻，來了解一下，現在也分享給大家。

※ 其實我也沒排很多體能活動吧？除了學校本來就有的體育課之外，一路以來學過的有體操、桌球、網球、羽球、游泳，假日會帶去爬山、攀岩館、游泳池、騎單車等等。

以下就是偷懶看的兩篇文章：都是review paper (看別人整理好的比較快一點)

Chaddock L, Pontifex MB, Hillman CH, Kramer AF. A review of the relation of aerobic fitness and physical activity to brain structure and function in children. J Int Neuropsychol Soc. 2011 Nov;17(6):975-85. doi: 10.1017/S1355617711000567. PMID: 22040896.

Khan NA, Hillman CH. The relation of childhood physical activity and aerobic fitness to brain function and cognition: a review. Pediatr Exerc Sci. 2014 May;26(2):138-46. doi: 10.1123/pes.2013-0125. Epub 2014 Apr 10. PMID: 24722921.

其實兩篇的結論都很類似，就是身體的活動或是有氧適能，會讓腦部的結構和功能 (特別是認知功能) 較好；人的大腦要到三十歲左右才完全發育，青春期前是大腦結構和功能改變的重要時刻，所以快帶你的孩子出去動一動！

※ 大家應該還記得兒童及青少年，活動量的建議吧？

一週內每天「平均」60分鐘以上，中到高強度的運動，並以有氧運動為主。

新來的朋友，可以去回顧一下之前的文章
https://www.facebook.com/FMOMdoctor/posts/2937191343178586?__tn__=%2CO*F

最後，一定會有人問到你腦長好了，不代表學業成績會不錯呀！特別是台灣還是以學業成績為導向，把時間拿去運動，不就課業一落千丈？

其實我也很好奇，不過目前沒看到東方人的研究結果；比較完整的研究報告是美國疾管署 (CDC) 的文章，還有一篇系統性回顧的文獻。

https://www.cdc.gov/healthyyouth/health_and_academics/pdf/pa-pe_paper.pdf

Rasberry, Catherine N., et al. "The association between school-based physical activity, including physical education, and academic performance: a systematic review of the literature." Preventive medicine 52 (2011): S10-S20.

結果就是體能活動和學業表現是有正相關的，但還沒達到統計學上的意義。就看大家信或不信囉？

總之我是信了，在課業壓力不大的幼兒園、國小階段，能讓他們多接觸一些不同的體能活動，進而培養出運動的習慣，應該是現階段我能送給他們最好的禮物吧？而且能受用一生。

#其實是自己愛往外跑

#lipid #gdl
Management of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline 2020

• 治療目標是預後（心血管疾病、健康、住院、死亡），而不是血脂濃度。
• 血脂（膽固醇、LDL-C、HDL-C、TG）：每 10 年檢驗一次，不需要禁食。
• 初級預防：中度劑量的 statins，不要用 PCSK9 抑制劑。高危險群者能加上地中海飲食。
• 次級預防：中度劑量的 statins，高危險群（AMI 之後、ACS 一年內、復發性 AMI/ACS/中風、糖尿病、抽煙、PAOD、PCI、CABG）病人可以用高強度 statins、加上 ezetimibe/PCSK9 抑制劑、禁食 TG > 150 mg/dL（非禁食 TG > 200 mg/dL）者能加上 VASCEPA（Icosapent Ethyl）、地中海飲食。
• 沒有幫助：CAC、CRP、ABI、apolipoproteins。
• 不要用 niacin、fibrates。
Lipitor (atorvastatin 10-20 mg/tablet), Crestor (rosuvastatin 10 mg/tablet).

1. Continue to Treat to Target Dose Not LDL-C Level

2. Use of Additional Tests to Refine Risk Prediction: Evidence Is Still Insufficient
coronary artery calcium (CAC), high-sensitivity C-reactive protein, ankle–brachial index, and apolipoprotein

3. Primary Prevention: Moderate-Dose Statin Therapy Is Still Emphasized; No to Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors
No RCT directly compared high-dose with moderate-dose statin therapy in primary prevention.

4. Secondary Prevention: Moderate Statin Doses Initially, Then Stepped Intensification in Higher-Risk Patients
For higher-risk patients (recent MI or acute coronary syndrome (in the past 12 months); recurrent acute coronary syndrome, MI, or stroke; or established CVD with additional major risk factors (such as current tobacco use, diabetes, peripheral artery disease, or previous coronary artery bypass graft surgery or percutaneous coronary intervention), evidence supports the addition of ezetimibe or PCSK9 inhibitors to moderate- or high-dose statin therapy.

5. Laboratory Testing: No Routine Fasting or Monitoring Is Needed; Less Is More
We recommend measuring lipid levels no more than every 10 years. Note that previously measured lipid levels may be used reliably in serial CVD risk assessments. We do not recommend rechecking lipid levels each time CVD risk is assessed, because lipid levels remain stable within each patient over time and contribute little to predicted risk relative to other factors.

6. Physical Activity: Increased Aerobic Exercise for All and Cardiac Rehabilitation After a Recent CVD Event

7. Nutrition, Supplements, Niacin, and Fibrates: Suggest a Mediterranean Diet for High-Risk Patients, Limit Icosapent Ethyl to Secondary Prevention, Avoid Supplements and Niacin, and Avoid Adding Fibrates to Statin Therapy
https://www.acpjournals.org/doi/full/10.7326/M20-4648

Cycling is mainly an aerobic activity, which means that your heart, blood vessels and lungs all get a workout. You will breathe deeper, perspire and experience increased body temperature, which will improve your overall fitness level. #Shorts

increased cardiovascular fitness
increased muscle strength and flexibility
improved joint mobility
decreased stress levels
improved posture and coordination
strengthened bones
decreased body fat levels
prevention or management of disease
reduced anxiety and depression.

#Singapore #SingaporeCycling #CylcingSingapore #DecathlonSingapore #BromptonJunction #Rodalink

Episode 5: CYCLING IN SINGAPORE TOUR WITH GOPRO HERO 9 Health benefits of regular cycling
Health benefits of regular cycling

Cycling is mainly an aerobic activity, which means that your heart, blood vessels and lungs all get a workout. You will breathe deeper, perspire and experience increased body temperature, which will improve your overall fitness level.

The health benefits of regular cycling include:
increased cardiovascular fitness
increased muscle strength and flexibility
improved joint mobility
decreased stress levels
improved posture and coordination
strengthened bones
decreased body fat levels
prevention or management of disease
reduced anxiety and depression.
Back to top
Cycling and specific health issues

Cycling can improve both physical and mental health, and can reduce the chances of experiencing many health problems.
Obesity and weight control

Cycling is a good way to control or reduce weight, as it raises your metabolic rate, builds muscle and burns body fat. If you’re trying to lose weight, cycling must be combined with a healthy eating plan. Cycling is a comfortable form of exercise and you can change the time and intensity – it can be built up slowly and varied to suit you.

Research suggests you should be burning at least 8,400 kilojoules (about 2,000 calories) a week through exercise. Steady cycling burns about 1,200 kilojoules (about 300 calories) per hour.

If you cycle twice a day, the kilojoules burnt soon add up. British research shows that a half-hour bike ride every day will burn nearly five kilograms of fat over a year.
Cardiovascular disease and cycling

Cardiovascular diseases include stroke, high blood pressure and heart attack. Regular cycling stimulates and improves your heart, lungs and circulation, reducing your risk of cardiovascular diseases.

Cycling strengthens your heart muscles, lowers resting pulse and reduces blood fat levels. Research also shows that people who cycle to work have two to three times less exposure to pollution than car commuters, so their lung function is improved. A Danish study conducted over 14 years with 30,000 people aged 20 to 93 years found that regular cycling protected people from heart disease.
Cancer and cycling

Many researchers have studied the relationship between exercise and cancer, especially colon and breast cancer. Research has shown that if you cycle, the chance of bowel cancer is reduced. Some evidence suggests that regular cycling reduces the risk of breast cancer.
Diabetes and cycling

The rate of type 2 diabetes is increasing and is a serious public health concern. Lack of physical activity is thought to be a major reason why people develop this condition. Large-scale research in Finland found that people who cycled for more than 30 minutes per day had a 40 per cent lower risk of developing diabetes.
Bone injuries, arthritis and cycling

Cycling improves strength, balance and coordination. It may also help to prevent falls and fractures. Riding a bike is an ideal form of exercise if you have osteoarthritis, because it is a low-impact exercise that places little stress on joints.

Cycling does not specifically help osteoporosis (bone-thinning disease) because it is not a weight-bearing exercise.
Mental illness and cycling

Mental health conditions such as depression, stress and anxiety can be reduced by regular bike riding. This is due to the effects of the exercise itself and because of the enjoyment that riding a bike can bring.

Episode 4: CYCLING IN SINGAPORE TOUR WITH GOPRO HERO 9 Health benefits of regular cycling

Cycling is mainly an aerobic activity, which means that your heart, blood vessels and lungs all get a workout. You will breathe deeper, perspire and experience increased body temperature, which will improve your overall fitness level.

The health benefits of regular cycling include:
increased cardiovascular fitness
increased muscle strength and flexibility
improved joint mobility
decreased stress levels
improved posture and coordination
strengthened bones
decreased body fat levels
prevention or management of disease
reduced anxiety and depression.