Risk modification rather than harm offset: protective boundaries of physical activity against adverse dietary exposures

Ning Ziheng; Zhao Shi’ao

doi:10.16016/j.2097-0927.202606116

您当前的位置：

首页 >

文章列表页 >

Risk modification rather than harm offset: protective boundaries of physical activity against adverse dietary exposures

Expert Review | 更新时间：2026-10-30

- Risk modification rather than harm offset: protective boundaries of physical activity against adverse dietary exposures
- Journal of Army Medical University Vol. 48, Issue 20, Pages: 2829-2837(2026)
- 作者机构：
  
  澳门理工大学健康科学及体育学院，澳门
- 作者简介：
- 基金信息：
- DOI：10.16016/j.2097-0927.202606116
  CLC： R151.41;R165
- Received：30 June 2026，
  
  Revised：2026-08-02，
  
  Accepted：03 August 2026，
  
  Published：30 October 2026
- 稿件说明：
移动端阅览
甯自衡，赵世傲.风险调节而非危害抵消：体力活动对不良饮食的健康保护边界［J］.陆军军医大学学报，2026，48（20）：2829-2837.DOI：10.16016/j.2097-0927.202606116.

Ning Z H，Zhao S A.Risk modification rather than harm offset： protective boundaries of physical activity against adverse dietary exposures［J］.J Army Med Univ，2026，48（20）：2829-2837.DOI：10.16016/j.2097-0927.202606116.
甯自衡，赵世傲.风险调节而非危害抵消：体力活动对不良饮食的健康保护边界［J］.陆军军医大学学报，2026，48（20）：2829-2837.DOI：10.16016/j.2097-0927.202606116. DOI：

Ning Z H，Zhao S A.Risk modification rather than harm offset： protective boundaries of physical activity against adverse dietary exposures［J］.J Army Med Univ，2026，48（20）：2829-2837.DOI：10.16016/j.2097-0927.202606116. DOI：

摘要

本文以不良饮食暴露为例，述评体力活动能否减轻、逆转或抵消不良饮食暴露相关健康风险。不良饮食暴露与体力活动不足是非传染性疾病发生发展和过早死亡的重要可改变因素，但二者并非简单替代关系。现有流行病学证据提示，较高体力活动水平和较好心肺适能可能减轻膳食质量不佳、酒精摄入、含糖饮料摄入及其他不良饮食暴露与慢性病发生发展和过早死亡之间的风险关联；其中，对整体膳食质量和饮酒的证据相对较多，对超加工食品、加工肉类和高钠饮食的直接交互证据仍有限。体力活动可通过改善能量平衡、体脂分布、胰岛素敏感性、炎症、血管功能和心肺适能，降低个体对部分饮食相关风险的易感性。体力活动可减轻部分不良饮食暴露相关风险，但这种风险调节不等同于生物学危害被中和。酒精乙醛毒性、DNA损伤、加工肉类相关致癌物、高钠血压负荷以及急性或成瘾性危害不会因运动而消失。公共卫生建议应强调减少不良饮食暴露与增加体力活动同步推进，而非将运动作为不健康行为的“抵消剂”。

Abstract

Focusing on adverse dietary exposures

this review examines whether physical activity can attenuate

reverse

or offset their associated health risks. Adverse dietary exposures and physical inactivity are both important modifiable factors in the development and progression of non-communicable diseases and premature mortality

but they are not simply interchangeable. Current epidemiological evidence suggests that higher levels of physical activity and cardiorespiratory fitness may attenuate the associations of poor diet quality

alcohol consumption

sugar-sweetened beverage intake

and other adverse dietary exposures with the development and progression of chronic diseases as well as premature mortality; among these

the evidence is relatively abundant for overall diet quality and alcohol consumption

whereas direct interaction evidence for ultra-processed foods

processed meat

and high-sodium diets remains limited. Physical activity may reduce individual susceptibility to some diet-related risks by improving energy balance

adiposity

insulin sensitivity

inflammation

vascular function

and cardiorespiratory fitness. It can attenuate some risks associated with adverse dietary exposures

but such risk regulation is not equivalent to the neutralization of biological hazards. Exposure-specific harms

including alcohol-related acetaldehyde toxicity and DNA damage

carcinogenic compounds from processed meat

sodium-related blood pressure load

addiction

or acute injury will not be eliminated by exercise. Therefore

public health recommendations should emphasize the simultaneous advancement of reducing adverse diet exposures and improving physical activity

rather than treating exercise as an “offset” for adverse dietary exposures.

关键词

Keywords

references

Brauer M ， Roth G A ， Aravkin A Y ， et al . Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations， 1990－2021： a systematic analysis for the Global Burden of Disease Study 2021 ［J］. Lancet ， 2024 ， 403 （ 10440 ）： 2162 - 2203 . DOI： 10.1016/s0140-6736（24）00933-4 http://dx.doi.org/10.1016/s0140-6736（24）00933-4 .

Lane M M ， Gamage E ， Du S T ， et al . Ultra-processed food exposure and adverse health outcomes： umbrella review of epidemiological meta-analyses ［J］. BMJ ， 2024 ， 384 ： e077310 . DOI： 10.1136/bmj-2023-077310 http://dx.doi.org/10.1136/bmj-2023-077310 .

World Health Organization ， Regional Office for Europe . No level of alcohol consumption is safe for our health ［EB/OL］. （ 2023-01-04 ）［ 2026-06-11 ］. https：//www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health .

Bull F C ， Al-Ansari S S ， Biddle S ， et al . World Health Organization 2020 guidelines on physical activity and sedentary behaviour ［J］. Br J Sports Med ， 2020 ， 54 （ 24 ）： 1451 - 1462 . DOI： 10.1136/bjsports-2020-102955 http://dx.doi.org/10.1136/bjsports-2020-102955 .

Perreault K ， Bauman A ， Johnson N ， et al . Does physical activity moderate the association between alcohol drinking and all-cause， cancer and cardiovascular diseases mortality？ A pooled analysis of eight British population cohorts ［J］. Br J Sports Med ， 2017 ， 51 （ 8 ）： 651 - 657 . DOI： 10.1136/bjsports-2016-096194 http://dx.doi.org/10.1136/bjsports-2016-096194 .

Thomas L A ， Hopkinson R J . The biochemistry of the carcinogenic alcohol metabolite acetaldehyde ［J］. DNA Repair ， 2024 ， 144 ： 103782 . DOI： 10.1016/j.dnarep. 2024. 103782 http://dx.doi.org/10.1016/j.dnarep.2024.103782 .

World Health Organization . Global status report on alcohol and health and treatment of substance use disorders ［R/OL］. （ 2024-06-25 ）［ 2026-07-29 ］. https：//www.who.int/publications/i/item/9789240096745 https://www.who.int/publications/i/item/9789240096745 .

Hawley J A ， Hargreaves M ， Joyner M J ， et al . Integrative biology of exercise ［J］. Cell ， 2014 ， 159 （ 4 ）： 738 - 749 . DOI： 10.1016/j.cell.2014.10.029 http://dx.doi.org/10.1016/j.cell.2014.10.029 .

Gleeson M ， Bishop N C ， Stensel D J ， et al . The anti-inflammatory effects of exercise： mechanisms and implications for the prevention and treatment of disease ［J］. Nat Rev Immunol ， 2011 ， 11 （ 9 ）： 607 - 615 . DOI： 10.1038/nri3041 http://dx.doi.org/10.1038/nri3041 .

Powers S K ， Deminice R ， Ozdemir M ， et al . Exercise-induced oxidative stress： Friend or foe？［J］. J Sport Health Sci ， 2020 ， 9 （ 5 ）： 415 - 425 . DOI： 10.1016/j.jshs. 2020. 04.001 http://dx.doi.org/10.1016/j.jshs.2020.04.001 .

Shivgulam M E ， Liu H X ， Schwartz B D ， et al . Impact of exercise training interventions on flow-mediated dilation in adults： an umbrella review ［J］. Sports Med ， 2023 ， 53 （ 6 ）： 1161 - 1174 . DOI： 10.1007/s40279-023-01837-w http://dx.doi.org/10.1007/s40279-023-01837-w .

Min L Z ， Ablitip A ， Wang R ， et al . Effects of exercise on gut microbiota of adults： a systematic review and meta-analysis ［J］. Nutrients ， 2024 ， 16 （ 7 ）： 1070 . DOI： 10.3390/nu16071070 http://dx.doi.org/10.3390/nu16071070 .

Whytock K L ， Goodpaster B H . Unraveling skeletal muscle insulin resistance： molecular mechanisms and the restorative role of exercise ［J］. Circ Res ， 2025 ， 137 （ 2 ）： 184 - 204 . DOI： 10.1161/CIRCRESAHA.125.325532 http://dx.doi.org/10.1161/CIRCRESAHA.125.325532 .

Lang J J ， Prince S A ， Merucci K ， et al . Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults： an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies ［J］. Br J Sports Med ， 2024 ， 58 （ 10 ）： 556 - 566 . DOI： 10.1136/bjsports-2023-107849 http://dx.doi.org/10.1136/bjsports-2023-107849 .

Edwards J J ， Deenmamode A H P ， Griffiths M ， et al . Exercise training and resting blood pressure： a large-scale pairwise and network meta-analysis of randomised controlled trials ［J］. Br J Sports Med ， 2023 ， 57 （ 20 ）： 1317 - 1326 . DOI： 10.1136/bjsports-2022-106503 http://dx.doi.org/10.1136/bjsports-2022-106503 .

Bouvard V ， Loomis D ， Guyton K Z ， et al . Carcinogenicity of consumption of red and processed meat ［J］. Lancet Oncol ， 2015 ， 16 （ 16 ）： 1599 - 1600 . DOI： 10.1016/S1470-2045（15）00444-1 http://dx.doi.org/10.1016/S1470-2045（15）00444-1 .

World Health Organization . WHO global report on sodium intake reduction ［R/OL］. （ 2023-03-09 ）［ 2026-07-29 ］. https：//www.who.int/publications/i/item/9789240069985 https://www.who.int/publications/i/item/9789240069985 .

Ding D ， van Buskirk J ， Nguyen B ， et al . Physical activity， diet quality and all-cause cardiovascular disease and cancer mortality： a prospective study of 346 627 UK Biobank participants ［J］. Br J Sports Med ， 2022 ： bjsports-bjsp2021- 105195 . DOI： 10.1136/bjsports-2021-105195 http://dx.doi.org/10.1136/bjsports-2021-105195 .

Aryannezhad S ， Mok A ， Imamura F ， et al . Combined associations of physical activity， diet quality and their changes over time with mortality： findings from the EPIC-Norfolk study， United Kingdom ［J］. BMC Med ， 2024 ， 22 ： 464 . DOI： 10.1186/s12916-024-03668-6 http://dx.doi.org/10.1186/s12916-024-03668-6 .

Knol M J ， VanderWeele T J . Recommendations for presenting analyses of effect modification and interaction ［J］. Int J Epidemiol ， 2012 ， 41 （ 2 ）： 514 - 520 . DOI： 10.1093/ije/dyr218 http://dx.doi.org/10.1093/ije/dyr218 .

VanderWeele T J ， Knol M J . A tutorial on interaction ［J］. Epidemiol Meth ， 2014 ， 3 （ 1 ）： 33 - 72 . DOI： 10.1515/em-2013-0005 http://dx.doi.org/10.1515/em-2013-0005 .

Carr T ， Kilian C ， Llamosas-Falcón L ， et al . The risk relationships between alcohol consumption， alcohol use disorder and alcohol use disorder mortality： a systematic review and meta-analysis ［J］. Addiction ， 2024 ， 119 （ 7 ）： 1174 - 1187 . DOI： 10.1111/add.16456 http://dx.doi.org/10.1111/add.16456 .

Inan-Eroglu E ， Ahmadi M ， Biswas R K ， et al . Joint associations of diet and device-measured physical activity with mortality and incident CVD and cancer： a prospective analysis of the UK biobank study ［J］. Cancer Epidemiol Biomarkers Prev ， 2024 ， 33 （ 8 ）： 1028 - 1036 . DOI： 10.1158/1055-9965.EPI-23-1185 http://dx.doi.org/10.1158/1055-9965.EPI-23-1185 .

Ding D ， Van Buskirk J ， Partridge S ， et al . The association of diet quality and physical activity with cardiovascular disease and mortality in 85， 545 older Australians： a longitudinal study ［J］. J Sport Health Sci ， 2024 ， 13 （ 6 ）： 841 - 850 . DOI： 10.1016/j.jshs.2024.05.011 http://dx.doi.org/10.1016/j.jshs.2024.05.011 .

Lichtenstein A H ， Khera A ， Anderson C A M ， et al . 2026 dietary guidance to improve cardiovascular health： a scientific statement from the American heart association ［J］. Circulation ， 2026 ， 153 （ 18 ）： e1285 - e1295 . DOI： 10.1161/CIR.0000000000001435 http://dx.doi.org/10.1161/CIR.0000000000001435 .

Wang P L ， Song M Y ， Eliassen A H ， et al . Optimal dietary patterns for prevention of chronic disease ［J］. Nat Med ， 2023 ， 29 （ 3 ）： 719 - 728 . DOI： 10.1038/s41591-023-02235-5 http://dx.doi.org/10.1038/s41591-023-02235-5 .

Im P K ， Wright N ， Yang L ， et al . Alcohol consumption and risks of more than 200 diseases in Chinese men ［J］. Nat Med ， 2023 ， 29 （ 6 ）： 1476 - 1486 . DOI： 10.1038/s41591-023-02383-8 http://dx.doi.org/10.1038/s41591-023-02383-8 .

Feng Y Y ， Powell L ， Vassallo A J ， et al . Does adequate physical activity attenuate the associations of alcohol and alcohol-related cancer mortality？ A pooled study of 54 686 British adults ［J］. Int J Cancer ， 2020 ， 147 （ 10 ）： 2754 - 2763 . DOI： 10.1002/ijc.33052 http://dx.doi.org/10.1002/ijc.33052 .

Powell L ， Feng Y Y ， Duncan M J ， et al . Does a physically active lifestyle attenuate the association between alcohol consumption and mortality risk？ Findings from the UK Biobank ［J］. Prev Med ， 2020 ， 130 ： 105901 . DOI： 10.1016/j.ypmed.2019.105901 http://dx.doi.org/10.1016/j.ypmed.2019.105901 .

Nauman J ， Ingeström E M L ， Tari A R ， et al . Running from death： can fitness outpace alcohol’s harm？Changes in alcohol intake， fitness and all-cause mortality in the HUNT study， Norway ［J］. Sports Med ， 2026 ， 56 （ 4 ）： 1023 - 1033 . DOI： 10.1007/s40279-025-02360-w http://dx.doi.org/10.1007/s40279-025-02360-w .

Monteiro C A ， Cannon G ， Levy R B ， et al . Ultra-processed foods： what they are and how to identify them ［J］. Public Health Nutr ， 2019 ， 22 （ 5 ）： 936 - 941 . DOI： 10.1017/s1368980018003762 http://dx.doi.org/10.1017/s1368980018003762 .

Vadiveloo M K ， Gardner C D ， Bleich S N ， et al . Ultraprocessed foods and their association with cardiometabolic health： evidence， gaps， and opportunities： a science advisory from the American Heart Association ［J］. Circulation ， 2025 ， 152 （ 12 ）： e245 - e263 . DOI： 10.1161/CIR.0000000000001365 http://dx.doi.org/10.1161/CIR.0000000000001365 .

Shen Z Z ， Zhu J H ， Liu B P ， et al . The joint associations of physical activity and ultra-processed food consumption with depression： a cohort study in the UK Biobank ［J］. J Affect Disord ， 2024 ， 367 ： 184 - 192 . DOI： 10.1016/j.jad. 2024.08.195 http://dx.doi.org/10.1016/j.jad.2024.08.195 .

Hosseinpour-Niazi S ， Niknam M ， Amiri P ， et al . The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata ［J］. BMC Public Health ， 2024 ， 24 （ 1 ）： 1955 . DOI： 10.1186/s12889-024-19351-7 http://dx.doi.org/10.1186/s12889-024-19351-7 .

Hall K D ， Ayuketah A ， Brychta R ， et al . Ultra-processed diets cause excess calorie intake and weight gain： an inpatient randomized controlled trial of ad libitum food intake ［J］. Cell Metab ， 2019 ， 30 （ 1 ）： 67 - 77.e3 . DOI： 10.1016/j.cmet.2019.05.008 http://dx.doi.org/10.1016/j.cmet.2019.05.008 .

Pacheco L S ， Tobias D K ， Li Y P ， et al . Sugar-sweetened or artificially-sweetened beverage consumption， physical activity， and risk of cardiovascular disease in adults： a prospective cohort study ［J］. Am J Clin Nutr ， 2024 ， 119 （ 3 ）： 669 - 681 . DOI： 10.1016/j.ajcnut.2024.01.001 http://dx.doi.org/10.1016/j.ajcnut.2024.01.001 .

Pacheco L S ， Tobias D K ， Haslam D E ， et al . Sugar-sweetened or artificially sweetened beverage consumption， physical activity and risk of type 2 diabetes in US adults ［J］. Diabetologia ， 2025 ， 68 （ 4 ）： 792 - 800 . DOI： 10.1007/s00125-024-06351-w http://dx.doi.org/10.1007/s00125-024-06351-w .

Ding Y H ， Chen H ， Shen J ， et al . Associations of sugary beverage intake with type 2 diabetes and the role of physical activity： a prospective cohort study ［J］. Nutr J ， 2024 ， 23 （ 1 ）： 138 . DOI： 10.1186/s12937-024-01006-3 http://dx.doi.org/10.1186/s12937-024-01006-3 .

World Health Organization . Use of non-sugar sweeteners： WHO guideline ［R/OL］. （ 2023-05-15 ）［ 2026-07-29 ］. https：//www.who.int/publications/i/item/9789240073616 https://www.who.int/publications/i/item/9789240073616 .

World Cancer Research Fund/American Institute for Cancer Research . Diet， nutrition， physical activity and colorectal cancer ［R/OL］. （ 2018 ）［ 2026-06-12 ］. https：//www.wcrf.org/wp-content/uploads/2024/10/Colorectal-cancer-report.pdf https://www.wcrf.org/wp-content/uploads/2024/10/Colorectal-cancer-report.pdf .

Neal B ， Wu Y F ， Feng X X ， et al . Effect of salt substitution on cardiovascular events and death ［J］. N Engl J Med ， 2021 ， 385 （ 12 ）： 1067 - 1077 . DOI： 10.1056/nejmoa2105675 http://dx.doi.org/10.1056/nejmoa2105675 .

Yuan Y F ， Jin A M ， Neal B ， et al . Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities： a cluster-randomized trial ［J］. Nat Med ， 2023 ， 29 （ 4 ）： 973 - 981 . DOI： 10.1038/s41591-023-02286-8 http://dx.doi.org/10.1038/s41591-023-02286-8 .

Sagelv E H ， Hopstock L A ， Morseth B ， et al . Device-measured physical activity， sedentary time， and risk of all-cause mortality： an individual participant data analysis of four prospective cohort studies ［J］. Br J Sports Med ， 2023 ， 57 （ 22 ）： 1457 - 1463 . DOI： 10.1136/bjsports-2022-106568 http://dx.doi.org/10.1136/bjsports-2022-106568 .

Momma H ， Kawakami R ， Honda T ， et al . Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases： a systematic review and meta-analysis of cohort studies ［J］. Br J Sports Med ， 2022 ， 56 （ 13 ）： 755 - 763 . DOI： 10.1136/bjsports-2021-105061 http://dx.doi.org/10.1136/bjsports-2021-105061 .

Coenen P ， Huysmans M A ， Holtermann A ， et al . Associations of occupational and leisure-time physical activity with all-cause mortality： an individual participant data meta-analysis ［J］. Br J Sports Med ， 2024 ， 58 （ 24 ）： 1527 - 1538 . DOI： 10.1136/bjsports-2024-108117 http://dx.doi.org/10.1136/bjsports-2024-108117 .

Fry A ， Littlejohns T J ， Sudlow C ， et al . Comparison of sociodemographic and health-related characteristics of UK biobank participants with those of the general population ［J］. Am J Epidemiol ， 2017 ， 186 （ 9 ）： 1026 - 1034 . DOI： 10.1093/aje/kwx246 http://dx.doi.org/10.1093/aje/kwx246 .

Vetter V M ， Özince D D ， Kiselev J ， et al . Self-reported and accelerometer-based assessment of physical activity in older adults： results from the Berlin Aging Study II ［J］. Sci Rep ， 2023 ， 13 （ 1 ）： 10047 . DOI： 10.1038/s41598-023-36924-5 http://dx.doi.org/10.1038/s41598-023-36924-5 .

Freedman L S ， Commins J M ， Moler J E ， et al . Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for energy and protein intake ［J］. Am J Epidemiol ， 2014 ， 180 （ 2 ）： 172 - 188 . DOI： 10.1093/aje/kwu116 http://dx.doi.org/10.1093/aje/kwu116 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Pan-lactylation drives PD-L1 upregulation and influences consensus molecular subtype-specific prognosis in colorectal cancer: an integrated analysis

Early origins of neurological disorders: Mendelian randomization evidence for a causal relationship between low birth weight and multiple sclerosis

Spheroid culture induces a quiescent state in nucleus pulposus stem cells by inhibition of the PI3K-Akt-mTOR pathway and activation of autophagy

Impact of subjective cognitive decline on frailty in elderly patients with metabolic syndrome: the parallel mediating effects of physical activity and depression

Personal traits as the core determinant of human heat tolerance: a multi-factorial interaction analysis based on the health ecological model

Related Author

No data

Related Institution

No data

Address：Military Medical University 30 Gaotanyan,Shiapingba,Chongqing,400038,China Postal code：400038
Tel：023-68752782
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.
Total Visits：143282 Visits Today：660 Online Users：8

⁰