身體活動與體適能，對兒童青少年常見疾病與醫療耗用之影響

A review of the effects of physical activity and fitness on common diseases and medical expenditure of children and adolescents

體適能乃身體適應生活與環境的綜合能力，許多研究都已證實身體活動可以延緩或降低疾病的發生，如減少上呼吸道感染、改善重度憂鬱症的症狀、降低肥胖發生率及代謝症候群的發生、提升胰島素敏感性等，進而減少醫療耗用及降低醫療費用的支出。此外，體適能在人體健康許多層面扮演重要的角色，可做為人體健康的預測因子，同時也是身體活動與健康結果事件或學業表現的中介因子，除了與健康結果事件有顯著相關，且能透過身體活動的介入措施提升體適能狀態，因此可適合做為評估健康促進成效的重要指標。透過文獻回顧，可肯定足夠的身體活動時間以及合適的運動強度，對於疾病的預防或是改善具有很大助益，文獻回顧資料亦呈現從事運動確實能夠減少醫療資源的耗用，降低醫療支出，不過文獻缺口在於兒童青少年身體活動與醫療耗用的研究較少，值得未來投入探索。另外，無論成人或是兒童青少年，均不確定體適能檢測的各項數據高低，是否會與未來疾病發生率有關，且幾項常見的體適能檢測項目，是否能對應出體適能表現優劣與醫療費用支出的差異？本研究建議若能串接我國的全民健保資料庫與學生體適能數據進行預測疾病與醫療耗用的研究，應可更進一步探索早期的體適能檢測如何影響疾病的發生，並據以評估提倡全民運動政策以降低醫療支出的實證數據。

Physical fitness is a comprehensive ability of the body to adapt to life and the environment. Many studies have explored that physical activity (PA) can delay the occurrence or reduce the morbidity of common diseases, such as reducing upper respiratory tract infections, improving symptoms of severe depression, reducing the incidence of obesity and metabolic syndrome, and improving insulin sensitivity...etc., thereby reducing medical consumption and lowering medical expenses. Moreover, physical fitness plays an important role in many aspects of human health. It can be used as a predictor of human health, and it is also an intermediary factor between PA and health status or academic performance. In addition to being significantly related to health, physical fitness can be improved through interventional measures of PA, so it can be suitable as an important indicator for evaluating the effectiveness of health promotion exercises. In the literature, it can be confirmed that taking PA time and appropriate exercise intensity sufficiently are of great help for disease prevention or improvement. The integrated data also shows that engaging in PA can indeed reduce the consumption of medical resources and reduce medical expenditures in adult. However, the drawback is that there are few studies on the relationship between children and adolescents' PA and medical expenditure, which is worth investigating in the future. However, all the adults, children and adolescents are not sure whether the various data of physical fitness will be related to the incidence of diseases developed in the future, and whether several common physical fitness items can correspond to physical fitness performance and medical expenses? In conclusion, if we can concatenate the National Health Insurance Research Database (NHIRD) with student physical fitness data for the purposes of predicting diseases occurrence and medical consumption, it should be possible to explore how early physical fitness performing affects the occurrence of diseases, and based on this empirical results that we can advocate a national campaign policy to reduce medical expenditures.