PROSPECTIVE STUDY OF HEALTH IN RUNNERS AND WALKERS

描述：(改编自《调查者摘要》)现任政府 身体健康指南指出：1)大多数人身体健康 快步走2英里可以获得体力活动的好处 一周中的大部分时间；和2)体育锻炼对健康的好处 主要取决于活动总量而不是强度 活动的一部分。尽管如此，目前还没有 现有的流行病学研究，专门设计来直接对比 适度运动(如步行)对健康的益处和成本 剧烈运动(如跑步)。 这项拟议的研究计划比较冠心病(CHD)的发病率， 68,000名跑步者和68,000名跑步者的癌症、总死亡率和运动损伤 步行者在四年的监视中。关于以下问题的调查问卷 已经有56,000名跑步者参加了跑步和其他身体活动 得到了调查结果，预计还会有来自13,000名跑步者的更多问卷 1997年3月之前。参赛选手将于1997年与68,000名选手一起接受复查 行尸。助行者也将通过出版 在Walking杂志上的调查问卷，然后直接邮寄 向425,000名订阅者发放问卷。总死亡率和死因分类死亡率 将根据国家死亡指数确定；致命和非致命癌症 将从SEER和46个州的登记中确定；非致命性冠状动脉 心脏病和伤害将通过问卷调查确定。生死存亡 分析将用于测试跑步者是否有更大的减少 每单位运动的心脏病、总死亡率和癌症。 还将检查与步行和跑步有关的运动损伤。 功率计算表明，检测跑步者和跑步者之间的差异 步行者，总死亡率为11%，冠心病为16%，总死亡率为12% 癌症，36%的乳腺癌，将是可能的。这些差异将会 根据每周步行和跑步消耗的卡路里进行调整， 步行和跑步距离，以及每项活动所花费的时间进行测试 这些变量是否解释了两国之间发病率的差异 步行者和跑步者。 在研究开始之前，在56,000人中进行了233,000人年的跟踪调查 跑步者(在1991年至1997年之间)将积累起来。到年底的时候 这项研究对6.8万名跑步者(1991年至2001年)的51.7万人年进行了调查 将可供分析。生存分析将被用来测试 跑步里程与冠心病和癌症的剂量-反应关系 风险，以及这种关系是否受到跑步强度的影响， 跑步频率、跑步历史、性别、肥胖、年龄或药物 使用。使用保守比率(比公布的值低25%)，统计 能量计算表明，可检测到的冠状动脉心脏减少 疾病风险可能低至每英里0.71%，这远远低于 与其他已发表的研究相比，估计减少了2.1%。另外， 每英里可检测到1.5%的乳腺癌风险降低 在女性中，这低于1.7%的风险降低估计 从其他发布的数据中分离出来。

DESCRIPTION: (Adapted from Investigator's Abstract) Current government physical fitness guidelines state that: 1) the majority of the health benefits from physical activity can be obtained by walking 2 miles briskly on most days of the week; and 2) the health benefits of physical activity depend principally on the total amount of activity rather than the intensity of the activity. Nevertheless, there are currently no prospective epidemiological studies extant, designed specifically to directly contrast the health benefits and costs of moderate exercise (e.g., walking) versus vigorous exercise (e.g., running). The proposed study plans to compare rates of coronary heart disease (CHD), cancer, total mortality and exercise injuries in 68,000 runners and 68,000 walkers during four years of surveillance. Questionnaires concerning running and other physical activities in 56,000 runners have already been obtained, and additional questionnaires from 13,000 runners are expected before March 1997. The runners will be resurveyed in 1997 along with 68,000 walkers. The walkers will also be solicited through the publication of the questionnaire in Walking magazine followed by a direct mailing of the questionnaire to 425,000 subscribers. Total and cause-specific mortality will be determined from the National Death Index; fatal and nonfatal cancers will be identified from the SEER and 46 state registries; nonfatal coronary heart disease and injuries will be determined from questionnaires. Survival analyses will be used to test whether runners have greater reduction in heart disease, total mortality, and cancer per unit of exercise. Exercise-related injuries from walking and running will also be examined. Power calculations suggest that detection of differences between runners and walkers, as small as 11% for total mortality, 16% for CHD, 12% for total cancers, and 36% for breast cancer, will be possible. The differences will be adjusted for weekly kilocalories expended by walking and running, for walking and running distance, and for time spent on each activity to test whether these variables account for differences in disease rates between walkers and runners. Before the start of the study, 233,000 person-years of follow-up in 56,000 runners (between 1991 and 1997) will have been accumulated. By the end of the study, 517,000 person years in 68,000 runners (between 1991 and 2001) will be available for analysis. Survival analysis will be used to test for a dose-response relationship between running mileage and CHD and cancer risk, and whether this relationship is affected by running intensity, running frequency, running history, gender, adiposity, age or medication use. Using conservative rates (25% below published values), statistical power calculations suggest that detectable reduction in coronary heart disease risk as small as 0.71% per mile will be possible, which is far below the estimated reduction from other published studies (2.1%). Additionally, a detectable reduction in breast cancer risk as small as 1.5% per mile run in women is calculated, which is below the 1.7% reduction in risk estimated from other published data.