Health benefits of vigorous exercise in middle-aged versus older men and women

描述(由申请人提供)：我们建议评估剧烈体力活动和心肺健康对糖尿病、高血压、高胆固醇血症、关节炎和其他与年龄有关的慢性病发病率的影响，在54,962名精力充沛的男性和女性的前瞻性流行病学队列中。虽然大多数流行病学研究只是将年龄作为一个协变量，但我们的分析直接集中在锻炼、健身和体重对发病率的特定年龄的影响上。这位首席研究员将运用他在体力活动研究方面二十年的生物统计学和研究经验来实现以下两个具体目标：目的1.测试增加剧烈体力活动和更好的心肺健康是否会降低糖尿病、高胆固醇血症、高血压、心绞痛、心血管疾病、中风、关节炎、胆囊病、视力(白内障、青光眼、黄斑变性)、心律失常、肾结石和癌症的特定年龄段的发病率。目的2.测试年龄是否影响与增加体力活动水平和更好的心肺功能相关的疾病风险的降低。目前，一些精心设计的队列研究能够评估中等强度的体力活动对疾病风险的影响。国家跑步者健康研究是唯一专门招募来评估剧烈体力活动对疾病风险影响的队列。这项研究始于1991年，是通过在徒步比赛活动中招募和征集跑步杂志订阅者的方式发起的。这些跑步者在1999至2000年间被重新联系，以更新他们关于跑步、体重、饮食和药物使用的数据，并确定他们是否有任何医疗条件。我们获得了跟踪调查或确定了80%的队列的生命状态，并在1998年获得了国家死亡指数搜索致命事件。尽管到目前为止已经发表了21篇关于基线跑步距离与心血管疾病风险生物标志物的横断面关系的论文，以及关于除体重以外的预期观察到的肥胖症变化与运动的关系的论文，但我们还没有研究体育运动的好处是否同样适用于所有年龄段。我们还评估了体育锻炼或健身对健康的益处是否可以更好地解释为减弱或推迟与年龄相关的疾病风险增加。目前没有资金支持正在进行的这项重要研究的数据分析。假设每份手稿有三周的时间，小额赠款应能为额外的六至八份手稿提供资金。公共卫生相关性：此应用程序请求工资支持首席调查员应用他20年的生物统计学经验，分析不同年龄段的男性和女性中剧烈体力活动与高血压、糖尿病、高胆固醇和其他疾病风险的关系。我们还将研究心肺适能与这些疾病的关系。此应用程序专门针对作为国家跑步者健康研究的一部分收集的先前存在的数据进行分析。尽管到目前为止已经发表了21篇关于这项研究结果的论文，但大多数发现仍然没有发表。目前没有资金来支持这些分析。这笔小额赠款将用于分析和编写另外6至8份手稿。

DESCRIPTION (provided by applicant): We propose to assess the effects of vigorous physical activity and cardiorespiratory fitness on the incidence of diabetes, hypertension, hypercholesterolemia, arthritis, and other chronic conditions in relation to age in a large prospective epidemiological cohort of 54,962 vigorously active men and women. Whereas most epidemiological studies treat age simply as a covariate, our analyses focus directly on the age-specific effects of exercise, fitness and body weight on disease rates. The principal investigator's twenty years of biostatistical and research experience in studies of physical activity will be applied to accomplish the following two specific aims: Aim 1. Test whether increasing doses of vigorous physical activity and greater cardiorespiratory fitness reduce the age-specific incidence rates of diabetes, hypercholesterolemia, hypertension, angina, cardiovascular disease, stroke, arthritis, gall bladder disease, vision (cataracts, glaucoma, macular degeneration), heart rhythm abnormalities, kidney stones, and cancer. Aim 2. Test whether age affects the reductions in disease risk associate with increasing levels of physical activity and greater cardiorespiratory fitness. Currently, a number of well-designed cohort studies are able to assess the impact of moderately intense physical activity on disease risk. The National Runners' Health Study is the only cohort specifically recruited to assess the effect of vigorous physical activity on disease risk. The study was initiated in 1991 through recruitment at foot race events and through solicitation of running magazine subscribers. The runners were recontacted between 1999 and 2000 to update their data on running, weight, diet, and medication use, and to determine whether they had any medical conditions. We obtained follow-up surveys or determined the vital status for 80% of the cohort, and obtained a National Death Index search for fatal events through 1998. Although 21 papers have been published to date on the cross-sectional relationship baseline running distance to biomarkers of cardiovascular disease risk, and on the relationship of changes in adiposity observed prospectively to exercise, except for body weight, we have not examined whether the benefits of physical activity apply equally to all age groups. We have also assessed whether the health benefits of physical activity or fitness might be better interpreted as attenuating or postponing the age-related increases in disease risk. There is no current funding to support ongoing data analyses for this important study. Assuming three weeks per manuscript, the small grant award should provide funding for six to eight additional manuscripts. PUBLIC HEALTH RELEVANCE: This application requests salary support for the principal investigator to apply his 20 years of biostatistical experience analyze the relationship of vigorous physical activity to the risks of hypertension, diabetes, high cholesterol, and other medical conditions among men and women of different ages. We will also examine the relationship of cardiorespiratory fitness in relationship to these diseases. This application is concerned exclusively with the analyses of pre-existing data collected as part of the National Runners' Health Study. Although 21 papers have been published to date on the results of this study, the majority of the findings remain unpublished. There is no current funding to support these analyses. This small grant award would support the analyses and preparation of six to eight additional manuscripts.