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

描述（由申请人提供）：我们建议在54,962名积极运动的男性和女性的大型前瞻性流行病学队列中评估剧烈运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相关的慢性疾病的发病率的影响。虽然大多数流行病学研究将年龄简单地视为协变量，但我们的分析直接关注运动、健康和体重对发病率的年龄特异性影响。首席研究员二十年的生物统计学和体育活动研究经验将用于实现以下两个具体目标：目标1。测试增加剧烈运动的剂量和增强心肺健康是否能降低糖尿病、高胆固醇血症、高血压、心绞痛、心血管疾病、中风、关节炎、胆囊疾病、视力（白内障、青光眼、黄斑变性）、心律异常、肾结石和癌症的年龄特异性发病率。目标2。测试年龄是否影响疾病风险的降低与增加身体活动水平和增强心肺健康有关。目前，一些设计良好的队列研究能够评估中等强度体育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运动对疾病风险影响的队列。这项研究是在1991年开始的，通过在赛跑活动中招募人员和征求跑步杂志的订阅者。在1999年至2000年期间，研究人员再次联系了这些跑步者，更新了他们的跑步、体重、饮食和药物使用数据，并确定他们是否有任何疾病。我们对80%的队列进行了随访调查或确定了生命状态，并获得了1998年死亡事件的国家死亡指数搜索。尽管迄今为止已经发表了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，以及关于除体重外，前瞻性观察到的肥胖变化与运动的关系的论文，但我们尚未研究体育活动的益处是否平等地适用于所有年龄组。我们还评估了体育活动或健身的健康益处是否可以更好地解释为减弱或延缓与年龄相关的疾病风险增加。目前没有资金支持这项重要研究的持续数据分析。假设每篇稿件需要三周的时间，小额资助奖应该为六到八篇额外的稿件提供资金。公共卫生相关性：本申请要求首席研究员运用其20年的生物统计学经验，分析不同年龄的男性和女性中剧烈体育活动与高血压、糖尿病、高胆固醇和其他医疗状况风险的关系。我们还将研究心肺健康与这些疾病的关系。这个应用程序只关注作为国家跑步者健康研究的一部分收集的预先存在的数据的分析。尽管迄今为止已经发表了21篇关于这项研究结果的论文，但大多数研究结果仍未发表。目前没有资金支持这些分析。这笔小额赠款将用于支持另外6至8份手稿的分析和编写。

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.