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

描述（由申请人提供）：我们建议在一个由54，962名活跃男性和女性组成的大型前瞻性流行病学队列中，评估剧烈体力活动和心肺功能对糖尿病、高血压、高胆固醇血症、关节炎和其他慢性疾病发病率的影响。虽然大多数流行病学研究只是将年龄作为协变量，但我们的分析直接关注运动，健身和体重对疾病率的年龄特异性影响。主要研究者在体力活动研究方面的20年生物统计和研究经验将用于实现以下两个具体目标：目标1。测试增加剧烈体力活动的剂量和更好的心肺功能是否会降低糖尿病、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体力活动水平和更大的心肺健康有关。目前，一些设计良好的队列研究能够评估中等强度体力活动对疾病风险的影响。国家跑步者健康研究是唯一一个专门招募来评估剧烈体育活动对疾病风险影响的队列。这项研究是在1991年开始的，通过在步行比赛活动和通过征求运行杂志订户招募。在1999年至2000年期间，再次联系了跑步者，以更新他们的跑步，体重，饮食和药物使用数据，并确定他们是否有任何医疗条件。我们获得了随访调查或确定了80%的队列的生命状态，并获得了截至1998年的国家死亡指数搜索致命事件。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截面关系以及前瞻性观察到的肥胖变化与运动（体重除外）的关系的论文，但我们还没有研究体力活动的益处是否同样适用于所有年龄组。我们还评估了身体活动或健身的健康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。目前没有资金支持这项重要研究的持续数据分析。假设每份手稿需要三周的时间，小额赠款将为另外六到八份手稿提供资金。公共卫生相关性：该申请要求主要研究者提供工资支持，以应用其20年的生物统计学经验分析不同年龄段男性和女性之间剧烈体育活动与高血压，糖尿病，高胆固醇和其他医疗条件风险的关系。我们还将研究心肺适应性与这些疾病的关系。本申请仅涉及作为国家跑步者健康研究的一部分收集的现有数据的分析。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分析和编写另外六至八份手稿。

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.