Physical Activity, All-Cause Mortality, and Longevity of College Alumni
06 Mar 1986-The New England Journal of Medicine (Massachusetts Medical Society)-Vol. 314, Iss: 10, pp 605-613
TL;DR: With or without consideration of hypertension, cigarette smoking, extremes or gains in body weight, or early parental death, alumni mortality rates were significantly lower among the physically active than among less active men.
Abstract: We examined the physical activity and other life-style characteristics of 16,936 Harvard alumni, aged 35 to 74, for relations to rates of mortality from all causes and for influences on length of life. A total of 1413 alumni died during 12 to 16 years of follow-up (1962 to 1978). Exercise reported as walking, stair climbing, and sports play related inversely to total mortality, primarily to death due to cardiovascular or respiratory causes. Death rates declined steadily as energy expended on such activity increased from less than 500 to 3500 kcal per week, beyond which rates increased slightly. Rates were one quarter to one third lower among alumni expending 2000 or more kcal during exercise per week than among less active men. With or without consideration of hypertension, cigarette smoking, extremes or gains in body weight, or early parental death, alumni mortality rates were significantly lower among the physically active. Relative risks of death for individuals were highest among cigarette smokers and men with hypertension, and attributable risks in the community were highest among smokers and sedentary men. By the age of 80, the amount of additional life attributable to adequate exercise, as compared with sedentariness, was one to more than two years.
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TL;DR: Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.
Abstract: Objective. —To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. Participants. —A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. Evidence. —The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. Consensus Process. —Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. Conclusion. —Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week. ( JAMA . 1995;273:402-407)
7,519 citations
Cites background from "Physical Activity, All-Cause Mortal..."
...We believe that the most reasonable interpretation of the currently available data is that (1) caloric expenditure and total time of physical activity are associated with reduced cardiovascular disease incidence and mortality; (2) there is a dose-response relationship for this association; (3) regular moderate physical activity provides substantial health benefits; and (4) intermittent bouts of physical activity, as short as 8 to 10 minutes, totaling 30 minutes or more on most days provide beneficial health and fitness effects....
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...(1,17,72,73) Therefore, the recommended 30 minutes of activity can be accumulated in short bouts of activity: walking up the stairs instead of taking the elevator, walking instead of driving short distances, doing calisthenics, or pedaling a stationary cycle while watching television....
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...(1) Five of the six studies shown in Figure 2 included men only; however, the relationship between physical fitness and cardiovascular disease mortality was identical for men and women in the one study that included both....
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...(1,29) A midlife increase in physical activity is associated with a decreased risk of mortality....
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...(1) In the Multiple Risk Factor Intervention Trial, (17) the most frequently reported activities were lawn and garden work (80% of men), walking (65%), and home repairs (60%)....
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TL;DR: It is revealed that the current Health Canada physical activity guidelines are sufficient to elicit health benefits, especially in previously sedentary people, and that a further increase in physical activity and fitness will lead to additional improvements in health status.
Abstract: The primary purpose of this narrative review was to evaluate the current literature and to provide further insight into the role physical inactivity plays in the development of chronic disease and premature death. We confirm that there is irrefutable evidence of the effectiveness of regular physical activity in the primary and secondary prevention of several chronic diseases (e.g., cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis) and premature death. We also reveal that the current Health Canada physical activity guidelines are sufficient to elicit health benefits, especially in previously sedentary people. There appears to be a linear relation between physical activity and health status, such that a further increase in physical activity and fitness will lead to additional improvements in health status.
6,852 citations
TL;DR: In this article, the authors quantify the effect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level.
6,119 citations
01 Jan 2012
TL;DR: In this article, the authors quantify the effect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level.
Abstract: Summary Background Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population is inactive, this link presents a major public health issue. We aimed to quantify the effect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level. Methods For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population. Findings Worldwide, we estimate that physical inactivity causes 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3·9–9·6) of type 2 diabetes, 10% (5·6–14·1) of breast cancer, and 10% (5·7–13·8) of colon cancer. Inactivity causes 9% (range 5·1–12·5) of premature mortality, or more than 5·3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533 000 and more than 1·3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world's population by 0·68 (range 0·41–0·95) years. Interpretation Physical inactivity has a major health effect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially. Funding None.
4,616 citations
TL;DR: In this paper, the authors describe physical activity levels worldwide with data for adults (15 years or older) from 122 countries and for adolescents (13-15-years-old) from 105 countries.
4,373 citations
References
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TL;DR: Ex-varsity athletes retained lower risk only if they maintained a high physical activity index as alumni, and peak exertion as strenuous sports play enhanced the effect of total energy expenditure.
Abstract: Risk of first heart attack was found to be related inversely to energy expenditure reported by 16,936 Harvard male alumni, aged 35-74 years, of whom 572 experienced heart attacks in 117,680 person-years of followup. Stairs climbed, blocks walked, strenuous sports played, and a composite physical activity index all opposed risk. Men with index below 2000 kilocalories per week were at 64% higher risk than classmates with higher index. Adult exercise was independent of other influences on heart attack risk, and peak exertion as strenuous sports play enhanced the effect of total energy expenditure. Notably, alumni physical activity supplanted student athleticism assessed in college 16-50 years earlier. If it is postulated that varsity athlete status implies selective cardiovascular fitness, such selection alone is insufficient to explain lower heart attack risk in later adult years. Ex-varsity athletes retained lower risk only if they maintained a high physical activity index as alumni.
1,994 citations
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01 Feb 1980
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1,554 citations
TL;DR: In the past most assessments of total energy needs have been made from dietary studies, but recently there has been a renewal of interest in such measurements due to the development of apparatus which can be conveniently applied under many industrial conditions, where it had not hitherto been practicable to use the more cumbersome apparatus designed for laboratory studies.
Abstract: HYSIOLOGICAL STUDY of man's food needs and capacity for physical work began on a systematic basis about seventy years ago. Following upon Atwater's classic experiments with a human calorimeter at the end of the last century, the validity of using rates of oxygen consumption as the basis for measuring energy expenditure (indirect calorimetry) was firmly established. Throughout this early period rates of energy expenditure during a variety of human activities were recorded. Recently there has been a renewal of interest in such measurements. This is in part due to the development of apparatus which can be conveniently applied under many industrial conditions, where it had not hitherto been practicable to use the more cumbersome apparatus designed for laboratory studies. Also, methods of work in many industries and in agriculture have changed markedly. Machines increasingly do the work formerly done by manual labor. This change is more noticeable in the highly industrialized coun.tries, but it is spreading throughout the world. Much of 'heavy' industry now consists in controlling large sources of mechanical power by means of levers and switches and the work for the human operator is often 'light.' Further, with increased productiveness there has been a shortening of the working week. There is now time and opportunity for recreations on a scale altogether different from fifty years ago. Many recreations demand much expenditure of physical energy and a wage earner may use his muscles more in his leisure time than during his earning hours. These factors call for new assessments of human energy expenditure , Indirect calorimetry enables the energy expended to be determined while a de& nite activity is undertaken for a limited period of time, usually measured in minutes. More information is necessa.ry to assess the energy expenditure in daily life. This energy has, of course, to be provided by the food, if health and activity are to be maintained. In the past most assessments of total energy needs have been made from dietary studies. This was the method used by Voit, Atwater and others, who first stated the energy expenditure of a variety of occupations, after analyzing records of the diets consumed by persons of known employment. The method is open to the theoretical objection that it assumes that the diets consumed provide exactly enough energy with no surplus or deficiency. It provides no direct yardstick of requirement. Indeed in the East and elsewhere large numbers of …
647 citations
TL;DR: Varying levels of vigorous exercise are associated with lower hypertension incidence, and, without necessarily altering body weight-for-height, avoids or reduces fat and promotes muscle; obesity, rather than excess weight- for- height, is associated with higher hypertension incidence; hence, vigorous exercise is appropriate for use as an intervention regimen in the prevention of hypertension.
Abstract: In a study population of 14,998 Harvard male alumni, 681 hypertensives were first diagnosed during a 6-10-year follow-up beginning 16-50 years after college entrance. The study comprised 105,662 man-years of observation of these men who had entered college in 1916-1950, and who were followed from 1962 or 1966 to 1972. Presence or absence of a background of collegiate sports did not influence risk of hypertension in this study population, nor did stair-climbing, walking, or light sports play by alumni. But, alumni who did not engage in vigorous sports play were at 35% greater risk of hypertension than those who did, and this relationship held at all ages, 35-74 years. Higher levels of body mass index, weight gain since college, history of parental hypertension, and lack of strenuous exercise independently predicted increased risk of hypertension in alumni. Men 20% or more over ideal weight-for-height were at 78% greater risk than lighter men. Those who had gained 25+ lbs (c. 11.5+ kg) since entering college were at 60% greater risk than those who had gained less. Alumni with a hypertensive parent were at 83% higher risk than men without such parentage. Contemporary vigorous exercise was inversely related to hypertension risk, but chiefly among alumni overweight-for-height. In the clinical sense, attributable risk estimates ranged from 30% to nearly 50% for the alumni characteristics of overweight, weight gain, parental hypertension, and lack of vigorous exercise. In the community sense, attributable risk of these same characteristics ranged 13-26%. To sum up, vigorous exercise is associated with lower hypertension incidence, and, without necessarily altering body weight-for-height, avoids or reduces fat and promotes muscle; obesity, rather than excess weight-for-height, is associated with higher hypertension incidence; hence, vigorous exercise is appropriate for use as an intervention regimen in the prevention of hypertension.
593 citations