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Biomedical subjects

R S Paffenbarger

Publications and source records attributed to R S Paffenbarger.

At least 55 records · Page 3Linked to original sources
PubMed1995

Exercise intensity and longevity in men. The Harvard Alumni Health Study.

OBJECTIVE: To examine the independent associations of vigorous (> or = 6 resting metabolic rate [MET] score) and nonvigorous (< 6 MET score) physical activity with longevity. DESIGN: Prospective cohort study, following up men from 1962 or 1966 through 1988. SETTING/PARTICIPANTS: Subjects were Harvard University alumni, without self-reported, physician-diagnosed cardiovascular disease, cancer, or chronic obstructive pulmonary disease (n = 17,321). Men with a mean age of 46 years reported their physical activities on questionnaires at baseline. MAIN OUTCOME MEASURE: All-cause mortality (3728 deaths). RESULTS: Total energy expenditure and energy expenditure from vigorous activities, but not energy expenditure from nonvigorous activities, related inversely to mortality. After adjustment for potential confounders, the relative risks of dying associated with increasing quintiles of total energy expenditure were 1.00 (referent), 0.94, 0.95, 0.91 and 0.91, respectively (P [trend] < .05). The relative risks of dying associated with less than 630, 630 to less than 1680, 1680 to less than 3150, 3150 to less than 6300, and 6300 or more kJ/wk expended on vigorous activities were 1.00 (referent), 0.88, 0.92, 0.87, and 0.87, respectively (P [trend] = .007). Corresponding relative risks for energy expended on nonvigorous activities were 1.00 (referent), 0.89, 1.00, 0.98, and 0.92, respectively (P [trend] = .36). Analyses of vigorous and nonvigorous activities were mutually adjusted. Among men who reported only vigorous activities (259 deaths), we observed decreasing age-standardized mortality rates with increasing activity (P = .05); among men who reported only nonvigorous activities (380 deaths), no trend was apparent (P = .99). CONCLUSIONS: These data demonstrate a graded inverse relationship between total physical activity and mortality. Furthermore, vigorous activities but not nonvigorous activities were associated with longevity. These findings pertain only to all-cause mortality; nonvigorous exercise has been shown to benefit other aspects of health.

Adult↗
PubMed1995

Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men.

OBJECTIVE: To evaluate the relationship between changes in physical fitness and risk of mortality in men. DESIGN: Prospective study, with two clinical examinations (mean interval between examinations, 4.9 years) to assess change or lack of change in physical fitness as associated with risk of mortality during follow-up after the subsequent examination (mean follow-up from subsequent examination, 5.1 years). SETTING: Preventive medicine clinic. STUDY PARTICIPANTS: Participants were 9777 men given two preventive medical examinations, each of which included assessment of physical fitness by maximal exercise tests and evaluation of health status. MAIN OUTCOME MEASURES: All cause (n = 223) and cardiovascular disease (n = 87) mortality. RESULTS: The highest age-adjusted all-cause death rate was observed in men who were unfit at both examinations (122.0/10,000 man-years); the lowest death rate was in men who were physically fit at both examinations (39.6/10,000 man-years). Men who improved from unfit to fit between the first and subsequent examinations had an age-adjusted death rate of 67.7/10,000 man-years. This is a reduction in mortality risk of 44% (95% confidence interval, 25% to 59%) relative to men who remained unfit at both examinations. Improvement in fitness was associated with lower death rates after adjusting for age, health status, and other risk factors of premature mortality. For each minute increase in maximal treadmill time between examinations, there was a corresponding 7.9% (P = .001) decrease in risk of mortality. Similar results were seen when the group was stratified by health status, and for cardiovascular disease mortality. CONCLUSIONS: Men who maintained or improved adequate physical fitness were less likely to die from all causes and from cardiovascular disease during follow-up than persistently unfit men. Physicians should encourage unfit men to improve their fitness by starting a physical activity program.

Adult↗
PubMed1994

Physical activity and personal characteristics associated with depression and suicide in American college men.

Among Harvard alumni aged 35-74 in 1962 or 1966, incidence rates of physician-diagnosed depression, together with suicide rates, were examined during a 23-27-year follow-up period, by antecedent physical activity habits and other personal characteristics. A total of 387 first attacks of depression developed among 10,201 alumni who survived through 1988; 129 suicides occurred among 21,569 alumni during follow-up through 1988. Depression rates were lower among the physically active and sports players, higher among cigarette smokers, unrelated to alcohol consumption, and higher among alumni reporting such personality traits as insomnia, exhaustion, cyclothymia, and self-consciousness. Suicide rates were largely unrelated to antecedent physical activity and alcohol consumption, higher among smokers, and substantially higher among men reporting the personality traits that predicted increased rates of depression.

Adult↗
PubMed1994

Prevention of non-insulin-dependent diabetes mellitus with physical activity.

Physical activity has been recommended by physicians in managing patients with noninsulin-dependent diabetes mellitus (NIDDM); however, it is unclear whether physical activity can prevent this disease. Several prospective studies have suggested that increased physical activity may lead to the prevention of NIDDM. In the University of Pennsylvania Alumni Health Study, 5990 men were surveyed to determine the relationship between physical activity and the development of NIDDM. A total of 202 men developed NIDDM from 1962 to 1976. Leisure-time physical activity, expressed in kilocalories (kcal) was inversely related to the development of NIDDM. Incidence rates declined as energy expenditure increased. For each 2000-kcal increment in energy expenditure, the risk of NIDDM was reduced by 24% [relative risk (RR) 0.76, 95% confidence interval (CI) 0.63-0.92]. This association remained when adjusting for obesity, hypertension, and parental history of diabetes. The protective effect of physical activity was strongest in individuals at highest risk for NIDDM. Based on the review of data from several large prospective studies, it is quite likely that increased levels of physical activity are effective in preventing NIDDM, and the protective benefit is especially pronounced in those individuals who have the highest risk of disease.

Adult↗
PubMed1994

Physical activity and its relation to cancer risk: a prospective study of college alumni.

Previous investigations regarding the influence of physical activity on cancer risk generally have utilized a single assessment of activity, thus failing to account for changes over time. Additionally, one assessment may be somewhat imprecise. We attempted to overcome these problems in a study of 17,607 men (aged 30-79 yr), followed from 1962 or 1966 (1962/1966) through 1988. We assessed physical activity (based on self-reported stair climbing, walking and participation in sports or recreational activities) twice: in 1962/1966 and again in 1977. A total of 280 colon, 53 rectal, 454 prostatic, 262 lung, and 88 pancreatic cancers developed during follow-up. Among alumni with Quetelet's index > or = 26 units, those highly active (energy expenditure > or = 2,500 kcal [> or = 10,460 kJ].wk-1) had 0.19 (95% confidence interval, 0.02-1.52) to 0.56 (0.29-1.09) times the colon cancer risk of those inactive (< 1,000 kcal [< 4,184 kJ].wk-1). Colon cancer risk was unrelated to level of activity among alumni with Quetelet's index < 26 units. Highly active alumni also had 0.39 (95% confidence interval, 0.18-0.85) to 0.62 (0.45-0.85) times the lung cancer risks of their inactive colleagues. Physical activity was not significantly associated with risks of rectal, prostatic, or pancreatic cancers. The biologic basis for a protective effect of increased activity on cancer risk appears plausible.

Adult↗
PubMed1994

Changes in physical activity and other lifeway patterns influencing longevity.

We studied the adoption or maintenance of physical activity and other optional lifeway patterns for their influence on mortality rates of Harvard College alumni. Men aged 45-84 in 1977, surveyed by questionnaire in 1962 or 1966 and again in 1977, were followed from 1977 through 1988 or to age 90. Of 14,786 alumni, 2,343 died in 165,402 man-years of follow-up. Relative risks of death, standardized for potential confounding influences, for men who between questionnaires increased their physical activity through walking, stair climbing, and sports or recreational activities to 1,500 kcal or more per wk were 0.72 (95% confidence interval 0.64-0.82), compared with 1.00 for men who remained less active. Corresponding relative risks for men who adopted moderately vigorous sports play (> or = 4.5 METs) were 0.73 (0.65-0.81) vs 1.00 for men not adopting such sports; and for cigarette smokers who quit, 0.74 (0.65-0.84) vs 1.00 for persistent smokers. Men with recently diagnosed hypertension had a lower death risk than long-term hypertensives (0.80; 0.70-0.92), as did men with consistent normotension (0.52; 0.47-0.58). Changes in body-mass index had little influence on mortality during follow-up. These findings fit the hypothesis that adopting a physically active lifeway, quitting cigarette smoking, and remaining normotensive independently delay all-cause mortality and extend longevity.

Adult↗
PubMed1993

Body weight and mortality. A 27-year follow-up of middle-aged men.

OBJECTIVE: To investigate the nature of the relation between body weight and all-cause mortality. DESIGN: Prospective cohort study, following up men from 1962 or 1966 (1962/1966) through 1988. SETTING/PARTICIPANTS: Harvard University alumni with a mean age of 46.6 years in 1962/1966 and without self-reported, physician-diagnosed coronary heart disease, stroke, or cancer, who completed questionnaires on weight, height, cigarette smoking habit, and physical activity (n = 19,297). We calculated body mass index (weight in kilograms divided by the square of height in meters) using self-reported measures. MAIN OUTCOME MEASURE: All-cause mortality (4370 deaths). RESULTS: In multivariate analysis adjusting for age, cigarette smoking habit, and physical activity, we found a J-shaped relation between body mass index and mortality. Relative risks of dying for men with a body mass index of less than 22.5, 22.5 to less than 23.5, 23.5 to less than 24.5, 24.5 to less than 26.0, and 26.0 or greater were 1.00 (referent), 0.99 (95% confidence interval, 0.89 to 1.20), 0.95 (0.87 to 1.05), 1.01 (0.91 to 1.10), and 1.18 (1.08 to 1.28), respectively (P for linear trend = .0008). Among current smokers, the relation between body mass index and mortality was U-shaped, with lowest risk of death at a body mass index of 23.5 to less than 24.5. During early follow-up (1962/1966 through 1974), we also observed a U-shaped curve, this time with lowest mortality risk at a body mass index of 24.5 to less than 26.0. To minimize confounding by cigarette smoking and bias from antecedent disease and early mortality, we conducted analysis only among never smokers and omitted the first 5 years of follow-up (510 deaths). The corresponding relative risks from this analysis, adjusted for age and physical activity, were 1.00, 1.23 (95% confidence interval, 0.90 to 1.67), 1.06 (0.80 to 1.42), 1.27 (0.96 to 1.68), and 1.67 (1.29 to 2.17), respectively (P for linear trend = .0001). CONCLUSIONS: In these prospective data, body weight and mortality were directly related. After accounting for confounding by cigarette smoking and bias resulting from illness-related weight loss or inappropriate control for the biologic effects of obesity, we found no evidence of excess mortality among lean men. Indeed, lowest mortality was observed among men weighing, on average, 20% below the US average for men of comparable age and height.

Body Mass Index↗
PubMed1993

The association of changes in physical-activity level and other lifestyle characteristics with mortality among men.

BACKGROUND: Recent trends toward increasing physical exercise, stopping cigarette smoking, and avoiding obesity may increase longevity. We analyzed changes in the lifestyles of Harvard College alumni and the associations of these changes with mortality. METHODS: Men who were 45 to 84 years of age in 1977 and who had reported no life-threatening disease on questionnaires completed in 1962 or 1966 and again in 1977 were classified according to changes in lifestyle characteristics between the first and second questionnaires. We analyzed changes in their level of physical activity, cigarette smoking, blood pressure, and body weight, and the relation of these factors to mortality between 1977 and 1985. RESULTS: Of the 10,269 men, 476 died during this period (which totaled 90,650 man-years of observation). Beginning moderately vigorous sports activity (at an intensity of 4.5 or more metabolic equivalents) was associated with a 23 percent lower risk of death (95 percent confidence interval, 4 to 42 percent; P = 0.015) than not taking up moderately vigorous sports. Quitting cigarette smoking was associated with a 41 percent lower risk (95 percent confidence interval, 20 to 57 percent; P = 0.001) than continuing smoking, but with a 23 percent higher risk than constant nonsmoking. Men with recently diagnosed hypertension had a lower risk of death than those with long-term hypertension (relative risk, 0.75; 95 percent confidence interval, 0.55 to 1.02; P = 0.057), as did men with consistently normal blood pressure (relative risk, 0.52; 95 percent confidence interval, 0.40 to 0.68; P < 0.001). Maintenance of lean body mass was associated with a lower mortality rate than long-term, recent, or previous obesity. The associations between changes in lifestyle and mortality were independent and were largely undiminished by age. Our findings on death from coronary heart disease mirrored those on death from all causes. CONCLUSIONS: Beginning moderately vigorous sports activity, quitting cigarette smoking, maintaining normal blood pressure, and avoiding obesity were separately associated with lower rates of death from all causes and from coronary heart disease among middle-aged and older men.

Aged↗
PubMed1993

Accuracy of the College Alumnus Physical Activity Questionnaire.

The validity and reproducibility of the Physical Activity Index from the College Alumnus Questionnaire (PAI-CAQ) were determined in 78 men and women (21-59 yr) with a broad range of physical activity habits. The PAI-CAQ was computed as the sum of energy expended in stair climbing, walking, and sports and recreational physical activity recalled from the past week. Data were validated against measures of cardiorespiratory fitness, body fatness, motion detection, and physical activity records. All physical activity was recorded by participants for six 48-hour periods. Each day of the week, including weekends, were represented at least twice in the physical activity records. Age-adjusted correlation coefficients between like activities on the College Alumnus Questionnaire and physical activity records ranged from 0.25 to 0.65 in men and 0.28 to 0.86 in women. Correlations between the PAI-CAQ and validation criteria that reflected total and heavy-intensity physical activities were higher (r = 0.34-0.69, p < 0.05) than for lighter-intensity physical activities and motion detection expressed in MET-min.d-1 and kcal.d-1 (r < 0.35, p > 0.05). Test-retest reproducibility was higher over 1 month (r = 0.72) than over 8 and 9 months (r = 0.34 and 0.43) (p < 0.05). Energy expended in walking and stair climbing was underestimated on the College Alumnus Questionnaire, resulting in lower PAI-CAQ scores, as compared to the physical activity records.

Adult↗
PubMed1993

Measurement of physical activity to assess health effects in free-living populations.

For physical activity surveys that would identify relations to chronic diseases, quality of life, and longevity, the method of choice remains the questionnaire, especially if it can be standardized and administered in uniform fashion to large populations. A sample questionnaire derived largely from epidemiological experience with the Harvard Alumni Health Study is presented that requests anthropometric estimates; physician-diagnosed diseases by year of onset; contemporary physical activities including walking, stair-climbing, and recreational pursuits; food-frequency data that estimate nutrient values and caloric intakes; and social habits affecting health. The questionnaire presents opportunities for cross-sectional, retrospective, and prospective studies. Personal characteristics, physical activities, and other elements of lifestyle may be used as predictor or outcome variables in testing specific hypotheses. Representative surveys are described that have validated and used questionnaires of various complexities, some complemented by measures of physiological fitness. The epidemiological survey questionnaire, when properly designed and administered, can measure effectively energy intake, energy retention, energy expenditure, physiological fitness, quality of life, and health maintenance.

Exercise↗
PubMed1993

Compendium of physical activities: classification of energy costs of human physical activities.

A coding scheme is presented for classifying physical activity by rate of energy expenditure, i.e., by intensity. Energy cost was established by a review of published and unpublished data. This coding scheme employs five digits that classify activity by purpose (i.e., sports, occupation, self-care), the specific type of activity, and its intensity as the ratio of work metabolic rate to resting metabolic rate (METs). Energy expenditure in kilocalories or kilocalories per kilogram body weight can be estimated for all activities, specific activities, or activity types. General use of this coding system would enhance the comparability of results across studies using self reports of physical activity.

Energy Metabolism↗
PubMed1992

Change in body weight and longevity.

OBJECTIVE: To investigate the effect of body weight change on longevity. DESIGN: Cohort analytic study, following men from 1977 through 1988. SETTING: The study was conducted among Harvard University alumni with mean age of 58 years. PATIENTS: Alumni, free of cardiovascular disease and cancer, completed questionnaires on weight, height, cigarette habit, and physical activities in 1962 or 1966 and in 1977 (n = 11,703). We assessed weight change between questionnaires, based on self-reported weights. MAIN OUTCOME MEASURE: Mortality from all causes (n = 1441), coronary heart disease (n = 345), and cancer (n = 459), determined from death certificates. RESULTS: Lowest all-cause mortality was among alumni maintaining stable weight (+/- 1 kg). With this category as referent (relative risk = 1.00), relative risks of death associated with losing more than 5 kg, losing between 1 and 5 kg, (more than 1 kg and up to 5 kg) gaining between 1 and 5 kg (more than 1 kg and up to 5 kg), and gaining more than 5 kg were 1.57 (95% confidence interval, 1.34 to 1.84), 1.26 (1.10 to 1.46), 1.06 (0.90 to 1.24), and 1.36 (1.11 to 1.66), respectively. For coronary heart disease mortality, relative risks were 1.75 (1.26 to 2.43), 1.43 (1.05 to 1.93), 1.28 (0.91 to 1.80), and 2.01 (1.36 to 2.97), respectively. Weight change did not predict cancer mortality. Findings were not explained by cigarette habit, physical activity, or body mass index. We observed similar trends for follow-up between 1977 and 1982 and between 1983 and 1988. Those losing or gaining more weight also reported greater total lifetime weight loss, which may indicate weight cycling. CONCLUSIONS: Both body weight loss and weight gain are associated with significantly increased mortality from all causes and from coronary heart disease but not from cancer.

Analysis of Variance↗
PubMed1992

Quetelet's index and risk of colon cancer in college alumni.

BACKGROUND: While previous studies suggest that overweight, middle-aged men may face increased risk of colon cancer, it is unclear whether their weights as young adults influence this risk. It is also unknown whether their level of physical activity affects their risk of developing colon cancer. PURPOSE: To determine the relationship between being overweight in middle-age or young adulthood and colon cancer risk, we prospectively studied alumni of Harvard University. We also investigated whether being overweight influences risk differently for men with different levels of physical activity. METHODS: In 1962 or 1966 (1962/1966), alumni completed questionnaires on weight, height, other sociodemographic characteristics, and medical history. We obtained information on weight and height at college entry from university archives. Alumni (n = 17,595) were followed from 1962/1966 to 1988 for colon cancer occurrence, ascertained from follow-up questionnaires in 1977 and 1988 and death certificates. RESULTS: Between 1962/1966 and 1988, 302 cases of colon cancer were diagnosed. Colon cancer risk increased with higher levels of Quetelet's index (weight [kg]/height [m]2) in 1962/1966. Relative risk per unit increase, adjusted for age, physical activity, and parental history of cancer, was 1.08 (95% confidence interval [CI], 1.04-1.13). Quetelet's index at college entry did not predict risk as well (adjusted relative risk per unit increase, 1.05; 95% CI, 1.00-1.10). The heaviest fifth of alumni during both college time and in 1962/1966 had almost two and one-half times the risk of the lightest fifth of alumni (adjusted relative risk, 2.40; 95% CI, 1.40-4.13). When alumni were classified according to activity level in 1962/1966, higher levels of Quetelet's index were significantly associated with colon cancer risk only among those who were less active. CONCLUSIONS: Overweight during middle-age or young adulthood is associated with higher colon cancer risk; in overweight, physically active men, however, the risk of colon cancer may not be increased.

Adult↗
PubMed1992

Time trends in physical activity among college alumni, 1962-1988.

Little direct evidence exists in the epidemiologic literature to support the widely held belief that an individual's physical activity behavior varies over the years. To provide data, the authors prospectively studied patterns of physical activity among 6,092 Harvard College alumni (average age at the start of follow-up, 43 years) who responded to questionnaires in 1962 or 1966, 1977, and 1988, and who declared themselves free of cardiovascular disease and cancer throughout that period. The median energy expenditure increased between 1962 or 1966 and 1977, but stabilized between 1977 and 1988. However, rank correlation coefficients between estimates of energy expenditure in 1977 and 1988 ranged from 0.36 to 0.41 for the various age groups (compared with 0.81-0.84 for the Quetelet index, and 0.60-0.65 for the current number of cigarettes smoked per day), implying that physical activity at the individual level was not constant. For 4,238 alumni for whom data on collegiate sports participation were available, the rank correlation coefficients between collegiate activity and alumni activity 1-7 decades later were even lower, ranging from 0.05 to 0.17 (compared with 0.31-0.58 for the Quetelet index). Thus, physical activity assessed over a short time period in an individual may not be a valid proxy for activity over the long term. The characteristics that distinguished alumni who consistently expended less than 1,000 kcal/week (in climbing stairs, walking, and playing sports) in 1962 or 1966, 1977, and 1988 from those who consistently expended greater than 2,500 kcal/week were as follows: at baseline, older age, overweight, and cigarette smoking; and during college, not having been a varsity athlete and fewer hours playing sports.

Adult↗
PubMed1992

Physical activity and risk of prostatic cancer among college alumni.

Clinical observations and laboratory experiments have suggested a role for testosterone in the development of prostatic cancer. Since physical training may act to lower testosterone levels, men who are very active may have a reduced risk of this cancer. To test this hypothesis, the authors prospectively followed 17,719 Harvard alumni (aged 30-79 years) from 1965 or 1969 to 1977, and 1980 to 1988 for the occurrence of prostatic cancer (n = 419). Physical activity was assessed in either 1962 or 1966, and again in 1977, based on self-reported stair climbing, walking, and sports played. Alumni who expended greater than 4,000 kcal/week at both assessments were at reduced risk of developing prostatic cancer (age-adjusted rate ratio, 0.12; 95% confidence interval 0.02-0.89) compared with their inactive counterparts who expended less than 1,000 kcal/week at both assessments. These results should be interpreted cautiously, since only one case of prostatic cancer was identified among alumni highly active at both assessments, who contributed 4% of total person-years to the analysis. Among alumni aged 70 years and older, those who extended greater than 4,000 kcal/week at either assessment had about half the risk of those who expended less than 1,000 kcal/week at either assessment (age-adjusted rate ratio, 0.53; 95% confidence interval 0.29-0.95). The authors attribute these findings to the increased precision with which physical activity could be measured when combining two activity assessments. Alternatively, long-term maintenance of a high level of physical activity may be necessary for further reduction of risk. There was no evidence of a dose-response relation.

Adult↗
PubMed1992

The role of physical exercise in the occurrence of Parkinson's disease.

A case-control study of Parkinson's disease and physical exercise was conducted in a cohort of 50,002 men who attended Harvard College (Cambridge, Mass) or the University of Pennsylvania (Philadelphia) between 1916 and 1950 and were followed up in adulthood for morbidity and mortality data. Cases of Parkinson's disease were identified from responses to mailed questionnaires and death certificates through 1978. Four controls from the same population were selected for each case. The association between physical activity at the time of college and subsequent risk of Parkinson's disease was evaluated for 137 cases and 548 controls, whereas the data on physical activity in adulthood before the disease occurrence was available only for 94 of these cases. Having belonged to a varsity team or having done regular physical exercise in college was associated with a lower nonsignificant risk of Parkinson's disease. In adulthood, practice of moderate or heavy sports was linked to a reduced risk, although more precise analysis revealed that there was only a modest nonsignificant reduction in risk for subjects who do a moderate amount of physical exercise, but this negative association disappears at higher levels of physical expenditure. These results, which require further confirmation, are compatible with a slight protective effect of physical exercise on the risk of Parkinson's disease, although the lack of association cannot be refuted.

Adolescent↗