July 2004

Grant Results

SUMMARY

From 2001 through 2003, Stanford University researchers conducted two analyses of survey responses from participants of the College Alumni Health Study to examine the influence of physical activity and other lifestyle factors on the development of cardiovascular disease and other illnesses in elderly men and women.

Key Findings
The researchers reported the following key findings to the Robert Wood Johnson Foundation (RWJF) and published them in Circulation and three other peer-reviewed journals:

  • The risk of cardiovascular disease fell as respondents reported greater levels of exertion during physical activity.
  • The researchers suggest it may be more appropriate to promote activity recommendations that rely on a relative intensity concept (e.g., walking at 75 percent of maximum heart rate) rather than the current absolute formulations (brisk walking), which require greater effort among less fit than better fit individuals.
  • Despite plausible biological mechanisms, neither physical activity nor body mass index (BMI) predicted death from pancreatic cancer.
  • Tea intake, likely consumed as black tea, was not strongly associated with a reduced risk of cardiovascular disease.

Funding
RWJF provided $148,420 to support the project from January 2001 to September 2003.

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THE PROBLEM

Physical activity can extend life, reduce disability and improve quality of life in middle-aged and older adults, numerous studies have demonstrated. The Surgeon General's Report on Physical Activity and Health notes that regular physical activity is associated with a decreased risk of developing chronic disease and an increase in physical fitness among middle-aged men and women. Little attention, however, has been directed to the relationship between physical activity and the primary and secondary prevention of chronic diseases in older adults, especially those over 75 years of age.

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RWJF STRATEGY

At the time of this grant, RWJF's Health and Behavior Team had as one of its strategic objectives the goal of increasing physical activity levels among sedentary mid-life and older adults. The results of these studies, which tracked a group of older adults over time, were expected to contribute to this goal by expanding the science base on the effects of physical activity and the health of older adults.

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THE PROJECT

The researchers conducted two analyses of the survey responses from participants of the College Alumni Health Study. The original sample included 71,000 men and women (39,000 men from Harvard and 32,000 men and women from Penn):

  • The first study looked at the effects of physical activity on the incidence of cardiovascular disease, death from all causes, and longevity. The investigators compared two measures of physical activity:
    • The first measure was the "absolute intensity" of respondent's physical activity, which can be thought of as the actual amount of energy respondents expended. (The researchers estimated the absolute intensity of the respondents' physical activities by referring to a compendium that listed various activities and their corresponding energy costs.) Current physical activity recommendations—at least 30 minutes of moderate intensity activity requiring 3–6 METS (multiples of a person's resting metabolic rate) on five or more days a week—are absolute intensity recommendations.
    • The second measure was the "relative intensity" of respondents' physical activity, which varies depending on each individual's fitness. (The researchers estimated the relative intensity of respondents' physical activity using the respondents' ratings of their physical exertion.) Many people who begin exercising will be told to monitor their heart rate and work toward a specific target heart rate to ensure a good, safe workout; this is a relative intensity recommendation.
  • The second study examined physical activity, other lifestyle habits and personal characteristics (e.g., high blood pressure, cigarette smoking, body weight) as they relate to chronic disease incidence in people 75 to 94 years old.

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FINDINGS

The researchers reported the following key findings to RWJF and in several peer reviewed publications (see the Bibliography):

  • The risk of cardiovascular disease fell as respondents reported greater levels of exertion (relative intensity) during physical activity. This was true, even among those who did not meet current guidelines for physical activity (30 minutes of moderate intensity activity requiring 3–6 METS on five or more days per week). The researchers suggest it may be more appropriate to promote activity recommendations that rely on a relative intensity concept (for example, walking at 75 percent of maximum heart rate) than the current absolute formulations (brisk walking), which requires greater effort among less fit than better fit individuals.
  • Despite plausible biological mechanisms, neither physical activity nor body mass index (BMI) predicted death from pancreatic cancer.
  • Tea intake, likely consumed as black tea, was not strongly associated with a reduced risk of cardiovascular disease.

Limitations

The researchers reported the following limitation to their research:

  • Alumni from Harvard College and the University of Pennsylvania tend to be more educated and affluent than the general population; however, the researchers believe the results of the study can be generalized to the entire U.S. population.

Communications

This research project directly resulted in one peer-reviewed journal article and indirectly in several others (see the Bibliography). In addition, the project director made a presentation on the research at the 2003 annual meeting of the American College of Sports Medicine and delivered preliminary findings at an honorary lecture to the European Society of Cardiology in Leipzig, Germany, in May 2002.

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AFTER THE GRANT

Future College Alumni Health Study research will focus on "weekend warriors" and the effects of physical activity clustering; the role of the environment in determining physical activity levels; and the contributions of physical activity to quality of life among older adults.

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GRANT DETAILS & CONTACT INFORMATION

Project

Physical Activity and the College Alumni Health Study

Grantee

Stanford University School of Medicine (Stanford,  CA)

  • Amount: $ 148,420
    Dates: January 2001 to September 2003
    ID#:  039425

Contact

Ralph S. Paffenbarger, M.D.
(650) 723-6417
paff@stanford.edu

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Articles

Lee IM, Sesso HD, Oguma Y and Paffenbarger RS Jr. "Relative Intensity of Physical Activity and Risk of Coronary Heart Disease." Circulation, 107(8): 1110–1116, 2003. Abstract available online.

Oguma Y, Sesso HD, Paffenbarger RS Jr. and Lee IM. "Physical Activity and Mortality in Women." Journal of the Japanese Menopause Society, 11: 34–41, 2003.

Sesso HD, Paffenbarger RS Jr., Oguma Y and Lee IM. "Lack of Association Between Tea and Cardiovascular Disease in College Alumni." International Journal of Epidemiology, 32(4): 527–533, 2003. Abstract available online.

Lee IM, Sesso HD, Oguma Y, Paffenbarger RS Jr. "Physical Activity, Body Weight and Pancreatic Cancer Mortality." British Journal of Cancer, 88(5): 679–683, 2003. Abstract available online.

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Report prepared by: Scott Edwards
Reviewed by: Richard Camer
Reviewed by: Molly McKaughan
Program Officer: Robin Mockenhaupt

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