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The Harvard Alumni Health Study

I-Min Lee, MBBS, ScD; Chung-cheng Hsieh, ScD; Ralph S. Paffenbarger, Jr, MD, DrPH

JAMA. 1995;273(15):1179-1184.

Abstract
Objective.
—To examine the independent associations of vigorous (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 allcause mortality; nonvigorous exercise has been shown to benefit other aspects of health.

(JAMA. 1995;273:1179-1184)

Author Affiliations
From the Department of Epidemiology, Harvard School of Public Health, Boston, Mass (Drs Lee, Hsieh, and Paffenbarger); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston (Dr Lee); and Division of Epidemiology, Stanford (Calif) University School of Medicine (Dr Paffenbarger).

Footnotes
Reprint requests to Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115 (Dr Lee).

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