This investigation described the effects of exercise, walking, and cycling for transportation, as well as the effect of overall nonexercise physical activity, on mortality in the Shanghai Women's Health Study (1997-2004). Women without heart disease, stroke, or cancer were followed for an average of 5.7 years (n = 67,143), and there were 1,091 deaths from all causes, 537 deaths from cancer, and 251 deaths from cardiovascular diseases. Information about physical activity and relevant covariates was obtained by interview. Proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals. Exercise and cycling for transportation were both inversely and independently associated with all-cause mortality (p(trend) < 0.05), but walking for transportation was less strongly associated with reduced risk (p(trend) = 0.07). Women reporting no regular exercise but who reported 10 or more metabolic equivalent (MET)-hours/day of nonexercise activity were at 25-50% reduced risk (p(trend) < 0.01) relative to less active women (0-9.9 MET-hours/day). Among women reporting the least nonexercise activity (0-9.9 MET-hours/day) but reporting regular exercise participation, exercise was associated with reduced mortality (hazard ratio = 0.78, 95% confidence interval: 0.62, 0.99). These findings add new evidence that overall physical activity levels are an important determinant of longevity, and that health benefit can be obtained through an active lifestyle, exercise, or combinations of both.
Background: Inactivity is a modifiable risk factor for many diseases. Rapid economic development in China has been associated with changes in lifestyle, including physical activity. The purpose of this study was to investigate the patterns and correlates of physical activity in middle-aged and elderly women from urban Shanghai.
Reproducibility and validity of the physical activity questionnaire (PAQ) used in the Shanghai Men's Health Study (2003-2006, People's Republic of China) was evaluated in a random sample of 196 participants aged 40-74 years. Participants completed a PAQ at baseline and again 1 year later, 12 monthly 7-day physical activity recalls, and four quarterly 1-week physical activity logs. Reproducibility was evaluated by using the two PAQs and validity by comparing the PAQs with 1-year averages of the two criterion measures: 7-day physical activity recall and physical activity log. The PAQ had moderate to high reproducibility for measuring adult exercise participation (kappa = 0.60) and energy expenditure (r(s) = 0.68), nonexercise activities (correlation coefficients = 0.42-0.68), and total daily energy expenditure (r(s) = 0.68, kappa(quartiles) = 0.47). Correlations between the PAQ and criterion measures of adult exercise were 0.45 (7-day physical activity recall) and 0.51 (physical activity log) for the first PAQ and 0.62 (7-day physical activity recall) and 0.71 (physical activity log) for the second PAQ. Correlations between PAQ nonexercise activities and the physical activity log and 7-day physical activity recall were 0.31-0.86. Correlations for total energy expenditure were high (0.62-0.77). Results indicate that the Shanghai Men's Health Study PAQ has reasonable reproducibility and validity for classifying men by their level of exercise and nonexercise activities in this cohort.
Stage T1 and T2 breast cancers located less proximally to the skin may be less likely to spread to the axillary lymph nodes. We observed what appears to be a threshold at approximately 14 mm from the skin (based upon this group of patients): none of 26 cancers below this level had spread to axillary nodes. Further research is needed to confirm these provocative findings.
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