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.
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.
In a population-based case-control study of colorectal cancer among Chinese men and women in western North America and the People's Republic of China, a common protocol was used to assess past life-style characteristics of 905 cases diagnosed during 1981-1986 and 2,488 controls. Risks for cancers of both the colon and rectum increased with increased food energy from fat, protein, carbohydrate, and all energy sources combined, for both sexes and on both continents. Yet, in multivariate analysis, colorectal cancer risk was significantly associated only with saturated fat; no relationships were seen with other dietary sources of energy. Colon cancer risk was elevated among men employed in sedentary occupations. On both continents and in both sexes, risks for cancers of both the colon and rectum increased with increasing time spent sitting. Further, the association between colorectal cancer risk and saturated fat was stronger among the sedentary than among the active. Risk among sedentary Chinese Americans of either sex increased more than fourfold from the lowest to the highest category of saturated fat intake. Among migrants to North America, risk increased with increasing years lived in North America. These observations suggest (a) that colorectal cancer risk increases with duration of exposure to a sedentary life-style and a diet rich in saturated fat; (b) that higher incidence among Chinese-American men relative to women is due to longer duration of these habits among men, who have lived longer in North America; and (c) that higher risk among Chinese Americans of both sexes relative to risk among the general population in China is due to differences in such habits. Attributable risk calculations suggest that, if these associations are causal, saturated fat intakes exceeding 10 g/day, particularly in combination with physical inactivity, could account for 60% of colorectal cancer incidence among Chinese-American men and 40% among Chinese-American women.
Vaginal exposures to talc and other particulates may play an etiologic role in epithelial ovarian cancer. Surgical sterilization may protect against ovarian cancer by blocking entry of such particulates into the peritoneal cavity. The authors assessed histories of talcum powder use, tubal sterilization, and hysterectomy with ovarian conservation in 188 women in the San Francisco Bay Area with epithelial ovarian cancers diagnosed in 1983-1985 and in 539 control women. To investigate the roles of blood-borne environmental exposures on ovarian cancer risk, they assessed lifetime consumption of coffee, tobacco, and alcohol in these women. Of the 539 controls, 280 were hospitalized women without overt cancer, and 259 were chosen from the general population by random digit telephone dialing. Ninety-seven (52%) of the cancer patients habitually used talcum powder on the perineum, compared with 247 (46%) of the controls. Adjusted for parity, the relative risk (RR) = 1.40, p = 0.06. There were no statistically significant trends with increasing frequency or duration of talc use, and patients did not differ from controls in use of talc on sanitary pads and/or contraceptive diaphragms. Fewer ovarian cancer patients (7%) than controls (13%) reported prior fallopian tube ligation (RR, adjusted for parity, = 0.56, p = 0.06), and fewer patients (20%) than controls (28%) reported prior hysterectomy (RR = 0.66, p = 0.05). The protective effect of hysterectomy was confined to those who underwent this surgery 10 or more years prior to interview and to those who had not undergone prior tubal sterilization. Consumption of cigarettes and alcohol did not differ between cases and controls. By contrast, 11 (6%) cases never regularly consumed coffee, compared with 31 (11%) hospital controls and 26 (10%) population controls (RR, adjusted for smoking, = 2.2, p = 0.03, for the comparison using all controls). Overall, ovarian cancer risk among women who had drunk coffee for more than 40 years was 3.4 times that of women who had never regularly consumed coffee (p less than 0.01). However, the data exhibited no clear trends in risk with increasing consumption. Although risk ratios relating duration of coffee drinking to ovarian cancer were unaffected by adjustment for several characteristics, further study is needed to exclude potential confounding by other unmeasured characteristics.
We examined patterns of physical activity and other characteristics that might deter hypertension or delay all-cause mortality among university alumni, 1962-1985. Collegiate sports play did not alter hypertension incidence, nor did contemporary walking, stair-climbing, or light sports play among 5463 University of Pennsylvania alumni, 739 of whom developed hypertension. But vigorous sports play reduced hypertension incidence; and overweight, gain in weight, history of parental hypertension, or any combination of these, increased it. Among 819 hypertensive Pennsylvania alumni (138 died during follow-up), vigorous sports play had minimal influence on mortality; but freedom from overweight and cigarette smoking deferred death. Among 16,936 Harvard College alumni, of whom 2614 died during follow-up, lack of vigorous sports play, or presence of hypertension, cigarette smoking, and overweight increased risk of premature mortality, heightened by any combination of these adverse characteristics. Overall, we found an inverse relationship between vigorous sports participation and hypertension risk but a direct relationship between risk and weight-for-height, weight gain, or parental hypertension. With regard to all-cause mortality, cigarette smoking and hypertension were most hazardous for the individual; smoking and lack of vigorous recreational play were most hazardous for the alumnus population as a whole.
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