The Effects of Physical Activity on Health and Disease

References

Abbott RD. Rodriguez BL, Burchfiel CM, Curb JD. Physi-
cal activity in older middle-aged men and reduced risk
of stroke: the Honolulu Heart Program. AmericanJour-
nal ofEpidemiology 1994;139:881-893.
Abraham S, Collins G, Nordsieck M. Relationship of
childhood weight status to morbidity inadults. Health
Services and Mental Health Administration Health
Reports 1971;86:273-284.

Adams JE. Injury to the throwing arm: a study of trau-
matic changes in the elbow joints of boy baseball
players. Calqornia Medicine 1965;102:127-132.
Albanes D. Caloric intake, body weight, and cancer: a
review. Nutrition and Cancer 1987;9:199-217.

Albanes D, Blair A, Taylor PR. Physical activity and risk of
cancer in the NHANES 1 population. American journal
of Public Health 1989;79:744-750.

hllegrante JP, Kovar PA, MacKenzie CR, Peterson MG,
Gutin B. A walking education program for patients with
osteoarthritis of the knee: theory and intervention strat-
egies. Health Education Quarterly 1993;20:63-81.
Allegrucci M, Whitney SL, lrrgang JJ, Clinical impfica-
tions of secondary impingement of the shoulder in
freestyle swimmers. journal of Orthopaedic and Sports
Physical Therapy 1994;20:307-318.
Allen SH. Exercise considerations for postmenopausal
women with osteoporosis. Arthritis Care and Research
1994;7:205-214.

Aloia JF, Vaswani AN, Yeh JK, Cohn SH. Premenopausal
bone mass is related to physical activity. Archives of
Internal Medicine 1988;148:121-123.

Alpert BS, Wilmore JH. Physical activity and blood pres-
sure in adolescents. Pediatric Exercise Science
1994;6:361-380.

American Cancer Society. Cancerfacts andfigures, 1996.
Atlanta: American Cancer Society, 1996. Publication
No. 5008.96.

American College of Sports Medicine. Guidelinesfor exer-
cise testing and prescription. 4th ed. Philadelphia: Lea
and Febiger, 1991.

American College of Sports Medicine. Position stand:
physical activity, physical fitness, and hypertension.
Medicine and Science in Sports and Exercise 1993;25:i-x.
American Diabetes Association. Technical review: exer-
cise and NIDDM. Diabetes Care 1990;13:785-789.

5

Anderson SD, Daviskas E, Smith CM. Exercise-induced
asthma: a difference in opinion regarding the stimulus.
Allergy Proceedings 1989;10:215-226.
Arbman G, Axelson 0, Fredriksson M, Nilsson E, Sjodahl
R. Do occupational factors influence the risk of colon
and rectal cancer in different ways? Cancer 1993;72:
2543-2549.

Armstrong N, Simons-Morton B. Physical activity and
blood lipids in adolescents. Pediatric Exercise Science
1994;6:381-405.

Armstrong SJ, Read RA, Ghosh P, Wilson DM. Moderate
exercise exacerbates the osteoarthritic lesions pro-
duced in cartilage by meniscectomy: a morphological
study. Osteoarthritis and Cartilage 1993;1:89-96.
Arokoski J, Kiviranta I, Jurvehn], Tammi M, Helminen
HJ. Long-distance running causes site-dependent de-
crease of cartilage gfycosaminoglycan content in the
knee joints of beagle dogs. Arthritis and Rheumatism
1993;36:1451-1459.

Arraiz GA, Wigle DT, Mao Y. Risk assessment of physical
activity and physical fitness in the Canada Health
SUNey Mortality Follow-up Study. Journal of Clinical
Epidemiology 1992;45:419-428.
Arroll B, Beaglehole R. Does physical activity lower blood
pressure? A critical review of the clinical trials.Joumal
of Clinical Epidemiology 1992;45:439-447.
Bahrke MS, Morgan WP. Anxiety reduction following
exercise and meditation. Cognitive Therapy and Re-
search 1978;2:323-333.

Ballard-Barbash R, Schatzkin A, Albanes D, Schiffman
MH, Kreger BE, Kannel W'B, et al. Physical activity and
risk of large bowel cancer in the Framingham study.
Cancer Research 1990;50:3610-3613.

Ballor DL, Keesey RE. A meta-analysis of the factors
affecting exercise-induced changes in body mass, fat
mass, and fat-free mass in males and females. Interna-
tional_lournal ofobesity 1991;15:717-726.
Barnard RJ, Jung T, Tnkeles SB. Diet and exercise in the
treatment of NIDDM: the need for early emphasis.
Diabetes Care 1994;17:1469-1472.

Bennett GE. Shoulder and elbow lesions of the profes-
sional baseball pitcher. Journal ofthe American Medical
Association 1941;117:510-514.

Berlin JA, Colditz GA. A meta-analysis of physical activity
in the prevention of coronary heart disease. American
Journal of Epidemiology 1990;132:612-628.


Physical Activity and Health

Bernstein L, Henderson BE, Hanisch R, Sullivan-Halley J,
Ross RK. Physical exercise and reduced risk of breast
cancer in young women. journal of the National Can-
cer Institute 1994;86:1403-1408.

Bjorntorp P, Krotkiewski M. Exercise treatment in diabe-
tes mellitus. Acta Medica Scandinavica 1985;217:3-7.

Bjomtorp P, Sjostrom L, Sullivan L. The role of physical
exercise in the management of obesity. In: Munro JF,
editor. The treatmenr of obesity. Baltimore: University
Park Press, 1979:123-138.

Blackburn H, Prineas R. Diet and hypertension: anthro-
pology, epidemiology, and public health implications.
Progress in Biochemical PhatmacoIogy 1983;19:31-79.
Blair SN. Physical activity, fitness, and coronary heart
disease. In: Bouchard C, Shephard RJ, Stephens T,
editors. Physical activity, fitness, and heafth: intcma-
tionalproceedingsandconsensusstatement. Champaign,
IL: Human Kinetics, 1994:579-590.

Blair SN, Goodyear NN, Gibbons LW, Cooper KH. Physi-
cal fitness and incidence of hypertension in healthy
normotensive men and women. Journal of the Ameri-
can Medical Association 1984;252:487-490.

Blair SN, Kohl HW, Barlow CE. Physical activity, physical
fitness, and ail-cause mortality in women: do women
need to be active? Journal of the American College of
Nutrition 1993;12:368-371.

Blair SN, Kohl HW, Goodyear NN. Rates and risks for
running and exercise injuries: studies in three popula-
tions. Research Qua,-tcrly Jar Exercise and Sport
1987;58:221-228.

Blair SN, Kohl HW Ill, Barlow CE, Paffenbarger RS Jr,
Gibbons LW, Macera CA. Changes in physical fitness
and all-cause mortality: a prospective study of healthy
and unhealthy men. Journal of the American Medical
Association 1995;273: 1093-1098.

Blair SN, Kohl HW III, Paffenbarger RS Jr, Clark DG,
Cooper KH, Gibbons LW. Physical fitness and all-
cause mortality: a prospective study of healthy men
and women. Journal of the American Medical Associa-
Lion 1989;262:2395-2401.

Blumenthal JA, Emery CF, Madden DJ, George LK,
Coleman RE, Riddle MW, et al. Cardiovascular and
behavtoral effects of aerobic exercise training in healthy
older men and women. Journal of Gerontology
1989;44:147-157.

Bouchard C, Desprcs J-P, Tremblay A. Exercise and obe-
sity. Obcsiry Research 1993;1:133-147.

Bradfield RB, Paulos J, Grossman L. Energy expenditure
and heart rate of obese high school girls. American
Journal of Clinical Nutrition 1971;24:1482-1488.
Bray GA. Complications of obesity. Annals of Internal
Medicine 1985;103(Suppl6, Pt 2):1052-1062.
Bray GA. The energetics of obesity. Medicine and Science
in Sports and Exercise 1983;15:32-40.
Brown DR. Exercise, fitness, and mental health. In:
Bouchard C, Shephard RJ, Stephens T, Sutton JR,
McPherson BD, editors. Exercise,fitness, and health: a
consensus of current knowledge. Champaign, 1L: Hu-
man Kinetics, 1990:607-626.

Brown DR, Wang Y. The relationships among exercise
training, aerobic capacity, and psychological well-
being in the general population. Medicine, Exercise,
Nutrifion, and Health 1992;3:125-142.

Brown DR, Wang Y, Ward A, Ebbeling CB, Fortlage L,
Puleo E, et al. Chronic psychological effects of exercise
and exercise plus cognitive strategies. Medicine and
Science in Sports and Exercise 1995;27:765-775.
Brownell KD, Stunkard AJ. Physical activity in the devel-
opment and control of obesity. In: Stunkard AJ, editor.
Obesity. Philadelphia: W.B. Saunders, 1980:300-324.
Brownson RC, Chang JC, Davis JR, Smith CA. Physical
activity on the job and cancer in Missouri. American
Journal of Public Health 1991;81:639-642.
Brownson RC, Zahm SH, ChangJC, Blair A. Occupational
risk of colon cancer: an analysis by anatomic subsite.
AmericanJournal oJEpidemiolosy 1989;130:675-687.
Brunner D, Manelis G, Modan M, Levin S. Physical
activity at work and the incidence of myocardial inf-
arction, angina pectoris, and death due to ischemic
heart disease: an epidemiological study in Israeli col-
lective settlements (kibbutzim). Journal of Chronic
Diseases 1974;27:217-233.

Bullen BA, Reed RB, Mayer J. Physical activity of obese
and nonobese adolescent girls appraised by motion
picture sampling. American Jour-nal of Clinical Nutri-
tion 1964;14:211-223.

Camacho TC, Roberts RE, Lazarus NB, Kaplan GA, Cohen
RD. Physical activity and depression: evidence from
the Alameda County Study. AmericanJournal ofEpide-
miology 1991;134:220-231.

Cassel J, Heyden S, Bartel AG, Kaplan BH, Tyroler HA,
CornoniJC,etal. Occupationandphysicalactivityand
coronary heart disease. Archives of Internal Medicine
1971;128:920-928.

152


Cavanaugh DJ? Cann CE. Brisk walking does not stop
bone loss in postmenopausal women. Bone 1988;9:20 l-
204.

Cederholm J, Wibell L. Glucose tolerance and physical
activity in a health survey of middle-aged subjects.
Acta Medica Scandinavica 1985;217:373-378.

Chang-Claude J, Frentzel-Beyme R. Dietary and lifestyle
determinants of mortality among German vegetarians.
InternationalJournaI oJEpidemioIogy 1993;22:228-236.

Chave SPW, Morris JN, Moss S, Semmence ,4M. Vigor-
ous exercise in leisure time and the death rate: a study
of male civil servants. Journal of Epidemiolog)i and
Community Health 1978;32:239-243.

Chen MK, Lowenstein FW. Epidemiology of factors re-
lated to self-reported diabetes among adults. American
Journal ofPreventive Medicine 1986;2:14-19.
Chesnut CH 111. Bone mass and exercise. AmericanJournal
of Medicine 1993;95(5A Suppl):34S-365.

Ching PLYH, Willett WC, Rimm EB, Colditz GA,
Gortmaker SL, Stampfer MJ. Activity level and risk of
overweight in male health professionals. American
Journal of Public Health 1996;86:25-30.
Chow RK, Harrison JE, Brown CF, Hajek V. Physical
fitness effect on bone mass in postmenopausal women.
Archives of Physical Medicine and Rehabilitation
1986;67:231-234.

Chow W-H, DosemeciM, ZhengW,Vetter R, McLaughlin
JK, Gao Y-T, et al. Physical activity and occupational
risk of colon cancer in Shanghai, China. International
Joumal alEpidemiology 1993;22:23-29.

Cohen GC. Cycling injuries. Canadian Family Physician
1993;39:628-632.

Cohen MV. Coronary collaterals: clinical and experimental
observations. Mount Kisco, NY: Futura Publishing
Company, 1985.

Conroy BP, Kraemer WJ, Maresh CM, Fleck SJ, Stone MH,
Fry AC, et al. Bone mineral density in elite junior
Olympic weightlifters. Medicine and Science in Sports
and Exercise 1993;25:1103-1109.

Cordain L, Latin RW, Behnke JJ. The effects of an aerobic
running program on bowel transit time. Journal oj
Sports Medicine and Physical Fitness 1986;26:101-
104.

Cramer SR, Nieman DC, Lee JW. The effects of moderate
exercise training on psychological well-beingand mood
state in women. Journal of Psychosomatic Research
1991;35:437-449.

The Effects of Physical Activity on Health and Disease

Cruz-Vidal M, Costas RJr, Garcia-Palmieri MR. Sorlie PD,
Hertzmark E. Factors related to diabetes mellitus in
Puerto Rican men. Diabetes 1979;28:300-307.

Cumming RG, Klineberg RJ. Case-control study of risk
factors for hip fractures in the elderly. AmericanJournal
of Epidemiology 1994; 139:493-503.
Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epide-
miology of osteoporosis and osteoporotic fractures.
Epidemiological Reviews 1985;7: 178-208.
Cummings SR, Nevitt MC, Browner WS, Stone K, Fox
KM, Ensrud KE, et al. Risk factors for hip fracture in
white women. New England Journal of Mcdicinc
1995;332:767-773. '

Dalsky GP, Stocke KS, Ehsani AA, Slatopolsky E, Lee WC,
Birge SJ, Weight-bearing exercise training and lumbar
bone mineral content in postmenopausal women. An-
nals of Internal Medicine 1988;108:824-828.
Dannenberg AL, Keller JB, Wilson PWF, Castelli WP.
Leisure-time physical activity in the Framingham Off-
spring Study: description, seasonal variation, and risk
factor correlates. American Journal of Epidemioloa
1989;129:76-88.

Davies MJ, Thomas AC. Plaque fissuring: the cause of
acute myocardial infarction, sudden ischaemic death,
and crescendo angina. British Heart Journal 1985;53:
363-373.

Dawson AK, Leon AS, Taylor HL. Effect of submaximal
exercise on vulnerability to fibrillation in the canine
ventricle. Circulation 1979;60:798-804.
DeBusk RF, Stenestrand U, Sheehan M, Haskell WL.
Training effects of long versus short bouts of exercise
in healthy subjects. American Journal of Cardiology
1990;65:1010-1013.

Despres J-P, Tremblay A, Nadeau A, Bouchard C. Physical
training and changes in regional adipose tissue distri-
bution. Acta Medica Scandinavica Supplementurn
1988;723:205-212.

DeVries HA. Tranquilizer effect of exercise: a critical
review. Physician and Sportsmedicine 1981;9:47-55.
DeVries HA, Adams GM. Electromyographic comparison
of single doses of exercise and meprobamate as to
effects on muscular relaxation. American Journal OI
Physical Medicine 1972;51:130-141.
DiPietro L. Physical activity, body weight, and adiposity:
an epidemiologic perspective. Exercise and Sport Sci-
ences Reviews 1995;23:275-303.

153


Physical Activity and Health

Dishman RK. Mental health. In: Seefeldt V, editor. Pltysi-
cal uctivity and well-being. Reston, VA: American Alli-
ance for Health, Physical Education, Recreation and
Dance, 1986:304-341.

Donahue RP, Abbott RD. Reed DM, Yano K. Physical
activity and coronary heart disease in middle-aged and
elderly men: the Honolulu Heart Program. American
Journal of Public Hcaltl~ 1988;78:683-685.

Donaldson CL, Hulley SB, Vogel JM, Hattner RS. Bayers
JH, McMillan DE. Effect of prolonged bed rest on bone
mineral. Metabolism Clinical and Experimental
1970;19:1071-1084.

Dorgan JF, Brown C, Barrett M, Splansky GL, Kreger BE,
D'Agostino RB, et al. Physical activity and risk of breast
cancer in the Framingham Heart Study. AmericanJour-
nal oJ Epidorniology 1994;139:662-669.

Dosemeci M, Hayes RB, Vetter R, Hoover RN, Tucker M,
Engin K, et al. Occupational physical activity, socio-
economic status, and risks oll5 cancer sites in Turkey.
Cancer Causes and Control 1993;4:313-321.

Dowse GK, Zimmet PZ, Gareeboo H, Alberti KGMM,
Tuomilehto J, Finch CF. et al. Abdominal obesity and
phystcal inactivity as risk factors for NIDDM and
impaired glucose tolerance in Indian, Creole, and
Chinese Mauritians. Diabetes Care 1991;14:271-282.

Doyne EJ, Ossip-Klein DJ, Bowman ED, Osborn KM,
McDougall-Wilson LB, Neimeyer RA. Running versus
weight lifting in the treatment of depression.Journal oJ
Consulting cmd Clinical Psyclwlogy 1987;55:748-754.

Drinkwater BL. Exercise in the prevention of osteoporo-
sis. Osteoporosis International 1993;1:S169-5171.

Drinkwater BL, Nilson K, Chesnut CH 111, Bremner WJ,
Shainholtz S, Southworth MB. Bone mineralcontent of
amenorrheic and eumenorrheic athletes. New England
Journal oJMedicinc 1984;311:277-281.

Duncan JJ, Gordon NF, Scott CB. Women walking for
health and fitness: how much is enough? Journal ofthe
American Medical Association 1991;266:3295-3299.

Dunn JE, Rudberg MA, Furner SE, Cassel CK. Mortality,
disability, and falls in older persons: the role of under-
lying disease and disability. AmericanJotirnal ofPublic
Health 1992;82:395-400.

Durstine JL. Haskell WL. Effects of exercise training on
plasma lipids and lipoproteins. Exercise and Sport Sci-
ences Reviews 1994;22:477-521.

Dustman RE, Emmerson R, Shearer D. Physical activity,
age, and cognitive-neuropsychological function.Jour-
nal of Aging and Physical Activity 1994;2: 143-181.

Dyer RG. Traditional treatment of obesity: does it work?
Baillieres Clinical Endocrinology and Metabolism
1994;8:661-688.

Ebisu T. Splitting the distance of endurance running: on
cardiovascular endurance and blood lipids. Japanese
Journal of Physical Education 1985;30:37-43.

Ekelund LG, Haskell WL, Johnson JL, Whaley FS, Criqui
MH, Sheps DS. Physical fitness as a predictor of cardio-
vascular mortality in asymptomatic North American
men: the Lipid Research Clinics Mortality Follow-up
Study.NewEnglandJoumalofMedicine 1988;319:1379-
1384.

England AC III, Fraser DW, Hightowe; AW, Tirinnanzi
R, Greenberg DJ, Powell KE, et al. Preventing severe
heat injury in runners: suggestions from the 1979
Peachtree Road Race experience. Annals of lntemaJ
Medicine 1982;97:196-201.

Epstein LH, Wing RR. Aerobic exercise and weight.
Addictive Behaviors 1980;5:371-388.

Erikssen J. Physical fitness and coronary heart disease
morbidity and mortality: a prospective study in appar-
ently healthy, middle-aged men. Acta Medica
Scandinavica Supplementurn 1986;711:189-192.

Eriksson K-F, Lindgarde F. Prevention of type 2 (non-
insulin-dependent) diabetes mellitus by diet and physi-
cal exercise. Diabetologia 1991;34:891-898.

Ettinger WH Jr, Afable RF:. Physical disability from knee
osteoarthritis: the role of exercise as an intervention.
Medicine and Science in Sports and Exercise 1994;26:
1435-1440.

Ewart CK. Psychological effects of resistive weight train-
ing: implications for cardiac patients. Medicine and
Science in Sports and Exercise 1989;21:683-688.

Ewbank PP, Darga LL, Lucas CP. Physical activity as a
predictor of weight maintenance in previously obese
subjects. Obesity Research 1995;3:257-263.

Fagard R, Bielen E, Hespel P, Lijnen P, StaessenJ, Vanhees
L, et al. Physical exercise in hypertension. In: Laragh
JH, Brenner BM, editors. Hypertension: pathophysiol-
ogy, diagnosis, and management. Vol. 2. New York:
Raven Press, 1990:1985-1998.

Falk E. Unstable angina with fatal outcome: dynamic
coronary thrombosis leading to infarction and/or
sudden death: autopsy evidence of recurrent mural
thrombosis with peripheral embolization culminat-
ing in total vascular occlusion. Circulation
1985;71:699-708.

154


The Effects of Physical Activity on Health and Disease

Farmer ME, Harris T, Madans JH, Wallace RB, Cornoni-
Huntley J, White LR. Anthropometric indicators and
hip fracture: the NHANES I Epidemiologic Follow-up
Study. Journal of the American Geriatrics Society
1989;37:9-16.

Farmer ME, Locke BZ, Moscicki EK, Dannenberg AL,
Larson DB, Radloff LS. Physical activity and depressive
symptoms: the NHANES I Epidemiologic Follow-up
Study.AmericanJoumalofEpidemiology 1988;128: 1340-
1351.

Fechner-Bates S, Coyne JC, Schwenk TL. The relation-
ship of self-reported distress to depressive disorders
and other psychopathology. journal of Consulting and
Clinical Psychology 1994;62:550-559.

Federation of American Societies for Experimental Biol-
ogy, Life Sciences Research Office. Third report on
nutrition monitoring in the United States. Vol. 1. Wash-
ington, DC: Interagency Board for Nutrition Monitor-
ing and Related Research, 1995:211-219.
Feskens EJ, Loeber JG, Kromhout D. Diet and physical
activity as determinants of hyperinsulinemia: the
Zutphen Elderly Study. American Journal ofEpidemiol-
og-y 1994;140:350-360.

Fiatarone MA, O'Neill EF, Ryan ND, Clements KM, Solares
GR, Nelson ME, et al. Exercise training and nutritional
supplementation for physical frailty in very elderly
people. New England Journal of Medicine 1994;330:
1769-1775.

Fisch A, Pichard E, Prazuck T, Leblanc H, Sidibe Y,
Briicker G. Prevalence and risk factors of diabetes
mellitus in the rural region of Mali (West Africa): a
practical approach. Diabetologia 1987;30:859-862.

Fisher NM, Gresham GE, Abrams M, Hicks J, Horrigan D,
Pendergast DR. Quantitativeeffectsofphysical therapy
on muscular and functional performance in subjects
with osteoarthritis of the knees. Archives of Physical
Medicine and Rehabilitation 1993;74:840-847.

Fisher NM, Kame VD Jr, Rouse L, Pendergast DR. Quan-
titative evaluation of a home exercise program on
muscle and functional capacity of patients with OS-
teoarthritis. AmericanJournal of Physical Medicine and
Rehabilitation 1994;73:413-420:

Fisher NM, Pendergast DR. Effects of a muscle exercise
program on exercise capacity in subjects with osteoar-
thritis. Archives ofPhysical Medicine and Rehabilitation
1994;75:792-797.

Fisher NM, Pendergast DR, Gresham GE, Calkins E.
Muscle rehabilitation: its effect on muscular and func-
tional performance of patients with knee osteoarthri-
tis. Archives o/ Physical Medicine and Rehabilitation
1991;72:367-374.

Folsom AR, Caspersen CJ, Taylor HL, Jacobs DR Jr,
Luepker RV, Gomez-Marin 0, etal. Leisure-time physi-
cal activity and its relationship to coronary risk factors
in a population-based sample: the Minnesota Heart
Survey. American Journal of Epidemiology 1985;121:
570-579.

Folsom AR, Prineas RJ, Kaye SA, Munger RG. Incidence
of hypertension and stroke in relation to body fat
distribution and other risk factors in older women.
Stroke 1990;21:701-706.

Fraser G, Pearce N. Occupational physical activity and
risk of cancer of the colon and rectum in New Zealand
males. Cancer Causes and Control 1993;4:45-50.

Fredriksson M, Bengtsson NO, Hardell L, Axelson 0.
Colon cancer, physical activity, and occupational expo-
sures: a case-controlstudy. Cancer 1989;63:1838-1842.

French SA, Jeffery RW, Forster JL, McGovern PG, Kelder
SH, Baxter JE. Predictors of weight change over two
years among a population of working adults: the Healthy
Worker Project. International Journal of Obesity
1994;18:145-154.

Friedenreich CM, Rohan TE. Physical activity and risk of
breast cancer. European Journal of Cancer Prevention
1995;4:145-151.

Frisch RE, Wyshak G, Albright NL, Albright TE, Schiff 1,
Jones KP, et al. Lower prevalence of breast cancer and
cancers of the reproductive system among former
college athletes compared to nonathletes. BritishJour-
nal of Cancer 1985;52:885-891.

Frisch RE, Wyshak G, Albright NL, Albright TE, Schiff I,
Witschi J, et al. Lower lifetime occurrence of breast
cancer and cancers of the reproductive system among
former college athletes. American Journal of Clinical
Nutrition 1987;45:328-335.

Frisch RE, Wyshak G, Albright TE, Albright NL, Schiff 1.
Lower prevalence of diabetes in female former college
athletes compared with nonathletes. Diabetes
1986;35:1101-1105.

Frizzell RT, Lang GH, Lowance DC, Lathan SR. Hy-
ponatremia and ultra-marathon running.Journal olthe
American Medical Association 1986:255:772-774.

155


Physical Activity and Health

Garabrant DH, Peters JM, Mack TM, Bernstein L. Job
activity and colon cancer risk. American Journal of
Epidemiology 1984;119:1005-1014.
Garcia-Palmieri MR, Costas RJr, Cruz-Vidal M, Sorlie PD,
Havlik RJ. Increased physical activity: a protective
factor against heart attacks in Puerto Rico. American
Journal of Cardiology 1982;50:749-755.
Garfinkel L. Stellman SD. Mortality by relative weight and
exercise. Cancer 1988;62: 1844-1850.

Garn SM, Leonard WR, Hawthorne VM. Three limitations
of the body mass index. American Journal of CIinicaf
Nutrition 1986;44:996-997.

Gerhardsson M, Steineck G, Hagman U, Rieger A, Norell
SE. Physical activity and colon cancer: a case-referent
study in Stockholm. International Journal of Cancer
1990;46:985-989.

Gerhardsson M, Floderus B, Norell SE. Physical activity
and colon cancer risk. InternationalJournaI ofEpidemi-
ology 1988;17:743-746.

Gerhardsson M. Norell SE, Kiviranta H, Pederson NL,
Ahlbom A. Sedentary jobs and colon cancer. American
Journal of Epidemiology 1986;123:775-780.

Getz GS. The involvement of lipoproteins in atherogen-
esis: evolving concepts. Annals of the New York Acad-
emy of Sciences 1990;598: 17-28.

Gibbons LW, Blair SN, Cooper KH, Smith M. Association
between coronary heart disease risk factors and physi-
cal fitness in healthy adult women. Cir-culation
1983;67:977-983.

Gilligan C, Checovich MM, Smith EL. Osteoporosis. In:
SkinnerJS,editor. Excrcisctcstingandexerciseprcscrip-
tionfor special cases: theoretical basis and clinical appli-
cation. 2nd ed. Philadelphia: Lea and Febiger, 1993:
127-137.

Gillum RF. Trends in acute myocardial infarction and
coronary heart disease death in the United States.
Jour.nal oJ(hc American Collcgc of Cardiology 1994;23:
1273-1277.

Giovannucci E, Ascherio A, Rimm EB, Colditz GA,
Stampfer M. Willett WC. Physical activity, obesity, and
risk for colon cancer and adenoma in men. Annals of
Internal Medicine 1995;122:327-334.

Goldberg AP. Aerobic and resistive exercise modify risk
factors for coronary heart disease. Mcdicinc and Science
in Sports and Exercise 1989:21:669-674.

Gordon NF, Scott CB. The role of exercise in the primary
and secondary prevention of coronary artery disease.
Clinics in Sports Medicine 1991;10:87-103.
Grimston SK, Willows ND, Hanley DA. Mechanical load-
ing regime and its relationship to bone mineral density
in children. Medicine and Science in Sports and Exercise
1993;25:1203-1210.

Grodzinsky AJ. Age-related changes in cartilage: physical
properties and cellular response to loading. In:
Buckwalter JA, Goldberg VM, Woo SLY, editors. Mus-
culoskefetal soft-tissue aging: impact on mobility.
Rosemont, IL: American Academy of Orthopedic Sur-
geons, 1993:137-149.

Gudat U, Berger M, Lefebvre PJ. Phyiical activity, fitness,
and non-insulin-dependent (type 11) diabetes melli-
tus. In: Bouchard C, Shephard RJ, Stephens T, editors.
Physical activity, fitness, and health: international pro-
ceedings and consensus statement. Champaign, IL: Hu-
man Kinetics, 1994:669-683.

Hagberg JM, Montain SJ, Martin WH III, Ehsani AA.
Effect of exercise training in 60- to 69-year-old per-
sons with essential hypertension. AmericanJournal of
Cardiology 1989;64:348-353.

Hahn RA, Teutsch SM, Rothenberg RB, Marks JS. Excess
deaths from nine chronic diseases in the United States,
1986. Journal of the American Medical Association
1990;264:2654-2659.

Hall AC, Urban JPG, Gehl KA. The effects of hydrostatic
pressure on matrix synthesis in articular cartilage.
Journal oforthopaedic Research 1991;9:1-10.

Hambrecht R, Niebauer J, Marburger C, Grunze M,
Kalberer B, Hauer K, et al. Various intensities of
leisure-time physical activity in patients with coronary
artery disease: effects on cardiorespiratory fitness and
progression of coronary atherosclerotic lesions.Jour-
nal ofthe American College ofCardiology 1993;22:468-
  477.

Hara H, Kawase T, Yamakido M, Nishimoto Y. Compara-
tive observation of micro- and macroangiopathies in
Japanese diabetics in Japan and U.S.A. In: Abe H,
Hoshi M, editors. Diabetic microangiopathy. Basel:
Karger, 1983.

Harmsen P, Rosengren A, Tsipogianni A, Wilhelmsen L.
Risk factors for stroke in middle-aged men in Gtiteborg,
Sweden. Stroke 1990;21:223-229.

156


The Effects of Physical Activity on Health and Disease

jarris MI. Classification, diagnostic criteria, and screen-
ing for diabetes. In: Harris MI, Cowie CC, Stern MP,
Boyko EJ, Reiber GE, Bennett PH, editors. Diabetes in
America. Bethesda, MD: National Institutes of Health,
National Institute of Diabetes and Digestive and Kid-
ney Diseases, 1995:15-36. NIH Publication NO. 95-
1468.

Harris MI. Epidemiological correlates of NIDDM in His-
panics, whites, and blacks in the U.S. population.
Diabetes Care 1991;14(Suppl 3):639-648.

Harris MI, Hadden WC, Knowler WC, Bennett PH. Preva-
lence of diabetes and impaired glucose tolerance and
plasma glucose levels in U.S. population aged 20-74
yr. Diabetes 1987;36:523-534.
Harrison GG. Height-weight Tables. Annals of Internal
Medicine 1985;103(Suppl 6, Pt 2):989-994.

Haskell WL. Physical activity in the prevention and man-
agement of coronary heart disease. Physical Activity
and Fitness Research 1995;Series 2:1-7.

Haskell WL, Alderman EL, Fair JM, Maron DJ, Mackey
SF, Superko HR, et al. Effects of intensive multiple risk
factor reduction on coronary atherosclerosis and clini-
cal cardiac events in men and women with coronary
artery disease: the Stanford Coronary Risk Interven-
tion Project (SCRIP). Circulation 1994;89:975-990.

Hein HO, Suadicani P, Gyntelberg F. Physical fitness or
physical activity as a predictor of ischaemic heart
disease: a 17-year follow-up in the Copenhagen Malt
Study.]ournal ofInternal Medicine 1992;232:471-479.

Heinonen A, Oja P, Kannus P, Sievanen H, Haapasalo H,
Manttari A, Vuori 1. Bone mineral density in female
athletes representing sports with different loading char-
acteristics of the skeleton. Bone 1995;17:197-203.

Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr.
Physical activity and reduced occurrence of non-
insulin-dependent diabetesmellitus. New Englandjour-
nal ofMedicine 1991;325:147-152.

Herman B, Schmitz PIM, Leyten ACM, Van Luijk JH,
Frenken CWGM, Opde Coul AAW, et al. Multivariate
logistic analysis of risk factors for stroke in Tilburg,
The Netherlands. American journal of Epidemiology
1983;118:514-525.

Hill AB. The environment and disease: association or
causation? Proceedings of the Royal Society of Medicine
1965;58:295-300.

Hill JO, Drougas HJ, Peters JC. Physical activity, fitness,
and moderate obesity. In: Bouchard C, Shephard RJ.
StephensT, editors. Physical activity,fitness, and health:
international proceedings and consensus statement.
Champaign, IL: Human Kinetics, 1994:684-695.
Hoeberigs JH. Factors related to the incidence of running
injuries: a review. Sports Medicine 1992;13:408-422.
Holbrook TL, Barrett-Connor E, Wingard DL. The asso-
ciation of lifetime weight and weight control patterns
with diabetes among men and women in an adult
community. International Journal of Obesity 1989;13:
723-729.               .

Hollenbeck CB, Haskell W, Rosenthal M, Reaven GM.
Effect of habitual physical activity on regulation of
insulin-stimulated glucose disposal in older males.
Journal ofthe American Geriatrics Society 1984;33:273-
277.

Holloszy JO, Schultz J, Kusnierkiewicz J, Hagberg JM,
Ehsani AA. Effects of exercise on glucose tolerance and
insulin resistance: brief review and some preliminary
results. Acta Medica Scandinavica Suppfementum
1986;711:55-65.

Holman H, Mazonson P, Lorig K. Health education for
self-management has significant early and sustained
benefits in chronic arthritis. Transactions of the ASSO-
ciation ofAmerican Physicians 1989;102:204-208.
Horton ES. Exercise and decreased risk of NIDDM. New
Englandjournal @Medicine 1991;325:196-198.
Howell DW. Musculoskeletal profile and incidence of
musculoskeletal injuries in lightweight women rowers.
American]ournal ofSports Medicine 1984;12:278-282.
Hubert HB, Feinleib M, McNamara PM, Castelli WP.
Obesity as an independent risk factor for cardiovascu-
lar disease: a 26-year follow-up of participants in the
Framingham Heart Study. Circulation 1983;67:968-
  977.

Hughes JR, Casal DC, Leon AS. Psychological effects of
exercise: a randomized cross-over trial.Joumal of Psy-
chosomatic Research 1986;30:355-360.

Jacobson PC, Beaver W, Grubb SA, Taft TN, Talmage RV.
Bone density in women: college athletes and older
athletic women. Journal o/ Orthopaedic Research
1984;2:328-332.

Jaglal SB, Kreiger N, Darlington G. Past and recent physi-
cal activity and risk of hip fracture. AmericanJollma101
Epidemiology 1993;138:107-118.

157


Physical Activity and Health

Jakicic JM, Wing RR, Butler BA, Robertson RJ. Prescribing
exercise in multiple short bouts versus one continuous
bout: effects on adherence, cardiorespiratory fitness,
and weight loss in overweight women. Internationaf
Joumaf of Obesity 1995;19:893-901.
Jarcbinski M, Adanja B, Vlajinac H. Case-control study of
relationship of some biosocial correlates to rectal can-
cer patients in Belgrade, Yugoslavia. Neoplasma 1989;36:
  369-374.

Jarrett RJ, Shipley MJ, Hunt R. Physical activity, glucose
tolerance, and diabetes mellitus: the Whitehall Study.
Dinbclic Mcdirinc 1986;3:549-551.

Johansson 5. Rosengren A, Tsipogianni A, Ulvenstam G,
Wiklund 1, Wilhelmsen L. Physical inactivity as a risk
factor for primary and secondary coronary events in
Gateborg, Sweden. Europcan Heart Journal 1988;9
(Suppl L):8-19.

JohnsonJE, Sim FH, Scott SG. Musculoskeletal injuries in
competitive swimmers. Mayo Clinic Proceedings 1987;
62:289-304.

Johnson ML, Burke BS. Mayer J. Relative importance of
inactivity and overeating in the energy balance of obese
high school girls. AmericanJournal o/Clinical Nutrition
1956;4:37-44.

Johnston FE. Health implications of childhood obesity.
Annals of Internal Mcdicinc 1985;103 (Suppl 6, Pt 2):
  1068-1072.

Jones BH, Cowan DN, Knapik JJ. Exercise, training, and
injuries. Sports Mcdicinc 1994;18:202-214.
Jorgensen CR. Gobel FL, Taylor HL, Wang Y. Myocardial
blood flow and oxygen consumption during exercise.
Anna/s ofthc New Yorh Academy ofSciences 1977;301:
  213-223.

Kahn HA. The relationship of reported coronary heart
disease mortality to physical activity of work. American
Journal o/Pubfic Health 1963;53:1058-1067.

Kamien M. A rational management of tennis elbow. Spot%
Medicine 1990;9:173-191.

Kannel WB, Belanger A, D'Agostino R, Israel 1. Physical
activity and physical demand on the job and risk of
cardiovascular disease and death: the Framingham
study. American Heart Joutmaf 1986;112:820-825.

Kannel WB, Sorlie P. Some health benefits of physical
activity: the Framingham study. Archives of Internal
Medicine 1979;139:857-861.

KaplanGA,SeemanTE, Cohen RD, Knudsen LP, Guralnik
J. Mortality among the elderly in the Alameda County
Study: behavioral and demographic risk factors. Ameri-
canJoumaf of Public Health 1987;77:307-312.
Kaplan RM, Bush JW. Health-related quality of life mea-
surement for evaluation research and policy analysis.
Health Psychology 1982;1:61-80.
Kato I, Tominaga S, lkari A. A case-control study of male
colorectal cancer in Aichi Prefecture, Japan: with spe-
cial reference to occupational activity level, drinking
habits, and family history. JapaneseJournal of Cancer
Research 1990;81:115-121.

Kawate R, Yamakido M, Nishimoto Y, Bennett PH,
Hamman RF, Knowler WC. Diabeies mellitus and its
vascular complications in Japanese migrants on the
island of Hawaii. Diaberes Cure 1979;2:161-170.

Kaye SA, Folsom AR, Prineas RJ, Potter JD, Gapstur SM.
The association of body fat distribution with lifestyle
and reproductive factors in a population study of
premenopausal women. International Journal of Obe-
sity 1990;14:583-591.

Kaye SA, Folsom AR, Sprafka JM, Prineas RJ, Wallace RB.
Increased incidence of diabetes mellitus in relation to
abdominal adiposity in older women.Joumaf ofcfini-
caf Epidemiology 1991;44:329-334.
Kayman 5, Bruvold W, Stern JS. Maintenance and relapse
after weight loss in women: behavioral aspects. Ameri-
canJournal of Clinical Nutrition 1990;52:800-807.

Kelley G, McClellan P. Antihypertensive effects ofaerobic
exercise: a brief meta-analytic review of randomized
controlled trials. American Journal of Hypertension
1994;7: 115-l 19.

Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes
M, Eshleman S, et al. Lifetime and 12-month preva-
lence of DSM-III-R psychiatric disorders in the United
States: results from the National Comorbidity Survey.
Archives of Generaf Psychiatry 1994;51:8-19.

Kiely DK, Wolf PA, Cupples LA, Beiser AS, Kannel WB.
Physical activity and stroke risk: the Framingham
study. AmericanJournal ofEpidemiology 1994;140:608-
620.

King AC, Taylor CB, Haskell WL. Effects of differing
intensities and formats of 12 months of exercise train-
ing on psychological outcomes in older adults. Health
Psychology 1993;12:292-300.

158


King AC, Taylor CB, Haskell WL, DeBusk RF. Influence of
regular aerobic exercise on psychological health: a
randomized, controlled trial of healthy middle-aged
adults. He&h Psychology 1989;8:305-324.

King H, Kriska AM. Prevention of type II diabetes by
physical training: epidemiology considerations and
study methods. Diabetes Care 1992;15:1794-1799.

King H, Taylor R, Zimmet P, Pargeter K, Raper LR, Berike
T, et al. Non-insulin-dependent diabetes mellitus
(NIDDM) in a newly independent Pacific nation: The
Republic of Kiribati. Diabetes Care 1984;7:409-415.

King H, Zimmet P, Raper LR, Balkau B. Risk factors for
diabetes in three Pacific populations. AmericanJournal
of Epidemiology 1984;119:396-409.

Kirchner EM, Lewis RD. O'Connor PJ. Effect of past
gymnastics participation on adult bone mass.Journal of
Applied Physiology 1996;80:225-232.

Klein MH, Greist JH, Gurman AS, Neimeyer RA, Lesser
DP, Bushnell NJ, et al. A comparative outcome study of
group psychotherapy vs exercise treatments for depres-
sion. International Journal of Mental Health 1985;13:
14&177.

Klesges RC, Klesges LM, Eck LH, Shelton ML. A longitu-
dinal analysis of accelerated weight gain in preschool
children. Pediatrics 1995;95:126-130.

Klesges RC, Klesges LM, Haddock CK, Eck LH. A longitu-
dinal analysis of the impact of dietary intake and
physical activity on weight change in adults. American
Journal ofclinical Nutrition 1992;55:818-822.

Kohl HW III, Powell KE, Gordon NF,Blair SN, Paffenbarger
RS Jr. Physical activity, physical fitness, and sudden
cardiac death. Epidemiologic Reviews 1992;14:37-58.

Kohrt WM, Snead DB, Slatopolsky E, Birge SJ Jr. Additive
effects ofweight-bearing exercise and estrogen on bone
mineral density in older women. Journal of Bone and
Mineral Research 1995;10:1303-1311.

Koivisto VA, Soman V, Conrad P, Hendler R, Nadel E,
Felig P. Insulin binding to monocytes in trained ath-
letes: changes in the resting state and after exercise.
Journal of Clinical Investigation 1979;64:101 l-1015.
Koivisto VA,Yki-Jtirvinen H, DeFronzo c. Physical train-
ing and insulin sensitivity. Diabetes/Metabolism Re-
views 1986;1:445-481.

Kokkinos PF, Hurley BF, Vaccaro P, Patterson JC, Gardner
LB, Ostrove SM, et al. Effects of low- and high-repeti-
tion resistive training on lipoprotein-lipid profiles.
Medicine and Science in Sports and Exercise 1988;20:50-
54.

Kono S, Shinchi K, Ikeda N, Yanai F, Imanishi K. Physical
activity, dietary habits, and adenomatous polyps of the
sigmoid colon: a study of self-defense officials in Japan.
Journal ofclinical Epidemiology 1991;44:1255-1261.
Koplan JP. Cardiovascular deaths while running. JoumaI of
the American Medical Association 1979;242:2578-2579.

Koplan JP, Powell KE, Sikes RK, Shirley RW, Campbell
CC. An epidemiologic study of the benefits and risks of
running. Journal of the American Medical Association
1982;248:3118-3121.

Krall LP, Beaser RS. Joslin diabetes manual. 12th ed.
Philadelphia: Lea and Febiger, 1989.
Kramsch DM, Aspen AJ, Abramowitz BM, Kreimendahl
T, Hood WI3 Jr. Reduction of coronary atherosclerosis
by moderate conditioning exercise in monkeys on an
atherogenic diet. New England Journal of Medicine
1981;305:1483-1489.

Kraus JF, Conroy C. Mortality and morbidity from inju-
ries in sports and recreation. Annual Review of Public
Health 1984;5:163-192.

Kriska AM, Bennett PH. An epidemiological perspective
of the relationship between physical activity and
NIDDM: from activity assessment to intervention.
Diabetes/Metabolism Reviews 1992;8:355-372.

Kriska AM, Blair SN, Pereira MA. The potential role of
physical activity in the prevention of noninsulin-
dependent diabetes mellitus: the epidemiological evi-
dence. Exercise and Sport Sciences Reviews 1994;
22:121-143.

Kriska AM, Gregg EW, Utter AC, Knowler WC, Narayan
V, Bennett PH. Association of physical activity and
plasma insulin levels in a population at high risk for
NIDDM. Medicine and Science in Sports and Exercisf
1993;26(5 Suppl):SlZl.

Kriska AM, LaPorte RE, Pettitt DJ, Charles MA, Nelson
RG, Kuller LH, et al. The association of physical activ-
ity with obesity, fat distribution, and glucose intoler-
ance in Pima Indians. Diabetofogia 1993;36:863-869.
Krolner B, Toft B, Pors Nielsen 5, Tsndevold E. Physical
exercise as prophylaxis against involutional vertebral
bone loss: a controlled trial. Clinical Science 1983;
64:541-546.

Krotkiewski M. Can body fat patterning be changed? Actu
MedicaScandinavicuSupplementum 1988;723:213-223.
Krotkiewski M. Physical training in the prophylaxis and
treatment of obesity, hypertension, and diabetes. Scun-
dinavian Journal of Rehabilitation Medicine Supplement
1983;9:55-70.

The Effects of Physical Activity on Health and Disease

159


Physical Activity and Health

Krummel D, Etherton TD, Peterson S, Kris-Etherton PM.
Effects of exercise on plasma lipids and lipoproteins of
women. Proceedings of the Society for Experimental
Biology and Medicine 1993;204:123-137.

Ku LC, Shapiro LR, Crawford PB, Huenemann RL. Body
composition and physical activity in 8-year-old
children. American Journal of Clinical Nutrition 1981;
34:2770-2775.

Kuczmarski RJ. Prevalence ofoverweight and weight gain
in the United States. AmericanJournal ofClinical Nutri-
tion 1992;55:495S-5025.

Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL.
Increasing prevalence of overweight among US adults:
the National Health and Nutrition Examination Sur-
veys, 1960 to 1991. Journal of the American Medical
Association 1994;272:205-211,

Kuipers H. Exercise-induced muscle damage. Intcma-
tional Journal of Sports Medicine 1994;15:132-135.

Kujala UM, Kaprio J, Sarna S. Osteoarthritis of weight-
bearing joints of lower limbs in former elite male
athletes. Brirish Medical Journal 1994;308:231-234.

Kujala UM, Kettuncn J, Paananen H, Aalto T, Battie MC,
Impivaara 0, et al. Knee osteoarthritis in former
runners, soccer players, weight lifters, and shooters.
Arthritis and Rheumatism 1995;38:539-546.

Kune GA, Kune S, Watson LF. Body weight and physical
activity as predictors of colorectal cancer risk. Nutri-
tion and Cancer 1990;13:9-17.

LaCroix AZ, Leveille SG, Hecht JA, Grothaus LC, Wagner
EH. Does walking decrease the risk of cardiovascular
disease hospitalizations and death in older adults?Jour-
nuf ofthe American Geriatrics Society 1996;34: 113-120.

LaFontaineTP, DiLorenzoTM. Frensch PA, Stucky-Ropp
RC, Bargman EP, McDonald DG. Aerobic exercise and
mood: a brief review, 1985-1990. Sports IMedicine
1992;13:160-170,

Lai J-S, Lan C, Wong M-K, Teng S-H. Two-year trends in
cardiorespirator) function among older Tai Chi Chuan
practitioners and sedentary subjects. Jou~-naf of the
American Gcriatl-its Society 1995;43:1222-1227.
Lammi M. [nf7ucnccs of in viva and in vitro loading on the
protcoglycan synthcscs ofnrricrrlarcnrtilugcchondrocq'tes.
Kuopio. Finland: Kuopio University, 1993.

Lampman RM, Schteingart DE. Effects of exercise train-
ing on glucose control, lipid metabolism, and insulin
sensitivity in hypertrlglyceridemia and non-insulin-
dependent diabetes mellitus. Medicine and Science in
Spa?-ts and Escrcise 1991;23:703-712.

Landers DM, Petruzzello SJ. Physical activity, fitness, and
anxiety. In: Bouchard C, Shephard RJ, Stephens T,
editors. Physical activity, fitness, and health: interna-
tional proceedings and consensus statement. Champaign,
IL: Human Kinetics, 1994:868-882.

Lane NE. Exercise: a cause of osteoarthritis. ]oumd O/
Rheumatology 1995;22 (Suppl 43):3-6.

Lane NE, Bloch DA, Jones HH, Marshall WH, Wood PD,
Fries JF. Long-distance running, bone density, and
osteoarthritis. Journal ofthe American Medical Associa-
tion 1986;255:1147-1151.

Lane NE, Michel 8, Bjorkengren A, OehlertJ, Shi H, Bloch
DA, et al. The risk of osteoarthritis with running and
aging: a 5-year longitudinal study. Journal ofliheuma-
tology 1993;20:461-468.

Lanyon LE. Functional strain in bone tissue as an objec-
tive, and controlling stimulus for adaptive bone re-
modelling.JoumulofBiomechnnics 1987;20:1083-1093.

Lanyon LE. Osteocytes, strain detection, bone modeling
and remodeling. Culcijied Tissue International 1993;53
(1 Suppl):S102-S107.

Lanyon LE. Using functional loading to influence bone
mass and architecture: objectives, mechanisms, and
relationship with estrogen of the mechanically adap-
tive process in bone. Bone 1996;18(1 Suppl):37S-43s.
Lapidus L, Bengtsson C. Socioeconomic factors and physi-
cal activity in relation to cardiovascular disease and
death: a 12-year follow-up of participants in a popula-
tion study of women in Gothenburg, Sweden. British
HcurtJournal 1986;55:295-301.

LaPorte RE, CauleyJA, Kinsey CM, CorbettW, Robertson
R, Black-Sandler R, et al. The epidemiology of physical
activity in children, college students, middle-aged men,
menopausal females, and monkeys.Journal of Chronic
Discascs 1982;35:787-795.

Laughlin MH. Effects of exercise training on coronary
circulation: introduction. Medicine and Science in Sports
and Exercise 1994;26: 1226-1229.

Le Marchand 1, Kolonel LN, Yoshizawa CN. Lifetime
occupational physical activity and prostate cancer risk.
ArnericunJournul of Epidemiology 1991;133:103-111.

Lee I-M. Physical activity, fitnesqandcancer. In: Bouchard
C, Shephard RJ, Stephens T, editors. Physical activity,
fitness, and health: international proceedings and consen-
sus statement. Champaign, IL: Human Kinetics,
1994:814-831.

160


The Effects of Physical Activity on Health and Disease

Lee I-M, Manson JE, Hennekens CH, Paffenbarger RS Jr.
Body weight and mortality: a 27-year follow-up of
middle-aged men. Joumaf of the American Medical
Association 1993;270:2823-2828.

Lee I-M, Paffenbarger RS Jr, Hsieh C-C. Physical activity
and risk of developing colorectal cancer among college
alumni. Journal of the National Cancer Institute
1991;83:1324-1329.

Lee I-M, Paffenbarger RS Jr, Hsieh C-C. Physical activity
and risk of prostatic cancer among college alumni.
AmericanJournal of Epidemiology 1992;135:169-179.

LeeJ, Lauer RM, Clarke WR. Lipoproteins in the progeny
of young men with coronary artery disease: children
with increased risk. Pediatrics 1986;78:330-337.

Leibel RL, Rosenbaum M, Hirsch J. Changes in energy
expenditure resulting from altered body weight. New
EnglandJournal of Medicine 1995;332:621-628.
Lennon D, Nagle F, Stratman F, Shrago E, Dennis S. Diet
and exercise training effects on resting metabolic rate.
International Journal of Obesity 1985;9:39-47.

Lennox SS, Bedell JR, Stone AA. The effect of exercise on
normal mood. Journal of Psychosomatic Research
1990;34:629-636.

Leon AS. Effects of exercise conditioning on physiologic
precursors of coronary heart disease. Journal of Car-
diopulmonary Rehabilitation 1991a;11:46-57.
Leon AS. Patients with diabetes mellitus. In: Franklin BA,
Gordon 5, Timmis GC, editors. Exercise in modern
medicine. Baltimore: Williams and Wilkins, 1989: 118-
  145.

Leon AS. Physical activity and risk of ischemic heart
disease: an update, 1990. In: Oja P, Telama R, editors.
Spot-tfor all. New York: Elsevier, 1991b:251-64.

Leon AS. Recent advances in the management of hyper-
tension. Journal of Cardiopulmonary Rehabilitation
1991c;l1:182-191.

Leon AS. The role of exercise in the prevention and
management of diabetes mellitus and blood lipid dis-
orders. In: Shephard RJ, Miller HS Jr, editors. Exercise
and the heart in health and disease. New,York: Marcel
Dekker, 1992:299-368.

Leon AS, Bloor CM. Effects of exercise and its cessation on
the heart and its blood supply, Journal of Applied
Physiofogv 1968;24:485-490.

Leon AS, Bloor CM. The effect of complete and partial
deconditioning on exercise-induced cardiovascular
changes in the rat. Advances in Cardiology 1976;18:
81-92.

Leon AS, Connett J. Physical activity and 10.5 year mor-
tality in the Multiple Risk Factor Intervention Trial
(MRFIT). International Journal of Epidemiology
1991;20:690-697.

Leon AS, Connett J, Jacobs DR Jr, Rauramaa R. Leisure-
time physical activity levels and risk of coronary heart
disease and death: the Multiple Risk Factor Interven-
tion Trial. Journal of the American Medical Association
1987;258:2388-2395.

Levi F, La Vecchia C, Negri E, Franceschi S. Selected
physical activities and the risk of endometrial cancer.
BritishJournal of Cancer 1993;67:846-851.
Levitt NS, Katzenellenbogen JM, Bradshaw D, Hoffman
MN, Bonnici F. The prevalence and identification of
risk factors for NIDDM in urban Africans in Cape
Town, South Africa. Diabetes Care 1993;16:601-607.

Lie H, Mundal R, Erikssen J. Coronary risk factors and
incidence of coronary death in relation to physical
fitness: seven-year follow-up study of middle-aged and
elderly men. European Heart Journal 1985;6: 147-157.
Lillioja S, Bogardus C. Obesity and insulin resistance:
lessons learned from the Pima Indians. Diabetes/
Metabolism Reviews 1988;4:517-540.

Lindberg H, Roos H, Gardsell P. Prevalence of coxarthrosis
in former soccer players: 286 players compared with
matched controls. Acta Orthopaedicn Scandinavica
1993;64:165-167.

Lindgarde F, Malmquist J, Balke B. Physical fitness, insu-
lin secretion, and glucose tolerance in healthy males
and mild type-2 diabetes. Acta Diabetologica Latina
1983;20:33-40.

Lindgarde F, Saltin B. Daily physical activity, work capac-
ity, and glucose tolerance in lean and obese
normoglycaemic middle-aged men. Diabetologia
1981;20:134-138.

Lindsted KD, Tonstad S, Kuzma JW. Self-report of physi-
cal activity and patterns of mortality in Seventh-day
Adventist men. Journal of Clinical Epidemiology
1991;44:355-364.

Little J, Logan RFA, Hawtin PG, Hardcastle JD, Turner ID.
Colorectal adenomas and energy intake, body size, and
physical activity: a case-control study of subjects par-
ticipating in the Nottingham faecal occult blood screen-
ing programme. British Journal of Cancer 1993;
67:172-176.

161


Physical Activity and Health

Longnecker MP, De Verdier MG, Frumkin H, Carpenter
C. A case-control study of physical activtty in relation
to risk of cancer of the right colon and rectum in men.
International Journal of Epidcmiolo~ 1995;24:42-50.

Lynge E, Thygesen L. Use of surveillance systems for
occupational cancer: data from the Danish National
system. Intcrnationnl Journal of Epidcmiofogy
1988;17:493-500.

Macera CA. Lower extremity injuries in runners: ad-
vances in prediction. Sports Mcdicinc 1992;13:50-57.

Macera CA, Pate RR, Powell KE, Jackson KL, Kendrick
JS, Craven TE. Predicting lower extremity injuries
among habitual runners, Archives of Inertial Medicine
1989;149:2565-2568.

Mahoney LT, Lauer RM, Lee J, Clarke WR. Factors
affecting tracking of coronary heart disease risk factors
in children: the Muscatine Study. Annals oJ the New
York Academy 01 Sciences 1991;623: 120-132.

Manson JE, Nathan DM, Krolewski AS, Stampfer MJ,
Willett WC, Hennekens CH. A prospective study of
exercise and incidence of diabetes among U.S. male
physicians. Jour-nnl ofthe American Medical Association
1992;268:63-67.

Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett
WC, Krolewski AS, et al. Physical activity and inci-
dence of non-insulin-dependent diabetes mellitus in
women. Lancet 1991;338:774778.

MansonJE, Willett WC, Stampfer MJ, Colditz GA, Hunter
DJ, Hankinson SE, et al. Body weight and mortality
among women. Ncbv Englartd Journal of Medicine
1995;333:677-685.

Marceau M, Kouame N, Lacourciere Y, Cleroux J. Effects
of different training intensities on 24 hour blood
pressure in hypertensive subjects. Cir-culation 1993;
S&2803-281 1.

Marcus PM, Newcomb PA, Storer BE. Early adulthood
phystcal activity and colon cancer risk among Wiscon-
sin women. Cancer EpidctniologY, Biomarhcrs and Pr-c-
vention 1994;3:641-644.

Marcus R, Cann C, Madvig P, MinkoffJ, Goddard M, Bayer
M, et al. Menstrual function and bone mass in elite
women distance runners: endocrine and metabolic fea-
tures. Annals ofInter71al Medicirrc 1985;102:158-163.

Markowitz S, Morabia A, Garibaldi K, Wynder E. Effect of
occupational and recreational activity on the risk of
colorectal cancer among males: a case-control study.
International Journal of Epidemiology 1992:21:1057-
1062.

Marti B. Benefits and risks of running among women: an
epidemiologic study. International Journal of Sports
Medicine 1988;9:92-98.

Marti B. Minder CE. Physische berufsaktivitat und
kolonkarzinommortalitat bei Schweizer mannern
1979-1982 [Physical occupational activity and CO-
Ionic carcinoma mortality in Swiss men, 1979-19821.
Social- und Priiventivmedizin 1989;34:30-37.

Marti B, Vader JP, Minder CE, Abelin T. On the epidemi-
ology of running injuries: the I984 Bern Grand-Prix
study. American Journal of Sports Medicine 1988;16:
285-294.

Martinsen EW, Medhus A, Sandvik L. Effects of aerobic
exercise on depression: a controlled study. British
MedicaIJournaI 1985;291:109-110.

Martinsen EW, Stephens T. Exercise and mental health in
clinical and free-living populations. In: Dishman RK,
editor. Advances in exercise adherence. Champaign, IL:
Human Kinetics, 1994:55-72.

Matsusaki M, Ikeda M, Tashiro E, Koga M, Miura 5,
Ideishi M, et al. Influence of workload on the antihy-
pertensive effect of exercise. Clinical and Experimental
Pharmacology and Physiology 1992;19:471-479.

McAuley E. Physical activity and psychosocial outcomes.
In: Bouchard C, Shephard RJ, Stephens T, editors.
Physical activity, $tness, and health: international pro-
ceedings and consensus statement. Champaign, IL: HU-
man Kinetics, 1994:551-568.

McAuley E, Rudolph D. Physical activity, aging, and
psychological well-being.Journal ofAging and Physical
Activity 1995;3:67-96.

McDonald DG, Hodgdon JA. The psychological ej$cfs of
aerobicfitness training: research and theory. New York:
Springer-Verlag, 1991.

McGinnis JM, Foege WH. Actual causes of death in the
United States. _lournal ofthe American MedicalAssocia-
tion 1993;270:2207-2212.

McKeigue PM, Pierpoint T, Ferrie JE, Marmot MG. Rela-
tionship of glucose intolerance and hyperinsulinaemia
to body fat pattern in south Asians and Europeans.
Diabetologia 1992;35:785-791.
Mellion MB. Common cycling injuries: management and
prevention. Sports Medicine 1991;11:52-70.
Menotti A, Keys A, Blackburn H, Aravanis C, Dontas A,
Fidanza F, et al. Twenty-year stroke mortality and
prediction in twelve cohorts of the Seven Countries
Study. International Journal of Epidemiology 1990;19:
309-315.

162


The Effects of Physical Activity on Health and Disease

uenotti A, Seccareccia F. Physical activity at workandjob
responsibility as risk factors for fatal coronary heart
disease and other causes of death. Journal of Epidemi-
ology and Community Health 1985;39:325-329.
Metropolitan Life Insurance Company. New weight stan-
dards for men and women. Statistical Bulletin of the
Metropolitan Life Insurance Compa~~y 1959;40:1-4.
Meyer HE, Tverdal A, Falch JA. Risk factors for hip
fracture in middle-aged Norwegian women and men.
AmericanJoumaiofEpidemio~ogy 1993;137:1203-1211.

Michel BA, Bloch DA, Fries JF. Weight-bearing exercise,
overexercise, and lumbar bone density over age 50
years. Archives of Internal Medicine 1989;149:2325-
2329.

Mink PJ, Folsom AR, Sellers TA, Kushi LH. Physical
activity, waist-to-hip ratio, and other risk factors for
ovarian cancer: a follow-up study of older women.
Epidemiology 1996;7:38-45.

Minor MA. Physical activity and management of arthritis.
Annals ofBcftavioraf Medicine 1991;13:117-124.
Minor MA, Brown JD. Exercise maintenance of persons
with arthritis after participation in a class experience.
Health Education Quarterly 1993;20:83-95.

Minor MA, Hewett JE, Webel RR, Anderson SK, Kay DR.
Efficacy of physical conditioning exercise in patients
with rheumatoid arthritis and osteoarthritis. Arthritis
and Rheumatism 1989;32:1396-1405.

Minor MA, Hewett JE, Webel RR, Dreisinger TE, Kay DR.
Exercise tolerance and disease-related measures in
patients with rheumatoid arthritis and osteoarthritis.
Journal of Rheumatology 1988;15:905-911.

Mittendorf R, Longnecker MP, Newcomb PA, Dietz AT,
Greenberg ER, Bogdan GF, et al. Strenuous physical
activity in young adulthood and risk of breast cancer
(UnitedStates). CancerCausesandControl1995;6:347-
353.

Mittleman MA, Maclure M, Tofler GH, Sherwood JB?
Goldberg RJ. MullerJE. Triggeringofacute myocardial
infarction by heavy physical exertion: protection against
triggering by regular exertion. New EngJandJournaf of
Medicine 1993;329:1677-1683.

Montoye HJ, Block WD, Metzner H, Keller JB. Habitual
physical activity and glucose tolerance: males age 16-64
in a total community. Diabetes 1977;26:172-176.

Moore M. Endorphins and exercise: a puzzling relation-
ship. Physician and Sportsmedicine 1982;10:111-114.

Moore LL, Nguyen US, Rothman KJ, Cupples LA, Ellison
RC. Preschool physical activity level and change in
body fatness in young children: the Framingham
Children's Study. American Journal of Epidemiology
1995;142:982-988.

Morgan WP. Anxiety reduction following acute physical
activity. Psychiatric Annals 1979a;9:36-45.
Morgan WP. Negative addiction in runners. Physician and
Sportsmedicine 1979b;7:57-70.
Morgan WP. Physical activity, fitness, and depression. In:
Bouchard C, Shephard RJ, StephensT, editors. Physical
activity, fitness, and health: intemarional proceedings
and consensus statement., Champaign, IL: Human
Kinetics, 1994:851-867.

Morgan WP. Psychological benefits of physical activity.
In: Nagle FJ, Montoye HJ, editors, Exercise in health and
disease. Springfield, 1L: Charles C. Thomas, 1981:299-
314.

Morgan WP, Brown DR, RaghnJS, O'Connor PJ, Ellickson
KA. Psychologicalmonitoringofovertrainingandstale-
ness. British Journal of Sports Medicine 1987;21:107-
114.

Morgan WP, Goldston SE, editors. Exercise and mental
health. Washington, DC: Hemisphere Publishing, 1987.
Morgan WP, Horstman DH, Cymerman A, Stokes J. Use of
exercise as a relaxation technique. Primary Cardiology
1980;6:48-57.

Morgan WP, Roberts JA, Brand FR, Feinerman AD. Psy-
chological effect of chronic physical activity. Medicine
and Science in Sports 1970;2:213-217.

Morris JN, Chave SPW, Adam C, Sirey C, Epstein L,
Sheehan DJ. Vigorous exercise in leisure-time and the
incidence of coronary heart disease. Lancer 1973;1:333-
339.

Morris JN, Clayton DG, Everitt MG, Semmence AM, Bur-
gess EH. Exercise in leisure time: coronary attack and
death rates. British HeartJournal 1990;63:325-334.

Morris JN. Crawford MD. Coronary heart disease and
physical activity ofwork: evidence ofa national necropsy
survey. British MedicalJournal 1958;2:1485-1496.

MorrisJN, Everitt MG, Pollard R, Chave SPW, Semmence
AM. Vigorous exercise in leisure time: protection against
coronary heart disease. Lancet 1980;2:1207-1210.

Morris JN, Heady JA, Raffle PAB, Roberts CG, Parks JW.
Coronary heart disease and physical activity of work.
Lancet 1953;2: 111 l-l 120.

163


Physical Activity and Health

Morris JN, Kagan A, Pattison DC, Gardner MJ, Raffle PAB.
Incidence and prediction of ischemic heart disease in
London busmen. Lancet 1966;2:553-559.

Moses J, Steptoe A, Mathews A, Edwards S. The effects of
exercise training on mental well-being in the normal
population: a controlled trial.Journal ofPsychosomatic
Research 1989;33:47-61.

Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH.
Long-term morbidity and mortality of overweight ado-
lescents: a follow-up of the Harvard Growth Study of
1922 to 1935. New England Journal of IMedicine
1992;327:1350-1355.

Nagulesparan M, Savage PJ, Bennion LJ, Unger RH, Bennett
PH. Diminished effect of caloric restriction on control
of hyperglycemia with increasing known duration of
type 11 diabetes mellitus.Joumal ofclinical Endocrinol-
ogy and Metabolism 1981;53:560-568.

National Advisory Mental Health Council. Health care
reform for Americans with severe mental illnesses:
report of the National Advisory Mental Health Coun-
cil.AmericanJot~malofPs~chiatr)! 1993;150:1447-1465.

National Center for Health Statistics. Vital Statistics ofthe
UnitedStates, 1990, Vol. 2, Mortality, Part A. Hyattsville,
MD: U.S. Department of Health and Human Services,
Public Health Service, Centers for Disease Control and
Prevention, National Center for Health Statistics, 1994.
DHHS Publication No. (PHS) 95-1102.

National Center for Health Statistics, Gardner P, Hudson
BL. Advance report of final mortality statistics, 1993.
Hyattsville, MD: U.S. Department of Health and Hu-
man Services, Public Health Service, Centers for Dis-
ease Control and Prevention, National Center for Health
Statistics, 1996. (Monthly vital statistics report; Vol.
44, No. 4, Suppl).

National Institutes of Health. Consensus Conference:
Osteoporosis.Jou,-ilal ofthe American Medical Associa-
tion 1984;252:799-802.

National Institutes of Health. Health implications of obe-
sity: National Institutes of Health Consensus Develop-
ment Conference Statement. Annals ofIntcrnaf h4edicine
1985;103(Suppl 6, Pt 2):1073-1077.
National Institutes of Health. The FiJth Report oftheJoint
National Committeeon Detection, Evaluation, and Treat-
mcnt of High Blood Pressure. Bethesda, MD: National
Institutes of Health. National Heart, Lung, and Blood
Institute. 1992:1-48. NIH Publication No. 93-1088.

Nelson ME, Fisher EC, Dilmanian FA, Dallal GE, Evans
WJ. A one-year walking program and increased dietary
calcium in postmenopausal women: effects on bone.
American-Journal of Clinica Nutrition 1991;53:1304-
1311.

Newsholme EA, Parry-Billings M. Effects of exercise on
the immune system. In: Bouchard C, Shephard RJ,
Stephens T, editors. Physical activity,fitness, and health:
international proceedings and consensus statement.
Champaign, IL: Human Kinetics, 1994:451-455.
Nichols DL, Sanborn CF, Bonnick SL, Ben-Ezra V, Gench
B, DiMarco NM. The effects of gymnastics training on
bone mineral density. Medicine and Science in Sports
and Exercise 1994;26:1220-1225.'

Nieto FJ, Szklo M, Comstock GW. Childhood weight and
growth rate as predictors of adult mortality. American
Journal oJEpidemiology 1992;136:201-213.

North TC, McCullagh P, Tran ZV. Effect of exercise on
d epression. Exercise and Sport Sciences Reviews
1990;18:379-415.

Obartanek E, Schreiber GB, Crawford PB, Goldman SR,
Barrier PM, Frederick MM, et al. Energy intake and
physical activity in relation to indexes of body fat: the
National Heart, Lung, and Blood Institute Growth and
Health Study. American Journal of Clinical Nutrition
1994;60: 15-22.

O'ConnorGT,BuringJE,YusufS,GoldhaberSZ,Olmstead
EM, Paffenbarger RS Jr, et al. An overview of random-
ized trials of rehabilitation with exercise after myocar-
dial infarction. Circulation 1989;80:234-244.

Oliveria SA, Kohl HW III, Trichopoulos D, Blair SN. The
association between cardiorespiratory fitness and pros-
tate cancer. Medicine and Science in Spurts and Exercise
1996;28:97-104.

Ornish D, Brown SE, Scherwitz LW, BillingsJH, Armstrong
WT, Ports TA, et al. Can lifestyle changes reverse
coronary heart disease? The Lifestyle Heart Trial.
Lancet 1990;336: 129-133.

Oscai LB. The role of exercise in weight control. Exercise
and Sport Sciences Reviews 1973;1:103-123.
Overholser KA, Laughlin MH, Bhatte MJ, Exercise train-
ing-induced increase in coronary transport capacity.
Medicine and Science in Sports and Exercise 1994;
26:1239-1244.

Paffenbarger RS Jr. Contributions of epidemiology to
exercise science and cardiovascular health. Medicine
and Science in Sports and Exercise 1988;20:426-438.

164


The Effects of Physical Activity on Health and Disease

Paffenbarger RS Jr. Factors predisposing to fatal stroke in
longshoremen. Preventive Medicine 1972;1:522-527.

Paffenbarger RS Jr, Hale WE. Work activity and coronary
heart mortality. New England Journal of LMcdicine
1975;292:545-550.

Paffenbarger RS Jr, Hale WE, Brand RJ, Hyde RT. Work-
energy level, personal characteristics, and fatal heart
attack: a birth-cohort effect. AmericanJournal ofEpide-
tniology 1977;105:200-213.

Paffenbarger RS Jr, Hyde RT, Wing AL. Physical activity
and incidence of cancer in diverse populations: a
preliminary report. AmericanJournal of Clinical Nutri-
tion 1987;45:312-317.

Paffenbarger RS Jr, Hyde RT, Wing AL, Hsieh C-C. Physi-
cal activity, all-cause mortality, and longevity of col-
lege alumni. New England journal of Medicine
1986;314:605-613.

Paffenbarger RS Jr. Hyde RT, Wing AL, Lee I-M, Jung DL.
Kampert JB. The association of changes in physical
activity level and other lifestyle characteristics with
mortality among men. New England]ournal ofMedicine
1993;328:538-545.

Paffenbarger RS Jr, Hyde RT, Wing AL, Lee I-M, Kampert
JB. Some interrelations of physical activity, physiologi-
cal fitness, health, and longevity. In: Bouchard C,
Shephard RJ, Stephens T, editors. Physical activity,
fitness, andhcalth: internationalproceedingsandconsen-
sus stalenzcnt. Champaign, IL: Human Kinetics,
1994:119-133.

Paffcnbarger RS Jr. Hyde RT, Wing AL, Steinmetz CH.
A natural history of athleticism and cardiovascular
health. Journal of the American Medical Associution
1984; 252:491-495.

Paffenbarger RS Jr, Jung DL, Leung RW, Hyde RT. Physi-
cal activity and hypertension: an epidemiological view.
Anna/s of Medicine 199 1;23:3 19-327.

Paffenbarger RS Jr, Lee I-M, Leung R. Physical activity and
personal characteristics associated wrth depression
and suicide in American college men. Acta Psychiatrica
Scandinavica Supplementurn 1994;377: 16-22.

Paffenbarger RS Jr, Thorne MC, Wing AL. Chronic dis-
ease in former college students: characteristics in youth
predisposing to hypertension in later years. American
Journal of Epidemiology 1968;88:25-32.

Paffenbarger RSJr, WilliamsJL. Chronic disease in former
college students: early precursors of fatal stroke. Ameri-
can journal of Public Health 1967;57:1290-1299.

Paffenbarger RSJr, WingAL, Hyde RT. Physicalactivityas
an index of heart attack risk in college alumni.
AmericanJournal of Epidemiology 1978;108:161-175.
Paffenbarger RS Jr, Wing AL, Hyde RT, Jung DL. Physical
activity and incidence of hypertension in college alumni.
Amcricartjournal of Epidemiology 1983;117:245-257.

Pan X, Li G, Hu Y. [Effect of dietary and/or exercise
intervention on incidence of diabetes in 530 subjects
with impaired glucose tolerance from 1986-19921.
Chinesejournal of Internal Medicine 1995;34: 108-l 12.

Panush RS, Hanson CS, Caldwell JR, Longley S, Stork J,
Thoburn R. Is running associated with osteoarthritis?
An eight-year follow-upstudy.Joumal ofClinical Rhcu-
matology 1995;1:35-39.

Panush RS, Lane NE. Exercise and the musculoskeletal
system. Bailliere's Clinical Rheumatology 1994;8:79-
102.

Panush RS, Schmidt C, CaldwellJR, Edwards NL, Langley
5, Yonker R, et al. Is running associated with degenera-
tive joint disease? Journal of the American Medical
Association 1986;255:1152-1154.

Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA,
Bouchard C, et al. Physical activity and public health:
a recommendation from the Centers for Disease Con-
trol and Prevention and the American College of Sports
Medicine. journal ofthe American Medical Association
1995;273:402-407.

Pekkanen J, Marti B, Nissinen A, Tuomilehto J, Punsar S,
Karvonen MJ. Reduction of premature mortality by
high physical activity: a 20-year follow-up of middle-
aged Finnish men. Lancer 1987;1:1473-1477,

Peters RK, Cady LD Jr, Bischoff DP, Bernstein L, Pike MC.
Physical fitness and subsequent myocardial infarction
in healthy workers. Journal of the American Medical
Association 1983;249:3052-3056.

Peters RK, Garabrant DH, Yu MC, Mack TM. A case-
control study of occupational and dietary factors in
colorectal cancer in young men by subsite. Cancer
Research 1989;49:5459-5468.

Pfeiffer RP, Kronisch RL. Off-road cycling injuries: an
overview. Sports Medicine 1995;19:311-325.
Pi-Sunyer FX. Exercise in the treatment of obesity. In:
Obesity und weight control: the health professional's
guide to understanding and treatment. Rockville, MD:
Aspen Publishers, 1988:241-255.

165


Physical Activity and Health

Pitsillides AA, Rawlinson SCF, Suswillo RFL, Bourrin 5,
Zaman G, Lanyon LE. Mechanical strain-induced NO
production by bone cells: a possible role in adaptive
bone (re)modeling. FASEBJournal1995;9:1614-1622.

Plante TG. Rodin J. Physical fitnessand enhanced psycho-
logical health. Current Psychology: Research and Re-
views 1990;9:3-24.

Pocock NA, Eisman JA. Yeates MG, Sambrook PN. Eberl
S. Physical fitness is a major determinant of femoral
neck and lumbar spine bone mineral density. Jotonaf OJ
Clinical Investigation 1986;78:618-621.

Polednak XP. College athletes, body size, and cancer
mortality. Cancer 1976;38:382-387.

Polivy J. Physical activity, fitness, and compulsive behav-
iors. In: Bouchard C, Shtphard RJ, StephensT, editors.
Physical activity, Iirncss, and health: international
proceedings and consensus statement. Champaign, IL:
Human Kinetics, 1994:883-897.

Pollock ML, Carroll JF, Graves JE. Leggett SH, Braith RW,
Limacher M, et al. Injuries and adherence to walk/jog
and resistance traimng programs in the elderly. Mcdi-
cinc and Scicncc in Sports and Exercise 1991;23: 1194-
1200.

Pollock ML, Gettman LR, Milesis CA, Bah MD, Durstine
L, Johnson RB. Effects of frequency and duration of
training on attrition and incidence of injury. Medicine
and Science in Spot-ts 1977;9:31-36.

Pomrehn PR, Wallace RB, Burmeister LF. lschemic heart
disease mortality in Iowa farmers: the influence of life-
style. Jour-nal of the American Medical Association
1982;248:1073-1076.

Powell KE, Blair SN. The public health burdens of seden-
tary living habits: theoretical but realisttc estimates.
Mcdicirte and Science in Sports and Exercise 1994;26:
85 l-856.

Powell KE, Thompson PD, Caspersen CJ, Kendrick JS.
Physical activity and the incidence of coronary heart
disease. Antmal Rcvicw ,fPublic Health 1987;8:253-287.
Prince RL, Smith M, Dick IM, Price RI, Webb PG.
Henderson NK, et al. Prevention of postmenopausal
osteoporosis: a comparative study of exercise, calcium
supplementation, and hormone-replacement therapy.
iVew EnglattdloutnalofMedicinc 1991:325:1189-1195.

Province MA, Hadley EC, Hornbrook MC, Lipsitz LA,
Miller JP, Mulrow CD, et al, The effects of exercise on
falls in elderly patients: a preplanned meta-analysis of
the FICSIT trials. Journal 01 the American Medical
Association 1995;273:1341-1347.

Pruitt LA, Jackson RD. Bartels RL, Lehnhard HJ. Weight-
training effects on bone mineral density in early post-
menopausal women. Journal of Bone and Mineral
Research 1992;7:179-185.

Puett DW, Griffin MR. Published trials of nonmedicinal
and noninvasive therapies for hip and knee osteoar-
thritis. Annals ofInternal Medicine 1994;121:133-140.

Pukkala E, Poskiparta M, Apter D, Vihko V. Life-long
physical activity and cancer risk among Finnish female
teachers. European Journal of Cancer Prevention
1993;2:369-376.

Raglin JS. Exercise and mental heaGh: beneficial and
detrimental effects. Sports Medicine 1990;9:323-329.

Raglin JS, Morgan WP. Influence of exercise and quiet
rest on state anxiety and blood pressure. Medicine and
Science in Sports and Exercise 1987;19:456-463.
Rall KL, McElroy GL, Keats TE. A study of long-term
effectsof football injury to the knee. Missouri Medicine
1964;61:435-438.

Ramaiya KL, Swai ABM, McLarty DG, Alberti KGMM.
Impaired glucose tolerance and diabetes mellitus in
Hindu Indian immigrants in Dar es Salaam. Diabetic
Medicine 1991;8:738-744.

Rankin JW. Diet, exercise, and osteoporosis. American
Coffege of Sports Medicine News, 1993;3:1-4.

Ransford CP. A role for amines in the antidepressant
effect of exercise: a review. Medicine and Science in
Sports and Exercise 1982;14:1-10.

Rauramaa R, Rankinen T, Tuomainen P, Vaisanen S,
Mercuri M. Inverse relationship between cardiorespi-
ratory fitness and carotid atherosclerosis. Atheroscle-
rosis 1995;112:213-221.

Ravussin E, Bennett PH, Valencia ME, Schulz LO, Esparza
J. Effects of a traditional lifestyle on obesity in Pima
Indians. Diabetes Care 1994;17:1067-1074.

Reeker RR, Davies KM, HindersSM, Heaney RP, Stegman
MR, Kimmel DB. Bone gain in young adult women.
Journal of the American Medical Association 1992;
268:2403-2408.

Regensteiner JG, Shetterly SM, Mayer EJ, Eckel RH,
Haskell WL, Baxter J, et al. Relationship between
habitual physical activity and insulin area among indi-
viduals with impaired glucose tolerance: the San Luis
Valley Diabetes Study. Diabetes Care 1995;18:490-
497.

1 f,h


The Effects of Physical Activity on Health and Disease

Regier DA, Narrow WE, Rae DS, Manderscheid RW,
Locke BZ, Goodwin FK. The defaclo U.S. mental and
addictive disordersservice system: epidemiologic catch-
ment area prospective l-year prevalence rates of disor-
ders and services. Archives of General Psychiatry
1993;50:85-94.

ReJeski WJ, Brawley LR, Schumaker SA. Physical activity
and health-related quality of life. Exercise and Sport
Scicncrs Reviews 1996;24:71-108.

Rejeski WJ, Gauvin L, Hobson ML, Norris JL. Effects of
baseline responses, in-task feelings, and duration of
activity on exercise-induced feeling states in women.
Health Psychology 1995;14:350-359.

Richie DH, Kelso SF, Bellucci PA. Aerobic dance injuries:
a retrospective study of instructors and participants.
Physician and Sportsmedicine 1985;13:130-140.

Richter EA, Ruderman NB, Schneider SH. Diabetes and
exercise. American Journal of Medicine 1981;70:201-
209.

Robinson TL, Snow-Harter C, Taaffe DR, Gillis D, Shaw J.
Marcus R. Gymnasts exhibit higher bone mass than
runners despite similar prevalence of amenorrhea and
oligomenorrhea.Journal of Bone and Mineral Research
1995;10:26-35.

Rodriguez BL, Curb JD, Burchfiel CM, Abbott RD,
Petrovitch H, Masaki K, et al. Physical activity and 23-
year incidence of coronary heart disease morbidity and
mortalityamongmiddle-agedmen: theHonolulu Heart
Program. Circulation 1994;89:2540-2544.

Roll C. Overuse injuries of the lower extremity in runners.
Scandinavian Journal of Medicine and Science in Sports
1995;5:181-190.

Ronnemaa T, Mattila K, Lehtonen A, Kallio V. A con-
trolled randomized study on the effect of long-term
physical exercise on the metabolic control in type 2
diabetic patients. Acta Medica Scandinavica 1986;
220:219-224.

ROOS H, Lindberg H, Gardsell P, Lohmander LS,
Wingstrand H. The prevalence of gonarthrosis and its
relation to meniscectomy in former soccer players.
Americanjournal ofSports Medicine 1994;22:219-222.

Rosenman RH, Bawol RD, Oscherwitz M. A 4-year pro-
spective study of the relationship of different habitual
vocational physical activity to risk and incidence of
ischemic heart disease in volunteer male federal em-
ployees. Annals of the New York Academy of Sciences
1977;301:627-641.

Ross CE, Hayes D. Exercise and psychologic well-being in
the community. American Journal of Epidemiology
1988;127:762-771.

Roth DL. Acute emotional and psychophysiological ef-
fects of aerobic exercise. Psychophysiology 1989;26:
593-602.

Rubin K, Schirduan V, Gendreau P, Sarfarazi M, Mendola
R, Dalsky G. Predictors of axial and peripheral bone
mineral density in healthy children and adolescents,
with special attention to the role of puberty.Joumal of
Pediatrics 1993;123:863-870.

Sallis JF, Patterson TL, McKenzie TL, Nader PR. Family
variables and physical activity in preschool children.
Journal ofDevelopmentalandBehavioralPediatrics 1988;
9:57-61.

Salonen JT, Puska P, Tuomilehto J. Physical activity and
risk of myocardial infarction, cerebral stroke, and
death: a longitudinal study in Eastern Finland. Ameri-
canJournal of Epidemiology 1982;115:526-537.

Salonen JT, Slater JS, Tuomilehto J, Rauramaa R. Leisure
time and occupational physical activity: risk of death
from ischemic heart disease. AmericanJournal ofEpide-
miology 1988;127:87-94.

Saltin B, Lindgarde F, Houston M, Horlin R, Nygaard E,
Gad P. Physical training and glucose tolerance in
middle-aged men with chemical diabetes. Diabetes
1979;28:30-32.

Sandler RB, Cauley JA, Sashin D, Scialabba MA, Kriska
AM. The effect of grip strength on radial bone in
postmenopausal women. Journal of Orthopaedic Re-
search 1989;7:440-444.

Sandler RS, Pritchard ML,BangdiwalaSI. Physicalactivity
and the risk of colorectal adenomas. Epidemioloa
1995;6:602-606.

Sandvik L, Erikssen J, Thaulow E, Erikssen G, Mundal R,
Rodahl K. Physical fitness as a predictor of mortality
among healthy, middle-aged Norwegian men. Ne\v
England journal of Medicine 1993;328:533-537.
Scheuer J. Effects of physical training on myocardial
vascularity and perfusion. Circulation 1982;66:491-
495.

Schneider SH,Amorosa LF, Khachadurian AK, Ruderman
NB. Studies on the mechanism of improved glucose
control during regular exercise in type 2 (non-
insulin-dependent) diabetes. Diabetologia 1984;26:
355-360.

167


Physical Activity and Health

Schranz A, Tuomilehto J, Marti B, Jarrett RJ, Grabauskas
V, Vassallo A. Low physical activity and worsening of
glucose tolerance: results from a 2-year follow-up of a
population sample in Malta. Diabetes Research and
Clinical Practice 1991;11:127-136.

Schuler G, Hambrecht R, Schlierf G, Niebauer J, Hauer K.
Neumann J, et al. Regular physical exercise and low fat
diet: effects on progression of coronary artery disease.
Circulation 1992;86: l-l 1.

Seccareccia F, Menotti A. Physical activity, physical fit-
ness, and mortality in a sample of middle-aged men
followed up 25 years. Journal of Sports Medicine and
Physical Fitness 1992; 32:206-213.
Seidell JC, Cigolini M, Deslypere J-P, Charzewska J,
Elfsinger B-M, Cruz A. Body fat distribution in relation
to physical activity and smoking habits in 38-year-old
European men. American /ournal uf Epidemiology
1991;133:257-265.

Severson RK, Nomura AMY, Grove JS, Stemmermann GN.
A prospective analysis of physical activity and cancer.
Amcricanjoumal of Epidemiology 1989;130:522-529.

Shangold MM. Exercise and the adult female: hormonal
and endocrine effects. Exercise and Sport Sciences Re-
views 1984;12:53-79.

Shaper AG, Wannamethee G. Physical activity and
ischaemic heart disease in middle-aged British men.
British Hcart]ournal 1991;66:384-394.

Shaper AG, Wannamethee G, Walker M. Physical activ-
ity, hypertension, and risk of heart attack in men
without evidence of ischaemic heart disease.Jour-real of
Human Hypcrtcnsion 1994;8:3-10.

Shear CL. Freedman DS, Burke GL, Harsha DW, Webber
LS, Berenson GS. Secular trends of obesity in early life:
the Bogalusa Heart Study. American Journal uf Public
Health 1988;78:75-77.

Shephard RJ. Exercise in the prevention and treatment of
cancer: an update. Sports Medicine 1993;15:258-280.

Shephard RJ, Verde TJ, Thomas SG, Shek P. Physical
activity and the immune system. Canadian,]ournal of
Sport Sciences 1991;16:163-185.     '

Sherman SE, D'Agostino RB, Cobb JL, Kannel WB. Physi-
cal activity and mortality in women in the Framingham
Heart Study. American Heart Journal 199$;128:879-
884.

Shimegi S, Yanagita M, Okano H, Yamada M, Fukui H,
Fukumura Y, et al. Physical exercise increases bone
mineral density in postmenopausal women. Endocrine
Jound 1994;41:49-56.

Shu X0, Hatch MC, Zheng W, Gao YT, Brinton LA.
Physical activity and risk of endometrial cancer. Epide-
miology 1993;4:342-349.

Shumaker SA, Anderson RT, Czajkowski SM. Psycho-
logical tests and scales. In: Spilker B, editor. Quality of
Iije assessments in clinical trials. New York: Raven
Press, 1990:95-l 13.

Sime WE. Discussion: exercise, fitness, and mental health.
In: Bouchard C, Shephard RJ, Stephens T, Sutton JR,
McPherson BD, editors. Exercise,fitness, and health:
a consensus of current knowledge. Champaign, IL:
Human Kinetics, 1990:627-633. .

Simons AD. McGowan CR, Epstein LH, Kupfer DJ,
Robertson RJ. Exercise as a treatment for depression:
an update. Clinical Psychology Review 1985;5;553-
568.

Simons CW, Birkimer JC. An exploration of factors pre-
dicting the effects of aerobic conditioning on mood
state. Journal of Psychosomatic Research 1988;32:63-
75.

Sinaki M, McPhee MC, Hodgson SF, Merritt JM, Offord
KP. Relationship between bone mineral density of
spine and strength of back extensors in healthy post-
menopausal women. Mayo Clinic Proceedings
1986;61:116-122.

Sinaki M, Offord KP. Physical activity in postmenopausal
women: effect on back muscle strength and bone
mineral density of the spine. Archives olphysical Medi-
cine and Rehabilitation 1988;69:277-280.

Sinert R, Kohl L, Rainone T, Scalea T. Exercise-induced
rhabdomyolysis. Annafs of Emergency Medicine
1994;23:1301-1306.

Siscovick DS, Weiss NS, Fletcher RH, Lasky T. The
incidence of primary cardiac arrest during vigorous
exercise. New England Journal oJ Medicine 1984;
311:874-877.

Slattery ML, Jacobs DRJr. Physical fitness and cardiovas-
cular disease mortality: the U.S. Railroad Study. Ameri-
canJournal ofEpidemiology 1988;127:571-580.

Slattery ML, Jacobs DR Jr, Nichaman MZ. Leisure-time
physical activity and coronary heart disease death: the
U.S. Railroad Study. Circulation 1989;79:304-311.

Slattery ML, McDonald A, Bild DE, Caan BJ, Hilner JE,
Jacobs DR Jr, et al. Associations of body fat and its
distribution with dietary intake, physical activity, al-
cohol, and smoking in blacks and whites. American
Journal of Clinical Nutrition 1992;55:943-950.

168


Slattery ML, Schumacher MC, Smith KR, West DW, Abd-
Elghany N. Physical activity, diet, and risk of colon
cancer in Utah. Amcricarr journal of Epidemiology
1988;128:989-999.

The Effects of Physical Activity on Health and Disease

  Sternfeld B, Williams CS, Quesenberry CP, Satariano WA,
   Sidney S. Lifetime physical activity and incidence of
   breast cancer. Medicine and Science in Sports and Exer-
   cise 1993;25(5 Suppl):S147.

Smith TW, Leon AS. Coronary heart disease: a behavioral
pcrspcctive. Champaign, 1L: Research Press, 1992:9-
20.

Sobolski J, Kornitzer M, DeBacker G, Dramaix M,
Abramowicz M, Degre S, et al. Protection against
ischemic heart disease in the Belgian Physical Fitness
Study: physical fitness. rather than physical activity?
AmcricanJournaf of Epidemiology 1987;125:601-610.

Stewart AL, Hays RD, Wells KB, Rogers WH, Spritzer KL,
Greenfield S. Long-term functioning and well-being
outcomes associated with physical activity and exer-
cise in patients with chronic conditions in the Medical
Outcomes Study.Joumal ofClinical Epidemioloa 1994;
47:719-730.

Stamler R, Stamler J, Gosch FC, Civinelli J. Fishman J.
McKeever P, et al. Primary prevention of hypertension
by nutritional-hygienic means: final report of a ran-
domized, controlled trial. Journal of the American
Medical Association 1989;262:1801-1807.

Stary HC. Evolution and progression of atherosclerotic
lesions in coronary arteries of children and young
adults. Arteriosclerosis 1989;9(Suppl 1):119-132.

Stefanick ML. Exercise and weight control. Exercise and
Sport Sciences Reviews 1993;21:363-396.

Stewart AL, King AC, Haskell WL. Endurance exercise
and health-related quality of life in 50-65-year-old
adults. Gerontologist 1993;33:782-9.
Strazzullo P, Cappuccio FP, Trevisan M, De Leo A, Krogh
V, Giorgione N, et al. Leisure-time physical activity
and blood pressure in schoolchildren. AmericanJour-
nal oJEpidemiology 1988;127:726-733.
Sturgeon SR, Brinton LA, Berman ML, Mortel R, Twiggs
LB, Barrett RJ, et al. Past and present physical activity
and endometrial cancer risk. British journal of Cancer
1993;68:584-589.

Stefanick ML, Wood PD. Physical activity, lipid and
lipoprotein metabolism, and lipid transport. In:
Bouchard C, Shephard RJ, Stephens T, editors. Physical
activity, Jitness, and health: international proceedings
and consensus statement. Champaign, IL: Human Ki-
netics, 1994:417-431.

Superko HR. Exercise training, serum lipids, and lipopro-
tein particles: is there a change threshold? Medicine
and Science in Sports und Exercise 1991;23:677-685.
Surgenor S, Uphold RE. Acute hyponatremia in ultra-
endurance athletes. American Journal of Emergetq
Medicine 1994;12:441-444.

Stefanik PA, Heald FP, Mayer J. Caloric intake in relation to
energy output of obese and nonobese adolescent boys.
AmericanJoumaI of Cfinicaf Nutrition 1959;7:55-62.

Stender M, Hense HW, Doring A, Keil U. Physical activity
at work and cardiovascular disease risk: results from
the MONICA Augsburg Study. lnternationalJournal of
Epidemiology 1993;22:644-650.

Stephens T. Physical activity and mental health in the
United States and Canada: evidence from four popula-
tion surveys. Preventive Medicine 1988;17:35-47.

Taioli E, Barone J, Wynder EL. A case-control study on
breast cancer and body mass: the American Health
Foundation, Division of Epidemiology. EuropcanJour-
nal of Cuncer 1995;3 lA:723-728.
Tall AR. Plasma high density lipoproteins: metabolism
and relationship to atherogenesis. Journal o/Clinical
Investigation 1990;86:379-384.
Talmage RV, Stinnett SS, Landwehr JT, Vincent LM,
McCartney WH. Age-related loss of bone mineral den-
sity in non-athletic and athletic women. Bone and
Mineral 1986;1:115-125.

Stephens T, Craig CL. The well-being of Canadians: high-
lights ofthe 1988 Campbell's Survey. Ottawa: Canadian
Fitness and Lifestyle Research Institute, 1990.

Steptoe .4, Edwards 5, Moses J, Mathews A. The effects of
exercise training on mood and perceived coping ability
in anxious adults from the general population.Joumal
ofPsychosomatic Research 1989;33:537-547.

Tang LY, Raab-Cullen DM, Yee JA, Jee WSS, Kimmef DB.
Prostaglandin E, increases skeletal response. Journal of
Bone and Mineral Research 1995;10:5246.
Task Force on Blood Pressure Control in Children. Re-
port of the Second Task Force on Blood Pressure
Control in Children-1987. Pediatrics 1987;79:1-25.
Taylor CB, Sallis JF, Needle R. The relation of physical
activity and exercise to mental health. Public Health
Reports 1985;100:195-202.

169


Physical Activity and Health

Taylor HL, Klepetar E, Keys A, Parlin W, Blackburn H,
Puchner T. Death rates among physically active and
sedentary employees of the railroad industry. Amcri-
can Journal of Public Health 1962;52: 1697-1707.

Taylor R, Ram P, Zimmet P, Raper LR, Ringrose H.
Physical activity and prevalence of diabetes in
Melanesian and Indian men in Fiji. Diabctologia
1984;27:578-582.

Taylor RJ. Bennett PH, LeGonidec G, Lacoste J, Combe D,
Joffres M, et al. The prevalence of diabetes mellitus in
a traditional-living Polynesian population: the Wallis
Island survey.  American Journal of Public Health
1983:6:334-340.

Tell GS, Vellar OD. Physical fitness, physical activity, and
cardiovascular disease risk factors in adolescents: the
OsloYouthStudy. PrevenlivcMcdicinc 1988;17:12-24.

Thomas JR, Landers DM, Salazar W, EtnierJ. Exercise and
cognitive function. In: Bouchard C, Shephard RJ,
StephensI', editors. Pf?ysical activity,filncss, and health:
irIter-national proceedings and consensus statcmcnt.
Champaign, 1L: Human Kinetics. 1994:521-529.

Thompson JK, Jarvie GJ, Lahey BB, Cureton KJ Exercise
and obesity: etiology, physiology, and intervention.
Psychological Bulletin 1982;91:55-79.

Thompson PD, Funk EJ, Carleton RA, Sturner WQ.
Incidence of death during jogging in Rhode Island
from 1975 through 1980. Journal of the Atncrlcan
Medical Association 1982;237:2535-2538.

Thompson PD, Mitchell JH. Exercise and sudden cardiac
death: protection or provocation? New England Journal
ofMedicine 1984;311:914-915.

Thor P, KonturekJW, Konturek SJ, Anderson JH. Role of
prostaglandins in control of intestinal motility. .Amcri-
can-/our-nal ofPhysiology 1985;248:G353-G359.

Thune I, Lund E. Physical activity and the risk of prostate
and testicular cancer: a cohort study of 53,000 Norwt-
gian men. Cancer Causes and Control 1994;5:549-556.

Tinetti ME, Baker Dl, McAvay G, Claus EB, Garrett P,
Gottschalk M, et al. A multifactorial intervention to
reduce the risk of falling among elderly people living in
the community. New England Journal of Mcdicinc
1994;331:821-827.

Tinetti ME, Speechley M, Ginter SF. Risk factors for falls
among elderly persons living in the community. New
EnglandJournal of&fedicinc 1988;319:1701-1707.

Tipton CM. Exercise and resting blood pressure. In:
Eckert HM, Montoye HJ, editors. Exercise and health.
Champaign, IL: Human Kinetics, 1984:32-41.

Tomanek RJ. Exercise-induced coronary angiogenesis: a
review. Medicine and Science in Sports and Exercise
1994;26:1245-1251.

Tremblay A, DesprPs J-P, Leblanc C, Craig CL, Ferris B,
Stephens T, et al. Effect of intensity of physical activity
on body fatness and fat distribution. AmericanJournal
of Clinical Nutrition 1990;51:153-157.

Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM,
Johnson CL. Overweight prevalence ,and trends for
children and adolescents: the National Health and
Nutrition Examination Surveys, 1963 to 1991. Ar-
chives of Pediatrics and Adolescent Medicine 1995;
149:1085-1091.

Troisi RJ, Heinold JW, Vokonas PS, Weiss ST. Cigarette
smoking, dietary intake, and physical activity: effects
on body fat distribution-the Normative Aging Study.
American Journal of Clinical Nutrition 1991;53:1104-
  1111.

Trovati M, Carta Q, Cavalot F, Vitali 5, Banaudi C,
Lucchina PG, et al. Influence of physical training on
blood glucose control, glucose tolerance, insuli,l se-
cretion, and insulin action in noninsulin-dependent-
diabetes patients. Diabetes Care 1984;7:416-420.

Tsopanakis AD, Sgouraki EP, Pavlou KN, Nadel ER,
Bussolari SR. Lipids and lipoprotein profiles in a 4-
hour endurance test on a recumbent cycloergometer.
American Journal of Clinical Nutrition 1989;49:980-
984.

Turner CH, Owan 1, Takano Y, Madali 5, Murrell GA.
Nitric oxide plays a role in bone mechanotrasduction.
Journal of Bone and Mineral Research 1995;10:5235.
Turner CH, Takano Y, Owan I. Aging changes mechanical
loading thresholds for bone formation in rats. ]ournal
of Bone and Mineral Research 1995;10:240.

Tutton PJM, Barkla DH. Influence of prostaglandin ana-
logues on epithelial cell proliferation and xenograft
growth. BritishJournal of Cancer 1980;41:47-51.
Underwood FB, Laughlin MH, Sturek M. Altered control
of calcium in coronary smooth muscle cells by exercise
training. Medicine and Science in Sports and Exercise
1994;26:1230-1238.

United Kingdom Testicular Cancer Study Group. Aetiol-
ogy of testicular cancer: association with congenital
abnormalities, age at puberty, infertility, and exercise.
British MedicalJournal 1994;308:1393-1399.

170


The Effects of Physical Activity on Health and Disease

U.S. Department of Health and Human Services. Health,
United States, 1994. Hyattsville, MD: U.S. Department
of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, National
Center for Health Statistics, 1995. DHHS Publication
No. (PHS)95-1232.

Cusitupa M, Siitonen 0, Pyijr& K, Aro A, Hersio K,
Penttila I, Voutilainen E. The relationship of cardio-
vascular risk factors to the prevalence of coronary
heart disease in newly diagnosed type 2 (non-insulin-
dependent) diabetes. Diabetologiu 1985;28:653-659.
Van Mechelen W. Running injuries: a review of the
epidemiological literature. Sports iMedicine 1992;
14:320-335.

Vena JE, Graham S, Zielezny M, Brasure J, Swanson MK.
Occupational exercise and risk of cancer. American
Journal of Clinical Nutrition 1987;45:318-327.

Vena JE, Graham S, Zielezny M, Swanson MK, Barnes RE,
Nolan J, Lifetime occupational exercise and colon
cancer.AmericanJoumaIofEpidemiolog~~ 1985;122:357-
365.

Vetter R, Dosemeci M, Blair A, Wacholder S, Unsal M,
Engin K, et al. Occupational physical activity and
colon cancer risk in Turkey. EwropcanJournaf ofEpidc-
miology 1992;8:845-850.

Vincelette P, Laurin CA, LPvesque HP. The footballer's
ankle and foot. Canadian Medical Association Journal
1972;107:872-877.

Vineis P, Ciccone G, Magnino A. Asbestos exposure,
physical activity, and colon cancer: a case control
study. Tumori 1993;79:301-303.

Vlajinac H, Jarebinski M, Adanja B. Relationship of some
biosocial factors to colon cancer in Belgrade (Yugosla-
via). Neoplasma 1987;34:503-507.

Voorrips LE, Meijers JHH, Sol P, Seidell JC. van Staveren
WA. History of body weight and physical activity of
elderly women differing in current physical activity.
International journal of Obesity 1992;16:199-205.

Wahrenberg H, Bolinder J, Arner P. Adrenergic regula-
tion of lipolysis in human fat cells during exercise.
European Journal of Clinical Investigation 1991;21:
534-541.

Wallberg-Henriksson H. Exercise and diabetes mellitus.
Exercise and Sport Sciences Reviews 1992;20:339-368.

Walter SD, Hart LE, McIntosh JM, Sutton JR. The Ontario
cohort study of running-related injuries. Archives of
Znternul Medicine 1989;149:2561-2564.

WangJT, Ho LT, Tang KT, Wang LM, Chen Y-DI, Reaven
GM. Effect of habitual physical activity on age-related
glucose intolerance.JoumaI of the American Geriatrics
Society 1989; 37:203-209.

Wannamethee G, Shaper AG. Physical activity and stroke
in British middle-aged men. British Medical Journal
1992;304:597-601.

Webber LS, Srinivasan SR, Wattigney WA, Berenson GS.
Tracking of serum lipids and lipoproteins from child-
hood to adulthood: the Bogalusa Heart Study. Ameri-
can Journal of Epidemiologjl 1991;133:884-899.
West DW, Slattery ML, Robison LM, FrenchTK, Mahoney
AW. Adult dietary intake and prostate cancer risk in
Utah: a case-control study with special emphasis on
aggressive tumors. Cancer Causes and Control
1991;2:85-94.

West KM. Epidemiology ofdiabetes and its vascular lesions.
New York: Elsevier, 1978.

Weyerer S. Physical inactivity and depression in the
community: evidence from the Upper Bavarian Field
Study. International Journal of Sports Medicine
1992;13:492-496.

Whittemore AS, Wu-Williams AH, Lee M, Shu Z, Gallagher
RP,Deng-aoJ,etal. Diet,physicalactivity,andcolorectal
cancer among Chinese in North America and China.
Journal of the National Cancer Institute 1990;82:915-
926.

Wilfley D, Kunce J. Differential physical and psychologi-
cal effects of exercise.]oumal ofcounseling Psychology
1986;33:337-342.

Willett WC, MansonJE, Stampfer MJ, Colditz GA, Rosner
B, Speizer FE, et al. Weight, weight change, and coro-
nary heart disease in women: risk within the `normal'
weight range. Journal ofthe American Medical Associa-
tion 1995;273:461-465.

Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer
FE. Relation of meat, fat, and fiber intake to the risk of
colon cancer in a prospective study among women.
New EnglandJournal ofMedicine 1990;323: 1664-1672.
Williamson DF, Madans J, Anda RF, Kleinman JC, Kahn
HS, Byers T. Recreational physical activity and ten-year
weight change in a US national cohort. International
Journal of Obesity 1993;17:279-286.

171


Physical Activity and Health

Willich SN, Lewis M, Lowe1 H, Arntz H-R, Schubert F,
Schroder R. Physical exertion as a trigger of acute
myocardial infarction. New England Journal o/ Medi-
cine 1993;329:1684-1690.

Wilmore JH. Body composition in sport and exercise:
directions for future research. Medicine and Science in
Sports and Exercise 1983;15:21-31.

Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga
P. Waist-to-hip ratio in middle-aged women: associa-
tions with behavioral and psychosocial factors and
with changes in cardiovascular risk factors. Arterio-
sclerosis and Thrombosis 1991;11:1250-1257.

Wolf AM, Gortmaker SL, Cheung L, Gray HM, Herzog
DB, Colditz GA. Activity, inactivity, and obesity:
racial, ethnic, and age differences among school-
girls. American Journal o/ Public Health 1993;83:
1625-1627.

Wolf SL, Barnhart HX. Kutner NG, McNeely E, Coogler
C, Xu T, et al. Reducing frailty and falls in older
persons: an investigation of Tai Chi and computerized
balance training. Journal of the American Geriatrics
Society 1996;44:489-497.

Wolfson L, Whipple R, Derby C, Judge J, King M,
Amerman P, et al. Balance and strength training in
older adults: intervention gains and Tai Chi mainte-
nance. Journal o/ tflc American Geriatrics Society
1996;44:498-506.

Woo R, Garrow JS, Pi-Sunyer FX. Effect of exercise on
spontaneous calorie intake in obesity. AmcricanJour-
nal of Clinical Nutrition 1982a;36:470-477.

Woo R, Garrow JS, Pi-Sunyer FX. Voluntary food intake
during prolonged exercise in obese women. American
Journal o/Clinical Nutrition 1982b;36:478-484.
World Health Organization. Constitution of the World
Health Organization. Chronicle OJ the World Health
Organization 1947;1:29-43.

Wu AH, Paganini-Hill A, Ross RK, Henderson BE. Alco-
hol, physical activity, and other risk factors for
colorectal cancer: a prospective study. Britishjournal
of Cancer 1987;55:687-694.

Yano K, Reed DM, McGee DL. Ten-year incidence of
coronary heart disease in the Honolulu Heart Program:
relationship to biologic and lifestyle characteristics.
AmericanJournal of Epidemiology 1984;119: 653-666.

Yanowitz FG. Atherosclerosis: processes vs origins.
1n:Yanowitz F, editor. Coronary heart disease preven-
tion. New York: Marcel Dekker, 1992:17-31.

Yu H, Harris RE, Wynder EL. Case-control study of
prostate cancer and socioeconomic factors. Prostate
1988;13:317-325.

Zheng W, Shu X0, McLaughlin JK, Chow WH, Gao YT,
Blot WJ. Occupational physical activity and the inci-
dence of cancer of the breast, corpus uteri, and ovary
in Shanghai. Cancer 1993;71:3620-3624.
Zimmet P, Faaiuso 5, Ainuu J, Whitehouse S, Mime B,
DeBoer W. The prevalence of diabetes in the rural
and urban Polynesian population of Western Samoa.
Diabetes 198 1;30:45-5 1.

Zimmet PZ. Kelly West Lecture 199 1 challenges in diabe-
tes epidemiology- from West to the rest. Diabetes
Cat-e 1992;15:232-252.

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     CHAPTER 5
PATTERNS AND TRENDS
IN PHYSICAL ACTWIN

Contents

Introduction  ..........................................................
Physical Activity among Adults in the United States  ...........................
Recent Patterns of Leisure-Time Physical Activity  ..........................
  Physical Inactivity during Leisure Time  ...............................
  Regular, Sustained Physical Activity during Leisure Time  .................
  Regular, Vigorous Physical Activity during Leisure Time  ..................
  Participation in Specific Physical Activities  .............................
Leisure-Time Physical Activity among Adults with Disabilities  ................
Trends in Leisure-Time Physical Activity  .................................

Physical Activity among Adolescents and Young Adults in the United States
Physical Inactivity  ............................................
Vigorous Physical Activity  .....................................
Other Physical Activity  ........................................
Physical Education in High School  ...............................
Sports Team Participation  ......................................

. 175

177

177

. 177

177

181

.  184

.  186

186

186

188

189

192

198

200

Conclusions  ............................................................... 200

ResearchNeeds  .......................................................... 201

Appendix A: Sources of National Survey Data . . . . . . . . 201

Appendix B: Measures of Physical Activity in Population Surveys . . . . . _ . . . . _ . 203

References ._...._....,.....__......._.........................,,........... 206


     CHAPTER 5
PATTERNS AND TRENDS

Introduction

T his chapter documents patterns and trends of
reported leisure-time physical activity of adults
and adolescents in the United States and compares
the findings to the goals set by Healthy People 2000
(U.S. Department of Health and Human Services
(USDHHS] 1990; see Chapter 2, Appendix A, for
the 1995 revised Healthy People 2000 objectives for
physical activity and fitness). The information pre-
sented here is based on cross-sectional data from
national- and state-based surveillance systems, spon-
sored by the Centers for Disease Control and Preven-
tion (CDC), that track health behaviors including
leisure-time physical activity. Although self-reported
survey information about physical activity is likely
to contain errors of overreporting, there is no other
feasible way to estimate physical activity patterns of
a population. Moreover, there is no widely accepted
"gold standard" methodology for measuring physi-
cal activity (see Chapter 2).

Occupational and most domestic physical activi-
ties are not presented because such information is
not available. Most national goals address leisure-
time rather than occupational physical activity be-
cause people have more personal control over how
they spend their leisure time and because most
people do not have jobs that require regular physical
exertion. Nonetheless, measuring only leisure-
time physical activity leads to an underestimate of
total physical activity, especially for those people
with physically demanding jobs.
Five surveys provided data oh physical activity
for this review: 1) the National Health Interview
Survey (NHIS), which included questions on physi-
cal activity among adults in 1985, 1990, and 1991;
2) the Behavioral Risk Factor Surveillance System
(BRFSS), a state-based survey of adults that was
conducted monthly by state health departments, in

IN PHYSICAL ACTIVITY

collaboration with the CDC, and included questions
on physical activity from 1986 through 1992 and in
1994; 3) the Third National Health and Nutrition
Examination Survey (NHANES 111) of U.S. adults
from 1988 through 1994 (data from Phase 1, 1988-
199 1, were available for presentation in this report);
4) the 1992 household-based NHIS Youth Risk Be-
havior Survey (NHIS-YRBS) of 12- through 21-year-
olds; and 5) the national school-based Youth Risk
Behavior Survey (YRBS), which was conducted in
1991, 1993, and 1995 among students in grades 9-
12. The methodologies of these surveys are summa-
rized in Table 5-1 and are described in detail in
Appendices A and B of this chapter.
When adult data from the NHIS, BRFSS, and
NHANES III are presented for comparison, they are
shown from the most nearly contemporaneous sur-
vey years. Otherwise, the most recent data are pre-
sented. For determining trends, BRFSS data are
restricted to those states that collected physical ac-
tivity information each year.

Responses to questions included in the surveys
were compiled (see Appendix B) into categories
approximately corresponding to the Healthy People
2000 physical activity objectives. These objectives
are based on the health-related physical activity
dimensions of caloric expenditure, aerobic intensity,
flexibility, and muscle strength (Caspersen 1994).
Thus the "regular, sustained physical activity" cat-
egory used here pertains to total caloric expenditure
and includes a summation of activities of any inten-
sity, whereas the "regular, vigorous" category per-
tains to aerobic intensity and therefore includes only
activities of vigorous intensity. Because some ac-
tivities (e.g., vigorous activity of 30 minutes dura-
tion) fall into bothof these categories, the categories
are not mutually exclusive. Adding together the
proportion of people in each category thus yields an