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09/12/2008
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Cohors, cohortis
What a difference a mile makes
Results
Nature or nurture
Results
Comment
Benefits of cohort studies
Is
Bandolier
obsessed with systematic reviews of randomised controlled trials? Surely not!
Systematic reviews and meta-analysis may be the best way of assessing the
effectiveness of interventions, but other study architectures can help
understanding, especially when more than one study points in the same direction
for the same effect.
Cohors, cohortis
For the classically minded we have previously given the definition of a cohort (
Bandolier 24
). This might conjure up a picture of Roman legionaries tramping to the limits of
the Empire (and if you want to see just how good their shoes were, check out some
of the museums along Hadrian's Wall).
The point, though, is that they did walk everywhere, and up until quite recently
daily walks to work or school of several miles were not remarkable. They are now,
which is why a study of the effects of walking in non-smoking retired men in
Hawaii [1] is important.
What a difference a mile makes
The study examined 707 non-smoking retired men of Japanese ancestry aged 61 to 81
years who were enrolled in the Honolulu Heart Program, which has been going since
1965. When they enrolled between 1980 and 1982 (then aged 45 to 68 years) they
had a physical examination. They were asked about the average distance walked
each day.
Results
The average distance walked each day was 1.8 miles (2.9 km). In the 12 years of
follow up there were 208 deaths - 33 from heart disease, 19 from stroke, 68 from
cancer and 88 from other causes. The death rate was examined according to whether
men walked less than 1 mile, 1 to 2 miles, or more than 2 miles a day.
There were no differences between these three groups in terms of cholesterol,
HDL, weight, hypertension, diabetes, diet or alcohol consumption. After 10 years,
walking patterns were checked, and confirmed that men, by and large, maintained
their walking patterns.
The less men walked, the more likely they were to die (Figure).
The reduction in mortality came not just from reduced heart
disease or stroke, but was also from cancer and other causes of death. The risk
of death in men who walked less than 1 mile a day was 1.8 times that of men who
walked more than 2 miles a day.
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