title: Adolescent exercise in association with mortality from all causes, cardiovascular disease, and cancer among middle-aged and older Chinese women.
abstract: BACKGROUND
  Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women.
  
  
  METHODS
  The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics Registry. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were derived from Cox regression models.
  
  
  RESULTS
  Adjusting for birth year and other adolescent factors, adolescent exercise was associated with reduced risk of cancer, CVD, and total mortality [HRs (95% CI), 0.83 (0.72-0.95), 0.83 (0.70-0.98), and 0.78 (0.71-0.85), respectively for ≤1.33 hours (h)/week, and 0.83 (0.74-0.93), 0.62 (0.53-0.72), and 0.71 (0.66-0.77), respectively for >1.33 h/week (reference = none)]. Results were attenuated after adjustment for adult SES and lifestyle factors. Participation in sports teams was inversely associated with cancer mortality [HR (95% CI), 0.86 (0.76-0.97)]. Joint adolescent and adult exercise was associated with reduced risk of all-cause, CVD, and cancer mortality [HRs (95% CIs), 0.80 (0.72-0.89), 0.83 (0.69-1.00), and 0.87 (0.74-1.01), respectively], adjusting for adult/adolescent factors, and adolescence exercise only was inversely associated with cancer mortality [HR (95% CI), 0.84 (0.71-0.98)].
  
  
  CONCLUSIONS
  Adolescent exercise participation, independent of adult exercise, was associated with reduced risk of cancer, CVD, and all-cause mortality.
  
  
  CONCLUSIONS
  Results support promotion of exercise in adolescence to reduce mortality in later life.
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee. sarah.nechuta@vanderbilt.edu.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Nechuta
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee.
authors.forename: Xiao Ou
authors.initials: XO
authors.lastname: Shu
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee.
authors.forename: Gong
authors.initials: G
authors.lastname: Yang
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee.
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.affiliation: Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China.
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Gao
authors.affiliation: Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China.
authors.forename: Hong-Lan
authors.initials: HL
authors.lastname: Li
authors.affiliation: Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China.
authors.forename: Yong-Bing
authors.initials: YB
authors.lastname: Xiang
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Nashville, Tennessee. Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011446:Prospective Studies; D055815:Young Adult