February 28 — 29, 2008 Advisory Committee Meeting Minutes

Adult Summary

I-Min Lee, M.D., Sc.D., summarized major outcomes to cover among the adult population sub-group as follows:

All-Cause Mortality
The studies consist of Type 3a level of evidence data. There is about a 30% risk reduction with at least 2 to 2.5 hours per week of moderate-to-vigorous activity. There appears to be a dose-response relationship and it is curvilinear in shape. There is limited data on dose-response for intensity.

Cardio-respiratory Health
The studies consist of Type 3a level of evidence for CHD, CVD and stroke. There is approximately a 20 – 35% risk reduction with at least 800 MET minutes per week. This includes specific data on walking at least 2 hours per week. The data is primarily based on aerobic activities. One can start to see risk reductions at levels below 800 MET minutes per week. There is very limited data on accumulation. Studies consisting of Type 1 evidence support the conclusions for CVD and CHD.

Cancer
For colon and breast cancer the research consists of Type 3a data. The data suggests about a 30% risk reduction for colon cancer and 20% for breast cancer based on at least 30 – 60 minutes per day of moderate-to-vigorous activity. There appears to be a dose-response relation; however, the shape of the curve is unclear. There is no information on accumulation.

The level of evidence for QOL and breast cancer survivors is Type 1 but consists of a very small body of evidence. The available data suggests physical activity improves outcomes. There is limited data on dose-response since most trials used currently recommended levels of physical activity.

Metabolic Health
Data consists of Type 2a and 3a for Type 2 Diabetes, Type 3a for macrovascular complications and Type 3a and 3b for metabolic syndrome. There appears to be about a 30 – 40% risk reduction based on 120 – 150 minutes per week. The data is based primarily on aerobic activity. There appears to be a dose-response relation for volume of physical activity. Risk reductions can be seen at levels below 120 – 150 minutes per week. There is limited data on accumulation.

For gestational diabetes data consists of Type 3a data; however, it is a relatively small body of data. The data supports benefit based on 30 minutes per day of moderate-to-vigorous activity. There is limited data on a dose-response relationship. There is no evidence that physical activity can prevent Type 1 Diabetes. The level of evidence for the positive effect for treatment of complications resulting from Type 1 Diabetes is 3b. Physical activity can help control HbA1c and may prevent progression of nephropathy and neuropathy.

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