From the original 59,506 surveys received on or after 1998 (when the question on usual running pace was introduced), we excluded 1 survey for missing sex, 76 for missing age, 967 for missing BMI, 1139 for missing running distance (many presumably nonrunners), and 1494 for missing usual running pace. We also excluded 1129 current smokers. Thus, complete data on distance run per day, usual running pace, and BMI were available for 25,552 male and 29,148 female nonsmoking runners. The sample was primarily white (men = 86.7%; women = 88.5%), with smaller percentages of Hispanic (men = 6.6%; women = 5.1%), Asian (men = 3.1%; women = 3.1%), African American (men = 1.9%; women = 1.5%), Native American (men = 0.6%; women = 0.5%), and mixed race (men = 0.9%; women, 1.1%). The men were significantly older than the women (mean ± SD: 44.4 ± 11.4 vs. 38.0 ± 10.1 yr), whereas their years of education were similar (16.5 ± 2.6 vs. 16.2 ± 2.6 yr, respectively).
The characteristics of the sample in relation to their self-reported usual pace are presented in . Faster runners of both sexes were younger, lighter, leaner, and smaller waisted but not necessarily distinguished by stature. Faster runners were also less likely to be ex-smokers. Younger age probably explains the shorter running history of the faster runners. Medication use was 8- to 14-fold greater in the slowest than fastest men and 5- to 7-fold greater in the slowest than fastest women. Intakes of meat and fruit were inversely related to running pace in women (P < 0.0001) but not men, whereas alcohol intake was inversely related to pace in men (P < 0.0001) but not women. On average, the men ran at 88.9% and the women at 92.7% of their 10-km performance speed. Usual running pace averaged 0.47 ± 0.44 m/s slower than the 10-km performance times in men and 0.30 ± 0.46 m/s slower in women; however, usual running pace and 10-km performance were strongly correlated (P < 0.0001) when unadjusted for other factors (men, r = 0.68; women, r = 0.58) and when adjusted for age (men, r = 0.61; women, r = 0.56) and kilometers per day (male, r = 0.55; females, r = 0.49) or age, kilometers per day, and BMI (men, r = 0.51; women, r = 0.46).
Characteristics of male and female runners by reported usual running speed
presents the odds ratios per meters-per-second increment in usual running speed adjusted for age, ex-smoker status, and diet. The odds for taking medications for high blood pressure, high cholesterol, or diabetes decreased in association with the meters per second of usual running speed (P < 0.0001), and these decreases were little affected by additional adjustment for distance. Further adjustment for BMI somewhat diminished the significances of the odds reductions; however, all remained statistically significant. With the exception of antidiabetic use in men, the odds reductions also remained significant when adjusted for waist circumference. Adjustment for the separate effects of height and weight produced odds ratios and significance levels entirely consistent with the BMI-adjusted odds ratios of (analyses not displayed).
Odds ratio (95% confidence intervals) for the prevalence of anti-hypertensive, LDL-cholesterol lowering, and anti-diabetic medication use per m/s of reported running speed during usual run (N=29,726 men and 12,222 women).
presents the men’s odds ratios for usual running speed adjusted for age, diet, ex-smoker status, and alcohol. The ratios are calculated relative to the odds for medication use in men who ran slower than a 10-min/mile (<2.68 m/s). The odds ratio for antihypertensive medication use declined linearly with usual speed and was significantly less than 1 in men who ran 9 min/mile or faster. Additional adjustment for running distance increased the odds ratios only slightly. Above the bars are the kilometers-per-day–adjusted significance levels for exceeding the running pace represented by the bar (i.e., the odds for using antihypertensive medications were significantly lower, P = 0.003, in men who ran faster than 7 min/mile than men who ran 7.1 to 8 min/mile). These significance levels show significant incremental reductions for antihypertensive medication usage throughout the range of running speeds when adjusted for distance run. Additional adjustment for BMI lessened the reductions in the odds ratio with usual running speed; however, medication usage remained significantly lower in men who ran 8.1 to 9, 7.1 to 8, or 7 min/mile or less compared to those running slower than 10 min/mile.
FIGURE 1 Odds ratios for medication use by usual running pace relative to the slowest men (referent group >10 min/mile), adjusted for age and intakes of meat, fish, fruit, and alcohol. Additional adjustment for running distance (km/wk) and BMI where indicated. (more ...)
When adjusted for distance, reductions in men’s use of LDL-cholesterol–lowering medication were significant for each minute per mile increment in usual running speed. The results were similar with or without kilometers per day and BMI adjustment. Relative to the slowest men, the odds for medication use in those who ran 7 min/mile or faster were reduced 81% without adjustment for kilometers per day, 78% with adjustment for kilometers per day, and 72% adjusted for kilometers per day and BMI.
There were also substantial reductions in antidiabetic medication use with usual running speed, particularly with respect to slower than 10 min/mile versus faster paces. Adjustment for BMI did lessen the significance of the odds reduction; however, men whose speed was 8 min/mile or faster had less than one half the odds for using antidiabetic medications than those requiring over 10 minutes to run a mile.
presents the corresponding graphs for women. Because the women averaged about a mile per minute slower than the men (mean ± SD: 9.2 ± 1.8 vs. 8.3 ± 1.4 min/mile), their speed categories were shifted to be 1 min/mile slower. Running an 11-min/mile or faster was associated with significantly lower odds for medication use than slower women (P < 0.0001 for antihypertensive and antidiabetic medications, and P = 0.0006 for LDL-cholesterol–lowering medications). Running a 10-min/mile or faster was also associated with lower odds for antihypertensive (P = 0.03), LDL-cholesterol–lowering (P = 0.02), and antidiabetic medications (P = 0.06) than running 10.1 to 11 min/mile. Adjustment for running distance had little effect on the women’s odds ratios, and although adjustment for BMI had a somewhat greater effect, the significance of the odds ratios was generally not lost except for LDL-cholesterol–lowering.
FIGURE 2 Odds ratios for medication use by usual running pace relative to the slowest women (referent group >11 min/mile), adjusted for age and intakes of meat, fish, fruit, and alcohol. Additional adjustment for running distance (km/wk) and BMI where (more ...)
presents the odds ratios for antihypertensive, LDL-cholesterol–lowering, and antidiabetic medication use by running distance in this sample. In men, usual running distance was associated with lower medication use both before and after adjustment for usual running speed, albeit the odds reductions per kilometers-per-day run were reduced when adjusted. The women’s odds reductions for antihypertensive and LDL-cholesterol–lowering medications were similar to those of men but lacked statistical significance when adjusted for usual running speed.
Odds ratio (95% confidence intervals) for the prevalence of anti-hypertensive, LDL-cholesterol lowering, and anti-diabetic medication use by running distance (km/day) before and after adjustment usual running speed (N=29,726 men and 12,222 women).
examines the independent contributions of running speed (m/s) during a usual run and maximum performance over a 10-km footrace by simultaneously including both in the logistic regression model. The analyses are restricted to 75% of men and 64.5% of women who provided their race times. Compared with those excluded for lacking these data, the runners included in these analyses were similar in age (mean ± SD for included vs. excluded males = 44.3 ± 10.6 vs. 44.9 ± 12.0 yr, females = 38.5 ± 9.6 vs. 37.7 ± 11.0 yr) but tended to be leaner (males = 24.0 ± 2.7 vs. 24.8 ± 3.1 kg/m2
, females = 21.4 ± 2.5 vs. 22.1 ± 3.2 kg/m2
), and run farther (males = 39.2 ± 22.5 vs. 28.8 ± 21.3 km/wk, females = 36.9 ± 21.0 vs. 26.6 ± 19.3 km/wk) and faster during their usual runs (males = 3.35 ± 0.45 vs. 3.22 ± 0.55 m/s, females = 3.05 ± 0.39 vs. 2.90 ± 0.51 m/s). The subset shows the same odds reduction in medication use with usual running speed in men as the complete sample but somewhat weaker odds reduction compared with the complete sample of women (cf. and ). There is also a general agreement between the odds ratio for medication use versus the 10-km performance for this subset and the entire cross-sectional sample [38
]. The analyses show that when adjusted for 10-km performance times (a measure of cardiorespiratory fitness), the odds ratio per meters-per-second increment in usual running speed remains significantly less than 1 for antidiabetic, LDL-cholesterol–lowering, and antidiabetic medication use in men and for antidiabetic and antihypertensive medication use in women. After additional adjustment for BMI, the separate contributions of usual running speed and 10-km performance are less distinguishable for antidiabetic medication use in men and all three medications in women. However, men’s usual running speed remains significantly related to their odds ratio for antihypertensive and LDL-cholesterol–lowering medications when adjusted for 10-km performance and BMI in addition to age, diet, and ex-smoker status. Faster 10-km performance was significantly related to lower antihypertensive and LDL-cholesterol–lowering medication use in men and antihypertensive medication use in women when adjusted for usual running speed. However, adjusting for the 10-km performance diminishes the odds reduction for medication use versus running speed, and correspondingly, adjusting for running speed diminishes the odds reduction for medication use versus the 10-km performance.
Odds ratio (95% confidence intervals) for the prevalence of anti-hypertensive, LDL-cholesterol lowering, and anti-diabetic medication use per m/s of running speed during usual run and 10km foot race (N=19,228 men and 18,806 women).
Additional analyses to assess whether relative intensity predicted the odds for medication use showed that runners who typically ran at a higher percentage of their 10-km performance were not at significantly lower odds for using antihypertensive, antidiabetic, or LDL-lowering medications (analyses not displayed).