Long-term follow up from the Harvard Alumni Health Study: collegiate sport participation in males is associated with higher physical activity throughout midlife

OBJECTIVE: To compare physical activity (PA) over midlife between (1) former collegiate athletes and non-athletes and (2) among athletes in different sports. METHODS: The Harvard Alumni Health Study (HAHS) is a prospective cohort study of male undergraduates who completed serial questionnaires regarding PA and health status between 1962 and 1993. PA was categorised by intensity (<3 METs, light; 3 to <6 METs, moderate; ≥6 METs, vigorous), and energy expenditure (kilocalories (kcal)/week) was estimated at each intensity and in total. HAHS data were merged with university athletics records. Mixed linear models, adjusted for graduating class, survey date, age and smoking, were compared with PA between relevant groups. RESULTS: 22 201 participants completed 38 448 surveys when 30-65 years old, of which 1533 (6.9%) participants were athletes completing 2733 (7.1%) surveys. The age at the first survey was 46.8±9.7 years. Athletes were more active than non-athletes throughout midlife (p<0.001), from age 35 (total PA: +856.8 [704.6 to 1009.1] kcal/week) to age 65 (+524.2 [359.1 to 689.4] kcal/week). Total PA levels converged with older age, and differences resulted from more vigorous intensity PA in athletes. Multisport collegiate athletes were more active than single sport athletes (+544.6 [196.5 to 892.7] kcal/week, p=0.002). Compared with other athletes, PA in midlife was higher in tennis (+750.1 [223.9 to 1276.2] kcal/week, p=0.005) and basketball (+373.6 [28.7 to 718.5] kcal/week, p=0.03) players. CONCLUSION: Collegiate sport participation, particularly participation in multiple sports, is associated with higher midlife PA levels in males. These results underscore the importance of early life sport exposure in supporting health-promoting levels of later life PA.