Abstract
Objective
To perform a meta-analysis of cohort studies aimed at providing an accurate overview
of mortality in elite athletes.
Patients and Methods
We reviewed English-language scientific articles available in Medline and Web of Science
databases following the recommendations of the Meta-analyses Of Observational Studies
in Epidemiology group. We searched for publications on longevity and professional or elite athletes (with no restriction on the starting date and up to March 31, 2014).
Results
Ten studies, including data from a total of 42,807 athletes (707 women), met all inclusion
criteria. The all-cause pooled standard mortality ratio (SMR) was 0.67 (95% CI, 0.55-0.81;
P<.001) with no evidence of publication bias (P=.24) but with significant heterogeneity among studies (I2=96%; Q=224.46; P<.001). Six studies provided data on cardiovascular disease (CVD) and 5 on cancer
(in a total of 35,920 and 12,119 athletes, respectively). When only CVD was considered
as a cause of mortality, the pooled SMR was 0.73 (95% CI, 0.65-0.82; P<.001) with no evidence of bias (P=.68) or heterogenity among studies (I2=38%; Q=8.07; P=.15). The SMR for cancer was 0.60 (95% CI, 0.38-0.94; P=.03) with no evidence of bias (P=.20) despite a significant heterogeneity (I2=91%; Q=44.21; P<.001).
Conclusion
The evidence available indicates that top-level athletes live longer than the general
population and have a lower risk of 2 major causes of mortality, namely, CVD and cancer.
Abbreviations and Acronyms:
CVD (cardiovascular disease), SMR (standard mortality rate)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Mayo Clinic ProceedingsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Exercise-based cardiac rehabilitation and improvements in cardiorespiratory fitness: implications regarding patient benefit.Mayo Clin Proc. 2013; 88: 431-437
- Physical activity promotion in the health care system.Mayo Clin Proc. 2013; 88: 1446-1461
- Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.Lancet. 2012; 380: 219-229
- Mortality and longevity of elite athletes.J Sci Med Sport. 2010; 13: 410-416
- Reduced mortality in former Tour de France participants: the benefits from intensive exercise or a select genetic tour de force?.Eur Heart J. 2013; 34: 3106-3108
- The dose of running that best confers longevity.Heart. 2013; 99: 588-590
- Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training.Circulation. 2011; 123: 13-22
- Potential adverse cardiovascular effects from excessive endurance exercise [published correction appears in Mayo Clin Proc. 2012;87(7):704].Mayo Clin Proc. 2012; 87: 587-595
- Meta-analysis of observational studies in epidemiology: a proposal for reporting.JAMA. 2000; 283: 2008-2012
- Direction and impact of language bias in meta-analyses of controlled trials: empirical study.Int J Epidemiol. 2002; 31: 115-123
- Association of the ACTN3 R577X polymorphism with power athlete status in Russians.Eur J Appl Physiol. 2008; 103: 631-634
Wells GA, Shea B, O’Connell D, et al. Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Countway Library of Medicine website. http://guides.library.harvard.edu/meta-analysis. Accessed June 3, 2014.
- Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players.Am J Cardiol. 2012; 109: 889-896
- Proportionate mortality of Italian soccer players: is amyotrophic lateral sclerosis an occupational disease?.Eur J Epidemiol. 2005; 20: 237-242
- Mortality of top athletes, actors and clergy in Poland: 1924-2000 follow-up study of the long term effect of physical activity.Eur J Epidemiol. 2008; 23: 335-340
- Does education matter? Major League Baseball players and longevity.Death Stud. 2007; 31: 653-670
- Disease-specific mortality among elite athletes.JAMA. 2001; 285: 44-45
- Mortality of French participants in the Tour de France (1947-2012).Eur Heart J. 2013; 34: 3145-3150
- Life expectancy in Italian track and field athletes.Eur J Epidemiol. 1990; 6: 257-260
- Longevity and causes of death in male athletic champions.Lancet. 1971; 2: 1364-1366
- All causes of mortality in male professional soccer players.Eur J Public Health. 2007; 17: 600-604
- The mortality experience of major-league baseball players.N Engl J Med. 1988; 318: 1278-1280
- Longevity of men capable of prolonged vigorous physical exercise: a 32 year follow up of 2259 participants in the Dutch eleven cities ice skating tour.BMJ. 1990; 301: 1409-1411
- Mortality amongst participants in Vasaloppet: a classical long-distance ski race in Sweden.J Intern Med. 2003; 253: 276-283
- Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study.Eur Heart J. 2013; 34: 3624-3631
- High prevalence of arrhythmias in elderly male athletes with a lifelong history of regular strenuous exercise.Heart. 1998; 79: 161-164
- Loss of ovarian function in mice results in abrogated skeletal muscle PPARdelta and FoxO1-mediated gene expression.Biochem Biophys Res Commun. 2010; 392: 1-3
- Leisure time physical activity of moderate to vigorous intensity and mortality: a large pooled cohort analysis.PLoS Med. 2012; 9: e1001335
- Letter by Ruiz et al regarding article, “Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training.”.Circulation. 2011; 124 (author reply e251): e250
- The Tour de France: a physiological review.Scand J Med Sci Sports. 2003; 13: 275-283
- Increased average longevity among the “Tour de France” cyclists.Int J Sports Med. 2011; 32: 644-647
- Increased life expectancy of world class male athletes.Med Sci Sports Exerc. 1993; 25: 237-244
- Use of medications and dietary supplements in later years among male former top-level athletes.Arch Intern Med. 2003; 163: 1064-1068
- Healthy lifestyles of former Finnish world class athletes.Med Sci Sports Exerc. 1994; 26: 224-229
Article Info
Publication History
Published online: August 12, 2014
Footnotes
For editorial comment, see page 1171; for a related article, see page 1187
Identification
Copyright
© 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
