Elsevier

Mayo Clinic Proceedings

Volume 89, Issue 9, September 2014, Pages 1195-1200
Mayo Clinic Proceedings

Original article
Elite Athletes Live Longer Than the General Population: A Meta-Analysis

https://doi.org/10.1016/j.mayocp.2014.06.004Get rights and content

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.

Section snippets

Data Sources and Searches

We followed the recommendations of the Meta-analyses Of Observational Studies in Epidemiology group9 [see the checklist in Supplemental Appendix 1 (available online at http://www.mayoclinicproceedings.org)]. We searched for publications on longevity and professional or elite athletes (with no restriction on the starting date and up to March 31, 2014). The search terms longevity or survival and professional, elite, or Olympic athletes were used, or combinations of 1 or more of these terms, with

Results

From an initial identification of 88,192 studies, 88,138 were excluded (ie, not potentially relevant studies, congress abstracts, and duplicated material). From the remaining 54 potentially relevant studies, 44 studies were excluded with reasons, namely, not written in English (n=3), SMR not reported (n=38), and duplicated or nonelite athletic population (n=3).

Ten studies,13, 14, 15, 16, 17, 18, 19, 20, 21, 22 including a total of 42,807 athletes (707 women), met all the inclusion criteria (

Discussion

The results of this meta-analysis indicate that elite athletes live longer than the general population. Such a powerful effect on human longevity is comparable, if not higher, to that reported for vigorous but less competitive exercise. For instance, the all-cause SMR of well-trained recreational athletes (Dutch endurance ice-skaters) was 0.76 (95% CI, 0.68-0.85).23

Growing evidence indicates that intense endurance exercise might produce cardiac alterations (mainly increased risk of atrial

Conclusion

Although more research is needed using more homogeneous cohorts and a more proportional representation of both sexes, the evidence available indicates that elite athletes (mostly men) live longer than the general population, which suggests that the beneficial health effects of exercise, particularly in decreasing CVD and cancer risk, are not necessarily confined to moderate doses. Future studies might elucidate whether the present high demands of professional sports participation also translate

Acknowledgments

The authors would like to thank Dr Pedro J. Marín for his advice and thoughtful comments.

References (34)

  • B. Benito et al.

    Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training

    Circulation

    (2011)
  • D.F. Stroup et al.

    Meta-analysis of observational studies in epidemiology: a proposal for reporting

    JAMA

    (2000)
  • P. Jüni et al.

    Direction and impact of language bias in meta-analyses of controlled trials: empirical study

    Int J Epidemiol

    (2002)
  • A.M. Druzhevskaya et al.

    Association of the ACTN3 R577X polymorphism with power athlete status in Russians

    Eur J Appl Physiol

    (2008)
  • Wells GA, Shea B, O’Connell D, et al. Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies...
  • S. Belli et al.

    Proportionate mortality of Italian soccer players: is amyotrophic lateral sclerosis an occupational disease?

    Eur J Epidemiol

    (2005)
  • A.K. Gajewski et al.

    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)
  • Cited by (127)

    • Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex

      2022, Journal of the American College of Cardiology
      Citation Excerpt :

      Men and women in the ≥98th percentile of peak exercise capacities of approximately 14.0 METs lived 6.0 and 6.7 years longer, respectively, compared with those in the ≤20th percentile of CRF. This is consistent with previous findings suggesting that elite athletes live longer than the general population.45,46 However, evidence of potential cardiac maladaptation, cardiac microdamage, myocardial fibrosis, coronary exercise–induced cardiac biomarker release, artery calcification, and myocardial fibrosis has been reported after high-volume and/or high-intensity exercise bouts.47,48

    View all citing articles on Scopus

    For editorial comment, see page 1171; for a related article, see page 1187

    View full text