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Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes

Adam Runacres, Kelly Mackintosh Orcid Logo, Melitta McNarry Orcid Logo

Sports Medicine, Volume: 51, Issue: 2, Pages: 289 - 301

Swansea University Authors: Adam Runacres, Kelly Mackintosh Orcid Logo, Melitta McNarry Orcid Logo

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DOI (Published version): 10.1007/s40279-020-01379-5

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IntroductionExercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be ‘J’ shaped; with elite athlete’s likely training above these...

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Published in: Sports Medicine
ISSN: 0112-1642 1179-2035
Published: Springer Science and Business Media LLC 2021
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A Meta-Analysis of 165,000 Former Athletes</title><swanseaauthors><author><sid>2a650b8b1240fe1382ce33ff2661d62e</sid><firstname>Adam</firstname><surname>Runacres</surname><name>Adam Runacres</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>bdb20e3f31bcccf95c7bc116070c4214</sid><ORCID>0000-0003-0355-6357</ORCID><firstname>Kelly</firstname><surname>Mackintosh</surname><name>Kelly Mackintosh</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>062f5697ff59f004bc8c713955988398</sid><ORCID>0000-0003-0813-7477</ORCID><firstname>Melitta</firstname><surname>McNarry</surname><name>Melitta McNarry</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2020-10-23</date><deptcode>FGSEN</deptcode><abstract>IntroductionExercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be &#x2018;J&#x2019; shaped; with elite athlete&#x2019;s likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes.Methods38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio&#x2019;s (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis.ResultsAthletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61&#x2013;0.78]; female SMR 0.51 [95% CI 0.40&#x2013;0.65]; both p&#x2009;&lt;&#x2009;0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91&#x2013;1.12]). Although male athlete&#x2019;s CVD (SMR 0.73 [95% CI 0.62&#x2013;0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63&#x2013;0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86&#x2013;1.40]) or END athletes cancer mortality (SMR 0.73 [0.50&#x2013;1.07]). There was insufficient data to calculate female sport-specific SMR&#x2019;s.DiscussionOverall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the &#x2018;J&#x2019; shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation.</abstract><type>Journal Article</type><journal>Sports Medicine</journal><volume>51</volume><journalNumber>2</journalNumber><paginationStart>289</paginationStart><paginationEnd>301</paginationEnd><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0112-1642</issnPrint><issnElectronic>1179-2035</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-02-01</publishedDate><doi>10.1007/s40279-020-01379-5</doi><url/><notes/><college>COLLEGE NANME</college><department>Science and Engineering - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGSEN</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-02-05T10:48:21.8762710</lastEdited><Created>2020-10-23T09:20:05.7985416</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Adam</firstname><surname>Runacres</surname><order>1</order></author><author><firstname>Kelly</firstname><surname>Mackintosh</surname><orcid>0000-0003-0355-6357</orcid><order>2</order></author><author><firstname>Melitta</firstname><surname>McNarry</surname><orcid>0000-0003-0813-7477</orcid><order>3</order></author></authors><documents><document><filename>55502__19193__a6a88bea329848008add53aaf997dbfc.pdf</filename><originalFilename>55502 (2).pdf</originalFilename><uploaded>2021-01-28T09:49:47.6782583</uploaded><type>Output</type><contentLength>2854021</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; The Author(s) 2020. 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spelling 2021-02-05T10:48:21.8762710 v2 55502 2020-10-23 Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes 2a650b8b1240fe1382ce33ff2661d62e Adam Runacres Adam Runacres true false bdb20e3f31bcccf95c7bc116070c4214 0000-0003-0355-6357 Kelly Mackintosh Kelly Mackintosh true false 062f5697ff59f004bc8c713955988398 0000-0003-0813-7477 Melitta McNarry Melitta McNarry true false 2020-10-23 FGSEN IntroductionExercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be ‘J’ shaped; with elite athlete’s likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes.Methods38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio’s (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis.ResultsAthletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61–0.78]; female SMR 0.51 [95% CI 0.40–0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91–1.12]). Although male athlete’s CVD (SMR 0.73 [95% CI 0.62–0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63–0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86–1.40]) or END athletes cancer mortality (SMR 0.73 [0.50–1.07]). There was insufficient data to calculate female sport-specific SMR’s.DiscussionOverall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the ‘J’ shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Journal Article Sports Medicine 51 2 289 301 Springer Science and Business Media LLC 0112-1642 1179-2035 1 2 2021 2021-02-01 10.1007/s40279-020-01379-5 COLLEGE NANME Science and Engineering - Faculty COLLEGE CODE FGSEN Swansea University 2021-02-05T10:48:21.8762710 2020-10-23T09:20:05.7985416 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Adam Runacres 1 Kelly Mackintosh 0000-0003-0355-6357 2 Melitta McNarry 0000-0003-0813-7477 3 55502__19193__a6a88bea329848008add53aaf997dbfc.pdf 55502 (2).pdf 2021-01-28T09:49:47.6782583 Output 2854021 application/pdf Version of Record true © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License true eng https://creativecommons.org/licenses/by/4.0/
title Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes
spellingShingle Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes
Adam Runacres
Kelly Mackintosh
Melitta McNarry
title_short Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes
title_full Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes
title_fullStr Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes
title_full_unstemmed Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes
title_sort Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes
author_id_str_mv 2a650b8b1240fe1382ce33ff2661d62e
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author_id_fullname_str_mv 2a650b8b1240fe1382ce33ff2661d62e_***_Adam Runacres
bdb20e3f31bcccf95c7bc116070c4214_***_Kelly Mackintosh
062f5697ff59f004bc8c713955988398_***_Melitta McNarry
author Adam Runacres
Kelly Mackintosh
Melitta McNarry
author2 Adam Runacres
Kelly Mackintosh
Melitta McNarry
format Journal article
container_title Sports Medicine
container_volume 51
container_issue 2
container_start_page 289
publishDate 2021
institution Swansea University
issn 0112-1642
1179-2035
doi_str_mv 10.1007/s40279-020-01379-5
publisher Springer Science and Business Media LLC
college_str Faculty of Science and Engineering
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hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 1
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description IntroductionExercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be ‘J’ shaped; with elite athlete’s likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes.Methods38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio’s (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis.ResultsAthletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61–0.78]; female SMR 0.51 [95% CI 0.40–0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91–1.12]). Although male athlete’s CVD (SMR 0.73 [95% CI 0.62–0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63–0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86–1.40]) or END athletes cancer mortality (SMR 0.73 [0.50–1.07]). There was insufficient data to calculate female sport-specific SMR’s.DiscussionOverall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the ‘J’ shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation.
published_date 2021-02-01T04:09:45Z
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