Elite Athletes Have Much Loer Mortality Rate

HEALTH

Elite Athletes Have Much Loer Mortality Rate

TRIPOD HAS SOME PROBLEMS WITH SENTENCE SEPARATION AND ENDS. SEE BELOW. I SPENT AN HOUR TRYING TO FIX IT.

Disease-Specific Mortality

Among Elite Athletes

To the Editor: Studies on the long-term

survival of athletes have yielded

conflicting results)²We investigated

whether the mortality rates of elite

athletes varies by participation in

different types of sports and how they

differ from those of the general

population.

Methods. We assessed the mortality, of all 2009 male athletes who had represented Finland in international competitions from 1920 to 1965 and

were alive in January 1971. Cause-specific deaths from 1971 through 1995 were obtained from Statistics Finland. This database provides

virtually complete population mortality data so that cause of death was undefined in only 0.2% of cases. We ranked sports based on average maximal oxygen uptake⁴as follows: endurance (highest maximal

oxygen uptake), mixed (medium maximal

oxygen uptake), and power (lowest maximal oxygen uptake). We computed the standardized mortality ratios (SMRs) for each subgroup of athletes and also

compared ratios of the SMRs of the subgroups.

Results. The TABLE shows the SMRs for cause of death when the mortality in at least 1 specific athlete group was statistically significantly different from

the mortality in the general population. All-cause SMRs were low among the athletes generally, particularly for those with high or medium oxygen uptake (the endurance and mixed sports groups). The SMRs for coronary heart disease were low for endurance and fixed sports athletes but not for power athletes; SMRS for pulmonary diseases were

low for all athlete groups and were again lowest for endurance athletes. All athletes had fewer cancer deaths, which was due to fewer deaths from smoking-related cancers, mainly lung cancer.

Compared with power athletes, the ratio of all-cause SMR was lower for endurance (0.63; 95% confidence interval [CII, 0.51-0.79) and mixed

sports athletes (0.76; 95% CI, 0.65-0.89); the respective ratios of SMRs for coronary heart disease were 0.59 (95% CI, 0.39-0.85) and 0.63 (95%

Cl, 0.47-0.84) for the same groups, respectively.

Comment. Athletes are a select group because people in poor health are less likely to become athletes and because specific physical characteristics may make it easier for some individuals to excel in specific sports. However, athletes also tend to smoke less and are physically more active as they age than age-matched control subjects.³These health habits are

likely to explain some of the reduction of coronary heart disease, pulmonary disease, and cancer mortality in this sample. Although differences among the athletic groups in leisure physical activities and

other health hahit appear to be less pronounced in old age,³in this sample all-cause and coronary heart

disease mortality were lower among endurance

athletes than power athletes. Thus, differences in biological characteristics between endurance and power athletes may explain the selection of specific

types of sports as well as some of the difference in risk of developing coronary heart disease that has been previously reported.

Urho M. Kujala, MD, PhD

Heikki 0. Tikkanen, MD, PhD

Unit for Sports and Exercise Medicine,

Institute of Clinical Medicine

44 JAMA January 3, 2001Vol 285, No. 1

There are two primary reasons why power athletes only had a 10% reduction in mortality. First is that the gain in mass entails more capilaries and thus more strain on the heart. The second is that they are much more likely to become obese. Their image of what look goods is that of being large and their peer group uses less negative social conditioning upon being large.