Increased longevity in elite athletes

Seventy years ago, a 25-year-old Englishman became the first person to run a mile (1.61 km) in under 4 minutes (3 minutes and 59.4 seconds). Since 1954, more than 1,755 athletes have been able to run the mile in under 4 minutes, the fastest being a Moroccan man whose record was 3 minutes and 43.13 seconds in 1999. Running that fast requires pushing the human body to its limits, which is very demanding on the cardiovascular system. Some believe that this kind of extreme exercise could have negative health consequences. They point to studies that show associations between the risk of cardiac events and the amount of exercise that are “U-shaped” or “inverted J-shaped.” These studies suggest that moderate-intensity exercise is beneficial for health, but that extremes (too little or too much exercise) may increase the risk of premature mortality. Other data seem to support this hypothesis, indicating that high-intensity exercise sessions or extreme sporting events such as marathons, Ironman-type triathlons, or endurance cycling are associated with markers of cardiac damage, a decrease in ventricular function at rest, and, in some cases, coronary calcification and myocardial fibrosis (see our article on the subject).

Most of the studies that suggest that intense exercise has adverse effects on cardiovascular health or can lead to premature mortality have been conducted using members of the general population and not elite endurance athletes. It is important to note that very few people within the general population exercise intensely, and therefore data collected in such studies should be interpreted with great caution. Indeed, the few epidemiological studies conducted using elite athletes who exercise a great deal (Tour de France cyclists (see here and here), Olympic athletes, rowers) have shown increased longevity among these groups compared to the general population.

In a recent study, researchers asked how long the first 200 athletes to run a mile in under 4 minutes lived. Of those 200 runners (all men), 60 had died and 140 were still alive. Overall, these athletes lived 4.7 years longer than the predicted life expectancy. Taking into account the decade in which the feat was accomplished, longevity increased by 9.2 years (1950s), 5.5 years (1960s), and 2.9 years (1970s). The authors of the study believe that the decrease in the favourable effect on longevity observed over the decades can be attributed to the increase in life expectancy in the general population, due to advances in the diagnosis and treatment of several diseases, both communicable and noncommunicable.

The factors contributing to the increased longevity among these sub-4-minute mile runners and other cohorts of endurance athletes remain to be precisely established. The increase in longevity observed among elite athletes is greatest among athletes who participate in endurance sports (running, cycling, rowing), while power athletes have a smaller increase in longevity or the same longevity as the general population. Studies of Tour de France cyclists and Olympic endurance athletes indicate that the increased longevity is mainly attributable to a reduction in cardiovascular and cancer-related mortality. Endurance athletes have in common the fact that they have developed a high maximal oxygen consumption capacity, which is one of the best predictors of cardiovascular disease, cancer, and all-cause mortality. In addition, elite athletes are likely to have favourable genetics and have adopted a healthy lifestyle (diet, sleep, etc.), in addition to training intensively and participating in competitions.