It remains an open question as to why top-level athletes live notably longer than the rest of us. The point of interest is to what degree the longevity difference is produced by exercise and training versus a population bias among successful athletes to more robust individuals who would live longer regardless of their profession. That's hard to answer at this point, and is a part of broader research regarding exercise, in that while moderate regular exercise is clearly beneficial, it is unknown as to whether anything more than merely moderate regular exercise is more beneficial over the long term.
To determine whether the health benefits of exercise are actually confined (or not) to noncompetitive, moderate (or recreational) practice is of broad medical interest and might help clinicians have more evidence-based data on exercise benefits. Thus, we conducted a meta-analysis of cohort studies comparing mortality in elite athletes with mortality in the general population. We hypothesized that the overall health benefits of competitive exercise would counteract any potential detrimental effect, resulting in higher longevity and lower disease risk in elite athletes than in the general population.
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 with no evidence of publication bias but with significant heterogeneity among studies. 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 with no evidence of bias or heterogenity among studies. The SMR for cancer was 0.60 with no evidence of bias despite a significant heterogeneity.
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. [This] 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 into an actual longevity and health benefit.