title: Elite athletes live longer than the general population: a meta-analysis.
abstract: OBJECTIVE
  To perform a meta-analysis of cohort studies aimed at providing an accurate overview of mortality in elite athletes.
  
  
  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 (I(2)=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 (I(2)=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 (I(2)=91%; Q=44.21; P<.001).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Physiotherapy and Nursing, University of Zaragoza, Huesca, Spain; Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Garatachea
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain; Department of Biomedical Sciences, University of León, León, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Santos-Lozano
authors.affiliation: Department of Physiology, University of Valencia and Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain.
authors.forename: Fabian
authors.initials: F
authors.lastname: Sanchis-Gomar
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain; European University, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Fiuza-Luces
authors.affiliation: Department of Physiology, University of Valencia and Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain.
authors.forename: Helios
authors.initials: H
authors.lastname: Pareja-Galeano
authors.affiliation: Department of Health Sciences, University of Pavia, Pavia, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Emanuele
authors.affiliation: Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain; European University, Madrid, Spain. Electronic address: alejandro.lucia@uem.es.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Lucia
mesh_terms: D056352:Athletes / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000401:mortality; D005260:Female; D006801:Humans; D008136:Longevity; D008297:Male; D009026:Mortality; D009369:Neoplasms / Q000401:mortality; D012307:Risk Factors