Positive effects from sports are achieved primarily through physical activity, but secondary effects bring health benefits such as psychosocial and personal development and less alcohol consumption. Negative effects, such as the risk of failure, injuries, eating disorders, and burnout, are also apparent. Because physical activity is increasingly conducted in an organized manner, sport’s role in society has become increasingly important over the years, not only for the individual but also for public health. In this paper, we intend to describe sport’s physiological and psychosocial health benefits, stemming both from physical activity and from sport participation per se. This narrative review summarizes research and presents health-related data from Swedish authorities. It is discussed that our daily lives are becoming less physically active, while organized exercise and training increases. Average energy intake is increasing, creating an energy surplus, and thus, we are seeing an increasing number of people who are overweight, which is a strong contributor to health problems. Physical activity and exercise have significant positive effects in preventing or alleviating mental illness, including depressive symptoms and anxiety- or stress-related disease. In conclusion, sports can be evolving, if personal capacities, social situation, and biological and psychological maturation are taken into account. Evidence suggests a dose–response relationship such that being active, even to a modest level, is superior to being inactive or sedentary. Recommendations for healthy sports are summarized.

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Background The relative age effect (RAE) is a worldwide phenomenon, allowing sport participation and elite selection to be based on birthdate distribution. Negative consequences include both a narrow, non-optimal elite selection and negative health effects on entire populations. This study investigated the RAE and athletic performance in multiple individual sports in Sweden. Methods Birthdates of athletes born between the years 1922 and 2015 were collected across 4-month periods (tertiles: T1, T2, T3) from cross-country skiing (N = 136,387), orienteering (N = 41,164), athletics (N = 14,503), alpine skiing (N = 508), E-sports (N = 47,030), and chess (N = 4889). In total, data from 244,560 athletes (women: N = 79,807, men: N = 164,753) was compared to the complete parent population of 5,390,954 births in Sweden during the same years. Chi-squared statistics compared parent and cohort distributions stratified by sport, sex, and age. Results A significantly skewed distribution of birthdates was present in all sports, both sexes, and most age groups. The largest RAEs are seen in children where T1 often constitutes 40–50% and T3, 20–25% of the population. In E-sports, an inversed RAE was seen in adults. In most investigated sports, birthdate distribution was correlated to performance in children but not in adults. Conclusions Skewed birthdate distributions were consistently prevalent in all investigated individual sports in Sweden, both physically demanding and cognitive/skill-based. As sport participation is related to total level of physical activity, both present and future, failing to address the RAE issue at an early age will result not only in a narrow and arbitrary selection for adult elite athletes but also in a negative impact on public health.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has unmasked mankind’s vulnerability to biological threats. Although higher age is a major risk factor for disease severity in COVID-19, several predisposing risk factors for mortality are related to low cardiorespiratory and metabolic fitness, including obesity, cardiovascular disease, diabetes, and hypertension. Reaching physical activity (PA) guideline goals contribute to protect against numerous immune and inflammatory disorders, in addition to multi-morbidities and mortality. Elevated levels of cardiorespiratory fitness, being non-obese, and regular PA improves immunological function, mitigating sustained low-grade systemic inflammation and age-related deterioration of the immune system, or immunosenescence. Regular PA and being non-obese also improve the antibody response to vaccination. In this review, we highlight potential physiological, cellular, and molecular mechanisms that are affected by regular PA, increase the host antiviral defense, and may determine the course and outcome of COVID-19. Not only are the immune system and regular PA in relation to COVID-19 discussed, but also the cardiovascular, respiratory, renal, and hormonal systems, as well as skeletal muscle, epigenetics, and mitochondrial function.

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