Mortality amongst participants in Vasaloppet: a classical long‐distance ski race in Sweden

Abstract

Objective. The aim of this study was to assess mortality amongst participants in long-distance ski races during the Vasaloppet week. We considered the 90 km races for men and 90 or 30 km for women. The vast majority of the participants in these races are not competing on the elite level. It is assumed, however, that they have to undergo regular physical training during a long period of time in order to successfully finish the race. Design. The cohort study consisted of 49 219 men and 24 403 women, who participated in any of the races during 1989-1998. All subjects were followed up in the National-Cause-of-Death-Register until 31 December 1999. We computed the standardized mortality ratios (SMRs) adjusting for age and calendar year.Results. Overall, 410 deaths occurred, compared with 850.6 expected, yielding an SMR of 0.48 [95% confidence interval (CI) 0.44-0.53]. Low SMRs were found in all age groups in both men and women and in all groups after categorization by finishing time and number of races. The lowest SMRs were found amongst older participants and in those who participated in several races. A decreased mortality was observed in all major diagnostic groups, namely cancers (SMR ¼ 0.61; 95% CI 0.52-0.71), diseases of the circulatory system (SMR ¼ 0.43; 95% CI 0.35-0.51), and injuries and poisoning (SMR ¼ 0.73; 95% CI 0.60-0.89). For lung cancer the SMR was 0.22, but even after exclusion of lung cancer the all-cancer mortality was low (SMR ¼ 0.72; 95% CI 0.59-0.86). Conclusions. We conclude that participants in longdistance skiing races, which demand prolonged regular physical training, have low mortality. The extent to which this is due to physical activity, related lifestyle factors, genetics or selection bias is yet to be assessed.

Risk of Recurrent Stroke and Death After First Stroke in Long‐Distance Ski Race Participants

“…Among these skiers, a faster finishing time and a high number of completed races are associated with a future higher incidence of AF5 that may theoretically increase the risk for embolic stroke. Yet, in contrast, the participants in the Vasaloppet have a substantially lower mortality rate compared with the general population 7. There is a seemingly contradictory relationship between a high level off physical activity and risk of cardiovascular disease.…”

Measured cardiorespiratory fitness and self‐reported physical activity: associations with cancer risk and death in a long‐term prospective cohort study

“…For other cancers, the association is less clear 1, 2. An inverse association is also observed between physical activity and cancer mortality, for total cancer 3, 4, 5, 6, 7, 8, 9 and cancer‐specific for colon, liver, and lung cancer 3, 6, 9, 10. Whether prediagnostic physical activity influences cancer survival in cancer patients is a question given less attention.…”

Can Intensive Exercise Harm the Heart?

“…For example, when >15 000 Olympic medalists from 9 different country groups were examined over decades after their first medal, there was a progressive increase in conditional survival (compared with age-and sex-matched controls from the general population in those countries; Figure 1) for the Olympic medalists which was greatest in the participants in endurance sports. 14 Although there are many possible explanations for such a finding (such as socioeconomic status, or healthier lifestyles), the concept of increased rather than decreased survival in elite endurance athletes has been demonstrated repeatedly, [15][16][17] and was most recently buttressed by a study of nearly 800 French Tour de France competitors who experienced a substantial reduction in mortality (40%) compared with the French male noncyclist population. 18 Therefore, although there is growing evidence that the heart may show some signs of fatigue, 19,20 especially of the right ventricle 21 after single bouts of extraordinary endurance effort, 22 which may be accompanied by the release of biomarkers of cell permeability, 23 there is little evidence that such physiological signals are pathological, 24 and no rash of deaths in participants of long-distance events such as marathons.…”