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RESEARCH PRODUCT

Essay: Does training adversely affect long-term health?

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A number of philosophers and physicians living in ancient Greece thought that sport could harm both mind and body. Hippocrates, for example, acknowledged the health benefits of physical activity, but also believed that intense athletic competition had a harmful effect on the heart and other organs, and lowered resistance to disease. That athletes do not have a shorter life expectancy than the general population, however, was not appreciated until the 19th century. In 1873, J E Morgan published the results of his study of 294 British oarsmen who participated in the Oxford versus Cambridge boat races between 1829 and 1869. His findings indicated that these sportsmen lived about 2 years longer than the “average Englishman” of insurance statistics. Today, many diverse sports are played at the highest level; these sports have different risks of injury associated with them and often have specific physiological requirements. Sports also differ in the ethical standards that their governing bodies demand of them. Cultural factors can affect training regimens and can govern to what degree athletes are expected to devote their life to their profession. Researching the physiological effects of vigorous training on athletes’ long-term health is, therefore, complicated. With Professor Seppo Sarna and colleagues, I have prospectively studied over the past few years the effects of training on the long-term health of about 2500 male Finnish athletes who competed in international competitions between 1920 and 1965. From 1920 we followed-up causes of deaths, from 1970 we used registers of hospital discharges, reimbursable medications, and cancer registries, among other things, and from 1985 we used health questionnaires. We also followed up controls (one per athlete) who were healthy at age 20 years and matched to cases for age and geographical location. We grouped the sports that the athletes competed in by degree of average maximum oxygen uptake as follows: endurance sports (highest maximum oxygen uptake—long-distance runners and cross-country skiers), mixed sports (medium maximum oxygen uptake—soccer, ice-hockey, basketball, track and field jumpers, and short-distance runners), and strength sports (lowest maximum oxygen uptake— weightlifters, wrestlers, boxers, and track and field throwers). Our aim was to ascertain what the major athletic risk factors were for the most common chronic diseases.