Centenary of the Tour de France Group: Mortality of French Participants from the Tour de France 1947-2012

Presented at the ESC congress 2013 by:   Xavier JOUVEN (Paris, FR)

Background

A beneficial effect has been described for moderate exercise as compared to intensive training. In that context a few deaths that happened during the Tour de France are striking. This exercise has been compared to running a marathon a few times per week, for three weeks on end.
This study compared mortality among French participants of the Tour de France, with a comparable group of men from the general population. 786 Tour de France participants were included, who participated in the Tour de France on average 2.5 times.

Main results

• The Tour de France participants showed a 41% lower mortality than the general population of the same age (SMR: 0.59, 95%CI: 0.51-0.68, P<0.0001).
• Based on the cohort of 1947-1951 it can be estimated that Tour de France participants live 6 years longer than men in the general population.
• The results were consistent among subgroups based on age, time period and cause of death, with an exception for death as a result of traumatic causes.

Conclusion

There was a considerable and significant decrease of mortality among participants of the Tour de France, as compared to men of the same age in the general population. In addition, Tour de France participants seem to live longer.
These results do not give insight in the balance between the positive effects of intensive physical exercise and selection of a selective group of healthy athletes, vs. possible harmful effects of intensive exercise and alleged doping use.
Dr. Jouven concluded from these results at the ESC congress that the message that is often given that intensive exercise is not healthy, might not be correct. Promoting too much prudence might even be harmful to the general population.
In the discussion at the ESC congress it was remarked that this study concerns a very selective group of elite-athletes, who continue a very healthy lifestyle also after their professional sports career. When somebody is capable to ride the Tour de France, he has a large chance of living 6 years longer. It is possible that the observed effect is not specific to cycling, but rather for the extent of exercise.
The data of the general population were not corrected for smoking. But, dr. Jouven said that his recommendation to not discourage intensive exercise is still valid, because they would have seen a negative effect, had there been one. The positive effects outweigh the negative effects, according to him.

Download TOUR de France 2013 PACE.pptxor click to enlarge.