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Reduced mortality in former Tour de France participants: the benefits from intensive exercise or a select genetic tour de force?

Abbas Zaidi, Sanjay Sharma
DOI: http://dx.doi.org/10.1093/eurheartj/eht373 3106-3108 First published online: 3 September 2013

This editorial refers to ‘Mortality of French participants in the Tour de France (1947–2012)’, by E. Marijon et al., on page 3145

During the 13th stage of the 1967 Tour de France, near the summit of Mount Ventoux, race leader Tom Simpson fell dramatically from his cycle. Legend dictates that Simpson demanded in whispered gasps ‘Put me back on my bike!’ just moments before succumbing to a fatal cardiac arrest. Although post-mortem examination revealed amphetamines in Simpson's body, the story bears testament not only to the fanatical devotion of many endurance athletes, but also to the gruelling nature of this 3500 km event. Riders completing the Tour are estimated to have scaled the combined equivalent of Ben Nevis, Scafell Pike, Snowdon, Mont Blanc, Kilimanjaro, and Everest within 21 days. In 2013, the year that has witnessed the 100th excursion of the Tour, the risk–benefit ratio of such extreme exercise continues to provoke fierce controversy amongst the scientific community.

Evidence for the health benefits of physical activity is incontrovertible. Individuals engaging in habitual exercise exhibit reduced levels of cardiovascular disease, obesity, hypertension, cancers, and depression, and live ∼6 years longer than their sedentary counterparts.1,2 These data are derived largely from analyses of modest exercise ‘doses’. A recent study of Danish joggers indicated that running at modest pace for 1–2.5 h/week yielded the greatest increase in life expectancy, above which the benefits plateaued.3 Meta-analyses …