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Is running associated with a lower risk of all-cause, cardiovascular and cancer mortality, and is the more the better? A systematic review and meta-analysis
  1. Zeljko Pedisic1,
  2. Nipun Shrestha1,
  3. Stephanie Kovalchik1,
  4. Emmanuel Stamatakis2,3,
  5. Nucharapon Liangruenrom1,4,
  6. Jozo Grgic1,
  7. Sylvia Titze5,
  8. Stuart JH Biddle6,
  9. Adrian E Bauman3,
  10. Pekka Oja7
  1. 1Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
  2. 2Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
  3. 3Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
  4. 4Institute for Population and Social Research, Mahidol University, Nakorn Pathom, Thailand
  5. 5Institute of Sport Science, University of Graz, Graz, Austria
  6. 6Institute for Resilient Regions, Centre for Health, Informatics, and Economic Research, University of Southern Queensland, Springfield Central, Queensland, Australia
  7. 7UKK Institute for Health Promotion Research, Tampere, Finland
  1. Correspondence to Professor Zeljko Pedisic, Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia; Zeljko.Pedisic{at}vu.edu.au

Abstract

Objective To investigate the association of running participation and the dose of running with the risk of all-cause, cardiovascular and cancer mortality.

Design Systematic review and meta-analysis.

Data sources Journal articles, conference papers and doctoral theses indexed in Academic Search Ultimate, CINAHL, Health Source: Nursing/Academic Edition, MasterFILE Complete, Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus and Web of Science.

Eligibility criteria for selecting studies Prospective cohort studies on the association between running or jogging participation and the risk of all-cause, cardiovascular and/or cancer mortality in a non-clinical population of adults were included.

Results Fourteen studies from six prospective cohorts with a pooled sample of 232 149 participants were included. In total, 25 951 deaths were recorded during 5.5–35 year follow-ups. Our meta-analysis showed that running participation is associated with 27%, 30% and 23% lower risk of all-cause (pooled adjusted hazard ratio (HR)=0.73; 95% confidence interval (CI) 0.68 to 0.79), cardiovascular (HR=0.70; 95% CI 0.49 to 0.98) and cancer (HR=0.77; 95% CI 0.68 to 0.87) mortality, respectively, compared with no running. A meta-regression analysis showed no significant dose–response trends for weekly frequency, weekly duration, pace and the total volume of running.

Conclusion Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity. Any amount of running, even just once a week, is better than no running, but higher doses of running may not necessarily be associated with greater mortality benefits.

  • exercise
  • physical activity
  • running
  • sport
  • survival
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Footnotes

  • Contributors ZP, PO, ES, ST and AEB conceptualised the study. ZP wrote the study protocol. ZP conducted the literature searches. ZP and NS conducted the study selection and data extraction. NL and SJHB conducted the study quality assessment. JG assisted in solving discrepancies between duplicate study selections, data extractions and quality assessments. SK conducted the meta-regression analysis. ZP conducted the other meta-analyses and created directed acyclic graphs. ZP and NS drafted the methods section of the manuscript. ZP drafted all other sections of the manuscript. All authors critically revised the draft manuscript and contributed to the subsequent revisions and the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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