Life Span Exercise Among Elite Intercollegiate Student Athletes

BACKGROUND: Despite prominent public attention, data on life span health and exercise outcomes among elite, competitive athletes are sparse and do not reflect the diversity of modern athletes. HYPOTHESIS: Life span exercise behavior differs between National Collegiate Athletic Association (NCAA) student athletes and a nonathlete control group. Sustained exercise is associated with improved cardiopulmonary health outcomes. STUDY DESIGN: Cross-sectional, descriptive epidemiology study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 496 students and alumni (age range, 17-84 year) at a large, NCAA Division I university, including student athletes and an age- and sex-matched nonathlete control group, completed anonymous, self-report health and exercise questionnaires. Age-stratified, cross-sectional analysis evaluated previous week’s total exercise volume (ExVol), self-rated exercise importance (ExImp), and compliance with American College of Sports Medicine (ACSM) exercise guidelines for healthy adults. The association of ACSM guideline compliance with lifetime cardiopulmonary health outcomes was also assessed. RESULTS: Current student athletes reported significantly greater ExVol (P < 0.001. Cohen d = 0.99, probability of clinically important difference [pCID] >99.5%), ExImp (P < 0.001, d = 1.96, pCID = 96%), and likelihood of compliance with ACSM guidelines (odds ratio [OR], 95% confidence interval [CI] = 30.6, 11.0-84.6) compared with nonathletes. No significant differences were found between alumni student athletes and nonathletes. Alumni student athletes demonstrated substantially lower ExVol (P < 0.001, d = –0.94, pCID >99.5%) and guideline compliance (OR = 0.09, 95% CI = 0.05-0.19) compared with current student athletes, whereas nonathletes had similar exercise behavior across the life span. Among alumni, ACSM guideline compliance was associated with significant attenuation of cardiopulmonary health concerns (P = 0.02, d = –0.50, pCID = 14%) independent of intercollegiate athletic participation. CONCLUSION: Although current NCAA Division I student athletes demonstrated significant, clinically important differences in exercise behavior compared with nonathletes, no group differences were evident later in life. Irrespective of collegiate athletic status, healthy exercise behavior among alumni was associated with cardiopulmonary health benefits. CLINICAL RELEVANCE: To realize life span health benefits, it is imperative that student athletes maintain consistent patterns of healthy exercise beyond retirement from competitive sports.