Cross-country skiing is associated with lower all-cause mortality: A population-based follow-up study.

The prospective relationship between leisure-time cross-country skiing and any fatal events is uncertain. We aimed to assess the associations of leisure-time cross-country skiing habits with the risk of all-cause mortality in a general population. A 12-month physical activity questionnaire was used at baseline to assess the frequency, average duration, and intensity of cross-country skiing in a prospective population-based cohort of 2087 middle-aged men from eastern Finland. Hazard ratios (HRs; 95% confidence intervals) were calculated for all-cause mortality. During a median (interquartile range) follow-up of 26.1 (18.7-28.0) years, 1028 all-cause mortality outcomes were recorded. In analyses adjusted for several established risk factors and other potential confounders, when compared to men who did not do any cross-country skiing, the HRs (95% CIs) of all-cause mortality were 0.84 (0.73-0.97) and 0.80 (0.67-0.96) for men who did 1-200 and >200 metabolic equivalent-hours per year of cross-country skiing, respectively. Similarly, compared to men who did not do any cross-country skiing, the corresponding adjusted HRs (95% CIs) for all-cause mortality were 0.84 (0.72-0.97) and 0.82 (0.69-0.97) for men who did 1-60 min/wk and >60 min/wk of cross-country skiing, respectively. The associations were similar across several subgroups, except for evidence of effect modification by body mass index and history of diabetes. Total volume as well as duration of leisure-time cross-country skiing is each inversely and independently associated with all-cause mortality in a middle-aged Caucasian male population.