Cross-Country Skiing and Running’s Association with Cardiovascular Events and All-Cause Mortality: A Review of the Evidence

Jari Antero Laukkanen, Setor K Kunutsor, Cemal Ozemek, Timo H. Mäkikallio, Duck-chul Lee, Ulrik Wisloff, Carl J. Lavie

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Citations (Scopus)
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A large body of evidence demonstrates positive, graded effects of PA on cardiovascular disease (CVD) morbidity and mortality with increasing intensity compared with lower PA intensity. Running is often designated as a high-intensity PA with substantial evidence supporting its health benefits. Cross-country skiing is among the most demanding aerobic endurance exercises and requires engaging the upper- and lower-body. Cross-country skiing is often regarded as high-intensity PA, which has been associated with significant health benefits. However, a robust body of evidence identifying the dose-response relation between cross-country skiing volume and health outcomes is sparse. Therefore, this review aims to summarize the available evidence linking cross-country skiing with CVD morbidity and all-cause mortality; postulated pathways that may elucidate the relation between these associations; outline areas of ongoing uncertainty; and the implications for primary and secondary CVD prevention. To put the findings into perspective, we also summarized the evidence linking running with CVD morbidity and all-cause mortality. Though a head-to-head comparison is not available, the evidence indicates that performing PA as cross-country skiing associates with lower mortality risk when compared with that observed in those undertaking their PA as running. Potential adverse effects of extreme high weekly doses of cross-country skiing over decades may be cardiac arrhythmias, such as atrial fibrillation. Evidence suggests that cross-country skiing may reduce the risk of CVD events and all-cause mortality via anti-inflammatory pathways, improvements in endothelial function and reduced levels of CVD risk factors, such as lipids, glucose, and blood pressure; and enhancement of cardiorespiratory fitness.
Original languageEnglish
Number of pages10
JournalProgress in Cardiovascular Diseases
Early online date7 Sep 2019
Publication statusE-pub ahead of print - 7 Sep 2019


  • Physical activity
  • exercise
  • skiing
  • running
  • cardiovascular disease


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