Montero · Scandinavian journal of medicine & science in sports 2017 · systematic review and meta-analysis · n=30 studies (299 participants)

Red cell volume response to exercise training: Association with aging.

Cited 34 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of exercise intervention studies.

PubMed 27859711 · doi:10.1111/sms.12798 · record verified 2026-08-27

What was done

Authors conducted a systematic review and meta-analysis of MEDLINE, Scopus, and Web of Science through February 2016 for studies evaluating the effect of normoxic exercise training (primarily lower-limb endurance training, mean duration 15.2 weeks) on red blood cell volume (RBCV) in healthy individuals. The analysis included 30 studies representing 299 participants (mean age 19–71 years; 271 males). Mean differences (MD) between pre- and post-training measurements were calculated overall and stratified by age (<60 years vs. ≥60 years).

What was found

Across all 299 participants, exercise training did not lead to a statistically significant increase in RBCV (MD = 49 mL, 95% CI: -11 to 108, P = 0.11). However, subgroup analysis showed a significant expansion in RBCV among young and middle-aged participants under 60 years old (n = 106, MD = 81 mL, 95% CI: 0 to 162, P < 0.05; I² = 0%), whereas older adults aged 60 and above experienced no meaningful change (n = 110, MD = 13 mL, 95% CI: -76 to 102, P = 0.77; I² = 0%).

Why it matters

These findings suggest that the hematological adaptation of expanding red cell volume in response to endurance exercise is age-dependent and attenuated or absent in older adults. This clarifies conflicting literature on exercise-induced hematological changes across the lifespan.

Limits

The total sample size is modest (299 individuals across 30 studies, averaging ~10 participants per study) and heavily male-dominated (90.6% men), limiting generalizability to women. The pooled studies primarily evaluated within-subject pre-post changes rather than randomized control comparisons, and training protocols across included studies may have differed in intensity and volume.

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