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BACKGROUND: The relative age effect (RAE) is a worldwide phenomenon, allowing sport participation and elite selection to be based on birthdate distribution. Negative consequences include both a narrow, non-optimal elite selection and negative health effects on entire populations. This study investigated the RAE and athletic performance in multiple individual sports in Sweden. METHODS: Birthdates of athletes born between the years 1922 and 2015 were collected across 4-month periods (tertiles: T1, T2, T3) from cross-country skiing (N = 136,387), orienteering (N = 41,164), athletics (N = 14,503), alpine skiing (N = 508), E-sports (N = 47,030), and chess (N = 4889). In total, data from 244,560 athletes (women: N = 79,807, men: N = 164,753) was compared to the complete parent population of 5,390,954 births in Sweden during the same years. Chi-squared statistics compared parent and cohort distributions stratified by sport, sex, and age. RESULTS: A significantly skewed distribution of birthdates was present in all sports, both sexes, and most age groups. The largest RAEs are seen in children where T1 often constitutes 40-50% and T3, 20-25% of the population. In E-sports, an inversed RAE was seen in adults. In most investigated sports, birthdate distribution was correlated to performance in children but not in adults. CONCLUSIONS: Skewed birthdate distributions were consistently prevalent in all investigated individual sports in Sweden, both physically demanding and cognitive/skill-based. As sport participation is related to total level of physical activity, both present and future, failing to address the RAE issue at an early age will result not only in a narrow and arbitrary selection for adult elite athletes but also in a negative impact on public health.
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