Proposed profile-informed rehabilitation framework for cardiometabolic risk after elite sport retirement: a scoping review

Retirement from elite sport can alter training, energy balance, pain, sleep, identity and structured support. Evidence is concentrated in selected male Western cohorts and remains fragmented across weight, metabolic, sleep, rhythm, women’s-health and rehabilitation domains. We mapped both cardiometabolic patterns and population-level evidence gaps after elite-sport retirement. A formal corrective search covered PubMed/MEDLINE, Scopus and Web of Science Core Collection from database inception through 14 July 2026. The review was retrospectively registered on OSF. Human title/abstract screening routed 287 records to full text; 162 retrieved reports received named human review and cross-review. Evidence was classified as direct retired-athlete (D), contextual athlete (C), general guidance/tool support (G), background (B) or author-proposed inference (P) and synthesised narratively. The searches produced 4,884 unique records. Of 286 unique report units sought for retrieval, 162 were retrieved and human-assessed, 21 were excluded and 141 were included; 124 were not retrieved and were not counted as eligibility exclusions. The included set comprised 102 new independent primary cohorts, 20 linked reports and 19 evidence syntheses. Non-mutually-exclusive charting identified 78 reports on cardiovascular structure/function/events, 68 on adiposity/body composition/weight, 59 on conventional metabolic risk, 50 on mortality/longevity and 17 on sleep-disordered breathing. The evidence suggested coexistence between favourable population-average longevity and less favourable weight, metabolic, sleep or cardiovascular findings in selected exposure profiles. Retired women, Asian and other non-Western athletes, combat- and weight-class athletes and para-athletes remained underrepresented. Post-retirement cardiometabolic evidence is heterogeneous but clinically and scientifically informative. A proposed profile-informed framework may organise weight and activity trajectories, conventional risk factors, symptoms and sport/exposure history without treating profile labels as biological classes. The framework is hypothesis-generating and requires prospective validation; it does not establish athlete-specific thresholds, fixed follow-up intervals or referral rules. Retrospective registration, non-duplicated title/abstract screening, incomplete retrieval and charting and the absence of auditable formal risk-of-bias ratings warrant cautious interpretation. Open Science Framework, retrospectively registered after initial submission, 16 May 2026 (A9J5Y; doi: https://doi.org/10.17605/OSF.IO/A9J5Y ).