Why Exercise Is The Key To A Longer Life
If extending lifespan is a priority for you then optimising fitness has to be front and centre.
High levels of fitness are arguably the best predictors of longevity.
If you want to extend your lifespan, prioritising fitness is essential.
If you are not prioritising fitness, then you are leaving huge potential gains on the table.
Here’s why.
The evidence that high levels of exercise and subsequent fitness are linked with increased lifespan and health span is clear.
We can characterise high levels of fitness in many ways, but all of them tend to point in one direction - towards a longer life.
While I have covered many of these fitness measures individually in previous posts, I wanted to summarise these metrics and how they relate to living longer and preventing major diseases such as cardiovascular disease, cancer and dementia.
Let’s start with the most basic measures and then examine increasingly complex ones.
By the end of this article, you should be convinced that high levels of fitness and daily exercise are a MUST for a longer quality of life without major illness.
Activity - Steps
Daily step count, although a crude measure of activity, is surprisingly powerful in predicting early death and disease onset.
While the magic figure of 10,000 steps per day was essentially pulled out of thin air by Japanese engineers who invented the first step counters, it has served as an excellent target for most people.
Achieving more than 7000 steps per day is associated with a 50 to 70% lower chance of dying from any cause over a 10-year time frame1.
This relationship has been demonstrated in multiple studies emphasising the need above all that daily ‘activity’ of whatever type is a must.
A higher daily step count is also linked to significantly lower cancer, stroke and heart disease rates.
Daily step counts of over 16,000 steps have been linked to over a 50% reduction in the rates of heart attacks2.
V02 Max
V02 Max is a measure of the maximum amount of oxygen your body can use during exercise and is best measured in a specialised sports physiology lab as part of a cardiopulmonary exercise test.
While V02 Max levels are, to an extent, genetically influenced, they can also be trained to much higher levels and will decay if left untrained.
High levels of V02 Max are the byproduct of YEARS of focused training. While V02 Max can be increased with short specific training periods, the real gains are made with decades of training.
The gains in terms of lifespan with high levels of V02 Max are immense.
Very high levels of V02 Max have been consistently shown to be associated with much lower rates of early death.
Those with the highest levels of V02 Max are over Five TIMES less likely to die from any cause over a ten-year time frame3.
This is a stunning difference.
Compare this to those who smoke versus those who do not, where the difference in mortality over a 10-year time frame was only 41%.
NOTHING else in healthcare can offer these levels of life extension.
High levels of V02 Max and aerobic fitness have also been associated with lower rates of most major chronic diseases, including cancer and diabetes.
Those with the very highest levels of fitness have almost nonexistent rates of type 2 diabetes4.
The relationship is clear.
The higher the fitness, the less chance of an early death or a major illness that typically leads to death.
Fitness & Dementia
This relationship is also clearly evident when it comes to rates of dementia.
Those in the highest fitness categories compared to even a moderate fitness level are 78% less likely to develop dementia over a 44-year follow-up.5
Heart Rate Recovery
How quickly your heart rate lowers after intense exercise is also a powerful predictor of an early death.
The reason for this likely relates to higher levels of parasympathetic activity, which is the opposing side of sympathetic activity, which is driven by higher levels of stress, etc.
Compared to those whose heart rates dropped by over 20 beats per minute, 60 seconds after an exercise stress test, those whose heart rates dropped the least had over a 5 times higher risk of early death over a 6-year follow-up6.
Heart rate recovery is a modifiable metric.
So far, we have primarily focused on aerobic fitness and activity measures, but muscle size and performance metrics are also crucial determinants of longevity and health.
Muscle Strength
Muscle strength is clearly linked to early mortality and less chronic disease.
As a metric, it can be measured in a variety of ways, but the most common measure of muscle strength is grip strength.
High levels of grip strength are associated with a 50% reduction in the chances of dying from any cause7.
For every 5kg reduction in grip strength, there is about a 10 to 20% increase in the risk of:
Cardiovascular Mortality
Respiratory Mortality
Cancer Mortality
It is important to note that grip strength is acting as a proxy for strength overall, and there is nothing magical about isolated grip strength alone.
Muscles Mass
In addition to muscle strength, muscle mass is also a powerful predictor of early death and other chronic diseases8.
While muscle strength is likely to be a better overall predictor, muscle mass is an important metric to track over time.
Conclusion
For almost every single metric and disease state we care about, low levels of fitness are associated with a higher incidence of those conditions9.
How To Train These Metrics.
The age-old question then becomes what type of training is needed to optimise these metrics of longevity.
While the in-depth answer to this question is beyond the scope of this article, a recent publication has attempted to answer this question.
What was the best combination of:
Moderate Physical Activity (MPA)
Vigorous Physical Activity (VPA)
Muscle Strengthening Activity (MSA)
I will leave the summary table below for you to examine in detail, but in general:
About 75-150 minutes of BOTH moderate physical activity AND vigorous physical activity IN ADDITION to 2 or more strength training activities led to about a 50% reduction in all-cause mortality over ten years10.
I wouldn't focus too much on the minor details but would rather focus on the main takeaway that ALL are needed at a reasonable amount.
However, with all of the above in mind.
My suggestion would be to:
Move. A LOT. EVERY DAY.
Train with a focus on raising your V02 Max, supported by a large aerobic base (a discussion for another day). i.e., mostly long and slow, with small amounts of fast and hard and a nice sprinkle of everything in between.
Make muscle strength and mass a priority. In that order. But it’s hard to focus on one in isolation, so I wouldn’t get too focused on separating them.
Track these metrics objectively. Measure. Train. Repeat.
Work with someone who can assist you with specifically optimising them.
Have fun. Enjoy the process.
Enjoy the results.
Regular exercise and high levels of physical fitness are the best predictors of longevity and disease prevention.
Avoid them at your peril.
Your life depends on it.
When You Are Ready, Here Is How We Can Help.
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Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study. JAMA Netw Open. 2021 Sep 1;4(9):e2124516.
Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events. J Am Coll Cardiol. null2023, 0 (0) .
Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing. JAMA Netw Open. 2018;1(6):e183605.
Prognostic value of exercise capacity in incident diabetes: a country with high prevalence of diabetes. BMC Endocr Disord 22, 297 (2022).
Midlife cardiovascular fitness and dementia: A 44-year longitudinal population study in women. Neurology. 2018 Apr 10;90(15):e1298-e1305.
Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med. 1999 Oct 28;341(18):1351-7.
Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: a systematic review with dose-response meta-analysis, Ageing Research Reviews, 2022, 101778, ISSN 1568-1637
Srikanthan P, Karlamangla AS. Muscle mass index as a predictor of longevity in older adults. Am J Med. 2014 Jun;127(6):547-53.
Association of Estimated Cardiorespiratory Fitness in Midlife With Cardiometabolic Outcomes and Mortality. JAMA Netw Open. 2021;4(10)
Prospective Associations of Different Combinations of Aerobic and Muscle-Strengthening Activity With All-Cause, Cardiovascular, and Cancer Mortality. JAMA Intern Med. Published online August 07, 2023.
This post is tremendous.
Thank you!
A really useful and informative article. At the tender age of 56 I’ve been a lifelong exerciser .. but having everything laid out so clearly and backed by data is most helpful.
Thank you … will be sharing widely here and on LinkedIn 👍🏻😎