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How Much Exercise and What Type Is Needed to Live Longer?
Well planned exercise routine leads to prolonged healthspan. Several studies examined what is the ideal amount of exercise per week, or how many steps we should walk every day.
Highlights
- Between 2,6 to 4,5 hours of physical activity per week is the sweet spot for longevity
- Physical activity can take the form of a variety of leisure-time sports or even walking
- A comprehensive exercise routine should include strength and balance training every week as well as strategies to mitigate time spent sitting
- Starting a well-formulated exercise routine is beneficial at any age
Introduction
The importance of exercise for longevity is hard to overstate. Scientific literature consistently shows that people who engage in even low levels of physical activity have reduced risk of death compared to the sedentary population. We also know that cardiorespiratory fitness is associated with living longer. Most of your clients will ask how much exercise they need to do to improve their chances of a long and healthy life. This article will help you answer it in detail.
The short answer
A good starting point in answering these questions is to look at The Physical Activity Guidelines (1) for Americans. This is how much physical activity they recommend:
- Adults should get at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week, or an equivalent combination.
- More substantial health benefits are seen with 300 minutes of moderate-intensity activity or 150 minutes of vigorous-intensity activity per week.
Moderate intensity can be reached by a variety of different sports such as running, cycling, or swimming. Examples of vigorous activity could be High-intensity interval training (HIIT) or Sprint Interval Training (SIT). The guidelines also discuss the inclusion of resistance and balance training for older adults to help prevent falls. It is important to understand each of these components to implement them into your client’s schedule properly. We will compare how these recommendations stack up against the habits of people that live long.
More is not always better
We know that better cardiorespiratory fitness correlates with better longevity, and there is no ceiling to that association. Unfortunately, this does not seem to be true for exercise. A study from 2021 looked at the exercise habits of nearly 9000 people. Researchers asked them to fill out a questionnaire about the duration of their leisure-time sports activities, which included tennis, badminton, soccer, handball, cycling, swimming, jogging, calisthenics, health club activities, weightlifting, and other sports. Their median follow-up with participants was 25,6 years, and they focused on all-cause mortality.
The study found that those who reported exercising between 2,6 and 4,5 hours per week were 40 % less likely to have died than participants who exercised less. It is also interesting that people who exercised more than 10 hours per week lost about one-third of the benefits compared to those who exercised between 2,6 and 4,5 hours (2). In other words, there is a limit to how much exercise is beneficial. At the highest end, adding exercise is actually working against longevity.
Walking plays a role in longevity
While walking typically requires lower intensity than most leisure-time sports activities, research shows a very similar relationship with longevity. A 2021 study looked at over 2000 participants’ walking habits. The participants wore accelerometers to measure their daily step count. The researchers followed up with participants after a mean of 10,8 years and focused on mortality rates. They found that participants with at least 7000 daily steps were about 50 % less likely to have died than those who took fewer steps. The mortality risk reduction kept increasing up to 70 % at 9000 daily steps. But participants taking more than 10000 steps per day rarely outlived those taking at least 7000 (3).
Compared with the previous study that looked at sport activities, it is reasonable to assume that those exercising 2,6 hours a week would accumulate around 7000 steps per day from a combination of exercise and regular daily activities. Those doing 4,5 hours a week may get close to 10000 steps. While there are obviously going to be outliers that exercise a lot but walk very little and vice versa, researchers from both studies observed a similar benefit ceiling that applies to both leisure sports and walking.
The case for resistance exercise
Walking and leisure-time sports activities are relatively easy to implement into a healthy lifestyle because they are often inherently enjoyable and offer an opportunity to strengthen the social connection. Strength or resistance training can be more challenging if your client does not naturally tend towards it. The research suggests that doing both strength training and aerobic exercise reduces mortality risk more than doing either alone. A study from 2022 finds that doing any amount of resistance training reduces the risk of all-cause mortality by 15%, cardiovascular disease mortality by 19%, and cancer mortality by 14% compared with no strength training. It also showed that a maximum risk reduction of 27% was observed at 60 minutes of resistance training per week (4). This is good news for those clients trying to do the least amount of strength training while improving longevity.
Balance is not to be underestimated
Balance training may be included in some leisure-time sports but is generally missing from the exercise routines of older adults. Balance training (unilateral exercises, yoga, Tai-chi, etc.) is often forgotten because it has very little to do with cardiorespiratory fitness, muscle retention, or calorie expenditure which is how most other forms of exercise contribute to longevity. It helps in a different way. It reduces the risk of falls and associated injuries that could have dire consequences at an older age. Research shows that people between ages 51 and 75 who are unable to stand on one leg for 10 consecutive seconds have double the risk of death from any cause within the next 10 years compared to people who can (5).
Reduction in time spent sitting
Research shows that what we do in between bouts of exercise matters too. Prolonged sedentary time is independently associated with increased risk of all-cause mortality, cardiovascular disease incidence, cancer, and type 2 diabetes incidence regardless of physical activity (6). Thankfully, reducing time spent sitting leads to meaningful positive outcomes. A study from 2020 shows that replacing sitting time with standing is associated with reduced mortality risk by up to 37 % among older women. It also showed that walking around while standing further reduced the mortality risk (7). Increasing time spent standing or moving around at the expense of sitting is an important part of a well-formulated longevity exercise routine.
A comprehensive exercise regimen works for older adults
Even older clients that have not developed a strong exercise habit should be encouraged to start one. Research shows that exercise can bring longevity benefits at any age. A 2020 study illustrated this by randomly assigning 1635 participants aged 70 to 89 into two groups.
One group went through the following moderate-intensity physical activity program:
- 150 minutes per week of walking
- 2x per week instructor-led exercise classes, including strength, flexibility, and balance training
- 3-4x per week home-based activity
The other group joined a health education program:
- 1x per week education workshops on travel safety, health screenings, and nutrition
- 1x per week, 5-10 minutes of instructor-led upper body stretching and flexibility exercises
The results showed that over 2,6 years, the physical activity program reduced the risk of major mobility disability by 18 % compared with the health education program (8). These findings strongly suggest that older adults benefit from physical activity.
Conclusion
The general guidelines to get 150 - 300 minutes of moderate-intensity aerobic activity per week hold up well as recommendations for longevity. They align well with what observation shows to be the optimal range of exercise duration. If we wanted to formulate a rough exercise plan based on what research suggests brings the most benefit for longevity, it would include the following.
- 2,6 - 4,5 hours of aerobic exercise per week
- 7000 - 10000 steps per day
- 60 minutes of resistance training per week
- Weekly balance training, especially for older adults
- Strategies to reduce time spent sitting
A very important takeaway from this article for all of your clients is that starting a well-formulated exercise routine brings benefits relevant to longevity at any age. This should be an excellent, motivating factor for those interested in living long and healthy lives.
References
- Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD. The Physical Activity Guidelines for Americans. JAMA 2018;320(19):2020-8. 10.1001/jama.2018.14854
- Schnohr P, O'Keefe JH, Lavie CJ, Holtermann A, Lange P, Jensen GB, Marott JL. U-Shaped Association Between Duration of Sports Activities and Mortality: Copenhagen City Heart Study. Mayo Clinic proceedings 2021;96(12):3012-20. 10.1016/j.mayocp.2021.05.028
- Paluch AE, Gabriel KP, Fulton JE, Lewis CE, Schreiner PJ, Sternfeld B, Sidney S, Siddique J, Whitaker KM, Carnethon MR. Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study. JAMA network open 2021;4(9):e2124516. 10.1001/jamanetworkopen.2021.24516
- Shailendra P, Baldock KL, Li LSK, Bennie JA, Boyle T. Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. American journal of preventive medicine 2022;63(2):277-85. 10.1016/j.amepre.2022.03.020
- Araujo CG, de Souza E Silva CG, Laukkanen JA, Fiatarone Singh M, Kunutsor SK, Myers J, Franca JF, Castro CL. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British journal of sports medicine 2022;56(17):975-80. 10.1136/bjsports-2021-105360
- Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine 2015;162(2):123-32. 10.7326/M14-1651
- Purva Jain, MPH et al., The Relationship of Accelerometer-Assessed Standing Time With and Without Ambulation and Mortality: The WHI OPACH Study, The Journals of Gerontology: Series A, Volume 76, Issue 1, January 2021, Pages 77–84, https://doi.org/10.1093/gerona/glaa227
- Pahor M et al., Impact and Lessons From the Lifestyle Interventions and Independence for Elders (LIFE) Clinical Trials of Physical Activity to Prevent Mobility Disability. Journal of the American Geriatrics Society 2020;68(4):872-81. 10.1111/jgs.16365
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Highlights
- Between 2,6 to 4,5 hours of physical activity per week is the sweet spot for longevity
- Physical activity can take the form of a variety of leisure-time sports or even walking
- A comprehensive exercise routine should include strength and balance training every week as well as strategies to mitigate time spent sitting
- Starting a well-formulated exercise routine is beneficial at any age
Introduction
The importance of exercise for longevity is hard to overstate. Scientific literature consistently shows that people who engage in even low levels of physical activity have reduced risk of death compared to the sedentary population. We also know that cardiorespiratory fitness is associated with living longer. Most of your clients will ask how much exercise they need to do to improve their chances of a long and healthy life. This article will help you answer it in detail.
The short answer
A good starting point in answering these questions is to look at The Physical Activity Guidelines (1) for Americans. This is how much physical activity they recommend:
- Adults should get at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week, or an equivalent combination.
- More substantial health benefits are seen with 300 minutes of moderate-intensity activity or 150 minutes of vigorous-intensity activity per week.
Moderate intensity can be reached by a variety of different sports such as running, cycling, or swimming. Examples of vigorous activity could be High-intensity interval training (HIIT) or Sprint Interval Training (SIT). The guidelines also discuss the inclusion of resistance and balance training for older adults to help prevent falls. It is important to understand each of these components to implement them into your client’s schedule properly. We will compare how these recommendations stack up against the habits of people that live long.
More is not always better
We know that better cardiorespiratory fitness correlates with better longevity, and there is no ceiling to that association. Unfortunately, this does not seem to be true for exercise. A study from 2021 looked at the exercise habits of nearly 9000 people. Researchers asked them to fill out a questionnaire about the duration of their leisure-time sports activities, which included tennis, badminton, soccer, handball, cycling, swimming, jogging, calisthenics, health club activities, weightlifting, and other sports. Their median follow-up with participants was 25,6 years, and they focused on all-cause mortality.
The study found that those who reported exercising between 2,6 and 4,5 hours per week were 40 % less likely to have died than participants who exercised less. It is also interesting that people who exercised more than 10 hours per week lost about one-third of the benefits compared to those who exercised between 2,6 and 4,5 hours (2). In other words, there is a limit to how much exercise is beneficial. At the highest end, adding exercise is actually working against longevity.
Walking plays a role in longevity
While walking typically requires lower intensity than most leisure-time sports activities, research shows a very similar relationship with longevity. A 2021 study looked at over 2000 participants’ walking habits. The participants wore accelerometers to measure their daily step count. The researchers followed up with participants after a mean of 10,8 years and focused on mortality rates. They found that participants with at least 7000 daily steps were about 50 % less likely to have died than those who took fewer steps. The mortality risk reduction kept increasing up to 70 % at 9000 daily steps. But participants taking more than 10000 steps per day rarely outlived those taking at least 7000 (3).
Compared with the previous study that looked at sport activities, it is reasonable to assume that those exercising 2,6 hours a week would accumulate around 7000 steps per day from a combination of exercise and regular daily activities. Those doing 4,5 hours a week may get close to 10000 steps. While there are obviously going to be outliers that exercise a lot but walk very little and vice versa, researchers from both studies observed a similar benefit ceiling that applies to both leisure sports and walking.
The case for resistance exercise
Walking and leisure-time sports activities are relatively easy to implement into a healthy lifestyle because they are often inherently enjoyable and offer an opportunity to strengthen the social connection. Strength or resistance training can be more challenging if your client does not naturally tend towards it. The research suggests that doing both strength training and aerobic exercise reduces mortality risk more than doing either alone. A study from 2022 finds that doing any amount of resistance training reduces the risk of all-cause mortality by 15%, cardiovascular disease mortality by 19%, and cancer mortality by 14% compared with no strength training. It also showed that a maximum risk reduction of 27% was observed at 60 minutes of resistance training per week (4). This is good news for those clients trying to do the least amount of strength training while improving longevity.
Balance is not to be underestimated
Balance training may be included in some leisure-time sports but is generally missing from the exercise routines of older adults. Balance training (unilateral exercises, yoga, Tai-chi, etc.) is often forgotten because it has very little to do with cardiorespiratory fitness, muscle retention, or calorie expenditure which is how most other forms of exercise contribute to longevity. It helps in a different way. It reduces the risk of falls and associated injuries that could have dire consequences at an older age. Research shows that people between ages 51 and 75 who are unable to stand on one leg for 10 consecutive seconds have double the risk of death from any cause within the next 10 years compared to people who can (5).
Reduction in time spent sitting
Research shows that what we do in between bouts of exercise matters too. Prolonged sedentary time is independently associated with increased risk of all-cause mortality, cardiovascular disease incidence, cancer, and type 2 diabetes incidence regardless of physical activity (6). Thankfully, reducing time spent sitting leads to meaningful positive outcomes. A study from 2020 shows that replacing sitting time with standing is associated with reduced mortality risk by up to 37 % among older women. It also showed that walking around while standing further reduced the mortality risk (7). Increasing time spent standing or moving around at the expense of sitting is an important part of a well-formulated longevity exercise routine.
A comprehensive exercise regimen works for older adults
Even older clients that have not developed a strong exercise habit should be encouraged to start one. Research shows that exercise can bring longevity benefits at any age. A 2020 study illustrated this by randomly assigning 1635 participants aged 70 to 89 into two groups.
One group went through the following moderate-intensity physical activity program:
- 150 minutes per week of walking
- 2x per week instructor-led exercise classes, including strength, flexibility, and balance training
- 3-4x per week home-based activity
The other group joined a health education program:
- 1x per week education workshops on travel safety, health screenings, and nutrition
- 1x per week, 5-10 minutes of instructor-led upper body stretching and flexibility exercises
The results showed that over 2,6 years, the physical activity program reduced the risk of major mobility disability by 18 % compared with the health education program (8). These findings strongly suggest that older adults benefit from physical activity.
Conclusion
The general guidelines to get 150 - 300 minutes of moderate-intensity aerobic activity per week hold up well as recommendations for longevity. They align well with what observation shows to be the optimal range of exercise duration. If we wanted to formulate a rough exercise plan based on what research suggests brings the most benefit for longevity, it would include the following.
- 2,6 - 4,5 hours of aerobic exercise per week
- 7000 - 10000 steps per day
- 60 minutes of resistance training per week
- Weekly balance training, especially for older adults
- Strategies to reduce time spent sitting
A very important takeaway from this article for all of your clients is that starting a well-formulated exercise routine brings benefits relevant to longevity at any age. This should be an excellent, motivating factor for those interested in living long and healthy lives.
References
- Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD. The Physical Activity Guidelines for Americans. JAMA 2018;320(19):2020-8. 10.1001/jama.2018.14854
- Schnohr P, O'Keefe JH, Lavie CJ, Holtermann A, Lange P, Jensen GB, Marott JL. U-Shaped Association Between Duration of Sports Activities and Mortality: Copenhagen City Heart Study. Mayo Clinic proceedings 2021;96(12):3012-20. 10.1016/j.mayocp.2021.05.028
- Paluch AE, Gabriel KP, Fulton JE, Lewis CE, Schreiner PJ, Sternfeld B, Sidney S, Siddique J, Whitaker KM, Carnethon MR. Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study. JAMA network open 2021;4(9):e2124516. 10.1001/jamanetworkopen.2021.24516
- Shailendra P, Baldock KL, Li LSK, Bennie JA, Boyle T. Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. American journal of preventive medicine 2022;63(2):277-85. 10.1016/j.amepre.2022.03.020
- Araujo CG, de Souza E Silva CG, Laukkanen JA, Fiatarone Singh M, Kunutsor SK, Myers J, Franca JF, Castro CL. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British journal of sports medicine 2022;56(17):975-80. 10.1136/bjsports-2021-105360
- Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, Alter DA. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine 2015;162(2):123-32. 10.7326/M14-1651
- Purva Jain, MPH et al., The Relationship of Accelerometer-Assessed Standing Time With and Without Ambulation and Mortality: The WHI OPACH Study, The Journals of Gerontology: Series A, Volume 76, Issue 1, January 2021, Pages 77–84, https://doi.org/10.1093/gerona/glaa227
- Pahor M et al., Impact and Lessons From the Lifestyle Interventions and Independence for Elders (LIFE) Clinical Trials of Physical Activity to Prevent Mobility Disability. Journal of the American Geriatrics Society 2020;68(4):872-81. 10.1111/jgs.16365
Article reviewed by
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Dr. Ana Baroni MD. Ph.D.
Scientific & Medical Advisor
Quality Garant
Ana has over 20 years of consultancy experience in longevity, regenerative and precision medicine. She has a multifaceted understanding of genomics, molecular biology, clinical biochemistry, nutrition, aging markers, hormones and physical training. This background allows her to bridge the gap between longevity basic sciences and evidence-based real interventions, putting them into the clinic, to enhance the healthy aging of people. She is co-founder of Origen.life, and Longevityzone. Board member at Breath of Health, BioOx and American Board of Clinical Nutrition. She is Director of International Medical Education of the American College of Integrative Medicine, Professor in IL3 Master of Longevity at Barcelona University and Professor of Nutrigenomics in Nutrition Grade in UNIR University.
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