Maximizing Lifespan: The Essential Guide to Exercise for Longevity
As we hit middle age, a choice begins to crystalize. On the one hand, there’s a future dominated by chronic disease, doctors’ visits, lethargy, aches and pains and a steep decline in physical function. In this future, movement becomes increasingly painful and difficult. Our muscles atrophy. And we retreat further and further into a sedentary existence.
On the other hand, there’s a future dominated by health and fitness. We spend our golden years skiing, hiking, SCUBA diving and playing like kids with our grandkids. We keep much of our strength, cardio and joint health right up to the end. And as an added benefit, we dramatically increase our life expectancy.
As I’ve noted elsewhere, genes account for only a fraction of our lifespan. Instead, we should focus on lifestyle, which can add 10-14 good years to the life of the average westerner.
In this article, we’re taking a detailed look at the relationship between exercise and longevity. If you want to build a body that will keep you off the sidelines and in the adventure for as long as possible, this article is for you.
We’ll look at. . .
Sedentary vs. Active Lifestyles: The Impact on Longevity
Learning from the Blue Zones: Natural Movement for Longevity
Strength Training: A Key Pillar in Longevity Fitness
Cardiovascular Exercise: Its Vital Impact on Longevity
Integrating It All: A Comprehensive Approach to Exercise for Longevity
This article is part of a series on longevity.
If you’d like the bird’s eye view of longevity and lifestyle, check out my article 5 keys to living longer: a complete guide to longevity.
And if you’d like a deep dive into diet and lifespan, check out my article Is there a longevity diet?
Sedentary vs. Active Lifestyles: The Impact on Longevity
At this point, everyone has heard that sitting is the new smoking. But is it really? And what can you do about it?
First, the bad news. Sedentary living increases your risks of
Death from all causes
Cardiovascular disease
Diabetes
Hypertension
Osteoporosis
Joint pain
And many forms of cancer
Sedentary living is often quantified as “sitting time”. Your sitting time is the total amount of time you spend sitting each day. It includes things like commuting in traffic, watching TV, office work, sitting on the couch, doom scrolling on your smartphone, playing video games and reading.
How much sitting time is too much? And just how dangerous is it? It’s actually really challenging to get to the bottom of this.
Are we talking about sitting on the floor and playing with the kids or sitting on the couch and mindlessly scrolling TikTok?
Does your sedentary time have intermittent breaks? One study found that breaking up your sedentary time seems to give you some health benefits, even if the total time being sedentary is identical.
Are you getting exercise? According to another study, even a low dose of moderate intensity physical activity reduced mortality by 22% in older adults. In other words, even small amounts of exercise can make a sizable impact on longevity even if you spend a lot of time being sedentary. (We’ll dive deep into exercise in a bit.)
However, having said all that, many studies suggest a dose-response relationship. This means, the more you sit, the greater your risks of dying from all causes.
One meta-analysis (a study that combined the data of six studies) estimated that every additional hour of sitting from 0-7 hours per day increased your risk of all-cause mortality by 2%. Furthermore, it found that sitting times greater than seven hours per day increased your risk of all-cause mortality by 5% per additional hour. These numbers assume some regular exercise.
To put it in perspective, compared to someone who is on their feet all day, sitting 10 hours per day increases your risk of dying from any cause by 35% (if you exercise) and 54% (if you don’t exercise).
Stuck sitting 7 or more hours a day? Don’t worry. The evidence is not definitive. For example, in some studies 150–299 minutes of exercise per week seems to wipe out the risks of sedentary behavior. As you’ll see below, exercise makes a world of difference. But first, let’s look more closely at the benefits of simply moving more and sitting less.
Learning from the Blue Zones: Natural Movement for Longevity
Imagine for a minute the opposite of sedentary living. You’re on your feet at work, and your leisure time is pregnant with movement. You work in your garden, go for hikes, cook and share meals with family and friends.
Welcome to the movement rich lifestyle of the world’s blue zones. Blue Zones are regions of the world, where people are ten times more likely to live to 100 than the average American. It includes places like Sardinia, Italy and Okinawa, Japan.
People living in Blue Zones avoid the dangers of sedentary living through constant light physical activity. This includes things like gardening, casual walking, grocery shopping, household chores, work that requires movement, casual bike riding and light playful activity.
They also engage in tons of natural movement, and unfortunately, many “natural” human movements are no longer natural for westerners. A classic example of this is your ability to sit and rise from the floor. Can you do it without using your hands? Can you do it without using your hands, elbows or knees?
Believe it or not, in many cultures, sitting and rising again from the floor using nothing but your feet is common, even among the elderly. Moreover, there’s actually several different ways to do it.
One study even tested it with elderly adults. Those who could sit and rise from the floor using only their feet were significantly less likely to die from any cause.
Another classic example is grip strength. How long can you hang from an overhead bar? Can you make it two minutes? It matters for your longevity. One study looked at grip strength and found that it correlated strongly with longevity.
What’s going on here? Why would these unconventional movements matter? What’s the secret?
First, this kind of movement builds strength, mobility, balance and coordination. To get up from the floor with just your feet requires strong mobile hips, knees and ankles. Essentially, it will make you more durable and acts as prehab for the wear and tear of life.
Second, it might be related to accident prevention. Accidents are the ninth leading cause of death among the elderly in America and account for 2% of elderly deaths. When you are 80 years old, a fall can kill you, and natural movers are far less likely to fall.
A third factor may be sustainability. Consider a 50-year-old lifter who squatted too heavy, too often and with the wrong technique and now has to go up the stairs sideways because his knees are shot.
Contrast that with the 80-year-old natural mover who climbs two flights of stairs up to her apartment 1-2 times every day. Which is more sustainable? Who will have the least sitting time in their 80’s?
Finally, many people may find natural movement to be more motivating. Contrast going for a hike with your grandkids versus hopping on the treadmill to walk off some calories. Which is more motivating? Which will keep you moving in your 80’s and 90’s?
Long story short, it’s a good idea to build some natural movement into your life. It will keep you more active and more robust as you age. This is another reason why many of my clients and I train MovNat.
Keep takeaways:
Are you sitting too many hours a day? Start replacing that time with some light physical activity. As stated above, each hour will reduce your risk of premature death by 2%-5%.
A little natural movement practice will help keep you moving as you age. Can you get up and down from the floor with just your feet? Can you hang from a bar for 2 minutes? Both correlate with longevity.
Essentially, use it or lose it.
Strength Training: A Key Pillar in Longevity Fitness
It should come as no surprise that regularly lifting heavy things has massive health benefits. It strengthens your connective tissues, builds muscle, strengthens your bones, improves insulin sensitivity and lowers chronic inflammation.
When done correctly, it’s a panacea of health. But does it matter for longevity, and if so, how much?
One team of researchers decided to find out. They followed a group of older adults aged 65 and older for 15 years. At the end of the study nearly a third of the participants had died. The participants who strength trained 2x per week were 46% less likely to have died. Moreover, after taking into account the participants' medical history and other lifestyle factors, the association remained.
In other words, this association is independent of diet, lifestyle, medical history or other training protocols.
What about younger lifters?
In 2019, researchers published a meta-analysis (a study of 11 studies) that asked the same question and looked at adults of all ages. They found that any amount of weekly strength training is associated with a 21% lower all-cause mortality. In other words, even lifting 1x per week, you were 21% less likely to have died.
Interestingly they saw no additional benefit to lifting more than 2-3 times per week. Consequently, training 4-6 times per week may provide other benefits, but it wasn’t seen as more protective than just 2-3 times.
Muscle mass
Muscle mass may have longevity benefits separate from strength. It can be protective against a decline in metabolic function. It might help you survive cancer. And it’s protective against diabetes.
Moreover, as you age, it becomes harder to build and maintain muscle mass. This is known as sarcopenia. This isn’t good, because Study after study has demonstrated that skeletal muscle mass is associated with increased longevity, as you age.
In one study, older adults, who had a muscle mass index score (MMIS) in the top 25%, had the lowest risk of death from any cause. The MMIS takes your limb skeletal muscle mass (kg) by the square of your height (m2). It’s similar to the body mass index (BMI).
Fortunately, you can build muscle at any age, even your 90’s, and of course, it helps if you enter your golden years with a strong foundation.
Key takeaways:
As you age, a full body strength training program done 2-3x per week can reduce your risks of death by 46% compared to people who don’t strength train. It’s a dose-responsive effect, so any amount of strength training is beneficial.
Having more muscle than 75% of the population as an older adult can reduce your chances of death from all causes. Moreover, it also is a dose responsive effect, so even a little extra mass is beneficial.
Essentially, it’s never too late to start strength training, and it’s always too early to stop.
Cardiovascular Exercise: Its Vital Impact on Longevity
You probably already know that cardio is great for your health. It’s up there with eating your veggies, not smoking and drinking moderately. Studies have shown that Cardiorespiratory Fitness (CFR). . .
And research shows that runners live about 3 years longer than non-runners.
So if you like jogging, swimming, cycling, hiking etc, you’re doing yourself a huge favor, and you’re likely to live longer.
Alright, that all sounds great, but can you have too much of a good thing?
If you’re interested in fitness and racing, you’ve probably heard TV doctors and Twitter MDs decry the hazards of extreme endurance. I certainly have. And for a while, I just accepted that my interest in extreme endurance was a net negative.
It’s hardly unreasonable. I mean, surely, running an 8-14 hour long Ironman or Spartan Ultra is just too much.
Or is it?
In 2018, researchers published an article in the Journal of the American Medical Association (JAMA) that looked squarely at this question. Are extreme levels of CRF just too much?
The study looked at 122,007 patients, and it broke them down into 5 categories of cardio fitness. To do this they measured their fitness running on a treadmill, and then they checked up on them 8.4 years later.
They discovered a dose response relationship between CRF and all-cause mortality. This means that every bit of additional cardio fitness is beneficial, and individuals with elite levels of fitness enjoy the greatest reduction in premature death. To be “Elite” the patients had to be in the top 2.3% of study participants. They were fitter than 97.7% of the 122,007 patients. In other words, more is actually better.
How much of a difference are we talking about?
Elites had an 80% reduction in death from any cause compared to the least fit category. If you’ve made it this far in the article, you probably think that’s a typo. It isn’t.
25% of the patients fell into the lowest fitness category. The elite category (2.3% of participants) had an 80% reduction in risk of death from any cause compared to the least fit category (25% of participants).
If that sounds crazy, it’s because it is crazy. As the authors of the paper note, possessing elite cardio has a stronger reduction in risk of death from all causes than being a nonsmoker.
Don’t worry, you don’t have to become an elite athlete to gain massive benefits. Although there’s a dose response relationship, there’s also strong diminishing returns. You can get the majority of the benefits just moving from untrained to above average, while the difference between highly trained and elite is relatively small.
Key takeaways:
Cardio makes a big difference in terms of your longevity. The difference between elite and untrained cardio is greater than the difference between a nonsmoker and a smoker.
In terms of longevity, it looks like more cardio is better. The elites can feel good about all the miles they put in.
There are diminishing returns. You don’t get nearly as much out of going from advanced to elite as you get going from untrained to above average.
Essentially, if you’re doing cardio 3-4 times a week, you’re getting the vast majority of the benefit.
Integrating It All: A Comprehensive Approach to Exercise for Longevity
To put this all together I’d like to draw your attention to three features that recur in the studies cited above.
First, the studies suggest a dose-response relationship between exercise and longevity. This means that there is no such thing as too little. Whatever you can do right now matters. Modern living is full of chronic stress, and we are always pressed for time. If all you can do is a couple walks around the block or some sporadic strength training, it STILL matters.
Second, there are diminishing returns. For example, building a solid base of strength and muscle helps, but building crazy amounts of strength and muscle probably doesn’t help. If you achieve 60-80% of your potential in strength, cardio and an active lifestyle, you’ve captured nearly all the benefits.
Third, each type of fitness is both independent and accumulative. For example, one study found that any frequency of lifting plus any frequency of cardio provided a greater reduction in risk of dying than either in isolation. In other words, being a fitness generalist may be best.
Thanks for reading!
Would you like help getting off the sidelines and into your own adventure? Check out my online coaching.
