Exercising 225 to 375 minutes per week maximizes longevity, no benefit from more
A total of 661,137 men and women (median age, 62 years; range, 21-98 years) and 116,686 deaths were included. Median follow-up time was 14.2 years. RESULTS: Compared with individuals reporting no leisure time physical activity, we observed a 20% lower mortality risk among those performing less than the recommended minimum of 7.5 metabolic-equivalent hours per week, a 31% lower risk at 1 to 2 times the recommended minimum, and a 37% lower risk at 2 to 3 times the minimum. An upper threshold for mortality benefit occurred at 3 to 5 times the physical activity recommendation (HR, 0.61); however, compared with the recommended minimum, the additional benefit was modest (31% vs 39%). There was no evidence of harm at 10 or more times the recommended minimum (HR, 0.69). A similar dose-response relationship was observed for mortality due to cardiovascular disease and to cancer.
https://www.ncbi.nlm.nih.gov/pubmed/25844730
Those who exercise most (22.5+ MET hours per week) boost longevity by 4.5 years
“We examined the association of leisure time physical activity with mortality during follow-up in pooled data from six prospective cohort studies in the National Cancer Institute Cohort Consortium, comprising 654,827 individuals, 21–90 y of age. Physical activity was categorized by metabolic equivalent hours per week (MET-h/wk). The study includes a median 10 y of follow-up and 82,465 deaths. A physical activity level of 0.1–3.74 MET-h/wk, equivalent to brisk walking for up to 75 min/wk, was associated with a gain of 1.8 y in life expectancy relative to no leisure time activity (0 MET-h/wk). Higher levels of physical activity were associated with greater gains in life expectancy, with a gain of 4.5 y at the highest level (22.5+ MET-h/wk, equivalent to brisk walking for 450+ min/wk). The respective hazard ratios were 0.61 and 0.59. A high level of moderate to vigorous leisure time physical activity was associated with a lower risk of mortality during follow-up and a longer life expectancy after age 40. Substantial gains were also observed in each BMI group. In joint analyses, being active (7.5+ MET-h/wk) and normal weight (BMI 18.5–24.9) was associated with a gain of 7.2 y of life compared to being inactive (0 MET-h/wk) and obese (BMI 35.0+).”
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001335
92 minutes of exercise per week reduces mortality risk by 14%; each additional 92 minutes/week further reduced mortality by 4%
“The health benefits of leisure-time physical activity are well known, but whether less exercise than the recommended 150 min a week can have life expectancy benefits is unclear. Methods: In this prospective cohort study, 416,175 individuals participated in a standard medical screening program in Taiwan, with an average follow-up of 8.05 years. On the basis of the amount of weekly exercise indicated in a self-administered questionnaire, participants were placed into one of five categories of exercise volumes: inactive, or low, medium, high, or very high activity. Findings: Compared with individuals in the inactive group, those in the low-volume activity group, who exercised for an average of 92 min per week or 15 min a day, had a 14% reduced risk of all-cause mortality, and had a 3 year longer life expectancy. Every additional 15 min of daily exercise beyond the minimum amount of 15 min a day further reduced all-cause mortality by 4% and all-cancer mortality by 1%. These benefits were applicable to all age groups and both sexes, and to those with cardiovascular disease risks. Individuals who were inactive had a 17% increased risk of mortality compared with individuals in the low-volume group.”
https://www.sciencedirect.com/science/article/pii/S0140673611607496
Those who exercise most (300+ min/wk) reduce mortality risk by 54%; vigorous exercise best
We performed a prospective cohort study with activity data linked to all-cause mortality data from February 1, 2006, through June 15, 2014, in 204,542 adults aged 45 through 75 years. RESULTS: Compared with those who reported no moderate to vigorous activity, the adjusted hazard ratios for all-cause mortality were 0.66, 0.53, and 0.46 for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Among those who reported any moderate to vigorous activity, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity the fully adjusted hazard ratio was 0.91 in those who reported some vigorous activity (but <30% of total activity) and 0.87 among those who reported 30% or more of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of moderate to vigorous activity, and in those with and without existing cardiovascular disease or diabetes mellitus.
https://www.ncbi.nlm.nih.gov/pubmed/25844882
Any amount of weekly running is similar in increasing longevity; 3 year life expectancy benefit
“We examined the associations of running with all-cause and cardiovascular mortality risks in 55,137 adults, aged 18 to 100 years (mean age, 44). During a mean follow-up of 15 years, 3,413 all-cause and 1,217 cardiovascular deaths occurred. Compared with non-runners, runners had 30% and 45% lower adjusted risks of all-cause and cardiovascular mortality, respectively, with a 3-year life expectancy benefit. In dose-response analyses, the mortality benefits in runners were similar across quintiles of running time, distance, frequency, amount, and speed, compared with non-runners. Weekly running even <51 minutes, <6 miles, 1-2 times, <506 metabolic equivalent-minutes, or <6 mph was sufficient to reduce risk of mortality, compared with not running. In the analyses of change in running behaviors and mortality, persistent runners had the most significant benefits with 29% and 50% lower risks of all-cause and cardiovascular mortality, respectively, compared with never-runners. Conclusions: Running, even 5-10 minutes per day and slow speeds <6 mph, is associated with markedly reduced risks of death from all causes and cardiovascular disease.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4131752/
Jogging 2 or 3 times per week (1 to 2.5 hours total) at a moderate pace is optimal for longevity, increasing frequency or speed decreases benefits
“This large prospective longitudinal observational study followed 1,878 joggers and 10,158 non-joggers for up to 35 years. They found that joggers, as compared with the non-joggers, had a remarkable 44% lower risk of mortality during follow-up for both men and women. The age-adjusted increase in survival was about 6 years in both genders. However, U-shaped curves were apparent for mortality with respect to quantity of jogging, estimated running speed, and frequency of jogging. These curves suggest that the benefits of jogging are most robust for those who jog between 1 and 2.5 hours per week, at a slow to moderate pace, at a frequency of about 2 or 3 times per week. In those joggers who were doing a higher volume, higher-intensity running, the long-term mortality rates were not significantly different from non-joggers. In other words, overdoing the running substantially diminishes the remarkable gains in longevity conferred by moderate jogging.”
https://heart.bmj.com/content/99/8/588.2.short
Exercising 2 to 3 times per week reduces heart attack and stroke risk; daily exercise does not, according to large study
“1.1 million women without prior vascular disease reported their frequency of physical activity and many other personal characteristics. Three years later, they were asked about hours spent walking, cycling, gardening, and housework each week. During an average of 9 years follow-up, 49 113 women had a first coronary heart disease event, 17 822 had a first cerebrovascular event, and 14 550 had a first venous thromboembolic event. In comparison with inactive women, those reporting moderate activity had significantly lower risks of all 3 conditions. However, women reporting strenuous physical activity daily had higher risks of coronary heart disease, cerebrovascular disease, and venous thromboembolic events than those reporting doing such activity 2 to 3 times per week. Risks did not differ between hemorrhagic and ischemic stroke, or between venous thromboembolic events with or without pulmonary embolism.”
https://www.ahajournals.org/doi/full/10.1161/circulationaha.114.010296
One high intensity workout per week reduces mortality risk over the next 16 years by up to 51%; no additional benefit from increasing frequency
“We studied the association between the amount and intensity of exercise and cardiovascular mortality in 27,143 men and 28,929 women who were free from known cardiovascular disease at the beginning of follow-up between 1984 and 1986. The relative risk of death was calculated as the rate of death among participants within a given physical activity category compared with the rate of death in the reference category (no physical activity). We used Cox regression analysis to adjust for age and other potentially confounding factors. A single weekly bout of exercise of high intensity reduced the risk of cardiovascular death, both in men [relative risk (RR) 0.61, and women (RR 0.49), compared with those who reported no activity. There was no additional benefit from increasing the duration or the number of exercise sessions per week. The risk reduction related to exercise increased with increasing age in men, but not in women.”
https://journals.sagepub.com/doi/abs/10.1097/01.hjr.0000216548.84560.ac
Exercising once per month reduces mortality risk over the next 10 years by 37%, no additional benefit found from higher frequency
“Using a case-control study, past (10 years prior) levels of leisure time physical activity were ascertained via proxy informants for 24,079 dead cases and 13,054 live controls aged ⩾35 years and were analyzed by unmatched logistic regression to determine their association with all-cause and cause-specific mortality. Results: Compared with an exercise frequency of <1 episode per month, ⩾1 episode of leisure time physical activity per month was inversely associated with all-cause mortality [multivariable odds ratio (OR) = 0.63; adjusted for age, education, smoking status, alcohol consumption, and physical demand at work]. Each activity level above the reference level of <1 episode per month (i.e., 1 episode per month to 1–3 episodes per week, ⩾4 episodes per week) had approximately the same level of risk reduction and no dose–response gradient was observed. The inverse association was stronger for cardiovascular than cancer deaths, particularly in males and was strongest for respiratory mortality. One-fifth of all 31,349 registered deaths in those aged 35 years and over in Hong Kong in 1998 were attributable to physical inactivity.”
https://www.sciencedirect.com/science/article/pii/S1047279703003028
Exercising 3-4 times per week increases longevity more than 5-6+ times per week
“The goal of this study was to analyze the relationship between exercise frequency and all-cause mortality for individuals diagnosed with and without diabetes mellitus. Methods: We analyzed data for 505,677 participants in the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort. Results: Cox proportional hazard regression models were developed to assess the effects of exercise frequency (0, 1-2, 3-4, 5-6, and 7 days per week) on mortality, separately in individuals with and without diabetes. We found a U-shaped association between exercise frequency and mortality in individuals with and without diabetes. However, the frequency of exercise associated with the lowest risk of all-cause mortality was 3-4 times per week (hazard ratio, 0.69) in individuals without diabetes, and 5-6 times per week in those with diabetes (HR, 0.93).”
Greatest longevity seen in runners who are also active in other physical activity (43% lower risk)
One of the most commonly asked questions regarding PA and health is simply, “What type of exercise or physical activity is the best for health?” When we directly compared these two groups (running vs. other physical activity), we found that runners who were inactive in other physical activity had a 27% lower risk of death versus non-runners who were active in other physical activity. However, as expected, the greatest mortality benefit, a 43% lower risk of death, was observed in runners who were also active in other physical activity (“runners” and “active”). Therefore, to get the maximal mortality benefits, participating in both running and other various physical activity is the best choice.
https://www.sciencedirect.com/science/article/pii/S0033062017300488?via%3Dihub
Modern hunter/gatherers exercise 134 min/day; have no evidence of cardiovascular disease
“The goal of this study is to explore moderate-to-vigorous physical activity and cardiovascular health in the Hadza, a modern hunting and gathering population living in Northern Tanzania. RESULTS: We show that Hadza participants spend large amounts of time in moderate-to-vigorous physical activity (134.92 ± 8.6 min/day), and maintain these activity levels across the lifespan. In fact, the Hadza engage in over 14 times as much moderate-to-vigorous physical activity as subjects participating in large epidemiological studies in the United States. We found no evidence of risk factors for cardiovascular disease in this population (low prevalence of hypertension across the lifespan, optimal levels for biomarkers of cardiovascular health).”
https://www.ncbi.nlm.nih.gov/pubmed/27723159
Regular exercise lowers mortality risk by 35% in elderly; performing more types of exercise and more intense exercise are beneficial
“Whether the major components of leisure physical activity (number of types, intensity, frequency, and duration) have independent contribution to mortality reduction and there is a minimum amount of activity beneficial for the elderly remain unclear. Methods: A total of 2113 persons aged 65 and older participating in 2001 Taiwan National Health Interview Survey were studied. Results:A total of 197 deaths occurred during a 2-year follow-up. Regular exercisers reduced 35% risk of death compared with sedentary individuals after adjustment for covariates. Moreover, exercisers with a weekly amount of energy exceeding 1000 kcal had significant benefit of risk reduction when energy expenditure is considered. There was a significant dose–response relationship between number of activity and the reduction in total mortality. The benefit on mortality reduction among the three components of total energy amount was only observed in intensity.”
https://www.sciencedirect.com/science/article/pii/S009174350600137X
Exercising 3+ times per week improves longevity in the elderly
“In the Canadian Study of Health and Aging (CSHA), of 8,403 people who had baseline cognition measured and exercise reported at CSHA-1, 2219 had died and 5376 were re-examined at CSHA-2. High exercisers (at least three times per week, at least as intense as walking, n = 3264) had more frequent stable or improved cognition (42.3%) over 5 years than did low/no exercisers (all other exercisers and non exercisers, n = 4331) (27.8%). The difference widened as baseline cognition worsened. People who did not exercise were also more likely to die (37.5% versus 18.3%). Even so, exercise conferred its greatest mortality benefit to people with the highest baseline cognition. Exercise is strongly associated with improving cognition. As the majority of mortality benefit of exercise is at the highest level of cognition, and declines as cognition declines, the net effect of exercise should be to improve cognition at the population level, even with more people living longer.”
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0003124
Exercising 2 to 5 times per week reduces mortality risk 26% in dialysis patients; no improvement seen with daily exercise
“Methods: Data for a subset of patients (n = 2,507; 62%) from the Dialysis Morbidity and Mortality Wave 2 study were used to explore the associations of exercise and limitations in physical activity with mortality. Results: Overall, 56% of patients exercised less than once a week, whereas the remainder reported more frequent physical activity; 2 to 3 times/wk in 18%, 4 to 5 times/wk in 6%, and daily exercise in 20%. Mortality risks were lower for patients who exercised 2 to 3 (RR, 0.74; 95% CI, 0.58 to 0.95) or 4 to 5 times/wk (RR, 0.70; 95% CI, 0.47 to 1.07), whereas no advantage was associated with daily exercise (RR, 1.06; 95% CI, 0.86 to 1.30). Conclusion: Although limitations in physical activity are common among new patients with ESRD in the United States and correlate highly with increased mortality risk, this study shows an association of frequent exercise of up to 4 to 5 times/wk with improved survival. The surprising lack of association of daily exercise with increased survival deserves additional study.”
https://www.sciencedirect.com/science/article/pii/S0272638604017111
Exercising up to three times per week reduces flu mortality more than no exercise or more frequent bouts
“We collected information about exercise habits and other lifestyles, and socioeconomic and demographic status, the underlying cause of death of 24,656 adults (21% aged 30–64, 79% aged 65 or above). We assessed the excess risks (ER) of influenza-associated mortality due to all-natural causes, cardiovascular diseases, or respiratory disease among different levels of exercise: never/seldom (less than once per month), low/moderate (once per month to three times per week), and frequent (four times or more per week). For all the mortality outcomes under study, never/seldom exercise (as reference) was associated with 5.8% to 8.5% excess risks of mortality, while low/moderate exercise was associated with excess risks which were 4.2% to 6.4% lower than those of the reference. Frequent exercise was not different from the reference. Conclusion: When compared with never or seldom exercise, exercising at low to moderate frequency is beneficial with lower influenza-associated mortality.”
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0002108
Once-weekly exercise reduces mortality risk by up to 32% in those with heart disease; increasing benefits from more frequent and higher intensity exercise
“Exercise amount and intensity were measured at baseline in 2137 men and 1367 women with coronary heart disease. During 18 years of follow-up, 1741 (81.6%) men and 1100 (80.5%) women died. Compared with the reference category (no activity), one weekly exercise session was associated with a lower all-cause mortality, both in men (relative risk 0.80) and women (relative risk 0.68). This inverse association became stronger with increasing frequency. Those who reported moderate or high-intensity exercise had a somewhat lower risk of death than those who exercised with low intensity. Exercise training reduced all-cause and cardiovascular mortality in men and women with CHD.”
https://journals.sagepub.com/doi/abs/10.1097/hjr.0b013e3283101671
Heart disease patients who exercising 2 to 4 times per week lived longest; daily exercise doubled mortality; inactivity quadrupled mortality
“Data were drawn from a prospective cohort of 1038 subjects with stable coronary heart disease in which frequency of strenuous leisure time physical activity was assessed repeatedly over 10 years of follow-up. Results: For all outcomes, the highest hazards were consistently found in the least active patient group, with a roughly twofold risk for major cardiovascular events and a roughly fourfold risk for both cardiovascular and all-cause mortality in comparison to the reference group of moderately frequent active patients. The crude rates of incidence of major cardiovascular events and mortality rates were consistently lowest in those who engaged in physical activity 2 to 4 times per week. Furthermore, when taking time-dependence of physical activity into account, our data indicated reverse J-shaped associations of physical activity level with cardiovascular mortality, with the most frequently active patients also having increased hazards (2.36).”
https://heart.bmj.com/content/100/13/1043.full
Increased risk of myocardial fibrosis in endurance athletes
This study examined the cardiac structure and function of a unique cohort of documented lifelong, competitive endurance veteran athletes (>50 yr). Twelve lifelong veteran male endurance athletes, 20 age-matched veteran controls, and 17 younger male endurance athletes without significant comorbidities underwent cardiac magnetic resonance (CMR) imaging to assess cardiac morphology and function, as well as CMR imaging with late gadolinium enhancement (LGE) to assess myocardial fibrosis. The prevalence of LGE in veteran athletes was not associated with age, height, weight, or body surface area, but was significantly associated with the number of years spent training, number of competitive marathons, and ultraendurance marathons completed. An unexpectedly high prevalence of myocardial fibrosis (50%) was observed in healthy, asymptomatic, lifelong veteran male athletes, compared with zero cases in age-matched veteran controls and young athletes. These data suggest a link between lifelong endurance exercise and myocardial fibrosis that requires further investigation.
https://www.physiology.org/doi/full/10.1152/japplphysiol.01280.2010
Higher exercise frequency and intensity are independently associated with longevity in Type 1 diabetes patients
“The aims of the study were to assess how baseline leisure-time physical activity and its exercise components intensity, duration, and frequency are associated with all-cause and cardiovascular mortality in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: The study design was prospective and observational and included 2,639 patients with type 1 diabetes from the ongoing nationwide multicenter Finnish Diabetic Nephropathy (FinnDiane) Study. Mean follow-up time was 11.4 years. RESULTS: Leisure-time physical activity and all its components were associated with all-cause mortality, even after adjustment for the potential confounders. Only exercise intensity was associated with cardiovascular mortality after adjustment for the confounders. The total amount of leisure-time physical activity and exercise frequency were independently associated with lower risk of all-cause mortality when adjusted for covariates.”
http://care.diabetesjournals.org/content/40/12/1727.abstract
Full-day kinder improves math and reading (temporarily), not behavior
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