How To Live a Longer and Healthier Life

We all want to live a long and happy life, right? While there are of course certain situations that can take this out of our control, according to the World Health Organisation ‘lifestyle choices’ are now the world’s biggest killer.

Some of these ‘lifestyle choices’ are drastically more under our own individual control than others. One that most certainly is under our control is our activity levels. 

Being physically active and reducing sedentary time lowers your risk of all-cause mortality (death of any cause). A pretty big statement, but one backed up by a substantial amount of research. It’s one of the best things we can do to live longer and healthier.

Over 6 decades of consistent research has demonstrated the health benefits of physical activity and the subsequent reduced risk of premature mortality. 

Studies show how to live longer and healthier

One of the early studies investigating the associations of light, moderate and vigorous intensity physical activity with longevity was the Harvard Alumni Health Study. Just under 17,00 men, aged 35-74, were followed up for 12-16 years with self-reports of their walking, stair climbing and sports and recreation activities.

A dose-response relationship was demonstrated between ‘total’ physical activity levels and death rates (mostly from cardiovascular and respiratory causes): meaning the more physical activity they did, the lower the risk of death. This dose-response relationship was maintained even after accounting for confounding factors (such as hypertension, smoking, higher BMI).¹

Subsequent studies have confirmed the same association in women, different ethnicities and low and middle income countries.² The consistency of this dose-response relationship is clear, however what it doesn’t tell us is how much is too little, how much is enough and how much does the intensity of the activity matter?

The majority of these studies have also used self-reported physical activities, which obviously have the potential for bias and overestimation of physical activity levels. Highlighting a need for studies based on more objective markers of physical activity, which are now possible with the ever-increasing usage and accuracy of wearable technology to monitor such things.

A 2019 systematic review in the British Medical Journal aimed to examine the dose-response relationship between total physical activity, sedentary time, and intensity of physical activity assessed objectively – using accelerometery.³ The studies were undertaken in middle aged and older adults.

They found that total physical activity and all intensities of physical activity were associated with a lower risk of death. Sedentary time was associated with a higher risk of death.

Importantly they found that any physical activity, regardless of intensity, was associated with a lower risk of mortality.
The participants were grouped in 4 categories based on their activity levels. Comparing the second least active group with the least active group, the risk of death was about 50% lower – the greatest reduction in mortality observed! A risk reduction was also seen for all intensities of physical activity – low, moderate and high.

This highlights that even small increases in physical activity, of any intensity, substantially reduces the risk of premature death.

The maximum risk reduction for all-cause mortality was found to be about 60%, for moderate-vigorous physical activity performed for about 24 minutes per day. For light intensity activity, for the same maximum risk reduction, the activity had to be performed for about 375 minutes per day. So although even light forms of physical activity can lead to substantial reduction in risk of death, it needs to be performed for much longer periods.

A statistically higher risk of death was found in people who spend 9.5 hours or more inactive or sedentary per day.

However, don’t be too disheartened if you have a job or lifestyle that requires you to be sat down all day. A recent meta-analysis looked at the combined associations of accelerometer measured physical activity and sedentary times on all-cause mortality.⁴

Their analysis demonstrated that the association between being sedentary and risk of death was weakened by performing about 30-40 minutes of moderate-vigorous physical activity per day. Showing it is possible with regular moderate-vigorous exercise to counteract the negatives effects of a sedentary lifestyle.

Finally, let’s consider muscle strengthening specifically. A systemic review and meta analysis found that any amount of resistance training (compared to no resistance training) led to a reduced risk of all-cause mortality of 15%!⁵

The maximum risk reduction was found in those performing around 60 minutes of strengthening exercises per week, with a 27% lower risk. However, it is when resistance exercise is added to aerobic exercise that we see the largest reduction: 40%!⁶

Key points for living longer

1. Any increase in total physical activity (regardless of intensity) is associated with reduced mortality
2. A high levels of sedentary time is associated with a significantly increased risk of mortality
3. The biggest differences in mortality risk are seen between those who are extremely sedentary/inactive and who are slightly more active – any activity at all can have substantial benefits
4. For maximum benefits moderate-vigorous intensity can be performed for much less time to achieve the same outcomes as many hours of low intensity activity
5. An estimated 30-40 minutes of daily moderate-vigorous intensity physical activity has shown to counteract the association between being very sedentary and mortality
6. Any regular muscle strengthening exercise compared to not doing any reduces your risk of death by 15%
7. Combined resistance training and aerobic exercise is the best thing you can do for your longevity! (40% lower risk of all-cause mortality!)

Ultimately any and every activity matters. You can start small. Find what you enjoy. And keep going, keep moving and keep strong.

If you’d like to learn more, we have a range of health and fitness resources for you to explore, whatever your current fitness level, to help you live a longer and healthier life.

Why not start by trying our free 6 week beginner or intermediate strength training programme?

1. Paffenbarger, R.S., Hyde, R., Wing, A.L. and Hsieh, C. (1986). Physical Activity, All-Cause Mortality, and Longevity of College Alumni. New England Journal of Medicine, 314(10), pp.605–613. doi:https://doi.org/10.1056/nejm198603063141003.
2. Ekelund, U., Dalene, K.E., Tarp, J. and Lee, I-Min. (2020). Physical activity and mortality: what is the dose response and how big is the effect? British Journal of Sports Medicine, 54(19), pp.1125–1126. doi:https://doi.org/10.1136/bjsports-2019-101765.
3. Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B.H., Jefferis, B., Fagerland, M.W., Whincup, P., Diaz, K.M., Hooker, S.P., Chernofsky, A., Larson, M.G., Spartano, N., Vasan, R.S., Dohrn, I.-M., Hagströmer, M., Edwardson, C., Yates, T., Shiroma, E., Anderssen, S.A. and Lee, I-Min. (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ, [online] 366(8211), p.l4570. doi:https://doi.org/10.1136/bmj.l4570.
4. Ekelund, U., Tarp, J., Fagerland, M.W., Johannessen, J.S., Hansen, B.H., Jefferis, B.J., Whincup, P.H., Diaz, K.M., Hooker, S., Howard, V.J., Chernofsky, A., Larson, M.G., Spartano, N., Vasan, R.S., Dohrn, I.-M., Hagströmer, M., Edwardson, C., Yates, T., Shiroma, E.J. and Dempsey, P. (2020). Joint associations of accelero-meter measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals. British Journal of Sports Medicine, 54(24), pp.1499–1506. doi:https://doi.org/10.1136/bjsports-2020-103270.
5. Shailendra, P., Baldock, K.L., Li, L.S.K., Bennie, J.A. and Boyle, T. (2022). Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. American Journal of Preventive Medicine, 63(2), pp.277–285. doi:https://doi.org/10.1016/j.amepre.2022.03.020.
6. Saeidifard, F., Medina-Inojosa, J.R., West, C.P., Olson, T.P., Somers, V.K., Bonikowske, A.R., Prokop, L.J., Vinciguerra, M. and Lopez-Jimenez, F. (2019). The association of resistance training with mortality: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 26(15), pp.1647–1665. doi:https://doi.org/10.1177/2047487319850718.