Being consistently physically active in adulthood is linked to a 30-40 per cent lower risk of death from any cause in later life, according to researchers who conducted a pooled data analysis of the evidence.

The article, published online today (11 July) in the British Journal of Sports Medicine, suggests that upping exercise levels from below those recommended for health is still associated with a 20-25 per cent lower risk.

It is written by an international team of researchers, and the first author is Ruyi Yu, a PHD student who is based in the School of Public Health at the University of Queensland, Brisbane, Australia.

The findings prompt the team to conclude that switching to a more active lifestyle at any point in adult life may extend the lifespan, and that it’s never too late to start.

Miss Yu and her fellow researchers wanted to find out if differing patterns of physical activity, as well as its cumulative impact during adulthood, might be associated with a lower risk of death from all causes, and specifically from cardiovascular disease and cancer. 

They scoured research databases for relevant studies that assessed physical activity at two or more points in time, and included in their review 85 studies published in English up to April 2024, with sample sizes ranging from 357 to 6,572,984 participants. 

Focus on 59 studies

Miss Yu and her colleagues found that 59 of the studies looked at long-term patterns of physical activity across adulthood; 16 looked at the average benefits of different physical activity levels; and 11 explored the potential impact of cumulative physical activity on risk of death.

To overcome the challenges posed by different analytical methods used, they carried out separate analyses for each of them. Pooled data analysis of the study results showed that, overall, a higher level of physical activity was associated with lower risks of all the included outcomes. 

People considered to be consistently active (32 studies) had about a 30-40 per cent lower risk of dying from any cause, while those who increased their levels of physical activity (21 studies) from below those recommended had a 20-25 per cent lower risk of death from any cause. 

Specifically, participants who switched from being physically inactive to being active were 22 per cent less likely to die from any cause than those who remained inactive, while those who increased their leisure time physical activity levels were 27 per cent less likely to do so.

On the other hand, swapping an active lifestyle for an inactive one wasn’t associated with a lower risk of death from any cause.

‘Our results emphasised the importance of [physical activity] across adulthood, indicating that initiating [it] at any point in adulthood may provide survival benefits’ [Ruyi Yu et al]

Key findings

Generally, the associations observed between a high level of physical activity and a lower risk of death were more evident for cardiovascular disease than for cancer. 

Compared with participants who were consistently inactive over time, those who were consistently active, overall, or only in their leisure time, were around 40 per cent and 25 per cent less likely to die from cardiovascular disease and cancer, respectively. 

But, in general, the evidence for the associations between physical activity patterns and death from a specific cause remained inconclusive, especially for death from cancer.

The pooled data suggested that people who were consistently active or who became active had lower risks of death from any cause, and specifically from cardiovascular disease, when meeting the recommended weekly physical activity levels.

But being consistently physically active and clocking up more than the recommended maximum weekly amount of moderate to vigorous intensity exercise was associated with only a small additional reduction in risk.

Maintaining or increasing physical activity at levels below the recommended weekly amount, however, was associated with appreciable health benefits, indicating that some physical activity is always better than none, say the researchers.  

And an average volume of physical activity that met the recommended weekly amount was also associated with a 30-40 per cent lower risk of death from all causes. But more research is needed to confirm this, they add.

Caveats and conclusions

Miss Yu and her fellow researchers acknowledge some limitations to their findings. For example, most of the studies included in the pooled data analyses relied on subjective assessments of physical activity, which may not always have been accurate. 

And there were only a few studies that looked at cumulative amounts of physical activity, or cancer deaths. Nevertheless, the findings have important public health implications, insist the researchers.

Miss Yu and her co-authors state: ‘First, our results emphasised the importance of [physical activity] across adulthood, indicating that initiating [it] at any point in adulthood may provide survival benefits.’ 

They add: ‘As being consistently active provides greater health benefits than being previously active (i.e., no longer maintaining activity), this highlights the importance of sustained [physical activity] over time. 

‘Future [physical activity] interventions may not only target inactive people, but also support active people to maintain their activity.’

Fact file

Adults should aim to maintain from 150 to 300 minutes of moderate intensity physical activity every week, or from 75 to 150 weekly minutes of vigorous intensity physical activity (or a combination of the two), according to current recommendations.

But while these recommendations are based on the best evidence available, most of it captured measurements of physical activity at only one point in time, which might hide the potential impact of changing patterns during adulthood, the authors suggest.

To access the full version of the article – titled Physical activity trajectories and accumulation over adulthood and their associations with all-cause and cause-specific mortality: a systematic review and meta-analysis Doi: 10.1136/bjsports-2024-109122 – see: https://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2024-109122

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