Increasing physical activity, practiced consistently and regularly, lowers the risk of premature death. This well-documented effect is complemented by a new finding. The key to healthy aging lies in the quality of exercise—a mix of several alternating sports, which appears to extend the benefit beyond the clinical gains tied to the recommended minutes of aerobic activity.
Because strength exercises and mixed disciplines can trigger different physiological adaptations. This is suggested by a Chinese-American study, published in BMJ Medicine, conducted on two large cohorts of patients tracked over the long term.
The Study
In a broad, long-term design, the study enrolled more than 11,400 participants of both sexes across two cohorts: the Nurses’ Health Study, comprising 121,700 women, and the Health Professionals Follow-Up Study, consisting of 51,529 men. For each participant, all were healthy at enrollment, with no diagnoses of diabetes, cardiovascular, respiratory, or neurological diseases or cancer. Data were collected via a dedicated questionnaire on personal characteristics, medical history, and lifestyle, repeated every two years.
The participants were followed over time for 30 years, starting from 1986, the year the trial began. The study’s objective was to define the benefit of physical activity in reducing the risk of premature death. A distinctive feature of the study was examining selective outcomes—more or less important—associated with one or more aerobic activities performed specifically or in combination with others.
Among these were walking, jogging, running, cycling (stationary or dynamic), swimming, rowing, calisthenics-type exercises, tennis, and squash/racquetball. In addition, the study evaluated both the amount and quality of activities, including weight training, resistance exercises, low-intensity activities such as yoga, stretching, and toning, outdoor activities of moderate intensity like maintenance and gardening, and high-intensity tasks such as digging and mowing the lawn.
Finally, participants were asked how many flights of stairs they climbed each day, assuming 8 seconds per flight. These activities were quantified in Metabolic Equivalent of Task hours (MET-hours per week), a metric that measures how much extra energy is burned during an activity compared with rest. Moreover, to reduce the risk of “reverse causation” (i.e., people moving less because they were already sick), the authors applied a four-year lag between the assessment of activity and the period in which the main outcome was considered.
The Results
The data analysis reveals that shifting from low to moderate levels of physical activity yields substantially greater benefits, with a tendency toward a plateau beyond a certain threshold. Further, more detailed analyses also showed a positive correlation between reductions in overall mortality and specific activities: for example, about 17% for walking, 15% for racquet sports such as tennis and squash, 14% for aerobic activities like rowing and calisthenics, 13% for running and weight/resistance training, 11% for jogging, 10% for stair climbing (even at 0.75 MET-hours/week), and 4% for cycling.
There was no significant association between total mortality and swimming, but there was a non-linear reduction in mortality from respiratory diseases. In short, the data show an inverse dose–response relationship between total physical activity and total mortality, characterized by a non-linear pattern.
However, the most notable aspect concerns the impact of the variety of physical activity, defined by a score that accounts for the number of different activities regularly practiced and the time devoted to each, awarding a point for surpassing 20 minutes per week (or 5 flights of stairs per day), and then averaging the scores over time to reflect long-term exposure and its relation to survival.
Diversity Is the Plus
When comparing participants who engaged in a wide variety of physical activities—at least 5 of different types—versus those with less variety and including total physical activity in the model, researchers observed a rough 19% reduction in total mortality, a 41% reduction for respiratory causes, and reductions ranging from 13% to 18% for cardiovascular, cancer, and other causes.
Finally, the joint analysis that combines quantity and variety of physical activity indicates that the risk profile is lowest in the group with high total activity and high variety, equating to a 21% reduction in death risk compared with the most sedentary group with monotone activity.
Because this study is observational in nature, it does not allow definitive cause-and-effect conclusions. Nevertheless, the evidence suggests that engaging in diverse activities may trigger complementary physiological adaptations, such as simultaneously improving aerobic capacity and muscular strength, and sustained engagement in multiple types of physical activity may help extend lifespan.
Source
Han H, Hu J, Lee DH et al. Physical activity types, variety, and mortality: results from two prospective cohort studies. BMJ Medicine, 2026, Vol. 5, Issue 1, 5:e001513. Doi: 10.1136/bmjmed-2025-001513
Abbonati a Karla Miller
