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All activities types reduce mortality

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Basically everything that has been looked at reduces mortality.

There are likely some issues in study design, bias for publishing positive results, as well as in reverse causation itself. Reverse causation in this context is sometimes called the "healthy exerciser bias", where health causes exercise. Anecdotally, this makes sense: if you're already healthy and not in pain, you’re more likely to go for a walk. On that note, consider that everything in your fridge both causes and prevents cancer in Fig 2 [40], as well as the cautionary note on reverse causality from Kujala [39].

everything_cancer.png

Fig 2. Relative cancer risk of foods with at least 10 studies shows results on both sides of good and bad for you [40].

On that positive note, let's dive in.

Health Conscientious - as rated by HealthIQ survey

  • Male 30-89 years - low → high = 33% reduction in mortality [9].
  • Female 30-89 years - low → high = 47% reduction in mortality [9].
  • Similar results for blood pressure, diabetes, etc.

Running

  • 30% reduction in all-cause mortality [7]
  • 45% reduction in cardiovascular mortality [7]
  • Men who run 2 marathons per year are 87% less likely to take anti-diabetic medication than non-marathoners and 59% less likely if they run 1 marathon every 5 years [8]
  • Men who run 2 marathons per year are 41% less likely to take blood pressure medication [8]

Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality Risk

Original Investigation

Duck-chul Lee, Russell R. Pate, Carl J. Lavie, Xuemei Sui, Timothy S. Church, and Steven N. Blair

J Am Coll Cardiol. 2014 Aug, 64 (5) 472–481

Editorial Comment: Minimal Amount of Exercise to Prolong Life: To Walk, to Run, or Just Mix It Up?∗

https://www.jacc.org/doi/10.1016/j.jacc.2014.04.058

Runners live about three more years than non-runners and have a lower risk of death from any cause and death from a cardiovascular event

Even small amounts, like 5 to 10 minutes a day, at slow speeds < 6 miles/h can result in these benefits.

This study underlined that running even at relatively low doses (5 to 10 min/day), below the current minimum guidelines of vigorous-intensity aerobic activity, was sufficient for substantial mortality benefits.

Swimming

  • A cohort study of over 80,000 middle-aged people found that swimming provides a 28% reduction in all-cause mortality [10].
  • According to a 2016 study in the American Journal of Cardiology, regular swimming can provide improved vascular function and significantly decreased carotid artery stiffness and inflammatory markers [11].
  • According to a 2013 literature review in International Journal of Cardiology, swimming recreationally can result in an 18% increase in peak left ventricular end-diastolic volume and an 8% increase in peak systolic blood pressure [12].
  • According to a 2009 research review in the Journal of Sports Medicine, swimming results in a 10% decrease in total & LDL cholesterol [13].

Cyclists

  • Cyclists who ride for 3 hours a week or more have a 28% lower risk of all-cause mortality than non-cyclists [14].
  • Cyclists who commute to work at least 30 miles a week have a 45% reduction in all cancer incidence as compared to non-cyclists [15].
  • Cyclists have a 18% lower incidence of cardiovascular disease as compared to non-cyclists [16].
  • Male cyclists live 2.9 - 5.3 years (varying by intensity) longer as compared to non-cycling males. Female cyclists live 2.2 - 3.9 years (varying by intensity) longer than non-cycling females [17].
  • Cyclists have a 15% increase in HDL-cholesterol as compared to non-cyclists [18].

Weight Lifters

  • Adults who strength-trained at least twice a week had a 46% reduction in mortality compared to those who did not strength train [19].
  • Adults who participated in 10 weeks of strength training 3 days a week found a 30% improvement in their sleep quality [20].
  • Effects on cholesterol [21]:
    • it increases HDL cholesterol by as much as 21%.
    • it decreases low-density lipoprotein (LDL) cholesterol by as much as 23%.
    • it reduces triglycerides by as much as 18%.
  • 40% decrease in visceral fat [22].

Triathletes

  • High-level athletes live longer than the general population and enjoy a 27% lower level of mortality from cardiovascular disease and a 40% lower level of mortality from cancer [23].
  • Spanish elite male athletes found that during recovery from maximum exertion, the heart rate of dynamic endurance athletes, including triathletes, drops 4% more than other elite athletes in the second minute of recovery, a significant difference [24].
  • Endurance athletes, including triathletes, who trained more than three times a week had 7.1% longer telomeres (a marker of cardiometabolic health) and a 26% lower resting heart rate compared to recreationally active healthy controls. The endurance athletes had prevented 10.4 years of biological aging [25].
  • Runners have a 35% reduction in risk of cataracts later in life [26].

HIIT

  • Men who did high-intensity exercise have a 35% lower risk of all-cause mortality. For women the risk reduction is 44% [27].
  • 7 sessions with 10 x 4 min intervals of HIIT improved VO2 max by 13%. [28]
  • A single weekly bout of exercise of high intensity reduces the risk of cardiovascular death by 39% in men and 51% in women. [29].
  • 20 minutes of HIIT running results in a significant blood glucose reduction when tested 2 hours after eating, comparable to 150 minutes of prolonged running. [30].

Yogis

  • Practicing yoga 2-3 times per week for 3 months resulted in a mean 3 mm HG drop in systolic blood pressure. A systolic blood pressure reading (the 'top' number) dropping by 2 mm Hg cuts the risk of dying from heart disease by 7% and the risk of stroke death by 10%. [31].
  • Women who practice yoga regularly for at least two years have 41% less serum IL-6 levels, a marker of inflammation in their bodies, than women who only recently have taken up the activity. [32].
  • Asana-based yoga interventions in adults found that yoga showed significant improvement for body mass index (−0.77 kg/m2) and significant changes in body weight (−2.32 kg). [33].
  • Practicing yoga regularly leads to more gray matter — brain cells — in certain brain areas and that regular practice of yoga may have neuroprotective effects against whole brain age-related GM decline. [34].

Vegans

  • Vegans have a 63% lower risk of hypertension than non vegetarians [35].
  • Vegans have a 15% lower incidence of all types of cancer, 34% lower risk of female-specific cancer and 22% lower risk of colorectal cancer. [36].
  • Vegans have a 49% lower risk of type 2 diabetes. [37].
  • Vegans have a 15% lower risk of all-cause mortality compared to meat eaters. [38].
  • When adjusted for body mass index, male vegans have a 19% lower risk of mortality from cardiovascular disease compared to meat eaters. [38].

References

Note that on this page, the references start at 7.

  1. Duck-chul Lee et al. J American College Cardiol. 2014;64(5):472-481 (doi:10.1016/j.jacc.2014.04.058)
  2. Paul T. Williams, Medicine and Science in Sports and Exercise, 41(3), 523 (doi: 10.1249/MSS.0b013e31818c1752)
  3. Health IQ reseach link link
  4. Oja et al Br J Sports Med (2017)
  5. Alkatan et al. Am J Card (2016)
  6. Lazar JM et al; Int J Cardiol. 2013 Sep 20;168(1):19-26. (doi: 10.1016/j.ijcard.2013.03.063.)
  7. Tanaka H, Sports Med 2009; 39 (5): 377-387 (doi: 10.2165/00007256-200939050-00004)
  8. Andersen et al. Arch Intern Med. 2000
    • In this study of over 30,000 participants, researchers evaluated the relationship between various exertion-levels during cycling and all-cause mortality. Overall, the study concluded that the risks from cycling were reduced equally across all age and gender groups.
  9. Celis-Morales et al. BMJ (2017)
    • This UK based prospective population based study investigated the association between active commuting and incident cardiovascular disease (CVD), cancer, and all cause mortality. The study included 263 450 participants (106 674 (52%) women; mean age 52.6) from 22 sites across the UK. The exposure variable was the mode of transport used (walking, cycling, mixed mode v non-active (car or public transport)) to commute to and from work on a typical day. The study found that commuting by cycling was associated with a lower risk of all cause mortality and adverse CVD and cancer outcomes, in a dose dependent manner and independent of a range of confounding factors.
  10. Hoevenaar-Blom MP et al. Eur J Cardiovasc Prev Rehabil. 2011 Feb;18(1):41-7. doi: 10.1097/HJR.0b013e32833bfc87.
    • This study of over 23,000 men and women analyzed the effect of different types of physical activities in relation to cardiovascular disease incidence. Participants that did another sport in addition to cycling had an even greater risk reduction of 36%.
  11. Schnohr et al. Eur J of Preventive Cardiology. 2012; Volume 19. doi:10.1177/1741826710393196
    • Recommended exercise amounts have historically remained around 30 minutes per day of moderate activity (brisk walking) if possible. This study aimed at examining the impact of intensity and duration of cycling on mortality. The study concluded that relative intensity, and not duration as previously thought, was more important when related to mortality.
  12. L I Tjelta et al. Journal for the Norwegian Medical Association. 2010. Volume 12; doi: 10.4045/tidsskr.09.0787
    • The study looked at the intervention study on health-related physiological effect of commuter cycling. Increase in HDL-cholesterol was one of the health benefits they found.
  13. Kraschnewski JL et al., Prev Med (2016)
    • This multi-year study followed the health of 30,000 adult participants, including the respondents through death certificate data from the National Center for Health Statistics National Death Index. Unlike aerobic exercise’s well-established effects, strength training has only recently garnered attention for its benefits in regaining muscle mass and strength often depleted with age and disability. While any regular physical activity has consistent and powerful relationships with longer life expectancy, the study aimed to prove that strength training also plays an important role in decreasing premature mortality.
  14. Singh, et al. Sleep (1997)
    • The study was a randomized, controlled, 1O-week clinical trial in which subjects with varying levels of diagnosed depression were placed in either a strength-training program or a health-education program. Sleep quality was measured before and after training with a well-validated questionnaire. Participants in the strength training group followed a high-intensity regimen training the large muscle groups, 3 days a week for 10 weeks. Strength gains were expected. But their confirmation that strength training is directly linked to sleep quality was groundbreaking, calling for further research to confirm and extend these findings.
  15. American college of sports medicine et al.Med Sci Sports Exerc. 2009 Jul;41(7):1510-30. (doi:10.1249/MSS.0b013e3181a0c95c)
    • The ACSM position stand on Exercise and Physical Activity is published once a year with what the ACSM board has deemed the issues and discoveries most critical to exercise and physical activity. Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity.
  16. Ross et al. J Appl Physiol (1996)
    • The selected group of middle-aged male participants in the study performed 8 to 12 reps of these strength exercises 3 days a week: leg extension, leg flexion, super pullover, chest press, chest cross, shoulder press, tricep extension, bicep curls, and setups. When retested after the trials were over, body weight was down approximately 10% and 40% of fatty tissue had been lost.
  17. Garatachea et al., Mayo Clin Proc. 2014;89(9):1195-1200
    • The goal of this meta-analysis was to provide an accurate overview of mortality in elite athletes compared to the general population. Due to the recent discussions over a possible threshold of cardiovascular benefits in endurance athletes, the researchers were examining if the overall health benefits of exercise would counteract any potential detrimental effects. Researchers reviewed English-language scientific articles available in Medline and Web of Science databases following the recommendations of the Meta-analyses Of Observational Studies in Epidemiology group. Ten studies met all inclusion criteria and included data from a total of 42,807 athletes. The evidence available indicates that top-level athletes live longer than the general population and have a lower risk of 2 major causes of mortality, namely, CVD and cancer.
  18. Penaido, et al. J Sports Med Phys Fitness. 2014 Jun;54(3):264-70.
    • The recovery heart rate is a fitness metric. During postexercise recovery, heart rate (HR) initially falls rapidly, followed by a period of slower decrease, until resting values are reached. The goal of the study was to examine the differences in the recovery heart rate (RHR) between athletes engaged in static and dynamic sports. The study subjects were 294 national and international level athletes. The athletes were subjected to a maximum exertion stress test and their HR recorded at 1, 2, 3 and 4 min into the HR recovery period along with other indices of recovery heart rate. Two way ANOVA was used to examine differences between the two groups.
  19. Denham et al. J App Pays (2016)
    • Leukocyte telomeres shorten with age. Exercise training may prevent age-related cardiometabolic diseases by maintaining telomere length. Researchers compared 122 high level endurance athletes —cyclists, triathletes, middle- or long-distance runners, and ultra-marathon runners—to recreationally active controls. The endurance athletes consistently trained more than three times per week for a minimum of 1 year. Although the researchers found that endurance athletes had significantly longer leukocyte telomeres, this was no longer significant after adjusting for resting heart rate and relative VO2 max. Resting heart rate emerged as an independent predictor of telomere length, and the researchers further found a dose-response effect with exercise volume.
  20. Paul T. Williams, Invest Ophthalmol Vis Sci. 2009 Jan;50(1):95-100. (doi: 10.1167/iovs.08-1797)
    • The study tested over 40,000 male and female runners. The results show that higher doses of vigorous physical activity and greater cardiorespiratory fitness reduced the risk for incident cataract in a large prospective study of runners. Some, but not all of these associations, were attributable to the leanness of the faster, higher mileage runners.
  21. H. L ö llgen et al, Int J Sports Med 2009
    • This meta-analysis study analyzed all-cause mortality with special reference to intensity categories. The criteria for a study to be included required 3 or 4 different intensities. Only prospective cohort studies on physical leisure activity were included with a study duration of at least four years. Studies were selected only when the following data were reported: number of subjects, sex, age, duration of study, kind of exercise, intensity (MET) with two or more activity categories. 38 studies made the final cut. The statistical analysis models used in the publications were either proportional hazard models or logistic regression models. In all the studies eligible for meta-analysis either age-adjusted, multivariate-adjusted or both types of relative risk estimates with corresponding confidence intervals were reported.
  22. Jason L. Talanian et al, J Appl Physiol 102: 1439–1447, 2007. (doi:10.1152/japplphysiol.01098.2006.)
    • The aim of the study was to examine the effects of seven high-intensity aerobic interval training (HIIT) sessions over 2 weeks on skeletal muscle fuel content, mitochondrial enzyme activities, fatty acid transport proteins, peak O2 consumption (VO2 peak), and whole body metabolic, hormonal, and cardiovascular responses to exercise.
  23. Wisloff U, Nilsen et al. Eur. J. Cardiovasc. Prev. Rehabil. 2006; 13:798Y804
    • The observation that exercise training reduces cardiovascular mortality is robust and consistent, but the amount and intensity of exercise that is required for risk reduction is not yet resolved. The study focused on the association between the amount and intensity of exercise and cardiovascular mortality in 27,143 men and 28,929 women with no known cardiovascular disease at the beginning of follow-up between 1984 and 1986. After 16 years of follow-up, 2946 men (10.8%) and 2486 women (8.6%) had died from ischaemic heart disease or stroke. A single weekly bout of exercise of high intensity reduced the risk of cardiovascular death, both in men and women, 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. These results challenge the current recommendation that expenditure of at least 1000 kcal per week is required to achieve exercise-induced protection against premature cardiovascular mortality.
  24. Lars Nybo et al; J. Med and Sci in Sports and Exercise, 2010 Oct;42(10):1951-8. (doi: 10.1249/MSS.0b013e3181d99203.)
    • All participants were males from 20-45, nonsmokers without metabolic or CVD diseases. Participants were divided into 4 groups: high intensity intervals, strength training, running, no added exercise. All training groups met 3 times a week for 12 weeks. The study investigated various health effects of brief but very intense exercise training, and the marked improvements in cardiovascular fitness, glucose tolerance, and exercise endurance as well as the lowering of systolic blood pressure which emphasized the potential benefits of high-intensity training and its ability to improve certain physiological health parameters.
  25. Cohen et al. J Clin Hypertension (2016)
    • After a 12 week pilot, the researchers did a randomized, non-blinded, prospective, controlled trial over 24 weeks in adults with prehypertension and stage 1 hypertension comparing yoga and blood pressure education as interventions. As an intervention, the difference in improvements by yoga were significant at 12 weeks, but not at 24. Although the improvements in blood pressure were small, the authors believe they could be important as even a small reduction in blood pressure has health benefits. Research shows that even a systolic blood pressure reading (the 'top' number) dropping by 2 mm Hg cuts the risk of dying from heart disease by 7 percent and the risk of stroke death by 10 percent.
  26. Kiecolt-Glaser et al., Psychosom Med. (2010)
    • Chronically high levels of inflammation are known to play a role in certain conditions, including asthma, cardiovascular disease and depression. Participants completed three stressful tasks in succession, but when yoga experts were exposed to stress, they experienced 41% less inflammation than yoga novices did. Subjects had catheters placed in their arms to collect blood samples periodically for key markers of inflammation, one of which is a protein called IL-6. Across all the tasks and other experimental scenarios, the seasoned yogis' IL-6 levels were 41% lower than the novices'. Yoga focuses on deep breathing and controlling breathing, which may slow down the body's "fight or flight" response. Yoga also involves meditation, which helps people learn to pay attention to how they are feeling. So yoga experts may be more aware of their stress and better able to control their response to it. Finally, yoga is a form of exercise, which is known to decrease inflammation.
  27. Chu et al. Eur J Prev Card (2014)
    • The authors conducted a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs), and included studies if in English, peer-reviewed, focused on asana-based yoga in adults, and reported relevant outcomes. Two reviewers independently selected articles and assessed quality using Cochrane’s Risk of Bias tool. Out of 1404 records, 37 RCTs were included in the systematic review and 32 in the meta-analysis. Compared to non-exercise controls, yoga showed significant improvement for body mass index (−0.77 kg/m2 (95% confidence interval −1.09 to −0.44)), systolic blood pressure (−5.21 mmHg (−8.01 to −2.42)), low-density lipoprotein cholesterol (−12.14 mg/dl (−21.80 to −2.48)), and high-density lipoprotein cholesterol (3.20 mg/dl (1.86 to 4.54)). Significant changes were seen in body weight (−2.32 kg (−4.33 to −0.37)), diastolic blood pressure (−4.98 mmHg (−7.17 to −2.80)), total cholesterol (−18.48 mg/dl (−29.16 to −7.80)), triglycerides (−25.89 mg/dl (−36.19 to −15.60), and heart rate (−5.27 beats/min (−9.55 to −1.00)), but not fasting blood glucose (−5.91 mg/dl (−16.32 to 4.50)) nor glycosylated hemoglobin (−0.06% Hb (−0.24 to 0.11)). The researchers recognized that findings are limited by small trial sample sizes, heterogeneity, and moderate quality of RCT but conclude there is promising evidence of yoga on improving cardio-metabolic health.
  28. Villemure et al. Front Hum Neurosci (2015)
    • In this study, the yogis dedicated on average about 70 percent of their practice to physical postures, about 20 percent to meditation and 10 percent to breath work, typical of most Western yoga routines. They also found that the more hours of practice per week, the bigger the increase in brain cells.
  29. Pettersen, Betty J et al. Public Health Nutrition (2012 October ; 15(10): 1909–1916. doi:10.1017/S1368980011003454)
    • This 2012 study compared hypertension risk of vegans versus as compared to other vegetarian groups and non-vegetarians. The study concluded that vegans have lower systolic and diastolic blood pressure(BP) resulting in 63% lower risk of hypertension than omnivores. Lower body mass, non-animal protein sources, and higher potassium and fiber intake all contribute to this reduction in risk for vegans.
  30. Dinu et al. Crit Rev Food Sci Nutr. (2016; ahead of print; DOI:10.1080/10408398.2016.1138447)
    • In a study that included 56,000 vegan participants, vegans had significantly lower levels of cancer when compared to non-vegans. The reasons for the beneficial effects of veganism on cancer lie mainly on the lower intake of total and saturated fats in a vegan diet. Reduced cancer risk is also associated with vegans' large consumption of foods known to decrease cancer risk, such as soybean, legumes, nuts and vegetable oils. Additionally, vegans can absorb more carotenoids, disease-fighting pigment, and polyphenols, that help prevent degenerative diseases like cancer.
  31. Tonstad et al. Diabetes Care Journal (2009, 32:791–796; doi 10.2337/dc08-1886)
    • The 5-unit BMI difference between vegans and non-vegans indicates a substantial potential of veganism to protect against obesity and diabetes. In the study, inclusion of any meat or fish, even on a less than weekly basis, seems to limit some of the protection associated with a vegan diet. The study also concluded that the portfolio of foods found in vegan diets may carry metabolic advantages helping reduce type 2 diabetes risk by 49%.
  32. Orlich et al. JAMA Int Med. (2013)
    • The Adventist Health Study 2 (AHS-2) is a large North American prospective cohort study. A total of 96 469 Seventh-day Adventist men and women recruited between 2002 and 2007, from which an analytic sample of 73 308 participants remained after exclusions. The authors of the paper conducted a mortality analysis by Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. Diet was assessed at baseline by a quantitative food frequency questionnaire. The findings of the present study are similar to those of prior North American Adventist cohorts, demonstrating a consistent association over several decades and replicating prior results in a population with greater geographic and ethnic diversity
  33. Kujala 2018, Is physical activity a cause of longevity? It is not as straightforward as some would believe. A critical analysis.
  34. Schoenfeld, Jonathan D., and John PA Ioannidis. "Is everything we eat associated with cancer? A systematic cookbook review." The American journal of clinical nutrition 97.1 (2013): 127-134.

Last modified: May 19, 2025