3 Kinds of Fitness Linked to a Longer Life

Doctors have long known that active people live longer. What's changed in the past decade is how precisely researchers can say which kinds of fitness matter most. The answer isn't one type of exercise. It's a handful of physical abilities that tend to decline with age unless they're trained.

Cardiorespiratory fitness

How well your heart and lungs deliver oxygen during effort is one of the strongest predictors of lifespan ever measured. A 2018 study in JAMA Network Open followed more than 120,000 adults who took treadmill tests at the Cleveland Clinic. The least fit had a far higher risk of death over the following years than the most fit, a gap larger than the one linked to smoking or diabetes in the same data. And there was no upper limit: the fittest group did best of all.

Much of this can be built at a moderate pace. "Zone 2" training, steady effort at which you can hold a conversation but not sing, improves the heart's efficiency and the muscles' ability to use oxygen. A smaller dose of harder intervals, such as a few minutes of fast uphill walking or cycling, raises the top end.

Strength

Muscle mass and strength fall steadily from middle age, and the loss speeds up after about 65. Strength turns out to matter well beyond looks. In the PURE study, which measured grip strength in nearly 140,000 adults in 17 countries, each 5-kilogram drop in grip strength was linked to a 16 percent higher risk of death from any cause. Grip itself isn't magic. It's a quick, cheap measure of overall strength.

Two sessions a week that work the major muscle groups, such as squats, lunges, pushes, pulls and carries, are enough to keep strength rising in most adults. Bodyweight and resistance bands count.

Balance

Falls are a leading cause of injury and loss of independence in older adults, and balance declines quietly. A simple check: stand on one leg with your eyes open. In a 2022 study of about 1,700 adults aged 51 to 75, roughly one in five couldn't hold it for 10 seconds, and that group had close to double the risk of dying over the following seven years. Tai chi, yoga and single-leg exercises improve balance at any age.

Putting it together

Official guidelines from the U.S. Department of Health and Human Services recommend at least 150 to 300 minutes a week of moderate activity, muscle-strengthening on two or more days, and balance training for older adults. A practical week might look like this:

• Three or four brisk 30- to 45-minute walks, bike rides or swims
• Two 30-minute strength sessions
• One short session of harder intervals
• A few minutes of balance work, such as standing on one leg while brushing your teeth

The benefit is biggest for people moving from doing nothing to doing something. Going from inactive to modestly active cuts risk more than any later step up.