Never too late to start exercise

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Even increasing physical activity in midlife reduces mortality by a third

A study published in the JAMA Network Open this week (March 8th, 2019) provided further evidence that regular exercise reduces the risk of dying by 29% to 36%. More shockingly, for inactive individuals, even increasing physical activity during midlife was associated with 32% to 35% lower risk for mortality - this translates to a reduction of death by a third! 

The authors looked at 315,059 participants in the US and surveyed how physically active the participants were in different stages their lives (at age groups of 15-18, 19-29, 35-39, and 40-61 years) and tracked their mortality records over time. With a mean follow-up of 13.6 years, 71,377 participants died from any cause, including 22,219 due to cardiovascular disease (CVD) and 16,388 due to cancer.

Compared with participants who were consistently inactive throughout adulthood, participants who maintained the highest amount of physical activity in each age period were at lower risks for (1) all-cause, (2) CVD-related, and even (3) cancer-related mortality.

The health-promoting / death-defying effects of exercise is preserved in those participants that only started regular exercises later in life. Adults who were less active throughout most of the adult life but increased physical activity in later adulthood (40-61 years of age) also had lower risk for all-cause (HR, 0.65; 95% CI, 0.62-0.68), CVD-related (HR, 0.57; 95% CI, 0.53-0.61), and cancer-related (HR, 0.84; 95% CI, 0.77-0.92) mortality.

Photo credit - Flickr | GoToVan | | CC BY 2.0

Pedro F. Saint-Maurice, PhD, from the National Cancer Institute, Rockville, Maryland, and colleagues in JAMA Network Open that 2 to 7 hours/week of leisure-time physical activity (LTPA) was associated with 29%-36% decreased risk for all-cause mortality32%-43% risk for CVD-related mortality, and 14%-16% decreased risk for cancer mortality compared to subjects with 1 hour/week or less of LTPA. 

Remarkably, the risk reductions in subjects who had maintained high LTPA from adolescence were similar to those in subjects who only became active in midlife.

"We had anticipated that participants who maintained the highest levels of activity throughout adulthood would be at lowest risk and were thus surprised to find that increasing activity early or late in adulthood was associated with comparable benefits...we specifically found that being inactive across early adulthood but increasing LTPA later at 40 to 61 years was associated with 16% to 43% risk reduction in mortality. These mortality benefits were comparable to those associated with maintaining LTPA in all age groups from adolescence and into adulthood."

At CardioQinetics, we believe that inactive middle aged / elderly adults should be encouraged to be more active, whereas young adults who are already active should strive to maintain their activity level as they get older. 

Maybe midlife is not too late to start exercising afterall!



1. Saint-Maurice, P.F., et al. Association of leisure-time physical activity across the adult life course with all-cause and cause-specific mortality. JAMA Network Open. 2019;2(3):e190355. doi:10.1001/jamanetworkopen.2019.0355